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Hypertension

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57 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28707234/the-elusive-search-for-optimal-blood-pressure-targets
#1
REVIEW
Alan H Gradman
BP treatment thresholds/targets determine when to initiate treatment and to what level BP should be reduced. The Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommended a target of <140/90 for most patients and a target <130/80 mmHg for patients with diabetes or chronic kidney disease. Subsequently, meta-analyses, retrospective studies relating on-treatment BP to clinical outcomes and two large, randomized clinical trials (RCTs) have re-evaluated BP targets...
August 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28692165/clinical-and-prognostic-significance-of-a-reverse-dipping-pattern-on-ambulatory-monitoring-an-updated-review
#2
REVIEW
Cesare Cuspidi, Carla Sala, Marijana Tadic, Elisa Gherbesi, Antonio De Giorgi, Guido Grassi, Giuseppe Mancia
Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm...
July 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28682567/-pres-posterior-reversible-encephalopathy-syndrome-potential-complication-of-hypertensive-crisis-case-report-and-literature-review
#3
Michele Vergura, Michele Prencipe, Antonio Maria Del Giudice, Rachele Grifa, Filomena Miscio, Anna Maria Pennelli, Teresa Popolizio, Anna Simeone, Mariangela Ferrara, Maurizio Leone, Filippo Aucella
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, usually reversible, characterized by vasogenic oedema in cerebral posterior regions in patients with autoimmune diseases, nephropathies, hypertensive crisis, eclampsia and exposure to cytotoxic drugs. The main symptoms are: headache, nausea, vomiting, seizures, visual disturbance and altered consciousness. Complications as cerebral hemorrhage and recurrences are rare. We describe a case of a 65 years old woman, affected by chronic kidney disease, recently exacerbated, diabetes and hypertension in treatment, who showed an heterogeneous clinical presentation with vomiting, headache, blurred vision and impaired consciousness during an episode of acute hypertension...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28658167/loss-of-nighttime-blood-pressure-dipping-as-a-risk-factor-for-coronary-artery-calcification-in-nondialysis-chronic-kidney-disease
#4
Hoon Young Choi, Chan Joo Lee, Jung Eun Lee, Hyun Su Yang, Ha Yan Kim, Hyeong Cheon Park, Hyeon Chang Kim, Hyuk-Jae Chang, Sung-Ha Park, Beom Seok Kim
Diurnal variations in blood pressure (BP) loss are closely associated with target organ damage and cardiovascular events. The quantity of coronary artery calcification (CAC) correlates with the atherosclerotic plaque burden, and an increased quantity indicates a substantially increased risk of cardiovascular events. This study investigated the nighttime diurnal variation in BP loss associated with CAC in patients with chronic kidney disease (CKD).Of the 1958 participants, we enrolled 722 participants with CKD without a history of acute coronary syndrome or symptomatic coronary artery disease...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28642330/effects-of-intensive-bp-control-in-ckd
#5
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/28597784/the-impact-of-non-dipper-circadian-rhythm-of-blood-pressure-on-left-ventricular-hypertrophy-in-patients-with-non-dialysis-chronic-kidney-disease
#6
Xiajing Che, Shan Mou, Weiming Zhang, Minfang Zhang, Leyi Gu, Yucheng Yan, Hua Ying, Chunhua Hu, Jiaqi Qian, Zhaohui Ni
Objective The aim of this study was to investigate the correlation between non-dipper circadian rhythm of blood pressure (BP) and left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). Methods and results All 257 patients with stage 1 to 5 CKD were enrolled in the study and classified into a CKD1-3 group and a CKD4-5 group according to renal function. The parameters and circadian rhythm of BP were measured by a GE Marquette Tonoport V Eng dynamic sphygmomanometer, and cardiac structure was examined by echocardiography...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28589557/does-a-blood-pressure-j-curve-exist-for-patients-with-chronic-kidney-disease
#7
REVIEW
Nicolás Roberto Robles, Roman Hernandez-Gallego, Francesco Fici, Guido Grassi
Aggressive reduction of blood pressure may increase cardiovascular events (the J-curve phenomenon) in certain populations. In this regard, most studies in patients with chronic kidney disease have shown a J curve for cardiovascular morbidity and mortality, and this phenomenon persists after adjusting for confounding factors. Since there is no evidence that a straighter blood pressure target (<130/70 mm Hg) could improve renal outcomes, the increased cardiovascular risk associated with extreme blood pressure reduction should be seen as undesirable...
June 7, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28556585/a-practical-approach-to-diagnosing-endocrine-hypertension
#8
REVIEW
Jun Yang, Jimmy Shen, Peter J Fuller
Hypertension is a leading cardiovascular risk factor that remains difficult to manage in a large segment of the population. Secondary causes of hypertension, which are amenable to targeted treatment or even cure, may contribute to poor blood pressure control. The most common endocrine cause, primary aldosteronism, requires biochemical screening as there are often no symptoms or signs other than hypertension. Screening tests should be done after adequate preparation to optimise the results and minimise the confounding effects of diet and medications...
May 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28451853/management-of-hypertension-in-patients-with-chronic-kidney-disease
#9
REVIEW
Seyed Mehrdad Hamrahian
Hypertension is the leading factor in the global burden of disease. It is the predominant modifiable risk factor for stroke, heart disease, and kidney failure. Chronic kidney disease (CKD) is both a common cause and sequel of uncontrolled hypertension. The pathophysiology of CKD-associated hypertension is complex and multi-factorial. This paper reviews the key pathogenic mechanisms of CKD-associated hypertension, the importance of standardized blood pressure (BP) measurement in establishing the diagnosis and management plus the significance of ambulatory BP monitoring for assessment of diurnal BP variation commonly seen in CKD...
May 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28399019/pathophysiology-and-implications-of-intradialytic-hypertension
#10
Peter Noel Van Buren
PURPOSE OF REVIEW: Intradialytic hypertension occurs regularly in 10--15% of hemodialysis patients. A large observational study recently showed that intradialytic hypertension of any magnitude increased mortality risk comparable to the most severe degrees of intradialytic hypotension. The present review review discusses the most recent evidence underlying the pathophysiology of intradialytic hypertension and implications for its management. RECENT FINDINGS: Patients with intradialytic hypertension typically have small interdialytic weight gains, but bioimpedance spectroscopy shows these patients have significant chronic extracellular volume excess...
July 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28390695/achieved-blood-pressure-and-cardiovascular-outcomes-in-high-risk-patients-results-from-ontarget-and-transcend-trials
#11
Michael Böhm, Helmut Schumacher, Koon K Teo, Eva M Lonn, Felix Mahfoud, Johannes F E Mann, Giuseppe Mancia, Josep Redon, Roland E Schmieder, Karen Sliwa, Michael A Weber, Bryan Williams, Salim Yusuf
BACKGROUND: Studies have challenged the appropriateness of accepted blood pressure targets. We hypothesised that different levels of low blood pressure are associated with benefit for some, but harm for other outcomes. METHODS: In this analysis, we assessed the previously reported outcome data from high-risk patients aged 55 years or older with a history of cardiovascular disease, 70% of whom had hypertension, from the ONTARGET and TRANSCEND trials investigating ramipril, telmisartan, and their combination, with a median follow-up of 56 months...
June 3, 2017: Lancet
https://www.readbyqxmd.com/read/28288249/association-of-intensive-blood-pressure-control-and-kidney-disease-progression-in-nondiabetic-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#12
Wan-Chuan Tsai, Hon-Yen Wu, Yu-Sen Peng, Ju-Yeh Yang, Hung-Yuan Chen, Yen-Ling Chiu, Shih-Ping Hsu, Mei-Ju Ko, Mei-Fen Pai, Yu-Kang Tu, Kuan-Yu Hung, Kuo-Liong Chien
Importance: The optimal blood pressure (BP) target remains debated in nondiabetic patients with chronic kidney disease (CKD). Objective: To compare intensive BP control (<130/80 mm Hg) with standard BP control (<140/90 mm Hg) on major renal outcomes in patients with CKD without diabetes. Data Sources: Searches of PubMed, MEDLINE, Embase, and Cochrane Library for publications up to March 24, 2016. Study Selection: Randomized clinical trials that compared an intensive vs a standard BP target in nondiabetic adults with CKD, reporting changes in glomerular filtration rate (GFR), doubling of serum creatinine level, 50% reduction in GFR, end-stage renal disease (ESRD), or all-cause mortality...
June 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28340239/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#13
REVIEW
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles J Ferro, Jean-Michel Halimi, Gunnar H Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verhaar, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease (ESRD) treated with haemodialysis or peritoneal dialysis, hypertension is common and often poorly controlled. Blood pressure (BP) recordings obtained before or after haemodialysis display a J- or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar haemodynamic setting related to dialysis treatment. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28161697/in-the-wake-of-systolic-blood-pressure-intervention-trial-new-targets-for-improving-hypertension-management-in-chronic-kidney-disease
#14
Crystal C Tyson, Thomas M Coffman
Systolic Blood Pressure Intervention Trial (SPRINT) was a multicenter randomized controlled trial showing the significant benefit of intensive reduction of blood pressure to a target of 120 mm Hg in individuals with hypertension and elevated cardiovascular risk. Because SPRINT includes the largest cohort of adults with chronic kidney disease (CKD) to be prospectively studied in a hypertension intervention trial, it has particular relevance to the field of nephrology. Here, we review the findings of SPRINT and assess their potential impact on guidelines for treatment of hypertension in patients with CKD...
2017: Nephron
https://www.readbyqxmd.com/read/28093357/are-the-innate-and-adaptive-immune-systems-setting-hypertension-on-fire
#15
REVIEW
Gisele F Bomfim, Fernanda Luciano Rodrigues, Fernando S Carneiro
Hypertension is the most common chronic cardiovascular disease and is associated with several pathological states, being an important cause of morbidity and mortality around the world. Low-grade inflammation plays a key role in hypertension and the innate and adaptive immune systems seem to contribute to hypertension development and maintenance. Hypertension is associated with vascular inflammation, increased vascular cytokines levels and infiltration of immune cells in the vasculature, kidneys and heart. However, the mechanisms that trigger inflammation and immune system activation in hypertension are completely unknown...
March 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28055048/detecting-heterogeneous-treatment-effects-to-guide-personalized-blood-pressure-treatment-a-modeling-study-of-randomized-clinical-trials
#16
Sanjay Basu, Jeremy B Sussman, Rod A Hayward
Background: Two recent randomized trials produced discordant results when testing the benefits and harms of treatment to reduce blood pressure (BP) in patients with cardiovascular disease (CVD). Objective: To perform a theoretical modeling study to identify whether large, clinically important differences in benefit and harm among patients (heterogeneous treatment effects [HTEs]) can be hidden in, and explain discordant results between, treat-to-target BP trials...
March 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27906749/sodium-and-potassium-in-the-pathogenesis-of-hypertension-focus-on-the-brain
#17
Horacio J Adrogué, Nicolaos E Madias
PURPOSE OF REVIEW: Primary hypertension is characterized by Na excess and K deficit in the body, which together are key to its pathogenesis. These derangements work jointly in the brain and the peripheral vascular wall to establish hypertension. In this review, we highlight recent evidence describing the central mechanisms through which Na surfeit and K deficit enhance sympathetic nerve activity, thereby raising peripheral vascular resistance and generating hypertension. RECENT FINDINGS: Animal studies point to a small increase in plasma and cerebrospinal fluid (CSF) [Na], a small decrease in CSF [K], and increased levels of circulating angiotensin II, aldosterone, and endogenous ouabain as the central signals evoking hypertension...
March 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27906836/visit-to-visit-blood-pressure-variability-is-a-risk-factor-for-all-cause-mortality-and-cardiovascular-disease-a-systematic-review-and-meta-analysis
#18
Jianqi Wang, Xubo Shi, Changsheng Ma, Hua Zheng, Jie Xiao, Hong Bian, Zhimin Ma, Ling Gong
OBJECTIVE: Clinical cohort studies have reported that visit-to-visit variability (VVV) of blood pressure (BP) is associated with cardiovascular disease (CVD) or mortality. However, the results were not consistent in all studies. The current study is, therefore, aimed to conduct a systematic review and meta-analysis to determine the association between VVV of BP and CVD and all-cause mortality. METHOD: PubMed and EMBASE were searched through 18 May 2014, using the following terms: VVV, BP, CVD, coronary heart disease (CHD), myocardial ischemia, stroke, and mortality...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27873228/hypertension-in-chronic-kidney-disease
#19
Seyed Mehrdad Hamrahian, Bonita Falkner
Hypertension, a global public health problem, is currently the leading factor in the global burden of disease. It is the major modifiable risk factor for heart disease, stroke and kidney failure. Chronic kidney disease (CKD) is both a common cause of hypertension and CKD is also a complication of uncontrolled hypertension. The interaction between hypertension and CKD is complex and increases the risk of adverse cardiovascular and cerebrovascular outcomes. This is particularly significant in the setting of resistant hypertension commonly seen in patient with CKD...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27898523/role-of-corin-in-the-regulation-of-blood-pressure
#20
Hui Li, Yue Zhang, Qingyu Wu
PURPOSE OF REVIEW: Corin is a transmembrane protease that activates atrial natriuretic peptide (ANP), an important hormone in regulating salt-water balance and blood pressure. This review focuses on the regulation of corin function and potential roles of corin defects in hypertensive, heart, and renal diseases. RECENT FINDINGS: Proprotein convertase subtilisin/kexin-6 has been identified as a primary enzyme that converts zymogen corin to an active protease. Genetic variants that impair corin intracellular trafficking, cell surface expression, and zymogen activation have been found in patients with hypertension, cardiac hypertrophy, and pre-eclampsia...
March 2017: Current Opinion in Nephrology and Hypertension
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