Latest & greatest articles for hypertension

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Top results for hypertension

1. 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)

2. 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

3. 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

4. Management of hypertension evidence map

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2020 Public Health Wales Observatory Evidence Service

5. 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

6. 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

7. 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

8. Risk of hypertension into adulthood in persons born prematurely: a national cohort study (Abstract)

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

9. 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

10. 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

11. Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers

to the coronavirus causing SARS, the COVID-19 virus binds to a specific enzyme called ACE2 to infect cells, and ACE2 levels are increased following treatment with ACE-i and ARBs. Because of the social media-related amplification, patients taking these drugs for their high blood pressure and their doctors have become increasingly concerned, and, in some cases, have stopped taking their ACE-I or ARB medications. This speculation about the safety of ACE-i or ARB treatment in relation to COVID-19 does not have (...) Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser. Did you

2020 European Society of Cardiology

12. 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

13. Impact of Moderate Aerobic Training on Physical Capacities of Hypertensive Obese Elderly. Full Text available with Trip Pro

Impact of Moderate Aerobic Training on Physical Capacities of Hypertensive Obese Elderly. The association of old age and chronic conditions, such as hypertension and obesity, can lead to larger decreases in the physical capacities of elderly, compared with their healthy counterparts. Physical exercise has been demonstrated to be efficient in postponing this phenomenon, mainly strength training. However, little is known about the effect of aerobic training on this condition. The aim of this work (...) was to investigate the impact of 12 weeks of moderate-intensity aerobic training on the physical capacities of hypertensive obese older women. Aerobic power, lower limb muscle power, upper limb muscle strength, endurance, and flexibility of 19 hypertensive obese elders were evaluated. Afterward, patients were blindly randomized into control group (CG) and exercise group (EG). EG underwent three sessions/week of 60 min of moderate-intensity aerobic training, during 12 weeks. EG showed increases in VO2max compared

2019 Gerontology & geriatric medicine Controlled trial quality: uncertain

14. Updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension Full Text available with Trip Pro

S8 online), or cardiomyopathy with elevated left ventricular end-diastolic filling pressures. AVT, acute vasoreactivity testing; ASD, atrial septal defect; CHD, congenital heart disease; iNO, inhaled nitric oxide; PAH, pulmonary arterial hypertension; PDA, patent ductus arteriosus; PH, pulmonary hypertension; PHVD, pulmonary hypertensive vascular disease; pre-OP, preoperatively; PVR, pulmonary vascular resistance; PVRi, pulmonary vascular resistance index; Qp, pulmonary blood flow; Qs, systemic (...) : , , , , , , , , Pulmonary hypertension (PH) and associated pulmonary vascular disease (PVD) are characterized by pulmonary vascular remodeling leading to elevated pulmonary arterial pressure and, over time, right ventricular (RV) dysfunction, underfilling/compression of the left ventricle, and terminal heart failure. x 1 Humbert, M, Guignabert, C, Bonnet, S et al. Pathology and pathobiology of pulmonary hypertension: State of the art and research perspectives. Eur Respir J . 2019 ; 53 , x 2 Vonk Noordegraaf, A, Chin

2019 International Society for Heart and Lung Transplantation

15. Cardiopulmonary exercise testing in a combined screening approach to individuate pulmonary arterial hypertension in systemic sclerosis Full Text available with Trip Pro

Cardiopulmonary exercise testing in a combined screening approach to individuate pulmonary arterial hypertension in systemic sclerosis The DETECT algorithm has been developed to identify SSc patients at risk for pulmonary arterial hypertension (PAH) yielding high sensitivity but low specificity, and positive predictive value. We tested whether cardiopulmonary exercise testing (CPET) could improve the performance of the DETECT screening strategy.Consecutive SSc patients over a 30-month period (...) were screened with the DETECT algorithm and positive subjects were referred for CPET before the execution of right-heart catheterization. The predictive performance of CPET on top of DETECT was evaluated and internally validated via bootstrap replicates.Out of 314 patients, 96 satisfied the DETECT application criteria and 54 were positive. PAH was ascertained in 17 (31.5%) and pre-capillary pulmonary hypertension in 23 (42.6%) patients. Within CPET variables, the slope of the minute ventilation

2019 EvidenceUpdates

16. Hydrochlorothiazide and Squamous Cell Skin Cancer: Remember when hypertension was easy?

Hydrochlorothiazide and Squamous Cell Skin Cancer: Remember when hypertension was easy? 1 Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care (...) research. www.acfp.ca November 25, 2019 (en français) Hydrochlorothiazide and Squamous Cell Skin Cancer: Remember when hypertension was easy? Clinical Question: Does hydrochlorothiazide increase the risk of squamous cell carcinoma (SCC) of the skin? Bottom Line: Observational data suggest an association between hydrochlorothiazide and the risk of SCC. Causation has not been proven. Risk appears to consistently increase with dose and duration (example: 5 years of use increases risk 3-4 times). Baseline

2019 Tools for Practice

17. 2019 AHA/ACC Clinical Performance and Quality Measures for Adults With High Blood Pressure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures Full Text available with Trip Pro

health insurers. In particular, the widespread use of the 2017 Hypertension Clinical Practice Guidelines classification scheme will also help to guide decision-making about when to prescribe antihypertensive medications in accordance with its current recommendations for the ACC/AHA stages of HBP (ie, stage 2, stage 1, and elevated blood pressure [BP]), as outlined in . Table 3. Guideline Recommendation for BP-Lowering Medications: ACC/AHA COR/LOE ASCVD Risk Stage 2 High BP (≥140 mm Hg) Stage 1 High (...) about intensity of BP lowering and choice of antihypertensive drugs (COR: 2a, LOE: C-EO). ACC indicates American College of Cardiology; AHA, American Heart Association; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; COR, Class of Recommendation; and LOE, Level of Evidence. In the 2017 Hypertension Clinical Practice Guidelines, the authors emphasized the critical importance of measuring atherosclerotic cardiovascular disease (ASCVD) risk for all patients with HBP, regardless

2019 American Heart Association

18. Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report

Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report Therapy for Pulmonary Arterial Hypertension in Adults - CHEST Follow CHEST: Email/Username: Password: Remember me Search Terms Search within Search Share this page Volume 155, Issue 3, Pages 565–586 To read this article in full, please review your options for gaining access at the bottom of the page. Therapy for Pulmonary Arterial Hypertension in Adults Update of the CHEST Guideline (...) . In these situations, other factors, such as patient preferences & values, cost, and insurance coverage, may guide decision-making. CCB = calcium channel blocker; 6MWD = 6-min walk distance; FC = functional class; PAH = pulmonary arterial hypertension; PH = pulmonary hypertension; RV = right ventricular; WHO = World Health Organization. Figure 1 Guideline algorithm for pharmacologic therapy for PAH in adults. Where multiple drug options are provided, there is no comparative effectiveness data to suggest greater

2019 American College of Chest Physicians

19. In patients taking a beta blocker for uncomplicated hypertension, what is the best way to taper it off?

therapy, there is an upregulation of receptors, which can lead to an adrenergic surge if BBs are abruptly stopped. This is particularly seen with short-acting BBs. So, how do we prevent an adrenergic surge and appropriately taper? We don’t really know, as there haven’t been many studies. One study from back in 1982 compared a propranolol taper over 6 to 9 days versus over 2 weeks and found no difference in blood pressure. Beta-adrenergic receptors have half-lives of 1.5 days, so tapering with halved (...) In patients taking a beta blocker for uncomplicated hypertension, what is the best way to taper it off? Chiefs’ Inquiry Corner 11/4/19 – Clinical Correlations Search Chiefs’ Inquiry Corner 11/4/19 November 4, 2019 2 min read Beta blockers (BBs) have fallen out of favor as first-line, or even second-line, treatment options for hypertension. And as patients’ medical regimens gradually drop BBs, concerns may arise about the rebound phenomenon we learn in medical school. With chronic beta blocker

2019 Clinical Correlations

20. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial Full Text available with Trip Pro

) to ingest the entire daily dose of ≥1 hypertension medications at bedtime (n = 9552) or all of them upon awakening (n = 9532). At inclusion and at every scheduled clinic visit (at least annually) throughout follow-up, ambulatory blood pressure (ABP) monitoring was performed for 48 h. During the 6.3-year median patient follow-up, 1752 participants experienced the primary CVD outcome (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke). Patients of the bedtime, compared (...) with the upon-waking, treatment-time regimen showed significantly lower hazard ratio-adjusted for significant influential characteristics of age, sex, type 2 diabetes, chronic kidney disease, smoking, HDL cholesterol, asleep systolic blood pressure (BP) mean, sleep-time relative systolic BP decline, and previous CVD event-of the primary CVD outcome [0.55 (95% CI 0.50-0.61), P < 0.001] and each of its single components (P < 0.001 in all cases), i.e. CVD death [0.44 (0.34-0.56)], myocardial infarction [0.66

2019 EvidenceUpdates