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

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

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

Potential Role of Antihypertensive Medications in Preventing Excessive Arterial Stiffening
AbstractPurpose of ReviewIncreased arterial stiffness, an abnormal structural and functional change in the vascular wall, is a precursor for hypertension, coronary heart disease, stroke, and associated cardiovascular disease (CVD). The aim of this paper is to review the etiology of arterial stiffening and potential therapeutic approaches to modulate arterial fibrosis and stiffness.Recent FindingsThe Framingham Heart Study demonstrated that arterial stiffness is an independent predictor of CVD and related morbidity and mortality. Dysfunction of endothelial cells, vascular smooth muscle cells, extracellular matrix, and other...
Source: Current Hypertension Reports - July 6, 2018 Category: Primary Care Source Type: research

Sympathetic Nervous System, Sleep, and Hypertension
AbstractPurpose of ReviewTo evaluate the relation between sleep alterations, with or without breathing disorders, and incidence of hypertension and other cardiovascular diseasesRecent FindingsSeveral studies have clearly shown the mechanisms linking sleep disorders and cardiovascular diseases. The sympathetic hyperactivity seems to play a fundamental role in favoring and sustaining the increase in blood pressure values. Several other mechanisms also contribute to this effect and to the increase cardiovascular risk.SummaryThe mechanisms responsible for the increase in blood pressure values in subjects with alteration in sle...
Source: Current Hypertension Reports - July 6, 2018 Category: Primary Care Source Type: research

Arterial Stiffness in Hypertension: an Update
AbstractPurpose of ReviewTo update and review novel insights into the mechanisms, measurements, and therapeutic approaches to arterial stiffness.Recent FindingsArterial (e.g., vascular) stiffness has been shown over time to prognosticate for cardiovascular and kidney outcomes. In this context, there has been increased interest behind the mechanisms that drive arterial stiffness beyond aging and interest in how to apply newer technologies in measurement of arterial stiffness. Pulse wave velocity has been the gold standard for measurement but industry has been innovating to improve measurement with use of single-point PWV as...
Source: Current Hypertension Reports - July 4, 2018 Category: Primary Care Source Type: research

Immigration and Acculturation: Impact on Health and Well-Being of Immigrants
AbstractAmong migrants who arrived in the USA and Europe, communicable diseases such as dermatologic, gastrointestinal, and respiratory infections are frequent; non-communicable diseases including chronic diseases such as hypertension and diabetes, and vaccine-preventable diseases are also prevalent. Refugees are often not up to date on routine immunizations and screenings for chronic diseases and cancer. In addition, many immigrants have trauma-related mental health problems, which are often not addressed by the healthcare systems where they reside. Determining the healthcare needs of specific immigration groups should le...
Source: Current Hypertension Reports - July 3, 2018 Category: Primary Care Source Type: research

Preeclampsia and Related Cardiovascular Risk: Common Genetic Background
AbstractPurpose of ReviewPreeclampsia (PE) is a hypertensive disorder exclusive for pregnancy. It affects women all over the world and poses a great threat to life, both for mother and child. No definitive treatment exists and placenta delivery comprises the only known cure for PE. One of the most severe complications observed in preeclamptic women is the occurrence of cardiovascular diseases (CVDs) later in life.Recent FindingsBoth PE and CVDs share some of their pathogenic pathways and gene variations. Thus far, a number of publications have examined those relationships; however, almost all of them focus only on common r...
Source: Current Hypertension Reports - July 3, 2018 Category: Primary Care Source Type: research

Peripartum Cardiomyopathy and Preeclampsia: Overlapping Diseases of Pregnancy
AbstractPurpose of ReviewHypertensive disorders of pregnancy (HDP) often result in cardiac dysfunction and have been variably included as a risk factor for peripartum cardiomyopathy (PPCM). However, there is debate regarding the relationship between the two entities.Recent FindingsDiastolic dysfunction appears to be more predominant among gravidas with HDP, while systolic dysfunction predominates in PPCM. However, this finding is not consistent in all studies. Recent examinations of mortality and morbidity associated with PPCM in the setting of HDP do not demonstrate a predominant pattern with a mixture of results. Further...
Source: Current Hypertension Reports - July 3, 2018 Category: Primary Care Source Type: research

Management of VEGF-Targeted Therapy-Induced Hypertension
AbstractPurpose of ReviewFrom a physiological point of view, VEGFs (vascular endothelial growth factors) and their receptors (VEGFR) play a critical role in vascular development angiogenesis, endothelial function, and vascular tone. On the pathological side, VEGF –VEGFR signaling may induce dysregulated angiogenesis, which contributes to the growth and to the spread of tumors, being essential for neoplastic proliferation and invasion.Recent FindingsPharmacological inhibition of VEGF –VEGFR is now a cornerstone in the treatment of many malignancies; however, treatment with VEGF inhibitors is commonly associated ...
Source: Current Hypertension Reports - June 29, 2018 Category: Primary Care Source Type: research

Stress, Genes, and Hypertension. Contribution of the ISIAH Rat Strain Study
AbstractPurpose of ReviewAcute psychoemotional stress is one of the causes of a sharp increase in blood pressure. However, the question if the stress may promote the hypertensive disease development is still open. This review aims, firstly, to show that the genetically determined enhanced responsiveness to stress is linked to sustained hypertension development and, secondly, to characterize the main physiological mechanisms and genetic factors implicated in the pathogenesis of stress-sensitive hypertension.Recent FindingsRecent findings helped to characterize the main neuroendocrine mechanisms and the specificity of the ge...
Source: Current Hypertension Reports - June 16, 2018 Category: Primary Care Source Type: research

Resistant Hypertension: Time to Consider the Best Fifth Anti-Hypertensive Treatment
AbstractPurpose of ReviewResistant hypertension (RH) is a growing clinical condition worldwide associated with target-organ damage and poor prognosis compared to non-resistant counterparts. The purpose of this review is to perform a critical evaluation of preferable drug choices for managing RH highlighting the evidence that significant proportion of patients remained uncontrolled despite using four anti-hypertensive drugs.Recent FindingsUntil recently, the fourth drug therapy was main derived from personal opinion or small interventional studies. The recent data derived from two multicentric randomized trials, namely PATH...
Source: Current Hypertension Reports - June 16, 2018 Category: Primary Care Source Type: research

Nurse ’s Contribution to Alleviate Non-adherence to Hypertension Treatment
AbstractPurpose of ReviewHypertension consists a major risk factor for cardiovascular events. Despite the proven effectiveness of antihypertensive treatment, approximately half of hypertensive patients have inadequate blood pressure control. Non-adherence to medication has been shown to be an important barrier to achieving adequate blood pressure control and nurse interventions can substantially improve therapeutic compliance. We sought to evaluate the role of nurse interventions in alleviating non-adherence to medication in patients with hypertension by performing a systematic review of the literature for all relevant art...
Source: Current Hypertension Reports - June 15, 2018 Category: Primary Care Source Type: research

Treatment of Hypertension in Chronic Kidney Disease
AbstractPurpose of ReviewChronic kidney disease (CKD) is recognized as a worldwide epidemic. Hypertension commonly coexists with CKD and its prevalence is progressively increasing as kidney function declines.Recent FindingsFor patients with established CKD and/or diabetes with albuminuria, the updated hypertension guidelines have recommended a blood pressure (BP) goal
Source: Current Hypertension Reports - June 11, 2018 Category: Primary Care Source Type: research

Resistant Hypertension in Pregnancy: How to Manage?
AbstractPurpose of ReviewThe concept of resistant hypertension may be changed during pregnancy by the physiological hemodynamic changes and the particularities of therapy choices in this period. This review discusses the management of pregnant patients with preexisting resistant hypertension and also of those who develop severe hypertension in gestation and puerperium.Recent FindingsThe main cause of severe hypertension in pregnancy is preeclampsia, and differential diagnosis must be done with secondary or primary hypertension. Women with preexisting resistant hypertension may need pharmacological therapy adjustment. Sever...
Source: Current Hypertension Reports - June 11, 2018 Category: Primary Care Source Type: research

Interplay between the renin-angiotensin system, the canonical WNT/ β-catenin pathway and PPARγ in hypertension
AbstractPurpose of ReviewHeterogeneous causes can determinate hypertension.Recent FindingsThe renin-angiotensin system (RAS) has a major role in the pathophysiology of blood pressure. Angiotensin II and aldosterone are overexpressed during hypertension and lead to hypertension development and its cardiovascular complications. In several tissues, the overactivation of the canonical WNT/ β-catenin pathway leads to inactivation of peroxisome proliferator-activated receptor gamma (PPARγ), while PPARγ stimulation induces a decrease of the canonical WNT/β-catenin pathway. In hypertension, the WNT/β-cat...
Source: Current Hypertension Reports - June 9, 2018 Category: Primary Care Source Type: research

Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep
We present contemporary evidence on the unequal burden of insufficient sleep in Blacks/African-Americans and the repercussions for disparate risk of hypertension.Recent FindingsThe prevalence of insufficient sleep is high and rising and has been recognized as an important cardiovascular risk factor. Presumably due to a constellation of environmental, psychosocial, and individual determinants, these risks appear exacerbated in Blacks/African-Americans, who are more likely to experience short sleep than other ethnic/racial groups. Population-based data suggest that the risk of hypertension associated with sleep deficiency is...
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

Hypertension in Pediatric Dialysis Patients: Etiology, Evaluation, and Management
AbstractPurpose of ReviewReview epidemiology, pathophysiology, and management of hypertension in the pediatric dialysis population.Recent FindingsInterdialytic blood pressure measurement, especially with ambulatory blood pressure monitoring, is the gold standard to assess for hypertension. Tools to assess dry weight aid in achievement of euvolemia, the primary therapy for management of hypertension. Persistent hypertension should be treated with antihypertensive medications and potentially with native nephrectomies.SummaryCardiovascular disease continues to be the primary cause of morbidity and mortality in the dialysis po...
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

Preeclampsia Risks in Kidney Donors and Recipients
AbstractPurpose of ReviewTo review the studies and practice guidelines on the preeclampsia risks in kidney donors and recipients.Recent FindingsThere is a small increased risk of gestational hypertension and preeclampsia in pregnancies that follow kidney donation. Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline (2017) and the 2015 American Society of Transplantation (AST) consensus conference statement recommends counseling kidney donors about this increased risk. There is no observed increase in fetal complications or eclampsia post-kidney donation. Preeclampsia is more commonly observed in ki...
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

ACE Inhibitor-Induced Angioedema: a Review
ConclusionACE-I are frequently used therapeutic agents that are associated with angioedema. Their use should be avoided in high-risk individuals and early diagnosis, tracheal intubation in cases of airway compromise, and absolute avoidance of re-challenge are important. (Source: Current Hypertension Reports)
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

Focused Update on Pharmacologic Management of Hypertensive Emergencies
AbstractPurpose of ReviewHypertensive emergency is defined as a systolic blood pressure>  180 mmHg or a diastolic blood pressure>  120 mmHg with evidence of new or progressive end-organ damage. The purpose of this paper is to review advances in the treatment of hypertensive emergencies within the last 5 years.Recent FindingsNew literature and recommendations for managing hypertensive emergencies in the setting of pregnancy, stroke, and heart failure have been published.SummaryOral nifedipine is now considered an alternative first-line therapy, along with intravenous hydralazine and labeta...
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

Sex-Specific Contributions of Endothelin to Hypertension
AbstractPurpose of ReviewMen and women differ in the prevalence, pathophysiology and control rate of hypertension in an age-dependent manner. The renal endothelin system plays a central role in sex differences in blood pressure regulation by control of sodium excretion and vascular function. Improving our understanding of the sex differences in the endothelin system, especially in regard to blood pressure regulation and sodium homeostasis, will fill a significant gap in our knowledge and may identify sex-specific therapeutic targets for management of hypertension.Recent FindingsThe current review will highlight evidence fo...
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

The Use of Precision Medicine to Manage Obstructive Sleep Apnea Treatment in Patients with Resistant Hypertension: Current Evidence and Future Directions
AbstractPurpose of ReviewThe significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause.Recent FindingsIn recent years, several studies have shown a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP), but this effect exhibits great variability. The diagnosis and management of OSA in patients with RH suggest a clinical option for a phenotype of patients for whom therape...
Source: Current Hypertension Reports - June 8, 2018 Category: Primary Care Source Type: research

Recent Findings in the Genetics of Blood Pressure: How to Apply in Practice or Is a Moonshot Required?
AbstractPurpose of ReviewHypertension is recognised as the biggest contributor to the global burden of disease, but it is controlled in less than a fifth of patients worldwide, despite being relatively easy to detect and the availability of inexpensive safe generic drugs. Blood pressure is regulated by a complex network of physiologic pathways with currently available drugs targeting key receptors or enzymes in the top pathways. Major advances in the dissection of both monogenic and polygenic determinants of blood pressure regulation and variation have not resulted in rapid translation of these discoveries into clinical ap...
Source: Current Hypertension Reports - June 7, 2018 Category: Primary Care Source Type: research

Carotid Body Ablation: a New Target to Address Central Autonomic Dysfunction
AbstractPurpose of ReviewAn abnormal heightened carotid body (CB) chemoreflex, which produces autonomic dysfunction and sympathetic overactivation, is the common hallmark of obstructive sleep apnea (OSA), resistant hypertension, systolic heart failure (HF), and cardiometabolic diseases. Accordingly, it has been proposed that the elimination of the CB chemosensory input to the brainstem may reduce the autonomic and cardiorespiratory alterations in sympathetic-associated diseases in humans.Recent FindingsA growing body of evidence obtained in preclinical animal models support that an enhanced CB discharge produces sympatheti...
Source: Current Hypertension Reports - May 22, 2018 Category: Primary Care Source Type: research

Insomnia, Short Sleep Duration, and High Blood Pressure: Recent Evidence and Future Directions for the Prevention and Management of Hypertension
AbstractPurpose of ReviewTo summarize research from the past 2  years on the association between insomnia, short sleep duration, and hypertension and provide a critical analysis of the evidence and suggestions for future directions in this field.Recent FindingsEvidence indicates that the association between insomnia and elevated blood pressure (BP) or stage 1 and 2 hypertension is stronger in those with chronic insomnia, as compared to those with isolated insomnia symptoms, and primarily found in those with the insomnia with objective short sleep duration phenotype. There is a key gap in ambulatory BP monitoring acros...
Source: Current Hypertension Reports - May 19, 2018 Category: Primary Care Source Type: research

Update on Endothelin Receptor Antagonists in Hypertension
AbstractPurpose of ReviewTo review the most recent data on the development of endothelin receptor antagonists (ERAs) for the treatment of hypertension and the management of diabetic nephropathyRecent FindingsRecent reviews and meta-analyses of experimental and clinical data obtained with ERAs confirmed that endothelin receptor blockade is associated with significant decreases in blood pressure in essential hypertension but also in resistant hypertension. In addition, in patients with diabetic nephropathy, ERAs induce significant 30 –40% decreases in albuminuria when administered on top of blockers of the renin-angiot...
Source: Current Hypertension Reports - May 19, 2018 Category: Primary Care Source Type: research

Genetics of Resistant Hypertension: the Missing Heritability and Opportunities
AbstractPurpose of the ReviewBlood pressure regulation in humans has long been known to be a genetically determined trait. The identification of causal genetic modulators for this trait has been unfulfilling at the least. Despite the recent advances of genome-wide genetic studies, loci associated with hypertension or blood pressure still explain a very low percentage of the overall variation of blood pressure in the general population. This has precluded the translation of discoveries in the genetics of human hypertension to clinical use. Here, we propose the combined use of resistant hypertension as a trait for mapping ge...
Source: Current Hypertension Reports - May 19, 2018 Category: Primary Care Source Type: research

ConfidenHT ™ System for Diagnostic Mapping of Renal Nerves
AbstractPurpose of ReviewTo summarize the evidence regarding the distribution of renal nerves and their patterns of anatomic variations in animal and human settings. Moreover, the methodology and results of studies regarding renal nerve stimulation (RNS) in both preclinical and clinical models are presented.Recent FindingsThere are differences regarding the number and the size of renal fibers, as well as their distance from the lumen in the diverse parts of the main renal arteries and the branches. In both animals and humans, RNS is safe and results in an increase of blood pressure (BP) while the effect on heart rate varie...
Source: Current Hypertension Reports - May 19, 2018 Category: Primary Care Source Type: research

Dietary Modifications and Lipid Accumulation Product Are Associated with Systolic and Diastolic Blood Pressures in the Women ’s Health Trial: Feasibility Study in Minority Populations
AbstractPurpose of ReviewApproximately 65% of adults over 60  years in the USA are hypertensive. Poor dietary habits and sedentary lifestyles are fueling the hypertension epidemic. The effects of higher intakes of fruits and vegetables and whole-grain products on systolic and diastolic blood pressures were analyzed using data at baseline, 6 months, and 12  months on 349 and 573 subjects, respectively, in the control and intervention groups of the Women’s Health Trial: Feasibility Study in Minority Populations.Recent FindingsModels for systolic and diastolic blood pressures have been estimated using cro...
Source: Current Hypertension Reports - May 19, 2018 Category: Primary Care Source Type: research

Correction to: Dimerization of AT 2 and Mas Receptors in Control of Blood Pressure
In the original publication, the Fig.  1 caption contains an error. The original article has been corrected. (Source: Current Hypertension Reports)
Source: Current Hypertension Reports - May 12, 2018 Category: Primary Care Source Type: research

Endovascular Baroreflex Amplification for Resistant Hypertension
AbstractPurpose of reviewMost hypertension devices have been designed to interrupt or modify the sympathetic nervous system, which seems to be unbalanced in hypertension. Carotid baroreceptors play a pivotal role in maintaining adrenergic balance via a direct feedback interface and would be an exceptional target for intervention. The purpose of this review is to define the role of the baroreceptor in hypertension, to examine device-based therapies targeting the baroreflex and to explore future promises of endovascular baroreflex amplification (EBA).Recent findingsIn the last two decades, two therapeutic strategies targetin...
Source: Current Hypertension Reports - May 9, 2018 Category: Primary Care Source Type: research

Anti-Inflammatory Effects of Melatonin in Obesity and Hypertension
AbstractPurpose of ReviewHere, we review the known relations between hypertension and obesity to inflammation and postulate the endogenous protective effect of melatonin and its potential as a therapeutic agent. We will describe the multiple effects of melatonin on blood pressure, adiposity, body weight, and focus on mitochondrial-related anti-inflammatory and antioxidant protective effects.Recent FindingsHypertension and obesity are usually associated with systemic and tissular inflammation. The progressive affection of target-organs involves multiple mediators of inflammation, most of them redundant, which make anti-infl...
Source: Current Hypertension Reports - May 9, 2018 Category: Primary Care Source Type: research

Modulation of Vascular Reactivity by Perivascular Adipose Tissue (PVAT)
AbstractPurpose of ReviewIn this review, we discuss the role of perivascular adipose tissue (PVAT) in the modulation of vascular contractility and arterial pressure, focusing on the role of the renin-angiotensin-aldosterone system and oxidative stress/inflammation.Recent FindingsPVAT possesses a relevant endocrine-paracrine activity, which may be altered in several pathophysiological and clinical conditions. During the last two decades, it has been shown that PVAT may modulate vascular reactivity. It has also been previously demonstrated that inflammation in adipose tissue may be implicated in vascular dysfunction. In part...
Source: Current Hypertension Reports - May 7, 2018 Category: Primary Care Source Type: research

The Role of Circadian Rhythms in the Hypertension of Diabetes Mellitus and the Metabolic Syndrome
AbstractPurpose of the ReviewCellular circadian clocks regulate physiological functions during day and night. It has been convincingly demonstrated that hypertension in patients suffering from diabetes mellitus or metabolic syndrome is characterized in most cases by a disturbed 24-h profile resulting in a nondipper pattern. We consider possible correlation between biological clocks and symptoms of the metabolic syndrome.Recent FindingsChanges in circadian clock function have been linked to metabolic disorders in genome-wide association studies. Epidemiological studies have shown that a loss of nocturnal decline in blood pr...
Source: Current Hypertension Reports - May 5, 2018 Category: Primary Care Source Type: research

Dimerization of AT 2 and Mas Receptors in Control of Blood Pressure
AbstractPurpose of ReviewAngiotensin type 2 receptor (AT2R) and receptor Mas (MasR) are part of the “protective arm” of the renin angiotensin system. Gene and pharmacological manipulation studies reveal that AT2R and MasR are involved in natriuretic, vasodilatory, and anti-inflammatory responses and in lowering blood pressure in various animal models under normal and pathological conditions such as salt-sensitive hypertension, obesity, and diabetes. The scope of this review is to discuss co-localization and heterodimerization as potential molecular mechanisms of AT2R- and MasR-mediated functions including antih...
Source: Current Hypertension Reports - May 1, 2018 Category: Primary Care Source Type: research

Selective vs. Global Renal Denervation: a Case for Less Is More
AbstractPurpose of ReviewReview the renal nerve anatomy and physiology basics and explore the concept of global vs. selective renal denervation (RDN) to uncover some of the fundamental limitations of non-targeted renal nerve ablation and the potential superiority of selective RDN.Recent FindingsRecent trials testing the efficacy of RDN showed mixed results. Initial investigations targeted global RDN as a therapeutic goal. The repeat observation of heterogeneous response to RDN including non-responders with lack of a BP reduction, or even more unsettling, BP elevations after RDN has raised concern for the detrimental effect...
Source: Current Hypertension Reports - May 1, 2018 Category: Primary Care Source Type: research

A Systematic Review of Sleep, Hypertension, and Cardiovascular Risk in Children and Adolescents
AbstractPurpose of ReviewMany of the risk factors for heart disease have recently been shown to develop during childhood such as left ventricular hypertrophy and fibrous plaque lesions. As risk for cardiovascular disease in children and adolescents has risen, sleep duration has decreased, and inadequate sleep in children and adolescents has been found to be associated with cardiovascular disease risk. The aims of this manuscript are to provide an updated systematic review of the literature assessing sleep, hypertension, and cardiovascular risk and evaluate the strength of the evidence based on the available research.Recent...
Source: Current Hypertension Reports - May 1, 2018 Category: Primary Care Source Type: research

Hypertension in Developing Countries: A Major Challenge for the Future
AbstractPurpose of ReviewOutline recent epidemiologic data regarding hypertension in developing countries, distinguish differences from developed countries, and identify challenges in management and future perspectives.Recent FindingsIncreased sugar intake, air and noise pollution, and low birth weight are emerging hypertension risk factors. The major challenges in management are difficulties in accurate diagnosis of hypertension and adequate blood pressure control.SummaryIn contrast to developed countries, hypertension prevalence rates are on the rise in developing countries with no improvement in awareness or control rat...
Source: Current Hypertension Reports - May 1, 2018 Category: Primary Care Source Type: research

The Complement Alternative Pathway and Preeclampsia
AbstractPurpose of ReviewSignificant and intricate immune adaptations are essential for the establishment and maintenance of normal pregnancy. Preeclampsia is a morbid, potentially life-threatening disease for both mother and neonate that occurs uniquely in pregnancy, at least in part, due to maternal immune maladaptation. We aim to review the literature that focuses on case reports, diagnostic approaches, and treatment strategies for disorders of the complement alternative pathway (CAP) as related to preeclampsia.Recent FindingsThere is evidence of complement dysregulation in preeclampsia and HELLP syndrome, similar to th...
Source: Current Hypertension Reports - May 1, 2018 Category: Primary Care Source Type: research