Latest & greatest articles for hypertension

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Top results for hypertension

21. Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial. (Abstract)

Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial. Deprescribing of antihypertensive medications is recommended for some older patients with polypharmacy and multimorbidity when the benefits of continued treatment may not outweigh the harms.This study aimed to establish whether antihypertensive medication reduction is possible without significant changes (...) in systolic blood pressure control or adverse events during 12-week follow-up.The Optimising Treatment for Mild Systolic Hypertension in the Elderly (OPTIMISE) study was a randomized, unblinded, noninferiority trial conducted in 69 primary care sites in England. Participants, whose primary care physician considered them appropriate for medication reduction, were aged 80 years and older, had systolic blood pressure lower than 150 mm Hg, and were receiving at least 2 antihypertensive medications were

2020 JAMA

22. Screening strategies for hypertension. (Abstract)

. age, gender, lifestyle factors, diabetes, blood cholesterol) can enable more accurate targeting of high-risk groups. Targeting of high-risk groups can help reduce costs in that resources are not spent on the entire population. Early detection in the form of screening for hypertension (and associated risk factors) can help identify high-risk groups, which can result in timely treatment and management of risk factors. Ultimately, early detection can help reduce morbidity and mortality linked (...) , harmful alcohol consumption, and poor management of stress. Over the long term, hypertension leads to risk for cardiovascular events, such as heart disease, stroke, kidney failure, disability, and premature mortality. Cardiovascular events can be preventable when high-risk populations are targeted, for example, through population-wide screening strategies. When available resources are limited, taking a total risk approach whereby several risk factors of hypertension are taken into consideration (e.g

2020 Cochrane

23. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. (Abstract)

Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. Catheter-based renal denervation has significantly reduced blood pressure in previous studies. Following a positive pilot trial, the SPYRAL HTN-OFF MED (SPYRAL Pivotal) trial was designed to assess the efficacy of renal denervation in the absence of antihypertensive medications.In this international, prospective, single (...) -blinded, sham-controlled trial, done at 44 study sites in Australia, Austria, Canada, Germany, Greece, Ireland, Japan, the UK, and the USA, hypertensive patients with office systolic blood pressure of 150 mm Hg to less than 180 mm Hg were randomly assigned 1:1 to either a renal denervation or sham procedure. The primary efficacy endpoint was baseline-adjusted change in 24-h systolic blood pressure and the secondary efficacy endpoint was baseline-adjusted change in office systolic blood pressure from

2020 Lancet

24. Treprostinil (Trepulmix) - chronic thromboembolic pulmonary hypertension (CTEPH)

(treprostinil) An overview of Trepulmix and why it is authorised in the EU What is Trepulmix and what is it used for? Trepulmix is a medicine for use in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH), a condition linked with high blood pressure in the lungs caused by blood clots. It can be used to improve the capacity for physical activity in patients: • who cannot have an operation for treating the condition; • whose condition remains or continues to return after an operation (...) that widens blood vessels and stops platelets (blood components) from sticking to each other to form blood clots. In patients with CTEPH, these effects of treprostinil prevent blood clots and lower blood pressure in the pulmonary artery and so improve symptoms of the disease. What benefits of Trepulmix have been shown in studies? A main study involving 105 patients with severe CTEPH who could not have an operation found that Trepulmix can improve patients’ capacity for physical activity, measured

2020 European Medicines Agency - EPARs

25. Epoprostenol for pulmonary arterial hypertension

Epoprostenol for pulmonary arterial hypertension 1 Driving better decision-making in healthcare Epoprostenol for treating pulmonary arterial hypertension Technology Guidance from the MOH Drug Advisory Committee Published on 1 April 2020 Guidance recommendations The Ministry of Health’s Drug Advisory Committee has recommended: ? ? epoprostenol (Veletri) 1.5 mg powder for solution for infusion for treating idiopathic or heritable pulmonary arterial hypertension (PAH) or PAH associated (...) Committee (“the Committee”) considered the evidence presented for the technology evaluation of epoprostenol (Veletri) for pulmonary arterial hypertension (PAH). The Agency for Care Effectiveness conducted the evaluation in consultation with clinical experts from public healthcare institutions. Published clinical and economic evidence for epoprostenol was considered in line with its registered indication. The Committee acknowledged that another brand of epoprostenol (Flolan) is available in Singapore

2020 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

26. A Randomized Trial of Distal Diuretics versus Dietary Sodium Restriction for Hypertension in Chronic Kidney Disease

. Methods: To investigate whether distal diuretics are noninferior to dietary sodium restriction in reducing BP in patients with CKD stage G3 or G4 and hypertension, we conducted a 6-week, randomized, open-label crossover trial comparing amiloride/hydrochlorothiazide (5 mg/50 mg daily) with dietary sodium restriction (60 mmol per day). Antihypertension medication was discontinued for a 2-week period before randomization. We analyzed effects on BP, kidney function, and fluid balance and related (...) hyponatremia. Conclusions: Distal diuretics are noninferior to dietary sodium restriction in reducing BP and extracellular volume in CKD. Diuretic sensitivity in CKD is maintained despite lower diuretic clearance. Clinical trial registry name and registration number: DD-study: Diet or Diuretics for Salt-sensitivity in Chronic Kidney Disease (DD), . Keywords: chronic kidney disease; clinical hypertension; clinical trial; diuretics; pharmacokinetics; water-electrolyte balance. Copyright © 2020

2020 EvidenceUpdates

27. Management of hypertension evidence map

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2020 Public Health Wales Observatory Evidence Service

28. A Community-Based Intervention for Managing Hypertension in Rural South Asia. Full Text available with Trip Pro

). The intervention involved home visits by trained government community health workers for blood-pressure monitoring and counseling, training of physicians, and care coordination in the public sector. A total of 2645 adults with hypertension were enrolled. The primary outcome was reduction in systolic blood pressure at 24 months. Follow-up at 24 months was completed for more than 90% of the participants.At baseline, the mean systolic blood pressure was 146.7 mm Hg in the intervention group and 144.7 mm Hg (...) A Community-Based Intervention for Managing Hypertension in Rural South Asia. The burden of hypertension is escalating, and control rates are poor in low- and middle-income countries. Cardiovascular mortality is high in rural areas.We conducted a cluster-randomized, controlled trial in rural districts in Bangladesh, Pakistan, and Sri Lanka. A total of 30 communities were randomly assigned to either a multicomponent intervention (intervention group) or usual care (control group

2020 NEJM

29. First-line combination therapy versus first-line monotherapy for primary hypertension. (Abstract)

Trials Registry Platform, and ClinicalTrials.gov. We used no language restrictions. We also searched clinical studies repositories of pharmaceutical companies, reviews of combination drugs on the US Food and Drug Administration and European Medicines Agency websites, and lists of references in reviews and clinical practice guidelines.We included randomised, double-blind trials with at least 12 months' follow-up in adults with primary hypertension (systolic blood pressure/diastolic blood pressure 140 (...) First-line combination therapy versus first-line monotherapy for primary hypertension. This is the first update of a review originally published in 2017. Starting with one drug and starting with a combination of two drugs are strategies suggested in clinical guidelines as initial treatment of hypertension. The recommendations are not based on evidence about clinically relevant outcomes. Some antihypertensive combinations have been shown to be harmful. The actual harm-to-benefit balance of each

2020 Cochrane

30. Essential Hypertension

. Reversible Causes of Sustained Elevated Blood Pressure Readings Medications: • NSAIDs * • oral contraceptive agents • glucocorticoid or mineralocorticoid steroids * interferes with antihypertensive medications Medications (continued): • appetite suppressants • anti-depressants • MAO inhibitors • cyclosporine • erythropoietin Lifestyle factors • alcohol > 2 drinks/day • sedentary lifestyle Illicit drugs • cocaine • amphetamines • anabolic steroids Diet • High sodium (esp. elderly or African-American (...) 2003; 362:759. Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy. Hypertension 2008;51:960-969. The 7th report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension, 2003; 42:1206. Complete report: NHLBI, 2004, NIH Publication No 04-5230. UMHS Hypertension Guideline, May 2014 16 APPENDIX. Standardized Blood Pressure Measurement Types of Measuring Devices • Aneroid manometer could be used. However

2020 University of Michigan Health System

31. Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving Blood Pressure Control Together (ACT) Randomized Comparative Effectiveness Trial (Abstract)

Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving Blood Pressure Control Together (ACT) Randomized Comparative Effectiveness Trial Effective hypertension self-management interventions are needed for socially disadvantaged African Americans, who have poorer blood pressure (BP) control compared to others.We studied the incremental effectiveness of contextually adapted hypertension self-management interventions among socially disadvantaged African (...) [95% CI] - 9.1 [- 15.1, - 3.1], - 7.4 [- 13.4, - 1.4], and - 11.3 [- 17.2, - 5.3] mmHg) and DBP (- 4.8 [- 8.3, - 1.3], - 4.0 [- 7.5, - 0.5], and - 5.4 [- 8.8, - 1.9] mmHg) for CHW, DoMyPART, and Problem Solving, respectively). There were no group differences in BP outcomes, BP self-monitor use, or clinic visit patient-centeredness. The Problem Solving group had higher odds of high hypertension self-care behaviors (OR [95% CI] 18.7 [4.0, 87.3]) and self-efficacy scores (OR [95% CI] 4.7 [1.5, 14.9

2020 EvidenceUpdates

32. Risk of hypertension into adulthood in persons born prematurely: a national cohort study Full Text available with Trip Pro

Risk of hypertension into adulthood in persons born prematurely: a national cohort study Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood.A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973-2014, who were (...) followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person

2020 EvidenceUpdates

33. Pregnancy Health: Exercise Programs to Prevent Gestational Hypertension

excessive weight gain and prevent gestational diabetes ( ). This systematic review assessed the effectiveness of exercise programs in preventing gestational hypertensive disorders, defined as new onset high blood pressure during pregnancy. There are four different types of gestational hypertensive disorders: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension (Vest et al., 2014). This CPSTF finding is specific to one type—gestational (...) hypertension without the development of preeclampsia-eclampsia. Summary of Results Detailed results from the systematic review are available in the . The systematic review and meta-analysis included 17 randomized controlled trials. Compared to interventions without an exercise program or to usual care, exercise programs reduced the development of high blood pressure during pregnancy by 46% (17 studies) Additional analyses of a subset of 16 studies showed the following: The cesarean delivery rate

2020 Community Preventive Services Task Force

34. Non-steroidal anti-inflammatory drug (NSAID) therapy in patients with hypertension, cardiovascular, renal or gastrointestinal comorbidities: joint APAGE/APLAR/APSDE/APSH/APSN/PoA recommendations

-selective NSAID plus a proton pump inhibitor (PPI), or a selective cyclo-oxygenase-2 (COX-2) inhibitor should be used; for those with a high risk of peptic ulcer disease, a selective COX-2 inhibitor plus PPI are needed. For patients with pre-existing hypertension receiving renin-angiotensin system blockers, empirical addition (or increase in the dose) of an antihypertensive agent of a different class should be considered. Blood pressure and renal function should be monitored in most cases. Conclusion (...) -resistant hypertension, high risk of cardiovascular disease and severe chronic kidney disease (CKD). Before treatment with a NSAID is started, blood pressure should be measured, unrecognised CKD should be screened in high risk cases, and unexplained iron-deficiency anaemia should be investigated. For patients with high cardiovascular risk, and if NSAID treatment cannot be avoided, naproxen or celecoxib are preferred. For patients with a moderate risk of peptic ulcer disease, monotherapy with a non

2020 EvidenceUpdates

35. Association of Isolated Diastolic Hypertension as Defined by the 2017 ACC/AHA Blood Pressure Guideline With Incident Cardiovascular Outcomes. Full Text available with Trip Pro

Association of Isolated Diastolic Hypertension as Defined by the 2017 ACC/AHA Blood Pressure Guideline With Incident Cardiovascular Outcomes. In the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline, the definition of hypertension was lowered from a blood pressure (BP) of greater than or equal to 140/90 to greater than or equal to 130/80 mm Hg. The new diastolic BP threshold of 80 mm Hg was recommended based on expert opinion and changes the definition (...) of isolated diastolic hypertension (IDH).To compare the prevalence of IDH in the United States, by 2017 ACC/AHA and 2003 Joint National Committee (JNC7) definitions, and to characterize cross-sectional and longitudinal associations of IDH with outcomes.Cross-sectional analyses of the National Health and Nutrition Examination Survey (NHANES 2013-2016) and longitudinal analyses of the Atherosclerosis Risk in Communities (ARIC) Study (baseline 1990-1992, with follow-up through December 31, 2017

2020 JAMA

36. Effect of Renal Denervation and Catheter Ablation vs Catheter Ablation Alone on Atrial Fibrillation Recurrence Among Patients With Paroxysmal Atrial Fibrillation and Hypertension: The ERADICATE-AF Randomized Clinical Trial. Full Text available with Trip Pro

Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation (ERADICATE-AF) trial was an investigator-initiated, multicenter, single-blind, randomized clinical trial conducted at 5 referral centers for catheter ablation of atrial fibrillation in the Russian Federation, Poland, and Germany. A total of 302 patients with hypertension despite taking at least 1 antihypertensive medication, paroxysmal atrial fibrillation, and plans for ablation were enrolled from April 2013 to March 2018 (...) fibrillation, atrial flutter, or atrial tachycardia at 12 months. Secondary end points included procedural complications within 30 days and blood pressure control at 6 and 12 months.Of the 302 randomized patients (median age, 60 years [interquartile range, 55-65 years]; 182 men [60.3%]), 283 (93.7%) completed the trial. All successfully underwent their assigned procedures. Freedom from atrial fibrillation, flutter, or tachycardia at 12 months was observed in 84 of 148 (56.5%) of those undergoing pulmonary

2020 JAMA

37. Management of Hypertension (HTN) in Primary Care

pressures, confirmatory out of office blood pressure measurements should be considered. Home blood pressure devices are usually more readily available than ambulatory blood pressure devices, but ABPM results can be utilized when office BP is high and home BP is not elevated. Home blood pressure Monitoring of blood pressure at home may selectively assist in diagnosing and managing hypertension. Recent studies indicate that self-monitoring may help in differentiating white-coat hypertension (i.e (...) . persistently elevated office BP with normotensive BP by home or ambulatory BP readings) from chronically high blood pressure readings and/or may provide additional readings in patients who are already being treated for hypertension but who also have a white-coat component. [26-28] There is some evidence to suggest that home blood pressure monitoring has good prognostic efficacy for predicting cardiovascular events. [27,29,30] Home blood pressure monitoring may also identify patients who have a normal blood

2020 VA/DoD Clinical Practice Guidelines

38. The Japanese Hypertension Guidelines

[23,24] and death from cancer [24] are higher in people who used antihypertensive drugs as compared with those without the medication. The risk is particularly high in people whose systolic blood pressure is below 120 [25]. In a recent cohort study, JACC study that followed about 28,000 people without cardiovascular disease, cancer, or renal disorder, the risk of death may be higher by 30% in antihypertensive users with lowest Review Review A: Intensive treatment compared with the standard treatment (...) of Hypertension Guidelines Part 2 NICE (UK) recommends treatment if blood pressure is 160/100 or over Neglect of Correcting Scientific Fraud: Ruling over Diovan Scandal Advrse Reactions Tamiflu: Death After Abnormal Behaviour in Teenagers Revisited High Risk of Death from Tamiflu and Xofluza CONTENTS (December 2019, Vol. 5, No. 15 ) 37 38 44 48 50 52 Volume 5 December C M ED HECKMED CHECK December 2019/ Vol.5 No.15 · Page 37 References The Japanese Hypertension Guidelines 2019: Problem in Selection of Members

2020 Med Check - The Informed Prescriber

39. Identifying and treating high blood pressure in men under 55 years with grade 1 hypertension: the TREAT CASP study and RCT Full Text available with Trip Pro

Identifying and treating high blood pressure in men under 55 years with grade 1 hypertension: the TREAT CASP study and RCT Identifying and treating high blood pressure in men under 55 years with grade 1 hypertension: the TREAT CASP study and RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above (...) to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} Using central aortic systolic pressure was not found to be a superior means to stratify men under 55 with grade 1 hypertension for antihypertensive therapy, when compared with conventional blood pressure measurement. {{author}} {{($index , , & . Bryan Williams 1, 2, * , Ewan McFarlane 1 , Dawid Jedrzejewski 1 , Peter S Lacy 1, 2 1 University College London Institute

2020 NIHR HTA programme

40. Coronavirus disease 2019 (COVID-19): Issues related to kidney disease and hypertension

Coronavirus disease 2019 (COVID-19): Issues related to kidney disease and hypertension UpToDate It seems to us that you have your JavaScript disabled on your browser. JavaScript is required in order for our site to behave correctly. Please enable JavaScript to use our site.

2020 UpToDate