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Byline: Jian. Wang, Rui. Wang, Hu. Qin, Lei. Zuo Purpose: Spontaneous intracerebral hemorrhage (ICH) cases caused by hypertension often have poor prognoses. The use of dehydrant agents, such as mannitol, [...]

Objective To estimate the prevalence and prognosis of proteinuria at enrolment in the 27 intervention clusters of the Community-Level Interventions for Pre-eclampsia cluster randomized trials. Methods We identified pregnant women eligible for inclusion in the trials in their communities in four countries (2013-2017). We included women who delivered by trial end and received an intervention antenatal care visit. The intervention was a community health worker providing supplementary hypertension-oriented care, including proteinuria assessment by visual assessment of urinary dipstick at the first visit and all subsequent visits when hypertension was detected. In a multilevel regression model, we compared baseline prevalence of proteinuria ([greater than or equal to] 1 + or [greater than or equal to] 2+) across countries. We compared the incidence of subsequent complications by baseline proteinuria. Findings Baseline proteinuria was detected in less than 5% of eligible pregnancies in each country (India: 234/6120; Mozambique: 94/4234; Nigeria: 286/7004; Pakistan: 315/10 885), almost always with normotension (India: 225/234; Mozambique: 93/94; Nigeria: 241/286; Pakistan: 264/315). There was no consistent relationship between baseline proteinuria (either [greater than or equal to] 1+ or [greater than or equal to] 2+) and progression to hypertension, maternal mortality or morbidity, birth at < 37 weeks, caesarean section delivery or perinatal mortality or morbidity. If proteinuria testing were restricted to women with hypertension, we projected annual cost savings of 153 223 981 United States dollars (US$) in India, US$ 9 055 286 in Mozambique, US$ 53 181 933 in Nigeria and US$ 38 828 746 in Pakistan. Conclusion Our findings question the recommendations to routinely evaluate proteinuria at first assessment in pregnancy. Restricting proteinuria testing to pregnant women with hypertension has the potential to save resources. [phrase omitted] [phrase omitted] Metodos Se identificaron mujeres embarazadas que cumplian los requisitos para participar en los ensayos en sus comunidades en cuatro paises (2013-2017). Se incluyeron las mujeres que tuvieron un parto al final del ensayo y recibieron una visita de atencion prenatal de intervencion. Esta intervencion consistio en un profesional sanitario de la comunidad quien presto atencion suplementaria centrada en la hipertension, incluida la evaluacion de la proteinuria a traves del analisis visual de la tira reactiva de orina en la primera visita y en todas las visitas posteriores si se presentaba hipertension. En un modelo de regresion multinivel, se comparo la prevalencia del valor basal de la proteinuria ([greater than or equal to] 1 + o [greater than or equal to] 2+) en todos los paises. Luego, se comparo la incidencia de las complicaciones posteriores en funcion del valor basal de la proteinuria. Resultados El valor basal de la proteinuria se detecto en menos del 5 % de los embarazos que cumplian los requisitos en cada pais (India: 234/6120; Mozambique: 94/4234; Nigeria: 286/7004, Pakistan: 315/10 885), la mayoria de las veces con una tension arterial normal (India: 225/234; Mozambique: 93/94; Nigeria: 241/286; Pakistan: 264/315). No se observo una relacion coherente entre el valor basal de la proteinuria (ya sea [greater than or equal to] 1 + o [greater than or equal to] 2+) y la progresion a la hipertension, la mortalidad o morbilidad materna, el nacimiento a las < 37 semanas, el parto por cesarea o la mortalidad o morbilidad perinatal. Si la prueba de proteinuria se limitara a las mujeres con hipertension, se calcularian ahorros anuales de 153 223 981 dolares estadounidenses (USD) en la India, 9 055 286 USD en Mozambique, 53 181 933 USD en Nigeria y 38 828 746 USD en Pakistan. Conclusion Los resultados cuestionan las recomendaciones de evaluar la proteinuria de forma rutinaria en la primera evaluacion durante el embarazo. Limitar la prueba de proteinuria a las mujeres embarazadas con hipertension podria suponer un ahorro de recursos. [phrase omitted] Objectif Estimer la prevalence et le pronostlc de la proteinurie au moment de l'inscription dans l'un des 27 groupes repris dans les essais randomises en grappes sur les interventions communautaires liees a la preeclampsie. Methodes Nous avons selectionne des femmes enceintes remplissant les conditions requises pour les essais menes au sein de leur communaute dans quatre pays (2013-2017). Nous avons inclus des femmes ayant accouche au terme de l'essai et ayant fait l'objet d'une consultation prenatale avec intervention. Lintervention etait menee par un professionnel de sante communautaire prodiguant des soins complementaires en lien avec l'hypertension, dont un controle de la proteinurie par examen visuel d'une bandelette reactive trempee dans les urines lors de la premiere visite, ainsi que lors des visites qui suivent tout diagnostic d'hypertension. Nous avons employe un modele de regression multiniveaux pour analyser la prevalence initiale de la proteinurie ([greater than or equal to] 1+ ou [greater than or equal to] 2+) dans les differents pays. Enfin, nous avons compare l'incidence des complications ulterieures en fonction de la proteinurie initiale. Resultats La proteinurie initiale a ete detectee chez moins de 5% des grossesses etudiees dans chaque pays (Inde: 234/6120; Mozambique: 94/4234; Nigeria: 286/7004, Pakistan: 315/10 885), et allait presque toujours de pair avec une tension arterielle normale (Inde: 225/234; Mozambique: 93/94; Nigeria: 241/286; Pakistan: 264/315). Nous n'avons identifie aucun lien concluant entre la proteinurie initiale (qu'elle soit [greater than or equal to] 1+ ou [greater than or equal to] 2+) et une progression vers de l'hypertension, une mortalite ou morbidite maternelle, une naissance avant 37 semaines, un accouchement par cesarienne, ou encore une mortalite ou morbidite perinatale. Si les tests de depistage de proteinurie etaient reserves aux femmes souffrant d'hypertension, les economies realisees chaque annee representeraient 153 223 981 dollars americains en Inde, 9 055 286 dollars americains au Mozambique, 53 181 933 dollars americains au Nigeria et 38 828 746 dollars americains au Pakistan. Conclusion Nos resultats remettent en question les recommandations selon lesquelles il convient de controler regulierement la proteinurie des le premier bilan de grossesse. Limiter les tests aux femmes enceintes souffrant d'hypertension pourrait potentiellement permettre de menager les ressources. Objetivo Estimar la prevalencia y el pronostico de la proteinuria al momento de la inscripcion en los 27 grupos de intervencion de los ensayos aleatorizados del grupo de intervenciones a nivel comunitario para la preeclampsia., Introduction Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal death and disability worldwide. As such, antenatal care is devoted in large part to the detection of [...]

Byline: Barkha. Bindu, Ranadhir. Mitra, Gyaninder. Singh, Manoj. Phalak Hypertension in the clinical setting of posterior fossa tumors is a known entity and occurs due to medullary compression by the [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2007.08.014 Byline: Kendall S. Hunter (a), Po-Feng Lee (b), Craig J. Lanning (a), D. Dunbar Ivy (a), K. Scott Kirby (a), Lori R. Claussen (a), K. Chen Chan (a), Robin Shandas (a)(c) Abstract: Pulmonary vascular resistance (PVR) is the current standard for evaluating reactivity in children with pulmonary arterial hypertension (PAH). However, PVR measures only the mean component of right ventricular afterload and neglects pulsatile effects. We recently developed and validated a method to measure pulmonary vascular input impedance, which revealed excellent correlation between the zero harmonic impedance value and PVR and suggested a correlation between higher-harmonic impedance values and pulmonary vascular stiffness. Here we show that input impedance can be measured routinely and easily in the catheterization laboratory, that impedance provides PVR and pulmonary vascular stiffness from a single measurement, and that impedance is a better predictor of disease outcomes compared with PVR. Author Affiliation: (a) Department of Pediatric Cardiology, University of Colorado Health Sciences Center, Denver, CO (b) Department of Bioengineering, Texas A&M University, College Station, TX (c) Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO Article History: Received 24 July 2007; Accepted 12 August 2007 Article Note: (footnote) This project was supported by in part by grants from the National Institutes of Health (R01-HL067393, T32-HL072738, SCCOR-HL081506, K24-HL084923, and M01-RR0069).

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2005.02.004 Byline: Biykem Bozkurt (a)(c), Anita Deswal (a)(b)(c) Abstract: Obesity is considered as an independent risk factor for development of heart failure (HF); however, its role in the progression of HF independent of atherosclerotic heart disease, hypertension, and diabetes is not well described. Author Affiliation: (a) Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX (b) Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Tex (c) Winters Center For Heart Failure Research, Baylor College of Medicine, Houston, Tex Article History: Received 29 June 2004; Accepted 2 February 2005 Article Note: (miscellaneous) None of the authors have any financial or other relations that could lead to a conflict of interest.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2004.06.029 Byline: Sante D. Pierdomenico, Domenico Lapenna, Anna Bucci, Bianca M. Manente, Mariantonietta Mancini, Franco Cuccurullo, Andrea Mezzetti Abstract: The independent prognostic value of blood pressure (BP) variability in essential hypertension and particularly in uncomplicated mild hypertension is not yet completely clear. We investigated the relationship between BP variability, evaluated by noninvasive monitoring, and cardiovascular outcome in uncomplicated mild hypertension patients. Author Affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Universita 'Gabriele d'Annunzio,' Chieti, Italy Article History: Received 25 March 2004; Accepted 6 June 2004

The prognostic value of home versus office blood pressure (BP) measurement by general practitioners is examined in a European population of elderly treated hypertensive patients. The home (BP) measurement has a better prognostic accuracy than office BP measurement.