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https://www.readbyqxmd.com/read/29731026/applicability-of-the-systolic-blood-pressure-intervention-trial-sprint-to-the-canadian-population
#1
Alexander A Leung, Hsiu-Ju Chang, Finlay A McAlister, Nadia A Khan, Doreen M Rabi, Hude Quan, Raj S Padwal
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT) showed significant reductions in major cardiovascular events and all-cause mortality with a systolic blood pressure (BP) goal of < 120 mm Hg compared with < 140 mm Hg. We sought to determine the proportion of Canadian adults who meet SPRINT eligibility criteria. METHODS: We conducted a cross-sectional study using cycles 1-3 of the nationally representative Canadian Health Measures Survey to estimate the prevalence and characteristics of Canadian adults between the ages of 20 and 79 who meet SPRINT eligibility criteria: age ≥ 50 years, elevated systolic BP of 130-180 mm Hg, and increased cardiovascular risk (with chronic kidney disease, Framingham Risk Score ≥ 15% in 10 years, and/or cardiovascular disease) but without diabetes, stroke, or end-stage renal disease...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29703600/vascular-toxicities-with-vegf-inhibitor-therapies-focus-on-hypertension-and-arterial-thrombotic-events
#2
REVIEW
Rhian M Touyz, Sandra M S Herrmann, Joerg Herrmann
The vascular endothelial growth factor (VEGF) signaling pathway (VSP) fulfills a cardinal role in endothelial cells and its inhibition has profound cardiovascular impact. This is true not only for the normal vasculature but also for the tumor vasculature when VSP inhibitors are used as anti-angiogenic therapies. Generalized endothelial dysfunction predisposes to vasoconstriction, atherosclerosis, platelet activation, and thrombosis (arterial more than venous). All of these have been reported with VSP inhibitors and collectively give rise to vascular toxicities, the most concerning of which are arterial thromboembolic events (ATE)...
March 21, 2018: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29663195/which-target-blood-pressure-in-year-2018-evidence-from-recent-clinical-trials
#3
REVIEW
Sondre Heimark, Julian E Mariampillai, Krzysztof Narkiewicz, Peter M Nilsson, Sverre E Kjeldsen
The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to < 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to < 130/80 mmHg. We aimed to review the latest research from large randomised controlled trials and observational analyses in order to investigate the evidence for new treatment targets. We assessed recent data from the Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD) study, the International Verapamil-Trandolapril Study (INVEST), the Telmisartan, Ramipril or Both in Patients at High Risk for Vascular Events trial (ONTARGET)/the Telmisartan Randomised AssessmenNt Study in aCE iNtolerant participants with cardiovascular Disease (TRANSCEND) study and The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) study...
April 16, 2018: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/29567858/serum-bicarbonate-concentration-and-cognitive-function-in-hypertensive-adults
#4
Mirela Dobre, Sarah A Gaussoin, Jeffrey T Bates, Michel B Chonchol, Debbie L Cohen, Thomas H Hostetter, Kalani L Raphael, Addison A Taylor, Alan J Lerner, Jackson T Wright, Mahboob Rahman
BACKGROUND AND OBJECTIVES: Cognitive function worsens as kidney function declines, but mechanisms contributing to this association are not completely understood. Metabolic acidosis, a common complication of CKD, leads to neural networks overexcitation and is involved in cerebral autoregulation. We aimed to evaluate the association between serum bicarbonate concentration as a measure of metabolic acidosis, and cognitive function in hypertensive adults with and without CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Five cognitive summary scores were measured (global cognitive function, executive function, memory, attention/concentration, and language) in 2853 participants in the Systolic BP Intervention Trial (SPRINT)...
March 22, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29566565/in-the-aftermath-of-sprint-further-comparison-of-unattended-automated-office-blood-pressure-measurement-and-24-hour-blood-pressure-monitoring
#5
Jitka Seidlerová, Julius Gelžinský, Markéta Mateřánková, Jiří Ceral, Petr König, Jan Filipovský
AIMS: Several papers reported that unattended automated office blood pressure (uAutoOBP) is closely related to daytime ambulatory blood pressure monitoring (ABPM). In the present study, we aim to study uAutoOBP and its relation to 24-hour ABPM and ABPM variability. MATERIAL AND METHODS: Stable treated hypertensive subjects were examined in two Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP three times with auscultatory method (AuscOBP) by the physician...
March 22, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29532983/intensive-blood-pressure-lowering-reduces-adverse-cardiovascular-outcomes-among-patients-with-high-normal-glucose-an-analysis-from-the-systolic-blood-pressure-intervention-trial-database
#6
Yan Gong, Steven M Smith, Eileen M Handberg, Carl J Pepine, Rhonda M Cooper-DeHoff
The objective of this analysis is to determine the effect of intensive (<120 mm Hg) versus standard (<140 mm Hg) systolic blood pressure (SBP) targets on cardiovascular (CV) outcomes among SPRINT participants with low-normal or high-normal fasting glucose (FG). We categorized the 5425 SPRINT participants with FG <100 mg/dL into 2 groups: <85 mg/dL (low-normal) and 85 to <100 mg/dL (high-normal). Among participants with low-normal glucose, there was no significant difference in the primary outcome (PO) between the 2 treatment arms (adjusted hazard ratio, HR: 1...
April 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29529604/influence-of-sprint-study-type-automated-office-blood-pressure-measurements-on-hypertension-diagnosis-in-kidney-transplant-patients
#7
Akanksha Bhatnagar, Ulrich Pein, Silke Markau, Karl Weigand, Paolo Fornara, Matthias Girndt, Eric Seibert
BACKGROUND/AIMS: We compare conventional office blood pressure measurements with automated SPRINT-study type readings in kidney transplant recipients in order to determine the impact of the white coat effect in a prospective observational study. METHODS: Adult patients with a functional renal transplant not dependent on dialysis were eligible. Readings were taken in the office in presence of the physician with an oscillometric method. Afterwards, readings were repeated with the patients resting alone in a quiet examination room with an automated blood pressure monitor...
March 6, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29525494/impact-of-cardiovascular-risk-on-the-relative-benefit-and-harm-of-intensive-treatment-of-hypertension
#8
Robert A Phillips, Jiaqiong Xu, Leif E Peterson, Ryan M Arnold, Joseph A Diamond, Adam E Schussheim
BACKGROUND: The lower rate of primary outcome events in the intensive treatment group in SPRINT (Systolic Pressure Intervention Trial) was associated with increased clinically significant serious adverse events (SAEs). In 2017, the American College of Cardiology/American Heart Association issued risk-based blood pressure treatment guidelines. The authors hypothesized that stratification of the SPRINT population by degree of future cardiovascular disease (CVD) risk might identify a group which could benefit the most from intensive treatment...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29493562/gender-blood-pressure-and-cardiovascular-and-renal-outcomes-in-adults-with-hypertension-from-the-systolic-blood-pressure-intervention-trial
#9
Capri G Foy, Laura C Lovato, Mara Z Vitolins, Jeffrey T Bates, Ruth Campbell, William C Cushman, Stephen P Glasser, Avrum Gillespie, William J Kostis, Marie Krousel-Wood, Joseph B Muhlestein, Suzanne Oparil, Kwame Osei, Roberto Pisoni, Mark S Segal, Alan Wiggers, Karen C Johnson
BACKGROUND: To determine if the effects of intensive lowering of systolic blood pressure (goal of less than 120 mmHg) versus standard lowering (goal of less than 140 mmHg) upon cardiovascular, renal, and safety outcomes differed by gender. METHODS: Nine thousand three hundred and sixty-one men and women aged 50 years or older with systolic blood pressure of 130 mmHg or greater, taking 0-4 antihypertensive medications, and with increased risk of cardiovascular disease, but free of diabetes, were randomly assigned to either a systolic blood pressure target of less than 120 mmHg (intensive treatment) or a target of less than 140 mmHg (standard treatment)...
April 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29483169/perspective-from-sweden-on-the-global-impact-of-the-2017-american-college-of-cardiology-american-heart-association-hypertension-guidelines-a-sprint-beyond-evidence-in-the-united-states
#10
Mattias Brunström, Bo Carlberg, Lars H Lindholm
No abstract text is available yet for this article.
February 27, 2018: Circulation
https://www.readbyqxmd.com/read/29421687/baseline-blood-pressure-the-2017-acc-aha-high-blood-pressure-guidelines-and-long-term-cardiovascular-risk-in-sprint
#11
Muthiah Vaduganathan, Manan Pareek, Arman Qamar, Ambarish Pandey, Michael H Olsen, Deepak L Bhatt
BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines include lower thresholds to define hypertension than previous guidelines. Little is known about the impact of these guideline changes in patients with or at high risk for cardiovascular disease. METHODS: In this exploratory analysis using baseline blood pressure assessments in Systolic Blood Pressure Intervention Trial (SPRINT), we evaluated the prevalence and associated cardiovascular prognosis of patients newly reclassified with hypertension based on the 2017 ACC/AHA (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg) compared with the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) guidelines (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg)...
February 5, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29414255/impact-of-the-sprint-trial-on-hypertension-management
#12
Lama Ghazi, Suzanne Oparil
The Systolic Blood Pressure Intervention Trial is the first large prospective randomized controlled trial to demonstrate the benefit of an intensive systolic blood pressure (SBP) treatment target (<120 mm Hg) compared to a standard target (<140 mm Hg) in reducing cardiovascular morbidity and mortality and all-cause mortality in high-risk hypertensive patients. The impact of SPRINT on hypertension treatment has been large, but major questions remain about the feasibility of achieving the SPRINT intensive SBP target in routine practice, the generalizability of the SPRINT findings to hypertensive populations that were excluded from the trial, and the cost effectiveness of adopting the SPRINT intensive treatment goal...
January 29, 2018: Annual Review of Medicine
https://www.readbyqxmd.com/read/29375010/aggressive-systolic-blood-pressure-control-in-older-subjects-benefits-and-risks
#13
REVIEW
Steven G Chrysant
Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespective of sex, or ethnicity, but it is worse with the advancement of age. Effective control of systolic blood pressure (SBP), is associated with significant reduction in the incidence of these complications...
March 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29337449/-blood-pressure-management-what-s-new-in-2017
#14
Michel Burnier, Grégoire Wuerzner
In the last 2 years, the attention of hypertension specialists has been focused on the results of the SPRINT trial and its post-hoc analyses and its possible implications for the management of hypertensive patients. While waiting for new European hypertension guidelines due in 2018, the year 2017 can be considered as a year of transition. Yet, several interesting clinical studies have been published which may affect the future management of hypertension. Thus we shall discuss new data on the benefits of eating more fruits and vegetables on cardiovascular mortality, the « quadpill » concept, the impact of various non-steroidal anti-inflammatory drugs on blood pressure and the most recent data on renal denervation...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29273586/incremental-effects-of-antihypertensive-drugs-instrumental-variable-analysis
#15
COMPARATIVE STUDY
Adam A Markovitz, Jacob A Mack, Brahmajee K Nallamothu, John Z Ayanian, Andrew M Ryan
OBJECTIVES: To assess the incremental effects of adding extra antihypertensive drugs from a new class to a patient's regimen. DESIGN: Instrumental variable analysis of data from SPRINT (Systolic Blood Pressure Intervention Trial). To account for confounding by indication-when treatments seem less effective if they are administered to sicker patients-randomization status was used as the instrumental variable. Patients' randomization status was either intensive (systolic blood pressure target <120 mm Hg) or standard (systolic blood pressure target <140 mm Hg) treatment...
December 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29218880/causal-inference-on-electronic-health-records-to-assess-blood-pressure-treatment-targets-an-application-of-the-parametric-g-formula
#16
Kipp W Johnson, Benjamin S Glicksberg, Rachel A Hodos, Khader Shameer, Joel T Dudley
Hypertension is a major risk factor for ischemic cardiovascular disease and cerebrovascular disease, which are respectively the primary and secondary most common causes of morbidity and mortality across the globe. To alleviate the risks of hypertension, there are a number of effective antihypertensive drugs available. However, the optimal treatment blood pressure goal for antihypertensive therapy remains an area of controversy. The results of the recent Systolic Blood Pressure Intervention Trial (SPRINT) trial, which found benefits for intensive lowering of systolic blood pressure, have been debated for several reasons...
2018: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/29212825/intensive-blood-pressure-lowering-in-patients-with-and-patients-without-type-2-diabetes-a-pooled-analysis-from-two-randomized-trials
#17
Tom F Brouwer, Jim T Vehmeijer, Deborah N Kalkman, Wouter R Berger, Bert-Jan H van den Born, Ron J Peters, Reinoud E Knops
OBJECTIVE: The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD-BP) study did not find a significant beneficial effect of intensive systolic blood pressure (SBP) lowering on cardiovascular events in hypertensive patients with type 2 diabetes mellitus (T2DM), while the Systolic Blood Pressure Intervention Trial (SPRINT) did find a significant beneficial effect in patients without T2DM. The objective of this analysis was to assess the effect of both T2DM and baseline cardiovascular disease (CVD) risk on the treatment effect of intensive blood pressure lowering...
December 6, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29203043/-blood-pressure-target-in-2017
#18
A Yannoutsos, A Bura-Rivière, P Priollet, J Blacher
OBJECTIVE: The issue of how far blood pressure (BP) should be lowered under antihypertensive treatment is still an important matter of scientific debate. The aim of the present review is to consider the clinical relevance of individualized BP goal under treatment in hypertensive patients according to their age, comorbidities or established cardio-vascular (CV) disease. DATA FROM THE LITERATURE: The French and European recommendations propose a systolic BP target between 130 and 139mmHg (<150mmHg after 80 years) and diastolic BP target <90mmHg in hypertensive patients whatever their level of risk...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29176391/the-relationship-of-all-cause-mortality-to-average-on-treatment-systolic-blood-pressure-is-significantly-related-to-baseline-systolic-blood-pressure-implications-for-interpretation-of-the-systolic-blood-pressure-intervention-trial-study
#19
Peter M Okin, Sverre E Kjeldsen, Richard B Devereux
BACKGROUND: The SPRINT study demonstrated that targeting systolic blood pressure (SBP) less than 120 mmHg was associated with lower cardiovascular event and mortality rates. In the LIFE study, however, a lower achieved SBP was associated with increased mortality. Mean baseline SBP in SPRINT was 140 mmHg and a third of the population had a baseline SBP 132 mmHg or less, raising the question of whether the lower baseline SBP in SPRINT could in part account for these differences. METHODS: All-cause mortality during 4...
April 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29133606/effects-of-bariatric-surgery-in-obese-patients-with-hypertension-the-gateway-randomized-trial-gastric-bypass-to-treat-obese-patients-with-steady-hypertension
#20
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damiani, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND: Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS: In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m2 . Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
March 13, 2018: Circulation
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