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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Ruth Webster, Abdul Salam, H Asita de Silva, Vanessa Selak, Sandrine Stepien, Senaka Rajapakse, Stanley Amarasekara, Naomali Amarasena, Laurent Billot, Arjuna P de Silva, Mervyn Fernando, Rama Guggilla, Stephen Jan, Jayanthimala Jayawardena, Pallab K Maulik, Sepalika Mendis, Suresh Mendis, Janake Munasinghe, Nitish Naik, Dorairaj Prabhakaran, Gotabaya Ranasinghe, Simon Thom, Nirmali Tisserra, Vajira Senaratne, Sanjeewa Wijekoon, Santharaj Wijeyasingam, Anthony Rodgers, Anushka Patel
Importance: Poorly controlled hypertension is a leading global public health problem requiring new treatment strategies. Objective: To assess whether a low-dose triple combination antihypertensive medication would achieve better blood pressure (BP) control vs usual care. Design, Setting, and Participants: Randomized, open-label trial of a low-dose triple BP therapy vs usual care for adults with hypertension (systolic BP >140 mm Hg and/or diastolic BP >90 mm Hg; or in patients with diabetes or chronic kidney disease: >130 mm Hg and/or >80 mm Hg) requiring initiation (untreated patients) or escalation (patients receiving monotherapy) of antihypertensive therapy...
August 14, 2018: JAMA: the Journal of the American Medical Association
Marianne A Mahrouse
Therapeutic drug monitoring of angiotensin converting enzyme inhibitors (ACEI) has a great impact in blood pressure control in patient with heart failure, hepatic and renal impairment. To provide an efficient tool for drug assessment in plasma, UPLC-MS/MS method was developed for simultaneous determination of benazepril hydrochloride (BNZ), fosinopril sodium (FOS), captopril (CAP) and hydrochlorothiazide (HCT) in human plasma samples. Solid phase extraction was applied for sample preparation using OASIS® hydrophilic-lipophilic balanced reversed phase sorbents cartridges...
August 14, 2018: Biomedical Chromatography: BMC
Elvira O Gosmanova, Csaba P Kovesdy
Hypertension is present in most patients with end-stage kidney disease initiating dialysis and management of hypertension is a routine but challenging task in everyday dialysis care. End-stage kidney disease patients are uniquely heterogeneous individuals with significant variations in demographic characteristics, functional capacity, and presence of concomitant comorbid conditions and their severity. Therefore, these patients require personalized approaches in addressing not only hypertension but related illnesses, while also accounting for overall prognosis and projected longevity...
July 2018: Seminars in Nephrology
Monika Rynkowska-Kidawa, Michał Kidawa, Joanna Kapusta, Robert Irzmański, Jan Kowalski
Hypertension is one of the most common chronic diseases in Poland. It occurs in all age groups, but most often affects people over 65 years of age. The correct diagnosis of hypertension in older people includes documenting elevated blood pressure values, differentiating disease changes from physiologically related changes to aging, as well as assessing organ related complications. Detection of organ complications is also an important parameter of prognosis assessment. AIM: The aim of the study was evaluation of renal function in the course of hypertension in the elderly...
July 30, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Christopher C Mayer, Julia Matschkal, Pantelis A Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C Braunisch, Marcus Baumann, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer
BACKGROUND: Evidence on the utility of ambulatory BP monitoring for risk prediction has been scarce and inconclusive in patients on hemodialysis. In addition, in cardiac diseases such as heart failure and atrial fibrillation (common among patients on hemodialysis), studies have found that parameters such as systolic BP (SBP) and pulse pressure (PP) have inverse or nonlinear (U-shaped) associations with mortality. METHODS: In total, 344 patients on hemodialysis (105 with atrial fibrillation, heart failure, or both) underwent ambulatory BP monitoring for 24 hours, starting before a dialysis session...
July 25, 2018: Journal of the American Society of Nephrology: JASN
Scott Martin Vouri, Joseph S van Tuyl, Margaret A Olsen, Hong Xian, Mario Schootman
OBJECTIVES: Dihydropyridine calcium channel blockers (DH-CCB) are associated with lower-extremity edema (LEE). Loop diuretics have been used inappropriately to treat DH-CCB-associated LEE, constituting a prescribing cascade (PC). The aim of this work was to identify the prevalence and factors associated with potential DH-CCB-LEE-loop diuretic PC. METHODS: The 2014 National Ambulatory Medical Care Survey was used to identify patient visits in which a DH-CCB was continued...
July 20, 2018: Journal of the American Pharmacists Association: JAPhA
Pantelis A Sarafidis, Francesca Mallamaci, Charalampos Loutradis, Robert Ekart, Claudia Torino, Antonios Karpetas, Vasileios Raptis, Athanasios Bikos, Aikaterini Papagianni, Olga Balafa, Konstantinos Siamopoulos, Giovanni Pisani, Massimo Morosetti, Antonio Del Giudice, Fillipo Aucella, Luca Di Lullo, Rocco Tripepi, Giovanni Tripepi, Kitty Jager, Friedo Dekker, Gerard London, Carmine Zoccali
Background: Population-specific consensus documents recommend that the diagnosis of hypertension in haemodialysis patients be based on 48-h ambulatory blood pressure (ABP) monitoring. However, until now there is just one study in the USA on the prevalence of hypertension in haemodialysis patients by 44-h recordings. Since there is a knowledge gap on the problem in European countries, we reassessed the problem in the European Cardiovascular and Renal Medicine working group Registry of the European Renal Association-European Dialysis and Transplant Association...
July 10, 2018: Nephrology, Dialysis, Transplantation
Elaine Ku, Joachim H Ix, Kenneth Jamerson, Navdeep Tangri, Feng Lin, Jennifer Gassman, Miroslaw Smogorzewski, Mark J Sarnak
BACKGROUND: During intensive BP lowering, acute declines in renal function are common, thought to be hemodynamic, and potentially reversible. We previously showed that acute declines in renal function ≥20% during intensive BP lowering were associated with higher risk of ESRD. Here, we determined whether acute declines in renal function during intensive BP lowering were associated with mortality risk among 1660 participants of the African American Study of Kidney Disease and Hypertension and the Modification of Diet in Renal Disease Trial...
July 13, 2018: Journal of the American Society of Nephrology: JASN
Stephen D Persell, Kunal N Karmali, Danielle Lazar, Elisha M Friesema, Ji Young Lee, Alfred Rademaker, Darren Kaiser, Milton Eder, Dustin D French, Tiffany Brown, Michael S Wolf
Importance: Complex medication regimens pose self-management challenges, particularly among populations with low levels of health literacy. Objective: To test medication management tools delivered through a commercial electronic health record (EHR) with and without a nurse-led education intervention. Design, Setting, and Participants: This 3-group cluster randomized clinical trial was performed in community health centers in Chicago, Illinois...
July 9, 2018: JAMA Internal Medicine
Paul E Drawz, Roland Brown, Luca De Nicola, Naohiko Fujii, Francis B Gabbai, Jennifer Gassman, Jiang He, Satoshi Iimuro, James Lash, Roberto Minutolo, Robert A Phillips, Kyle Rudser, Luis Ruilope, Susan Steigerwalt, Raymond R Townsend, Dawei Xie, Mahboob Rahman
BACKGROUND AND OBJECTIVES: Ambulatory BP is increasingly recognized as a better measure of the risk for adverse outcomes related to hypertension, an important comorbidity in patients with CKD. Varying definitions of white-coat and masked hypertension have made it difficult to evaluate differences in prevalence of these BP patterns across CKD cohorts. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The International Database of Ambulatory BP in Renal Patients collaborative group established a large database of demographic, clinical, and ambulatory BP data from patients with CKD from cohorts in Italy, Spain, the Chronic Renal Insufficiency Cohort (CRIC) and the African American Study of Kidney Disease and Hypertension Cohort Study (AASK) in the United States, and the CKD Japan Cohort (CKD-JAC)...
July 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Negiin Pourafshar, Saeed Alshahrani, Ashkan Karimi, Manoocher Soleimani
Thiazides are the most commonly used medications for the treatment of mild and moderate hypertension. Despite their recognized effect, the mechanism by which thiazides reduce systemic blood pressure remains uncertain. The prevailing belief is that thiazides reduce blood pressure primarily via enhancement of salt excretion consequent to the inhibition of the Na-Cl cotransporter (NCC) in the distal convoluted tubules (DCT). However, recent reports point to a reduction in peripheral vascular resistance as a major mechanism of anti-hypertensive effect of thiazides...
July 1, 2018: Current Drug Metabolism
David A Jaques, Hajo Müller, Chantal Martinez, Sophie De Seigneux, Pierre-Yves Martin, Belen Ponte, Patrick Saudan
BACKGROUND: Few studies have assessed the role of 24-h ambulatory blood pressure monitoring (ABPM) in adults with nondialysis chronic kidney disease (CKD). We examined the potential determinants of left ventricular hypertrophy (LVH) and mass index (LVMI) in this population. PARTICIPANTS AND METHODS: We carried out a cross-sectional study on 69 stage 3b-5 CKD adults who had ABPM and transthoracic echocardiography performed simultaneously. Hypertension (HT) was defined as 24 h blood pressure (BP) of at least 130/80 mmHg...
June 28, 2018: Blood Pressure Monitoring
Anita Slomski
No abstract text is available yet for this article.
June 26, 2018: JAMA: the Journal of the American Medical Association
Thomas F Lüscher
No abstract text is available yet for this article.
June 21, 2018: European Heart Journal
Alissa A Frame, Richard D Wainford
The pathophysiology of hypertension, which affects over 1 billion individuals worldwide, involves the integration of the actions of multiple organ systems, including the kidney. The kidney, which governs sodium excretion via several mechanisms including pressure natriuresis and the actions of renal sodium transporters, is central to long term blood pressure regulation and the salt sensitivity of blood pressure. The impact of renal sodium handling and the salt sensitivity of blood pressure in health and hypertension is a critical public health issue owing to the excess of dietary salt consumed globally and the significant percentage of the global population exhibiting salt sensitivity...
June 2017: Kidney Research and Clinical Practice
Chi-yuan Hsu, Raymond K Hsu, Jingrong Yang, Juan D Ordonez, Sijie Zheng, Alan S Go
The connection between AKI and BP elevation is unclear. We conducted a retrospective cohort study to evaluate whether AKI in the hospital is independently associated with BP elevation during the first 2 years after discharge among previously normotensive adults. We studied adult members of Kaiser Permanente Northern California, a large integrated health care delivery system, who were hospitalized between 2008 and 2011, had available preadmission serum creatinine and BP measures, and were not known to be hypertensive or have BP>140/90 mmHg...
March 2016: Journal of the American Society of Nephrology: JASN
Maria Luisa S Sequeira-Lopez, R Ariel Gomez
No abstract text is available yet for this article.
June 13, 2018: Nature Reviews. Nephrology
Fabio Angeli, Giorgio Gentile, Monica Trapasso, Paolo Verdecchia, Gianpaolo Reboldi
Hypertension is a key risk factor for chronic kidney disease (CKD), but can also be a detrimental consequence of established CKD. Unsurprisingly, the majority of subjects with abnormal creatinine in the general population are also hypertensive, with a huge toll on national health care systems worldwide due to a staggering increase in the risk of cardiovascular complications and end-stage renal disease requiring renal replacement therapy. In this setting, a comprehensive and careful assessment of the whole 24-h blood pressure (BP) profile could be of paramount importance in ensuring a timely diagnosis of hypertension and an optimal therapeutic control...
June 13, 2018: Journal of Human Hypertension
Rigas G Kalaitzidis, Moses S Elisaf
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is recognized as a worldwide epidemic. Hypertension commonly coexists with CKD and its prevalence is progressively increasing as kidney function declines. RECENT FINDINGS: For patients with established CKD and/or diabetes with albuminuria, the updated hypertension guidelines have recommended a blood pressure (BP) goal < 130/80 mmHg. Blood pressure level above 130/80 mmHg in CKD patients requires lifestyle modifications and multiple antihypertensive medications...
June 11, 2018: Current Hypertension Reports
Tara I Chang, Mark J Sarnak
No abstract text is available yet for this article.
May 24, 2018: Clinical Journal of the American Society of Nephrology: CJASN
2018-06-11 22:44:28
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