The second most attributed cause of mortality and morbidity globally is stroke and it accounts for the third most common cause of disability.[1] Elevated blood pressure is a common modifiable risk factor as confirmed in several studies. Hypertension is observed in an estimated 64% of stroke patients with approximately 51% of stroke mortality being attributed to hypertension worldwide.[2,3] Screening and early optimal treatment of hypertension at community level presents many missed opportunities to reduce the burden of stroke. Hypertension contributes as a major risk factor for both ischemic and hemorrhagic stroke.[3] The relationship between hypertension and cerebrovascular disease risk is well established and the causal association has been confirmed with a progressively graded association with increasing BP values.[2] The relationship between BP and cerebrovascular events is continuous, making the distinction between normal BP and hypertension, based on cutoff BP values, somewhat ambiguous. Progressively higher BP value entails greater risk of stroke in both non-hypertensive and hypertensive range of BP values. The definition of hypertension is the level of raised BP above normal values at which the benefits of treatment (either with lifestyle interventions or drugs) unequivocally outweigh the risks of treatment, as documented by clinical trials. More than two-third of individuals above age of 65 years are diagnosed to have hypertension. Although awareness and treatment of hypertension has improved over the past two decades, control rates are around 50%. The European Guidelines for the Management of Hypertension recommend aiming to achieve a target systolic BP to <140 mmHg for all patient categories, including independent elderly patients, with an ideal target of 130 mmHg for all patients if tolerated [Table 1].[4] Isolated systolic hypertension in the elderly also contributes to the risk of stroke. The deleterious contribution of hypertension as a risk factor in stroke is based on a continuum rather than a threshold effect. Epidemiological studies have concluded that optimal BP control reduces the risk of stroke and for every 10 mmHg control of systolic blood pressure by onethird in patients aged 60–79 years. This benefit is sustained up to BP level of 115/75 mmHg and is observed in all stroke subtypes, both genders, and all age groups. SBP ≥ 140 mmHg contributes to about 70% of the mortality and disability burden. Both office BP and home or ambulatory BP have an independent and Abstract
{"title":"Target Blood Pressure Goals in Cerebrovascular Disease","authors":"A. Pai, Nikith Shetty","doi":"10.15713/INS.JOHTN.0208","DOIUrl":"https://doi.org/10.15713/INS.JOHTN.0208","url":null,"abstract":"The second most attributed cause of mortality and morbidity globally is stroke and it accounts for the third most common cause of disability.[1] Elevated blood pressure is a common modifiable risk factor as confirmed in several studies. Hypertension is observed in an estimated 64% of stroke patients with approximately 51% of stroke mortality being attributed to hypertension worldwide.[2,3] Screening and early optimal treatment of hypertension at community level presents many missed opportunities to reduce the burden of stroke. Hypertension contributes as a major risk factor for both ischemic and hemorrhagic stroke.[3] The relationship between hypertension and cerebrovascular disease risk is well established and the causal association has been confirmed with a progressively graded association with increasing BP values.[2] The relationship between BP and cerebrovascular events is continuous, making the distinction between normal BP and hypertension, based on cutoff BP values, somewhat ambiguous. Progressively higher BP value entails greater risk of stroke in both non-hypertensive and hypertensive range of BP values. The definition of hypertension is the level of raised BP above normal values at which the benefits of treatment (either with lifestyle interventions or drugs) unequivocally outweigh the risks of treatment, as documented by clinical trials. More than two-third of individuals above age of 65 years are diagnosed to have hypertension. Although awareness and treatment of hypertension has improved over the past two decades, control rates are around 50%. The European Guidelines for the Management of Hypertension recommend aiming to achieve a target systolic BP to <140 mmHg for all patient categories, including independent elderly patients, with an ideal target of 130 mmHg for all patients if tolerated [Table 1].[4] Isolated systolic hypertension in the elderly also contributes to the risk of stroke. The deleterious contribution of hypertension as a risk factor in stroke is based on a continuum rather than a threshold effect. Epidemiological studies have concluded that optimal BP control reduces the risk of stroke and for every 10 mmHg control of systolic blood pressure by onethird in patients aged 60–79 years. This benefit is sustained up to BP level of 115/75 mmHg and is observed in all stroke subtypes, both genders, and all age groups. SBP ≥ 140 mmHg contributes to about 70% of the mortality and disability burden. Both office BP and home or ambulatory BP have an independent and Abstract","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91325416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Identification of hypertension in pregnancy is important not only for fetal outcomes but hypertensive disease in pregnancy also portends a higher risk for future cardiovascular events in women.[1] The prevalence of gestational hypertension (hypertension that manifests for the 1st time during pregnancy) is 6%;[2] additionally, up to 3% of childbearing women have chronic hypertension (the prevalence is increasing as obesity rates go up).[3] Hypertension increases the risk of complications during pregnancy, including preeclampsia, fetal growth restriction, and abruptio placentae.[3] In addition, it puts expectant mothers at risk for heart failure (both with reduced and preserved ejection fraction) and right ventricular dysfunction; later in life, women are also at substantially increased risk of coronary artery disease and heart failure.[4] In fact, the treatment of hypertension has been shown to reduce maternal morbidity, but it has not been shown to substantially impact fetal outcomes.[3] In a normal pregnancy, systemic blood pressure drops due to systemic vasodilation and decreased peripheral vascular resistance. As a result, many women with mild chronic hypertension can stop taking medication during pregnancy. Thus far, no evidence has been found that treatment of mild-tomoderate hypertension improves fetal or maternal outcomes; therefore, guidelines for treatment goals remain controversial.[4] According to the ACC/AHA guidelines, it is reasonable to treat Stage 1 hypertension to prevent future cardiovascular events. Two of the classic first-line agents for hypertensive control have relative contraindications in pregnancy. Angiotensinconverting enzyme inhibitors and angiotensin receptor blockers can cause skull hypoplasia in the fetus, as well as anuria and renal failure (particularly in the first trimester).[5] Thiazides can cause neonatal jaundice, volume depletion, or thrombocytopenia (although one study showed no significant difference in adverse pregnancy outcomes with diuretics).[3,6] Calcium channel blockers may be used to treat hypertension in pregnancy, however, and are often considered first-line agents.[4] The most well-studied agents for hypertension in pregnancy are beta-blockers and methyldopa. Beta-blockers, particularly labetalol, are well-studied and have been shown to be safe in pregnancy. Labetalol also has an enhanced effect on blood pressure because of its concomitant alpha-blockade. In some studies, atenolol has been shown to have an association with fetal growth restriction: Although data are limited, many practitioners avoid using atenolol as a result.[3] Methyldopa, as mentioned, is one of the drugs that have been used the longest in pregnant women; it acts on a central alpha receptor, decreasing sympathetic tone to the heart, kidneys, and peripheral vasculature.[7] Methyldopa has an extensive safety record in pregnancy; however, its effect on blood pressure is only modest, and many women require a second agent for impro
{"title":"Hypertension in Pregnancy","authors":"E. Armenia, Michael Vornovitsky","doi":"10.15713/ins.johtn.0179","DOIUrl":"https://doi.org/10.15713/ins.johtn.0179","url":null,"abstract":"Identification of hypertension in pregnancy is important not only for fetal outcomes but hypertensive disease in pregnancy also portends a higher risk for future cardiovascular events in women.[1] The prevalence of gestational hypertension (hypertension that manifests for the 1st time during pregnancy) is 6%;[2] additionally, up to 3% of childbearing women have chronic hypertension (the prevalence is increasing as obesity rates go up).[3] Hypertension increases the risk of complications during pregnancy, including preeclampsia, fetal growth restriction, and abruptio placentae.[3] In addition, it puts expectant mothers at risk for heart failure (both with reduced and preserved ejection fraction) and right ventricular dysfunction; later in life, women are also at substantially increased risk of coronary artery disease and heart failure.[4] In fact, the treatment of hypertension has been shown to reduce maternal morbidity, but it has not been shown to substantially impact fetal outcomes.[3] In a normal pregnancy, systemic blood pressure drops due to systemic vasodilation and decreased peripheral vascular resistance. As a result, many women with mild chronic hypertension can stop taking medication during pregnancy. Thus far, no evidence has been found that treatment of mild-tomoderate hypertension improves fetal or maternal outcomes; therefore, guidelines for treatment goals remain controversial.[4] According to the ACC/AHA guidelines, it is reasonable to treat Stage 1 hypertension to prevent future cardiovascular events. Two of the classic first-line agents for hypertensive control have relative contraindications in pregnancy. Angiotensinconverting enzyme inhibitors and angiotensin receptor blockers can cause skull hypoplasia in the fetus, as well as anuria and renal failure (particularly in the first trimester).[5] Thiazides can cause neonatal jaundice, volume depletion, or thrombocytopenia (although one study showed no significant difference in adverse pregnancy outcomes with diuretics).[3,6] Calcium channel blockers may be used to treat hypertension in pregnancy, however, and are often considered first-line agents.[4] The most well-studied agents for hypertension in pregnancy are beta-blockers and methyldopa. Beta-blockers, particularly labetalol, are well-studied and have been shown to be safe in pregnancy. Labetalol also has an enhanced effect on blood pressure because of its concomitant alpha-blockade. In some studies, atenolol has been shown to have an association with fetal growth restriction: Although data are limited, many practitioners avoid using atenolol as a result.[3] Methyldopa, as mentioned, is one of the drugs that have been used the longest in pregnant women; it acts on a central alpha receptor, decreasing sympathetic tone to the heart, kidneys, and peripheral vasculature.[7] Methyldopa has an extensive safety record in pregnancy; however, its effect on blood pressure is only modest, and many women require a second agent for impro","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89207696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.2174/1876526201911010011
B. Tiksnadi, Arief Taufiqurrohman, A. D. Permana, F. Y. Fihaya, Y. Sofiatin, Kurnia Wahyudi, M. R. Akbar, R. Roesli
Hypertension is a global health problem, with the prevalence increasing by 30% from 2013 to 2018 in Indonesia. Furthermore, obesity, a major risk factor for hypertension, has also escalated by 50%. Hence, the incidence of Obstructive Sleep Apnoea Syndrome (OSAS), which is strongly associated with hypertension and obesity, is expected to increase. OSAS is part of the complex sleep disorder breathing syndrome, but there is a lack of data regarding its prevalence and association with hypertension. To investigate the prevalence of OSAS and its association with hypertension in Jatinangor, West Java, Indonesia. A cross-sectional study was conducted from September to October 2018 of subjects from two villages in Indonesia selected by purposive sampling. Fifteen neighbourhoods were chosen by the cluster random sampling method, with a total of 1,308 respondents included in this study. Inclusion criteria were age > 17 years old and resident in the village for more than one year. OSAS was determined by a 4-variable screening tool questionnaire (4-V) and hypertension was measured by a standardised method (average of three measurements in each session with a one-minute break using a digital device); both measurements were performed by trained health cadres. All results were statistically analysed using chi-square and logistic regression. Of the total of 1308 respondents included in this study, 33 (2.5%) had OSAS and 299 respondents (22.8%) had hypertension. In the population with OSAS, 18 respondents (54.5%) had hypertension, significantly higher (p<0.001) compared to the non-OSAS group (22%). After adjustment for age, gender, and Body Mass Index (BMI), OSAS was still an independent predictor of hypertension (OR = 4.3, p = 0.000). The prevalence of OSAS in the Jatinangor district of Indonesia is 2.5% and it is significantly associated with hypertension.
{"title":"Prevalence of Obstructive Sleep Apnoea Syndrome (OSAS) and Its Association with Hypertension in Jatinangor West Java","authors":"B. Tiksnadi, Arief Taufiqurrohman, A. D. Permana, F. Y. Fihaya, Y. Sofiatin, Kurnia Wahyudi, M. R. Akbar, R. Roesli","doi":"10.2174/1876526201911010011","DOIUrl":"https://doi.org/10.2174/1876526201911010011","url":null,"abstract":"\u0000 \u0000 Hypertension is a global health problem, with the prevalence increasing by 30% from 2013 to 2018 in Indonesia. Furthermore, obesity, a major risk factor for hypertension, has also escalated by 50%. Hence, the incidence of Obstructive Sleep Apnoea Syndrome (OSAS), which is strongly associated with hypertension and obesity, is expected to increase. OSAS is part of the complex sleep disorder breathing syndrome, but there is a lack of data regarding its prevalence and association with hypertension.\u0000 \u0000 \u0000 \u0000 To investigate the prevalence of OSAS and its association with hypertension in Jatinangor, West Java, Indonesia.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was conducted from September to October 2018 of subjects from two villages in Indonesia selected by purposive sampling. Fifteen neighbourhoods were chosen by the cluster random sampling method, with a total of 1,308 respondents included in this study. Inclusion criteria were age > 17 years old and resident in the village for more than one year. OSAS was determined by a 4-variable screening tool questionnaire (4-V) and hypertension was measured by a standardised method (average of three measurements in each session with a one-minute break using a digital device); both measurements were performed by trained health cadres. All results were statistically analysed using chi-square and logistic regression.\u0000 \u0000 \u0000 \u0000 Of the total of 1308 respondents included in this study, 33 (2.5%) had OSAS and 299 respondents (22.8%) had hypertension. In the population with OSAS, 18 respondents (54.5%) had hypertension, significantly higher (p<0.001) compared to the non-OSAS group (22%). After adjustment for age, gender, and Body Mass Index (BMI), OSAS was still an independent predictor of hypertension (OR = 4.3, p = 0.000).\u0000 \u0000 \u0000 \u0000 The prevalence of OSAS in the Jatinangor district of Indonesia is 2.5% and it is significantly associated with hypertension.\u0000","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47383429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-30DOI: 10.2174/1876526201911010006
Majda Dali-Sahi, Nouria Dennouni-Medjati, Youssouf Kachekouche, Hamza N.M. Boudia, H. Boulenouar
The existing literature reports results on the association of lipid parameters with the level of insulin secretion and the risk of arterial hypertension. This study evaluated the role of the insulin dosage and lipid fractions in the risk of arterial hypertension in type 2 diabetic patients in Western Algeria. This was a cross-sectional observational study involving 101 subjects with type 2 diabetes mellitus. The data collected was about the biodemographic profile of the participants. We performed multiple regressions to test the effect of insulin concentration on the parameters studied. The multiple regression analytical study showed that HOMA-IR, BMI and waist circumference were predictors for the insulinemia response variable (P<0.05). It should be noted that in insulinopenia, insulin secretion is positively and significantly correlated with non-HDL-C (P=0.037), and it is also significantly and positively correlated with LDL-C (P=0.042). Multiple regression also shows that SBP and DBP are significantly and positively related to insulin resistance. Our data suggest a possible direct relationship between fasting insulin and blood pressure. Monitoring of circulating insulin concentrations is critically important in a population of type 2 diabetics.
{"title":"Association of Insulin Secretion Level on Lipid Fractions and Risk of Arterial Hypertension","authors":"Majda Dali-Sahi, Nouria Dennouni-Medjati, Youssouf Kachekouche, Hamza N.M. Boudia, H. Boulenouar","doi":"10.2174/1876526201911010006","DOIUrl":"https://doi.org/10.2174/1876526201911010006","url":null,"abstract":"\u0000 \u0000 The existing literature reports results on the association of lipid parameters with the level of insulin secretion and the risk of arterial hypertension.\u0000 \u0000 \u0000 \u0000 \u0000 This\u0000 study evaluated the role of the insulin dosage and lipid fractions in the risk of arterial hypertension in type 2 diabetic patients in Western Algeria.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional observational study involving 101 subjects with type 2 diabetes mellitus. The data collected was about the biodemographic profile of the participants. We performed multiple regressions to test the effect of insulin concentration on the parameters studied.\u0000 \u0000 \u0000 \u0000 The multiple regression analytical study showed that HOMA-IR, BMI and waist circumference were predictors for the insulinemia response variable (P<0.05). It should be noted that in insulinopenia, insulin secretion is positively and significantly correlated with non-HDL-C (P=0.037), and it is also significantly and positively correlated with LDL-C (P=0.042). Multiple regression also shows that SBP and DBP are significantly and positively related to insulin resistance. Our data suggest a possible direct relationship between fasting insulin and blood pressure.\u0000 \u0000 \u0000 \u0000 Monitoring of circulating insulin concentrations is critically important in a population of type 2 diabetics.\u0000","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45068894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-31DOI: 10.2174/1876526201911010001
H. Lashkardoost, Fateme Hoseyni, Elham Rabbani, Farzane Q. moqadam, L. Hosseini, Salimeh Azizi, Andishe Hamedi
North Khorasan province has one of the highest rates of hypertension. One of the main causes of hypertension is obesity. Obesity is one of the most important public health problems around the world as a risk factor for non-communicable diseases. Since a similar study was not conducted in Bojnurd, we examined the relationship between waist to hip ratio with hypertension. The present cross-sectional study was conducted on women referring to Bojnurd health centers. To analyze the data, we used t-test, chi-square, multiple logistic regression and Pearson correlation in Stata 12 software. In this cross-sectional study, the prevalence of systolic blood pressure was 14.78% and diastolic blood pressure was 15.65%. So waist to the hips showed the highest correlation with the changes in hypertension. There are significant relationships between the age and the number of pregnancies with the risk of hypertension. Since a significant percentage of people are unaware of the existence of hypertension, changing diet and having regular physical activity along with social support is an important strategy.
{"title":"Hypertension and its Relation with Waist to Hip Ratio in Women Referred to Bojnurd Urban Health Centers in 2014","authors":"H. Lashkardoost, Fateme Hoseyni, Elham Rabbani, Farzane Q. moqadam, L. Hosseini, Salimeh Azizi, Andishe Hamedi","doi":"10.2174/1876526201911010001","DOIUrl":"https://doi.org/10.2174/1876526201911010001","url":null,"abstract":"\u0000 \u0000 North Khorasan province has one of the highest rates of hypertension. One of the main causes of hypertension is obesity. Obesity is one of the most important public health problems around the world as a risk factor for non-communicable diseases. Since a similar study was not conducted in Bojnurd, we examined the relationship between waist to hip ratio with hypertension.\u0000 \u0000 \u0000 \u0000 The present cross-sectional study was conducted on women referring to Bojnurd health centers. To analyze the data, we used t-test, chi-square, multiple logistic regression and Pearson correlation in Stata 12 software.\u0000 \u0000 \u0000 \u0000 In this cross-sectional study, the prevalence of systolic blood pressure was 14.78% and diastolic blood pressure was 15.65%. So waist to the hips showed the highest correlation with the changes in hypertension.\u0000 \u0000 \u0000 \u0000 There are significant relationships between the age and the number of pregnancies with the risk of hypertension. Since a significant percentage of people are unaware of the existence of hypertension, changing diet and having regular physical activity along with social support is an important strategy.\u0000","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48194608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sunil Gurmukhani, Preeti Gahlan, Sanjay Shah, Tejas M. Patel
3 rd day of hospitalization� In view of young hypertension and recurrent flash pulmonary edema, we suspected renovascular etiology. On blood investigation, her Hb was 12.3, total count 12,300, platelets 3�2 lac, serum creatinine 0�7, serum potassium 4�2, and serum sodium 142� She had high plasma renin activity (>24) and high aldosterone level� Erythrocyte sedimentation rate (ESR) was 112 and C-reactive protein (CRP) was 98� Ultrasono graphy abdomen showed asymmetrical kidney size� Computerized tomograph y angiogram revealed diffuse thickening and enhancement of aortic wall and its major branches along with critical narrowing of ostium of left renal artery [Figure Atherosclerotic RAS is extremely unknown at this age� We put two differential diagnosis, one is unifocal FMD and other is Abstract Vasculitis as a cause of renovascular hypertension is not uncommon. However, isolated involvement of the left renal artery without affection of other vascular beds is extremely rare in any vasculitis, including Takayasu arteritis. Here, we present a case of a young girl with resistant hypertension and recurrent flash pulmonary edema secondary to renal artery stenosis (RAS). The cause of the RAS was vasculitis probably Takayasu arteritis. She was managed with immunosuppression with endovascular intervention.
{"title":"Isolated Unilateral Renal Artery Stenosis in Young Female with Takayasu Arteritis: Case Report","authors":"Sunil Gurmukhani, Preeti Gahlan, Sanjay Shah, Tejas M. Patel","doi":"10.15713/ins.johtn.0166","DOIUrl":"https://doi.org/10.15713/ins.johtn.0166","url":null,"abstract":"3 rd day of hospitalization� In view of young hypertension and recurrent flash pulmonary edema, we suspected renovascular etiology. On blood investigation, her Hb was 12.3, total count 12,300, platelets 3�2 lac, serum creatinine 0�7, serum potassium 4�2, and serum sodium 142� She had high plasma renin activity (>24) and high aldosterone level� Erythrocyte sedimentation rate (ESR) was 112 and C-reactive protein (CRP) was 98� Ultrasono graphy abdomen showed asymmetrical kidney size� Computerized tomograph y angiogram revealed diffuse thickening and enhancement of aortic wall and its major branches along with critical narrowing of ostium of left renal artery [Figure Atherosclerotic RAS is extremely unknown at this age� We put two differential diagnosis, one is unifocal FMD and other is Abstract Vasculitis as a cause of renovascular hypertension is not uncommon. However, isolated involvement of the left renal artery without affection of other vascular beds is extremely rare in any vasculitis, including Takayasu arteritis. Here, we present a case of a young girl with resistant hypertension and recurrent flash pulmonary edema secondary to renal artery stenosis (RAS). The cause of the RAS was vasculitis probably Takayasu arteritis. She was managed with immunosuppression with endovascular intervention.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73427233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy O. Go, L. D. Santiago, A. Miranda, Raul D. Jara
General objective The general objective of this study was to evaluate the effects of the different beta-blockers in patients with HTN and HFrEF. Specific objectives The specific objectives of this study were as follows: • To discuss the pathophysiologic mechanisms behind the development of HTN and HF • To determine which beta-blockers are effective in reducing rates of hospitalization, morbidity, and mortality among hypertensive patients with HFrEF.
{"title":"Effect of Beta-blockers on Hypertension and Heart Failure with Reduced Ejection Fraction: A Systematic Review of Randomized Controlled Trials","authors":"Jeremy O. Go, L. D. Santiago, A. Miranda, Raul D. Jara","doi":"10.15713/ins.johtn.0157","DOIUrl":"https://doi.org/10.15713/ins.johtn.0157","url":null,"abstract":"General objective The general objective of this study was to evaluate the effects of the different beta-blockers in patients with HTN and HFrEF. Specific objectives The specific objectives of this study were as follows: • To discuss the pathophysiologic mechanisms behind the development of HTN and HF • To determine which beta-blockers are effective in reducing rates of hospitalization, morbidity, and mortality among hypertensive patients with HFrEF.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75587063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. F. F. Diaz, Jojo R. Evangelista, C. Chua, Abdias V. Aquino, R. Castillo
The burden of stroke has not been mitigated over the past 2–4 decades. In terms of the proportions of disability and mortality as a result of stroke, the less developed regions of the world surpass most developed nations.[1] The primary causes of the increased global burden of stroke are related to the increase in stroke risk factors, particularly hypertension. Part of the reason for the higher disability and mortality rates is probably in the lack of understanding on how best to manage the blood pressure (BP) in different stroke settings.[2,3] In general, acute ischemic strokes (AISs) account for 80% of the stroke cases while hemorrhagic strokes account about 20% depending on the specific population. Recent data from the Risk Factors for Ischemic and Intracerebral Stroke in 22 Countries (INTERSTROKE) study, which included the Philippines, China, Malaysia and Sudan showed that the proportions of ischemic and Abstract
{"title":"Management of Hypertension in the Setting of Acute Stroke: A Literature Review","authors":"A. F. F. Diaz, Jojo R. Evangelista, C. Chua, Abdias V. Aquino, R. Castillo","doi":"10.15713/ins.johtn.0159","DOIUrl":"https://doi.org/10.15713/ins.johtn.0159","url":null,"abstract":"The burden of stroke has not been mitigated over the past 2–4 decades. In terms of the proportions of disability and mortality as a result of stroke, the less developed regions of the world surpass most developed nations.[1] The primary causes of the increased global burden of stroke are related to the increase in stroke risk factors, particularly hypertension. Part of the reason for the higher disability and mortality rates is probably in the lack of understanding on how best to manage the blood pressure (BP) in different stroke settings.[2,3] In general, acute ischemic strokes (AISs) account for 80% of the stroke cases while hemorrhagic strokes account about 20% depending on the specific population. Recent data from the Risk Factors for Ischemic and Intracerebral Stroke in 22 Countries (INTERSTROKE) study, which included the Philippines, China, Malaysia and Sudan showed that the proportions of ischemic and Abstract","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90883153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular diseases (CVDs) cause most of the death worldwide. Hypertension (HTN) leads to 57% of cerebrovascular accidents and 24% of all coronary artery disease-deaths in India.[1] According to the World Health Organisation, HTN is one of the leading causes of premature deaths around the globe�[2] The prevalence of CVD is increasing in alarming proportion in India and it accounts for 30% of all deaths. Increasing incidence of CV risk factors such as hypertension (HTN), diabetes mellitus, tobacco use, and metabolic syndrome leads to increasing CVD in India. Apart from tobacco cessation, control of HTN forms the most important of the various treatment strategies to reduce CV mortality. HTN control is poor in developing countries. The Prospective Urban Rural Epidemiology study reported that control of HTN is about 50% in high-income countries and 10% in lowand lower middle-income countries.[3] Studies have reported better control of HTN rates in the past 50 years from Western Europe and the USA.[4] The National Health and Nutrition Examination Surveys from 1988 to 2008 and 1999 to 2012 have reported that the prevalence of HTN remained static at 30–35% during this period, whereas increasing rates of HTN treatment (from 60% to 75%) and its control (from 53% to 69%) were observed.[5] There is a linear relationship between elevation of blood pressure (BP) and CV risk, as the BP rises above 115/75 mmHg.[6] The Global Burden of Diseases (GBD) 2015 analysis reveals that the estimated mortality rate per year associated with systolic BP (SBP) of at least 110–115 mmHg between 1990 and 2015 has risen from 135�6 to 145�2/100,000 persons�[7] Patel et al� have estimated that a decrease of 2 mmHg SBP in the population can prevent approximately 150,000 strokes and coronary artery disease (CAD) deaths in our country�[8] However, prospective data on HTN trends with respect to prevalence, awareness, and treatment from our country are scarce�
{"title":"Hypertension and Cardiovascular Trends in India","authors":"Ravikanth Garipalli, M. Azam","doi":"10.15713/ins.johtn.0163","DOIUrl":"https://doi.org/10.15713/ins.johtn.0163","url":null,"abstract":"Cardiovascular diseases (CVDs) cause most of the death worldwide. Hypertension (HTN) leads to 57% of cerebrovascular accidents and 24% of all coronary artery disease-deaths in India.[1] According to the World Health Organisation, HTN is one of the leading causes of premature deaths around the globe�[2] The prevalence of CVD is increasing in alarming proportion in India and it accounts for 30% of all deaths. Increasing incidence of CV risk factors such as hypertension (HTN), diabetes mellitus, tobacco use, and metabolic syndrome leads to increasing CVD in India. Apart from tobacco cessation, control of HTN forms the most important of the various treatment strategies to reduce CV mortality. HTN control is poor in developing countries. The Prospective Urban Rural Epidemiology study reported that control of HTN is about 50% in high-income countries and 10% in lowand lower middle-income countries.[3] Studies have reported better control of HTN rates in the past 50 years from Western Europe and the USA.[4] The National Health and Nutrition Examination Surveys from 1988 to 2008 and 1999 to 2012 have reported that the prevalence of HTN remained static at 30–35% during this period, whereas increasing rates of HTN treatment (from 60% to 75%) and its control (from 53% to 69%) were observed.[5] There is a linear relationship between elevation of blood pressure (BP) and CV risk, as the BP rises above 115/75 mmHg.[6] The Global Burden of Diseases (GBD) 2015 analysis reveals that the estimated mortality rate per year associated with systolic BP (SBP) of at least 110–115 mmHg between 1990 and 2015 has risen from 135�6 to 145�2/100,000 persons�[7] Patel et al� have estimated that a decrease of 2 mmHg SBP in the population can prevent approximately 150,000 strokes and coronary artery disease (CAD) deaths in our country�[8] However, prospective data on HTN trends with respect to prevalence, awareness, and treatment from our country are scarce�","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"41 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77749646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Vinny Defensor-Mina, Arnold Benjamin C. Mina, D. Morales
Department of Internal Medicine, Adventist University of the Philippines – College of Medicine, Silang Cavite, Philippines, Consultant in Rheumatology, University of Perpetual Help Medical Center Heart and Vascular Institute, Biñan Laguna, Philippines, Pioneer Faculty, Adventist University of the Philippines – College of Medicine, Silang Cavite, Philippines, Consultant in Cardiology, University of Perpetual Help Medical Center Heart and Vascular Institute, Biñan Laguna, Philippines, Faculty and Consultant in Cardiology, University of the Philippines College of Medicine, Philippine General Hospital, Manila Doctors Hospital, Philippines, Philippine College of Physicians, Philippine Heart Association, Philippine Society of Hypertension, Philippine Lipid and Atherosclerosis Society
{"title":"Revisiting Salt Sensitivity and the Therapeutic Benefits of Salt Restriction in Hypertension","authors":"Maria Vinny Defensor-Mina, Arnold Benjamin C. Mina, D. Morales","doi":"10.15713/ins.johtn.0155","DOIUrl":"https://doi.org/10.15713/ins.johtn.0155","url":null,"abstract":"Department of Internal Medicine, Adventist University of the Philippines – College of Medicine, Silang Cavite, Philippines, Consultant in Rheumatology, University of Perpetual Help Medical Center Heart and Vascular Institute, Biñan Laguna, Philippines, Pioneer Faculty, Adventist University of the Philippines – College of Medicine, Silang Cavite, Philippines, Consultant in Cardiology, University of Perpetual Help Medical Center Heart and Vascular Institute, Biñan Laguna, Philippines, Faculty and Consultant in Cardiology, University of the Philippines College of Medicine, Philippine General Hospital, Manila Doctors Hospital, Philippines, Philippine College of Physicians, Philippine Heart Association, Philippine Society of Hypertension, Philippine Lipid and Atherosclerosis Society","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"200 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79920299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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