Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis.

This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity. METHODS: A systematic review was conducted of articles published in Medline, Embase and the Cochrane Library up to January 2018. Randomised controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorised by whether they examined a low/high intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12-months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS: A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (-3.12 mmHg, [95%CI -4.78, -1.46 mmHg]; p value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (p
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research

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CONCLUSION: Thus, diabetes mellitus itself was not an independent factor associated with IAD. A larger IAD was preferentially associated with the presence of PAD, and this association was modified by age. PMID: 31813900 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
ConclusionsThe data regarding ketamine use in mechanically ventilated patients is limited in terms of quantity, methodological quality, and demonstrated clinical benefit. Ketamine may play a role as a sedative-sparing agent, but may be associated with harm. High-quality studies are needed before widespread adoption of ketamine earlier in the sedation pathway.
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
AbstractBackgroundFunctional limitations may be more common in middle-aged adults than previously recognized. However, there are few published data on the prevalence of activity limitations, and their association with multimorbidity, among adults 50 to 64  years old.ObjectiveTo describe the prevalence of activity limitations and the association with multimorbidity in middle-aged adults.DesignCross-sectional analysis of US population-based National Health and Nutrition Examination Survey (NHANES) 2011 –2016.ParticipantsThe total number of community-dwelling NHANES participants aged 50 –64 years old is ...
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Conclusion: Periodontal disease is significantly and positively correlated with increased risk of hypertension in Chinese population, and exact mechanisms of this association should be explored in future. Introduction Periodontal disease is a complex polymicrobial inflammation, including gingivitis and periodontitis. According to the 2015 Global Burden of Disease (GBD) study, the prevalence of severe chronic periodontitis in 2015 has reached 616 million (Kassebaum et al., 2017). In China, the periodontal disease standardized DALYs rate has risen from 24.7 in 1990 to 25.7 in 2013 according to the data from 2013 GBD ...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusion Activation of the Nrf2-dependent antioxidant system plays an important role in cell defense against oxidative stress damage, whereas the insufficiency of the Nrf2 system is associated with multiple aspects of the genesis and progression of metabolic diseases, posing a great risk to the cardiovascular system (Figure 1). The systemic increase of Nrf2 activity by several activators may be beneficial in the treatment of metabolic diseases. In addition, selective upregulation of Nrf2 genes may represent a potential therapy in obesity, diabetes and atherosclerosis. Looking to the future, experimental research that el...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion: Increased IASBPD is an independent predictor of incident CKD in the general population.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Kidney Source Type: research
ConclusionsWe found SGBIIA is associated with a reduced risk of CHD for PUD patients.
Source: Obesity Surgery - Category: Surgery Source Type: research
Conclusions Future studies should test tailored interventions to address the specific needs of population subgroups in order to improve their health.
Source: American Journal of Preventive Medicine - Category: Global & Universal Source Type: research
Conclusions: In this longitudinal sample of older men, the findings supported the hypothesis that long-term PM2.5 exposure negatively affects renal function and increases renal function decline. Citation: Mehta AJ, Zanobetti A, Bind MC, Kloog I, Koutrakis P, Sparrow D, Vokonas PS, Schwartz JD. 2016. Long-term exposure to ambient fine particulate matter and renal function in older men: the VA Normative Aging Study. Environ Health Perspect 124:1353–1360; http://dx.doi.org/10.1289/ehp.1510269 Address correspondence to A.J. Mehta, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Landmar...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Article September 2016 Source Type: research
This study investigated the association of estimated glomerular filtration rate (eGFR) with prevalent CVDs, 10-year Framingham risk for coronary heart disease (CHD), and 10-year risk of atherosclerotic cardiovascular diseases (ASCVD) in 239 832 participants from the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study. With an interviewer-assisted questionnaire, we collected information on CVD, including reported CHD, stroke, or myocardial infarction. Chronic Kidney Disease–Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. Compared with ind...
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Cardiovascular Disease, Epidemiology, Lifestyle, Risk Factors Kidney in Cardiovascular Disease Source Type: research
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