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Latest & greatest articles for hypertension
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% of maternal deaths, whereas in Africa and Asia they contribute to 9% of deaths. Although maternal mortality is much lower in high-income countries than in developing countries, 16% of maternal deaths can be attributed to hypertensivedisorders . In the United States, the rate of preeclampsia increased by 25% between 1987 and 2004 . Moreover, in comparison with women giving birth in 1980, those giving birth in 2003 were at 6.7-fold increased risk of severe preeclampsia . This complication is costly: one (...) Magnesium Concentration and Toxicities Table 3. Antihypertensive Agents Used for Urgent BloodPressure Control in Pregnancy ACOG Family of Sites ACOG Family of Sites American College of Obstetricians and Gynecologists 409 12th Street SW, Washington, DC 20024-2188 Copyright 2020. All rights reserved. | Please Confirm Bulk pricing was not found for item. Please try reloading page. Price Member Price
, angiotensin converting enzyme inhibitor; AHA-ACC, American Heart Association-American College of Cardiology; ARB, angiotensin receptor blocker; BP, bloodpressure; CCB, calcium channel blocker; DBP, diastolic bloodpressure; ESH, European Society of Hypertension; HBPM, home bloodpressure monitoring; SBP, systolic bloodpressure. Table 6. Bloodpressure thresholds for diagnosis of resistant hypertension Description BP threshold Diabetes Systolic BP> 130 mm Hg or diastolic BP> 80 mm Hg High cardiovascular (...) 25, 2019. After the discussions, the guidelines were further revised and ?nalized for anelectronic vote by all 81 members of the HCGC, with > 70% support required for approval of each new guideline. Guidelines for the diagnosis, assessment, prevention, and treatment of hyper- tension in adults and children are published separately. 10 Key Messages Resistant hypertension (RHT) is de?ned as bloodpressure (BP) above target despite 3 or more BP- lowering drugs at optimal doses preferably including
The Diagnosis and Management of Hypertension in the Primary Care Setting Diagnosis and Management of Hypertension (HTN) in Primary Care (2020) - VA/DoD Clinical Practice Guidelines Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through (...) the submenu options to access/activate the submenu links. Get help from Veterans Crisis Line Locator Contact Search Contact Us Locator Get help from Veterans Crisis Line Search Enter your search text Button to start search More VA More VA Inside VA Budget and Performance Inside the Media Room National Observances Special Events » » » » » Diagnosis and Management of Hypertension (HTN) in Primary Care (2020) VA/DoD Clinical Practice Guidelines Menu Menu Quick Links Enter ZIP code here Enter ZIP code here
Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term BloodPressure 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 bloodpressure 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 bloodpressure lower than 150 mm Hg, and were receiving at least 2 antihypertensive medications were
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 bloodpressure 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 bloodpressure 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 bloodpressure and the secondary efficacy endpoint was baseline-adjusted change in office systolic bloodpressure from
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
(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 highbloodpressure 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 bloodpressure 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
). 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 bloodpressure at 24 months. Follow-up at 24 months was completed for more than 90% of the participants.At baseline, the mean systolic bloodpressure 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
-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. Bloodpressure 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, bloodpressure 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
excessive weight gain and prevent gestational diabetes ( ). This systematic review assessed the effectiveness of exercise programs in preventing gestational hypertensivedisorders, defined as new onset highbloodpressure during pregnancy. There are four different types of gestational hypertensivedisorders: 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 highbloodpressure during pregnancy by 46% (17 studies) Additional analyses of a subset of 16 studies showed the following: The cesarean delivery rate
Risk of hypertension into adulthood in persons born prematurely: a national cohort study Preterm birth has been associated with elevatedbloodpressure 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
Hypertension Self-management in Socially Disadvantaged African Americans: the Achieving BloodPressure Control Together (ACT) Randomized Comparative Effectiveness Trial Effective hypertension self-management interventions are needed for socially disadvantaged African Americans, who have poorer bloodpressure (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 highhypertension 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
Association of Isolated Diastolic Hypertension as Defined by the 2017 ACC/AHA BloodPressure 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 bloodpressure (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
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 bloodpressure 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
[23,24] and death from cancer  are higher in people who used antihypertensive drugs as compared with those without the medication. The risk is particularly high in people whose systolic bloodpressure is below 120 . 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 bloodpressure 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