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Hypertension Risk Stratification

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1. Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model

Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5-10% and >10%, respectively. This risk assessment strategy awaits validation.We analysed data from patients (...) with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation.Data

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2017 EvidenceUpdates

2. Risk stratification in hypertension: NT-proBNP and R wave in aVL lead combination better than echocardiographic left ventricular mass. (PubMed)

Risk stratification in hypertension: NT-proBNP and R wave in aVL lead combination better than echocardiographic left ventricular mass. Plasma N-terminal pro brain natriuretic peptide (NT-proBNP) and R wave in aVL lead (RaVL) have been associated with mortality in hypertension. The aim of the current study was to compare the prognostic value of their combination to that of the left ventricular mass index (LVMI) assessed by echocardiography.A total of 1104 hypertensive patients who had (...) of the combination had the highest C-index (0.772 and 0.839, respectively) in comparison with LVMI (0.746 and 0.806, respectively).Risk stratification in hypertension using the combination of NT-proBNP and RaVL is a simple method that may be considered in first line screening.

2019 Journal of Hypertension

3. Evaluation, risk stratification and management of hypertensive patients in the perioperative period. (PubMed)

Evaluation, risk stratification and management of hypertensive patients in the perioperative period. Uncontrolled hypertension represents an important cause for postponing a non-cardiac surgery. Perioperative management of hypertensive patients should focus on cardiovascular risk stratification, evaluation of blood pressure levels and hypertension control, registration of the ongoing antihypertensive regimen and counseling about clinical decisions related to the expected perioperative blood (...) pressure fluctuations. To date, there is a lack of evidence on how hypertensive patients should be perioperatively treated, while an empirical clinical approach is usually pursued in the usual practice. The present review appraises the gaps in the evidence and illustrates the current empirical approach of perioperative management of hypertension in non-cardiac surgery.Copyright © 2019. Published by Elsevier B.V.

2019 European journal of internal medicine

4. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy

2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy - Heart Rhythm Email/Username: Password: Remember me Search both HRS Journals Search Terms Search within Search Access provided by Volume 16, Issue 11, Pages e301–e372 2019 HRS expert consensus statement on evaluation, risk stratification, and management (...) 1 . ---- | ---- Figure 20 Diagnosis and risk stratification of left ventricular noncompaction (LVNC) (A) and family and genetic evaluation of LVNC (B). CMR = cardiac magnetic resonance imaging; COR = Class of Recommendation; LOE = Level of Evidence; NC/C = maximum noncompaction to compaction ratio. Colors correspond to COR in Figure 1 . ---- | Figure 21 Left ventricular noncompaction (LVNC) treatment recommendations. Anticoagulation refers to vitamin K antagonists and direct oral anticoagulants

2019 International Society for Heart and Lung Transplantation

5. Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model. (PubMed)

Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model. The 2015 European pulmonary hypertension (PH) guidelines propose a risk stratification strategy for patients with pulmonary arterial hypertension (PAH). Low-, intermediate- and high-risk strata are defined by estimated 1-year mortality risks of <5%, 5-10% and >10%, respectively. This risk assessment strategy awaits validation.We analysed data from patients (...) with newly diagnosed PAH enrolled into COMPERA (Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension), a European-based PH registry. An abbreviated version of the risk assessment strategy proposed by the European PH guidelines was applied, using the following variables: World Health Organization functional class, 6-min walking distance, brain natriuretic peptide or its N-terminal fragment, right atrial pressure, cardiac index and mixed venous oxygen saturation.Data

2017 European Respiratory Journal

6. Diagnosis, Risk Stratification, and Management of Pulmonary Hypertension of Sickle Cell Disease: An Official ATS Clinical Practice Guideline

Diagnosis, Risk Stratification, and Management of Pulmonary Hypertension of Sickle Cell Disease: An Official ATS Clinical Practice Guideline AMERICANTHORACICSOCIETY DOCUMENTS AnOf?cialAmericanThoracicSocietyClinicalPracticeGuideline: Diagnosis,RiskStrati?cation,andManagementofPulmonary HypertensionofSickleCellDisease Elizabeth S. Klings*, Roberto F. Machado*, Robyn J. Barst † , Claudia R. Morris, Kamal K. Mubarak, Victor R. Gordeuk, Gregory J. Kato, Kenneth I. Ataga, J. Simon Gibbs, Oswaldo (...) . Conclusions:Evidence-basedrecommendationsforthe managementofpatientswithSCDwithincreasedmortalityriskare provided,butwillrequirefrequentreassessmentandupdating. Keywords: sickle cell disease; mortality; pulmonary hypertension; dyspnea; hemolysis Contents Overview Introduction Methods How to Use These Guidelines De?nition of PH in SCD Diagnosis of PH in SCD Estimating Mortality Risk in SCD Doppler Echocardiography N-TerminalPro–BrainNatriuretic Peptide Rationale for Risk Strati?cation Treatment of Patients with SCD

2014 American Thoracic Society

7. Power of resting echocardiographic measurements to classify pulmonary hypertension patients according to European society of cardiology exercise testing risk stratification cut-offs. (PubMed)

Power of resting echocardiographic measurements to classify pulmonary hypertension patients according to European society of cardiology exercise testing risk stratification cut-offs. Right ventricular function is the major determinant of morbidity and mortality in pulmonary arterial hypertension (PAH). The ESC risk assessment strategy for PAH is based on clinical status, exercise testing, NTproBNP, imaging and haemodynamics but does not include right ventricular function. Our aims were to test (...) the power of resting echocardiographic measurements to classify PAH patients according to ESC exercise testing risk stratification cut-offs and to determine if the classification power of echocardiographic parameters varied in chronic thrombo-embolic pulmonary hypertension (CTEPH).We prospectively and consecutively recruited 46 PAH patients and 42 CTEPH patients referred for cardio-pulmonary exercise testing and comprehensive transthoracic echocardiography. Exercise testing parameters analyzed were peak

2018 International journal of cardiology

8. IMPACT OF AGE AND COMORBIDITY ON RISK STRATIFICATION IN IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION. (PubMed)

IMPACT OF AGE AND COMORBIDITY ON RISK STRATIFICATION IN IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION. Recent reports from worldwide pulmonary hypertension registries show a new demographic picture for patients with idiopathic pulmonary arterial hypertension (IPAH), with an increasing prevalence among the elderly.We aimed to investigate the effects of age and comorbidity on risk stratification and outcome of patients with incident IPAH.The study population (n=264) was categorised into four age (...) groups: 18-45, 46-64, 65-74 and ≥75 years. Individual risk profiles were determined according to a risk assessment instrument, based on the European Society of Cardiology and the European Respiratory Society guidelines. The change in risk group from baseline to follow-up (median 5 months) and survival were compared across age groups. In the two youngest age groups, a significant number of patients improved (18-45 years, Z= -4.613, p<0.001; 46-64 years, Z= -2.125, p=0.034), but no significant

2018 European Respiratory Journal

9. Risk stratification strategy and assessment of disease progression in patients with pulmonary arterial hypertension: Updated Recommendations from the Cologne Consensus Conference 2018. (PubMed)

Risk stratification strategy and assessment of disease progression in patients with pulmonary arterial hypertension: Updated Recommendations from the Cologne Consensus Conference 2018. In the summer of 2016, delegates from the German Respiratory Society, the German Society of Cardiology and the German Society of Pediatric Cardiology met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary arterial hypertension (PAH (...) ). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines and included new evidence, where available, and were last updated in the spring of 2018. This article focusses on the proposed risk stratification and assessment of disease progression in patients with pulmonary arterial hypertension (PAH), covering 3 parts: In part 1, methods and markers that are recommended to assess severity and progression of PAH are discussed and commented. These updated comments incorporate most recent

2018 International journal of cardiology

10. Gender, subclinical organ damage and cardiovascular risk stratification in hypertensive patients. (PubMed)

Gender, subclinical organ damage and cardiovascular risk stratification in hypertensive patients. The aims of the study were to assess subclinical organ damage in men and women with hypertension and its subsequent effect on cardiovascular risk, and use of new statistical methods for more precise estimation of cardiovascular risk using vascular cardiovascular risk factors: ankle-brachial index (ABI), intima-media thickness (IMT) and pulse wave velocity (PWV).We studied 200 patients: 100 (...) hypertensive and 100 normotensive. The parameters we evaluated included: patient age, ABI, IMT, PWV, serum uric acid and serum C-reactive protein (CRP). In addition, the cardiovascular risk according to the SCORE and Framingham scales was assessed.In the hypertensive group, there were significant correlations between ABI and the Framingham scale in both sexes. In hypertensive women, there were also significant correlations between IMT and the SCORE scale risk, and IMT and the Framingham scale risk

2018 Current medical research and opinion

11. Risk stratification and medical therapy of pulmonary arterial hypertension. (PubMed)

Risk stratification and medical therapy of pulmonary arterial hypertension. Pulmonary arterial hypertension (PAH) remains a severe clinical condition despite the availability over the past 15 years of multiple drugs interfering with the endothelin, nitric oxide and prostacyclin pathways. The recent progress observed in medical therapy of PAH is not, therefore, related to the discovery of new pathways, but to the development of new strategies for combination therapy and on escalation (...) of treatments based on systematic assessment of clinical response. The current treatment strategy is based on the severity of the newly diagnosed PAH patient as assessed by a multiparametric risk stratification approach. Clinical, exercise, right ventricular function and haemodynamic parameters are combined to define a low-, intermediate- or high-risk status according to the expected 1-year mortality. The current treatment algorithm provides the most appropriate initial strategy, including monotherapy

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2018 European Respiratory Journal

12. Biological and Electrocardiographic Biomarkers for Risk Stratification in Hypertension.

Biological and Electrocardiographic Biomarkers for Risk Stratification in Hypertension. Biological and Electrocardiographic Biomarkers for Risk Stratification in Hypertension. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Biological and Electrocardiographic Biomarkers for Risk Stratification in Hypertension. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03068364 Recruitment Status : Completed First Posted : March 1, 2017 Last Update Posted : March 9, 2017 Sponsor: Hospices Civils de Lyon

2017 Clinical Trials

13. A comprehensive risk stratification at early follow-up determines prognosis in pulmonary arterial hypertension. (PubMed)

A comprehensive risk stratification at early follow-up determines prognosis in pulmonary arterial hypertension. Guidelines recommend a goal-oriented treatment approach in pulmonary arterial hypertension (PAH). The aim is to reach a low-risk profile, as determined by a risk assessment instrument. This strategy is incompletely validated. We aimed to investigate the bearing of such risk assessment and the benefit of reaching a low-risk profile.Five hundred and thirty PAH patients were included (...) . Follow-up assessments performed after a median of 4 (interquartile range 3-5) months were available for 383 subjects. Patients were classified as 'Low', 'Intermediate', or 'High risk' and the benefit of reaching the 'Low risk' group was estimated. Survival differed (P < 0.001) between the risk groups at baseline and at follow-up. Survival was similar for patients who remained in or improved to the 'Low risk' group. Survival was similar for patients who remained in or worsened to the 'Intermediate

2017 European Heart Journal

14. Risk stratification of sudden cardiac death in hypertension (PubMed)

Risk stratification of sudden cardiac death in hypertension In the United States, up to 450,000 people per year die suddenly; an average of 1 sudden death every 70s. Strategies for preventing sudden cardiac death are urgently needed. Systemic arterial hypertension is a major risk factor for sudden cardiac death and the increasing burden of hypertension is a worldwide problem. The lifetime risk of sudden cardiac death at 30years of age is higher by 30% in individuals with hypertension. Each 20 (...) /10mmHg increase in systolic/diastolic blood pressure, is associated with a 20% additional increase in sudden cardiac death risk. Theoretically, antihypertensive treatment should be an effective strategy for sudden cardiac death prevention. However, a recent meta-analysis of 15 randomized controlled trials showed that antihypertensive treatment does not reduce the incidence of sudden cardiac death. This manuscript reviews ECG predictors of sudden cardiac death and the importance of risk stratification

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2017 Journal of electrocardiology

15. The Value of Epicardial Adipose Tissue Thickness for Cardiovascular Risk Stratification in Hypertensive Patients (PubMed)

The Value of Epicardial Adipose Tissue Thickness for Cardiovascular Risk Stratification in Hypertensive Patients 28959113 2018 11 13 1011-6842 33 5 2017 Sep Acta Cardiologica Sinica Acta Cardiol Sin The Value of Epicardial Adipose Tissue Thickness for Cardiovascular Risk Stratification in Hypertensive Patients. 559 Ramazan Oncel Can C Department of Cardiology, Bucak State Hospital, Burdur. Kucuk Murathan M Department of Cardiology, Akdeniz University Medical Faculty, Antalya, Turkey. eng

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2017 Acta Cardiologica Sinica

16. CHA<sub>2</sub>DS<sub>2</sub>-VASc scores and Intermountain Mortality Risk Scores for the joint risk stratification of dementia among patients with atrial fibrillation. (PubMed)

CHA2DS2-VASc scores and Intermountain Mortality Risk Scores for the joint risk stratification of dementia among patients with atrial fibrillation. High CHA2DS2-VASc scores in atrial fibrillation (AF) patients are generally associated with increased risks of stroke and dementia. At lower CHA2DS2-VASc scores, there remains an unquantifiable cranial injury risk, necessitating an improved risk assessment method within these lower-risk groups.The purpose of this study (...) further stratified by IMRS categories of low, moderate, and high. Multivariable Cox hazard regression was used to determine dementia risk.High-risk IMRS patients were generally older and had higher rates of hypertension, diabetes, heart failure, and prior stroke. Higher CHA2DS2-VASc score strata (≥3 vs ≤1: women, hazard ratio [HR] 7.77, 95% confidence interval [CI] 5.94-10.17, P < .001; men: HR 4.75, 95% CI 4.15-5.44, P < .001) and IMRS categories (high vs low: women, HR 3.09, 95% CI 2.71-3.51, P

2019 Heart Rhythm

17. Clinical utility of the global anti-phospholipid syndrome score for risk stratification: a pooled analysis

Clinical utility of the global anti-phospholipid syndrome score for risk stratification: a pooled analysis Recently, our group conceived a risk score for clinical manifestations of APS (the global APS score, or GAPSS) that takes into account the combination of independent cardiovascular risk factors and the aPL positivity profile. These include hyperlipidaemia, arterial hypertension, aCL, anti-β2 glycoprotein-I, aPS-PT and the LA. A complementary version, the adjusted GAPSS (aGAPSS), which (...) excludes aPS-PT, was also designed. The aim of our study was to systematically review the literature to assess the clinical utility of the GAPSS and aGAPSS for risk stratification of any APS clinical manifestation.We pooled data from available cohort studies, including a total of 10 studies, comprising 2273 patients, in which the GAPSS has been applied. A search strategy was developed a priori to identify an available cohort that reported findings which investigated the clinical utility of GAPSS

2018 EvidenceUpdates

18. Risk assessment in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

Risk assessment in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension Current pulmonary hypertension treatment guidelines recommend use of a risk stratification model encompassing a range of parameters, allowing patients to be categorised as low, intermediate or high risk. Three abbreviated versions of this risk stratification model were previously evaluated in patients with pulmonary arterial hypertension (PAH) in the French, Swedish and COMPERA registries. Our (...) objective was to investigate the three abbreviated risk stratification methods for patients with mostly prevalent PAH and chronic thromboembolic pulmonary hypertension (CTEPH), in patients from the PATENT-1/2 and CHEST-1/2 studies of riociguat.Risk was assessed at baseline and at follow-up in PATENT-1 and CHEST-1. Survival and clinical worsening-free survival were assessed in patients in each risk group/strata.With all three methods, riociguat improved risk group/strata in patients with PAH after 12

2019 EvidenceUpdates

19. 7th Brazilian Guideline of Arterial Hypertension: Chapter 4 - Cardiovascular Risk Stratification (PubMed)

7th Brazilian Guideline of Arterial Hypertension: Chapter 4 - Cardiovascular Risk Stratification 27819383 2017 06 27 2018 11 13 1678-4170 107 3 Suppl 3 2016 09 Arquivos brasileiros de cardiologia Arq. Bras. Cardiol. 7th Brazilian Guideline of Arterial Hypertension: Chapter 3 - Clinical and Complementary Assessment 18-24 S0066-782X2016004800018 10.5935/abc.20160154 Malachias M V B MVB Neves M F T MF Mion D D Júnior Silva G V GV Lopes H F HF Oigman W W eng por Journal Article Practice Guideline (...) 7ª Diretriz Brasileira de Hipertensão Arterial: Capítulo 4 - Estratificação de Risco Cardiovascular Brazil Arq Bras Cardiol 0421031 0066-782X 97C5T2UQ7J Cholesterol IM Blood Pressure Cardiovascular Diseases diagnosis etiology Cholesterol blood Evidence-Based Medicine Female Humans Hypertension complications diagnosis Male Risk Assessment standards Risk Factors Sex Factors 2016 11 8 6 0 2016 11 8 6 0 2017 6 28 6 0 ppublish 27819383 S0066-782X2016004800018 10.5935/abc.20160154 PMC5319462

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2016 Arquivos brasileiros de cardiologia

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