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Latest & greatest articles for hypertension
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on hypertension or other clinical topics then use Trip today.
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Pharmacotherapy for hypertension in adults 60 years or older. This is the second substantive update of this review. It was originally published in 1998 and was previously updated in 2009. Elevated blood pressure (known as 'hypertension') increases with age - most rapidly over age 60. Systolic hypertension is more strongly associated with cardiovascular disease than is diastolic hypertension, and it occurs more commonly in older people. It is important to know the benefits and harms (...) of antihypertensive treatment for hypertension in this age group, as well as separately for people 60 to 79 years old and people 80 years or older.Primary objective• To quantify the effects of antihypertensive drug treatment as compared with placebo or no treatment on all-cause mortality in people 60 years and older with mild to moderate systolic or diastolic hypertensionSecondary objectives• To quantify the effects of antihypertensive drug treatment as compared with placebo or no treatment on cardiovascular
Hypertension. Recent guidelines on diagnosis and management of high blood pressure (BP) include substantial changes and several new concepts compared with previous guidelines. These are reviewed and their clinical implications are discussed in this article. The goal is to provide a practical reference to assist clinicians with up-to-date management of patients with high BP. Important issues include new diagnostic thresholds, out-of-office BP monitoring, intensified treatment goals (...) , and a different approach to resistant hypertension. Finally, differences among guidelines, the persistent controversies that have led to them, and their implications for clinical practice are discussed.
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
Guided imagery for treating hypertension in pregnancy. Hypertension (high blood pressure) in pregnancy carries a high risk of maternal morbidity and mortality. Although antihypertensive drugs are commonly used, they have adverse effects on mothers and fetuses. Guided imagery is a non-pharmacological technique that has the potential to lower blood pressure among pregnant women with hypertension. Guided imagery is a mind-body therapy that involves the visualisation of various mental images (...) to facilitate relaxation and reduction in blood pressure.To determine the effect of guided imagery as a non-pharmacological treatment of hypertension in pregnancy and its influence on perinatal outcomes.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, and two trials registers (October 2018). We also searched relevant conference proceedings and journals, and scanned the reference lists of retrieved studies.We included randomised controlled trials (RCTs). We would have included RCTs
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
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
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
The effectiveness of electronic health interventions on blood pressure control, self-care behavioural outcomes and psychosocial well-being in patients with hypertension: A systematic review and meta-analysis Hypertension is a global health issue. Electronic health (eHealth) is a potential alternative for managing hypertension and modifying hypertension-related self-care set of behaviour. This review aims to identify the delivery mode and strategies used by current eHealth interventions (...) , 95% CI: 0.57-0.84, p < .001) and their body weight (MD: -1.08 kg, 95% CI: -2.04 to -0.13, p < .05). Regarding self-care behavioural outcomes, the pooled results show that eHealth interventions significantly reduced the sodium intake.This study reported that eHealth interventions positively affect blood pressure control and thus could be a promising alternative in the management of hypertension. However, their effectiveness on self-care behavioural change and psychosocial well-being
Assessment of hypertension Assessment of hypertension - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Assessment of hypertension Last reviewed: February 2019 Last updated: February 2019 Summary Hypertension is a common disorder that affects a large proportion of the community. It is usually asymptomatic and is detected on routine examination or after the occurrence of a complication such as a heart attack or stroke (...) . Lip GY. Hypertension, platelets, and the endothelium: the "thrombotic paradox" of hypertension (or "Birmingham paradox") revisited. Hypertension. 2003 Feb;41(2):199-200. http://hyper.ahajournals.org/cgi/content/full/41/2/199 http://www.ncbi.nlm.nih.gov/pubmed/12574081?tool=bestpractice.com Hypertension has been defined in joint guidelines by American learned bodies (American College of Cardiology [ACC] and American Heart Association [AHA] among others) Whelton PK, Carey RM, Aronow WS, et al. 2017
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.
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 (...) on a topic. 3. Assess the topic against HTW selection criteria. Topic: Albumin:creatinine ratio (ACR) ) testing compared to protein:creatinine ratio (PCR) testing for the detection of proteinuria in patients with hypertension and/or chronic kidney disease Topic exploration report number TER005 Referrer: Dr Soha Zouwail, Consultant Chemical Pathologist, Cardiff and Vale University Health Board Topic exploration undertaken by: Health Technology Wales Aim of Search Health Technology Wales researchers
Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality A systematic review and meta-analysis was conducted to assess the efficacy of low-sodium salt substitutes (LSSS) as a potential intervention to reduce cardiovascular (CV) diseases.Five engines and ClinicalTrials.gov were searched from inception to May 2018. Randomised controlled trials (RCTs) enrolling adult hypertensive or general populations that compared detected hypertension, systolic blood (...) pressure (SBP), diastolic blood pressure (DBP), overall mortality, stroke and other CV risk factors in those receiving LSSS versus regular salt were included. Effects were expressed as risk ratios or mean differences (MD) and their 95% CIs. Quality of evidence assessment followed GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.21 RCTs (15 in hypertensive (n=2016), 2 in normotensive (n=163) and 4 in mixed populations (n=5224)) were evaluated. LSSS formulations were
Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period INTERIM UPDATE ACOGCOMMITTEEOPINION Number 767 (Replaces Committee Opinion Number 692, September 2017) Committee on Obstetric Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice in collaboration with committee members Yasser Y. El-Sayed, MD, and Ann E. Borders, MD, MSc, MPH. INTERIM UPDATE: This Committee Opinion (...) is updated as highlighted to align with the American College of Obstetricians and Gynecologists’ guidance on gestational hypertension, preeclampsia, and chronic hypertension in pregnancy. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period ABSTRACT: Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset
A Three-Arm Randomized Trial of Different Renal Denervation Devices and Techniques in Patients With Resistant Hypertension (RADIOSOUND-HTN) Both radiofrequency and ultrasound endovascular renal sympathetic denervation (RDN) have proven clinical efficacy for the treatment of hypertension. We performed a head-to-head comparison of these technologies.Patients with resistant hypertension were randomly assigned in a 1:1:1 manner to receive either treatment with (1) radiofrequency RDN of the main (...) ).In patients with resistant hypertension, endovascular ultrasound-based RDN was found to be superior to radiofrequency ablation of the main renal arteries only, whereas a combined approach of radiofrequency ablation of the main arteries, accessories, and side branches was not.URL: https://www.clinicaltrials.gov . Unique identifier: NCT02920034.
Phosphodiesterase 5 inhibitors for pulmonary hypertension. Pulmonary hypertension (PH) comprises a group of complex and heterogenous conditions, characterised by elevated pulmonary artery pressure, and which left untreated leads to right-heart failure and death. PH includes World Health Organisation (WHO) Group 1 pulmonary arterial hypertension (PAH); Group 2 consists of PH due to left-heart disease (PH-LHD); Group 3 comprises PH as a result of lung diseases or hypoxia, or both; Group 4 (...) includes PH due to chronic thromboembolic occlusion of pulmonary vasculature (CTEPH), and Group 5 consists of cases of PH due to unclear and/or multifactorial mechanisms including haematological, systemic, or metabolic disorders. Phosphodiesterase type 5 (PDE5) inhibitors increase vasodilation and inhibit proliferation.To determine the efficacy of PDE5 inhibitors for pulmonary hypertension in adults and children.We performed searches of CENTRAL, MEDLINE, Embase, CINAHL, and Web of Science up to 26
Lifestyle changes may be more important than drugs for mild hypertension Lifestyle changes for mild hypertension rather than drugs Discover Portal Discover Portal Lifestyle changes may be more important than drugs for mild hypertension Published on 22 January 2019 doi: Consideration of wider risk factors may be important when treating adults with low-risk mild hypertension (raised blood pressure). A large NIHR-funded UK study compared rates of mortality and risk of cardiovascular disease (...) between patients who received antihypertensive treatment and those who did not. There was an increased risk of adverse effects, like low blood pressure. It found no evidence to support starting drug treatment for adults of low-cardiovascular risk with mild hypertension. This is in line with current NICE guidelines which suggest offering lifestyle advice on several occasions before looking for pharmacological treatment in mild hypertension. There is an ongoing debate about treatment thresholds for mild
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