The Mediterranean Diet: Lost in Translation
AbstractPurpose of ReviewDespite substantive evidence documenting the efficacy of the Mediterranean diet to reduce cardiovascular events, underutilization is common. An overview of the data set supporting the role of the Mediterranean diet as confirmed in both observational and interventional trials should stimulate greater clinician interest in the diet. Additionally, the availability of patient-friendly tools that enable prompt and easy adoption of the Mediterranean diet, that are able to be used by clinicians who claim no special expertise in diet knowledge, should simplify the path to successful dietary change.Recent F...
Source: Current Hypertension Reports - November 14, 2018 Category: Primary Care Source Type: research

Inflammation in Salt-Sensitive Hypertension and Renal Damage
AbstractPurpose of ReviewLow-grade inflammation drives elevations in blood pressure (BP) and consequent target organ damage in diverse experimental models of hypertension. Here, we discuss recent advances elucidating immune-mediated mechanisms of BP elevation and associated target organ damage.Recent FindingsInflammatory mediators produced by immune cells or target organs act on the kidney, vasculature, skin, and nervous system to modulate hypertension. For example, cells of the innate immune system, including monocytes, neutrophils, and dendritic cells (DCs), can all promote BP elevation via actions in the vasculature and...
Source: Current Hypertension Reports - October 30, 2018 Category: Primary Care Source Type: research

The Relationship Between Psychosocial Status and Hypertensive Condition
AbstractPurpose of ReviewThe aim of the paper is to test the influence of social status and psychological well-being (independent variables) on hypertensive condition (dependent variable), when adjusting for traditional risk factors of cardiovascular disease (control variables). The analysis is based on data collected from SEPHAR III, a nationally representative epidemiologic study of the Romanian adult population.Recent FindingsUnderstanding the social roots of health issues is of considerable importance in developing effective strategies and policies. In this context, most studies explain the influence of social and psyc...
Source: Current Hypertension Reports - October 25, 2018 Category: Primary Care Source Type: research

Out of Office Blood Pressure Measurement in Pregnancy and the Postpartum Period
AbstractPurposeHypertensive disorders of pregnancy are increasing in prevalence and associated with significant maternal and perinatal morbidity and mortality.Recent FindingsIncreased emphasis has been placed recently on the use of out-of-office (i.e., home and ambulatory) blood pressure (BP) monitoring to diagnose and manage hypertension in the general population. Current guidelines offer limited recommendations on the use of out-of-office BP monitoring during pregnancy and postpartum.SummaryThis review will discuss the recent literature on BP measurement outside of the office and its use for screening, diagnosis, and tre...
Source: Current Hypertension Reports - October 25, 2018 Category: Primary Care Source Type: research

Inflammation as a Regulator of the Renin-Angiotensin System and Blood Pressure
AbstractPurpose of ReviewMechanisms facilitating progression of hypertension via cross stimulation of the renin-angiotensin system (RAS) and inflammation have been proposed. Accordingly, we review and update evidence for regulation of RAS components by pro-inflammatory factors.Recent FindingsAngiotensin II (Ang II), which is produced by RAS, induces vasoconstriction and consequent blood pressure elevation. In addition to this direct action, chronically elevated Ang II stimulates several pathophysiological mechanisms including generation of oxidative stress, stimulation of the nervous system, alterations in renal hemodynami...
Source: Current Hypertension Reports - October 5, 2018 Category: Primary Care Source Type: research

Obesity and Pulmonary Hypertension
AbstractPurpose of ReviewWhether the present obesity epidemic will increase the prevalence of pulmonary hypertension over the next decades is unclear. We review the obesity-related mechanisms that may further the development and progression of pulmonary hypertension.Recent FindingsSystemic and local inflammation, insulin resistance and oxidative stress contribute to the pathobiology of obesity and pulmonary arterial hypertension. Preliminary data suggest that expansion of adipose tissue surrounding the pulmonary artery may hasten the progression of pulmonary arterial hypertension in obese persons. Further, obesity-associat...
Source: Current Hypertension Reports - October 5, 2018 Category: Primary Care Source Type: research

Effect of L-Citrulline Supplementation on Blood Pressure: a Systematic Review and Meta-Analysis of Clinical Trials
AbstractPurpose of ReviewSeveral interventional studies assessed the impact of dietary supplements on blood pressure. The aim of the present systematic review and meta-analysis was to determine the efficacy of L-citrulline supplementation on blood pressure.Recent FindingPubmed, Scopus, Google Scholar, and ISI Web of Science were comprehensively searched until May 2018 to assess whether L-citrulline reduces blood pressure. Human clinical trials which reported the effect of L-citrulline supplementation on aortic and brachial blood pressure were included. Characteristics of studies and potential sources of heterogeneity were ...
Source: Current Hypertension Reports - October 3, 2018 Category: Primary Care Source Type: research

Chronotherapy for Hypertension
AbstractPurpose of ReviewGiven the emerging knowledge that circadian rhythmicity exists in every cell and all organ systems, there is increasing interest in the possible benefits of chronotherapy for many diseases. There is a well-documented 24-h pattern of blood pressure with a morning surge that may contribute to the observed morning increase in adverse cardiovascular events. Historically, antihypertensive therapy involves morning doses, usually aimed at reducing daytime blood pressure surges, but an absence of nocturnal dipping blood pressure is also associated with increased cardiovascular risk.Recent FindingsTo more e...
Source: Current Hypertension Reports - September 28, 2018 Category: Primary Care Source Type: research

Adipose Tissue and Modulation of Hypertension
AbstractPurpose of ReviewObesity is a major risk factor for the development of hypertension (HTN), a leading cause of cardiovascular morbidity and mortality. Growing body of research suggests that adipose tissue function is directly associated with the pathogenesis of obesity-related HTN. In this review, we will discuss recent research on the role of adipose tissue in blood pressure (BP) regulation and activation of brown adipose tissue (BAT) as a potentially new therapeutic means for obesity-related HTN.Recent FindingsAdipose tissue provides mechanical protection of the blood vessels and plays a role in regulation of vasc...
Source: Current Hypertension Reports - September 18, 2018 Category: Primary Care Source Type: research

SPRINT and the Kidney: What Have We Learned?
AbstractPurpose of ReviewTo review the impact of the Systolic Blood Pressure Interventional Trial (SPRINT) on renal function and chronic kidney disease.Recent FindingsHypertension is a risk factor for cardiovascular and kidney outcomes in patients with chronic kidney disease (CKD). The benefits of intensive blood pressure lowering in the CKD population in previous studies are unclear. The SPRINT compared standard (
Source: Current Hypertension Reports - September 14, 2018 Category: Primary Care Source Type: research

Skin Sodium and Hypertension: a Paradigm Shift?
AbstractPurpose of ReviewDietary sodium is an important trigger for hypertension and humans show a heterogeneous blood pressure response to salt intake. The precise mechanisms for this have not been fully explained although renal sodium handling has traditionally been considered to play a central role.Recent FindingsAnimal studies have shown that dietary salt loading results in non-osmotic sodium accumulation via glycosaminoglycans and lymphangiogenesis in skin mediated by vascular endothelial growth factor-C, both processes attenuating the rise in BP. Studies in humans have shown that skin could be a buffer for sodium and...
Source: Current Hypertension Reports - September 13, 2018 Category: Primary Care Source Type: research

Catheter-Based Renal Denervation for Hypertension
AbstractPurpose of ReviewThis review was undertaken to update readers on the field of therapeutic renal denervation for hypertension during the 2016 through 2018 period.Recent FindingsAfter the failure of Symplicity HTN-3 to meet its top line objective, intense scrutiny revealed several possible concerns addressed by the newer investigations into the area of renal denervation. These included better device technology, more intense subject monitoring for off-protocol antihypertensive drug usage, and deeper penetration into the renal vasculature by the interventionist.SummaryWhether untreated by medication for hypertension or...
Source: Current Hypertension Reports - September 10, 2018 Category: Primary Care Source Type: research

Modulation of Sympathetic Overactivity to Treat Resistant Hypertension
AbstractPurpose of ReviewTo review the role and evidence for sympathetic overactivity in resistant hypertension and review the therapies that have been studied to modulate the sympathetic nervous system to treat resistant hypertension, with a focus on non-pharmacologic therapies such as renal denervation, baroreflex activation therapy, and carotid body ablation.Recent FindingsBased on the two best current techniques available for assessing sympathetic nerve activity, resistant hypertension is characterized by increased sympathetic nerve activity. Several device therapies, including renal denervation baroreflex activation t...
Source: Current Hypertension Reports - September 7, 2018 Category: Primary Care Source Type: research

Candidate Gene, Genome-Wide Association and Bioinformatic Studies in Pre-eclampsia: a Review
AbstractPurpose of ReviewRegardless of the familial linkage reported in pre-eclampsia development, understanding the polymorphic genes associated with pre-eclampsia remains limited. Hence, this review aims to outline the main genetic factors that have been investigated in respect to pre-eclampsia development.Recent FindingsIt is apparent that different genes show significance in varying populations. Notably, it is reported that apolipoprotein-1 gene polymorphisms are associated with pre-eclampsia development in an African-American population, which may be worthwhile to investigate in a Black South African cohort.SummaryDes...
Source: Current Hypertension Reports - August 29, 2018 Category: Primary Care Source Type: research

Novel Medical Treatments for Hypertension and Related Comorbidities
AbstractPurpose of ReviewThe purpose of this review is to summarize the most recent data available on advances in development of novel medical treatments for hypertension and related comorbidities.Recent FindingsApproximately half of all hypertensive patients have not achieved goal blood pressure with current available antihypertensive medications. Recent landmark studies and new hypertension guidelines have called for stricter blood pressure control, creating a need for better strategies for lowering blood pressure. This has led to a shift in focus, in recent years, to the development of combination pills as a means of ac...
Source: Current Hypertension Reports - August 25, 2018 Category: Primary Care Source Type: research

Enhancing Mitochondrial Health to Treat Hypertension
AbstractPurpose of ReviewThis review summarizes literature pertaining to the dawning field of therapeutic targeting of mitochondria in hypertension and discusses the potential of these interventions to ameliorate hypertension-induced organ damage.Recent FindingsIn recent years, mitochondrial dysfunction has been reported as an important contributor to the pathogenesis of hypertension-related renal, cardiac, and vascular disease. This in turn prompted development of novel mitochondria-targeted compounds, some of which have shown promising efficacy in experimental studies and safety in clinical trials. In addition, drugs tha...
Source: Current Hypertension Reports - August 17, 2018 Category: Primary Care Source Type: research

Mineralocorticoids and Cardiovascular Disease in Females with Insulin Resistance and Obesity
AbstractPurpose of the ReviewIn the present review, we will discuss the evidence and the mechanisms underlying the complex interplay between obesity, mineralocorticoid receptor activation, and cardiovascular dysfunction with special emphasis on the pathogenesis of cardiovascular disease (CVD) in obese and insulin-resistant females.Recent FindingsSince the initial isolation of aldosterone in 1953 and the cloning of the mineralocorticoid receptor (MR) decades later, our understanding has expanded tremendously regarding their involvement in the pathogenesis of CVD. Recent results from both pre-clinical and clinical studies su...
Source: Current Hypertension Reports - August 14, 2018 Category: Primary Care Source Type: research

Environmental Toxicant Exposure and Hypertensive Disorders of Pregnancy: Recent Findings
AbstractPurpose of ReviewTo assess the strength of evidence for associations between environmental toxicants and hypertensive disorders of pregnancy, suggest potential biological mechanisms based on animal and in vitro studies, and highlight avenues for future research.Recent FindingsEvidence is strongest for links between persistent chemicals, including lead, cadmium, organochlorine pesticides, and polycyclic biphenyls, and preeclampsia, although associations are sometimes not detectable at low-exposure levels. Results have been inconclusive for bisphenols, phthalates, and organophosphates. Biological pathways may include...
Source: Current Hypertension Reports - August 8, 2018 Category: Primary Care Source Type: research

Effectiveness of mHealth Interventions in Improving Medication Adherence Among People with Hypertension: a Systematic Review
This study aims to systematically review existing evidence on the effectiveness of mobile health technology (mHealth) interventions in addressing medication adherence among people with hypertension.Recent FindingsTwenty-one studies of mHealth interventions were included in the final review after systematic searching and screening of publications from 2000 to 2017 in PubMed, Web of Science, and Embase. Key features of the mHealth interventions include high intervention intensity, multifactorial components, and patient-centered approaches with tailored content and interaction. All studies found tendencies to improvement in m...
Source: Current Hypertension Reports - August 7, 2018 Category: Primary Care Source Type: research

The Role of Out-of-Clinic Blood Pressure Measurements in Preventing Hypertension
AbstractPurpose of ReviewOne of the possible strategies for preventing hypertension is identifying high-risk people and then implementing lifestyle modifications or therapeutic interventions. Out-of-clinic blood pressure measurements, either home or ambulatory blood pressure monitoring, may identify people with early blood pressure elevation or white-coat or masked hypertension and potentially help prevent hypertension. In this review, we will summarize the evidence on the role of out-of-clinic blood pressure measurements in preventing hypertension either from prehypertension or high normal or elevated blood pressure, or f...
Source: Current Hypertension Reports - July 30, 2018 Category: Primary Care Source Type: research

Phosphodiesterase Inhibition in the Treatment of Preeclampsia: What Is New?
AbstractPurpose of ReviewThe present study intends to review the possibility of using phosphodiesterase inhibitors as a treatment option for preeclampsia, addressing potential risks and benefits.Recent FindingsPreeclampsia is the most common hypertensive disorder of pregnancy, often responsible for severe maternal and fetal complications, which can lead to early pregnancy termination and death. Despite the numerous studies, its pathophysiology is still unclear, although it seems to involve a multiplicity of complex factors related to angiogenesis, ineffective vasodilation, oxidative stress, inflammatory cytokines, and endo...
Source: Current Hypertension Reports - July 26, 2018 Category: Primary Care Source Type: research

The Incidence and Pathophysiology of the Obesity Paradox: Should Peritoneal Dialysis and Kidney Transplant Be Offered to Patients with Obesity and End-Stage Renal Disease?
AbstractPurpose of ReviewTo educate nephrologists and primary-care physicians about the incidence, pathophysiology, and survival benefits of the obesity paradox in end-stage renal disease (ESRD). This review also discusses the future of kidney transplant and peritoneal dialysis in obese dialysis patients.Recent FindingsObesity paradox in ESRD was first reported three decades ago, and since then, there have been several epidemiological studies that confirmed the phenomenon. Regardless of the anthropometric indices used to define obesity in ESRD patients, these markers serve to predict the dialysis patient ’s survival....
Source: Current Hypertension Reports - July 26, 2018 Category: Primary Care Source Type: research

Big Data and Blood Pressure Control: Insights from the PAMELA and BP-CARE Study Cohorts
AbstractPurpose of ReviewThe paper examines the patterns of BP control achieved in two large scale observational studies, i.e., the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study and the Blood Pressure control rate and CArdiovascular Risk profilE (BP-CARE), carried out in the general population and in treated hypertensive patients, respectively.Recent FindingsIt is well known that only a minor fraction among the treated hypertensive patients exhibits a good blood pressure control. However, few study investigated blood pressure control on the basis not only of office, but also home and ambulatory blood pr...
Source: Current Hypertension Reports - July 26, 2018 Category: Primary Care Source Type: research

The Incidence and Pathophysiology of the Obesity Paradox: Should Peritoneal Dialysis and Kidney Transplant Be Offered to Patients with Obesity and End-Stage Renal Disease?
AbstractPurpose of ReviewTo educate nephrologists and primary-care physicians about the incidence, pathophysiology, and survival benefits of the obesity paradox in end-stage renal disease (ESRD). This review also discusses the future of kidney transplant and peritoneal dialysis in obese dialysis patients.Recent FindingsObesity paradox in ESRD was first reported three decades ago, and since then, there have been several epidemiological studies that confirmed the phenomenon. Regardless of the anthropometric indices used to define obesity in ESRD patients, these markers serve to predict the dialysis patient ’s survival....
Source: Current Hypertension Reports - July 26, 2018 Category: Primary Care Source Type: research

Phosphodiesterase Inhibition in the Treatment of Preeclampsia: What Is New?
AbstractPurpose of ReviewThe present study intends to review the possibility of using phosphodiesterase inhibitors as a treatment option for preeclampsia, addressing potential risks and benefits.Recent FindingsPreeclampsia is the most common hypertensive disorder of pregnancy, often responsible for severe maternal and fetal complications, which can lead to early pregnancy termination and death. Despite the numerous studies, its pathophysiology is still unclear, although it seems to involve a multiplicity of complex factors related to angiogenesis, ineffective vasodilation, oxidative stress, inflammatory cytokines, and endo...
Source: Current Hypertension Reports - July 26, 2018 Category: Primary Care Source Type: research

Big Data and Blood Pressure Control: Insights from the PAMELA and BP-CARE Study Cohorts
AbstractPurpose of ReviewThe paper examines the patterns of BP control achieved in two large scale observational studies, i.e., the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study and the Blood Pressure control rate and CArdiovascular Risk profilE (BP-CARE), carried out in the general population and in treated hypertensive patients, respectively.Recent FindingsIt is well known that only a minor fraction among the treated hypertensive patients exhibits a good blood pressure control. However, few study investigated blood pressure control on the basis not only of office, but also home and ambulatory blood pr...
Source: Current Hypertension Reports - July 26, 2018 Category: Primary Care Source Type: research

The Effects of Oral Taurine on Resting Blood Pressure in Humans: a Meta-Analysis
AbstractPurpose of ReviewThe aims of this meta-analysis were to investigate the effects of orally administered isolated taurine on resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) in humans.Recent FindingsThere is growing evidence that taurine deficiency is associated with hypertension and that oral supplementation can have antihypertensive effects in humans. However, these investigations have been conducted across a number of decades and populations and have not been collectively reviewed. A search was performed using various databases in May 2018 and later screened using search criteria for eligib...
Source: Current Hypertension Reports - July 13, 2018 Category: Primary Care Source Type: research

The Role of Uric Acid in Preeclampsia: Is Uric Acid a Causative Factor or a Sign of Preeclampsia?
AbstractPurpose of ReviewBecause of the significant discrepancies on this topic, this review will focus on the role of uric acid in PE, uric acid as a predictor of preeclampsia and fetal growth retardation. We considered eligible review and original articles relevant to the research question.Recent FindingsHypertensive disorders of pregnancy such as preeclampsia (PE) are a major cause of both maternal and fetal morbidity and mortality worldwide. Uric acid has been reported as a key factor contributing to the pathogenesis of PE. Some studies have indicated that serum uric acid levels increase with the severity of PE, while ...
Source: Current Hypertension Reports - July 10, 2018 Category: Primary Care Source Type: research

An Overview of Metabolic Phenotyping in Blood Pressure Research
AbstractPurpose of the ReviewThis review presents the analytical techniques, processing and analytical steps used in metabolomics phenotyping studies, as well as the main results from epidemiological studies on the associations between metabolites and high blood pressure.Recent FindingsA variety of metabolomic approaches have been applied to a range of epidemiological studies to uncover the pathophysiology of high blood pressure. Several pathways have been suggested in relation to blood pressure including the possible role of the gut microflora, inflammatory, oxidative stress, and lipid pathways. Metabolic changes have als...
Source: Current Hypertension Reports - July 10, 2018 Category: Primary Care Source Type: research

Visceral Adipose Tissue Accumulation and Residual Cardiovascular Risk
AbstractPurpose of the ReviewLow-grade systemic inflammation increases residual cardiovascular risk. The pathogenesis of low-grade systemic inflammation is not well understood.Recent FindingsVisceral adipose tissue accumulates when the subcutaneous adipose tissue can no longer store excess nutrients. Visceral adipose tissue inflammation initially facilitates storage of nutrients but with time become maladaptive and responsible for low-grade systemic inflammation. Control of low-grade systemic inflammation requires reversal of visceral adipose tissue accumulation with intense and sustained aerobic exercise or bariatric surg...
Source: Current Hypertension Reports - July 10, 2018 Category: Primary Care Source Type: research

Orexins, Sleep, and Blood Pressure
AbstractPurpose of ReviewThe aim of this review was to summarize collected data on the role of orexin and orexin neurons in the control of sleep and blood pressure.Recent FindingsAlthough orexins (hypocretins) have been known for only 20  years, an impressive amount of data is now available regarding their physiological role. Hypothalamic orexin neurons are responsible for the control of food intake and energy expenditure, motivation, circadian rhythm of sleep and wake, memory, cognitive functions, and the cardiovascular system. Mu ltiple studies show that orexinergic stimulation results in increased blood pressure an...
Source: Current Hypertension Reports - July 10, 2018 Category: Primary Care Source Type: research

The Role of Uric Acid in Preeclampsia: Is Uric Acid a Causative Factor or a Sign of Preeclampsia?
AbstractPurpose of ReviewBecause of the significant discrepancies on this topic, this review will focus on the role of uric acid in PE, uric acid as a predictor of preeclampsia and fetal growth retardation. We considered eligible review and original articles relevant to the research question.Recent FindingsHypertensive disorders of pregnancy such as preeclampsia (PE) are a major cause of both maternal and fetal morbidity and mortality worldwide. Uric acid has been reported as a key factor contributing to the pathogenesis of PE. Some studies have indicated that serum uric acid levels increase with the severity of PE, while ...
Source: Current Hypertension Reports - July 10, 2018 Category: Primary Care Source Type: research

An Overview of Metabolic Phenotyping in Blood Pressure Research
AbstractPurpose of the ReviewThis review presents the analytical techniques, processing and analytical steps used in metabolomics phenotyping studies, as well as the main results from epidemiological studies on the associations between metabolites and high blood pressure.Recent FindingsA variety of metabolomic approaches have been applied to a range of epidemiological studies to uncover the pathophysiology of high blood pressure. Several pathways have been suggested in relation to blood pressure including the possible role of the gut microflora, inflammatory, oxidative stress, and lipid pathways. Metabolic changes have als...
Source: Current Hypertension Reports - July 10, 2018 Category: Primary Care Source Type: research

Evaluation and Management of Stage 2 Hypertension in Pediatric Patients
AbstractPurpose of ReviewTo update the definition and clinical practice of stage 2 hypertension (HTN) in pediatrics.Recent FindingsThe 2017 American Academy of Pediatrics Clinical Practice Guideline (AAP CPG) for Screening and Management of High Blood Pressure in Children and Adolescent includes new normative blood pressure tables for children and adolescents ages 1 to 17  years and new definitions for stage 2 HTN. This review will highlight these aspects as well as new recommendations in the guideline specific to stage 2 HTN. It will outline how the new guideline differs from the previous 2004 guideline, the implicat...
Source: Current Hypertension Reports - July 6, 2018 Category: Primary Care Source Type: research

Future Direction for Using Artificial Intelligence to Predict and Manage Hypertension
AbstractPurpose of ReviewEvidence that artificial intelligence (AI) is useful for predicting risk factors for hypertension and its management is emerging. However, we are far from harnessing the innovative AI tools to predict these risk factors for hypertension and applying them to personalized management. This review summarizes recent advances in the computer science and medical field, illustrating the innovative AI approach for potential prediction of early stages of hypertension. Additionally, we review ongoing research and future implications of AI in hypertension management and clinical trials, with an eye towards per...
Source: Current Hypertension Reports - July 6, 2018 Category: Primary Care Source Type: research