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Hypertension Evaluation History

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121. Suspected Pulmonary Hypertension

of the nonspecific symptoms as well as the large, diverse group of diseases that can cause PH, diagnosis can be challenging. A careful history is critical to evaluate for risk factors for PH, including family history, history of drugs and toxins associated with PH, collagen vascular disease, human immunodeficiency virus (HIV), portal hypertension, congenital or left heart disease, and venous thromboembolic disease [11,12]. Clinical evaluation includes pulmonary function tests, arterial blood gases, routine (...) requests to: publications@acr.org. ACR Appropriateness Criteria ® 3 Suspected Pulmonary Hypertension Additionally, Miniati et al [20] showed high sensitivity (96.9%) and specificity (99.1%) for detection of PH by CXR. However, CXR is known to be insensitive in the detection of mild PH. Thus, a normal CXR does not exclude PH and further imaging evaluation should be pursued if there are persistent unexplained symptoms such as dyspnea or risk factors for PH [2,14,21,22]. Findings of PH on CXR include

2016 American College of Radiology

122. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management

resonance elastography; NASH, nonalcoholic steatohepatitis; NITs, noninvasive tests; NO, nitric oxide; NSBBs, nonselective beta- blockers; PH, portal hypertension; PP, portal pressure; PRBC, packed red blood cell; PVT, portal vein thrombosis; RCTs, randomized ,controlled trials; SBP, spontaneous bacterial peritonitis; SMT, somatostatin; SS, spleen stiffness; SVR, sustained virological response; SWE, shear wave elastography; TE, transient elastography; TIPS, transjugular intrahepatic portosystemic shunt (...) " Budd-Chiari syndrome Unable to catheterize hepatic vein Posthepatic Right heart failure "" Normal *PH is classi?ed by the site of increased resistance to blood ?ow. † Gradient or HVPG is calculated by subtracting the FHVP from the WHVP. ‡ In advanced stages of presinusoidal causes of PH, the WHVP and HVPG will increase. Abbreviations: WHVP, wedged hepatic venous pressure; FHVP, free hepatic venous pressure; HCV, hepatitis C virus; NASH, nonal- coholic steatohepatitis; PH, portal hypertension

2016 American Association for the Study of Liver Diseases

123. Subclinical Hypertensive Heart Disease in Black Patients With Elevated Blood Pressure in an Inner-City Emergency Department. (Abstract)

Subclinical Hypertensive Heart Disease in Black Patients With Elevated Blood Pressure in an Inner-City Emergency Department. We examine the point prevalence of subclinical hypertensive heart disease in a cohort of urban emergency department (ED) patients with elevated blood pressure.A convenience sample of hypertensive (blood pressure ≥ 140/90 mm Hg on 2 measurements) patients aged 35 years or older with no history of cardiac or renal disease who presented to a single urban ED and were (...) black, and 51.6% were men. Nearly all (93.8%) had a history of hypertension, and many (68.3%) were receiving antihypertensive therapy at baseline. Mean systolic and diastolic blood pressures were 183.9 mm Hg (SD 25.1 mm Hg) and 109.5 mm Hg (SD 14.4 mm Hg), respectively. Subclinical hypertensive heart disease was found in 146 patients (90.7%; 95% confidence interval [CI] 85.2% to 94.3%), with most (n=131) displaying evidence of diastolic dysfunction (89.7%; 95% CI 83.7% to 93.7%). Left-ventricular

2012 Annals of Emergency Medicine

124. Hypertensive Urgency: Considerations for Management

on the floor & arm supported) (Please refer to Hypertension Canada’s Blood Pressure Measurement Information Sheet for more detailed guidance). ? Obtain medical history & current medication list (prescription, OTC, recreational) ? Physical exam - focus on any signs of target organ damage (e.g. shortness of breath, chest pain, numbness/weakness) ? Lab tests & investigations may be required (e.g. CBC, ECG, urinalysis, renal function; ultrasound for aortic dissection if very high BP) ? Hypertensive urgency (...) urgencies and emergencies: a systematic review of the literature. J Gen Intern Med. 2002 Dec;17(12):937-45. 5 Merlo C, Bally K, Tschudi P, Martina B, Zeller A. Management and outcome of severely elevated blood pressure in primary care: a prospective observational study. Swiss Med Wkly. 2012 Jan 27;142:w13507. 6 Kessler CS, Joudeh Y. Evaluation and treatment of severe asymptomatic hypertension. Am Fam Physician. 2010 Feb 15;81(4):470-6. 7 Marik PE, Rivera R. Hypertensive emergencies: an update. Curr Opin

2014 RxFiles

125. Cohort study: Aiming too high or too low? Searching for the appropriate therapeutic thresholds in hypertension is not over yet Full Text available with Trip Pro

Aiming too high or too low? Searching for the appropriate therapeutic thresholds in hypertension is not over yet Free Artur Fedorowski Statistics from Altmetric.com Commentary on : Rodriguez CJ , Swett K , Agarwal SK , et al . Systolic blood pressure levels among adults with hypertension and incident cardiovascular events: the Atherosclerosis Risk in Communities Study . Context Increased arterial blood pressure (BP) is an established and modifiable cardiovascular (CV) risk factor. Consequently (...) as the realistic treatment goal, can be extrapolated onto middle-aged individuals free from CV disease, that is, those with low-to-moderate CV risk. Moreover, the decision on whether or not to treat the increased office SBP above 160 mm Hg may be additionally supported by elevated night-time BP. References James PA , Oparil S , Carter BL , et al . 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee

2015 Evidence-Based Medicine

126. Beta-blockers in Uncomplicated Hypertension: Is it Time for Retirement?

into use and have become the mainstay in the treatment of hypertension. In the subsequent 40 years, beta-blockers battled high blood pressure in the front-lines. But in 2014, after a 10-year hiatus, the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC) released its 8th guideline on treating hypertension ( ). In these new recommendations, beta-blockers were relegated to second-line treatment, behind thiazide-diuretics, calcium channel blockers (CCB (...) randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet. 2000;356(9227):366-72. Jones DW, Hall JE . Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and evidence from new hypertension trials. Hypertension. 2004;43(1):1-3. Carlberg B, Samuelsson O, Lindholm LH . Atenolol in hypertension

2015 Clinical Correlations

127. Pediatric Pulmonary Hypertension: ATS/AHA Clinical Practice Guidelines

/ Downloaded from by guest on March 15, 2016 http://circ.ahajournals.org/ Downloaded from 2 Circulation November 24, 2015 1. Introduction 1.1. Rationale and Goals This guidelines document addresses approaches to the evalu- ation and treatment of pulmonary hypertension (PH) in chil- dren, defined as a resting mean pulmonary artery pressure (mPAP) >25 mm Hg beyond the first few months of life. This document focuses on childhood disorders of PH result- ing from pulmonary vascular disease (PVD) and includes PH (...) but includes subjects with elevated TPG (mPAP-left atrial pressure or PAWP >6 mm Hg) or high PVRI as observed in patients with cavopulmonary anastomoses without high mPAP HPAH indicates heritable pulmonary artery hypertension; IPAH, idiopathic pulmonary artery hypertension; mPAP, mean pulmonary artery pressure; PAH, pulmonary artery hypertension; PAWP, pulmonary artery wedge pressure; PH, pulmonary hypertension; PHVD pulmonary hypertensive vascular disease; PVRI, pulmonary vascular resistance index

2015 American Thoracic Society

128. Treatment of Hypertension in Patients With Coronary Artery Disease Full Text available with Trip Pro

groups. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure uses the traditional definition of hypertension as an SBP of ≥140 mm Hg or a DBP of ≥90 mm Hg and/or the current use of antihypertensive medication. With this definition, an estimated 65 million adult Americans, or nearly one fourth of the adult population of the United States, have hypertension. Another quarter of the population have prehypertension, defined as an SBP (...) Receptor Blockers 1394 6.7.4. β-Blockers 1394 6.7.5. Nitrates and Hydralazine 1395 6.7.6. Aldosterone Receptor Antagonists 1395 6.8. Renal Denervation 1395 6.9. Goal BP 1395 6.10. Drugs to Avoid 1395 6.11. Recommendations 1396 This is an update of the American Heart Association (AHA) scientific statement “Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association Council for High Blood Pressure Research

2015 American Heart Association

129. Pediatric Pulmonary Hypertension Full Text available with Trip Pro

known to be associated with PAH Referred to as HPAH with positive family or genetic evaluation PHVD Broad category that includes forms of PAH but includes subjects with elevated TPG (mPAP-left atrial pressure or PAWP >6 mm Hg) or high PVRI as observed in patients with cavopulmonary anastomoses without high mPAP HPAH indicates heritable pulmonary artery hypertension; IPAH, idiopathic pulmonary artery hypertension; mPAP, mean pulmonary artery pressure; PAH, pulmonary artery hypertension; PAWP (...) on Cardiovascular Disease in the Young; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia; and the American Thoracic Society Downloaded from http://ahajournals.org by on March 27, 20192038 Circulation November 24, 2015 1. Introduction 1.1. Rationale and Goals This guidelines document addresses approaches to the evalu- ation and treatment of pulmonary hypertension (PH) in chil- dren, defined as a resting mean pulmonary artery pressure (mPAP) >25 mm Hg beyond

2015 American Heart Association

130. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 6: Hypertension Full Text available with Trip Pro

the bladder quickly. BP indicates blood pressure. Evaluation All people who are diagnosed as hypertensive, whether competitive athletes or not, need a thorough but directed history and physical examination with a minimal number of laboratory tests. The history should be sure to determine whether the person has a family history of hypertension or cardiovascular disease, symptoms suggestive of a pheochromocytoma (paroxysmal hypertension, headache, diaphoresis, and palpitations) or if he or she uses (...) , Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and the American College of Cardiology Originally published 2 Nov 2015 Circulation. 2015;132:e298–e302 You are viewing the most recent version of this article. Previous versions: Introduction An elevation of blood pressure (BP) in the systemic circulation (hypertension) is the most common cardiovascular condition in the general population and considered to be the most ubiquitous cardiovascular risk

2015 American Heart Association

131. Whom should you test for secondary causes of hypertension?

that all children and adolescents with a new diagnosis of hypertension undergo renal ultrasound and laboratory evaluation for renal pathology (strength of recommendation [SOR]: C, consensus-based guidelines). Specific diagnostic tests are recommended for newly diagnosed patients who have suspicious clinical findings suggestive of a secondary cause of hypertension based on the initial history (excess daytime sleepiness, palpitations, tremor, sweating); physical examination (abdominal bruit, thyromegaly (...) , malar rash); or laboratory analysis (elevated serum creatinine, low thyroid-stimulating hormone) (SOR: C, consensus-based guidelines). Patients with undifferentiated resistant hypertension should receive further directed evaluation for secondary causes (SOR: C, consensus-based guidelines). URI Citation Journal of Family Practice, 63(1) 2014: 41-42, 54. Rights OpenAccess. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. Collections hosted by hosted by

2014 Clinical Inquiries

132. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. Full Text available with Trip Pro

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure (...) 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events. (Grade: strong recommendation, high-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.ACP and AAFP recommend

2017 Annals of Internal Medicine

133. The "Hypertension Approaches in the Elderly: a Lifestyle study" multicenter, randomized trial (HAEL Study): rationale and methodological protocol. Full Text available with Trip Pro

-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals.Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events (...) The "Hypertension Approaches in the Elderly: a Lifestyle study" multicenter, randomized trial (HAEL Study): rationale and methodological protocol. Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health

2019 BMC Public Health Controlled trial quality: uncertain

134. Blood pressure trajectory and category and risk of hypertensive disorders of pregnancy in nulliparous women. (Abstract)

Blood pressure trajectory and category and risk of hypertensive disorders of pregnancy in nulliparous women. Recently updated American College of Cardiology/ American Heart Association (ACC/AHA) guidelines redefine blood pressure categories as Stage 1 hypertension (systolic 130-139mmHg or diastolic 80-89mmHg), Elevated (systolic 120-129mmHg and diastolic <80mm) and Normal (<120/<80 mmHg), but their relevance to an obstetric population is uncertain.We sought to evaluate the risk of gestational (...) hypertensive disorders of pregnancy. Elevated blood pressure was associated with an aRR 1.54 (95%CI 1.18-2.02) and Stage 1 hypertension was associated with aRR 2.16 (95%CI 1.31-3.57) of any hypertensive disorder of pregnancy. Stage 1 hypertension was associated with the highest risk of preeclampsia with severe features with an aRR 2.48 (95%CI 1.38-8.74). Both systolic and diastolic blood pressure trajectories were also significantly associated with the risk of hypertensive disorders of pregnancy

2019 American Journal of Obstetrics and Gynecology

135. Incidence of Rebound Hypertension after Discontinuation of Dexmedetomidine. (Abstract)

medications.This retrospective, matched cohort study evaluated the incidence of rebound hypertension in intensive care unit patients receiving continuous infusions of at least 72 hours in duration of dexmedetomidine, propofol, or midazolam.The study population consisted of 216 patients: 54 treated with dexmedetomidine and 162 treated with propofol or midazolam. Rebound hypertension occurred significantly more often in patients with a history of hypertension (71.1%) than in patients with no prior hypertension (...) Incidence of Rebound Hypertension after Discontinuation of Dexmedetomidine. To date, no studies have evaluated the incidence of rebound hypertension occurring with the discontinuation of long-term (> 72 hrs) dexmedetomidine infusions. Rebound hypertension has been documented in the literature with clonidine, a structurally and pharmacologically similar medication.To compare the incidence of rebound hypertension associated with cessation of dexmedetomidine infusion with other sedative

2019 Pharmacotherapy

136. A Postpartum Remote Hypertension Monitoring Protocol Implemented at the Hospital Level. (Abstract)

A Postpartum Remote Hypertension Monitoring Protocol Implemented at the Hospital Level. To evaluate the feasibility, acceptability, and compliance of a remote blood pressure monitoring protocol implemented as a quality improvement measure at the hospital level for management of hypertension in postpartum women after hospital discharge.This is an ongoing quality improvement project that included women admitted to the postpartum unit of a single tertiary care hospital. We designed nursing call (...) %) participants had antihypertensives initiated or titrated through the program. Three hundred forty women (83%) continued the program beyond 3 weeks postpartum, and 360 (88%) attended an in-person 6-week postpartum visit. Two hundred thirty-five out of 250 women who completed a postprogram survey (94%) reported satisfaction with the program.In this study, we detail results from an ongoing remote blood pressure monitoring program. We demonstrate high compliance, retention, and patient satisfaction

2019 Obstetrics and Gynecology

137. Esophageal Capsule Endoscopy (ECE) in Children and Young Adults with Portal Hypertension. (Abstract)

Esophageal Capsule Endoscopy (ECE) in Children and Young Adults with Portal Hypertension. Variceal hemorrhage (VH) is a serious complication of portal hypertension (PH). We evaluated the feasibility, safety, and clinical impact of esophageal capsule endoscopy (ECE) in pediatric and young adult patients with known or suspected portal hypertension.Children and young adults with PH at Boston Children's Hospital (2005-2017) were offered ECE for variceal screening or surveillance. Patient histories (...) , ECE findings, and clinical outcomes were reviewed retrospectively.149 ECE studies were performed in 98 patients (57.1% male) using 3 ECE devices for variceal screening (66.5%) or surveillance (33.5%). 3 readers interpreted the studies (88.3%, 10.3%, and 1.4%, respectively). Median age was 16y (IQR 13.7, 18.5). 103 ECE studies involved patients <18y (69.1%). 15 patients (29 ECE studies) had a GI bleeding (GIB) history, 5 in the preceding 12m.62 ECE studies (44.9%) detected varices: 59 esophageal

2019 Journal of Pediatric Gastroenterology and Nutrition

138. The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. (Abstract)

The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. To evaluate the effects of self-management education tailored to health literacy on medication adherence and blood pressure control.This randomized controlled trial was conducted in 2018 with 118 elderly people with uncontrolled primary hypertension and inadequate health literacy. Self-management (...) education was developed on the basis of the health literacy index. Medication adherence and blood pressure were assessed using 8-items Morisky Medication Adherence Scale and a mercury sphygmomanometer, respectively.At baseline, there were no significant between-group differences regarding participants' demographic characteristics, medical history, and medication adherence. After the intervention, between-group comparisons adjusted for pretest scores showed a significant reduction in the mean score

2019 Patient education and counseling Controlled trial quality: uncertain

139. Patient-Level Prediction of Cardio-Cerebrovascular Events in Hypertension Using Nationwide Claims Data. Full Text available with Trip Pro

management via the nationwide health maintenance program, and health care providers should inform patients about their risks of a complication caused by hypertension.Our goal was to develop and compare machine learning models predicting high-risk vascular diseases for hypertensive patients so that they can manage their blood pressure based on their risk level.We used a 12-year longitudinal dataset of the nationwide sample cohort, which contains the data of 514,866 patients and allows tracking of patients (...) test F1-score=.705). Concerning the number of features, in the within test, the long short-term memory-based algorithms outperformed regardless of the number of features. However, in the external test, the random forest-based algorithm was the best, irrespective of the number of features it encountered.We developed and compared machine learning models predicting high-risk vascular diseases in hypertensive patients so that they may manage their blood pressure based on their risk level. By relying

2019 Journal of medical Internet research

140. Interaction between low-density lipoprotein-cholesterolaemia, serum uric level and incident hypertension: data from the Brisighella Heart Study. (Abstract)

selected from the general database of the Brisighella Heart Study four groups of age and sex-matched nonhypertensive individuals with different levels of LDL-C and SUA level and examined during the 2008 population survey. Incident hypertension has been defined as the increase of SBP values over 140 mmHg and/or of DBP over 90 mmHg and or the beginning of an antihypertensive treatment.In a model adjusted for age, sex, baseline blood pressure, family history of hypertension, smoking status, BMI (...) Interaction between low-density lipoprotein-cholesterolaemia, serum uric level and incident hypertension: data from the Brisighella Heart Study. Previous evidence suggest that high low-density lipoprotein cholesterol (LDL-C) and serum uric acid (SUA) levels are risk factors for endothelial dysfunction and vascular ageing. The aim of our study was to evaluate the short-term interaction between SUA, LDL-C and incident hypertension in a sample of overall healthy individuals.In January 2018, we

2019 Journal of Hypertension

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