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hypertension resistent

Chloe Y Y Cheung, Elaine Y L Hui, Chi-Ho Lee, Kelvin H M Kwok, Rita A Gangwani, Kenneth K W Li, Jeffrey C W Chan, Yu-Cho Woo, Wing-Sun Chow, Michele M A Yuen, Rachel L C Wong, Carol H Y Fong, Aimin Xu, David S H Wong, Pak-Chung Sham, Karen S L Lam
Purpose: Diabetic retinopathy (DR) is a common microvascular complication of type 2 diabetes (T2DM). Genome-wide association studies (GWAS) had identified novel DR-susceptibility genetic variants in various populations. We examined the associations of these DR-associated single nucleotide polymorphisms (SNPs) with severe DR in a Chinese T2DM cohort. Methods: Cross-sectional case-control studies on sight-threatening DR (STDR) and proliferative DR (PDR) were performed...
October 1, 2016: Investigative Ophthalmology & Visual Science
Brent M Egan, Bo Kai, C Shaun Wagner, Douglas O Fleming, Joseph H Henderson, Archie H Chandler, Angelo Sinopoli
Apparent treatment-resistant hypertension (aTRH) may confound the reported relationship between low blood pressure (BP) and increased cardiovascular disease (CVD) in treated hypertensive patients. Incident CVD was assessed in treated hypertensive patients with and without aTRH (BP ≥140 and/or ≥90 mm Hg on ≥3 medications or <140/<90 mm Hg on ≥4 BP medications) at three BP levels: 1: <120 and/or <70 mm Hg and <140/<90 mm Hg; 2: 120-139/70-89 mm Hg; and 3: ≥140 and/or ≥90 mm Hg. Electronic health data were matched to emergency and hospital claims for incident CVD in 118 356 treated hypertensive patients...
October 21, 2016: Journal of Clinical Hypertension
Katarina E A Nostell, Sanna S Lindåse, Johan T Bröjer
BACKGROUND: Insulin resistance (IR) in humans is related to hypertension and impaired vasodilation. Insulin administration has been shown to lower blood pressure both in insulin resistant as well as in insulin sensitive individuals. The aim of the study was to investigate the association between insulin sensitivity and alterations in blood pressure in healthy horses before and after a euglycemic-hyperinsulinemic clamp (EHC). A 3-h EHC was performed in 13 healthy horses (11 mares, 2 geldings)...
October 20, 2016: Acta Veterinaria Scandinavica
Krzysztof Narkiewicz, Laura E K Ratcliffe, Emma C Hart, Linford J B Briant, Marzena Chrostowska, Jacek Wolf, Anna Szyndler, Dagmara Hering, Ana P Abdala, Nathan Manghat, Amy E Burchell, Claire Durant, Melvin D Lobo, Paul A Sobotka, Nikunj K Patel, James C Leiter, Zoar J Engelman, Angus K Nightingale, Julian F R Paton
Animal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hypertension. The procedure proved to be safe and feasible. Overall, no change in blood pressure was found. However, 8 patients showed significant reductions in ambulatory blood pressure coinciding with decreases in sympathetic activity...
August 2016: JACC. Basic to Translational Science
Almudena Gómez-Hernández, Nuria Beneit, Sabela Díaz-Castroverde, Óscar Escribano
This review focuses on the contribution of white, brown, and perivascular adipose tissues to the pathophysiology of obesity and its associated metabolic and vascular complications. Weight gain in obesity generates excess of fat, usually visceral fat, and activates the inflammatory response in the adipocytes and then in other tissues such as liver. Therefore, low systemic inflammation responsible for insulin resistance contributes to atherosclerotic process. Furthermore, an inverse relationship between body mass index and brown adipose tissue activity has been described...
2016: International Journal of Endocrinology
D Stott, M Bolten, D Paraschiv, I Papastefanou, J B Chambers, N A Kametas
OBJECTIVE: Pregnant hypertensive women who do not respond to labetalol but need vasodilatory therapy for blood pressure (BP) control rapidly progress to severe disease, which may be delayed by early recognition and individualised BP treatment. In this study, we sought to create prediction models at presentation, at 1 and 24 hours after commencement of treatment to identify patients who will not show a sustained response to labetalol and therefore need vasodilatory therapy. METHODS: The study population comprised of 134 women presenting with hypertension at a UK hospital...
October 20, 2016: Ultrasound in Obstetrics & Gynecology
Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
Mangesh Tiwaskar
No abstract text is available yet for this article.
July 2016: Journal of the Association of Physicians of India
Mihály B Tapolyai, Ákos Pethő, Tibor Fülöp
No abstract text is available yet for this article.
October 19, 2016: Journal of Clinical Hypertension
Petra Rust, Cem Ekmekcioglu
Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown...
October 19, 2016: Advances in Experimental Medicine and Biology
Masato Nishimura, Toshiko Tokoro, Satoru Yamazaki, Tetsuya Hashimoto, Hiroyuki Kobayashi, Toshihiko Ono
BACKGROUND: We examined the prevalence, prognosis, and effect of endothelin receptor antagonists on survival in end-stage kidney disease patients with idiopathic pre-capillary pulmonary hypertension. METHODS: We investigated 1988 end-stage kidney disease patients in Toujinkai Hospital from January 1, 2001 to December 31, 2014. Pulmonary hypertension was screened by symptoms (dyspnea, hypotension, or near syncope) and echocardiography, and diagnosed by computed tomography with enhancement, pulmonary flow scintigraphy, and right heart catheterization...
October 19, 2016: Clinical and Experimental Nephrology
Min Soo Kim, Kyung Il Jo, Je Young Yeon, Jong Soo Kim, Keon Ha Kim, Pyoung Jeon, Seung Chyul Hong
INTRODUCTION: The purpose of this study was to explore the safety and efficacy of an antiplatelet response assay and drug adjustment to prevent delayed thromboembolic events after stent-assisted coil embolization. METHODS: A total of 370 patients were enrolled in this study between December 2005 and July 2014. Of these, 124 patients were placed into the drug resistance test (DRT) group with drug adjustment according to response to an antiplatelet agent, and 246 patients comprised the control group with a standard antiplatelet regimen...
October 18, 2016: Neuroradiology
Raphael Jose Ferreira Felizardo, Angela Castoldi, Vinicius Andrade-Oliveira, Niels Olsen Saraiva Câmara
Recent findings regarding the influence of the microbiota in many inflammatory processes have provided a new way to treat diseases. Now, one may hypothesize that the origin of a plethora of diseases is related to the health of the gut microbiota and its delicate, although complex, interface with the epithelial and immune systems. The 'westernization' of diets, for example, is associated with alterations in the gut microbiota. Such alterations have been found to correlate directly with the increased incidence of diabetes and hypertension, the main causes of chronic kidney diseases (CKDs), which, in turn, have a high estimated prevalence...
June 2016: Clinical & Translational Immunology
Margarida Mendes, Julie Dubourg, Anne Blanchard, Damien Bergerot, Pierre-Yves Courand, Valentina Forni, Michael Frank, Guillaume Bobrie, Joel Menard, Michel Azizi
OBJECTIVES: The participation of vasopressin in the mechanisms of resistant hypertension is unclear. We compared plasma copeptin concentration, a surrogate marker for vasopressin secretion, between patients with resistant hypertension and those with controlled blood pressure (CBP), in a post hoc analysis of the Prise en charge de l'Hypertension Artérielle RESistante au traitement trial. METHODS: After 4-week treatment with irbesartan 300 mg/day, hydrochlorothiazide 12...
October 15, 2016: Journal of Hypertension
Jonathan G Moss, Anna-Maria Belli, Antonio Coca, Michael Lee, Giuseppe Mancia, Jan H Peregrin, Josep Redon, Jim A Reekers, Costas Tsioufis, Dierk Vorwerk, Roland E Schmieder
Renal denervation (RDN) was reported as a novel exciting treatment for resistant hypertension in 2009. An initial randomized trial supported its efficacy and the technique gained rapid acceptance across the globe. However, a subsequent large blinded, sham arm randomized trial conducted in the USA (to gain Food and Drug Administration approval) failed to achieve its primary efficacy end point in reducing office blood pressure at 6 months. Published in 2014 this trial received both widespread praise and criticism...
October 17, 2016: Journal of Hypertension
Michael G Ziegler, Milos Milic
PURPOSE OF REVIEW: The sympathetic nervous system (SNS) mediates short-term increases in blood pressure. Evidence that psychosocial stress leads to chronic hypertension is mixed. The SNS activation found in obstructive sleep apnea (OSA), caregiving for a severely demented spouse, and obesity more specifically address whether SNS activation might lead to the metabolic syndrome and hypertension. RECENT FINDINGS: Obesity is associated with both increased SNS electrical activity and plasma norepinephrine...
October 15, 2016: Current Opinion in Nephrology and Hypertension
Sandip K Boss, Irina Hutson, Charles Harris
Exogenous glucocorticoid (GC) administration results in hyperglycemia, insulin resistance, hepatic dyslipidemia and hypertension, a constellation of findings known as Cushing's syndrome. These effects are mediated by the glucocorticoid receptor (GR). Since GR activation in liver and adipose has been implicated in metabolic syndrome we wanted to determine the role of GR in these tissues in the development of metabolic syndrome. Since GRKO mice (whole body KO) exhibit perinatal lethality due to respiratory failure, we generated tissue specific (liver or adipose) GRKO mice using cre-lox technology...
October 18, 2016: Endocrinology
Zhiming Zhu
Management of hypertension in diabetes is critical for reducing cardiovascular mortality and morbidity. Dietary approaches for controlling high blood pressure have historically focused on sodium. Thus, many guidelines recommend that patients with type 2 diabetes reduce high sodium intake. Nonetheless, the potential benefits of sodium reduction are debatable. The kidney has a crucial role in glucose filtration and reabsorption in addition to its regulation of fluid and electrolyte homeostasis. A key factor linking sodium uptake and glucose transport is the sodium-glucose cotransporter 2 (SGLT2) in renal proximal tubular cells...
September 2016: Journal of Hypertension
Teba Alnima
Electrical carotid baroreflex activation therapy is an emerging device-based treatment for patients with treatment-resistant hypertension. Its blood pressure lowering effect has been demonstrated in several animal and human studies. In addition, this treatment has showed its prolonged effect over the long-term. The main mechanism of the blood pressure reduction during this therapy is by inhibition of the sympathetic outflow. Yet the question arises whether the inhibition of central sympathetic activity is sufficient to be the sole mechanism behind the sustained reduction in blood pressure...
September 2016: Journal of Hypertension
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
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