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Latest & greatest articles for hypertension
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Latanoprost + timolol (Fixapost) Reduction of intraocular pressure (IOP) in patients with open angle glaucoma and ocular hypertension who are insufficiently responsive to topical beta-blockers or prostaglandin analogues. Published 13 May 2019 Product update SMC2159 latanoprost 50 micrograms/mL plus timolol 5mg/mL preservative free eye drops (Fixapost®) Thea Pharmaceuticals Limited 5 April 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises (...) NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated submission latanoprost plus timolol (Fixapost®) is accepted for restricted use within NHSScotland. Indication under review: reduction of intraocular pressure (IOP) in patients with open angle glaucoma and ocular hypertension who are insufficiently responsive to topical beta-blockers or prostaglandin analogues. SMC restriction: to use
Prostacyclin for pulmonary arterial hypertension. Pulmonary arterial hypertension (PAH) is characterised by pulmonary vascular changes, leads to elevated pulmonary artery pressures, dyspnoea, a reduction in exercise tolerance, right heart failure, and ultimately death.Prostacyclin analogue drugs mimic endogenous prostacyclin which leads to vasodilation, inhibition of platelet aggregation, and reversal of vascular remodelling. Prostacyclin's short half-life theoretically enhances selectivity (...) cardiopulmonary haemodynamics (reduction in mean pulmonary artery pressure by 3.60 mmHg (95% CI -4.73 to -2.48); pulmonary vascular resistance by 2.81 WU (95% CI -3.80 to -1.82); right atrial pressure by 1.90 mmHg (95% CI -2.58 to -1.22), and increase in cardiac index by 0.31 L/min/m2 (95% CI 0.23 to 0.38); low-certainty evidence), improved dyspnoea (low-certainty evidence, and improved quality of life (moderate-certainty evidence), when compared to control. When only subcutaneous/inhaled trials were included
β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Clinical decompensation of cirrhosis is associated with poor prognosis. Clinically significant portal hypertension (CSPH), defined by a hepatic venous pressure gradient (HVPG) ≥10 mm Hg, is the strongest predictor of decompensation. This study aimed at assessing whether lowering HVPG with β blockers could (...) decrease the risk of decompensation or death in compensated cirrhosis with CSPH.This study on β blockers to prevent decompensation of cirrhosis with portal hypertension (PREDESCI) was an investigator-initiated, double-blind, randomised controlled trial done in eight hospitals in Spain. We enrolled patients with compensated cirrhosis and CSPH without high-risk varices. All participants had HVPG measurements with assessment of acute HVPG-response to intravenous propranolol. Responders (HVPG-decrease ≥10
2019LancetControlled trial quality: predicted high
Latanoprostene bunod (Vyzulta) - for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization of a product
Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report Pulmonary arterial hypertension (PAH) carries a poor prognosis if not promptly diagnosed and appropriately treated. The development and approval of 14 medications over the last several decades have led to a rapidly evolving approach to therapy, and have necessitated periodic updating of evidence-based treatment guidelines. This guideline statement, which now includes a visual algorithm
changes are recommended for all patients: weight loss, exercise, decreased sodium intake, Dietary Approaches to Stop Hypertension (DASH) diet, and moderation of alcohol consumption. Choice of drug therapy is often driven by considerations related to comorbid disease, but achievement of bloodpressure goal may be accomplished with a variety of therapeutic agent(s). Definition Essential hypertension is defined as bloodpressure (BP) ≥140/90 mmHg, with no secondary cause identified. National Heart, Lung (...) , and Blood Institute. The seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of HighBloodPressure. Aug 2004 [internet publication]. http://www.nhlbi.nih.gov/files/docs/guidelines/jnc7full.pdf Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-104. https://academic.oup.com/eurheartj/article/39/33/3021/5079119 http://www.ncbi.nlm.nih.gov/pubmed/30165516?tool
Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Primary open angle glaucoma and ocular hypertension are habitually treated with eye drops that lower intraocular pressure. Selective laser trabeculoplasty is a safe alternative but is rarely used as first-line treatment. We compared the two.In this observer-masked, randomised controlled trial treatment-naive patients with open angle (...) glaucoma or ocular hypertension and no ocular comorbidities were recruited between 2012 and 2014 at six UK hospitals. They were randomly allocated (web-based randomisation) to initial selective laser trabeculoplasty or to eye drops. An objective target intraocular pressure was set according to glaucoma severity. The primary outcome was health-related quality of life (HRQoL) at 3 years (assessed by EQ-5D). Secondary outcomes were cost and cost-effectiveness, disease-specific HRQoL, clinical
2019LancetControlled trial quality: predicted high
guidelines definition represents a more aggressive approach to diagnosis and treatment of hypertension compared with Joint National Committee (JNC) 7 and JNC 8 recommendations, where bloodpressure in the range of 120-139 mmHg/80-89 mmHg is considered pre-hypertension and bloodpressure >140/90 mmHg is considered elevated. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of HighBloodPressure: the JNC 7 (...) ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of highbloodpressure in adults. J Am Coll Cardiol. 2018 May 15;71(19):e127-248. http://www.ncbi.nlm.nih.gov/pubmed/29146535?tool=bestpractice.com and also by the British Society of Hypertension Williams B, Poulter NR, Brown MJ, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens
Lifestyle changes may be more important than drugs for mild hypertension. The studySheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs R, McManus R. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension.Published on 1 December 2018 JAMA Intern Med 2018;178:1626-34.This project was funded by a grant from the National Institute for Health Research (NIHR-RP-R2-12-O15) and the Medical Research Council (MRC) Strategic Skills Postdoctoral Fellowship.To (...) read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000713/lifestyle-changes-for-mild-hypertension-rather-than-drugs.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
be used to screen for diabetic kidney disease (section 9.3.2 p86), while NICE CG127 states that ACR should be offered to screen for protein in the urine for patients with chronic kidney disease or hypertension (recommendation 1.3.3 p13). The KDIGO Clinical Practice Guideline for Page 2 of 6 TER005 December 2018 the Management of BloodPressure in Chronic Kidney Disease does not specifically recommend one test over the other. Other sources of evidence identified by this search are summarised in Table 1 (...) Albumin:creatinine ratio testing in the assessment and/or identification of proteinuria in people with chronic kidney disease or primary hypertension Page 1 of 6 TER005 December 2018 Topic Exploration Report Topic explorations are designed to provide a high-level briefing on new topics submitted for consideration by Health Technology Wales. The main objectives of this report are to: 1. Inform discussions on new topics received by HTW. 2. Determine the quantity and type of evidence available
Project to Implement Diuretics, a randomized clinical trial, was conducted at 13 Veterans Affairs primary care clinics from August 1, 2006, to July 31, 2008, with 12 months of follow-up. A total of 61 019 patients were screened to identify 2853 eligible patients who were not taking a thiazide and not at their bloodpressure (BP) goal; 598 consented to participate. Statistical analysis was conducted from December 1, 2017, to September 12, 2018.Patients were randomized to a control group (n = 196) or 1 (...) % (72 of 128); and group C, 68.7% (90 of 131) (P = .004).This patient activation intervention about thiazides for hypertension resulted in two-thirds of patients having discussions and nearly one-third initiating a prescription of thiazide. Adding a financial incentive and telephone call to the letter resulted in incremental improvements in both outcomes. By 12 months, improved BP control was also evident. This low-cost, low-intensity intervention resulted in high rates of discussions between
renal arteries; (2) radiofrequency RDN of the main renal arteries, side branches, and accessories; or (3) an endovascular ultrasound-based RDN of the main renal artery. The primary end point was change in systolic daytime ambulatory bloodpressure at 3 months.Between June 2015 and June 2018, 120 patients were enrolled (mean age, 64±9 years±SD; mean daytime bloodpressure, 153/86±12/13 mm Hg). Of these, 39 were randomly assigned to radiofrequency main renal artery ablation, 39 to combined (...) radiofrequency ablation of the main artery and branches, and 42 to ultrasound-based treatment. Baseline daytime bloodpressure, clinical characteristics, and treatment were well balanced between the groups. At 3 months, systolic daytime ambulatory bloodpressure decreased by 9.5±12.3 mm Hg ( P<0.001) in the whole cohort. Although bloodpressure was significantly more reduced in the ultrasound ablation group than in the radiofrequency ablation group of the main renal artery (-13.2±13.7 versus -6.5±10.3 mm Hg
of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of HighBloodPressure. NIH Publication No. 04-5230. Bethesda (MD): NHLBI;2004. Available at https://www.nhlbi.nih.gov/files/docs/guidelines/ jnc7full.pdf. Retrieved December 5, 2016. Box 3. Sample Order Set for Severe Intrapartum or Postpartum Hypertension, Initial First-line Management With Labetalol* c Notify physician if systolic bloodpressure (BP) mea- surement is greater than or equal to 160 mm Hg or if diastolic BP (...) urgent antihypertensive therapy. c Close maternal and fetal monitoring by a physician andnursingstaffareadvisedduringthetreatmentof acute-onset, severe hypertension. c After initial stabilization, the team should monitor bloodpressure closely and institute maintenance therapy as needed. c Intravenous (IV) labetalol and hydralazine have long been considered first-line medications for the e174 VOL. 133, NO. 2, FEBRUARY 2019 OBSTETRICS & GYNECOLOGYmanagement of acute-onset, severe hypertension
for 4 weeks), moxibustion treatment group B (3 sessions/week for 4 weeks), and control group (nontreated group). The primary outcome measure was the change in bloodpressure after 4 weeks of treatment. Safety was assessed at every visit.There were no significant differences in systolic bloodpressure (SBP) or diastolic bloodpressure (DBP) among three groups after 4 weeks of treatment (p = 0.4798 and p = 0.3252, respectively). In treatment group B, there was a significant decrease in SBP and DBP (...) from baseline to 4 weeks of treatment (mean difference (MD) -9.55; p = 0.0225, MD -7.55; p = 0.0098, respectively). There were no significant differences among groups in secondary outcome measures after 4 weeks of treatment. Six adverse events (AEs) in the treatment group A and 12 AEs in the treatment group B occurred related to the moxibustion treatment.In conclusion, the results of this study show that moxibustion (3 sessions/week for 4 weeks) might lower bloodpressure in patients
, which collects six variables of interest (World Health Organization Functional Class, 6-min walk distance, brain natriuretic peptide, right atrial pressure, cardiac index and mixed venous oxygen saturation).We included patients with at least one follow-up visit, no pulmonary endarterectomy and at least three of the six variables available, and classified the patients into low-, intermediate- and high-risk groups. As a secondary analysis, the number of noninvasive low-risk criteria was counted (...) Risk assessment in medically treated chronic thromboembolic pulmonary hypertension patients Abbreviated versions of the risk stratification strategy of the European Society of Cardiology (ESC)/European Respiratory Society (ERS) pulmonary hypertension guidelines have been recently validated in patients with pulmonary arterial hypertension. We aimed to investigate their prognostic value in medically treated chronic thromboembolic pulmonary hypertension (CTEPH) patients from the COMPERA registry
be diagnosed in children and adolescents who have auscultatory-confirmed bloodpressure readings greater than the 95 th percentile, based on sex, age, and height tables, at three different visits. Children and adolescents being evaluated for highBP should have a perinatal history, appropriate nutritional history, physical activity history, psychosocial history, and family history recorded and a physical examination to identify findings suggestive of secondary causes of hypertension. Electrocardiography (...) Academy of Pediatrics and categorized as Affirmation of Value by the American Academy of Family Physicians. Key Recommendations: Children and adolescents three years of age or older should have their bloodpressured measured annually. Bloodpressure checks should be performed at every health care encounter for children and adolescents who are obese, take medications that raisebloodpressure, have renal disease, diabetes or a history of aortic arch obstruction or coarctation. Hypertension should
accounts Username * Password * your user name or password? You are here Harm-benefit analysis: treatment of mild hypertension in low-risk individuals Article Text Commentary Adult nursing Harm-benefit analysis: treatment of mild hypertension in low-risk individuals Terri Kean Statistics from Altmetric.com Commentary on : Sheppard et al . Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension. JAMA Internal Medicine Implications for practice and research A risk (...) Adult nursing: Harm-benefit analysis: treatment of mild hypertension in low-risk individuals Harm-benefit analysis: treatment of mild hypertension in low-risk individuals | Evidence-Based Nursing Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional