What Is the Most Common Cause of Secondary Hypertension?: An Interdisciplinary Discussion
AbstractPurpose of ReviewTraditional statements in medical textbooks pointed that 90 to 95% of cases of hypertension is essential or primary. However, secondary hypertension seems to be common in those patients with resistant forms of hypertension. Appropriate investigation and treatment may have prognostic impact but frequently hypertension remission did not occur raising concerns about the real meaning of secondary hypertension. Here, we provided an interdisciplinary and critical discussion comprising an endocrinologist, a nephrologist, and a cardiologist with expertise in resistant hypertension. We reviewed the literatu...
Source: Current Hypertension Reports - October 29, 2020 Category: Primary Care Source Type: research

Stellate Ganglion Blockade: an Intervention for the Management of Ventricular Arrhythmias
AbstractPurpose of ReviewTo highlight the indications, procedural considerations, and data supporting the use of stellate ganglion blockade (SGB) for management of refractory ventricular arrhythmias.Recent FindingsIn patients with refractory ventricular arrhythmias, unilateral or bilateral SGB can reduce arrhythmia burden and defibrillation events for 24 –72 h, allowing time for use of other therapies like catheter ablation, surgical sympathectomy, or heart transplantation. The efficacy of SGB appears to be consistent despite the type (monomorphic vs polymorphic) or etiology (ischemic vs non-ischemic cardiomyopa...
Source: Current Hypertension Reports - October 23, 2020 Category: Primary Care Source Type: research

Female Sex, a Major Risk Factor for Salt-Sensitive Hypertension
AbstractPurpose of ReviewHigh dietary salt is a significant contributor to essential hypertension in clinical populations. However, although clinical studies indicate a higher prevalence of salt sensitivity in women over men, knowledge of salt-sensitive mechanisms is largely restricted to males, and female-specific mechanisms are presently being elucidated.Recent FindingsMale-specific mechanisms of salt-sensitive hypertension are well published and predominantly appear to involve dysfunctional renal physiology. However, emerging novel evidence indicates that aldosterone production is sex-specifically heightened in salt-sen...
Source: Current Hypertension Reports - October 21, 2020 Category: Primary Care Source Type: research

Cannabinoids in Metabolic Syndrome and Cardiac Fibrosis
This article provides a concise overview of how cannabinoids and the endocannabinoid system (ECS) have significant implications for the prevention and treatment of metabolic syndrome (MetS) and for the treatment of cardiovascular disorders, including cardiac fibrosis.Recent FindingsOver the past few years, the ECS has emerged as a pivotal component of the homeostatic mechanisms for the regulation of many bodily functions, including inflammation, digestion, and energy metabolism. Therefore, the pharmacological modulation of the ECS by cannabinoids represents a novel strategy for the management of many diseases. Specifically...
Source: Current Hypertension Reports - October 21, 2020 Category: Primary Care Source Type: research

Endocrine Causes of Hypertension
AbstractPurpose of ReviewTo discuss selected endocrine causes of hypertension and to provide practical clinical recommendations regarding the evaluation and treatment of these disorders.Recent FindingsMore than 15 endocrine disorders with varying rates of prevalence can cause hypertension. For example, primary aldosteronism may exist in up to 20% of patients with resistant hypertension. Recognition of these important secondary causes of hypertension is essential to provide contemporary targeted therapies in order to improve long-term disease outcomes. Clinicians must have a broad understanding of the prevalence, clinical p...
Source: Current Hypertension Reports - October 20, 2020 Category: Primary Care Source Type: research

Fixed-Dose Combination Medications for Treating Hypertension: A Review of Effectiveness, Safety, and Challenges
AbstractPurpose of ReviewTo summarize the recent evidence on the effectiveness and safety of antihypertensive fixed-dose combination (FDC) medications, and to describe the facilitators and barriers to implementing FDCs in US clinical practice.Recent FindingsRecent clinical practice guidelines include FDC use for treating high BP. Clinical trials in recent years support the use of antihypertensive FDCs including low-dose triple- and quadruple-therapy FDCs. Initiating a low-to-standard dose dual-therapy FDCs showed better BP control than initiating treatment with a standard-dose monotherapy, and triple-therapy FDCs produced ...
Source: Current Hypertension Reports - October 14, 2020 Category: Primary Care Source Type: research

Is there any Hope for Monitoring Adherence in an Efficient and Feasible Way for Resistant Hypertension Diagnosis and Follow-Up?
AbstractPurpose of ReviewNon-adherence to antihypertensive treatment is highly prevalent and represents a major factor affecting their effectiveness in hypertensive patients, thus contributing to apparent treatment resistance. It is however often overlooked because the methods to assess non-adherence are mainly subjective, limiting their usefulness in clinical practice. Non-adherence to treatment affects daily patient management, resulting in inappropriate, costly, and potentially harmful treatments and loss of the expected benefits from antihypertensive drugs.Recent FindingsSpecialized centers now use a combination of obj...
Source: Current Hypertension Reports - October 14, 2020 Category: Primary Care Source Type: research

Letter to the Editor Re: Meta-Analysis of Cocoa Consumption and Blood Pressure in Middle-Aged and Elderly Subjects: Methodological Issue by Sadegh Jafarnejad, Mina Salek, Cain C. T. Clark, and Mohsen Taghizadeh
(Source: Current Hypertension Reports)
Source: Current Hypertension Reports - September 23, 2020 Category: Primary Care Source Type: research

Cuff Under Pressure for Greater Accuracy
AbstractPurpose of ReviewTo present the evidence that describes what is being measured by upper-arm cuff blood pressure (BP) and the level of accuracy compared with invasive central aortic and brachial BP. Potential causes of inaccuracy and emerging methods are also discussed.Recent FindingsOn average cuff systolic BP systematically underestimates invasive brachial systolic BP, although in a given individual it may substantially under- or over-estimate central aortic systolic BP. Such errors may affect individual health management outcomes and distort population level data on hypertension prevalence and control. Oscillomet...
Source: Current Hypertension Reports - September 21, 2020 Category: Primary Care Source Type: research

Obstetrical Complications and Long-Term Cardiovascular Outcomes
AbstractPurpose of ReviewObstetrical complications including indicated preterm birth (PTB), hypertension (HTN), IUGR, and GDM are risk factors for future cardiovascular disease. To identify patients at risk, the American Heart Association recommends obtaining a detailed obstetric history. Our objective was to determine if non-OB-GYN physicians-in-training obtain an obstetric history when assessing a risk profile for cardiovascular disease and to identify differences based on level of training. In 2019, an anonymous survey was distributed to trainees in internal medicine, cardiology, endocrinology, nephrology, and neurology...
Source: Current Hypertension Reports - September 16, 2020 Category: Primary Care Source Type: research

Preeclampsia and Kidney Disease: Deciphering Cause and Effect
AbstractPurpose of ReviewPreeclampsia and chronic kidney disease have a complex, bidirectional relationship. Women with kidney disease, with even mild reductions in glomerular filtrate rate, have an increased risk of developing preeclampsia. Preeclampsia, in turn, has been implicated in the subsequent development of albuminuria, chronic kidney disease, and end-stage kidney disease. We will discuss observational evidence and mechanisms linking the two disease processes.Recent FindingsPreeclampsia is characterized by an imbalance in angiogenic factors that causes systemic endothelial dysfunction. Chronic kidney disease may p...
Source: Current Hypertension Reports - September 13, 2020 Category: Primary Care Source Type: research

Renin-Angiotensin System Inhibitors and COVID-19: a Systematic Review and Meta-Analysis. Evidence for Significant Geographical Disparities
AbstractPurpose of ReviewWhile the COVID-19 pandemic is constantly evolving, it remains unclear whether the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) affects the clinical course of SARS-CoV-2 infection. For this meta-analysis, PubMed, CENTRAL, and grey literature were searched from their inception to 19 May 2020 for randomized, controlled trials or observational studies that evaluate the association between the use of either ACE inhibitors or ARBs and the risk for major clinical endpoints (infection, hospitalization, admission to ICU, death) in adult patients during the C...
Source: Current Hypertension Reports - September 9, 2020 Category: Primary Care Source Type: research

The Role of the Renin-Angiotensin-Aldosterone System in Preeclampsia: a Review
AbstractPurpose of ReviewPreeclampsia (PE) is a complex human pregnancy-specific condition and is clinically characterized by new onset hypertension and proteinuria in the second half of pregnancy. The precise etiology of PE is unknown, but much of the pathophysiology has been elucidated, and it is accepted that the disorder is multifactorial in nature. Historically, because of the presence of proteinuria, the role of the renin-angiotensin-aldosterone system (RAAS) has been considered in the etiology of PE. However, the results of studies (including maternal circulatory angiotensin II, urinary angiotensinogen, plasma renin...
Source: Current Hypertension Reports - September 6, 2020 Category: Primary Care Source Type: research

Preventing Premature Atherosclerotic Disease
AbstractPurpose of ReviewCardiovascular disease (CVD) can begin in youth. Prevention is essential to reducing the burden of CVD-related risk factors in childhood and disease development in adulthood. This review addresses the clinical scope of CVD prevention, including a review of conditions encountered, proposed diagnostic criteria, and management strategies. We also highlight the impact of the intrauterine environment on the development of CVD risk. Finally, we highlight the potential role of telehealth in the management of pediatric patients with risk factors for premature CVD.Recent FindingsGrowing evidence suggests th...
Source: Current Hypertension Reports - September 6, 2020 Category: Primary Care Source Type: research

Psychiatric Medications and Hypertension
AbstractPurpose of ReviewThe purpose of this review is to provide an overview of psychiatric medications that impact blood pressure in adult patients either as a direct side effect or indirectly, via negative metabolic impact or interactions with other medications. In addition, pertinent interactions between psychiatric medications and antihypertensive agents will be discussed.Recent FindingsAlthough the novel intranasal antidepressant, esketamine, has been shown to increase blood pressure shortly after dosing, treatment with antihypertensive medications is not typically required. In addition, no increase in serious advers...
Source: Current Hypertension Reports - September 6, 2020 Category: Primary Care Source Type: research

Effect of Sleep Disorders on Blood Pressure and Hypertension in Children
AbstractPurpose of ReviewIn this review, we aim to discuss the pathophysiologic basis of hypertension in sleep disorders and the current evidence in the medical literature linking sleep disorders and hypertension in children.Recent FindingsThe medical literature in adults is clear about the contribution of sleep disorders, poor sleep quality, and sleep deprivation to hypertension and increased cardiovascular risk. The literature on cardiovascular consequences of sleep disorders in children is not as robust, but there is some evidence of early cardiovascular changes in children with sleep deprivation and obstructive sleep a...
Source: Current Hypertension Reports - September 6, 2020 Category: Primary Care Source Type: research

A Contemporary Approach to Hypertensive Cardiomyopathy: Reversing Left Ventricular Hypertrophy
AbstractPurpose of ReviewTo highlight pharmacological and non-pharmacological approaches to reversing hypertensive left ventricular hypertrophy (LVH). We identify high-risk phenotypes that may benefit from aggressive blood pressure (BP) management to prevent incident outcomes such as the development of atherosclerotic cardiovascular disease, stroke, and heart failure.Recent FindingsLVH is a modifiable risk factor. Intensive BP lowering (systolic BP
Source: Current Hypertension Reports - September 4, 2020 Category: Primary Care Source Type: research

Resistant Hypertension in Chronic Kidney Disease (CKD): Prevalence, Treatment Particularities, and Research Agenda
AbstractPurpose of ReviewTo explore the prevalence, treatment particularities, and research agenda in the management of resistant hypertension among patients with chronic kidney disease (CKD).Recent FindingsThe prevalence of resistant hypertension is reported to be 2 –3 times higher in patients with CKD than in the general hypertensive population. Based in part on the results of the PATHWAY-2 trial showing add-on spironolactone to be superior to placebo or active treatment with an α- or β-blocker in reducing BP, international guidelines recommend the use of spironolactone as fourth-line agent in pharmacoth...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Hypertension and Age-Related Cognitive Impairment: Common Risk Factors and a Role for Precision Aging
AbstractPurpose of ReviewPrecision Aging ® is a novel concept that we have recently employed to describe how the model of precision medicine can be used to understand and define the multivariate risks that drive age-related cognitive impairment (ARCI). Hypertension and cardiovascular disease are key risk factors for both brain function and cognitive aging. In this review, we will discuss the common mechanisms underlying the risk factors for both hypertension and ARCI and how the convergence of these mechanisms may be amplified in an individual to drive changes in brain health and accelerate cognitive decline.Recent Fin...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Urban-Related Environmental Exposures during Pregnancy and Placental Development and Preeclampsia: a Review
AbstractPurpose of ReviewTo summarize the current knowledge of the pathophysiological implications and the clinical role of urban-related environmental exposures in pregnancy.Recent FindingsThe ongoing urbanization worldwide is leading to an increasing number of pregnant women being exposed to higher levels of urban-related environmental hazards such as air pollution and noise and, at the same time, having less contact with natural environments. Pregnancy represents a particular and vulnerable life period both for women and their children. Extensive physiological and metabolic changes, as well as changes to the cardiovascu...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Renal Denervation for Resistant Hypertension: Where Do We Stand?
AbstractPurpose of ReviewTo review the data about the use of renal denervation (RDN), a minimally invasive surgery, for resistant hypertension (RH) and to provide practical guidance for practitioners who are establishing an RDN service.Recent FindingsRDN can selectively ablate renal sympathetic nerve fibres, block the transmission of nerve impulses between central sympathetic nerve and kidney, to control blood pressure to as a novel promising non-drug treatment option for RH. At present, there are many researches on the treatment of RH by RDN, but there are some controversies. This review summarises and critically examines...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

The Role of Exercise in Patients with Obesity and Hypertension
AbstractPurpose of ReviewThis review sought to evaluate the role of exercise in patients with obesity and comorbid hypertension, with a focus on contemporary literature (since January 2015).Recent FindingsNo reviews have included patients classified with both obesity and hypertension and there is a paucity of randomised controlled trials examining the benefits of exercise in this population. Moreover, just one of 19 reviews examining the role of exercise on blood pressure included studies that met pre-defined inclusion criterion for hypertension, although seven conducted subgroup analyses stratified by mean baseline blood ...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

The Gut Microbiome, Inflammation, and Salt-Sensitive Hypertension
AbstractPurpose of ReviewSalt sensitivity of blood pressure (SSBP) is an independent predictor of death due to cardiovascular events and affects nearly 50% of the hypertensive and 25% of the normotensive population. Strong evidence indicates that reducing sodium (Na+) intake decreases blood pressure (BP) and cardiovascular events. The precise mechanisms of how dietary Na+ contributes to elevation and cardiovascular disease remain unclear. The goal of this review is to discuss mechanisms of salt-induced cardiovascular disease and how the microbiome may play a role.Recent FindingsThe innate and adaptive immune systems are in...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Extracellular Vesicles in Essential Hypertension: Hidden Messengers
AbstractPurpose of ReviewHypertension affects about half of all Americans, yet in the vast majority of cases, the factors causing the hypertension cannot be clearly delineated. Developing a more precise understanding of the molecular pathogenesis of HTN and its various phenotypes is therefore a pressing priority. Circulating and urinary extracellular vesicles (EVs) are potential novel candidates as biomarkers and bioactivators in HTN. EVs are a heterogeneous population of small membrane fragments shed from various cell types into various body fluids. As EVs carry protein, RNA, and lipids, they also play a role as effectors...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Hypertension and Metabolic Syndrome in Persons with HIV
AbstractPurpose of ReviewWith the advent of highly active antiretroviral therapy (ART), the life span of persons with HIV (PWH) has been nearly normalized. With aging, prevalence of the metabolic syndrome (MetS), including hypertension, has increased in the HIV population and exceeds that in the general population in some studies. This is due to a combination of traditional risk factors in addition to the effects attributable to the virus and ART. We review recent findings on the mechanisms contributing to MetS and hypertension in PWH, particularly those specific to the viral infection and to ART.Recent FindingsActivation ...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Hypertension as a Road to Treatment of Heart Failure with Preserved Ejection Fraction
AbstractPurpose of ReviewHypertension heralds the diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) in 75 –85% of cases and shares many of its adverse outcomes as well as its acute and chronic symptoms. This review provides important new data about the pathophysiology and mechanisms that connect hypertension and HFpEF as well as therapy used in both conditions.Recent FindingsThe traditional model of HFpEF pathophysiology emphasizes the role of hypertension causing increased afterload on the left ventricle (LV), leading to LV hypertrophy (LVH) and subsequent LV diastolic dysfunction. Recent work...
Source: Current Hypertension Reports - September 2, 2020 Category: Primary Care Source Type: research

Hypertension (Blood Pressure) and Lifetime Risk of Target Organ Damage
AbstractPurpose of ReviewThe purpose of this review is to describe the long-term or lifetime relationship between blood pressure and target organ damage. The use of the term “blood pressure” as opposed to hypertension is purposeful. The risk of cardiovascular disease from blood pressure begins below the levels of blood pressure defined as hypertension by contemporary definitions.Recent FindingsAn important recent publication that bears on this topic was the 2017 ACC/AHA Blood Pressure Management Guidelines. The redefinition of hypertension and blood pressure treatment goal to 130/80  mmHg and the decision ...
Source: Current Hypertension Reports - September 1, 2020 Category: Primary Care Source Type: research

Efficacy of Probiotics in Patients of Cardiovascular Disease Risk: a Systematic Review and Meta-analysis
AbstractThis meta-analysis examined the effect of probiotics on outcomes associated with cardiovascular disease risk factors (high blood pressure, overweight BMI, high cholesterol and triglycerides, elevated HbA1c and serum glucose). All randomised controlled trials publish on PubMed, Scopus, Embase, Grey Literature and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1990 to 2020 were systematically searched. The PEDro scale was used to assess the quality of studies. A total of 34 studies with 2177 adults were selected for inclusion in the analysis. The mean difference and effect size with a 95% confidenc...
Source: Current Hypertension Reports - August 28, 2020 Category: Primary Care Source Type: research

Tobacco Smoke and Endothelial Dysfunction: Role of Aldehydes?
AbstractPurpose of ReviewTobacco smoking is the most significant modifiable risk factor in the development of cardiovascular disease (CVD). Exposure to mainstream cigarette smoke (MCS) is associated with CVD through the development of endothelial dysfunction, a condition characterized by an imbalance of vasoactive factors in the vasculature. This dysfunction is thought to be induced in part by aldehydes generated at high levels in MCS.Recent FindingsElectronic cigarettes (e-cigs) may also pose CVD risk. Although the health effects of e-cigs are still largely unknown, the presence of aldehydes in e-cig aerosol suggests that...
Source: Current Hypertension Reports - August 27, 2020 Category: Primary Care Source Type: research

ENaC in Salt-Sensitive Hypertension: Kidney and Beyond
AbstractPurpose of ReviewThe main goal of this article is to discuss the role of the epithelial sodium channel (ENaC) in extracellular fluid and blood pressure regulation.Recent FindingsBesides its role in sodium handling in the kidney, recent studies have found that ENaC expressed in other cells including immune cells can influence blood pressure via extra-renal mechanisms. Dendritic cells (DCs) are activated and contribute to salt-sensitive hypertension in an ENaC-dependent manner. We discuss recent studies on how ENaC is regulated in both the kidney and other sites including the vascular smooth muscles, endothelial cell...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Clinical Decision Support for the Diagnosis and Management of Adult and Pediatric Hypertension
AbstractPurpose of ReviewTo review literature from 2016 to 2019 on clinical decision support (CDS) for diagnosis and management of hypertension in children and adults.Recent FindingsTen studies described hypertension CDS systems. Novel advances included the integration of patient-collected blood pressure data, automated information retrieval and management support, and use of CDS in low-resource/developing-world settings and in pediatrics. Findings suggest that CDS increases hypertension detection/control, yet many children and adults with hypertension remain undetected or undercontrolled. CDS challenges included poor usab...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Cullin-3: Renal and Vascular Mechanisms Regulating Blood Pressure
AbstractPurpose of ReviewThe goal of this review is to evaluate recent advances in understanding the pivotal roles of Cullin-3 (CUL3) in blood pressure regulation with a focus on its actions in the kidney and blood vessels.Recent FindingsCul3-based ubiquitin ligase regulates renal electrolyte transport, vascular tone, and redox homeostasis by facilitating the normal turnover of (1) with-no-lysine kinases in the distal nephron, (2) RhoA and phosphodiesterase 5 in the vascular smooth muscle, and (3) nuclear factor E2-related factor 2 in antioxidant responses. CUL3 mutations identified in familial hyperkalemic hypertension (F...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Age of Hypertension Onset: Overview of Research and How to Apply in Practice
AbstractPurpose of ReviewTo review the current evidence on research related to age of hypertension onset —its definition, correlates, heritability, and association with adverse outcomes. We also propose a framework for implementing assessment of hypertension onset age into clinical practice.Recent FindingsPrior studies have used both objective measurements and self-report to determine age of hypertension onset or early-onset hypertension. Yet, no criterion for standard definition currently exists for either. Data from epidemiological and clinical studies demonstrate that early-onset hypertension is a highly heritable...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Low-Dose Combination Therapy for Initial Treatment of Hypertension
AbstractPurpose of ReviewTo summarise the advances that have been made from 2017 in dual, triple, and quadruple low-dose combination therapy for treating high blood pressure.Recent FindingsMany people require multiple blood pressure lowering medicines to achieve target blood pressures, and initiating treatment with combination blood pressure lowering therapy is being increasingly investigated and recommended. Low-dose combinations of blood pressure lowering provide more effective blood pressure lowering, with fewer adverse events. Recent advances include listing of four dual combinations on the WHO Essential Medicines List...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Endothelial Dysfunction in COVID-19: Lessons Learned from Coronaviruses
AbstractPurpose of ReviewTo review current literature on endothelial dysfunction with previous coronaviruses, and present available data on the role of endothelial dysfunction in coronavirus disease-2019 (COVID-19) infection in terms of pathophysiology and clinical phenotypeRecent FindingsRecent evidence suggests that signs and symptoms of severe COVID-19 infection resemble the clinical phenotype of endothelial dysfunction, implicating mutual pathophysiological pathways. Dysfunction of endothelial cells is believed to mediate a variety of viral infections, including those caused by previous coronaviruses. Experience from p...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Is Sex a Determinant of COVID-19 Infection? Truth or Myth?
AbstractPurpose of ReviewAngiotensin-converting enzyme 2 (ACE2), a specific high-affinity angiotensin II-hydrolytic enzyme, is the vector that facilitates cellular entry of SARS-CoV-1 and the novel SARS-CoV-2 coronavirus. SARS-CoV-2, which crossed species barriers to infect humans, is highly contagious and associated with high lethality due to multi-organ failure, mostly in older patients with other co-morbidities.Recent FindingsAccumulating clinical evidence demonstrates that the intensity of the infection and its complications are more prominent in men. It has been postulated that potential functional modulation of ACE2 ...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Measurement and Changes in Cerebral Oxygenation and Blood Flow at Rest and During Exercise in Normotensive and Hypertensive Individuals
AbstractPurpose of ReviewSummarize the methods used for measurement of cerebral blood flow and oxygenation; describe the effects of hypertension on cerebral blood flow and oxygenation.Recent FindingsInformation regarding the effects of hypertension on cerebrovascular circulation during exercise is very limited, despite a plethora of methods to help with its assessment. In normotensive individuals performing incremental exercise testing, total blood flow to the brain increases. In contrast, the few studies performed in hypertensive patients suggest a smaller increase in cerebral blood flow, despite higher blood pressure lev...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

AI (Artificial Intelligence) and Hypertension Research
AbstractPurpose of ReviewThis review a highlights that to use artificial intelligence (AI) tools effectively for hypertension research, a new foundation to further understand the biology of hypertension needs to occur by leveraging genome and RNA sequencing technology and derived tools on a broad scale in hypertension.Recent FindingsFor the last few years, progress in research and management of essential hypertension has been stagnating while at the same time, the sequencing of the human genome has been generating many new research tools and opportunities to investigate the biology of hypertension. Cancer research has appl...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines
AbstractPurpose of ReviewHypertensive disorders of pregnancy (HDP) —gestational hypertension, preeclampsia, and eclampsia—are a leading cause of adverse maternal and perinatal outcomes internationally. Prevention, timely diagnosis, and prompt management can reduce associated morbidity. The purpose of this review is to compare international guidelines pertaining to HDP.Recent FindingsFourteen HDP guidelines were compared relative to guidelines for the United States (US) where the authors practice. Aspirin is universally recommended for high-risk women to reduce preeclampsia risk. Recommended dose and gestational...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Hypertension During Pregnancy
AbstractPurpose of ReviewHypertensive disorders of pregnancy affect about 5 –10% of pregnancies impacting maternal, fetal, and neonatal outcomes. We review the recent studies in this field and discuss the pathophysiology, diagnosis, and management of hypertension during pregnancy, as well as the short- and long-term consequences on the cardiovascular health of women.Recent FindingsAlthough the American College of Cardiology/American Heart Association revised their guidelines for hypertension in the general population in 2017, hypertension during pregnancy continues to be defined as a systolic blood pressure (SBP) &ge...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

The Story of the Silent Killer
AbstractHypertension is the leading risk factor for death and disability-adjusted life-years lost globally. Despite this tremendous impact on health, blood pressure measurement and treatment are relatively new to medical practice, with widespread measurement beginning just over 100  years ago. How, in such a short time, did blood pressure become such an integral measurement in medical practice that it is now considered one of the vital signs? Key revelations through Stephen Hales and his horse experiment, Riva-Rocci’s modern blood pressure cuff, Korotkoff sounds, and Presid ent Roosevelt’s death set the st...
Source: Current Hypertension Reports - August 26, 2020 Category: Primary Care Source Type: research

Haemodynamics of Hypertension in Children
AbstractPurpose of ReviewTo review the haemodynamic characteristics of paediatric hypertension.Recent FindingsPulsatile components of blood pressure are determined by left ventricular dynamics, aortic stiffness, systemic vascular resistance and wave propagation phenomena. Recent studies delineating these factors have identified haemodynamic mechanisms contributing to primary hypertension in children.SummaryStudies to date suggest a role of cardiac over activity, characterized by increased heart rate and left ventricular ejection, and increased aortic stiffness as the main haemodynamic determinants of primary hypertension i...
Source: Current Hypertension Reports - August 24, 2020 Category: Primary Care Source Type: research

Correction to: Maternal Hypertension, Advanced Doppler Haemodynamics and Therapeutic Precision: Principles and Illustrative Cases
The original publication of this article, unfortunately, contains the following errors. (Source: Current Hypertension Reports)
Source: Current Hypertension Reports - August 23, 2020 Category: Primary Care Source Type: research

Postpartum Hypertension
AbstractPurpose of ReviewHypertension affects approximately 10% of pregnancies and may persist in the postpartum period. Furthermore, de novo hypertension may present after delivery, but its exact prevalence is not verified. Both types of hypertension expose the mother to eventually severe complications like eclampsia, stroke, pulmonary edema, and HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome.Recent FindingsUntil today, there are limited data regarding the risk factors, pathogenesis, and pathophysiology of postpartum hypertensive disorders. However, there is certain evidence that preeclampsia may in larg...
Source: Current Hypertension Reports - August 5, 2020 Category: Primary Care Source Type: research

Bariatric Surgery for Resistant Hypertension: Working in Progress!
AbstractPurpose of ReviewTo discuss the recent evidence pointing the benefits of the bariatric surgery on blood pressure control in patients with obesity and hypertension. Particular focus is devoted to discuss the potential impact on resistant hypertension.Recent FindingsGrowing evidence suggest that bariatric surgery promotes not only a significant reduction in the anti-hypertensive medication while maintained blood pressure control but also a significant proportion of hypertension remission as compared to the usual care. In a sub-analysis of the GATEWAY trial using both office and24–h ambulatory blood pressure mon...
Source: Current Hypertension Reports - July 14, 2020 Category: Primary Care Source Type: research

Endothelial Dysfunction in Patients with Rheumatoid Arthritis: the Role of Hypertension
AbstractPurpose of ReviewTo review the data on the role of endothelial dysfunction and the impact of hypertension as a potent mediator of cardiovascular disease in patients with rheumatoid arthritis (RA).Recent FindingsRA represents the most common autoimmune rheumatic disorder and is characterized by chronic systemic inflammation predisposing to cardiovascular complications. Cardiovascular mortality is increased among patients with RA and represents the leading cause of death. Although the exact prevalence is debated, hypertension is increased in RA. Hypertension acts synergistically with chronic inflammation and accounts...
Source: Current Hypertension Reports - July 14, 2020 Category: Primary Care Source Type: research

Vitamin D and Arterial Hypertension: Facts and Myths
AbstractPurpose of ReviewVitamin D and its derivatives are biologically active fat-soluble steroid hormones, which are transcription factors for numerous genes. The results of several observational studies suggest the relationship between plasma concentration of vitamin D and the risk of arterial hypertension, as well as between the intensity of insolation and the risk of arterial hypertension.Recent FindingsBased on the results of the abovementioned studies, it was hypothesized that vitamin D is characterized by the antihypertensive properties. Animal experiments have shown that vitamin D reduces activity of the renin-ang...
Source: Current Hypertension Reports - July 14, 2020 Category: Primary Care Source Type: research

Associations Between Sleep Disorders and Hypertensive Disorders of Pregnancy and Materno-fetal Consequences
AbstractPurpose of the ReviewTo review the data supporting the associations between sleep disorders and hypertensive disorders of pregnancy, their diagnosis, consequences, treatment, and potential mechanisms.Recent FindingsThe prevalence of sleep-disordered breathing, insomnia, and restless legs syndrome increases as pregnancy progresses secondary to physiologic changes associated with pregnancy. Sleep-disordered breathing is strongly associated with the development of gestational hypertension and preeclampsia, both of which are associated with increased risk of perinatal complications. Diagnosing sleep disorders in pregna...
Source: Current Hypertension Reports - July 14, 2020 Category: Primary Care Source Type: research

First Course DASH, Second Course Mediterranean: Comparing Renal Outcomes for Two “Heart-Healthy” Diets
In conclusion, we urge physicians to help patients choose either the DASH diet or Mediterranean diet based on the patient preference. (Source: Current Hypertension Reports)
Source: Current Hypertension Reports - July 14, 2020 Category: Primary Care Source Type: research

Benefits of Community-Based Approaches in Assessing and Addressing Sleep Health and Sleep-Related Cardiovascular Disease Risk: a Precision and Personalized Population Health Approach
We describe community-based and P3H approaches and programs as solutions to accurately capture estimates of sleep health and reduce burden of sleep health problems and corollary CVD outcomes at the level of the community and population. Specifically, we describe seven critical steps needed to successfully implement a community-based and P3H approach to address sleep health problems.SummaryCommunity-based and P3H approaches are effective strategies to assessing and addressing sleep health problems and related health conditions. (Source: Current Hypertension Reports)
Source: Current Hypertension Reports - July 14, 2020 Category: Primary Care Source Type: research