Hypertension

Nonadherence to antihypertensive drug therapy increased risk of stroke, hospitalization for stroke and stroke-related mortality.

Mid-life hypertension is a risk factor for cognitive decline. A 10 mm Hg rise in systolic pressure led to an intermediate cognitive decline in 7% of the cohort on follow-up.

At the ASH meeting, one could get a pretty good sense of where the beta-blocker hypertension debate is headed.

Adult-onset psoriasis is uncommon without a precipitating factor. In this patient’s case, an oral beta-blocker precipitated the psoriasis.

Yoga practice resulted in a 3-4 mm Hg decline in systolic BP at 24 weeks and a 2-3 mm Hg decline in diastolic BP on 24-hour ambulatory monitoring.

Awareness of this major health problem is on the rise, as evidenced by numerous recent reports about important new study findings.

The number of people who require 2 or more antihypertensives to reach target blood pressure is on the increase. So, simply stated, what goes best with what? The 2013 ASH meeting offered some good suggestions under the heading of “Within Class Differences.”

HIV-infected patients are undertreated for hypertension and at higher risk for cardiovascular complications than age-matched controls.

Lowering blood pressure saves lives and primary care practice is where treatment for hypertension begins.

Resistant hypertension requires aggressive treatment with multiple drugs. Spironolactone is a key addition to the regimen.

Hypertension in hospitalized patients is best treated conservatively.

More about the current move away from beta-blocker therapy for hypertension as discussed by speakers at the 2013 ASH annual meeting. Following are some more of the key points, including a discussion of so-called beta-blockers "plus."

ASH 2013 has uncovered 2 glaring gaps in the management of people with sleep disorders (OSA as well as others) and appropriate care after a stroke. Both cohorts frequent primary care practice.

Patients with resistant hypertension and hypertensive patients prone to hyperkalemia are on the rise. They are not easy to care for, but certain “tricks of the trade” can help. Details here.

The meeting's goals are to increase understanding and, perhaps, find a cure.

To what cause of sudden loss of vision do the funduscopic findings point?

Organizations are intensifying efforts to control this disease, the number one risk factor for disability and death in the United States and worldwide.

Recommendations consider the whole patient, the spectrum of risks and complications for the patient, and evidence-based approaches to treatment.

More than one-third of adults in the United States have high blood pressure, but close to half of them do not have it controlled. This compact slide show provides visual presentations of a range of related problems.

A call for intensified efforts to prevent and control hypertension is the theme of World Health Day 2013, observed this month to focus attention on reducing heart attacks and strokes.

Antidepressants and pre-term delivery; annual BP check?; stroke before age 50; niacin questioned; incretins and pancreatic disease

Measuring a patient’s blood pressure once a year instead of at every visit would reduce the rate of false-positive results in patients who do not have hypertension and eliminate the need for further workup in many patients.

A recent meta-analysis of beta-blocker use in patients with HF found that the drugs conferred no reduction in rates of mortality or hospitalization among patients with comorbid AF.

The reduction in dementia is not simply the result of the drugs reducing their blood pressure.

Typical interventions in persons without CKD are essential. SHARP and TNT have added to our knowledge. Aggressive cholesterol lowering (probably also affecting LDL particle number as well as traditional measures of LDL) seems to afford better outcomes by lessening residual risk in those with chronic kidney disease.

Goals for HbA1C, blood pressure, and LDL-C among diabetes patients are being met by more, according to the NIH.

FDA approves 3 drugs for type 2 diabetes; African Americans undertreated for hypertension; poor participation in clincall trials; impact of restricted marketing on medical students; PCPs and radiology reporting.

It appears that the attractiveness of beta-blockers is waning for patients with heart failure and also for those with acute MI. Carvedilol is becoming a preferred agent.

Researchers found that among African American patients with uncontrolled hypertension, fewer than half were prescribed guideline-recommended first-line therapy with diuretics.

Dark chocolate, tomatoes, and grapeseed oil are just a few of the natural approaches to cardiovascular risk reduction supported by science.