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By Venkatesh Ariyamuthu Transplant Nephrologist at UT Southwestern Medical Center
https://www.readbyqxmd.com/read/27633875/the-case-a-handful-of-hypertension
#1
Bert-Jan H van den Born, Louise C Oskam, Majida Zidane, Carolin Schächterle, Enno Klussmann, Sylvia Bähring, Friedrich C Luft
No abstract text is available yet for this article.
October 2016: Kidney International
https://www.readbyqxmd.com/read/27643001/os-19-03-treatment-with-patiromer-resulted-in-decreases-in-aldosterone-in-patients-with-chronic-kidney-disease-and-hyperkalemia-on-raas-inhibitors-results-from-opal-hk
#2
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27516235/bp-control-and-long-term-risk-of-esrd-and-mortality
#3
Elaine Ku, Jennifer Gassman, Lawrence J Appel, Miroslaw Smogorzewski, Mark J Sarnak, David V Glidden, George Bakris, Orlando M Gutiérrez, Lee A Hebert, Joachim H Ix, Janice Lea, Michael S Lipkowitz, Keith Norris, David Ploth, Velvie A Pogue, Stephen G Rostand, Edward D Siew, Mohammed Sika, C Craig Tisher, Robert Toto, Jackson T Wright, Christina Wyatt, Chi-Yuan Hsu
We recently showed an association between strict BP control and lower mortality risk during two decades of follow-up of prior participants in the Modification of Diet in Renal Disease (MDRD) trial. Here, we determined the risk of ESRD and mortality during extended follow-up of the African American Study of Kidney Disease and Hypertension (AASK) trial. We linked 1067 former AASK participants with CKD previously randomized to strict or usual BP control (mean arterial pressure ≤92 mmHg or 102-107 mmHg, respectively) to the US Renal Data System and Social Security Death Index; 397 patients had ESRD and 475 deaths occurred during a median follow-up of 14...
August 11, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27012910/how-does-sprint-systolic-blood-pressure-intervention-trial-direct-hypertension-treatment-targets-for-ckd
#4
EDITORIAL
Sandra J Taler
No abstract text is available yet for this article.
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26912547/masked-hypertension-and-elevated-nighttime-blood-pressure-in-ckd-prevalence-and-association-with-target-organ-damage
#5
Paul E Drawz, Arnold B Alper, Amanda H Anderson, Carolyn S Brecklin, Jeanne Charleston, Jing Chen, Rajat Deo, Michael J Fischer, Jiang He, Chi-Yuan Hsu, Yonghong Huan, Martin G Keane, John W Kusek, Gail K Makos, Edgar R Miller, Elsayed Z Soliman, Susan P Steigerwalt, Jonathan J Taliercio, Raymond R Townsend, Matthew R Weir, Jackson T Wright, Dawei Xie, Mahboob Rahman
BACKGROUND AND OBJECTIVES: Masked hypertension and elevated nighttime BP are associated with increased risk of hypertensive target organ damage and adverse cardiovascular and renal outcomes in patients with normal kidney function. The significance of masked hypertension for these risks in patients with CKD is less well defined. The objective of this study was to evaluate the association between masked hypertension and kidney function and markers of cardiovascular target organ damage, and to determine whether this relationship was consistent among those with and without elevated nighttime BP...
April 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26806824/salt-and-health-time-to-revisit-the-recommendations
#6
Tilman B Drüeke
The relationship between salt and human health has been the subject of controversy over the past century. The largest study in the field demonstrates a J-curve relationship between sodium intake and adverse clinical outcomes, suggesting a need to reevaluate current recommendations to restrict sodium intake to less than 2 g/d in the general population.
February 2016: Kidney International
https://www.readbyqxmd.com/read/26806825/a-sprint-to-the-finish-or-just-the-beginning-implications-of-the-sprint-results-for-nephrologists
#7
Michael V Rocco, Alfred K Cheung
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated a significant reduction in major cardiovascular events and all-cause mortality with intensive blood pressure control in older individuals at high cardiovascular risk, including patients with chronic kidney disease and mild proteinuria. Nephrologists should consider the SPRINT results when determining the optimal blood pressure target for patients with chronic kidney disease.
February 2016: Kidney International
https://www.readbyqxmd.com/read/26804018/hypertension-rest-before-blood-pressure-measurement-a-lesson-from-sprint
#8
COMMENT
Rajiv Agarwal
No abstract text is available yet for this article.
March 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/26636542/antihypertensive-treatments-in-adult-autosomal-dominant-polycystic-kidney-disease-network-meta-analysis-of-the-randomized-controlled-trials
#9
Cheng Xue, Chenchen Zhou, Bing Dai, Shengqiang Yu, Chenggang Xu, Zhiguo Mao, Chaoyang Ye, Dongping Chen, Xuezhi Zhao, Jun Wu, Wansheng Chen, Changlin Mei
BACKGROUND: Blood pressure (BP) control is one of the most important treatments of Autosomal dominant polycystic kidney disease (ADPKD). The comparative efficacy of antihypertensive treatments in ADPKD patients is inconclusive. METHODS: Network meta-analysis was used to evaluate randomized controlled trials (RCT) which investigated antihypertensive treatments in ADPKD. PubMed, Embase, Ovid, and Cochrane Collaboration were searched. The primary outcome was estimated glomerular filtration rate (eGFR)...
December 15, 2015: Oncotarget
https://www.readbyqxmd.com/read/26550920/time-to-reassess-blood-pressure-goals
#10
Aram V Chobanian
More than 70 million people in the United States and more than 1 billion worldwide have hypertension — defined by a systolic blood pressure of at least 140 mm Hg and a diastolic blood pressure of at least 90 mm Hg — and the numbers are increasing steadily. Despite remarkable advances in..
November 26, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26551394/redefining-blood-pressure-targets-sprint-starts-the-marathon
#11
EDITORIAL
Vlado Perkovic, Anthony Rodgers
Blood pressure is a potent determinant of cardiovascular risk, but the most appropriate targets for blood-pressure lowering have long been debated. Observational studies with a low risk of confounding have shown a linear relationship between blood pressure and cardiovascular risk down to 115/75 mm..
November 26, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26551272/a-randomized-trial-of-intensive-versus-standard-blood-pressure-control
#12
RANDOMIZED CONTROLLED TRIAL
Jackson T Wright, Jeff D Williamson, Paul K Whelton, Joni K Snyder, Kaycee M Sink, Michael V Rocco, David M Reboussin, Mahboob Rahman, Suzanne Oparil, Cora E Lewis, Paul L Kimmel, Karen C Johnson, David C Goff, Lawrence J Fine, Jeffrey A Cutler, William C Cushman, Alfred K Cheung, Walter T Ambrosius
BACKGROUND: The most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain. METHODS: We randomly assigned 9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, to a systolic blood-pressure target of less than 120 mm Hg (intensive treatment) or a target of less than 140 mm Hg (standard treatment). The primary composite outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes...
November 26, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26553785/managing-hypertension-in-patients-with-ckd-a-marathon-not-a-sprint
#13
Glenn M Chertow, Srinivasan Beddhu, Julia B Lewis, Robert D Toto, Alfred K Cheung
In this manuscript, nephrologist-investigators from one of five Clinical Center Networks of the Systolic Blood Pressure Intervention Trial (SPRINT) provide background information and context on the intensity of anti-hypertensive therapy in conjunction with the release of detailed results from SPRINT's primary analysis. The authors highlight published evidence on the safety and efficacy of differing intensities of anti-hypertensive therapy in mild to moderate CKD, where SPRINT will help to inform practice, as well as where gaps in evidence will remain...
January 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/26174784/orthostatic-hypotension-mechanisms-causes-management
#14
REVIEW
Phillip A Low, Victoria A Tomalia
Orthostatic hypotension (OH) occurs when mechanisms for the regulation of orthostatic BP control fails. Such regulation depends on the baroreflexes, normal blood volume, and defenses against excessive venous pooling. OH is common in the elderly and is associated with an increase in mortality rate. There are many causes of OH. Aging coupled with diseases such as diabetes and Parkinson's disease results in a prevalence of 10-30% in the elderly. These conditions cause baroreflex failure with resulting combination of OH, supine hypertension, and loss of diurnal variation of BP...
July 2015: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/11136953/effects-on-blood-pressure-of-reduced-dietary-sodium-and-the-dietary-approaches-to-stop-hypertension-dash-diet-dash-sodium-collaborative-research-group
#15
RANDOMIZED CONTROLLED TRIAL
F M Sacks, L P Svetkey, W M Vollmer, L J Appel, G A Bray, D Harsha, E Obarzanek, P R Conlin, E R Miller, D G Simons-Morton, N Karanja, P H Lin
BACKGROUND: The effect of dietary composition on blood pressure is a subject of public health importance. We studied the effect of different levels of dietary sodium, in conjunction with the Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in vegetables, fruits, and low-fat dairy products, in persons with and in those without hypertension. METHODS: A total of 412 participants were randomly assigned to eat either a control diet typical of intake in the United States or the DASH diet...
January 4, 2001: New England Journal of Medicine
https://www.readbyqxmd.com/read/25832858/hypertension
#16
REVIEW
Neil R Poulter, Dorairaj Prabhakaran, Mark Caulfield
Raised blood pressure is the biggest single contributor to the global burden of disease and to global mortality. The numbers of people affected and the prevalence of high blood pressure worldwide are expected to increase over the next decade. Preventive strategies are therefore urgently needed, especially in less developed countries, and management of hypertension must be optimised. Genetic advances in some rare causes of hypertension have been made lately, but the aggregate effect on blood pressure of all the genetic loci identified to date is small...
August 22, 2015: Lancet
https://www.readbyqxmd.com/read/25653099/assessment-and-management-of-hypertension-in-transplant-patients
#17
REVIEW
Matthew R Weir, Ellen D Burgess, James E Cooper, Andrew Z Fenves, David Goldsmith, Dianne McKay, Anita Mehrotra, Mark M Mitsnefes, Domenic A Sica, Sandra J Taler
Hypertension in renal transplant recipients is common and ranges from 50% to 80% in adult recipients and from 47% to 82% in pediatric recipients. Cardiovascular morbidity and mortality and shortened allograft survival are important consequences of inadequate control of hypertension. In this review, we examine the epidemiology, pathophysiology, and management considerations of post-transplant hypertension. Donor and recipient factors, acute and chronic allograft injury, and immunosuppressive medications may each explain some of the pathophysiology of post-transplant hypertension...
June 2015: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/25416665/treatment-resistant-hypertension-in-the-transplant-recipient
#18
REVIEW
Jay I Lakkis, Matthew R Weir
Treatment-resistant hypertension (TRH) is defined as follows: (1) the failure to achieve optimal blood pressure control to levels less than 140/90 mm Hg despite the concomitant use of 3 or more different classes of antihypertensive agents, one of which is a diuretic, or (2) the simultaneous use of 4 or more different classes of antihypertensive agents in a patient irrespective of blood pressure control and the exclusion of pseudoresistance. Patients with TRH constitute only a subset of patients with poorly controlled hypertension, which also includes other subsets of patients who are treated inadequately or who are noncompliant with prescribed pharmacologic and nonpharmacologic therapy...
2014: Seminars in Nephrology
https://www.readbyqxmd.com/read/25583291/a-patient-with-acute-kidney-pain-and-high-blood-pressure
#19
Debbie L Cohen, Michael C Soulen
This case presented challenging diagnostic and management issues in a young healthy man who presented with abdominal pain and new-onset hypertension. The differential diagnosis evolved over the course of the clinical presentation. The patient had severe vascular involvement of his renal and basal cerebral arteries that initially was assumed to be due to a vasculitic process or hypercoagulable state. Finally it became apparent that the patient did not have a systemic illness but rather a localized vascular disease most likely due to segmental arterial mediolysis, a rare, under-recognized condition that can potentially be fatal...
April 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/25531552/effects-of-blood-pressure-reduction-in-mild-hypertension-a-systematic-review-and-meta-analysis
#20
REVIEW
Johan Sundström, Hisatomi Arima, Rod Jackson, Fiona Turnbull, Kazem Rahimi, John Chalmers, Mark Woodward, Bruce Neal
BACKGROUND: Effects of blood pressure reduction in persons with grade 1 hypertension are unclear. PURPOSE: To investigate whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with grade 1 hypertension. DATA SOURCES: Trials included in the BPLTTC (Blood Pressure Lowering Treatment Trialists' Collaboration) and trials identified from a previous review and electronic database searches. STUDY SELECTION: Patients without cardiovascular disease with blood pressures in the grade 1 hypertension range (140 to 159/90 to 99 mm Hg) who were randomly assigned to an active (antihypertensive drug or more intensive regimen) or control (placebo or less intensive regimen) blood pressure-lowering regimen...
February 3, 2015: Annals of Internal Medicine
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