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https://www.readbyqxmd.com/read/28642330/effects-of-intensive-bp-control-in-ckd
#1
Alfred K Cheung, Mahboob Rahman, David M Reboussin, Timothy E Craven, Tom Greene, Paul L Kimmel, William C Cushman, Amret T Hawfield, Karen C Johnson, Cora E Lewis, Suzanne Oparil, Michael V Rocco, Kaycee M Sink, Paul K Whelton, Jackson T Wright, Jan Basile, Srinivasan Beddhu, Udayan Bhatt, Tara I Chang, Glenn M Chertow, Michel Chonchol, Barry I Freedman, William Haley, Joachim H Ix, Lois A Katz, Anthony A Killeen, Vasilios Papademetriou, Ana C Ricardo, Karen Servilla, Barry Wall, Dawn Wolfgram, Jerry Yee
The appropriate target for BP in patients with CKD and hypertension remains uncertain. We report prespecified subgroup analyses of outcomes in participants with baseline CKD in the Systolic Blood Pressure Intervention Trial. We randomly assigned participants to a systolic BP target of <120 mm Hg (intensive group; n=1330) or <140 mm Hg (standard group; n=1316). After a median follow-up of 3.3 years, the primary composite cardiovascular outcome occurred in 112 intensive group and 131 standard group CKD participants (hazard ratio [HR], 0...
June 22, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28623175/elevated-high-density-lipoprotein-cholesterol-is-associated-with-hyponatremia-in-hypertensive-patients
#2
Ariel Israel, Ehud Grossman
BACKGROUND: Recently, the Systolic Blood Pressure Intervention Trial (SPRINT) showed that intensive lowering of systolic blood pressure is beneficial, but is associated with more adverse events. Hyponatremia was notably more frequent in the intensive treatment group. Investigating its risk factors is crucial for preventing this complication. OBJECTIVE: To identify risk factors for hyponatremia in the adult population. METHODS: We investigated the baseline demographic, clinical and laboratory data from the 9,361 participants of SPRINT to identify the best predictors of hyponatremia (serum sodium ≤ 130mEq/L), and adverse events which could be attributed to hyponatremia, using machine learning and multivariable Cox proportional hazards models...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28612327/the-j-shaped-curve-for-blood-pressure-and-cardiovascular-disease-risk-historical-context-and-recent-updates
#3
REVIEW
Faisal Rahman, John W McEvoy
PURPOSE OF REVIEW: The definition and treatment of hypertension have both changed dramatically over the last century, with recent trials suggesting benefit for lower blood pressure (BP) targets than ever before considered. However, tempering the enthusiasm for more intensive BP targets are long-held concerns that BP reduction below a certain threshold may pose dangers, the so-called "J-curve." In this review, we summarize the evidence for a J-curve in the treatment of hypertension. RECENT FINDINGS: The Systolic Blood Pressure Intervention Trial (SPRINT) reported that achieving a systolic BP target of 120 mmHg reduces cardiovascular disease in high-risk individuals, supporting more intensive BP reduction...
August 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28606731/cognitive-function-and-kidney-disease-baseline-data-from-the%C3%A2-systolic-blood-pressure-intervention-trial-sprint
#4
Daniel E Weiner, Sarah A Gaussoin, John Nord, Alexander P Auchus, Gordon J Chelune, Michel Chonchol, Laura Coker, William E Haley, Anthony A Killeen, Paul L Kimmel, Alan J Lerner, Suzanne Oparil, Mohammad G Saklayen, Yelena M Slinin, Clinton B Wright, Jeff D Williamson, Manjula Kurella Tamura
BACKGROUND: Chronic kidney disease is common and is associated with cardiovascular disease, cerebrovascular disease, and cognitive function, although the nature of this relationship remains uncertain. STUDY DESIGN: Cross-sectional cohort using baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT). SETTING & PARTICIPANTS: Participants in SPRINT, a randomized clinical trial of blood pressure targets in older community-dwelling adults with cardiovascular disease, chronic kidney disease, or high cardiovascular disease risk and without diabetes or known stroke, who underwent detailed neurocognitive testing in the cognition substudy, SPRINT-Memory and Cognition in Decreased Hypertension (SPRINT-MIND)...
June 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28602550/examining-the-applicability-of-sprint-in-patients-with-subclinical-or-established-atherothrombotic-disease-a-reach-registry-analysis
#5
Anubodh Varshney, Ph Gabriel Steg, Yedid Elbez, Emmanuel Sorbets, Kim A Eagle, Deepak L Bhatt
BACKGROUND: The optimal blood pressure (BP) target to reduce the risk of cardiovascular (CV) events remains uncertain, especially in patients with coronary artery disease (CAD). Results from the Systolic Blood Pressure Intervention Trial (SPRINT) suggest that targeting a systolic BP<120mmHg decreases the rate of death and CV events in patients with hypertension and increased CV risk. We sought to evaluate the real-world applicability of SPRINT to patients with atherothrombosis. METHODS: We divided 35,411 hypertensive patients from the REACH registry into SPRINT-eligible and SPRINT-ineligible based on the trial's inclusion and exclusion criteria...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28559651/the-2017-focused-update-of-the-guidelines-of-the-taiwan-society-of-cardiology-tsoc-and-the-taiwan-hypertension-society-ths-for-the-management-of-hypertension
#6
REVIEW
Chern-En Chiang, Tzung-Dau Wang, Tsung-Hsien Lin, Hung-I Yeh, Ping-Yen Liu, Hao-Min Cheng, Ting-Hsing Chao, Chen-Huan Chen, Kou-Gi Shyu, Kwo-Chang Ueng, Chung-Yin Chen, Pao-Hsien Chu, Shih-Hsien Sung, Kang-Ling Wang, Yi-Heng Li, Kuo-Yang Wang, Fu-Tien Chiang, Wen-Ter Lai, Jyh-Hong Chen, Wen-Jone Chen, San-Jou Yeh, Ming-Fong Chen, Shing-Jong Lin, Jiunn-Lee Lin
Hypertension (HT) is the most important risk factor for cardiovascular diseases. Over the past 25 years, the number of individuals with hypertension and the estimated associated deaths has increased substantially. There have been great debates in the past few years on the blood pressure (BP) targets. The 2013 European Society of Hypertension and European Society of Cardiology HT guidelines suggested a unified systolic BP target of 140 mmHg for both high-risk and low-risk patients. The 2014 Joint National Committee report further raised the systolic BP targets to 150 mmHg for those aged ≥ 60 years, including patients with stroke or coronary heart disease, and raised the systolic BP target to 140 mmHg for diabetes...
May 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28555286/-management-of-arterial-hypertension
#7
J A Wermelt, H Schunkert
Arterial hypertension has a high prevalence and is a major risk factor for the development of cardiovascular diseases. It is a major contributor to worldwide morbidity and mortality and hence poses a huge socioeconomic burden. Despite great progress in perception, diagnosis and treatment of hypertension, blood pressure control is inadequate in less than half of the hypertensive patients (<140/90 mm Hg). The diagnosis of arterial hypertension starts in most patients with the conventional office blood pressure measurement...
May 29, 2017: Herz
https://www.readbyqxmd.com/read/28544636/visit-to-visit-systolic-blood-pressure-variability-predicts-treatment-related-adverse-event-of-hyponatremia-in-sprint
#8
Abhinav Goyal, Kenechukwu Mezue, Janani Rangaswami
Hypertension is a common condition and an important cardiovascular risk factor. SPRINT trial showed that the beneficial effects of targeting systolic blood pressure <120 mmHg were accompanied by more adverse events. De-identified SPRINT database was used for this analysis. All subjects in each group that achieved their respective target blood pressure (<120, intensive; <140, standard) were included. Only readings after reaching target blood pressure for the first time were included. Subjects that never reached target or had <2 readings upon reaching target were excluded...
May 25, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28529721/the-impact-of-antihypertensives-on-kidney-disease
#9
REVIEW
Diego F Marquez, Gema Ruiz-Hurtado, Luis Ruilope
Arterial hypertension and chronic kidney disease (CKD) are intimately related. The control of blood pressure (BP) levels is strongly recommended in patients with CKD in order to protect the kidney against the accompanying elevation in global cardiovascular (CV) risk. Actually, the goal BP in patients with CKD involves attaining values <140/90 mmHg except if albuminuria is present. In this case, it is often recommended to attain values <130/80 mmHg, although some guidelines still recommend <140/90 mmHg...
2017: F1000Research
https://www.readbyqxmd.com/read/28512184/effect-of-intensive-blood-pressure-lowering-on-left-ventricular-hypertrophy-in-patients-with-hypertension-the-systolic-blood-pressure-intervention-sprint-trial
#10
Elsayed Z Soliman, Walter T Ambrosius, William C Cushman, Zhu-Ming Zhang, Jeffrey T Bates, Javier A Neyra, Thaddeus Y Carson, Leonardo Tamariz, Lama Ghazi, Monique E Cho, Brian P Shapiro, Jiang He, Lawrence J Fine, Cora E Lewis
Background -It is currently unknown whether intensive blood pressure (BP) lowering beyond that recommended would lead to more lowering of the risk of Left ventricular hypertrophy (LVH) in patients with hypertension, and whether reducing the risk of LVH explains the reported cardiovascular disease (CVD) benefits of intensive BP lowering in this population. Methods -This analysis included 8,164 participants (mean age 67.9 years, 35.3% women, 31.2% blacks) with hypertension but no diabetes from the Systolic Blood Pressure Intervention (SPRINT) Trial; 4,086 randomly assigned to intensive BP lowering (target systolic BP<120mmHg) and 4,078 assigned to standard BP lowering (target systolic BP <140mmHg)...
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28492286/has-the-sprint-trial-introduced-a-new-blood-pressure-goal-in-hypertension
#11
REVIEW
Gema Ruiz-Hurtado, José R Banegas, Pantelis A Sarafidis, Massimo Volpe, Bryan Williams, Luis M Ruilope
SPRINT is the first randomized, controlled trial showing that a systolic blood-pressure goal of <120 mmHg can be attained with cardiovascular benefits in a select group of patients with hypertension and an elevated cardiovascular risk with different origins. Although the patient population with characteristics like those in SPRINT makes up only 20-30% of the total hypertensive population, SPRINT is a landmark study that highlights the need to consider lower blood- pressure goals in the treatment of hypertension...
May 11, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28475386/achieving-blood-pressure-targets-for-prolonged-cardiovascular-health-a-historical-perspective
#12
Steven G Chrysant
Hypertension is a major risk factor for coronary artery disease (CAD), stroke, heart failure, and chronic kidney disease (CKD), and its successful control leads to a decrease or prevention of these complications. Areas covered: Over the years the Joint National Committees and the American Heart Association have issued guidelines regarding the treatment of hypertension. Those of 2003 and 2007 respectively, have recommended reduction of blood pressure (BP) to < 140/90 mmHg for uncomplicated hypertension and to < 130/80 mmHg for hypertensive patients with diabetes mellitus, CKD, or CAD...
May 15, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28451910/hypertension-across-the-atlantic-a-sprint-or-a-marathon
#13
EDITORIAL
Massimo Volpe, Barbara Citoni, Roberta Coluccia, Allegra Battistoni, Giuliano Tocci
No abstract text is available yet for this article.
April 27, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28373269/personalizing-the-intensity-of-blood-pressure-control-modeling-the-heterogeneity-of-risks-and-benefits-from-sprint-systolic-blood-pressure-intervention-trial
#14
Krishna K Patel, Suzanne V Arnold, Paul S Chan, Yuanyuan Tang, Yashashwi Pokharel, Philip G Jones, John A Spertus
BACKGROUND: In SPRINT (Systolic Blood Pressure Intervention Trial), patients with hypertension and high cardiovascular risk treated with intensive blood pressure (BP) control (<120 mm Hg) had fewer major adverse cardiovascular events (MACE) and deaths but higher rates of treatment-related serious adverse events (SAE) than patients randomized to standard BP control (<140 mm Hg). However, the degree of benefit or harm for an individual patient could vary because of heterogeneity in treatment effect...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28365055/precision-medicine-for-hypertension-management-in-chronic-kidney-disease-relevance-of-sprint-for-therapeutic-targets-in-nondiabetic-renal-disease
#15
REVIEW
Marcel Ruzicka, Kevin D Burns, Swapnil Hiremath
In this review we evaluate the literature to determine if lower blood pressure (BP) targets are beneficial for patients with nondiabetic chronic kidney disease (CKD). Modification of Diet in Renal Disease (MDRD), African American Study of Kidney Disease and Hypertension (AASK), and Ramipril Efficacy in Nephropathy-2 (REIN-2), designed to assess the benefit of lower BP on progression of nondiabetic CKD, generally came to the same negative conclusion. They were not designed and powered to assess an effect of lower BP on cardiovascular outcomes...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28346238/management-of-hypertension-in-2017-targets-and-therapies
#16
Monica Ahluwalia, Sripal Bangalore
PURPOSE OF REVIEW: Approximately one-fourth of the adult population is diagnosed with hypertension, which has been associated with increased cardiovascular morbidity and mortality including cardiovascular death, myocardial infarction, heart failure and stroke. Early detection and treatment is key and can lead to a significant reduction in cardiovascular morbidity and mortality. RECENT FINDINGS: In this review, we discuss the management and treatment strategies in patients with hypertension in the current era...
July 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28331987/hypertension-up-to-date-sprint-to-spyral
#17
REVIEW
Saarraaken Kulenthiran, Sebastian Ewen, Michael Böhm, Felix Mahfoud
Hypertension is the most common chronic cardiovascular condition with increasing prevalence all over the world. Treatment of patients at risk requires a multimodal therapeutic concept to adjust blood pressure, including systematic identification of secondary causes of hypertension or pseudo-resistance, lifestyle modification, polypharmacy, and as well as accompanying risk factors and comorbidities. The present review discusses recent studies on patients with increased cardiovascular risk potentially influencing future treatment strategies...
July 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28267687/hypertension-s-3-dilemmas-and-3-solutions-pharmacology-of-the-kidney-in-hypertension
#18
William A Pettinger
The Hypertension Community has 3 conflicting dilemmas: a goal systolic pressure of 120 mm Hg or less (the SPRINT Trials), 40% of our 60,000,000 hypertensives still sustain blood pressures above 140/90 mm Hg, and our most potent antihypertensive drug minoxidil sits on the sidelines, imprisoned in the Food and Drug Administration's Black Box designation. My solutions to these dilemmas are: (1) review of the facts of our most potent antihypertensive drug minoxidil which is essentially free of toxicity, (2) treatment focus on the fundamental cause of high blood pressure, that is excess dietary sodium and, (3) prevention of, and/or reversal of, the fundamental mechanism of worsening hypertension, arteriolar hypertrophy...
March 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28185469/hypertension-treatment-in-the-elderly-a-sprint-to-the-finish
#19
Christine Parsons, Farouk Mookadam, Martina Mookadam
No abstract text is available yet for this article.
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28166324/effect-of-intensive-blood-pressure-control-on-gait-speed-and-mobility-limitation-in-adults-75-years-or-older-a-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Michelle C Odden, Carmen A Peralta, Dan R Berlowitz, Karen C Johnson, Jeffrey Whittle, Dalane W Kitzman, Srinivasan Beddhu, John W Nord, Vasilios Papademetriou, Jeff D Williamson, Nicholas M Pajewski
Importance: Intensive blood pressure (BP) control confers a benefit on cardiovascular morbidity and mortality; whether it affects physical function outcomes is unknown. Objective: To examine the effect of intensive BP control on changes in gait speed and mobility status. Design, Setting, and Participants: This randomized, clinical trial included 2636 individuals 75 years or older with hypertension and no history of type 2 diabetes or stroke who participated in the Systolic Blood Pressure Intervention Trial (SPRINT)...
April 1, 2017: JAMA Internal Medicine
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