39,911 results
Search Results
2. Comparing urine point-of-care tests to screen preeclampsia: Congo-red dot paper test versus dipstick urinalysis.
- Author
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Wang L, Gao J, Tang P, Hu H, Chen X, Chen Z, and Sun Y
- Subjects
- Pregnancy, Humans, Female, Congo, Urinalysis, ROC Curve, Sensitivity and Specificity, Pre-Eclampsia diagnosis, Hypertension
- Abstract
To compare the urine Congo-red dot paper test (CRD) with dipstick urinalysis to screen preeclampsia (PE). A total of 409 paired spot urine samples were obtained prospectively from women with suspected pre-eclampsia attending for routine hospital visits. Congo-red dot paper test and dipstick urinalysis were examined and compared to screen pre-eclampsia. The agreement between the two urinary test is modest (kappa coefficient = 0.28, 95% CI 0.14-0.42). The specificity of CRD was higher than urinalysis (97.4% vs. 90.4%, p < .001). Urinalysis performed better in sensitivity (77.3% vs. 40.9%, p = .04) and the area under the receiver operating characteristic curves (AUC) (0.84 [95% CI 0.74-0.94] vs. 0.69 [95% CI 0.55-0.83], p = .04) than CRD, respectively. The sensitivity, specificity, AUC of the parallel test of them is 86.4% (64.0%-96.4%), 89.1% (85.5%-92.0%), and 0.88 (95% CI 0.79-0.96). And the serial test is 31.8% (14.7%-54.9%), 98.7% (96.8%-99.5%), 0.65 (95% CI 0.51-0.79), accordingly. The urinalysis is a better diagnosing test for preeclampsia. CRD could aid in the diagnosis of patients with preeclampsia. Combined the two tests in suspected patients may further improve the performance in the diagnosis of preeclampsia. Further study need to be made for its potential clinical practice., (© 2024 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)
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- 2024
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3. Milestone Papers on Signal Transduction Mechanisms of Hypertension and Its Complications.
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Eguchi S, Torimoto K, Adebiyi A, Kanthakumar P, Bomfim GF, Wenceslau CF, Dahlen SA, and Osei-Owusu P
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- Humans, Signal Transduction, Blood Pressure, Renin-Angiotensin System physiology, Angiotensin II metabolism, Hypertension, Cardiovascular System
- Abstract
To celebrate 100 years of American Heart Association-supported cardiovascular disease research, this review article highlights milestone papers that have significantly contributed to the current understanding of the signaling mechanisms driving hypertension and associated cardiovascular disorders. This article also includes a few of the future research directions arising from these critical findings. To accomplish this important mission, 4 principal investigators gathered their efforts to cover distinct yet intricately related areas of signaling mechanisms pertaining to the pathogenesis of hypertension. The renin-angiotensin system, canonical and novel contractile and vasodilatory pathways in the resistance vasculature, vascular smooth muscle regulation by membrane channels, and noncanonical regulation of blood pressure and vascular function will be described and discussed as major subjects., Competing Interests: Disclosures None.
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- 2024
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4. Add-On Digital Cartoon Video versus Paper Based Counselling for Medication Adherence in Hypertensive Patients Followed at a Referral Hospital in Yaoundé (Cameroon): A Randomized Control Trial (e-Adherence Study)
- Author
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Rudy Arnaud Nana, Serge Clotaire Billong, Jérôme Boombhi, Francky Teddy Endomba, Hilaire Djantio, and Alain Menanga
- Abstract
Treatment adherence is one of the milestones in the care of hypertensive patients, with new information and communication technologies as potential educational tools. This study aimed to evaluate the add-on effect of a digital cartoon educative video on the therapeutic observance of patients followed up in the General Hospital Yaoundé compared to standard of care. We conducted a randomized simple blind clinical trial at the cardiology unit of the Yaoundé General Hospital over a 6-month period from 1st March to 30th August 2022. We enrolled 110 patients and randomized them in blocs of 4 creating two groups of 57 and 53, respectively, without (group 1) and with (group 2) intervention. Preintervention treatment adherence was assessed using the Morisky Medication Adherence Scale (MMAS). In the standard group (G1), we provided standard paper-based clinical counselling, including oral advice, and in the intervention group (G2), we did the same and added a digital cartoon video containing exactly the same message as images and audio. The primary outcome was medication adherence after three months. The mean age was 56.65 ± 10.98 years in group 1 (paper) and 56.42 ± 10.46 years in group 2 (paper + video), without any significant difference. The two groups were similar regarding the proportion of females (36.8% in G1 and 49.3% in G2) and educational levels. According to the Morisky medication adherence scale, before the intervention, the proportions of patients with good, medium and low treatment adherence in groups 1 and 2 were 7%, 25.6%, 67.4%, and 5.1%, 43.6%, 51.3%, respectively, without any significant difference. After interventions, the proportion of patients presenting a good observance moved from 7 to 11% in group 1 (paper) and 5.1 to 20% in group 2 (paper + video). The intragroup variation in treatment adherence in the intervention group (before-after) tended to be significant, with a p-value = 0.0572, while this p-value was 0.712 in the standard group. Our results provide insight into how digital cartoon videos can help to have an add-on effect on the treatment adherence of hypertensive patients, with clinical significance.
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- 2024
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5. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension.
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Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M, Patil M, Schultz MG, Wallen MP, Renna NF, Islam SMS, Hiremath S, Gyeltshen T, Chia YC, Gupta A, Schutte AE, Klein B, Borghi C, Browning CJ, Czesnikiewicz-Guzik M, Lee HY, Itoh H, Miura K, Brunström M, Campbell NRC, Akinnibossun OA, Veerabhadrappa P, Wainford RD, Kruger R, Thomas SA, Komori T, Ralapanawa U, Cornelissen VA, Kapil V, Li Y, Zhang Y, Jafar TH, Khan N, Williams B, Stergiou G, and Tomaszewski M
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- Humans, Life Style, Blood Pressure, Hypertension prevention & control, Hypertension complications, Cardiovascular Diseases etiology, Heart Failure complications
- Abstract
Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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6. Telemedicine and Digital Medicine in the Clinical Management of Hypertension and Hypertension-Related Cardiovascular Diseases: A Position Paper of the Italian Society of Arterial Hypertension (SIIA).
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Minuz P, Albini FL, Imbalzano E, Izzo R, Masi S, Pengo MF, Pucci G, Scalise F, Salvetti M, Tocci G, Cicero A, Iaccarino G, Savoia C, Sechi L, Parati G, Borghi C, Volpe M, Ferri C, Grassi G, and Muiesan ML
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- Humans, Risk Factors, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Hypertension diagnosis, Hypertension drug therapy, Hypertension epidemiology, Telemedicine, Heart Diseases
- Abstract
High blood pressure is the leading cause of death and disability globally and an important treatable risk factor for cardiovascular, cerebrovascular and chronic kidney diseases. Digital technology, including mobile health solutions and digital therapy, is expanding rapidly in clinical medicine and has the potential to improve the quality of care and effectiveness of drug treatment by making medical interventions timely, tailored to hypertensive patients' needs and by improving treatment adherence. Thus, the systematic application of digital technologies could support diagnosis and awareness of hypertension and its complications, ultimately leading to improved BP control at the population level. The progressive implementation of digital medicine in the national health systems must be accompanied by the supervision and guidance of health authorities and scientific societies to ensure the correct use of these new technologies with consequent maximization of the potential benefits. The role of scientific societies in relation to the rapid adoption of digital technologies, therefore, should encompass the entire spectrum of activities pertaining to their institutional role: information, training, promotion of research, scientific collaboration and advice, evaluation and validation of technological tools, and collaboration with regulatory and health authorities., (© 2023. The Author(s).)
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- 2023
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7. Blood pressure variability: methodological aspects, clinical relevance and practical indications for management - a European Society of Hypertension position paper ∗.
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Parati G, Bilo G, Kollias A, Pengo M, Ochoa JE, Castiglioni P, Stergiou GS, Mancia G, Asayama K, Asmar R, Avolio A, Caiani EG, De La Sierra A, Dolan E, Grillo A, Guzik P, Hoshide S, Head GA, Imai Y, Juhanoja E, Kahan T, Kario K, Kotsis V, Kreutz R, Kyriakoulis KG, Li Y, Manios E, Mihailidou AS, Modesti PA, Omboni S, Palatini P, Persu A, Protogerou AD, Saladini F, Salvi P, Sarafidis P, Torlasco C, Veglio F, Vlachopoulos C, and Zhang Y
- Subjects
- Humans, Blood Pressure, Clinical Relevance, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory, Hypertension diagnosis, Hypertension drug therapy, Hypertension complications, Coronary Artery Disease complications
- Abstract
Blood pressure is not a static parameter, but rather undergoes continuous fluctuations over time, as a result of the interaction between environmental and behavioural factors on one side and intrinsic cardiovascular regulatory mechanisms on the other side. Increased blood pressure variability (BPV) may indicate an impaired cardiovascular regulation and may represent a cardiovascular risk factor itself, having been associated with increased all-cause and cardiovascular mortality, stroke, coronary artery disease, heart failure, end-stage renal disease, and dementia incidence. Nonetheless, BPV was considered only a research issue in previous hypertension management guidelines, because the available evidence on its clinical relevance presents several gaps and is based on heterogeneous studies with limited standardization of methods for BPV assessment. The aim of this position paper, with contributions from members of the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability and from a number of international experts, is to summarize the available evidence in the field of BPV assessment methodology and clinical applications and to provide practical indications on how to measure and interpret BPV in research and clinical settings based on currently available data. Pending issues and clinical and methodological recommendations supported by available evidence are also reported. The information provided by this paper should contribute to a better standardization of future studies on BPV, but should also provide clinicians with some indications on how BPV can be managed based on currently available data., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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8. Digitization of Symbol-Denoted Blood Pressure Data From Intraoperative Paper Health Records in a Low-Middle-Income Country Using Deep Image Segmentation and Associated Postoperative Outcomes: A Feasibility Study.
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Ndaribitse C, Durieux ME, Adorno W, Brown DE, Tsang S, and Naik BI
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- Humans, Blood Pressure physiology, Feasibility Studies, Regression Analysis, Hypertension diagnosis
- Abstract
Background: In low-middle-income countries (LMICs), perioperative clinical information is almost universally collected on paper health records (PHRs). The lack of accessible digital databases limits LMICs in leveraging data to predict and improve patient outcomes after surgery. In this feasibility study, our aims were to: (1) determine the detection performance and prediction error of the U-Net deep image segmentation approach for digitization of hand-drawn blood pressure symbols from an image of the intraoperative PHRs and (2) evaluate the association between deep image segmentation-derived blood pressure parameters and postoperative mortality and length of stay., Methods: A smartphone mHealth platform developed by our team was used to capture images of completed intraoperative PHRs. A 2-stage deep image segmentation modeling approach was used to create 2 separate segmentation masks for systolic blood pressure (SBP) and diastolic blood pressure (DBP). Iterative postprocessing was utilized to convert the segmentation mask results into numerical SBP and DBP values. Detection performance and prediction errors were evaluated for the U-Net models by comparison with ground-truth values. Using multivariate regression analysis, we investigated the association of deep image segmentation-derived blood pressure values, total time spent in predefined blood pressure ranges, and postoperative outcomes including in-hospital mortality and length of stay., Results: A total of 350 intraoperative PHRs were imaged following surgery. Overall accuracy was 0.839 and 0.911 for SBP and DBP symbol detections, respectively. The mean error rate and standard deviation for the difference between the actual and predicted blood pressure values were 2.1 ± 4.9 and -0.8 ± 3.9 mm Hg for SBP and DBP, respectively. Using the U-Net model-derived blood pressures, minutes of time where DBP <50 mm Hg (odds ratio [OR], 1.03; CI, 1.01-1.05; P = .003) was associated with an increased in-hospital mortality. In addition, increased cumulative minutes of time with SBP between 80 and 90 mm Hg was significantly associated with a longer length of stay (incidence rate ratio, 1.02 [1.0-1.03]; P < .05), while increased cumulative minutes of time where SBP between 140 and 160 mm Hg was associated with a shorter length of stay (incidence rate ratio, 0.9 [0.96-0.99]; P < .05)., Conclusions: In this study, we report our experience with a deep image segmentation model for digitization of symbol-denoted blood pressure from intraoperative anesthesia PHRs. Our data support further development of this novel approach to digitize PHRs from LMICs, to provide accessible, curated, and reproducible data for both quality improvement- and outcome-based research., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 International Anesthesia Research Society.)
- Published
- 2023
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9. STRUGGLE FOR. Italian-Polish-Spanish-Uzbek-Vietnamese Expert Forum Position Paper 2023 for better control of classical modifiable risk factors in clinical practice.
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Filipiak KJ, Barrios V, Ferri C, Fozilov K, Freire Castro SJ, Kuzior A, Martinez-Martin FJ, Mullabaeva G, Nguyen LH, Nizamov U, Tomaszuk-Kazberuk A, Trigulova R, and Gąsecka A
- Subjects
- Humans, Poland, Vietnam, Antihypertensive Agents therapeutic use, Antihypertensive Agents adverse effects, Risk Factors, Lipids, Hypertension diagnosis, Hypertension drug therapy, Hypertension epidemiology, Diabetes Mellitus drug therapy, Diabetes Mellitus epidemiology
- Abstract
The progress in pharmacotherapy that has been made in recent years, including the introduction of very effective and safe lipid-lowering and antihypertensive drugs, has not yet translated into the expected universal control of blood pressure, lipid disorders and diabetes. In the STRUGGLE FOR Italian- -Polish-Spanish-Uzbek-Vietnamese Expert Forum Position Paper 2023, experts from five countries recounted several points about the paradigms of cardiological and cardiometabolic care for better control of classical modifiable risk factors in the year 2023. It is believed herein, that the need to intensify treatment, actively search for patients with cardiovascular risk factors, especially with arterial hypertension, hypercholesterolemia and diabetes, should go hand in hand with the implementation of the latest therapy, based on single pill combinations including proven, effective antihypertensive, lipid-lowering and antidiabetic molecules, many of which are listed in the present document. There is a need to use both new technological concepts, completely new drugs, as well as novel treatment concepts such as metabolic treatment in coronary artery disease, try to intensify the fight against smoking in every way, including the available range of drugs and procedures reducing the harm. This approach will provide substantially better control of the underlying cardiovascular risk factors in countries as varied as Italy, Poland, Spain, Uzbekistan and Vietnam.
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- 2023
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10. Virtual management of hypertension: lessons from the COVID-19 pandemic-International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension.
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Khan NA, Stergiou GS, Omboni S, Kario K, Renna N, Chapman N, McManus RJ, Williams B, Parati G, Konradi A, Islam SM, Itoh H, Mooi CS, Green BB, Cho MC, and Tomaszewski M
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- Adult, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Humans, Pandemics, COVID-19, Hypertension diagnosis, Hypertension drug therapy, Hypertension epidemiology
- Abstract
The coronavirus disease 2019 pandemic caused an unprecedented shift from in person care to delivering healthcare remotely. To limit infectious spread, patients and providers rapidly adopted distant evaluation with online or telephone-based diagnosis and management of hypertension. It is likely that virtual care of chronic diseases including hypertension will continue in some form into the future. The purpose of the International Society of Hypertension's (ISH) position paper is to provide practical guidance on the virtual management of hypertension to improve its diagnosis and blood pressure control based on the currently available evidence and international experts' opinion for nonpregnant adults. Virtual care represents the provision of healthcare services at a distance with communication conducted between healthcare providers, healthcare users and their circle of care. This statement provides consensus guidance on: selecting blood pressure monitoring devices, accurate home blood pressure assessments, delivering patient education virtually, health behavior modification, medication adjustment and long-term virtual monitoring. We further provide recommendations on modalities for the virtual assessment and management of hypertension across the spectrum of resource availability and patient ability., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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11. Bedtime dosing of antihypertensive medications: systematic review and consensus statement: International Society of Hypertension position paper endorsed by World Hypertension League and European Society of Hypertension.
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Stergiou G, Brunström M, MacDonald T, Kyriakoulis KG, Bursztyn M, Khan N, Bakris G, Kollias A, Menti A, Muntner P, Orias M, Poulter N, Shimbo D, Williams B, Adeoye AM, Damasceno A, Korostovtseva L, Li Y, Muxfeldt E, Zhang Y, Mancia G, Kreutz R, and Tomaszewski M
- Subjects
- Blood Pressure, Blood Pressure Monitoring, Ambulatory, Circadian Rhythm, Humans, Prospective Studies, Antihypertensive Agents pharmacology, Hypertension drug therapy
- Abstract
Antihypertensive drug therapy is one of the most efficient medical interventions for preventing disability and death globally. Most of the evidence supporting its benefits has been derived from outcome trials with morning dosing of medications. Accumulating evidence suggests an adverse prognosis associated with night-time hypertension, nondipping blood pressure (BP) profile and morning BP surge, with increased incidence of cardiovascular events during the first few morning hours. These observations provide justification for complete 24-h BP control as being the primary goal of antihypertensive treatment. Bedtime administration of antihypertensive drugs has also been proposed as a potentially more effective treatment strategy than morning administration. This Position Paper by the International Society of Hypertension reviewed the published evidence on the clinical relevance of the diurnal variation in BP and the timing of antihypertensive drug treatment, aiming to provide consensus recommendations for clinical practice. Eight published outcome hypertension studies involved bedtime dosing of antihypertensive drugs, and all had major methodological and/or other flaws and a high risk of bias in testing the impact of bedtime compared to morning treatment. Three ongoing, well designed, prospective, randomized controlled outcome trials are expected to provide high-quality data on the efficacy and safety of evening or bedtime versus morning drug dosing. Until that information is available, preferred use of bedtime drug dosing of antihypertensive drugs should not be routinely recommended in clinical practice. Complete 24-h control of BP should be targeted using readily available, long-acting antihypertensive medications as monotherapy or combinations administered in a single morning dose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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12. Inconsistencies in the sensitivity and specificity values in an Review Paper published in the Journal of Clinical Hypertension.
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Ortiz MS
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- Humans, Publications, Sensitivity and Specificity, Hypertension diagnosis
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- 2022
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13. TIMES TO ACT. Italian-Spanish-Polish-Uzbek Expert Forum Position Paper 2022. Dyslipidemia and arterial hypertension: The two most important and modifiable risk factors in clinical practice.
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Filipiak KJ, Babkowski MC, Cameli M, Carugo S, Ferri C, Irisov DB, Narkiewicz K, Nizamov U, Pérez de Isla L, Tomaszuk-Kazberuk A, Ungar A, and Gąsecka A
- Subjects
- Antihypertensive Agents therapeutic use, Humans, Lipids, Lipoproteins, Poland, Proprotein Convertase 9, Risk Factors, COVID-19, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, Dyslipidemias diagnosis, Dyslipidemias drug therapy, Dyslipidemias epidemiology, Hypertension diagnosis, Hypertension drug therapy, Hypertension epidemiology
- Abstract
Hypertension and lipid disorders are two of the main cardiovascular risk factors. Both risk factors - if detected early enough - can be controlled and treated with modern, effective drugs, devoid of significant side effects, available in four countries as different as Italy, Spain, Poland, and Uzbekistan. The aim herein, was to develop this TIMES TO ACT consensus to raise the awareness of the available options of the modern and intensified dyslipidemia and arterial hypertension treatments. The subsequent paragraphs involves consensus and discussion of the deleterious effects of COVID-19 in the cardiovascular field, the high prevalence of hypertension and lipid disorders in our countries and the most important reasons for poor control of these two factors. Subsequently proposed, are currently the most efficient and safe therapeutic options in treating dyslipidemia and arterial hypertension, focusing on the benefits of single-pill combination (SPCs) in both conditions. An accelerated algorithm is proposed to start the treatment with a PCSK9 inhibitor, if the target low-density-lipoprotein values have not been reached. As most patients with hypertension and lipid disorders present with multiple comorbidities, discussed are the possibilities of using new SPCs, combining modern drugs from different therapeutic groups, which mode of action does not confirm the "class effect". We believe our consensus strongly advocates the need to search for patients with cardiovascular risk factors and intensify their lipid-lowering and antihypertensive treatment based on SPCs will improve the control of these two basic cardiovascular risk factors in Italy, Spain, Poland and Uzbekistan.
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- 2022
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14. Interpretation of the Position Paper on Telemedicine and Digital Medicine in the Clinical Management of Hypertension and Hypertension-related Cardiovascular Diseases by the Italian Society of Arterial Hypertension (SIIA) in 2023
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YANG Rong, YANG Ziyu, LIAO Xiaoyang, LIU Lidi, ZHANG Peng, TIAN Chenyu, YANG Hanfei, YAO Yi, JIA Yu, CHENG Yonglang, SHEN Can, JIANG Lihua, DAI Hua
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hypertension ,remote healthcare ,digital medicine ,italian society of arterial hypertension ,interpretation ,Medicine - Abstract
High prevalence and low control rate of hypertension have brought a significant disease burden globally. In order to improve the level of hypertension prevention and treatment, remote healthcare and digital medicine have been rapidly developed and widely used worldwide. Currently, there are no relevant regulations in China for these technologies. In 2023, the Italian Society of Arterial Hypertension issued a position statement to guide the development, validation, and clinical use of remote medicine and digital healthcare. This article will interpret this position paper, focusing on the forms of application of telemedicine and digital healthcare in managing hypertension and its related cardiovascular diseases, key research evidence, existing advantages, as well as current opportunities and challenges. The aim is to guide general practitioners in China on how to utilize these technologies in managing hypertension and related cardiovascular conditions.
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- 2024
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15. Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension.
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Parati G, Stergiou GS, Bilo G, Kollias A, Pengo M, Ochoa JE, Agarwal R, Asayama K, Asmar R, Burnier M, De La Sierra A, Giannattasio C, Gosse P, Head G, Hoshide S, Imai Y, Kario K, Li Y, Manios E, Mant J, McManus RJ, Mengden T, Mihailidou AS, Muntner P, Myers M, Niiranen T, Ntineri A, O'Brien E, Octavio JA, Ohkubo T, Omboni S, Padfield P, Palatini P, Pellegrini D, Postel-Vinay N, Ramirez AJ, Sharman JE, Shennan A, Silva E, Topouchian J, Torlasco C, Wang JG, Weber MA, Whelton PK, White WB, and Mancia G
- Subjects
- Blood Pressure, Blood Pressure Determination, Humans, Societies, Medical, Blood Pressure Monitoring, Ambulatory, Hypertension diagnosis
- Abstract
The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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16. Hypertension and heart failure with preserved ejection fraction: position paper by the European Society of Hypertension.
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Kasiakogias A, Rosei EA, Camafort M, Ehret G, Faconti L, Ferreira JP, Brguljan J, Januszewicz A, Kahan T, Manolis A, Tsioufis K, Weber T, von Lueder TG, Smiseth OA, Wachtell K, Kjeldsen SE, Zannad F, Mancia G, and Kreutz R
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- Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors, Humans, Stroke Volume, Heart Failure drug therapy, Hypertension drug therapy
- Abstract
Hypertension constitutes a major risk factor for heart failure with preserved ejection fraction (HFpEF). HFpEF is a prevalent clinical syndrome with increased cardiovascular morbidity and mortality. Specific guideline-directed medical therapy (GDMT) for HFpEF is not established due to lack of positive outcome data from randomized controlled trials (RCTs) and limitations of available studies. Although available evidence is limited, control of blood pressure (BP) is widely regarded as central to the prevention and clinical care in HFpEF. Thus, in current guidelines including the 2018 European Society of Cardiology (ESC) and European Society of Hypertension (ESH) Guidelines, blockade of the renin-angiotensin system (RAS) with either angiotensin-converting enzyme inhibitors or angiotensin receptor blockers provides the backbone of BP-lowering therapy in hypertensive patients. Although superiority of RAS blockers has not been clearly shown in dedicated RCTs designed for HFpEF, we propose that this core drug treatment strategy is also applicable for hypertensive patients with HFpEF with the addition of some modifications. The latter apply to the use of spironolactone apart from the treatment of resistant hypertension and the use of the angiotensin receptor neprilysin inhibitor. In addition, novel agents such as sodium-glucose co-transporter-2 inhibitors, currently already indicated for high-risk patients with diabetes to reduce heart failure hospitalizations, and finerenone represent promising therapies and results from ongoing RCTs are eagerly awaited. The development of an effective and practical classification of HFpEF phenotypes and GDMT through dedicated high-quality RCTs are major unmet needs in hypertension research and calls for action., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2021
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17. Reply to "Letter to the Editor for the Review Paper: The association between blood pressure variability with dementia and cognitive function: A systematic review and meta-analysis".
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Chiu TJ, Yeh JT, and Cheng HM
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- Blood Pressure, Cognition, Humans, Dementia, Hypertension diagnosis, Hypertension epidemiology
- Published
- 2021
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18. European Society of Hypertension position paper on renal denervation 2021.
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Schmieder RE, Mahfoud F, Mancia G, Azizi M, Böhm M, Dimitriadis K, Kario K, Kroon AA, D Lobo M, Ott C, Pathak A, Persu A, Scalise F, Schlaich M, Kreutz R, and Tsioufis C
- Subjects
- Antihypertensive Agents pharmacology, Antihypertensive Agents therapeutic use, Blood Pressure, Denervation, Humans, Kidney, Treatment Outcome, Hypertension drug therapy, Hypertension surgery, Sympathectomy
- Abstract
This ESH Position Paper 2021 with updated proposed recommendations was deemed necessary after the publication of a set of new pivotal sham-controlled randomized clinical trials (RCTs), which provided important information about the efficacy and safety of endovascular device-based renal denervation (RDN) for hypertension treatment. RDN is effective in reducing or interrupting the sympathetic signals to the kidneys and decreasing whole body sympathetic activity. Five independent, fully completed, sham-controlled RCTs provide conclusive evidence that RDN lowers ambulatory and office blood pressure (BP) to a significantly greater extent than sham treatment. BP-lowering efficacy is evident both in patients with and without concomitant antihypertensive medication. The average decrease of 10 mmHg in office BP is estimated to lower the incidence of cardiovascular events by 25-30%, based on meta-analyses of RCTs using pharmacological treatment. Neither peri-procedural, nor short-term or long-term adverse events or safety signals (available up to 3 years) have been observed. Implementing RDN as an innovative third option in the armamentarium of antihypertensive treatment requires a structured process that ensures the appropriate performance of the endovascular RDN procedure and adequate selection of hypertensive patients. The latter should also incorporate patients' perspective and preference that needs to be respected in a shared decision-making process., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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19. Cardiovascular risk management in type 2 diabetes mellitus: A joint position paper of the Italian Cardiology (SIC) and Italian Diabetes (SID) Societies.
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Avogaro A, Barillà F, Cavalot F, Consoli A, Federici M, Mancone M, Paolillo S, Pedrinelli R, Perseghin G, Perrone Filardi P, Scicali R, Sinagra G, Spaccarotella C, Indolfi C, and Purrello F
- Subjects
- Antihypertensive Agents adverse effects, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases physiopathology, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 physiopathology, Dyslipidemias diagnosis, Dyslipidemias epidemiology, Dyslipidemias physiopathology, Heart Disease Risk Factors, Humans, Hypertension diagnosis, Hypertension epidemiology, Hypertension physiopathology, Hypoglycemic Agents adverse effects, Hypolipidemic Agents adverse effects, Platelet Aggregation Inhibitors therapeutic use, Prevalence, Risk Assessment, Treatment Outcome, Antihypertensive Agents therapeutic use, Cardiovascular Diseases prevention & control, Diabetes Mellitus, Type 2 drug therapy, Dyslipidemias drug therapy, Hypertension drug therapy, Hypoglycemic Agents therapeutic use, Hypolipidemic Agents therapeutic use
- Abstract
Aim: This review represents a joint effort of the Italian Societies of Cardiology (SIC) and Diabetes (SID) to define the state of the art in a field of great clinical and scientific interest which is experiencing a moment of major cultural advancements, the cardiovascular risk management in type 2 diabetes mellitus., Data Synthesis: Consists of six chapters that examine various aspects of pathophysiology, diagnosis and therapy which in recent months have seen numerous scientific innovations and several clinical studies that require extensive sharing., Conclusions: The continuous evolution of our knowledge in this field confirms the great cultural vitality of these two cultural spheres, which requires, under the leadership of the scientific Societies, an ever greater and effective collaboration., Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
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- 2021
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20. Impact of Hypertension on Left Ventricular Pressure-Strain Loop Characteristics and Myocardial Work
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Creamer, Stephen A., Zhao, Debbie, Quill, Gina M., Hasaballa, Abdallah I., Wang, Vicky Y., Gamage, Thiranja P. Babarenda, Edwards, Nicola C., Legget, Malcolm E., Lowe, Boris S., Doughty, Robert N., Arri, Satpal, Ruygrok, Peter N., Young, Alistair A., Paton, Julian F. R., Talou, Gonzalo D. Maso, Nash, Martyn P., Goos, Gerhard, Founding Editor, Hartmanis, Juris, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Camara, Oscar, editor, Puyol-Antón, Esther, editor, Sermesant, Maxime, editor, Suinesiaputra, Avan, editor, Tao, Qian, editor, Wang, Chengyan, editor, and Young, Alistair, editor
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- 2024
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21. Aldosterone, gut microbiome and hypertension: selected papers from APCH 2019.
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Stowasser M
- Subjects
- Aldosterone, Humans, Gastrointestinal Microbiome, Hypertension
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- 2021
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22. Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper.
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Omboni S, McManus RJ, Bosworth HB, Chappell LC, Green BB, Kario K, Logan AG, Magid DJ, Mckinstry B, Margolis KL, Parati G, and Wakefield BJ
- Subjects
- Blood Pressure Determination methods, COVID-19, Coronavirus Infections epidemiology, Disease Management, Evidence-Based Medicine, Female, Humans, Hypertension diagnosis, Italy, Male, Occupational Health, Pandemics statistics & numerical data, Patient Safety, Pneumonia, Viral epidemiology, Severity of Illness Index, Coronavirus Infections prevention & control, Cross Infection prevention & control, Hypertension drug therapy, Pandemics prevention & control, Pneumonia, Viral prevention & control, Telemedicine statistics & numerical data
- Abstract
Telemedicine allows the remote exchange of medical data between patients and healthcare professionals. It is used to increase patients' access to care and provide effective healthcare services at a distance. During the recent coronavirus disease 2019 (COVID-19) pandemic, telemedicine has thrived and emerged worldwide as an indispensable resource to improve the management of isolated patients due to lockdown or shielding, including those with hypertension. The best proposed healthcare model for telemedicine in hypertension management should include remote monitoring and transmission of vital signs (notably blood pressure) and medication adherence plus education on lifestyle and risk factors, with video consultation as an option. The use of mixed automated feedback services with supervision of a multidisciplinary clinical team (physician, nurse, or pharmacist) is the ideal approach. The indications include screening for suspected hypertension, management of older adults, medically underserved people, high-risk hypertensive patients, patients with multiple diseases, and those isolated due to pandemics or national emergencies.
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- 2020
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23. Mechanisms of Vascular Inflammation and Potential Therapeutic Targets: A Position Paper From the ESH Working Group on Small Arteries.
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Rios, Francisco J., de Ciuceis, Carolina, Georgiopoulos, Georgios, Lazaridis, Antonios, Nosalski, Ryszard, Pavlidis, George, Tual-Chalot, Simon, Agabiti-Rosei, Claudia, Camargo, Livia L., Dąbrowska, Edyta, Quarti-Trevano, Fosca, Hellmann, Marcin, Masi, Stefano, Lopreiato, Mariarosaria, Mavraganis, Georgios, Mengozzi, Alessandro, Montezano, Augusto C., Stavropoulos, Konstantinos, Winklewski, Pawel J., and Wolf, Jacek
- Abstract
Inflammatory responses in small vessels play an important role in the development of cardiovascular diseases, including hypertension, stroke, and small vessel disease. This involves various complex molecular processes including oxidative stress, inflammasome activation, immune-mediated responses, and protein misfolding, which together contribute to microvascular damage. In addition, epigenetic factors, including DNA methylation, histone modifications, and microRNAs influence vascular inflammation and injury. These phenomena may be acquired during the aging process or due to environmental factors. Activation of proinflammatory signaling pathways and molecular events induce low-grade and chronic inflammation with consequent cardiovascular damage. Identifying mechanism-specific targets might provide opportunities in the development of novel therapeutic approaches. Monoclonal antibodies targeting inflammatory cytokines and epigenetic drugs, show promise in reducing microvascular inflammation and associated cardiovascular diseases. In this article, we provide a comprehensive discussion of the complex mechanisms underlying microvascular inflammation and offer insights into innovative therapeutic strategies that may ameliorate vascular injury in cardiovascular disease. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Consensus paper on the evaluation and treatment of resistant hypertension by the Turkish Society of Cardiology.
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Sahinarslan A, Gazi E, Aktoz M, Ozkan C, Ulusal Okyay G, Ucar Elalmis O, Belen E, Bitigen RA, Derici U, Bascil Tutuncu N, and Yildirir A
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- Cardiology, Humans, Societies, Medical, Turkey, Hypertension therapy
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- 2020
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25. Position Paper of the Department of Hypertension of the Brazilian Society of Nephrology: Use of renin-angiotensin system blockers during the course of Covid-19 infection.
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Rodrigues CIS
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- Brazil, COVID-19, Humans, Nephrology, Pandemics, SARS-CoV-2, Withholding Treatment, Angiotensin II Type 1 Receptor Blockers therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Betacoronavirus, Coronavirus Infections epidemiology, Hypertension drug therapy, Pneumonia, Viral epidemiology
- Abstract
This position statement of the Department of Hypertension of the Brazilian Society of Nephrology (SBN) addresses the controversy surrounding the use or suspension/replacement of the renin-angiotensin-aldosterone system blockers (particularly inhibitors of the angiotensin-converting enzyme or angiotensin II AT1 receptor blockers) prophylactically in individuals using these drugs, due to the possibility of allegedly worsening the prognosis of hypertensive patients infected with SARS-CoV-2. The SBN Hypertension Department recommends individualizing treatment and maintaining these medications until better scientific evidence is available.
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- 2020
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26. Indirect implications of COVID-19 prevention strategies on non-communicable diseases : An Opinion Paper of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk Assessment in Subjects Living in or Emigrating from Low Resource Settings.
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Modesti PA, Wang J, Damasceno A, Agyemang C, Van Bortel L, Persu A, Zhao D, Jarraya F, Marzotti I, Bamoshmoosh M, Parati G, and Schutte AE
- Subjects
- COVID-19, China epidemiology, Emigration and Immigration, Health Resources, Humans, Risk Assessment, Risk Factors, SARS-CoV-2, Betacoronavirus, Cardiovascular Diseases, Coronavirus Infections prevention & control, Hypertension, Noncommunicable Diseases, Pandemics prevention & control, Pneumonia, Viral prevention & control
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Background: After its outbreak in China, the novel COronaVIrus Disease 19 is spreading across the globe. It is an emergency the world has never seen before., Main Text: The attention of health systems is mainly focused on COronaVIrus Disease 19 patients and on the risk that intensive care units might be overwhelmed by the serious pulmonary complications. Different countries are also attempting to establish infection prevention and control strategies which proved effective in China where the outbreak was initially reported. We reflect on important lessons to be learnt from different countries. The effects that infection prevention and control strategies, such as social distancing or isolation, can have on the care of millions of patients with non-communicable diseases, who may be indirectly affected, have not been taken into consideration so much., Conclusions: When dealing with COronaVIrus Disease 19, policy makers and healthcare personnel should consider the indirect effects on the treatment of non-communicable diseases.
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- 2020
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27. Update of the position paper on arterial hypertension and erectile dysfunction.
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Viigimaa M, Vlachopoulos C, Doumas M, Wolf J, Imprialos K, Terentes-Printzios D, Ioakeimidis N, Kotsar A, Kiitam U, Stavropoulos K, Narkiewicz K, Manolis A, Jelakovic B, Lovic D, Kreutz R, Tsioufis K, and Mancia G
- Subjects
- Adrenergic beta-Antagonists therapeutic use, Arteries physiopathology, Atherosclerosis complications, Cardiology standards, Cardiovascular Diseases complications, Cardiovascular Diseases epidemiology, Coronary Artery Disease physiopathology, Endothelium physiopathology, Erectile Dysfunction epidemiology, Erectile Dysfunction physiopathology, Humans, Hypertension epidemiology, Hypertension physiopathology, Impotence, Vasculogenic complications, Impotence, Vasculogenic epidemiology, Male, Nebivolol therapeutic use, Phosphodiesterase 5 Inhibitors therapeutic use, Risk Factors, Sexual Dysfunction, Physiological chemically induced, Societies, Medical, Testosterone therapeutic use, Antihypertensive Agents therapeutic use, Erectile Dysfunction complications, Hypertension complications, Penile Erection drug effects
- Abstract
: Sexual health is an integral part of overall health, and an active and healthy sexual life is an essential aspect of a good life quality. Cardiovascular disease and sexual health share common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking) and common mediating mechanisms (endothelial dysfunction, subclinical inflammation, and atherosclerosis). This generated a shift of thinking about the pathophysiology and subsequently the management of sexual dysfunction. The introduction of phosphodiesterase type 5 inhibitors revolutionized the management of sexual dysfunction in men. This article will focus on erectile dysfunction and its association with arterial hypertension. This update of the position paper was created by the Working Group on Sexual Dysfunction and Arterial Hypertension of the European Society of Hypertension. This working group has been very active during the last years in promoting the familiarization of hypertension specialists and related physicians with erectile dysfunction, through numerous lectures in national and international meetings, a position paper, newsletters, guidelines, and a book specifically addressing erectile dysfunction in hypertensive patients. It was noted that erectile dysfunction precedes the development of coronary artery disease. The artery size hypothesis has been proposed as a potential explanation for this observation. This hypothesis seeks to explain the differing manifestation of the same vascular condition, based on the size of the vessels. Clinical presentations of the atherosclerotic and/or endothelium disease in the penile arteries might precede the corresponding manifestations from larger arteries. Treated hypertensive patients are more likely to have sexual dysfunction compared with untreated ones, suggesting a detrimental role of antihypertensive treatment on erectile function. The occurrence of erectile dysfunction seems to be related to undesirable effects of antihypertensive drugs on the penile tissue. Available information points toward divergent effects of antihypertensive drugs on erectile function, with diuretics and beta-blockers possessing the worst profile and angiotensin receptor blockers and nebivolol the best profile.
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- 2020
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28. How to Apply European and American Guidelines on High Blood Pressure in Children and Adolescents. A Position Paper Endorsed by the Italian Society of Hypertension and the Italian Society of Pediatrics.
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Genovesi S, Parati G, Giussani M, Bona G, Fava C, Maffeis C, Ferri C, and Giordano U
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- Adolescent, Age Factors, Body Height, Child, Female, Humans, Hypertension epidemiology, Hypertension physiopathology, Italy epidemiology, Male, Nomograms, Predictive Value of Tests, Reference Values, Sex Factors, Arterial Pressure, Blood Pressure Determination standards, Hypertension diagnosis
- Abstract
Children are defined as hypertensive when their blood pressure values equal or exceed the 95th percentile of the blood pressure value distribution in a pediatric population, according to gender, age and height. The population on which reference tables are based is of fundamental importance to establish the threshold values for the diagnosis of hypertension in pediatric age. Before 2017, both American and European guidelines used nomograms created in the same reference population which included children of all weight classes. Given the close and well-known association between hypertension and excess weight in childhood, the 2017 American guidelines proposed new reference nomograms excluding subjects with overweight and obesity from the "historical" reference population. Furthermore, the new American guidelines suggested a fixed cut-off of 130/80 mmHg, starting from 13 years and regardless of gender and height, to make the diagnosis of hypertension. In this document, the Italian Hypertension Society (SIIA) and the Italian Pediatric Society (SIP) jointly discuss a number of issues raised by the new American guidelines that involve the entire medical community, and also address the definition of arterial hypertension in the transition phase between childhood and adulthood.
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- 2020
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29. Ambulatory blood pressure monitoring over 24 h: A Latin American Society of Hypertension position paper-accessibility, clinical use and cost effectiveness of ABPM in Latin America in year 2020.
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Sánchez RA, Boggia J, Peñaherrera E, Barroso WS, Barbosa E, Villar R, Cobos L, Hernández Hernández R, Lopez J, Octavio JA, Parra Carrillo JZ, Ramírez AJ, and Parati G
- Subjects
- Blood Pressure, Cost-Benefit Analysis, Humans, Latin America epidemiology, Blood Pressure Monitoring, Ambulatory, Hypertension diagnosis, Hypertension drug therapy, Hypertension epidemiology
- Abstract
Accurate office blood pressure measurement remains crucial in the diagnosis and management of hypertension worldwide, including Latin America (LA). Office blood pressure (OBP) measurement is still the leading technique in LA for screening and diagnosis of hypertension, monitoring of treatment, and long-term follow-up. Despite this, due to the increasing awareness of the limitations affecting OBP and to the accumulating evidence on the importance of ambulatory BP monitoring (ABPM), as a complement of OBP in the clinical approach to the hypertensive patient, a progressively greater attention has been paid worldwide to the information on daytime and nighttime BP patterns offered by 24-h ABPM in the diagnostic, prognostic, and therapeutic management of hypertension. In LA countries, most of the Scientific Societies of Hypertension and/or Cardiology have issued guidelines for hypertension care, and most of them include a special section on ABPM. Also, full guidelines on ABPM are available. However, despite the available evidence on the advantages of ABPM for the diagnosis and management of hypertension in LA, availability of ABPM is often restricted to cities with large population, and access to this technology by lower-income patients is sometimes limited by its excessive cost. The authors hope that this document might stimulate health authorities in each LA Country, as well as in other countries in the world, to regulate ABPM access and to widen the range of patients able to access the benefits of this technique., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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30. Italian Society of Arterial Hypertension (SIIA) Position Paper on the Role of Renal Denervation in the Management of the Difficult-to-Treat Hypertensive Patient.
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Bruno RM, Taddei S, Borghi C, Colivicchi F, Desideri G, Grassi G, Mazza A, Muiesan ML, Parati G, Pontremoli R, Trimarco B, Volpe M, and Ferri C
- Subjects
- Antihypertensive Agents therapeutic use, Clinical Decision-Making, Decision Support Techniques, Drug Resistance, Humans, Hypertension diagnosis, Hypertension physiopathology, Medication Adherence, Patient Safety, Patient Selection, Risk Factors, Treatment Outcome, Ablation Techniques adverse effects, Arterial Pressure drug effects, Hypertension therapy, Kidney blood supply, Renal Artery innervation, Sympathectomy adverse effects
- Abstract
Renal denervation is a device-based procedure for hypertension for which safety and efficacy has been demonstrated. At present, its clinical use is still matter of debate, despite the most recent clinical trials have shown promising results with new-generation devices in various hypertensive populations. This position paper was deemed necessary by the Italian Society of Arterial Hypertension, in order to provide indications about the applications of renal denervation in the clinical setting. A state-of-the art review of the literature, focusing on safety and efficacy data, is provided. Furthermore, based on current evidence and expert consensus, clinical profiles of possible candidates for renal denervation are proposed. The selection process should take into account not only blood pressure values, global cardiovascular risk profile, but also drug adherence and tolerability and patient preferences. This position paper also defines minimum requirements for renal denervation selection centers and a flowchart for the difficult-to-treat hypertensive patient. Further studies are needed to support these preliminary indications, which are based on expert-consensus only.
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- 2020
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31. Recommendations for home blood pressure monitoring in Latin American countries: A Latin American Society of Hypertension position paper.
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Villar R, Sánchez RA, Boggia J, Peñaherrera E, Lopez J, Barroso WS, Barbosa E, Cobos L, Hernández Hernández R, Octavio JA, Parra Carrillo JZ, Ramírez AJ, and Parati G
- Subjects
- Blood Pressure, Blood Pressure Determination, Canada, Humans, Latin America epidemiology, Blood Pressure Monitoring, Ambulatory, Hypertension diagnosis, Hypertension drug therapy, Hypertension epidemiology
- Abstract
Out-of-office blood pressure (BP) monitoring appears to be a very useful approach to hypertension management insofar it allows to obtain multiple measurements in the usual environment of each individual, allows the detection of hypertension phenotypes, such as white-coat and masked hypertension, and appears to have superior prognostic value than the conventional office BP measurements. Out-of-office BP can be obtained through either home or ambulatory monitoring, which provide complementary and not identical information. Home BP monitoring yields BP values self-measured in subjects' usual living environment; it is an essential method for the evaluation of almost all untreated and treated subjects with suspected or diagnosed hypertension, best if combined with telemonitoring facilities, also allowing long-term monitoring. There is also increasing evidence that home BP monitoring improves long-term hypertension control rates by improving patients' adherence to prescribed treatment. In Latin American Countries, it is widely available, being relatively inexpensive, and well accepted by patients. Current US, Canadian, Japanese, and European guidelines recommend out-of-office BP monitoring to confirm and refine the diagnosis of hypertension., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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32. Tenth Hypertension Research Award for authors of outstanding papers in Hypertension Research.
- Author
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Ishimitsu T
- Subjects
- Animals, Humans, Awards and Prizes, Hypertension, Research
- Published
- 2020
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33. Distributional Effects of Education on Health. NBER Working Paper No. 25898
- Author
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National Bureau of Economic Research, Barcellos, Silvia H., Carvalho, Leandro S., and Turley, Patrick
- Abstract
This paper studies distributional effects of education on health. In 1972, England, Scotland, and Wales raised their minimum school-leaving age from 15 to 16 for students born after 9/1/1957. Using a regression discontinuity design and objective health measures for 0.27 million individuals, we find that education reduced body size and increased blood pressure in middle age. The reduction in body size was concentrated at the upper tail of the distribution with a 7.5 percentage point reduction in obesity. The increase in blood pressure was concentrated at the lower tail of the distribution with no effect on stage 2 hypertension. [Additional funding for this research was provided by University of Southern California's Roybal Center for Health Decision Making and Financial Independence in Old Age and the USC Population Research Center.]
- Published
- 2019
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34. Ninth Hypertension Research Award for authors of outstanding papers in Hypertension Research.
- Author
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Ishimitsu T
- Subjects
- Humans, Japan, Awards and Prizes, Hypertension, Research, Societies, Medical
- Abstract
The Japanese Society of Hypertension (JSH) has announced the winners of the 9th Hypertension Research Award at the 41st Annual Scientific Meeting held on 14-16 September 2018 in Asahikawa, Hokkaido, Japan. This award was established in 2010 to recognize significant contributions of researchers to the advancement of researches in hypertension and related studies. Among the first or main authors of the articles published in Hypertension Research, official journal of JSH, from April 2017 (Vol. 40, No. 4) to March 2018 (Vol. 41, No. 3) the journal's editorial committee members selected the following winners.
- Published
- 2018
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35. European Society of Hypertension position paper on renal denervation 2018.
- Author
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Schmieder RE, Mahfoud F, Azizi M, Pathak A, Dimitriadis K, Kroon AA, Ott C, Scalise F, Mancia G, and Tsioufis C
- Subjects
- Europe, Humans, Hypertension physiopathology, Randomized Controlled Trials as Topic, Societies, Medical, Sympathectomy methods, Hypertension surgery, Kidney innervation, Renal Artery innervation
- Abstract
: This ESH update was deemed necessary with the publication of new results of sham-controlled randomized blinded prospective trials with renal denervation (RDN). Proof of concept studies and first randomized trials (some were sham-controlled) displayed discrepant results about the efficacy of RDN. Three sham-controlled randomized trials of the 2.0 generation yielded now similarity in the average blood pressure decrease following RDN. Reduction of ambulatory blood pressure was approximately 5 to 7 mmHg and of office blood pressure 10 mmHg. Such a decrease in blood pressure by pharmacologic therapy has been found to be associated with lower incidence of cardiovascular events in particular with respect to heart failure and stroke by roughly 25%. Nevertheless, some questions about renal denervation are unanswered. The heterogeneity of the blood pressure-lowering response point to the clinical need to identify predictors for efficacy, and questions on long-term safety could not have been answered due to the short duration of the sham-controlled randomized clinical trials.
- Published
- 2018
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36. Isolated systolic hypertension in the young: a position paper endorsed by the European Society of Hypertension.
- Author
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Palatini P, Rosei EA, Avolio A, Bilo G, Casiglia E, Ghiadoni L, Giannattasio C, Grassi G, Jelakovich B, Julius S, Mancia G, McEniery CM, O'Rourke MF, Parati G, Pauletto P, Pucci G, Saladini F, Strazzullo P, Tsioufis K, Wilkinson IB, and Zanchetti A
- Subjects
- Adolescent, Adult, Blood Pressure drug effects, Blood Pressure Determination methods, Child, Europe epidemiology, Humans, Hypertension diagnosis, Life Style, Middle Aged, Obesity diagnosis, Practice Guidelines as Topic, Prevalence, Prognosis, Pulse Wave Analysis, Risk Factors, Societies, Medical, White Coat Hypertension diagnosis, Young Adult, Antihypertensive Agents therapeutic use, Hypertension epidemiology
- Abstract
: Whether isolated systolic hypertension in the young (ISHY) implies a worse outcome and needs antihypertensive treatment is still a matter for dispute. ISHY is thought to have different mechanisms than systolic hypertension in the elderly. However, findings from previous studies have provided inconsistent results. From the analysis of the literature, two main lines of research and conceptualization have emerged. Simultaneous assessment of peripheral and central blood pressure led to the identification of a condition called pseudo or spurious hypertension, which was considered an innocent condition. However, an increase in pulse wave velocity has been found by some authors in about 20% of the individuals with ISHY. In addition, obesity and metabolic disturbances have often been documented to be associated with ISHY both in children and young adults. The first aspect to consider whenever evaluating a person with ISHY is the possible presence of white-coat hypertension, which has been frequently found in this condition. In addition, assessment of central blood pressure is useful for identifying ISHY patients whose central blood pressure is normal. ISHY is infrequently mentioned in the guidelines on diagnosis and treatment of hypertension. According to the 2013 European Guidelines on the management of hypertension, people with ISHY should be followed carefully, modifying risk factors by lifestyle changes and avoiding antihypertensive drugs. Only future clinical trials will elucidate if a benefit can be achieved with pharmacological treatment in some subgroups of ISHY patients with associated risk factors and/or high central blood pressure.
- Published
- 2018
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37. Eighth Hypertension Research Award for authors of outstanding papers in Hypertension Research.
- Author
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Ishimitsu T
- Subjects
- Periodicals as Topic, Awards and Prizes, Hypertension, Research
- Published
- 2018
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38. Ocular Disease Recognition Using Convolutional Neural Networks
- Author
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Mangla, Abhinav, Dhall, Shafali, Gupta, Neha, Rastogi, Shikha, Yadav, Sarita, Filipe, Joaquim, Editorial Board Member, Ghosh, Ashish, Editorial Board Member, Prates, Raquel Oliveira, Editorial Board Member, Zhou, Lizhu, Editorial Board Member, Garg, Deepak, editor, Narayana, V. A., editor, Suganthan, P. N., editor, Anguera, Jaume, editor, Koppula, Vijaya Kumar, editor, and Gupta, Suneet Kumar, editor
- Published
- 2023
- Full Text
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39. A Time Study for the Analysis of the Potential for the Automated Stepwise Screening Program for Preeclampsia at Week 12 of Gestation
- Author
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Pedersen, Louise, Wagner, Stefan, Skov, Henriette, Sandager, Puk, Filipe, Joaquim, Editorial Board Member, Ghosh, Ashish, Editorial Board Member, Prates, Raquel Oliveira, Editorial Board Member, Zhou, Lizhu, Editorial Board Member, Papadopoulos, George Angelos, editor, Achilleos, Achilleas, editor, Pissaloux, Edwige, editor, and Velázquez, Ramiro, editor
- Published
- 2023
- Full Text
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40. [Blood Pressure Measurement and Treatment Targets: Position Paper of the DHL® Task Force Scientific Statements and Guidelines].
- Author
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Krämer BK, Hausberg M, Sanner B, Kusche-Vihrog K, Weil J, Weisser B, Wenzel U, and Trenkwalder P
- Subjects
- Germany, Humans, Hypertension classification, Reference Values, Societies, Medical, Antihypertensive Agents therapeutic use, Blood Pressure Determination, Hypertension diagnosis, Hypertension drug therapy
- Abstract
Competing Interests: Interessenkonflikte: Die Autoren sind aktuelle, bzw. ehemalige Vorstandsmitglieder der Deutschen Hochdruckliga DHL.
- Published
- 2017
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41. Non-invasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients: A consensus paper from the European Association of Cardiovascular Imaging (EACVI), the European Society of Cardiology Council on Hypertension, and the European Society of Hypertension (ESH).
- Author
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Perrone-Filardi P, Coca A, Galderisi M, Paolillo S, Alpendurada F, de Simone G, Donal E, Kahan T, Mancia G, Redon J, Schmieder R, Williams B, and Agabiti-Rosei E
- Subjects
- Asymptomatic Diseases, Cardiac Imaging Techniques methods, Cardiology, Cardiovascular Diseases etiology, Consensus, Europe, Female, Humans, Hypertension diagnosis, Male, Risk Assessment, Societies, Medical, Cardiac Imaging Techniques standards, Cardiovascular Diseases diagnostic imaging, Hypertension complications, Practice Guidelines as Topic
- Abstract
Arterial hypertension (HTN) accounts for the largest amount of attributable cardiovascular (CV) mortality worldwide, and risk stratification in hypertensive patients is of crucial importance to manage treatment and prevent adverse events. Asymptomatic involvement of different organs in patients affected by HTN represents an independent determinant of CV risk and the identification of target organ damage (TOD) is recommended to further reclassify patients' risk. Non-invasive CV imaging is progressively being used and continues to provide new technological opportunities to TOD evaluation at early stage. The aim of this article is to provide the community of cardiology with an update on appropriate and justified use of non-invasive imaging tests in the growing population of hypertensive patients., (© The Authors, 2017. This article has been co-published in European Heart Journal - Cardiovascular Imaging and Journal of Hypertension The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article.)
- Published
- 2017
- Full Text
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42. Seventh Hypertension Research Award for authors of outstanding papers in Hypertension Research.
- Author
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Ishimitsu T
- Subjects
- Humans, Awards and Prizes, Hypertension, Research
- Published
- 2017
- Full Text
- View/download PDF
43. Executive summary of the joint position paper on renal denervation of the Cardiovascular and Interventional Radiological Society of Europe and the European Society of Hypertension.
- Author
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Moss JG, Belli AM, Coca A, Lee M, Mancia G, Peregrin JH, Redon J, Reekers JA, Tsioufis C, Vorwerk D, and Schmieder RE
- Subjects
- Blood Pressure, Consensus, Humans, Kidney physiopathology, Practice Guidelines as Topic, Coronary Vasospasm surgery, Denervation, Hypertension surgery, Kidney innervation
- Abstract
Renal denervation (RDN) was reported as a novel exciting treatment for resistant hypertension in 2009. An initial randomized trial supported its efficacy and the technique gained rapid acceptance across the globe. However, a subsequent large blinded, sham arm randomized trial conducted in the USA (to gain Food and Drug Administration approval) failed to achieve its primary efficacy end point in reducing office blood pressure at 6 months. Published in 2014 this trial received both widespread praise and criticism. RDN has effectively stopped out with clinical trials pending further evidence. This joint consensus document representing the European Society of Hypertension and the Cardiovascular and Radiological Society of Europe attempts to distill the current evidence and provide future direction and guidance.
- Published
- 2016
- Full Text
- View/download PDF
44. 6th Hypertension Research Award for authors of outstanding papers in HR.
- Author
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Ishimitsu T
- Subjects
- Awards and Prizes, Biomedical Research, Humans, Research, Hypertension therapy
- Published
- 2016
- Full Text
- View/download PDF
45. American Society of Hypertension position paper: central blood pressure waveforms in health and disease.
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Townsend RR, Rosendorff C, Nichols WW, Edwards DG, Chirinos JA, Fernhall B, and Cushman WC
- Subjects
- Age Factors, Blood Pressure Determination instrumentation, Blood Pressure Determination methods, Humans, Predictive Value of Tests, Prognosis, Sex Factors, Arterial Pressure physiology, Hypertension diagnosis, Hypertension physiopathology, Pulse Wave Analysis methods
- Abstract
A number of devices are available which noninvasively estimate central aortic blood pressure using a variety of approaches such as tonometry or oscillometry. In this position paper, we discuss how the central pressure waveform is generated and measured, how central pressure waveforms appear in health and disease, the predictive value of central blood pressure measurements, the effects of interventions on waveforms, and areas of future need in this field of clinical and research endeavor., (Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
46. Needs assessment and planning for a clinic-community-based implementation program for hypertension control among blacks in New York City: a protocol paper
- Author
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Gyamfi, Joyce, Cooper, Claire, Barber, Aigna, Onakomaiya, Deborah, Lee, Wen-Yu, Zanowiak, Jennifer, Mansu, Moses, Diaz, Laura, Thompson, Linda, Abrams, Roger, Schoenthaler, Antoinette, Islam, Nadia, and Ogedegbe, Gbenga
- Published
- 2022
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47. Assessing cardiovascular disease risk in women with a history of hypertensive disorders of pregnancy: A guidance paper for studies using administrative data.
- Author
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Johnston, Amy, Smith, Graeme N., Tanuseputro, Peter, Coutinho, Thais, and Edwards, Jodi D.
- Subjects
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CARDIOVASCULAR diseases , *PREGNANCY , *CARDIOVASCULAR diseases risk factors , *PREECLAMPSIA , *HYPERTENSION , *RESEARCH questions , *PREGNANCY tests , *MATERNAL mortality - Abstract
Background: Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality, and their association with increased cardiovascular disease (CVD) risk represents a major public health concern. However, assessing CVD risk in women with a history of these conditions presents unique challenges, especially when studies are carried out using routinely collected data. Objectives: To summarise and describe key challenges related to the design and conduct of administrative studies assessing CVD risk in women with a history of HDP and provide concrete recommendations for addressing them in future research. Methods: This is a methodological guidance paper. Results: Several conceptual and methodological factors related to the data‐generating mechanism and study conceptualisation, design/data management and analysis, as well as the interpretation and reporting of study findings should be considered and addressed when designing and carrying out administrative studies on this topic. Researchers should develop an a priori conceptual framework within which the research question is articulated, important study variables are identified and their interrelationships are carefully considered. Conclusions: To advance our understanding of CVD risk in women with a history of HDP, future studies should carefully consider and address the conceptual and methodological considerations outlined in this guidance paper. In highlighting these challenges, and providing specific recommendations for how to address them, our goal is to improve the quality of research carried out on this topic. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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48. [Position paper on the results of Symplicity HTN-3 trial. Grupo de estudio de la hipertensión arterial resistente].
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Azpiri-López JR, Assad-Morell JL, Ponce de León-Martínez E, Monreal-Puente R, Dávila-Bortoni A, Vázquez-Díaz LA, Treviño-Frutos RJ, Barrera-Oranday F, Del Angel-Soto JG, Martínez JG, and Arellano-Torres M
- Subjects
- Humans, Denervation, Hypertension surgery, Kidney innervation, Kidney surgery, Randomized Controlled Trials as Topic
- Abstract
Renal artery denervation has shown to be an effective treatment for resistant hypertension. Symplicity HTN 1 and 2 trials showed in small and uncontrolled groups, significant systolic blood pressure reductions down to 30 mm Hg. Symplicity HTN-3, a double blind, randomized, placebo controlled clinical trial shaded this initial enthusiasm. Surprisingly, their results showed that renal denervation has a similar effect to placebo. Pre-specified subgroup analysis showed that non-black race individuals, younger than 65 years and with normal renal function, had a statistically significant systolic blood pressure decrease. This manuscript critically appraises the Symplicity HTN-3 trial, proposing possible explanations for the results. Also declares our group position and future actions regarding renal denervation., (Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.)
- Published
- 2015
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49. Immune and inflammatory mechanisms in hypertension.
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Guzik TJ, Nosalski R, Maffia P, and Drummond GR
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- Humans, Cytokines metabolism, Cytokines immunology, Inflammation Mediators metabolism, Animals, Hypertension immunology, Hypertension physiopathology, Inflammation immunology, Inflammation physiopathology
- Abstract
Hypertension is a global health problem, with >1.3 billion individuals with high blood pressure worldwide. In this Review, we present an inflammatory paradigm for hypertension, emphasizing the crucial roles of immune cells, cytokines and chemokines in disease initiation and progression. T cells, monocytes, macrophages, dendritic cells, B cells and natural killer cells are all implicated in hypertension. Neoantigens, the NLRP3 inflammasome and increased sympathetic outflow, as well as cytokines (including IL-6, IL-7, IL-15, IL-18 and IL-21) and a high-salt environment, can contribute to immune activation in hypertension. The activated immune cells migrate to target organs such as arteries (especially the perivascular fat and adventitia), kidneys, the heart and the brain, where they release effector cytokines that elevate blood pressure and cause vascular remodelling, renal damage, cardiac hypertrophy, cognitive impairment and dementia. IL-17 secreted by CD4
+ T helper 17 cells and γδ T cells, and interferon-γ and tumour necrosis factor secreted by immunosenescent CD8+ T cells, exert crucial effector roles in hypertension, whereas IL-10 and regulatory T cells are protective. Effector mediators impair nitric oxide bioavailability, leading to endothelial dysfunction and increased vascular contractility. Inflammatory effector mediators also alter renal sodium and water balance and promote renal fibrosis. These mechanisms link hypertension with obesity, autoimmunity, periodontitis and COVID-19. A comprehensive understanding of the immune and inflammatory mechanisms of hypertension is crucial for safely and effectively translating the findings to clinical practice., (© 2024. Springer Nature Limited.)- Published
- 2024
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50. Systolic blood pressure visit-to-visit variability and outcomes in Asian patients with atrial fibrillation.
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Chichareon P, Methavigul K, Lip GYH, and Krittayaphong R
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- Humans, Female, Male, Aged, Middle Aged, Asian People, Anticoagulants therapeutic use, Registries, Aged, 80 and over, Atrial Fibrillation drug therapy, Atrial Fibrillation physiopathology, Blood Pressure physiology, Hypertension drug therapy
- Abstract
We aimed to assess the association between SBP-VVV and outcomes in Asian patients with atrial fibrillation (AF). AF patients in the COOL-AF registry with SBP measured at baseline, and at least two other visits were studied. We defined SBP-VVV using the standard deviation (SD) of average SBP. Patients were categorized according to the quartiles of SBP SD. The associations between SBP-VVV and outcomes were assessed in the adjusted Cox model. We studied 3172 patients (mean age 67.7 years; 41.8% female), with the prevalence of hypertension being 69%. Warfarin was used in 69% of patients, whereas 7% received non-vitamin K antagonist oral anticoagulants. The minimum and maximum SD of average SBP in the study population was 0.58 and 56.38 mmHg respectively. The cutoff of SD of average SBP for each quartile in our study were 9.09, 12.15, and 16.21 mmHg. The rates of all-cause mortality, ischemic stroke or systemic embolization (SSE), major bleeding, and intracranial hemorrhage (ICH) were 3.10, 1.42, 2.09, and 0.64 per 100 person-years, respectively. Compared with the first quartile, patients in the fourth quartile had a significantly higher risk of mortality (adjusted HR 1.60, 95%CI 1.13-2.25), bleeding (aHR 1.92, 95%CI 1.25-2.96) and ICH (aHR 3.51, 95%CI 1.40-8.76). The risk of SSE was not significantly different among the quartiles. SBP-VVV had a significant impact on the long-term outcomes of Asian patients with AF, particularly mortality and bleeding. Adequate SBP control and maintaining SBP stability over time may improve outcomes for AF patients., (© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
- Published
- 2024
- Full Text
- View/download PDF
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