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Hypertension Management for Specific Comorbid Diseases

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1. Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association

of overweight and obesity 6 in the general population and in patients with increased cardiovascular risk, and a recent report from the Eighth Joint Na- tional Committee addressed the management of hypertension. 7 However, these guidelines did not specifically address the management of such comorbidities in patients with HF. Similarly, the most recent ACCF/AHA HF practice guidelines 8 in 2013 addressed the overall management of comorbidities in patients with HF in broad terms, but again, specific (...) Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; Council on Hypertension; and Council on Quality and Outcomes Research Contributory risk and Management of Comorbidities of Hypertension, obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure A Scientific Statement From the American Heart Association © 2016 American Heart Association, Inc. Key Words: AHA Scientific Statements ? cardiovascular diseases ? comorbidity ? diabetes mellitus ? heart

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2016 American Heart Association

2. Hypertension Management for Specific Comorbid Diseases

Hypertension Management for Specific Comorbid Diseases Hypertension Management for Specific Comorbid Diseases Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse (...) Cancer Administration 4 Hypertension Management for Specific Comorbid Diseases Hypertension Management for Specific Comorbid Diseases Aka: Hypertension Management for Specific Comorbid Diseases , AntiHypertensives for Specific Comorbid Diseases From Related Chapters II. Management: Endocrine Conditions (with or without ) See or In black patients, use or instead s III. Management: Cardiovascular Conditions (Risk of sudden death) Central active agonists s s or (use with caution, CIBIS II, MERIT-HF

2018 FP Notebook

3. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities

the propriety of any specific therapy must be made by the physician and the patient in light of all the circumstances presented by the individual patient, and the known variability and biologic behavior of the disease. This guideline reflects the best available data at the time the guideline was prepared. The results of future studies might require revisions to the recommendations in this guideline to reflect new data. Scope This guideline addresses the management of extracutaneous manifestations (...) Clinical questions What are the available screening and/or therapeutic interventions in managing the following comorbidities in adults: i. Psoriatic arthritis ii. Cardiovascular disease iii. Metabolic syndrome iv. Mental health v. Lifestyle choices vi. Inflammatory bowel disease vii. Malignancy viii. Renal disease ix. Sleep apnea x. Chronic obstructive pulmonary disease xi. Uveitis xii. Hepatic disease For a full description of the methodology used herein, please refer to the Appendix . Definition

2019 American Academy of Dermatology

4. Hypertension in pregnancy: diagnosis and management

of birth 46 Antihypertensive treatment during the postnatal period, including during breastfeeding 48 Risk of recurrence of hypertensive disorders of pregnancy and long-term cardiovascular disease 49 Context 50 Hypertension in pregnancy: diagnosis and management (NG133) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 54Finding more information and resources 52 Update information 53 Hypertension in pregnancy (...) -eclampsia. [2010, amended 2019] [2010, amended 2019] Antiplatelet agents Antiplatelet agents 1.1.2 Advise pregnant women at high risk of pre-eclampsia to take 75–150 mg of aspirin [1] daily from 12 weeks until the birth of the baby. Women at high risk are those with any of the following: hypertensive disease during a previous pregnancy chronic kidney disease autoimmune disease such as systemic lupus erythematosus or antiphospholipid Hypertension in pregnancy: diagnosis and management (NG133) © NICE 2019

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

5. Hypertension in adults: diagnosis and management

use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. The recommendations in this guideline apply to people with suspected or diagnosed hypertension, including those with type 2 diabetes, unless otherwise stated. For managing hypertension in people with chronic kidney disease, see NICE's guideline (...) and management (NG136) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 401.2.5 While waiting for confirmation of a diagnosis of hypertension, carry out: investigations for target organ damage (see recommendation 1.3.3), followed by formal assessment of cardiovascular risk using a cardiovascular risk assessment tool (see the section on full formal risk assessment in NICE's guideline on cardiovascular disease). [2019

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

6. Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease

Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease Indranil Dasgupta DM FRCP , Debasish Banerjee MD FRCP , Tahseen A Chowdhury MD FRCP , Parijat De MD FRCP , Mona Wahba MA FRCP , Stephen Bain MD FRCP , Andrew Frankel MD FRCP , Damian Fogarty MD FRCP , Ana Pokrajac (...) in patients with diabetes and CKD stages 4 and 5 28 Management of hyperkalaemia with RAAS blockade in patients with diabetes and CKD stages 4 and 5 29 Non-pharmacological management of hypertension in patients with diabetes and CKD stages 4 and 5 30 4 Hypertension management in patients with diabetes and chronic kidney disease who are on dialysis (stage 5D) 31 Recommendations 32 Audit standards 32 Areas that require further research 33 Introduction 33 Blood pressure measurement in patients with diabetes

2017 Association of British Clinical Diabetologists

7. Choice of therapy for Adults With Hypertension Without Compelling Indications for Specific Agents

-acting calcium channel blocker (CCB) (Grade B). ‘Hypertension without compelling indications’ refers to patients with hypertension but without other identified comorbid conditions (such as diabetes mellitus or heart disease) that represent compelling indications for specific drug therapy. Randomized controlled trials have shown that antihypertensive therapy in these patients can reduce incidence of cardiovascular disease by 20% to 30%, depending on the specific outcome considered . Reduction (...) of hypertension-related complications continues to be paramount, and to depend more on the extent of blood pressure (BP) lowering than on choice of any specific drug class as first-line therapy for those patients without comorbid conditions which compel a specific drug class choice (such as diabetes mellitus, cardiac disease or renal disease) . Therefore, in the choice of antihypertensive drugs, consideration of BP control effectiveness supersedes consideration of ‘pleiotropic’ effects of the five major

2018 Hypertension Canada

8. ESC/ESH Management of Arterial Hypertension

, hypertension remains the major preventable cause of cardiovascular disease (CVD) and all-cause death globally and in our continent. These 2018 ESC/ESH Guidelines for the management of arterial hypertension are designed for adults with hypertension, i.e. aged ≥18 years. The purpose of the review and update of these Guidelines was to evaluate and incorporate new evidence into the Guideline recommendations. The specific aims of these Guidelines were to produce pragmatic recommendations to improve (...) therapy3090 8.21 Perioperative management of hypertension3090 9 Managing concomitant cardiovascular disease risk3091 9.1 Statins and lipid-lowering drugs3091 9.2 Antiplatelet therapy and anticoagulant therapy3091 9.3. Glucose-lowering drugs and blood pressure3092 10 Patient follow-up3092 10.1 Follow-up of hypertensive patients3092 10.2 Follow-up of subjects with high–normal blood pressure and white-coat hypertension3092 10.3 Elevated blood pressure at control visits3093 10.4 Improvement in blood pressure

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2018 European Society of Cardiology

9. Guidance on the clinical management of anxiety disorders, specifically focusing on diagnosis and treatment strategies

Guidance on the clinical management of anxiety disorders, specifically focusing on diagnosis and treatment strategies Objective: To provide practical clinical guidance for the treatment of adults with panic disorder, social anxiety disorder and generalised anxiety disorder in Australia and New Zealand. Method: Relevant systematic reviews and meta-analyses of clinical trials were identified by searching PsycINFO, Med- line, Embase and Cochrane databases. Additional relevant studies were (...) triggers diagnostically specific fears of negative consequences of the anxiety itself, and triggers related avoidance behav- iours, which can be disabling. Individuals seek to escape from or avoid situations that trigger these anxieties. This strategy reduces anxiety in the short term, but promotes avoidance as a preferred strategy for managing threat and anxiety in the longer term, which results in the considerable disability and distress associated with an anxiety disorder. These self-reinforcing

2018 Royal Australian and New Zealand College of Psychiatrists

10. Chronic obstructive pulmonary disease in over 16s: diagnosis and management

53 Oral prophylactic antibiotic therapy 54 Long-term oxygen therapy 55 Ambulatory and short-burst oxygen therapy 56 Managing pulmonary hypertension and cor pulmonale 57 Lung volume reduction procedures, bullectomy and lung transplantation 58 Risk factors for COPD exacerbations 59 Self-management, education and telehealth monitoring 60 Context 62 Finding more information and resources 63 Update information 64 Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115) © (...) if sputum is persistently present and purulent Serial home peak flow measurements T o exclude asthma if diagnostic doubt remains Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG115) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 65Electrocardiogram (ECG) and serum natriuretic peptides* T o assess cardiac status if cardiac disease or pulmonary hypertension are suspected because

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

11. Pharmacological Management of Hypertension

availability) Direct acting vasodilators (e.g., hydralazine, minoxidil) Centrally acting antiadrenergic drugs (e.g., clonidine, methyldopa) (Strong for) The Work Group recommends against the use of alpha-adrenergic blockers as monotherapy, but this class of agents may be used as supplemental therapy or if warranted by comorbid conditions (e.g., symptomatic prostatic hypertrophy). ( Modified from 2004 VA/DoD HTN CPG .) ( Strong against ) Specific Populations In patients with hypertension and CKD (reduced (...) on a periodic discussion of the benefits and harms of specific BP targets with the patient. An SBP target of less than 140 mmHg is a reasonable goal for some patients with increased cardiovascular risk. The target depends on many factors unique to each patient, including comorbidity, medication burden, risk for adverse events, and cost. Clinicians should individually assess cardiovascular risk for patients. Generally, increased cardiovascular risk includes persons with known vascular disease, most patients

2017 National Guideline Clearinghouse (partial archive)

12. Guideline for the diagnosis and management of hypertension in adults — 2016

Guideline for the diagnosis and management of hypertension in adults — 2016 Guideline for the diagnosis and management of hypertension in adults — 2016 | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date range from Date range to Article type Author's surname Volume First page doi: 10.5694/mja__.______ Search Reset  close Individual Login Purchase options Connect person_outline Login keyboard_arrow_down Individual Login (...) Foundation of Australia has updated the Guide to management of hypertension 2008: assessing and managing raised blood pressure in adults (updated December 2010). Main recommendations For patients at low absolute cardiovascular disease risk with persistent blood pressure (BP) ≥ 160/100 mmHg, start antihypertensive therapy. The decision to treat at lower BP levels should consider absolute cardiovascular disease risk and/or evidence of end-organ damage, together with accurate BP assessment. For patients

2016 MJA Clinical Guidelines

13. Preventing and Managing Infectious Diseases Among People who Inject Drugs in Ontario

, panellists agreed with many of the points raised in the citizen brief about what is driving the problem. However, in deliberating they distinguished between structural factors that drive the challenges encountered in providing effective prevention, treatment and management of infectious diseases and a range of specific challenges that are encountered in getting what’s needed from health and social systems. With respect to the former, panellists strongly emphasized two structural factors as being central (...) and recognized by the same health professionals who would make it continually difficult to get access to the care they needed. • Panellists also described how enduring stigma limited the development and implementation of programs and policies needed to strengthen health and social systems. Specific challenges related to the prevention, treatment and management of infectious diseases Services and supports have not been designed with the needs of those who inject drugs in mind • Throughout the deliberations

2019 McMaster Health Forum

14. Clinical relevance of aortic stiffness in end-stage renal disease and diabetes: implication for hypertension management. (PubMed)

Clinical relevance of aortic stiffness in end-stage renal disease and diabetes: implication for hypertension management. : Evidence suggests that aortic stiffness may antedate and contribute initially to the development of hypertension and cardiovascular risk (CVR). In treated hypertensive patients, both diabetes and end-stage renal disease (ESRD) are comorbid conditions associated with increased aortic stiffness and high CVR. Thus, the pathophysiological relationship between aortic stiffness (...) , blood pressure (BP) and CVR may have clinical implication in the management of hypertension. In patients with diabetes or ESRD, aortic stiffness is a significant predictor of CVR, independently of BP control. The hallmark of accelerated aortic stiffening in these patients associates the presence of vascular calcification, which is considered as a time-dependent process. Aortic stiffness represents a marker of structural but also functional arterial damage associated with increased pressure

2018 Journal of Hypertension

15. Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care

Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2018 update | CMAJ Main menu User menu Search Search for this keyword Search for this keyword Guideline Canadian Cardiovascular Harmonized National Guidelines Endeavour (C (...) -CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2018 update Sheldon W. Tobe , James A. Stone , Todd Anderson , Simon Bacon , Alice Y.Y. Cheng , Stella S. Daskalopoulou , Justin A. Ezekowitz , Jean C. Gregoire , Gord Gubitz , Rahul Jain , Karim Keshavjee , Patty Lindsay , Mary L’Abbe , David C.W. Lau , Lawrence A. Leiter , Eileen O’Meara , Glen J. Pearson , Doreen M. Rabi , Diana Sherifali , Peter Selby , Jack V. Tu , Sean Wharton , Kimberly M. Walker

2018 CPG Infobase

16. Management of Cardiovascular Diseases during Pregnancy

3.10.4 In vitro fertilization 3181 3.11 Recommendations 3182 4. Congenital heart disease and pulmonary hypertension 3182 4.1 Introduction 3182 4.2 Pulmonary hypertension and Eisenmenger’s syndrome 3183 4.2.1 Pulmonary hypertension 3183 4.2.2 Eisenmenger’s syndrome 3183 4.2.3 Cyanotic heart disease without pulmonary hypertension 3184 4.3 Specific congenital heart defects 3184 4.3.1 Left ventricular outflow tract obstruction 3184 4.3.2 Atrial septal defect 3184 4.3.3 Ventricular septal defect 3184 (...) of this classification, and follow-up and management during pregnancy according to this mWHO classification, are presented in Table . Indications for intervention (surgical or catheter) do not differ in women who contemplate pregnancy compared with other patients. The few exceptions to this rule are women with at least moderate mitral stenosis and women with aortic dilatation. See also the disease-specific sections of these Guidelines. Fertility treatment is contraindicated in women with mWHO class IV, and should

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2018 European Society of Cardiology

17. Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease

% of survivors being age 65 years or older. Many of those affected by cancer may be at increased risk for osteoporosis and fracture, either as a consequence of their cancer and/or cancer therapy or as a concurrent comorbid condition. Identifying late effects of cancer therapy is a clinically important part of oncology care and, as the data illustrate, also a public health concern. Clinical question 1 identifies risks that are associated with osteoporotic fractures in nonmetastatic disease and specifically (...) Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLES Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.19.01696 Journal of Clinical Oncology - published online before print September 18, 2019 PMID: Management

2019 American Society of Clinical Oncology Guidelines

18. Management of Valvular Heart Disease

. Table 3 Essential questions in the evaluation of patients for valvular intervention VHD = valvular heart disease. a Life expectancy should be estimated according to age, sex, comorbidities, and country-specific life expectancy. 3.1 Patient evaluation Precise evaluation of the patient’s history and symptomatic status as well as proper physical examination, in particular auscultation and search for heart failure signs, are crucial for the diagnosis and management of VHD. In addition, assessment (...) is a key component in decision making. The essential questions in the evaluation of a patient for valvular intervention are summarized in Table . The current background information and detailed discussion of the data for the following section of these Guidelines can be found in . Table 3 Essential questions in the evaluation of patients for valvular intervention VHD = valvular heart disease. a Life expectancy should be estimated according to age, sex, comorbidities, and country-specific life expectancy

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2017 European Society of Cardiology

19. The 2012 Canadian Hypertension Education Program recommendations for the management of hypertension: Blood pressure measurement, diagnosis, assessment of risk, and therapy

pharmacological therapy to control hypertension? (6) What BP level should be attained in hypertensive patients and in patients with coexisting diabetes or CKD? (7) What lifestyle interventions are effective in preventing hypertension and reducing BP? (8) What are the optimal pharmacological agents for treatment of hypertension, as well as hypertension occurring in patients with specific comorbid conditions, including diabetes, cardiovascular disease, stroke, or kidney disease? (9) How can we improve adherence (...) of the evidence, BP targets for patients with nondiabetic chronic kidney disease (CKD) is now < 140/90 mm Hg instead of < 130/80 mm Hg; (4) The BP target for patients with hypertension and diabetes mellitus did not change ( < 130/80 mm Hg) based on evaluation of recent meta-analyses. Recommendations on lifestyle modifications to prevent and treat hypertension, indications for pharmacologic management of hypertension, treatment thresholds and targets, choice of therapy for adults with hypertension and without

2012 CPG Infobase

20. Non-alcoholic Fatty Liver Disease, Diagnosis and Management

- characterizedNAFLDsubjectsfromtheNASHClinical Research Network (NASH CRN), signi?cant elevations in serum autoantibodies (antinuclear antibodies>1:160 or antismooth muscle antibodies>1:40) were present in 21% andwerenotassociatedwithmoreadvanceddisease oratypicalhistologicalfeatures. (87) CHALASANI ET AL. HEPATOLOGY, January 2018 334While other diseases are being excluded, history shouldbecarefullytakenforthepresenceofcommonly associated comorbidities, including central obesity, hypertension, dyslipidemia, diabetes or insulin resis- tance (...) Non-alcoholic Fatty Liver Disease, Diagnosis and Management The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance From the American Association for the Study of Liver Diseases Naga Chalasani, 1 Zobair Younossi , 2 Joel E. Lavine, 3 Michael Charlton, 4 Kenneth Cusi, 5 Mary Rinella, 6 Stephen A. Harrison, 7 Elizabeth M. Brunt, 8 and Arun J. Sanyal 9 Preamble This guidance providesadata-supportedapproachto the diagnostic, therapeutic, and preventive aspects

2018 American Association for the Study of Liver Diseases

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