Severe Hypertension.net

2-arm blood pressure check indicator for risk from heart disease or death

2012-01-30T08:42:00Z

A systematic review and meta-analysis carried out by researchers at the University of Exeter Peninsula College of Medicine and Dentistry (PCMD) has found that differences in systolic blood pressure between arms could be a useful indicator of the likelihood of vascular risk and death.

The findings add support to the calls for both-arm blood pressure checks to be performed as standard.

The review is published in The Lancet online today (30th January) and the study is supported by the Royal College of General Practitioners, the South West GP Trust and the National Institute for Health Research Peninsula Collaboration for Leadership in Applied Health Research and Care.

Swimming lowers older adults’ blood pressure

2012-01-24T20:02:00Z

Many older adults like to take a dip a pool, and now a small study suggests it can be good for their blood pressure.

Researchers found that among 43 older men and women, those who started swimming a few times a week lowered their systolic blood pressure - the “top” number in a blood pressure reading.

On average, the swimmers started the study with a systolic blood pressure of 131 millimeters of mercury (mm Hg). Three months later, it was 122 mm Hg.

Normal blood pressure is defined as an average reading no higher than 120/80 mm Hg. Readings of 140/90 or higher are considered high blood pressure, and anything in between is considered “pre-hypertension.”

Hypertension in Pregnant Women

2012-01-22T19:15:01Z

Hypertension in pregnancy involves a significant risk to both mother and baby. Although the incidence of eclampsia is falling, hypertension in pregnancy still results in some maternal deaths, and can cause miscarriages, preterm deliveries, and small for date babies due to placental problems. Mothers can be left with chronic hypertension and increased lifelong cardiovascular risk.

Chronic hypertension affects 1 to 5% of pregnancies.
Pregnancy-induced hypertension (now preferably known as gestational hypertension) affects 5 to 10% of all pregnancies. It is more common in first pregnancies (up to 25%).

Hypertension in pregnancy includes:

Gestational hypertension - pregnancy-induced hypertension which develops after 20 weeks’ gestation and may be either transient hypertension of pregnancy or chronic hypertension identified in the latter half of pregnancy.
Pre-eclampsia: pregnancy-induced hypertension in association with proteinuria and/or oedema or both.
Eclampsia - occurrence of one or more convulsions superimposed on pre-eclampsia.

Pre-Hypertension Still Raises Heart Risk in Men

2012-01-20T19:17:01Z

Pre-hypertensive middle-aged men may have more to worry about than developing full-blown high blood pressure. They also are at an increased risk for a heart arrhythmia.

Having blood pressure in the upper end of the “normal” blood pressure range during their 40s and 50s appears to to increase the likelihood men will develop a common heart arrhythmia called atrial fibrillation later in life.

Hypertension is considered a risk factor for atrial fibrillation, but not much has been understood about the health consequences of having blood pressure in the pre-hypertensive range.

Canada’s first renal denervation procedure to reduce high blood pressure performed today

2012-01-18T08:00:00Z

Doctors at the Peter Munk Cardiac Centre today performed a minimally invasive surgical procedure to treat high blood pressure, called renal denervation, for the first time in Canada. The procedure can significantly reduce high blood pressure in patients who cannot effectively treat their hypertension through drugs. These patients, numbering approximately 250,000 Canadians, have to endure an especially high risk of heart attacks and stroke, which continues to kill thousands of Canadians every year.

The first Canadian patient to undergo renal denervation, a 57-year-old male from Toronto, will be discharged tomorrow after overnight observation. The procedure was performed by a multi-disciplinary team, led by Dr. Dheeraj Rajan, Interventional Radiology Specialist; Dr. Douglas Ing, Cardiologist and Dr. George Oreopoulos, Vascular Surgeon. The team recently returned from Germany, where they trained for the procedure. Germany has approved the use of renal denervation to treat selected patients with hypertension.

The Peter Munk Cardiac Centre was the first centre in Canada to receive approval for renal denervation from Health Canada under the Special Access Program that allows practitioners to request access to procedures or drugs that are currently not otherwise approved for use in Canada. As the Health Canada web site notes: “This access is limited to patients with serious or life-threatening conditions on a compassionate or emergency basis when conventional therapies have failed, are unsuitable, or are unavailable.”

Expectant mothers on antidepressants risk newborns with high blood pressure

2012-01-13T08:36:01Z

Mothers who take anti-depressants during pregnancy are more likely to give birth to children with persistent pulmonary hypertension (high blood pressure in the lungs) finds a study published today on bmj.com.

Persistent pulmonary hypertension is an increase in blood pressure in the lungs leading to shortness of breath and difficulty breathing. It is a rare, but severe disease with strong links to heart failure.

The study, carried out by researchers at the Centre for Pharmacoepidemiology at Karolinska Institutet in Stockholm Sweden, reviewed 1.6 million births in total between 1996 and 2007 in five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. The babies were assessed after 231 days (33 weeks).

A total of 1,618,255 singleton births were included in the study. Approximately 11,000 of the mothers filled out a prescription for anti-depressants in late pregnancy and approximately 17,000 in early pregnancy. Those who did fill out a prescription were generally older mothers who also smoked. A further 54,184 mothers were identified as having previously undergone psychiatric diagnosis but were not currently taking any medication.

Blood pressure control: Now or later?

2012-01-09T17:39:00Z

Confronted with a high blood pressure value in a diabetic patient, most doctors would treat aggressively with medications. According to new research, however, delaying drug treatment for up to a year is unlikely to be harmful. The delay allows doctors and their patients to focus on lifestyle changes such as salt restriction, weight management, and exercise. According to Neda Laiteerapong and colleagues from the University of Chicago in the US, the level of harm depends on the duration of the delays in blood pressure control, with significant complications occurring after ten years of non-treatment. Their work?? appears online in the Journal of General Internal Medicine??, published by Springer.

Blood pressure management is integral to diabetes treatment. However, in patients with diabetes, delays in controlling blood pressure are not uncommon. Two main reasons stand out: poor access to health care for some patients and inertia by doctors and patients in those who do have access. Among those who are prescribed blood pressure drugs, at least 20 percent of patients with diabetes do not stick to their treatment. To date, the implications of these delays on patients’ health have not been quantified.

Laiteerapong and team looked into the expected magnitude of harm of different delays in controlling blood pressure in patients with diabetes, using a theoretical, simulation model with a hypothetical population of adults aged 50-59 years with newly diagnosed type 2 diabetes.

Young women may reduce heart disease risk eating fish with omega 3 fatty acids

2011-12-06T06:57:00Z

Young women may reduce their risk of developing cardiovascular disease simply by eating more fish rich in omega-3 fatty acids, researchers reported in Hypertension: Journal of the American Heart Association.

In the first population-based study in women of childbearing age, those who rarely or never ate fish had 50 percent more cardiovascular problems over eight years than those who ate fish regularly.

Compared to women who ate fish high in omega-3 weekly, the risk was 90 percent higher for those who rarely or never ate fish.

Researchers used a Danish nationwide population based pregnancy cohort to examine whether or not eating more fish might reduce cardiovascular disease risk in the young women.

New Formula Developed to Reassure Patients About Low Heart Attack Risk

2011-11-16T09:40:00Z

If your doctor says you have a negative stress test, or that your cholesterol or blood pressure are normal, how assured can you be that you??�re not likely to have a heart attack in the next seven to 10 years? Assessing traditional risk factors, such as age, high blood pressure, cholesterol, smoking and family history can estimate a person??�s risk, but the picture is not always clear-cut. Some newer tests can be offered to provide reassurance or guidance about the need for medications or further testing.

Michael Blaha, M.D., M.P.H, from the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, has developed a simple mathematical formula to help doctors calculate their patients??� risks based on a variety of tests, such as a blood test for C-reactive protein, carotid ultrasound and coronary calcium scoring, which are not part of the usual menu of risk factors. The goal was to determine which test, if results were normal, would provide the most reassurance for patients.

The study shows that by far, a test that looks for coronary calcium is the best indicator of low risk compared with other tests. Blaha will present the results of the study, ???Comparing Zero Coronary Artery Calcium with Other Negative Risk Factors for Coronary Heart Disease,??? at the American Heart Association Scientific Sessions, on Nov. 15, 2011, at 2:30 p.m.

Blood pressure and stroke risk gets more complicated

2011-11-15T16:43:00Z

For patients who have suffered an ischemic stroke, traditional treatment prescribes keeping subsequent blood pressure levels as low as possible to reduce the risk of another stroke. A new international study, however, suggests this conventional approach may not be helpful, and could actually increase recurrent stroke risk - at least in the first few months after the first event.

The findings, from a team of scientists led by Bruce Ovbiagele, MD, professor of neurosciences at the University of California, San Diego School of Medicine, are published in the November 16 issue of JAMA, the Journal of the American Medical Association.

The 5-year study examined the cases of 20,330 patients (age 50 years and older) at 695 centers in 35 countries who had suffered a recent non-cardioembolic ischemic stroke, which is caused by drifting blood clots formed outside of the heart. Patients were categorized by their average Systolic blood pressure (SBP) level: very low-normal (less than 120 mmHg), low-normal (120 to less than 130 mm Hg), high-normal (130 to less than 140 mm Hg), high (140 to less than 150 mm Hg) and very high (150 mm Hg or greater).

The occurrence rate for the primary or first stroke was highest in patients with a very high SBP (14.1 percent), followed by patients with high SBP (8.7 percent). Next came patients with very low-normal SBP at 8 percent, low-normal SBP at 7.2 percent and then high-normal SBP at 6.8 percent. The occurrence rate for a second stroke or other vascular event followed the same pattern.

When blood pressure refuses to go down

2011-11-11T21:39:00Z

Five to 15 percent of all patients with hypertension fail to respond to drug treatment. However, a range of treatment options are now available in these cases. Alongside the established measures stand new and promising interventions such as renal sympathetic denervation. Felix Mahfoud, Frank Himmel and their co-authors present the current treatment strategies for resistant arterial hypertension in the latest issue of Deutsches ?�rzteblatt International (Dtsch Arztebl Int 2011; 108(43): 725).

A multimodal interdisciplinary strategy is necessary for the successful treatment of resistant arterial hypertension. Drug treatment must be tailored to the individual patient, and reversible or secondary causes of hypertension must be systematically sought and treated. The important non-pharmacological conservative treatment measures include optimization of weight, a low-salt diet, physical exercise, and abstinence from alcohol.

Minimally invasive renal denervation and baroreceptor stimulation are two alternative treatment options for selected patients with resistant arterial hypertension.

Breakthrough in understanding the genetics of high blood pressure

2011-11-09T20:40:00Z

A researcher from the University of Leicester’s Department of Cardiovascular Sciences has been involved in a ground-breaking study into the causes of high blood pressure.

The study, published in the academic journal Hypertension, analysed genetic material in human kidneys in a search for genes that might contribute to high blood pressure. The findings open up new avenues for future investigation into the causes of high blood pressure in humans.

The study identified key genes, messenger RNAs and micro RNAs present in the kidneys that may contribute to human hypertension. It also uncovered two microRNAs that contribute to the regulation of renin ??� a hormone long thought to play to part in controlling blood pressure.

Breastfeeding tied to lower blood pressure risk

2011-11-02T06:44:00Z

Mothers who breastfeed for the recommended amount of time may have a somewhat lower risk of developing high blood pressure later on, new research suggests.

The findings, from a large study of nurses, do not prove that breastfeeding is the reason for the healthier blood pressure. But they do add to evidence that breastfeeding might have benefits not only for babies, but for moms as well, researchers say.

In general, experts recommend that babies be breastfed exclusively for their first six months, then continue getting breast milk along with solid food until they are a year old.

Double duty for blood pressure drugs: how they could revolutionize how we treat valve disease

2011-10-25T10:44:00Z

??� A type of medication known as angiotensin-receptor blockers could reduce risk of mortality in people with a heart disease called calcific aortic stenosis (AS) by 30 per cent over an eight-year period, Heart and Stroke Foundation researcher Dr. Philippe Pibarot told delegates at the Canadian Cardiovascular Congress. The condition is currently managed with open heart surgery.

“Our discovery shifts how we think about AS by looking at a new pathway which both prevents and reverses calcification,” says Dr. Pibarot, a professor at Laval University and Canada Research Chair in Valvular Heart Diseases, Qu?�bec Heart & Lung Institute. “It broadens how we can approach therapies, opening up new avenues of research, and has tremendous potential to lead to a major discovery.”

From a health economics point of view, drug treatment is also far less expensive than replacing a valve through surgery, which Dr. Pibarot says costs at least $30,000.

Every year, AS is responsible for 10,000 to 15,000 deaths in North America, and upwards of 80,000 heart surgeries. Now, this promising research suggests the first possible drug therapy to treat AS.

Blood pressure-lowering drug after stroke aids recovery, study finds

2011-10-21T17:04:00Z

A commonly prescribed blood pressure-lowering medication appears to kick start recovery in the unaffected brain hemisphere after a stroke by boosting blood vessel growth, a new University of Georgia study has found.

The discovery, based on a study using rats and published recently in the online journal PLoS ONE, occurred only because the team, led by Susan Fagan, professor of clinical and administrative pharmacy at the UGA College of Pharmacy, struck a new path in stroke research by examining the healthy side of brain after the stroke occurred.

“I’m very excited because I think we can harness the restorative properties of the contralesional hemisphere-the other side of the brain-with drug therapies,” Fagan said. “When most researchers study stroke they compare the animal’s side of the brain that’s damaged to the opposite side, assuming that that side is normal or not affected.”