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Hypertension older adult

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https://www.readbyqxmd.com/read/28535297/antihypertensive-adherence-trajectories-among-older-adults-in-the-first-year-after-initiation-of-therapy
#1
Jennifer L Hargrove, Virginia Pate, Carri H Casteel, Yvonne M Golightly, Laura R Loehr, Stephen W Marshall, Til Stürmer
BACKGROUND: Adherence to antihypertensives is suboptimal, but previous methods of quantifying adherence fail to account for varying patterns of use over time. We sought to improve classification of antihypertensive adherence using group-based trajectory models, and to determine whether individual factors predict adherence trajectories. METHODS: We identified older adults initiating antihypertensive therapy during 2008-2011 using a 20% sample of Medicare (federal health insurance available to US residents over the age of 65) beneficiaries enrolled in parts A (inpatient services), B (outpatient services), and D (prescription medication)...
May 23, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28531241/effect-of-statin-treatment-vs-usual-care-on-primary-cardiovascular-prevention-among-older-adults-the-allhat-llt-randomized-clinical-trial
#2
Benjamin H Han, David Sutin, Jeff D Williamson, Barry R Davis, Linda B Piller, Hannah Pervin, Sara L Pressel, Caroline S Blaum
Importance: While statin therapy for primary cardiovascular prevention has been associated with reductions in cardiovascular morbidity, the effect on all-cause mortality has been variable. There is little evidence to guide the use of statins for primary prevention in adults 75 years and older. Objectives: To examine statin treatment among adults aged 65 to 74 years and 75 years and older when used for primary prevention in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)...
May 22, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28530383/diabetes-update-prevention-and-management-of-diabetes-complications
#3
Beth Choby
Macrovascular complications of diabetes include cardiovascular events, whereas common microvascular complications include neuropathy, retinopathy, and diabetic kidney disease. Control of hypertension and dyslipidemia is an important step in minimizing the risk of complications. Blood pressure (BP) levels should be maintained at less than 140 mm Hg systolic and less than 90 mm Hg diastolic. In older adults, medical therapy to reduce BP to less than 130/70 mm Hg is not recommended. In these patients, a systolic BP level less than 130 mm Hg has not been shown to improve atherosclerotic cardiovascular disease (ASCVD) outcomes, and a diastolic BP less than 70 mm Hg is associated with a higher mortality risk...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28525536/independent-and-differential-effects-of-obesity-and-hypertension-on-cognitive-and-functional-abilities
#4
Robert P Fellows, Maureen Schmitter-Edgecombe
Objective: The primary aim of this study was to identify the independent and differential associations of obesity and hypertension with cognitive, physical, and directly observed functional abilities among middle age and older adults. Method: Participants were 119 adults between the ages of 51 and 89, who underwent a cross-sectional assessment of cognitive, physical, functional and relevant health-related variables. Results: Obesity predicted significantly poorer executive functions (β = -...
May 19, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28523857/arrhythmia-burden-and-related-outcomes-in-eisenmenger-syndrome
#5
Shankar Baskar, Philippa Horne, Samantha Fitzsimmons, Philip R Khoury, Joseph Vettukattill, Koichiro Niwa, Teiji Agaki, Mark Spence, Hisanori Sakazaki, Gruschen Veldtman
BACKGROUND: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death. OBJECTIVE: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger's syndrome and to identify risk factors for arrhythmias. METHODS: This retrospective study included patients aged ≥ 18 years of age with Eisenmenger's syndrome from three institutions...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28523847/sex-differences-in-cardiovascular-risk-profiles-of-ischemic-stroke-patients-with-diabetes-in-the-greater-cincinnati-northern-kentucky-stroke-study
#6
Tracy E Madsen, Jane C Khoury, Kathleen A Alwell, Charles J Moomaw, Stacie L Demel, Matthew L Flaherty, Daniel Woo, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Simona Ferioli, Opeolu Adeoye, Pooja Khatri, Brett M Kissela, Dawn Kleindorfer
BACKGROUND: We aimed to compare sex-specific associations between cardiovascular risk factors and diabetes mellitus (DM) among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS). METHODS: The GCNKSS ascertained AIS cases in 2005 and 2010 among adult (age ≥20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors were compared between those with and without DM using chi-square and multiple logistic regression to examine sex-specific profiles...
May 18, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28520751/-do-it-yourself-home-blood-pressure-as-a-predictor-of-traditional-and-everyday-cognition-in-older-adults
#7
Sophie E Yeung, Wendy Loken Thornton
BACKGROUND: Hypertension guidelines recommend home blood pressure (HBP) monitoring in adjunct to office blood pressure (OBP) for its greater reproducibility and prognostic utility in the prevention of cardiovascular outcomes, especially stroke. To date, the relationship between HBP and cognitive function remains unexplored. METHODS: We examined HBP as a cognitive predictor in a multi-ethnic group of community-dwelling adults aged 60 and over (N = 133) using neuropsychological measures and analyzed the data using multiple regression analyses...
2017: PloS One
https://www.readbyqxmd.com/read/28511695/absolute-and-relative-accelerometer-thresholds-for-determining-the-association-between-physical-activity-and-metabolic-syndrome-in-the-older-adults-the-generation-100-study
#8
Nina Zisko, Javaid Nauman, Silvana Bucher Sandbakk, Nils Petter Aspvik, Øyvind Salvesen, Trude Carlsen, Hallgeir Viken, Jan Erik Ingebrigtsen, Ulrik Wisløff, Dorthe Stensvold
BACKGROUND: When assessing population adherence to physical activity (PA) recommendation using accelerometers, absolute intensity threshold definition is applied despite having limited validity in those with low cardiorespiratory fitness (CRF), who are unable to reach them (e.g older adults). Thus, PA thresholds relative to CRF may be an alternative approach. We compared the proportion of the older adults meeting the PA recommendation when PA is assessed using absolute versus sex-and-CRF-adjusted (relative) accelerometer thresholds and determined the association between relative versus absolute moderate PA (MPA), vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) and metabolic syndrome (MetS)...
May 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28509343/the-influence-of-vascular-risk-factors-on-cognitive-function-in-early-parkinson-s-disease
#9
Maxime Doiron, Mélanie Langlois, Nicolas Dupré, Martine Simard
OBJECTIVES: Hypertension, dyslipidemia, diabetes, and obesity are well-established risk factors for cognitive impairment and dementia in older adults. In contrast, previous studies that have assessed the impact of vascular risk factors (VRFs) on cognition in Parkinson's disease (PD) have had methodological limitations and reported conflicting findings. We address this question in a large well-characterized cohort of de novo PD patients. METHODS: A total of 367 untreated and non-demented patients aged 50 years and older with early PD (H&Y = 1...
May 16, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28508572/clinical-characteristics-and-factors-associated-with-mortality-in-idiopathic-pulmonary-fibrosis-an-experience-from-a-tertiary-care-center-in-pakistan
#10
Ali Zubairi, Huzaifa Ahmad, Maryam Hassan, Sajjad Sarwar, Aamir Abbas, Talha Shahzad, Irfan Muhammad
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease (ILD) that predominantly affects older adults . IPF has the highest mortality burden of all ILDs. Data on mortality in patients with IPF is limited in developing countries. OBJECTIVES: To identify factors associated with mortality in patients with IPF at a tertiary care center in Pakistan. METHODS: A retrospective chart review was conducted at the Aga Khan University Hospital (AKUH) in Karachi, Pakistan from January 2005 to December 2015...
May 15, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28506233/measurement-and-decomposition-of-socioeconomic-inequality-in-single-and-multimorbidity-in-older-adults-in-china-and-ghana-results-from-the-who-study-on-global-ageing-and-adult-health-sage
#11
Rasha Kunna, Miguel San Sebastian, Jennifer Stewart Williams
BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana...
May 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28505660/prevalence-of-elevated-cardiovascular-risks-in-young-adults-a-cross-sectional-analysis-of-national-health-and-nutrition-examination-surveys
#12
Krishna K Patel, Glen B Taksler, Bo Hu, Michael B Rothberg
Background: The 2013 cholesterol management guidelines from the American College of Cardiology and American Heart Association (ACC/AHA) recommend lipid screening in all adults older than 20 years to identify those at increased risk for atherosclerotic cardiovascular disease (ASCVD). Statins may be considered for patients with elevated 10-year risk (>5%) or a low-density lipoprotein cholesterol (LDL-C) level of 4.92 mmol/L (190 mg/dL) or greater. Objective: To describe the prevalence of elevated ASCVD risk among nondiabetic adults younger than 50 years...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28503912/high-burden-of-metabolic-comorbidities-in-a-citywide-cohort-of-hiv-outpatients-evolving-health-care-needs-of-people-aging-with-hiv-in-washington-dc
#13
M E Levy, A E Greenberg, R Hart, L Powers Happ, C Hadigan, A Castel
OBJECTIVES: With the increasing impact of cardiovascular disease among populations aging with HIV, contemporary prevalence estimates for predisposing metabolic comorbidities will be important for guiding the provision of relevant lifestyle and pharmacological interventions. We estimated the citywide prevalence of hypertension, type 2 diabetes, dyslipidaemia, and obesity; examined differences by demographic subgroups; and assessed clinical correlates. METHODS: Utilizing an electronic medical record (EMR) database from the DC Cohort study - a multicentre prospective cohort study of HIV-infected outpatients - we assessed the period prevalence of metabolic comorbidities between 2011 and 2015 using composite definitions that incorporated diagnoses, pharmacy records, and clinical/laboratory results...
May 15, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28497426/a-systematic-review-of-vasopressor-blood-pressure-targets-in-critically-ill-adults-with-hypotension
#14
Mathieu Hylands, Morten Hylander Moller, Pierre Asfar, Augustin Toma, Anne Julie Frenette, Nicolas Beaudoin, Émilie Belley-Côté, Frédérick D'Aragon, Jon Henrik Laake, Reed Alexander Siemieniuk, Emmanuel Charbonney, François Lauzier, Joey Kwong, Bram Rochwerg, Per Olav Vandvik, Gordon Guyatt, François Lamontagne
PURPOSE: Clinicians must balance the risks from hypotension with the potential adverse effects of vasopressors. Experts have recommended a mean arterial pressure (MAP) target of at least 65 mmHg, and higher in older patients and in patients with chronic hypertension or atherosclerosis. We conducted a systematic review of randomized-controlled trials comparing higher vs lower blood pressure targets for vasopressor therapy administered to hypotensive critically ill patients. METHODS: We searched MEDLINE®, EMBASE™, and the Cochrane Central Register of Controlled Trials for studies of higher vs lower blood pressure targets for vasopressor therapy in critically ill hypotensive adult patients...
May 11, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28494529/nash-therapy-omega-3-supplementation-vitamin-e-insulin-sensitizers-and-statin-drugs
#15
Stephen Caldwell
Non-alcoholic steatohepatitis (NASH) is the more aggressive form of non-alcoholic fatty liver disease (NAFLD). NASH can progress to hepatic fibrosis, cirrhosis, portal hypertension and primary liver cancer. Therapy is evolving with a substantial number of trials of promising new agents now in progress. In this article however, we will examine data for several older forms of therapy which have been fairly extensively studied over the years: Polyunsaturated Fatty Acid (PUFA) supplements, vitamin E, insulin sensitizing agents with a focus on pioglitazone and statin agents...
May 10, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28493694/community-vulnerability-to-health-impacts-of-wildland-fire-smoke-exposure
#16
Ana G Rappold, Jeanette M Reyes, George Pouliot, Wayne E Cascio, David Diaz-Sanchez
Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on factors known to increase the risks of health effects from air pollution and wildfire smoke exposures. These factors included county prevalence rates for asthma in children and adults, chronic obstructive pulmonary disease, hypertension, diabetes, obesity, percent of population 65 years of age and older, and indicators of socioeconomic status including poverty, education, income and unemployment...
May 11, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28493551/utilization-of-a-sobering-center-for-acute-alcohol-intoxication
#17
Shannon Smith-Bernardin, Adam Carrico, Wendy Max, Susan Chapman
OBJECTIVE: To describe the population utilizing a sobering center for public alcohol intoxication, and compare between single-visit users, repeat users, and high users. METHODS: We conducted a secondary analysis of 1,271 adults cared for in the Sobering Center from July 2014 to June 2015. We divided the population into three groups: single-use (1 visit), repeat users (2-5 visits) and high (6+) users, and evaluated demographics, lifetime health diagnoses utilizing the Elixhauser Comorbidity Index, rates of public service utilization including ambulance and emergency department, and related costs...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28489142/cognitive-cooperation-groups-mediated-by-computers-and-internet-present-significant-improvement-of-cognitive-status-in-older-adults-with-memory-complaints-a-controlled-prospective-study
#18
Rodrigo de Rosso Krug, Anna Quialheiro Abreu da Silva, Ione Jayce Ceola Schneider, Luiz Roberto Ramos, Eleonora d'Orsi, André Junqueira Xavier
Objective: To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. Methods: A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care...
April 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28487149/corrigendum-to-systolic-diastolic-hypertension-versus-isolated-systolic-hypertension-and-incident-heart-failure-in-older-adults-insights-from-the-cardiovascular-health-study-int-j-cardiol-235-2017-11-16
#19
Apostolos Tsimploulis, Helen M Sheriff, Phillip H Lam, Daniel J Dooley, Markus S Anker, Vasilios Papademetriou, Ross D Fletcher, Charles Faselis, Gregg C Fonarow, Prakash Deedwania, Michel White, Miroslava Valentova, Marc R Blackman, Maciej Banach, Charity J Morgan, Kannayiram Alagiakrishnan, Richard M Allman, Wilbert S Aronow, Stefan D Anker, Ali Ahmed
No abstract text is available yet for this article.
May 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28486836/inverse-relationship-between-vitamin-d-levels-and-platelet-indices-in-korean-adults
#20
Yon Chul Park, Jin Kim, Min Seok Seo, Sung Won Hong, Eun Seok Cho, Jong-Koo Kim
BACKGROUND AND AIMS: Vitamin D deficiency and increased platelet indices are associated with increased rate or risk of several diseases such as cardiovascular disease and metabolic syndrome, respectively. We investigated whether vitamin D deficiency is associated with increased platelet count (PC) and mean platelet volume (MPV). METHODS AND RESULTS: The study included 3190 subjects older than 20 years. Subjects were divided into three groups based on their vitamin D levels: vitamin D deficiency (<10...
May 10, 2017: Hematology (Amsterdam, Netherlands)
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