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Published in Henry J. Woodford, Essential Geriatrics, 2022
Because some medications can promote hyperglycaemia, medication review should consider if discontinuation or switching drug class would be appropriate. As part of vascular risk reduction, those who smoke should be encouraged to stop. Antiplatelets are only recommended for people who also have cardiovascular disease.91 Statin medications may be indicated (see Chapter 3). Blood pressure control is discussed in Chapter 18. Reducing blood pressure can reduce both micro- and macrovascular complications. ACE inhibitors or angiotensin receptor blockers (ARBs) tend to be used in preference for BP control in people with diabetes. ARBs may reduce the risk of developing end-stage renal disease in people with albuminuria but neither drug appears to improve all-cause mortality compared to placebo.97
Complications of carotid endarterectomy
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Laura T. Boitano, Mark F. Conrad
The most important management strategy for cerebral hyperperfusion syndrome is prevention. This includes strict blood pressure control with a goal systolic blood pressure of less than 150 mmHg. Intravenous agents such as labetalol, nitroprusside, and nitroglycerin can be utilized to meet this goal. Patients who present with a severe ipsilateral headache should undergo head CT and have strict blood pressure control. Seizures can be treated with standard antiepileptic medication. In severe cases, patients may receive platelet transfusions to ameliorate the antiplatelet effect of aspirin or other antiplatelet medication (Table 13.1).
Physical Activity, Weight Gain, and Obesity
Published in James M. Rippe, Increasing Physical Activity, 2020
A number of studies have shown that overweight and obesity are associated with the risk of developing hypertension. A study by Rankin et al. demonstrated that cardiorespiratory fitness attenuates that risk (69). Chen et al. reported that BMI had a closer relationship to systolic blood pressure than did fitness (70). Wing et al. reported that both BMI and cardiorespiratory fitness were significantly associated with systolic blood pressure in women whether or not they were taking medicine for blood pressure control (71). In men not taking medication for blood pressure control, however, BMI and fitness were not associated with systolic blood pressure. These findings suggest that both BMI and fitness are important for blood pressure control in overweight and obese adults.
Hypertension burden, treatment, and control among people with HIV at a clinical care center in the Southeastern US, 2014–2019
Published in AIDS Care, 2023
Molly Remch, Nora Franceschini, Thibaut Davy-Mendez, Michelle Floris-Moore, Sonia Napravnik
In conclusion, in this cohort of PWH, patients experienced a high burden of both prevalent and incidence hypertension. When treated, most patients achieved blood pressure control. However, patients with incident hypertension were largely not prescribed an antihypertensive within one year of hypertension onset, indicating missed opportunities to reduce CVD risk. Most PWH receive routine medical care from infectious disease specialists, not physicians with expertise in CVD or blood pressure management. As such, continued research on the prevalence, incidence, and treatment of cardiovascular diseases in the context of HIV care is important. Appropriate care of other non-HIV chronic conditions also requires coordination of care by multiple medical professionals, and further research is needed to understand how other comorbid chronic conditions are diagnosed and managed in this population. As PWH continue to live longer lives with other comorbid conditions, continuing to monitor incidence, treatment, and outcomes of hypertension in this medically vulnerable group is important. Additionally, as care for chronic conditions, including hypertension, increases in complexity among those aging with HIV, care coordination across medical specialties will become increasingly important.
Left ventricular long-axis ultrasound strain (GLS) is an ideal indicator for patients with anti-hypertension treatment
Published in Clinical and Experimental Hypertension, 2022
Tingting Wu, Lulu Zheng, Saidan Zhang, Lan Duan, Jing Ma, Lihuang Zha, Lingfang Li
The Research Ethics Committee of the Xiangya Hospital of Central South University had approved this study. All participating members had carefully read and signed informed consent. All enrolled members were divided into three groups, including 1) hypertensive treatment experimental group: 56 patients with newly diagnosed essential hypertension were followed up. 3) Healthy control group: 37 normal volunteers from the physical examination center were collected. The inclusion criteria are as follows: 1) Newly diagnosed essential hypertension. The diagnostic criteria included not taking antihypertensive drugs, measuring blood pressure three times on a different day, systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (14); 2) 2) Patients with the previous diagnosis of hypertension and poor blood pressure control. After taking antihypertensive drugs, blood pressure was measured three times on a different day. The systolic blood pressure ≥140 mmHg and/or diastolic blood pressure≥90 mmHg. Moreover, exclusion criteria were as follows: 1) Patients have diagnosed as coronary heart disease; 2) Patients with various types of valvular heart disease; 3) Patients with various types of cardiomyopathy; 4) Patients with atrial fibrillation and atrial flutter; 5) Patients were previously diagnosed with primary and secondary pulmonary hypertension; 6) Patients with secondary hypertension; 7) LVEF <50% of patients with hypertension; 8) Patients with diabetes; 9) Patients with atrioventricular block of
Socioeconomic status affects achievement of blood pressure target in hypertension: contemporary results from the Swedish primary care cardiovascular database
Published in Scandinavian Journal of Primary Health Care, 2021
Georgios Mourtzinis, Karin Manhem, Thomas Kahan, Linus Schiöler, Jetish Isufi, Charlotta Ljungman, Tobias Andersson, Per Hjerpe
The main finding of this study is the independent association between low personal disposable income and lower likelihood to achieve blood pressure target. This is in agreement with our previous findings, where patients with higher income had lower discontinuation rates of antihypertensive drug treatment, while there was no association between educational level and treatment persistence [14]. This may, at least in part explain our findings. Previous studies have presented conflicting results regarding the relations between income and blood pressure control. However, the impact of income depends partly on social infrastructure, which varies between different societies and countries. Perhaps more important, different methods to measure economic disparities have been used in previous studies, including simple questions, self-administered questionnaires [7,15], and comparisons between economic status in different areas, communities, or countries [16]. We stratified all individuals according to their personal disposable income acquired directly from a validated national register. Moreover, we have previously shown that low income is associated with a higher risk of mortality and cardiovascular events in patients with hypertension [17]. Our results suggest that patients with low income should be offered increased attention to ascertain adequate blood pressure control to prevent hypertensive end-organ damage and subsequent cardiovascular morbidity and mortality.