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Hypertension targets

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https://www.readbyqxmd.com/read/28102856/the-impact-of-integrated-evaluation-of-hemodynamics-using-targeted-neonatal-echocardiography-with-indices-of-tissue-oxygenation-a-new-approach
#1
Y N Elsayed, R Amer, M M Seshia
OBJECTIVE: To study the impact of integrated evaluation of hemodynamics (IEH) using targeted neonatal echocardiography, together with regional tissue oxygenation, fractional oxygen extraction using near-infrared spectroscopy on the management of infants with compromised hemodynamics. STUDY DESIGN: Retrospective cohort comparison of two groups of infants with compromised hemodynamics. EPOCH 1: did not undergo IEH (January 2012 to March 2014); EPOCH 2: underwent IEH (April 2014 to December 2015)...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102522/present-and-future-of-interventional-treatment-of-resistant-hypertension
#2
REVIEW
Ayhan Yoruk, Sinan S Tankut, John P Gassler, John D Bisognano
The increasing prevalence of hypertension, a significant cause of disability and premature death throughout the world, is a major public health concern. This is especially true for the subset of patients who suffer from resistant hypertension, which is associated with a fourfold greater risk of cardiovascular events as compared to those hypertensive patients able to achieve target blood pressure. Though quite daunting in number and ill effect, hypertension remains the most common and the most important modifiable risk factor for coronary heart disease, congestive heart failure, peripheral vascular disease, stroke, and chronic kidney disease...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28100891/reverse-right-ventricular-remodeling-after-lung-transplantation-in-patients-with-pulmonary-arterial-hypertension-under-combination-therapy-of-targeted-medical-drugs
#3
Toshihiro Sarashina, Kazufumi Nakamura, Satoshi Akagi, Takahiro Oto, Hiroki Oe, Kentaro Ejiri, Koji Nakagawa, Nobuhiro Nishii, Hiromi Matsubara, Motomu Kobayashi, Hiroshi Morimatsu, Shinichiro Miyoshi, Hiroshi Ito
BACKGROUND: Patients with pulmonary arterial hypertension (PAH) are currently treated with combination therapy of PAH-targeted drugs. Reverse right ventricular (RV) remodeling after lung transplantation (LTx) in patients with end-stage PAH despite combination therapy of PAH-targeted drugs has not been fully elucidated.Methods and Results:A total of 136 patients, including 32 with PAH, underwent LTx from 1998 to 2014. We enrolled 12 consecutive patients with PAH treated with combination therapy of PAH-targeted drugs who underwent LTx and retrospectively analyzed the temporal and serial changes in hemodynamics and echocardiography before LTx and at 3 and 12 months after LTx...
January 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28100544/oscillatory-whole-body-vibration-improves-exercise-capacity-and-physical-performance-in-pulmonary-arterial-hypertension-a-randomised-clinical-study
#4
Felix Gerhardt, Daniel Dumitrescu, Carina Gärtner, Ralf Beccard, Thomas Viethen, Tilmann Kramer, Stephan Baldus, Martin Hellmich, Eckhard Schönau, Stephan Rosenkranz
OBJECTIVE: In patients with pulmonary arterial hypertension (PAH), supportive therapies may be beneficial in addition to targeted medical treatment. Here, we evaluated the effectiveness and safety of oscillatory whole-body vibration (WBV) in patients on stable PAH therapy. METHODS: Twenty-two patients with PAH (mean PAP≥25 mm Hg and pulmonary arterial wedge pressure (PAWP)≤15 mm Hg) who were in world health organization (WHO)-Functional Class II or III and on stable PAH therapy for≥3 months, were randomised to receive WBV (16 sessions of 1-hour duration within 4 weeks) or to a control group, that subsequently received WBV...
January 18, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28100465/prevalence-of-masked-hypertension-among-us-adults-with-nonelevated-clinic-blood-pressure
#5
Y Claire Wang, Daichi Shimbo, Paul Muntner, Andrew E Moran, Lawrence R Krakoff, Joseph E Schwartz
Masked hypertension (MHT), defined as nonelevated blood pressure (BP) in the clinic setting and elevated BP assessed by ambulatory monitoring, is associated with increased risk of target organ damage, cardiovascular disease, and mortality. Currently, no estimate of MHT prevalence exists for the general US population. After pooling data from the Masked Hypertension Study (n = 811), a cross-sectional clinical investigation of systematic differences between clinic BP and ambulatory BP (ABP) in a community sample of employed adults in the New York City metropolitan area (2005-2012), and the National Health and Nutrition Examination Survey (NHANES; 2005-2010; n = 9,316), an ongoing nationally representative US survey, we used multiple imputation to impute ABP-defined hypertension status for NHANES participants and estimate MHT prevalence among the 139 million US adults with nonelevated clinic BP, no history of overt cardiovascular disease, and no use of antihypertensive medication...
January 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28099680/novel-putative-pharmacologic-therapies-to-protect-the-right-ventricle-in-pulmonary-hypertension-a-review-of-current-literature
#6
REVIEW
Gerald J Maarman, Rainer Schulz, Karen Sliwa, Ralph Schermuly, Sandrine Lecour
Pulmonary hypertension (PH) is defined by elevated mean pulmonary artery pressure following the pathologic remodelling of small pulmonary arteries. An increase in right ventricular (RV) afterload results in RV hypertrophy and RV failure. The pathophysiology of PH, and RV remodelling in particular, are not well understood, thus explaining, at least in part, why current PH therapies have a limited effect. Existing therapies mostly target the pulmonary circulation. Because the remodelled RV fails to support normal cardiac function, patients eventually succumb from RV failure...
January 18, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28099585/impact-of-different-normality-thresholds-for-24-hour-abpm-at-the-primary-health-care-level
#7
Guilherme Brasil Grezzana, David William Moraes, Airton Tetelbon Stein, Lucia Campos Pellanda
Background: Hypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC) physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP) remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM) can lead to different medical decisions in PHC. Objective: To evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines...
January 16, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28099229/twenty-four-hour-ambulatory-blood-pressure-monitoring-for-clinical-evaluation-of-hypertensive-patients-in-primary-care-which-groups-would-most-benefit
#8
Guilherme B Grezzana, Airton T Stein, Lucia C Pellanda
BACKGROUND: Arterial hypertension is an important risk factor for cardiovascular outcomes. Blood pressure (BP) control levels remain largely out of target among primary healthcare (PHC) patients. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) may contribute toward the identification of cardiovascular risk groups. OBJECTIVE: To assess concordance between conventional office BP measurements and 24-h ABPM of hypertension control in cardiovascular risk groups of PHC hypertensive patients...
January 17, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28099082/therapeutics-targeting-drivers-of-thoracic-aortic-aneurysms-and-acute-aortic-dissections-insights-from-predisposing-genes-and-mouse-models
#9
Dianna M Milewicz, Siddharth K Prakash, Francesco Ramirez
Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling...
January 14, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/28098882/downregulation-of-microrna%C3%A2-34b-is-responsible-for-the-elevation-of-blood-pressure-in-spontaneously-hypertensive-rats
#10
Fan Yang, Haiyu Li, Youyou Du, Qiangwei Shi, Luosha Zhao
The present study aimed to identify the microRNA (miRNA) responsible for the development of primary hypertension, and examine the downstream signaling pathway, which mediates the effect of the miRNA. Reverse transcription‑quantitative polymerase chain reaction analysis was performed to identify which miRNA may be involved in the pathogenesis of hypertension. In silico analysis and a luciferase assay were used to validate the target of the selected miRNA, and miRNA mimics and small interfering (si)RNA of the target were transfected into smooth muscle cells to examine its effect on the biological activity of the cells...
January 16, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28098594/mediators-of-diabetic-neuropathy-is-hyperglycemia-the-only-culprit
#11
Anna Grisold, Brian C Callaghan, Eva L Feldman
PURPOSE OF REVIEW: Diabetic peripheral neuropathy (DPN) is a disabling, highly prevalent complication of both type 1 and type 2 diabetes mellitus (T1DM and T2DM). Large clinical studies support the concept that, in addition to hyperglycemia, components of the metabolic syndrome (MetS) may underlie the pathogenesis of DPN, especially in T2DM. This review will present the evidence supporting the MetS and its individual components as potential causal factors for the development of neuropathy...
January 16, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28096461/differential-contribution-of-transmembrane-domains-iv-v-vi-and-vii-to-human-angiotensin-ii-type-1-receptor-homomer-formation
#12
Brent M Young, Elaine Nguyen, Matthew A J Chedrawe, Jan K Rainey, Denis J Dupré
G protein-coupled receptors (GPCRs) play an important role in drug therapy, and represent one of the largest families of drug targets. The angiotensin II type 1 receptor (AT1R) is notable as it has a central role in the treatment of cardiovascular disease. Blockade of AT1R signaling has been shown to alleviate hypertension and improve outcomes in patients with heart failure. Despite this, it has become apparent that our initial understanding of AT1R signaling is over-simplified. There is considerable evidence to suggest that AT1R signaling is highly modified in the presence of receptor-receptor interactions, but there is very little structural data available to explain this phenomenon even with the recent elucidation of the AT1R crystal structure...
January 17, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28093466/effects-of-sacubitril-valsartan-versus-olmesartan-on-central-hemodynamics-in-the-elderly-with-systolic-hypertension-the-parameter-study
#13
Bryan Williams, John R Cockcroft, Kazuomi Kario, Dion H Zappe, Patrick C Brunel, Qian Wang, Weinong Guo
Effective treatment of systolic hypertension in elderly patients remains a major therapeutic challenge. A multicenter, double-blind, randomized controlled trial with sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, was conducted to determine its effects versus olmesartan (angiotensin receptor blocker) on central aortic pressures, in elderly patients (aged ≥60 years) with systolic hypertension and pulse pressure >60 mm Hg, indicative of arterial stiffness. Patients (n=454; mean age, 67...
January 16, 2017: Hypertension
https://www.readbyqxmd.com/read/28093217/abnormal-cd161-immune-cells-and-ror%C3%AE-t-mediated-enhanced-il-17f-expression-in-genetic-hypertension
#14
Madhu V Singh, Michael Z Cicha, Santosh Kumar, David K Meyerholz, Kaikobad Irani, Mark W Chapleau, François M Abboud
BACKGROUND: Hypertension is considered an immunological disorder. However, the role of IL-17 family in genetic hypertension of the spontaneously hypertensive rat (SHR) has not been investigated. OBJECTIVE: We tested the hypothesis that enhanced Th17 programming and IL-17 expression in abundant CD161+ immune cells in SHR represent an abnormal proinflammatory adaptive immune response. Furthermore, we propose that this response is driven by the master regulator RORγt and a nicotinic proinflammatory innate immune response...
January 13, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28093201/molecular-targets-of-the-warburg-effect-and-inflammatory-cytokines-in-the-pathogenesis-of-pulmonary-artery-hypertension
#15
REVIEW
Na Liu, Stephanie Parry, Yunbin Xiao, Shenghua Zhou, Qiming Liu
Pulmonary arterial hypertension (PAH) is a progressive vascular disease characterized by increased pulmonary arterial pressure and vasoconstriction and structural remolding of pulmonary arterioles. Recent clinical and experimental studies have discovered the relationship between metabolic alterations and the pathogenesis of PAH. The primary metabolic alteration, previously demonstrated in various cancers, is a gradual change in energy generated from complete aerobic cellular respiration to from solely "aerobic glycolysis," termed the "Warburg effect...
January 13, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28092664/expression-of-specific-inflammasome-gene-modules-stratifies-older-individuals-into-two-extreme-clinical-and-immunological-states
#16
David Furman, Junlei Chang, Lydia Lartigue, Christopher R Bolen, François Haddad, Brice Gaudilliere, Edward A Ganio, Gabriela K Fragiadakis, Matthew H Spitzer, Isabelle Douchet, Sophie Daburon, Jean-François Moreau, Garry P Nolan, Patrick Blanco, Julie Déchanet-Merville, Cornelia L Dekker, Vladimir Jojic, Calvin J Kuo, Mark M Davis, Benjamin Faustin
Low-grade, chronic inflammation has been associated with many diseases of aging, but the mechanisms responsible for producing this inflammation remain unclear. Inflammasomes can drive chronic inflammation in the context of an infectious disease or cellular stress, and they trigger the maturation of interleukin-1β (IL-1β). Here we find that the expression of specific inflammasome gene modules stratifies older individuals into two extremes: those with constitutive expression of IL-1β, nucleotide metabolism dysfunction, elevated oxidative stress, high rates of hypertension and arterial stiffness; and those without constitutive expression of IL-1β, who lack these characteristics...
January 16, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28091541/apelin-receptor-homodimer-oligomers-revealed-by-single-molecule-imaging-and-novel-g-protein-dependent-signaling
#17
Xin Cai, Bo Bai, Rumin Zhang, Chunmei Wang, Jing Chen
The apelin receptor (APJ) belongs to family A of the G protein-coupled receptors (GPCRs) and is a potential pharmacotherapeutic target for heart failure, hypertension, and other cardiovascular diseases. There is evidence APJ heterodimerizes with other GPCRs; however, the existence of APJ homodimers and oligomers remains to be investigated. Here, we measured APJ monomer-homodimer-oligomer interconversion by monitoring APJ dynamically on cells and compared their proportions, spatial arrangement, and mobility using total internal reflection fluorescence microscopy, resonance energy transfer, and proximity biotinylation...
January 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28090762/use-of-ace-inhibition-and-blood-pressure-management-in-deferring-dialysis-initiation
#18
Lucia Del Vecchio, Ugo Teatini, Francesco Locatelli
Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for < 140/90 mmHg is suggested for non-proteinuric CKD patients...
January 13, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28090300/bk-channels-in-rat-and-human-pulmonary-smooth-muscle-cells-are-bk%C3%AE-%C3%AE-1-functional-complexes-lacking-the-oxygen-sensitive-stress-axis-regulated-exon-insert
#19
Neil D Detweiler, Li Song, Samantha J McClenahan, Rachel J Versluis, Sujay V Kharade, Richard C Kurten, Sung W Rhee, Nancy J Rusch
A loss of K(+) efflux in pulmonary arterial smooth muscle cells (PASMCs) contributes to abnormal vasoconstriction and PASMC proliferation during pulmonary hypertension (PH). Activation of high-conductance Ca(2+)-activated (BK) channels represents a therapeutic strategy to restore K(+) efflux to the affected PASMCs. However, the properties of BK channels in PASMCs-including sensitivity to BK channel openers (BKCOs)-are poorly defined. The goal of this study was to compare the properties of BK channels between PASMCs of normoxic (N) and chronic hypoxic (CH) rats and then explore key findings in human PASMCs...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28090297/exhaled-nitric-oxide-in-pulmonary-arterial-hypertension-associated-with-systemic-sclerosis
#20
Zeling Cao, Stephen C Mathai, Laura K Hummers, Ami A Shah, Fredrick M Wigley, Noah Lechtzin, Paul M Hassoun, Reda E Girgis
The fractional exhaled concentration of nitric oxide (FENO) has been shown to be reduced in idiopathic pulmonary arterial hypertension (PAH) but has not been adequately studied in PAH associated with systemic sclerosis (SSc). We measured FENO at an expiratory flow rate of 50 mL/s in 21 treatment-naive patients with SSc-associated PAH (SSc-PAH), 94 subjects with SSc without pulmonary involvement, and 84 healthy volunteers. Measurements of FENO at additional flow rates of 100, 150, and 250 mL/s were obtained to derive the flow-independent nitric oxide exchange parameters of maximal airway flux (J'awNO) and steady-state alveolar concentration (CANO)...
December 2016: Pulmonary Circulation
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