The HCPLive hypertension page is a resource for medical news and expert insights on high blood pressure. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for hypertension, and more.
A patient with "masked" hypertension
September 22nd 2008A 65-year-old man diagnosed with essential hypertension had been treated with antihypertensive medication for 2 years at his physician's office. His systolic/diastolic blood pressure in the office had been controlled at about 130/80 mm Hg with 2 antihypertensive drugs taken in the morning after breakfast. Although he does not have any cardiovascular complications, he is a smoker, is obese, and has diabetes.
Uncovering masked hypertension: Is the blood pressure really normal?
A number of studies have documented the incremental predictive ability of 24 hour ambulatory blood pressure (BP) monitoring over traditional office or casual BP monitoring for predicting adverse cardiovascular events.
Obesity and cardiovascular risk in hypertensive patients with left ventricular hypertrophy
The observed relationship linking obesity, severity of hypertension, and increase in cardiovascular risk was traditionally thought to emanate from the increase in circulatory volume, persistently increased systemic resistance from obesity, and clustering of major cardiovascular risk factors (eg, hypercholesterolemia and diabetes mellitus) among obese patients.
Dangers of aggressively lowering blood pressure in coronary artery disease
September 17th 2008We assessed whether there is a paradoxical increase in cardiovascular events with lower blood pressure values among patients with hypertension and coronary artery disease (CAD) who were enrolled in the International Verapamil-Trandolapril Study (INVEST). The relationship between systolic and diastolic pressure and the risk of primary outcome followed a J-curve pattern, with the relationship being relatively weak for systolic pressure but more significant for diastolic pressure. Our data indicate that excessive lowering of diastolic pressure in hypertensive patients with CAD should be avoided.
What does the J-shaped curve spell out when lowering blood pressure?
The manuscript by Messerli and colleagues, entitled "Dangers of aggressively lowering blood pressure in coronary artery disease," raises a controversial issue with important clinical implications—the J-shaped curve.
C-reactive protein and hypertension
September 11th 2008We assessed whether C-reactive protein (CRP) concentrations predicted future risk of hypertension in a cohort of young adults. Results showed that CRP levels do not independently predict risk of incident hypertension after accounting for body mass index. Further research is needed in the area of inflammation and hypertension, with a special focus on the effect of obesity and age-related changes on this process.
Relationship between insulin use and development of hypertension
September 11th 2008This study evaluated whether exogenous insulin use to control blood glucose in patients with type 2 diabetes was associated with the development of hypertension by analyzing data obtained from a large national sample in Taiwan. Exogenous insulin use was shown to be a significant risk factor for hypertension development.
Predicting survival in elderly patients with heart failure
September 10th 2008Over a period of 14 years, we followed 282 patients aged 70 years or older who were hospitalized with heart failure. Median survival was 2.5 years, but 25% of patients died within 1 year, and 25% survived for at least 5 years following hospital discharge. A simple 7-item risk score based on data readily available at the time of hospitalization effectively stratified patients into low-, intermediate-, and high-risk categories for subsequent mortality.
Alcohol consumption in men with hypertension
September 10th 2008We assessed the association between the incidence of coronary heart disease and alcohol consumption among hypertensive men enrolled in the Health "Professionals" Follow-Up Study. Moderate alcohol consumption (1 to 2 drinks per day) was associated with a lower risk of myocardial infarction, as in the general population, but was not associated with the risks of stroke, total mortality, or mortality from cardiovascular causes. These results show that men with hypertension who drink moderately may not need to change their drinking habits.
Primary aldosteronism in hypertensive patients
September 10th 2008We evaluated the prevalence of primary aldosteronism in subjects newly diagnosed with hypertension who were referred to specialized hypertension centers. An aldosterone-producing adenoma was diagnosed in the subjects with lateralized aldosterone secretion, adenoma at surgery and on pathologic evaluation, and a blood pressure fall after adrenalectomy. Evidence of excess autonomous aldosterone secretion without such criteria led to a diagnosis of idiopathic hyperaldosteronism. Aldosterone-producing adenoma and idiopathic hyperaldosteronism were conclusively diagnosed in 4.8% and 6.4% of the subjects, respectively. Thus, with a prevalence of 11.2%, primary aldosteronism is quite common in patients with newly diagnosed hypertension.
Uncorking new evidence in the alcohol-hypertension relationship
Klatsky reports a link between elevated blood pressures and increased risk of hospitalizations for coronary heart disease and stroke that is independent of alcohol intake.
Atrial fibrillation (AF) is the most common arrhythmia, accounting for approximately one third of all patient discharges with arrhythmia as the principal diagnosis and the greatest number of hospitalization days for arrhythmia each year.
Effect of medication nonadherence in diabetes mellitus
September 10th 2008We evaluated the association between medication nonadherence and outcomes among subjects with diabetes mellitus. Nonadherent subjects had higher blood pressure, glycosylated hemoglobin, and low-density lipoprotein cholesterol levels. In addition, there was an association between medication nonadherence and an increased risk of all-cause hospitalization and all-cause mortality. These findings suggest that interventions are needed to increase medication adherence so that patients can realize the full benefit of prescribed therapies.