Novel Interventions for the Prevention of Preeclampsia
AbstractPurpose of ReviewTo review the rationale and biological plausibility and discuss the current research on novel interventions for the prevention of preeclampsia.Recent FindingsPreeclampsia affects up to 8% of pregnancies worldwide and remains a major cause of maternal and neonatal morbidity and mortality. Multiple medications have been investigated or repurposed as potential effective interventions for preeclampsia prevention. Aspirin is currently the only drug for which there is some evidence of benefit for preeclampsia prevention, and its use is recommended by professional societies for pregnancies at risk. Statin...
Source: Current Hypertension Reports - February 12, 2020 Category: Primary Care Source Type: research

Implant-Mediated Therapy of Arterial Hypertension
AbstractPurpose of ReviewTo give an overview on recent developments in permanent implant-based therapy of resistant hypertension.Recent FindingsThe American Heart Association (AHA) recently updated their guidelines to treat high blood pressure (BP). As elevated BP now is defined as a systolic BP above 120  mmHg, the prevalence of hypertension in the USA has increased from 32% (old definition of hypertension) to 46%. In the past years, device- and implant-mediated therapies have evolved and extensively studied in various patient populations. Despite an initial drawback in a randomized controlled tria l (RCT) of bilater...
Source: Current Hypertension Reports - February 6, 2020 Category: Primary Care Source Type: research

Mechanisms of Synergistic Interactions of Diabetes and Hypertension in Chronic Kidney Disease: Role of Mitochondrial Dysfunction and ER Stress
AbstractPurpose of ReviewTo discuss the importance of synergistic interactions of diabetes mellitus (DM) and hypertension (HT) in causing chronic kidney disease and the potential molecular mechanisms involved.Recent FindingsDM and HT are the two most important risk factors for chronic kidney disease (CKD) and development of end-stage renal disease (ESRD). The combination of HT and DM may synergistically promote the progression of renal injury through mechanisms that have not been fully elucidated. Hyperglycemia and other metabolic changes in DM initiate endoplasmic reticulum (ER) stress and mitochondrial (MT) adaptation in...
Source: Current Hypertension Reports - February 3, 2020 Category: Primary Care Source Type: research

Pathophysiology of Hypertensive Heart Disease: Beyond Left Ventricular Hypertrophy
AbstractPurpose of ReviewGiven that the life expectancy and the burden of hypertension are projected to increase over the next decade, hypertensive heart disease (HHD) may be expected to play an even more central role in the pathophysiology of cardiovascular disease (CVD). A broader understanding of the features and underlying mechanisms that constitute HHD therefore is of paramount importance.Recent FindingsHHD is a condition that arises as a result of elevated blood pressure and constitutes a key underlying mechanism for cardiovascular morbidity and mortality. Historically, studies investigating HHD have primarily focuse...
Source: Current Hypertension Reports - February 3, 2020 Category: Primary Care Source Type: research

Obstructive Sleep Apnea and Arterial Hypertension: Implications of Treatment Adherence
AbstractPurpose of ReviewThis review seeks to present an overview of the recent literature on the importance of CPAP and antihypertensive treatment adherence in blood pressure control of hypertensive patients, especially those with obstructive sleep apnea.Recent FindingsAlthough it is unquestionable that a good adherence to CPAP and antihypertensive drugs is crucial to improvements in sleep-related symptoms, blood pressure levels (even the modest reductions of 2 –2.5 mmHg achieved by CPAP treatment) and future cardiovascular risk, this adherence decreases over time, despite efforts made toward behavioral interve...
Source: Current Hypertension Reports - February 3, 2020 Category: Primary Care Source Type: research

Dietary Protein: Mechanisms Influencing Hypertension and Renal Disease
AbstractPurpose of ReviewThis review will provide an in-depth coverage of the epidemiological and pre-clinical literature surrounding the role of dietary protein in hypertension, with a special emphasis on the history of our work on the Dahl salt-sensitive rat.Recent FindingsOur studies have dedicated much effort into understanding the relationship between dietary protein and its effect on the development of salt-sensitive hypertension and renal injury. Our evidence over the last 15  years have demonstrated that both the source and amount of dietary protein can influence the severity of disease, where we have determin...
Source: Current Hypertension Reports - February 3, 2020 Category: Primary Care Source Type: research

Diet and Kidney Function: a Literature Review
AbstractPurpose of ReviewThe burden of chronic kidney disease (CKD) is increasing worldwide. For CKD prevention, it is important to gain insight in commonly consumed foods and beverages in relation to kidney function.Recent FindingsWe included 21 papers of prospective cohort studies with 3 –24 years of follow-up. We focused on meat, fish, dairy, vegetables, fruit, coffee, tea, soft drinks, and dietary patterns. There was convincing evidence that a healthy dietary pattern may lower CKD risk. Plant-based foods, coffee, and dairy may be beneficial. Unhealthy diets and their components , such as red (processed) meat...
Source: Current Hypertension Reports - February 3, 2020 Category: Primary Care Source Type: research

Blood Pressure Variability in Pregnancy: an Opportunity to Develop Improved Prognostic and Risk Assessment Tools
AbstractPurpose of ReviewThis review discusses the mortality and morbidity of hypertensive disorders of pregnancy (HDP) and the current diagnostic thresholds. It then explores measurement of variability in blood pressure (BP) during pregnancy as an opportunity to identify women at high risk of cardiovascular disease (CVD) later in life.Recent FindingsHDP is known to be associated with increased risk of long-term CVD. Current CVD prognostic tools do not incorporate a history of HDP given a lack of improved risk discrimination. However, HDP diagnostic criteria are currently based on a binary threshold, and there is some evid...
Source: Current Hypertension Reports - February 1, 2020 Category: Primary Care Source Type: research

Hypertension Management in Nursing Homes: Review of Evidence and Considerations for Care
AbstractPurpose of ReviewWe sought to summarize recent evidence regarding optimal blood pressure (BP) treatment targets and antihypertensive regimen intensity for nursing home (NH) residents and similar older, complex patients with hypertension.Recent FindingsRecent trials have demonstrated cardiovascular benefits from more intensive BP targets among ambulatory, less complex older adults, but generalizability to NH residents is questionable. Other trials have demonstrated that de-intensifying antihypertensives in frail, older patients is feasible, with no or modest increases in BP, but most have not assessed effects on pat...
Source: Current Hypertension Reports - January 14, 2020 Category: Primary Care Source Type: research

Of Machines and Men: Intelligent Diagnosis and the Shape of Things to Come
AbstractArtificial Intelligence (AI), although well established in many areas of everyday life, has only recently been trialed in the diagnosis and management of common clinical conditions. This editorial review highlights progress to date and suggests further improvements in and trials of AI in the management of conditions such as hypertension. (Source: Current Hypertension Reports)
Source: Current Hypertension Reports - January 14, 2020 Category: Primary Care Source Type: research

The Renin-Angiotensin System in the Central Nervous System and Its Role in Blood Pressure Regulation
AbstractPurpose of the ReviewThe main goal of this article is to discuss how the development of state-of-the-art technology has made it possible to address fundamental questions related to how the renin-angiotensin system (RAS) operates within the brain from the neurophysiological and molecular perspective.Recent FindingsThe existence of the brain RAS remains surprisingly controversial. New sensitive in situ hybridization techniques and novel transgenic animals expressing reporter genes have provided pivotal information of the expression of RAS genes within the brain. We discuss studies using genetically engineered animals...
Source: Current Hypertension Reports - January 10, 2020 Category: Primary Care Source Type: research

Arterial Stiffness and Coronary Ischemia: New Aspects and Paradigms
AbstractPurpose of ReviewAortic stiffness (AS) is widely associated with hypertension and considered as a major predictor of coronary heart disease (CHD). AS is measured using carotid –femoral pulse wave velocity (PWV), particularly when this parameter is associated with an index involving age, gender, heart rate, and mean blood pressure. The present review focuses on the interest of measurement of PWV and the calculation of individual PWV index for the prediction of CHD, in ad dition with the use of new statistical nonlinear models enabling results with very high levels of accuracy.Recent FindingsPWV index may so co...
Source: Current Hypertension Reports - January 10, 2020 Category: Primary Care Source Type: research

Effect of Garlic ’s Active Constituents in Inflammation, Obesity and Cardiovascular Disease
AbstractPurpose of ReviewSeveral studies have attributed garlic ’s beneficial properties to its high content of organosulfur compounds (OSCs). Here, we summarized recent studies published and some own findings regarding OSCs and its effects on cardiovascular disease, inflammation, and obesity.Recent FindingThe analysis of the multiple actions produced by OSCs suggests that many of its bioactivities interfere against inflammation, oxidative stress, obesogenic effects, and mitochondrial dysfunction. Accumulating evidence from in vitro, animal, and human studies reinforce the notion that OSCs modify signaling pathways t...
Source: Current Hypertension Reports - January 10, 2020 Category: Primary Care Source Type: research

Approaches for the Management of Resistant Hypertension in 2020
AbstractPurpose of ReviewResistant hypertension is diagnosed if the blood pressure (BP) is not controlled despite optimum doses of 3 first-line classes of antihypertensive drugs including a thiazide diuretic or if adequate BP control needs 4 or more antihypertensive drugs from different classes.Recent FindingsPseudohypertension and white coat hypertension must be excluded. Poor patient compliance, inadequate doses of antihypertensive drugs, poor office BP measurement technique, and having to pay for costs of drugs are factors associated with pseudoresistant hypertension. Secondary hypertension must be excluded and treated....
Source: Current Hypertension Reports - January 8, 2020 Category: Primary Care Source Type: research

Overexpression of ACE in Myeloid Cells Increases Immune Effectiveness and Leads to a New Way of Considering Inflammation in Acute and Chronic Diseases
AbstractPurpose of ReviewTo review recent studies exploring how myeloid cell overexpression of angiotensin-converting enzyme (ACE) affects the immune response and to formulate an approach for considering the effectiveness of inflammation in cardiovascular diseaseRecent FindingsWhile it is widely appreciated that the renin-angiotensin system affects aspects of inflammation through the action of angiotensin II, new studies reveal a previously unknown role of ACE in myeloid cell biology. This was apparent from analysis of two mouse lines genetically modified to overexpress ACE in monocytes/macrophages or neutrophils. Cells ov...
Source: Current Hypertension Reports - January 8, 2020 Category: Primary Care Source Type: research

Food Products That May Cause an Increase in Blood Pressure
AbstractPurpose of ReviewTo review latest reports of the food products which might increase blood pressure and therefore might participate in the pathogenesis of hypertension.Recent FindingsResults of clinical study suggest that consumption of high-sodium food leads to transient increase in plasma sodium concentration. This is accompanied by blood pressure increase. Results of both clinical and experimental studies suggest direct vasculotoxic effects of sodium. Increased plasma sodium concentration could mediate its effects on blood pressure by changes in endothelial cell stiffness and glycocalyx integrity. Energy drinks a...
Source: Current Hypertension Reports - January 8, 2020 Category: Primary Care Source Type: research

Cocoa Consumption and Blood Pressure in Middle-Aged and Elderly Subjects: a Meta-Analysis
AbstractPurpose of ReviewThe effect of cocoa consumption on blood pressure (BP) has been investigated in previous studies; however, to date, no meta-analysis has been conducted specific to middle-aged and elderly subjects. Thus, the aim of the present study was to evaluate the effect of cocoa consumption on indices of blood pressure, in middle-aged and elderly subjects.Recent FindingsPubmed/Medline ™, Cochrane Library™, Google Scholar™, and Scopus™ were searched until March 2019. The quantitative Jadad scale was used as the systematic assessment of bias in the included trials. We used a random effec...
Source: Current Hypertension Reports - January 6, 2020 Category: Primary Care Source Type: research

State of the Art: the Not-So-Great Wall of America
AbstractPurpose of ReviewThis paper aims to review the literature regarding the impact of Donald Trump ’s candidacy and presidency on the health of immigrants in America.Recent FindingsThe increase in detentions of alleged undocumented immigrants under the Trump presidency, especially his administration ’s attempts to detain children apart from their families, have placed thousands into conditions that can have long-lasting physical and mental health effects. Similarly, the Trump administration’s efforts to increase deportations and restrict legal immigration has lead to immigrants’ seeking f ewer h...
Source: Current Hypertension Reports - December 19, 2019 Category: Primary Care Source Type: research

Hypertensive Disorders of Pregnancy and Future Maternal Health: How Can the Evidence Guide Postpartum Management?
AbstractPurpose of ReviewTo review the postpartum management of hypertensive disorders of pregnancy.Recent FindingsHypertensive disorders are associated with an increased risk of future cardiovascular disease; however, there is a poor understanding of the underlying mechanisms and few recommendations to guide care in the postpartum period. Recent studies have shown high rates of masked hypertension and home blood pressure monitoring in the first year postpartum may be a promising opportunity to monitor health given evidence of high maternal adherence to this approach. In longer term, women with a history of a hypertensive ...
Source: Current Hypertension Reports - November 27, 2019 Category: Primary Care Source Type: research

Pro-inflammatory Cytokines and Resistant Hypertension: Potential for Novel Treatments?
AbstractPurpose of ReviewTo gather data from studies evaluating the pro-inflammatory profile of individuals with resistant hypertension (RH), and bring a clinical update of new and potential complementary therapies to treat inflammation in RH.Recent FindingsIncreases in pro-inflammatory cytokines are related to elevated blood pressure and target organ damage in RH patients. Clinical and experimental studies have shown that some biological therapies, especially TNF- α inhibitors, regulated pro- and anti-inflammatory cytokines associated with improvements in clinical outcomes, although they are not yet reported in RH.S...
Source: Current Hypertension Reports - November 26, 2019 Category: Primary Care Source Type: research

Pregnancy History, Hypertension, and Cognitive Impairment in Postmenopausal Women
AbstractPurpose of ReviewRisks for developing cardiovascular disease and cognitive decline increase with age. In women, these risks may be influenced by pregnancy history. This review provides an integrated evaluation of associations of pregnancy history with hypertension, brain atrophy, and cognitive decline in postmenopausal women.Recent FindingsAtrophy in the occipital lobes of the brain was evident in women who had current hypertension and a history of preeclampsia. Deficits in visual memory in women with a history of preeclampsia are consistent with these brain structural changes. The blood velocity response to chemic...
Source: Current Hypertension Reports - November 18, 2019 Category: Primary Care Source Type: research

Arterial Hypertension, Aldosterone, and Atrial Fibrillation
AbstractPurposeAtrial fibrillation is the most common sustained arrhythmia, with a prevalence of 1 –2% in the general population and over 15% in people older than 80 years. Due to aging of the population it imposes an increasing burden on the healthcare system because of the need for life-long pharmacological treatment and the associated increased risk of heart failure and hospitalization. Hen ce, identification of the factors that predispose to atrial fibrillation it is of utmost relevance.Recent FindingsSeveral conditions exist that are characterized by inappropriately high levels of aldosterone, mostly primar...
Source: Current Hypertension Reports - November 18, 2019 Category: Primary Care Source Type: research

Using Telehealth to Disseminate Primary, Secondary, and Tertiary CVD Interventions to Rural Populations
This study aims to review the evidence on telehealth interventions in rural communities that use primary, secondary, or tertiary strategies for the prevention and management of cardiovascular disease (CVD).Recent FindingsStudies focused on the reduction of CVD risk factors and mitigation of disease progression among rural populations using telehealth are limited in number but appear to be increasing in the last 5  years. These studies suggest primary-, secondary-, and tertiary-level interventions can impact CVD risk and management. The current review found more studies addressing primary CVD intervention strategies, a...
Source: Current Hypertension Reports - November 7, 2019 Category: Primary Care Source Type: research

Cost-Effectiveness and Challenges of Implementing Intensive Blood Pressure Goals and Team-Based Care
AbstractPurpose of ReviewReview the effectiveness, cost-effectiveness, and implementation challenges of intensive blood pressure (BP) control and team-based care initiatives.Recent FindingsIntensive BP control is an effective and cost-effective intervention; yet, implementation in routine clinical practice is challenging. Several models of team-based care for hypertension management have been shown to be more effective than usual care to control BP. Additional research is needed to determine the cost-effectiveness of team-based care models relative to one another and as they relate to implementing intensive BP goals.Summar...
Source: Current Hypertension Reports - November 7, 2019 Category: Primary Care Source Type: research

Potential Contribution of Carotid Body-Induced Sympathetic and Renin-Angiotensin System Overflow to Pulmonary Hypertension in Intermittent Hypoxia
AbstractPurpose of ReviewObstructive sleep apnea (OSA), featured by chronic intermittent hypoxia (CIH), is an independent risk for systemic hypertension (HTN) and is associated with pulmonary hypertension (PH). The precise mechanisms underlying pulmonary vascular remodeling and PH in OSA are not fully understood. However, it has been suggested that lung tissue hypoxia, oxidative stress, and pro-inflammatory mediators following CIH exposure may contribute to PH.Recent FindingsNew evidences obtained in preclinical OSA models support that an enhanced carotid body (CB) chemosensory reactiveness to oxygen elicits sympathetic an...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

From Clinical Trials to Bedside: the Use of Antihypertensives in Aged Individuals. Part 1: Evaluation and Evidence of Treatment Benefit
AbstractPurpose of ReviewUse of antihypertensives in older adults can be complicated by the potential for undesired effects on comorbidities, adverse effects of the drugs, and overall medication burden. The purpose of this two-part review is to discuss contemporary issues encountered in the management of hypertension in aged individuals, with a particular focus on the individualization of treatment. In part 1, we discuss the evaluation of the aged hypertensive patient and review the clinical trial evidence for treatment benefit of hypertension in the elderly.Recent FindingsElderly patients with suspected hypertension need ...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

Is Heart Failure with Preserved Ejection Fraction a Kidney Disorder?
AbstractPurpose of ReviewHeart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome of exertional intolerance, cardiac dysfunction, and fluid overload and is associated with significant morbidity and mortality.Recent FindingsAs our understanding of this syndrome has evolved, we are beginning to recognize the similarities and associations with chronic kidney disease (CKD). Salt and fluid retention are common in CKD and may be the sentinel event leading ultimately to the syndrome of HFpEF. Mechanisms linking both disease states include hypervolemia, inflammation, and endothelial dysfunction, which are...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

Measuring Blood Pressure: from Cuff to Smartphone
AbstractPurpose of ReviewFor measurement of blood pressure, using inflatable cuff-based technology can be inconvenient, uncomfortable, and requires special equipment. These issues could be overcome by using a contactless technology that measures blood pressure with the ubiquitous smartphone.Recent FindingsIn a proof of concept study involving normotensive participants, Luo et al. demonstrated brachial blood pressure measurements from video of the face with accuracy comparable to traditional automated blood pressure monitors.SummaryThere is still some way to go before contactless blood pressure measurement technology is suf...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

From Clinical Trials to Bedside: the Use of Antihypertensives in Aged Individuals. Part 2: Approach to Treatment
AbstractPurpose of ReviewUse of antihypertensives in older adults can be complicated by the potential for undesired effects on comorbidities, adverse effects of the drugs, and overall medication burden. The purpose of this two-part review is to discuss contemporary issues encountered in the management of hypertension in aged individuals, with a particular focus on considerations for the individualization of treatment. In Part 2, we discuss the individualized approach to treating hypertension in the elderly.Recent FindingsAchieving lower blood pressure goals in older adults has the potential to increase risks for complicati...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

Pheochromocytoma as a Clinical Model of Peripheral Sympathetic Overdrive: Old and New Findings
AbstractPurpose of ReviewThe present paper will review the results of experimental and clinical studies aimed at defining the functional behavior of the central and peripheral nervous system in adrenal pheochromocytoma.Recent FindingsThe contribution of sympathetic neural influences to the development of high blood pressure values in pheochromocytoma is complex. Studies performed in experimental animal models have shown that hypertension and the concomitant high circulating levels of catecholamines can lead to inhibition of central sympathetic neural outflow by reflex mechanisms and direct stimulation of central adrenergic...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

Trends and Status of the Prevalence of Elevated Blood Pressure in Children and Adolescents in China: a Systematic Review and Meta-analysis
AbstractPurpose of ReviewTo evaluate the status of elevated blood pressure in Chinese children and adolescents, and identify potential influence factors.Recent FindingsWe searched PubMed, the Web of science, the WanFang, the VIP, and the CNKI to identify articles that were published from Jan 1, 1997, to May 30, 2019. We used random effects models to estimate the pooled prevalence of elevated blood pressure, and heterogeneity among the studies was assessed with Cochran ’s Q statistic. The potential source of heterogeneity was explored by meta-regression and subgroup comparisons using Q test based on ANOVA. Fifty-nine ...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

Bilirubin Safeguards Cardiorenal and Metabolic Diseases: a Protective Role in Health
AbstractPurpose of ReviewTo discuss recent advances indicating that bilirubin safeguards against cardiorenal and metabolic diseases.Recent FindingsSeveral investigations from human patient populations and experimental animal models have shown that bilirubin improves cardiorenal and metabolic dysfunction. The latest studies found an entirely new function of bilirubin suggesting that it acts as a hormone signaling molecule capable of activating nuclear receptors for burning fat, which may explain several of its protective actions.SummaryThis review highlights the current findings (within the last 3  years) regarding car...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

Legacy Effect in the Treatment of Hypertension: Persistent Cardiovascular Protection after Conclusion of Randomized Clinical Trials in Hypertension
AbstractRecent FindingsEssential hypertension is the main determinant of cardiovascular morbidity and mortality worldwide. During the last decades, several antihypertensive drug therapies have been introduced and tested in clinical trials, both as monotherapies and combination therapies. The current recommended therapeutic approaches effectively reduce the lifetime risk of experiencing major cardiovascular outcomes and disabling comorbidities, such as myocardial infarction, stroke, and congestive heart failure. On the basis of multiple proofs, antihypertensive therapy is currently recommended for improving event-free survi...
Source: Current Hypertension Reports - October 10, 2019 Category: Primary Care Source Type: research

The Potential of mHealth Applications in Improving Resistant Hypertension Self-Assessment, Treatment and Control
AbstractPurpose of ReviewTo review the evidence supporting the use of mobile health (mHealth) apps to improve resistant hypertension self-assessment, treatment and control.Recent FindingsmHealth apps have been used to directly measure blood pressure (BP) levels, either using the oscillometric method with automated inflatable cuffs or using pulse wave signals detected by smartphone technology without the need for cuffs. These app-based BP monitors tend to over or underestimate BP levels when compared to a gold standard aneroid sphygmomanometer. However, the differences in BP measurements are within the acceptable range of 5...
Source: Current Hypertension Reports - October 9, 2019 Category: Primary Care Source Type: research

New Molecules for Treating Resistant Hypertension: a Clinical Perspective
AbstractPurpose of ReviewTo review the findings of trials evaluating pharmacological treatment approaches for hypertension in general, and resistant hypertension (RH) in particular, and propose future research and clinical directions.Recent FindingsRH is defined as blood pressure (BP) that remains above target levels despite adherence to at least three antihypertensive medications, including a diuretic. Thus far, clinical trials of pharmacological approaches in RH have focused on older molecules, with spironolactone being demonstrated as the most efficacious fourth-line agent. However, the use of spironolactone in clinical...
Source: Current Hypertension Reports - September 10, 2019 Category: Primary Care Source Type: research

Alcohol and Hypertension —New Insights and Lingering Controversies
AbstractPurpose of ReviewTo examine outstanding issues in the relationship of alcohol to hypertension. These include whether the increase in BP with alcohol is causally related, the nature of the relationship in women, the contribution of alcohol-related increases in BP to cardiovascular disease and the aetiology of alcohol-related hypertension.Recent FindingsIntervention studies and Mendelian randomisation analyses confirm the alcohol –BP relationship is causal. The concept that low-level alcohol intake reduces BP in women is increasingly unsustainable. Alcohol-related hypertension is in the causal pathway between a...
Source: Current Hypertension Reports - September 7, 2019 Category: Primary Care Source Type: research

Mineralocorticoid Receptor and Endothelial Dysfunction in Hypertension
AbstractPurpose of ReviewTo review the latest reports of the contributions of the endothelial mineralocorticoid receptor to endothelial dysfunction and hypertension to begin to determine the clinical potential for this pathway for hypertension treatment.Recent FindingsEndothelial mineralocorticoid receptor expression is sex-specifically increased in female mice and humans compared with males. Moreover, the expression of endothelial mineralocorticoid receptors is increased by endothelial progesterone receptor activation and naturally occurring fluctuations in progesterone levels (estrous, pregnancy) predict endothelial mine...
Source: Current Hypertension Reports - September 4, 2019 Category: Primary Care Source Type: research

Steroid Profiling and Immunohistochemistry for Subtyping and Outcome Prediction in Primary Aldosteronism —a Review
AbstractPurpose of ReviewSteroid profiling and immunohistochemistry are both promising new tools used to improve diagnostic accuracy in the work-up of primary aldosteronism (PA) and to predict treatment outcomes. Herein, we review the recent literature and present an outlook to the future of diagnostics and therapeutic decision-making in patients with PA.Recent FindingPA is the most common endocrine cause of arterial hypertension and unilateral forms of the disease are potentially curable by surgical resection of the overactive adrenal. Recent studies have shown that adrenal steroid profiling by liquid chromatography-tande...
Source: Current Hypertension Reports - September 3, 2019 Category: Primary Care Source Type: research

Comparison of the 2017 ACC/AHA Hypertension Guideline with Earlier Guidelines on Estimated Reductions in Cardiovascular Disease
AbstractPurpose of ReviewTo review the recommendations of the 2017 American College of Cardiology/American Heart Association hypertension guideline and to compare it with previous guidelines on potential cardiovascular disease (CVD) and mortality risk reductions.Recent FindingsCompared with previous guidelines, the 2017 hypertension guideline increased the prevalence of hypertension and the number of adults recommended for antihypertensive therapy in the US population. Based on data from recent analyses, the new guideline effectively directs antihypertensive therapy toward individuals at higher CVD risk. Two recent analyse...
Source: Current Hypertension Reports - August 31, 2019 Category: Primary Care Source Type: research

Hypertension in Premenopausal and Postmenopausal Women
AbstractPurpose of ReviewTo examine available clinical data on the differences between premenopausal and postmenopausal women with hypertension (HTN). Clinical conditions related to HTN and reproductive status differ in younger women compared with older women. Due to recent changes in the definition of HTN, the prevalence of HTN has increased significantly in all women. Rising rates of obesity among women of all ages increase the risk for HTN.Recent FindingsAmong younger women, long-term vascular consequences of preeclampsia, the under-reported prevalence of fibromuscular dysplasia, and widespread use of oral contraceptive...
Source: Current Hypertension Reports - August 26, 2019 Category: Primary Care Source Type: research

Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa
AbstractPurpose of ReviewTo review the current literature on use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness technology infrastructure in SSA to improve population-level blood pressure control.Recent FindingsDespite the high burden of hypertension in SAA, strategies to improve awareness, diagnosis, and management are inadequate. In high-income countries, telehealth has increased patient access to high-quality care at reduced costs. Notwithstanding the limited evidence on the use of telehealth at the different stages of the hyperte...
Source: Current Hypertension Reports - August 26, 2019 Category: Primary Care Source Type: research

Fragmented QRS as a Marker of Myocardial Fibrosis in Hypertension: a Systematic Review
This article aimed to demonstrate importance and usefulness of fQRS in hypertensive patients.Recent FindingsCurrent evidence suggest that the frequency of fQRS is significantly higher in hypertensive patients compared to normotensives. Also, fQRS seems to be a predictor of left ventricular hypertrophy, increased systolic blood pressure, non-dipping, deterioration of the left ventricular geometry, and worse systolic and diastolic functions in hypertensive patients.SummaryAs a simple and easy detectable electrocardiographic finding, fQRS may indicate myocardial fibrosis, uncontrolled blood pressure, and deteriorated cardiac ...
Source: Current Hypertension Reports - August 26, 2019 Category: Primary Care Source Type: research

Investigating Maternal Brain Alterations in Preeclampsia: the Need for a Multidisciplinary Effort
AbstractPurpose of ReviewTo provide insight into the mechanisms underlying cerebral pathophysiology and to highlight possible methods for evaluation, screening, and surveillance of cerebral complications in preeclampsia.Recent FindingsThe pathophysiology of eclampsia remains enigmatic. Animal studies show that the cerebral circulation in pregnancy and preeclampsia might be affected with increased permeability over the blood-brain barrier and altered cerebral blood flow due to impaired cerebral autoregulation. The increased blood pressure cannot be the only underlying cause of eclampsia and cerebral edema, since some cases ...
Source: Current Hypertension Reports - August 2, 2019 Category: Primary Care Source Type: research

Ambulatory Blood Pressure Monitoring in Pediatrics
AbstractPurpose of ReviewThis is a review of ambulatory blood pressure monitoring (ABPM) use in pediatrics, summarizing current knowledge and uses of ABPM.Recent FindingsUpdated guidelines from the American Academy of Pediatrics have emphasized the value of ABPM. ABPM is necessary to diagnose white coat hypertension, masked hypertension, and nocturnal hypertension associated with specific conditions. There is growing evidence that ABPM may be useful in these populations. ABPM has been demonstrated to be more predictive of end-organ damage in pediatric hypertension compared to office blood pressure.SummaryABPM is an importa...
Source: Current Hypertension Reports - July 26, 2019 Category: Primary Care Source Type: research

Blood Pressure and Statin Effects on Cognition: a Review
AbstractPurpose of ReviewThis is a review of available data on the effects of blood pressure and statins on cognition.Recent FindingsRecent randomized clinical trials have shown that intensive control of systolic blood pressure in older adults prevented the development of mild cognitive impairment (MCI) and the combined effects of MCI and probable dementia. Previous randomized clinical trials have suggested that statin use may prevent a decline in cognition; however, no randomized clinical trials have clearly shown evidence of statin ’s either positive or negative effect on cognition.SummaryContinued follow-up of SPR...
Source: Current Hypertension Reports - July 26, 2019 Category: Primary Care Source Type: research

A Review of Angiogenic Imbalance in HIV-Infected Hypertensive Disorders of Pregnancy
AbstractPurpose of ReviewThis review provides a comprehensive insight into the angiogenic profile of hypertensive and normotensive pregnancies compromised by HIV infection. Furthermore, we evaluate the economic implementation of the sFlt-1/PlGF ratio and review the reports on therapeutic apheresis in limiting sFlt-1 production.Recent FindingsIn preeclampsia, an increased expression of sFlt-1 triggers angiogenic imbalance. Women of African ancestry have high levels of angiogenic factors than other racial groups. The sFlt-1/PlGF ratio shows promise in the early assessment of preeclampsia, while sFlt-1 apheresis restores angi...
Source: Current Hypertension Reports - July 24, 2019 Category: Primary Care Source Type: research

Adaptive Immunity in Hypertension
AbstractPurpose of ReviewIn recent years, a vast body of evidence has accumulated indicating the role of the immune system in the regulation of blood pressure and modulation of hypertensive pathology. Numerous cells of the immune system, both innate and adaptive immunity, have been indicated to play an important role in the development and maintenance of hypertension. The purpose of this review was to summarize the role of adaptive immunity in experimental models of hypertension (genetic, salt-sensitive, and Angiotensin (Ang) II induced) and in human studies. In particular, the role of T and B cells is discussed.Recent Fin...
Source: Current Hypertension Reports - July 18, 2019 Category: Primary Care Source Type: research

Resistant Hypertension Management: Comparison of the 2017 American and 2018 European High Blood Pressure Guidelines
AbstractPurpose of ReviewTo compare European and American guidelines for the diagnosis, evaluation, and management of resistant hypertension.Recent FindingsResistant hypertension is defined as high blood pressure that remains above goal with the use of 3 or more antihypertensive agents, commonly a renin-angiotensin blocker (either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker), a long-acting calcium channel blocker, and thiazide or thiazide-like diuretic. Resistant hypertension is common, with a recent analysis indicating that it affects approximately 17 –19% of adult Americans with hy...
Source: Current Hypertension Reports - July 18, 2019 Category: Primary Care Source Type: research

Anxiety and Hypertension: Is There a Link? A Literature Review of the Comorbidity Relationship Between Anxiety and Hypertension
AbstractPurpose of ReviewTo review the most recent literature on the association between comorbid anxiety disorders and hypertension.Recent FindingsRecent longitudinal and cross-sectional studies across geographic regions and age groups predominantly demonstrate a positive association between comorbid anxiety and prevalent or incident hypertension. Growing research on blood pressure variability and reduced baroreflex sensitivity in response to autonomic dysfunction provides a greater understanding of mechanistic relationships between anxiety and hypertension. Observational studies demonstrate that young adults are at a hig...
Source: Current Hypertension Reports - July 18, 2019 Category: Primary Care Source Type: research

Letter to the Editor re “Hypertension and Pre-Hypertension Among Iranian Adults Population: a Meta-Analysis of Prevalence, Awareness, Treatment, and Control” by Afsargharehbagh et al. (2019) Published in Current Hypertension Reports
(Source: Current Hypertension Reports)
Source: Current Hypertension Reports - July 10, 2019 Category: Primary Care Source Type: research