Hypertensive Mediated Organ Damage and Hypertension Management. How to Assess Beneficial Effects of Antihypertensive Treatments?

AbstractThe presence of hypertensive mediated organ damage is related to increased vascular risk and mortality and its prevention should be a therapeutic target and a surrogate marker of in/adequate blood pressure control. In old adult hypertensive patients the therapeutic target should be to prevent major cardiovascular events, but in young hypertensive subjects the focus should be pointed on preventing the development of hypertensive mediated organ damage, since most of the hard events are preceded by functional and structural tissues injury. Hypertension Guidelines of the European Society of Cardiology and European Society of Hypertension recognizes that some variables like electrocardiographic or echocardiographic left ventricle hypertrophy, chronic kidney disease or advance retinopathy, all considered as hypertensive mediated organ damage, may be modifiers of cardiovascular risk estimated by the SCORE system, and for that reason they should be screened in hypertensive patients. It is well known the problem of limited health systems financial resources in many low and even median income countries which precludes the possibilities of generalizing the search for hypertension mediated organ damage in all hypertensive patients. In these scenario the recommendation to perform a detailed screening should be critically evaluated. Some questions remained unanswered: the screening generalization of hypertensive mediated organ damage should modify the cardiovascular risk score of t...
Source: High Blood Pressure and Cardiovascular Prevention - Category: Cardiology Source Type: research

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AbstractThe prognostic impact of left atrial size in patients without systolic dysfunction nor atrial fibrillation (AF) has not been fully elucidated in Japan. We retrospectively analyzed data obtained from 4444 consecutive patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in our hospital. Those who presented with a history of myocardial infarctions, severe and moderate valvular diseases, low ejection fraction (  34 ml/m2. The primary outcome measure was a composite of all-cause death and major adverse cardiac events. A total of 2792 patients were categoriz...
Source: Heart and Vessels - Category: Cardiology Source Type: research
CONCLUSIONS: The majority of outpatient cTn orders were intended to evaluate for MI, although electrocardiograms were frequently not ordered and few patients were sent for further ED evaluation. Providers should be encouraged to use cTn testing in a manner that minimizes the potential risk to patients with possible MI. PMID: 31050800 [PubMed - in process]
Source: Southern Medical Journal - Category: General Medicine Tags: South Med J Source Type: research
This study aimed at describing the clinical features and outcome of AF patients at a tertiary hospital in Botswana. METHODS: This prospective study was carried out in the Princess Marina Hospital in Gaborone, Botswana between August 2016 and July 2018. We consecutively enrolled 138 (97.8% black Africans) adult patients with electrocardiographically documented AF. Their baseline clinical and biomedical data were documented, and each patient was followed up for 12 months. The primary study outcome was 12-month all-cause mortality. RESULTS: The mean [standard deviation (SD) ] age of enrolled patients was 66.7 (17.2)...
Source: Cardiovascular Journal of Africa - Category: Cardiology Authors: Tags: Cardiovasc J Afr Source Type: research
ConclusionsValsartan was generally well tolerated, with an AE profile consistent with angiotensin receptor blockers in the overall population and in patients with underlying CKD. Long-term efficacy was maintained and a beneficial effect on proteinuria was observed.
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
Publication date: Available online 13 December 2018Source: The Lancet HIVAuthor(s): Joseph J Eron, Jean-Daniel Lelievre, Robert Kalayjian, Jihad Slim, Anson K Wurapa, Jeffrey L Stephens, Cheryl McDonald, Eric Cua, Aimee Wilkin, Brigitte Schmied, Mehri McKellar, Stephanie Cox, Sophia R Majeed, Shuping Jiang, Andrew Cheng, Moupali Das, Devi SenGuptaSummaryBackgroundCurrent treatment for HIV-infected individuals with renal failure on haemodialysis frequently requires complex regimens with multiple pills. A daily single-tablet regimen of coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide is approve...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research
In conclusion, our study reports, for the first time, identification of compound heterozygous TRPM4 null mutations in a proband with, at an arrhythmogenic level, only a Brugada type 1-like electrocardiogram. By combining the genotype/phenotype relationship of this case and analysis of previously reported TRPM4 variations, we suggest that loss-of-function TRPM4 variations, in a heterozygous status, could not be considered as pathogenic or likely pathogenic mutations in cardiac channelopathies such as Long QT syndrome or Brugada syndrome. PMID: 30142439 [PubMed - as supplied by publisher]
Source: European Journal of Medical Genetics - Category: Genetics & Stem Cells Authors: Tags: Eur J Med Genet Source Type: research
AbstractPurpose of ReviewWe sought to determine whether a role existed for the screening of certain populations with electrocardiogram (ECG) to improve risk stratification and facilitate risk reduction for primary prevention.Recent FindingsCurrent screening guidelines do not recommend ECG screening for the general population.SummaryWhile current guidelines, based on the available evidence, do not recommend ECG screening for the general population, in this report, we show that certain groups such as the elderly, those with hypertension, diabetes, or chronic kidney disease, may benefit from screening as a cost-effective mean...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
Rationale: Ozone autohemotherapy as an alternative treatment method has been applied to the treatment of several diseases. Here, we report a patient used ozone autohemotherapy to treat her hypertension and diabetes. Nevertheless, the patient occurred sudden dizziness and black haze due to hyperkalemia. Patient concerns: A 54-year-old woman who was admitted to our emergency department complaining of sudden dizziness and black haze for 5 hours. Diagnoses: The blood potassium test showed hyperkalemia. Upon further inquiry of her medical history, the patient received ozone autohemotherapy to treat hypertension and di...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusions: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium. Additional research is needed to confirm these findings in other populations. https://doi.org/10.1289/EHP1521 Received: 22 December 2016 Revised: 17 September 2017 Accepted: 19 September 2017 Published: 19 October 2017 Address correspondence to T. Wu, or A. Pan, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd., Wuhan 430030, Hubei, China. Telephone: +86-27-83692347. Email: wut@mails.tjmu.edu.cn or p...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
Background: Low risk patients with suspected coronary ischemic syndrome (CIS) undergo hospital procedures despite unclear benefit. False negative evaluations can contribute to unnecessary testing that increases cost. This analysis stratified the likelihood of non-obstructive disease at time of coronary angiography (CA) to determine predictors of a negative study and assessed subsequent costs resulting from negative CA.Methods: 564 coronary angiograms were performed during 2013 at a single institution. Patients with ST-segment elevation myocardial infarction, cardiac arrest, multiple angiograms, or a clear non-CIS indicatio...
Source: Circulation: Cardiovascular Quality and Outcomes - Category: Cardiology Authors: Tags: Session Title: Poster Session I Source Type: research
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