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Latest & greatest articles for hypertension
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on hypertension or other clinical topics then use Trip today.
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Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Primary open angle glaucoma and ocular hypertension are habitually treated with eye drops that lower intraocular pressure. Selective laser trabeculoplasty is a safe alternative but is rarely used as first-line treatment. We compared the two.In this observer-masked, randomised controlled trial treatment-naive patients with open angle (...) glaucoma or ocular hypertension and no ocular comorbidities were recruited between 2012 and 2014 at six UK hospitals. They were randomly allocated (web-based randomisation) to initial selective laser trabeculoplasty or to eye drops. An objective target intraocular pressure was set according to glaucoma severity. The primary outcome was health-related quality of life (HRQoL) at 3 years (assessed by EQ-5D). Secondary outcomes were cost and cost-effectiveness, disease-specific HRQoL, clinical
The effectiveness of electronic health interventions on blood pressure control, self-care behavioural outcomes and psychosocial well-being in patients with hypertension: A systematic review and meta-analysis Hypertension is a global health issue. Electronic health (eHealth) is a potential alternative for managing hypertension and modifying hypertension-related self-care set of behaviour. This review aims to identify the delivery mode and strategies used by current eHealth interventions (...) , 95% CI: 0.57-0.84, p < .001) and their body weight (MD: -1.08 kg, 95% CI: -2.04 to -0.13, p < .05). Regarding self-care behavioural outcomes, the pooled results show that eHealth interventions significantly reduced the sodium intake.This study reported that eHealth interventions positively affect blood pressure control and thus could be a promising alternative in the management of hypertension. However, their effectiveness on self-care behavioural change and psychosocial well-being
Assessment of hypertension Assessment of hypertension - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Assessment of hypertension Last reviewed: February 2019 Last updated: February 2019 Summary Hypertension is a common disorder that affects a large proportion of the community. It is usually asymptomatic and is detected on routine examination or after the occurrence of a complication such as a heart attack or stroke (...) . Lip GY. Hypertension, platelets, and the endothelium: the "thrombotic paradox" of hypertension (or "Birmingham paradox") revisited. Hypertension. 2003 Feb;41(2):199-200. http://hyper.ahajournals.org/cgi/content/full/41/2/199 http://www.ncbi.nlm.nih.gov/pubmed/12574081?tool=bestpractice.com Hypertension has been defined in joint guidelines by American learned bodies (American College of Cardiology [ACC] and American Heart Association [AHA] among others) Whelton PK, Carey RM, Aronow WS, et al. 2017
Lifestyle changes may be more important than drugs for mild hypertension. The studySheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs R, McManus R. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension.Published on 1 December 2018 JAMA Intern Med 2018;178:1626-34.This project was funded by a grant from the National Institute for Health Research (NIHR-RP-R2-12-O15) and the Medical Research Council (MRC) Strategic Skills Postdoctoral Fellowship.To (...) read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000713/lifestyle-changes-for-mild-hypertension-rather-than-drugs.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Albumin:creatinine ratio testing in the assessment and/or identification of proteinuria in people with chronic kidney disease or primary hypertension Page 1 of 6 TER005 December 2018 Topic Exploration Report Topic explorations are designed to provide a high-level briefing on new topics submitted for consideration by Health Technology Wales. The main objectives of this report are to: 1. Inform discussions on new topics received by HTW. 2. Determine the quantity and type of evidence available (...) on a topic. 3. Assess the topic against HTW selection criteria. Topic: Albumin:creatinine ratio (ACR) ) testing compared to protein:creatinine ratio (PCR) testing for the detection of proteinuria in patients with hypertension and/or chronic kidney disease Topic exploration report number TER005 Referrer: Dr Soha Zouwail, Consultant Chemical Pathologist, Cardiff and Vale University Health Board Topic exploration undertaken by: Health Technology Wales Aim of Search Health Technology Wales researchers
Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality A systematic review and meta-analysis was conducted to assess the efficacy of low-sodium salt substitutes (LSSS) as a potential intervention to reduce cardiovascular (CV) diseases.Five engines and ClinicalTrials.gov were searched from inception to May 2018. Randomised controlled trials (RCTs) enrolling adult hypertensive or general populations that compared detected hypertension, systolic blood (...) pressure (SBP), diastolic blood pressure (DBP), overall mortality, stroke and other CV risk factors in those receiving LSSS versus regular salt were included. Effects were expressed as risk ratios or mean differences (MD) and their 95% CIs. Quality of evidence assessment followed GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.21 RCTs (15 in hypertensive (n=2016), 2 in normotensive (n=163) and 4 in mixed populations (n=5224)) were evaluated. LSSS formulations were
Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period INTERIM UPDATE ACOGCOMMITTEEOPINION Number 767 (Replaces Committee Opinion Number 692, September 2017) Committee on Obstetric Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice in collaboration with committee members Yasser Y. El-Sayed, MD, and Ann E. Borders, MD, MSc, MPH. INTERIM UPDATE: This Committee Opinion (...) is updated as highlighted to align with the American College of Obstetricians and Gynecologists’ guidance on gestational hypertension, preeclampsia, and chronic hypertension in pregnancy. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period ABSTRACT: Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset
A Three-Arm Randomized Trial of Different Renal Denervation Devices and Techniques in Patients With Resistant Hypertension (RADIOSOUND-HTN) Both radiofrequency and ultrasound endovascular renal sympathetic denervation (RDN) have proven clinical efficacy for the treatment of hypertension. We performed a head-to-head comparison of these technologies.Patients with resistant hypertension were randomly assigned in a 1:1:1 manner to receive either treatment with (1) radiofrequency RDN of the main (...) ).In patients with resistant hypertension, endovascular ultrasound-based RDN was found to be superior to radiofrequency ablation of the main renal arteries only, whereas a combined approach of radiofrequency ablation of the main arteries, accessories, and side branches was not.URL: https://www.clinicaltrials.gov . Unique identifier: NCT02920034.
Phosphodiesterase 5 inhibitors for pulmonary hypertension. Pulmonary hypertension (PH) comprises a group of complex and heterogenous conditions, characterised by elevated pulmonary artery pressure, and which left untreated leads to right-heart failure and death. PH includes World Health Organisation (WHO) Group 1 pulmonary arterial hypertension (PAH); Group 2 consists of PH due to left-heart disease (PH-LHD); Group 3 comprises PH as a result of lung diseases or hypoxia, or both; Group 4 (...) includes PH due to chronic thromboembolic occlusion of pulmonary vasculature (CTEPH), and Group 5 consists of cases of PH due to unclear and/or multifactorial mechanisms including haematological, systemic, or metabolic disorders. Phosphodiesterase type 5 (PDE5) inhibitors increase vasodilation and inhibit proliferation.To determine the efficacy of PDE5 inhibitors for pulmonary hypertension in adults and children.We performed searches of CENTRAL, MEDLINE, Embase, CINAHL, and Web of Science up to 26
Lifestyle changes may be more important than drugs for mild hypertension Lifestyle changes for mild hypertension rather than drugs Discover Portal Discover Portal Lifestyle changes may be more important than drugs for mild hypertension Published on 22 January 2019 doi: Consideration of wider risk factors may be important when treating adults with low-risk mild hypertension (raised blood pressure). A large NIHR-funded UK study compared rates of mortality and risk of cardiovascular disease (...) between patients who received antihypertensive treatment and those who did not. There was an increased risk of adverse effects, like low blood pressure. It found no evidence to support starting drug treatment for adults of low-cardiovascular risk with mild hypertension. This is in line with current NICE guidelines which suggest offering lifestyle advice on several occasions before looking for pharmacological treatment in mild hypertension. There is an ongoing debate about treatment thresholds for mild
Risk assessment in medically treated chronic thromboembolic pulmonary hypertension patients Abbreviated versions of the risk stratification strategy of the European Society of Cardiology (ESC)/European Respiratory Society (ERS) pulmonary hypertension guidelines have been recently validated in patients with pulmonary arterial hypertension. We aimed to investigate their prognostic value in medically treated chronic thromboembolic pulmonary hypertension (CTEPH) patients from the COMPERA registry
Moxibustion for prehypertension and stage I hypertension: a pilot randomized controlled trial. Prehypertension and hypertension are associated with cardiovascular disease, ischemic heart disease, and stroke morbidity. The purpose of this study is to evaluate the effectiveness and safety of moxibustion in patients with prehypertension or hypertension.Forty-five subjects with prehypertension or stage I hypertension were randomized into three groups: moxibustion treatment group A (2 sessions/week (...) with prehypertension or stage I hypertension and treatment frequency might affect effectiveness of moxibustion in BP regulation. Further randomized controlled trials with a large sample size on prehypertension and hypertension should be conducted.This study was registered with the 'Clinical Research Information Service (CRIS)', Republic of Korea (KCT0000469), and the protocol for this study was presented orally at the 15th International Council of Medical Acupuncture and Related Techniques (ICMART) in Athens, 25
Haemodynamics and serial risk assessment in systemic sclerosis associated pulmonary arterial hypertension The prognostic importance of follow-up haemodynamics and the validity of multidimensional risk assessment are not well established for systemic sclerosis (SSc)-associated pulmonary arterial hypertension (PAH).We assessed incident SSc-PAH patients to determine the association between clinical and haemodynamic variables at baseline and first follow-up right heart catheterisation (RHC
Torsemide for Prevention of Persistent Postpartum Hypertension in Women With Preeclampsia: A Randomized Controlled Trial To evaluate whether torsemide reduces the rate of persistent postpartum hypertension in women with preeclampsia.We conducted a randomized, double-blind, placebo-controlled trial of women with preeclampsia at a tertiary center from August 2016 to September 2017. Those with gestational hypertension or renal or cardiopulmonary failure were excluded. Within 24 hours of delivery (...) , women were randomized one to one to oral torsemide, 20 mg/d, or placebo, for 5 days. Our primary outcome was blood pressure greater than or equal to 150 mm Hg systolic or 100 mm Hg diastolic (or both) on two occasions at least 4 hours apart by postpartum day 5 or by the time of hospital discharge. Assuming a 50% rate of persistent hypertension in women with preeclampsia, 118 participants were required to detect a 50% rate reduction. Analyses were by intention to treat.From August 2016 to September
Acupuncture for hypertension. Elevated blood pressure (hypertension) affects about one billion people worldwide. It is important as it is a major risk factor for stroke and myocardial infarction. However, it remains a challenge for the medical profession as many people with hypertension have blood pressure (BP) that is not well controlled. According to Traditional Chinese Medicine theory, acupuncture has the potential to lower BP.To assess the effectiveness and safety of acupuncture (...) for lowering blood pressure in adults with primary hypertension.We searched the Hypertension Group Specialised Register (February 2017); the Cochrane Central Register of Controlled Trials (CENTRAL) 2017, Issue 2; MEDLINE (February 2017); Embase (February 2017), China National Knowledge Infrastructure (CNKI) (January 2015), VIP Database (January 2015), the World Health Organisation Clinical Trials Registry Platform (February 2017)and ClinicalTrials.gov (February 2017). There were no language restrictions.We
First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension. This is the first update of a Cochrane Review first published in 2015. Renin angiotensin system (RAS) inhibitors include angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and renin inhibitors. They are widely prescribed for treatment of hypertension, especially for people with diabetes because of postulated advantages for reducing (...) diabetic nephropathy and cardiovascular morbidity and mortality. Despite widespread use for hypertension, the efficacy and safety of RAS inhibitors compared to other antihypertensive drug classes remains unclear.To evaluate the benefits and harms of first-line RAS inhibitors compared to other first-line antihypertensive drugs in people with hypertension.The Cochrane Hypertension Group Information Specialist searched the following databases for randomized controlled trials up to November 2017
Low plasma stem cell factor combined with high transforming growth factor-Î± identifies high-risk patients in pulmonary arterial hypertension In pulmonary arterial hypertension (PAH), severe vasoconstriction and remodelling of small pulmonary arteries result in high mortality. Receptor tyrosine kinases and their ligands, such as transforming growth factor (TGF)-α, modulate proliferation in PAH. Although the receptor tyrosine kinase c-Kit has been shown to be overexpressed in PAH, the expression (...) Early and Long-Term Pulmonary Arterial Hypertension Disease Management) risk scores in PAH patients correlated to SCF/TGF-α levels (r=-0.50, p=0.0003). In conclusion, low plasma SCF combined with high TGF-α identifies high-risk PAH patients at baseline. Lower circulating SCF levels, which are associated with worse haemodynamics, may be related to the c-Kit accumulation previously observed in PAH.
Distribution of diabetes, hypertension and non-communicable disease risk factors among adults in rural Bangladesh: a cross-sectional survey Non-communicable diseases (NCDs) are increasing in low-income settings. We conducted a survey of risk factors, blood pressure and blood glucose in rural Bangladesh and assessed variations by age, sex and wealth.We surveyed a random sample of 12 280 adults aged >30 years in 96 villages in rural Bangladesh. Fieldworkers measured blood glucose and conducted (...) an insulin tolerance test with a repeat blood test 120 min post glucose ingestion. Blood pressure, anthropometric, socioeconomic, lifestyle and behavioural risk factors data were also collected. Data were analysed to describe the prevalence of diabetes, intermediate hyperglycaemia, hypertension and NCD risk factors by age, sex and wealth.Women had higher levels of overweight or obesity and lower levels of physical activity and fruit and vegetable consumption than men; 63% of men used tobacco compared