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Hypertension

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65 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29045334/blood-pressure-parameters-and-morbid-and-mortal-outcomes-in-nondialysis-dependent-chronic-kidney-disease
#1
Carl P Walther, Aravind Chandra, Sankar D Navaneethan
PURPOSE OF REVIEW: Observational and interventional studies provide conflicting evidence regarding optimal blood pressure (BP) control in persons with chronic kidney disease (CKD). Recent publications provide additional information to inform therapeutic decision-making. RECENT FINDINGS: Targeting SBP to less than 120 mmHg, versus less than 140 mmHg, decreased cardiovascular events and all-cause mortality in persons with nondiabetic CKD. A meta-analysis of trials testing blood pressure management among nondialysis-dependent CKD patients (15 924 total patients) found more intensive therapies generally reduced mortality in all subgroups...
October 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29044764/estimated-glomerular-filtration-rate-and-the-risk-benefit-profile-of-intensive-blood-pressure-control-among-non-diabetic-patients-a-post-hoc-analysis-of-a-randomized-clinical-trial
#2
Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Ayumi Shintani, Csaba P Kovesdy, Takayuki Hamano
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT; ClinicalTrials. gov, NCT01206062) reported reduced cardiovascular events by intensive blood pressure (BP) control among hypertensive patients without diabetes. However, the risk-benefit profile of intensive BP control may differ across estimated glomerular filtration rate (eGFR) levels. METHODS: This is a post-hoc analysis of the SPRINT. Non-diabetic hypertensive adults (n=9,361) with eGFR >20 mL/min/1...
October 16, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29036427/impact-of-achieved-blood-pressure-on-renal-function-decline-and-first-stroke-in-hypertensive-patients-with-chronic-kidney-disease
#3
Youbao Li, Min Liang, Chongfei Jiang, Guobao Wang, Jianping Li, Yan Zhang, Fangfang Fan, Ningling Sun, Yiming Cui, Mingli He, Genfu Tang, Delu Yin, Xiaoshu Cheng, Binyan Wang, Yong Huo, Xin Xu, Fan Fan Hou, Xiping Xu, Xianhui Qin
Background: The effect of achieved blood pressure (BP) on first stroke and renal function decline among hypertensive patients with mild to moderate chronic kidney disease (CKD) is still uncertain. Methods: In total, 3230 hypertensive patients with estimated glomerular filtration rate 30-60 mL/min/1.73 m 2 and/or proteinuria were included in the present analyses. Eligible participants were randomly assigned to a daily treatment of a combined enalapril 10 mg and folic acid 0...
September 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28985328/blood-pressure-variability-predicts-adverse-events-and-cardiovascular-outcomes-in-chronic-kidney-disease-a-post-hoc-analysis-of-the-sprint-trial
#4
Kenechukwu Mezue, Abhinav Goyal, Gregg S Pressman, Jay C Horrow, Janani Rangaswami
BACKGROUND: Visit-to-visit blood pressure variability has been associated with adverse cardiovascular outcomes. Using the SPRINT trial data set, we explored the relationship between blood pressure variability, cardiovascular outcomes, and hypoperfusion-related adverse events of antihypertensive therapy in patients with chronic kidney disease (CKD) enrolled in the study. METHODS: The analyses included patients with CKD randomized in SPRINT who reached the target systolic blood pressure for their respective groups (intensive <120 mm Hg; standard <140 mm Hg)...
July 31, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28827377/clinical-practice-guideline-for-screening-and-management-of-high-blood-pressure-in-children-and-adolescents
#5
Joseph T Flynn, David C Kaelber, Carissa M Baker-Smith, Douglas Blowey, Aaron E Carroll, Stephen R Daniels, Sarah D de Ferranti, Janis M Dionne, Bonita Falkner, Susan K Flinn, Samuel S Gidding, Celeste Goodwin, Michael G Leu, Makia E Powers, Corinna Rea, Joshua Samuels, Madeline Simasek, Vidhu V Thaker, Elaine M Urbina
These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy...
September 2017: Pediatrics
https://www.readbyqxmd.com/read/28750929/blood-pressure-parameters-are-associated-with-all-cause-and-cause-specific-mortality-in-chronic-kidney-disease
#6
Sankar D Navaneethan, Jesse D Schold, Stacey E Jolly, Susana Arrigain, Matthew F Blum, Wolfgang C Winkelmayer, Joseph V Nally
Previous observational studies reported J or U-shaped associations between blood pressure parameters and mortality in patients with chronic kidney disease (CKD). Here we examined the associations of different blood pressure levels with various causes of death in a CKD population that included patients with eGFR 15-59 ml/min/1.73 m(2) with underlying hypertension receiving at least one antihypertensive agent. We obtained data on date and cause of death from State Department of Health mortality files and classified deaths into three categories: cardiovascular, malignancy-related, and non-cardiovascular/non-malignancy related...
July 24, 2017: Kidney International
https://www.readbyqxmd.com/read/28729287/bp-targets-in-ckd-mortality-and-sprint-what-have-we-learned
#7
EDITORIAL
Stephen C Textor, Gary L Schwartz
No abstract text is available yet for this article.
September 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28724611/tumor-necrosis-factor-%C3%AE-kidney-function-and-hypertension
#8
REVIEW
Eamonn Mehaffey, Dewan S A Majid
Hypertension is considered to be a low-grade inflammatory condition characterized by the presence of various proinflammatory cytokines. Tumor necrosis factor-α (TNF-α) is a constituent of the proinflammatory cytokines that is associated with salt-sensitive hypertension (SSH) and related renal injury. Elevated angiotensin II (ANG II) and other factors such as oxidative stress conditions promote TNF-α formation. Many recent studies have provided evidence that TNF-α exerts a direct renal action by regulating hemodynamic and excretory function in the kidney...
October 1, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28707234/the-elusive-search-for-optimal-blood-pressure-targets
#9
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
#10
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
#11
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
#12
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
#13
RANDOMIZED CONTROLLED TRIAL
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...
September 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
#14
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
#15
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...
August 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28556585/a-practical-approach-to-diagnosing-endocrine-hypertension
#16
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
#17
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
#18
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
#19
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
#20
REVIEW
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
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