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Hypertension

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29204655/blood-pressure-trajectories-in-the-20-years-before-death
#1
João Delgado, Kirsty Bowman, Alessandro Ble, Jane Masoli, Yang Han, William Henley, Scott Welsh, George A Kuchel, Luigi Ferrucci, David Melzer
Importance: There is mixed evidence that blood pressure (BP) stabilizes or decreases in later life. It is also unclear whether BP trajectories reflect advancing age, proximity to end of life, or selective survival of persons free from hypertension. Objective: To estimate individual patient BP for each of the 20 years before death and identify potential mechanisms that may explain trajectories. Design, Study, and Participants: We analyzed population-based Clinical Practice Research Datalink primary care and linked hospitalization electronic medical records from the United Kingdom, using retrospective cohort approaches with generalized linear mixed-effects modeling...
December 4, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29146534/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#2
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29162340/effects-of-intensive-blood-pressure-treatment-on-acute-kidney-injury-events-in-the-systolic-blood-pressure-intervention-trial-sprint
#3
Michael V Rocco, Kaycee M Sink, Laura C Lovato, Dawn F Wolfgram, Thomas B Wiegmann, Barry M Wall, Kausik Umanath, Frederic Rahbari-Oskoui, Anna C Porter, Roberto Pisoni, Cora E Lewis, Julia B Lewis, James P Lash, Lois A Katz, Amret T Hawfield, William E Haley, Barry I Freedman, Jamie P Dwyer, Paul E Drawz, Mirela Dobre, Alfred K Cheung, Ruth C Campbell, Udayan Bhatt, Srinivasan Beddhu, Paul L Kimmel, David M Reboussin, Glenn M Chertow
BACKGROUND: Treating to a lower blood pressure (BP) may increase acute kidney injury (AKI) events. STUDY DESIGN: Data for AKI resulting in or during hospitalization or emergency department visits were collected as part of the serious adverse events reporting process of the Systolic Blood Pressure Intervention Trial (SPRINT). SETTING & PARTICIPANTS: 9,361 participants 50 years or older with 1 or more risk factors for cardiovascular disease...
November 18, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29153686/progression-of-gestational-hypertension-to-pre-eclampsia-a-cohort-study-of-20-103-pregnancies
#4
Kuo-Hu Chen, Kok-Min Seow, Li-Ru Chen
OBJECTIVE: To investigate previously un-identified risk factors for the progression of gestational hypertension (GH) to pre-eclampsia (PE) by considering Grade III preterm placental calcification (PPC) and excessive weight gain (≧10kgw) at 28weeks gestation. METHODS: At a tertiary teaching hospital, obstetric ultrasonography was performed at 28weeks gestation to establish a diagnosis of grade III PPC. Weight gain during pregnancy was recorded at the same time...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29131895/association-of-blood-pressure-lowering-with-mortality-and-cardiovascular-disease-across-blood-pressure-levels-a-systematic-review-and-meta-analysis
#5
Mattias Brunström, Bo Carlberg
Importance: High blood pressure (BP) is the most important risk factor for death and cardiovascular disease (CVD) worldwide. The optimal cutoff for treatment of high BP is debated. Objective: To assess the association between BP lowering treatment and death and CVD at different BP levels. Data Sources: Previous systematic reviews were identified from PubMed, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effect...
November 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29061722/longitudinal-blood-pressure-in-late-stage-chronic-kidney-disease-and-the-risk-of-end-stage-kidney-disease-or-mortality-best-blood-pressure-in-chronic-kidney-disease-study
#6
Manish M Sood, Ayub Akbari, Douglas G Manuel, Marcel Ruzicka, Swapnil Hiremath, Deborah Zimmerman, Brendan McCormick, Monica Taljaard
Whether different methods of quantitating blood pressure (BP) in late chronic kidney disease better mimic pathophysiological processes and clinical outcomes remains unclear. In a retrospective study, we determined the association of BP with end-stage kidney disease (ESKD) and all-cause mortality with BP modeled at baseline versus longitudinally with time-varying Cox models as (1) current (most recent) clinic visit, (2) lag (visit immediately preceding the current), (3) cumulative (average of previous measurements), and (4) change from baseline to the most recent...
December 2017: Hypertension
https://www.readbyqxmd.com/read/29101187/consequences-of-overinterpreting-serum-creatinine-increases-when-achieving-bp-reduction-balancing-risks-and-benefits-of-bp-reduction-in-hypertension
#7
EDITORIAL
Hala Yamout, George L Bakris
No abstract text is available yet for this article.
November 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29101991/acr-appropriateness-criteria%C3%A2-renovascular-hypertension
#8
Howard J Harvin, Nupur Verma, Paul Nikolaidis, Michael Hanley, Vikram S Dogra, Stanley Goldfarb, John L Gore, Stephen J Savage, Michael L Steigner, Richard Strax, Myles T Taffel, Jade J Wong-You-Cheong, Don C Yoo, Erick M Remer, Karin E Dill, Mark E Lockhart
Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101186/bp-reduction-kidney-function-decline-and-cardiovascular-events-in-patients-without-ckd
#9
Rita Magriço, Miguel Bigotte Vieira, Catarina Viegas Dias, Lia Leitão, João Sérgio Neves
BACKGROUND AND OBJECTIVES: In the Systolic Blood Pressure Intervention Trial (SPRINT), intensive systolic BP treatment (target <120 mm Hg) was associated with fewer cardiovascular events and higher incidence of kidney function decline compared with standard treatment (target <140 mm Hg). We evaluated the association between mean arterial pressure reduction, kidney function decline, and cardiovascular events in patients without CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We categorized patients in the intensive treatment group of the SPRINT according to mean arterial pressure reduction throughout follow-up: <20, 20 to <40, and ≥40 mm Hg...
November 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29051347/bp-measurement-in-clinical-practice-time-to-sprint-to-guideline-recommended-protocols
#10
Paul E Drawz, Joachim H Ix
Hypertension is the leading chronic disease risk factor in the world and is especially important in patients with CKD, nearly 90% of whom have hypertension. Recently, in the Systolic BP Intervention Trial (SPRINT), intensive lowering of clinic systolic BP to a target <120 mm Hg, compared with a standard BP target of <140 mm Hg, reduced risk for cardiovascular disease and all-cause mortality. However, because BP was measured unobserved using an automated device, some investigators have questioned the ability to translate SPRINT results into routine clinical practice, in which measurement of BP is typically less standardized...
October 19, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29045334/blood-pressure-parameters-and-morbid-and-mortal-outcomes-in-nondialysis-dependent-chronic-kidney-disease
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
November 2017: Kidney International
https://www.readbyqxmd.com/read/28729287/bp-targets-in-ckd-mortality-and-sprint-what-have-we-learned
#17
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
#18
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
#19
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
#20
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
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