2016-04-22T19:21:12+00:00The leading cause of death in the elderly, the fastest growing segment of the population, is cardiovascular disease (CVD). Prevention of cardiovascular events in elderly patients presents a therapeutic challenge because this age group is generally underrepresented in clinical trials, and doctors often assume that it is too late to initiate preventive therapy in the elderly. A review by clinical experts of the best available evidence concluded that cholesterol-lowering and blood pressure-controlling therapy are the most effective treatments for reducing cardiovascular events in older adults, but that treatment needs to be individualized, reports the Canadian Journal of Cardiology. “Primary prevention trials in younger populations demonstrate small absolute risk reductions over many years, which is difficult to extrapolate to older patients,” explained senior author Michelle M. Graham, MD, FRCPC, Professor of Medicine, Division of Cardiology, Mazankowski Alberta Heart Institute and University of Alberta Faculty of Medicine and Dentistry. “Some assume elderly individuals may not have the life expectancy to derive benefit from preventive cardiovascular therapy; however, their baseline level of risk, and subsequent relative risk reduction with appropriate therapy, may actually be higher than in younger patients.”
2016-01-28T20:14:42+00:00A new blood clotting analysis system designed in Japan makes it easier to determine the effects of taking one or more antithrombotic (anti-clotting) drugs. Myocardial infarction, arrhythmia (atrial fibrillation), cerebral infarction and economy-class syndrome all have one thing in common: they are all diseases that are caused by a blood clot blocking a blood vessel. Anti-clotting drugs that thin the blood to make it more difficult to form clots in the blood vessels are taken to prevent and cure those diseases that result from blood clotting. The newest type of these drugs, novel oral anti-coagulants (NOACs), have become very popular in recent years. These breakthrough drugs are highly effective, combine easily with other drugs, and do not come with dietary restrictions.
2015-12-21T20:15:53+00:00The number and percentage of patients treated at emergency departments for hypertension are on the rise across the United States, according to a Vanderbilt University Medical Center study published recently in the American Journal of Cardiology. “We found that around 25 percent of all emergency department visits involved patients with hypertension, and that the rate of hypertension-related visits has gone up more than 20 percent since 2006,” said Candace McNaughton, M.D., MPH, assistant professor of Emergency Medicine, one of the researchers. Uncontrolled hypertension is a major treatable risk factor for the development of cardiovascular disease and a significant cause of death in the United States.
2015-05-14T21:57:50+00:00For medical practices, having more unique doctors on staff and having doctors see more patients doesn’t necessarily lead to improved patient outcomes - and in fact, may have the opposite effect, according to a brief report in the June issue of Medical Care. The journal is published by Wolters Kluwer. The study shows that high blood pressure (BP) is less likely to normalize during times when the number of unique doctors on staff is higher and more patients are seen, suggesting that “[W]hen practices are busier, BP care may suffer,” writes Nancy R. Kressin, PhD, of Boston University School of Medicine, and the VA Boston Healthcare System and her colleagues. They add, “Our findings suggest that clinical operations factors can affect clinical outcomes like BP normalization, and point to the importance of considering outcome effects when organizing clinical care.” Staffing Levels and Appointment Volume Affect BP Control Using data from the electronic medical records system of a large, multi-clinic internal medicine practice, Dr. Kressin and colleagues looked at how organizational factors affected time to bring high blood pressure under control. The study focused on approximately 7,400 patients who had episodes of uncontrolled BP requiring treatment.
2015-05-05T17:40:22+00:00Obesity is a serious health problem affecting approximately one-third of the adult population in the United States. Obese individuals have an increased risk of diabetes and cardiovascular disease, including hypertension. A recent study led by a University of Missouri researcher has identified the enzyme responsible for obesity-related hypertension - a finding that could lead to new treatment options. “Hypertension is a condition in which arterial blood vessels are exposed to persistently elevated blood pressure, making the heart work harder to pump blood to the body,” said William Durante, a professor of medical pharmacology and physiology at the MU School of Medicine and lead author of the study. “Hypertension can lead to severe health issues such as heart attacks, kidney failure, organ damage, and weakened or ruptured blood vessels. By comparing genetically obese rats to lean rats, we discovered that obese animals were deficient in the amino acid arginine due to elevated activity of the enzyme arginase, which breaks down this molecule.” Although arginase is present throughout the body, it is primarily found in the liver. Its role is to assist in the breakdown of ammonia, which is eventually flushed out during urination. However, Durante’s team found significantly increased arginase activity within blood vessels and in the blood of obese rats compared to lean animals.
2015-04-27T16:39:48+00:00Eating 3,000 mg per day of salt or more appears to have no adverse effect on blood pressure in adolescent girls, while those girls who consumed 2,400 mg per day or more of potassium had lower blood pressure at the end of adolescence, according to an article published online by JAMA Pediatrics. The scientific community has historically believed most people in the United States consume too much salt in their diets. The current Dietary Guidelines for Americans recommends limiting sodium intake to less than 2,300 mg per day for healthy individuals between the ages of 2 and 50. The relationship between dietary sodium and blood pressure in children and adolescents is largely unexamined in prospective studies, according to the study background. Lynn L. Moore, D.Sc., M.P.H., of the Boston University School of Medicine, and coauthors examined the long-term effects of dietary sodium and potassium on blood pressure at the end of adolescence. The authors used data from the National Heart, Lung and Blood Institute’s Growth and Health Study and participants included 2,185 black and white girls (ages 9 to 10) who were followed up for 10 years.
2015-04-10T21:32:47+00:00A recent study on university-going young adults, by researchers from the Duke-NUS Graduate Medical School Singapore (Duke-NUS), is the first ever to show an association between meals eaten away from home and high blood pressure. These findings highlight lifestyle factors that can affect hypertension and emphasise the importance of being aware of the salt and calorie content in food, to facilitate better meal choices when eating out. Globally, high blood pressure, or hypertension, is the leading risk factor for death associated with cardiovascular disease. Studies have shown that young adults with pre-hypertension, or slightly elevated blood pressure, are at very high risk of hypertension. Eating meals away from home have been shown to be associated with higher caloric intake, higher saturated fat intake and higher salt intake. These eating patterns are thought to cause high blood pressure. Duke-NUS Professor Tazeen Jafar designed and supervised a study to find behaviours associated with hypertension in a young adult population in Southeast Asia. Her team, including Duke-NUS medical student Dominique Seow, surveyed 501 university-going young adults aged 18 to 40 years in Singapore. Data on blood pressure, body mass index and lifestyle, including meals eaten away from home and physical activity levels, were collected. Their association with hypertension was then determined.
2015-03-13T18:49:37+00:00People exposed to prolonged periods of shortened sleep have significant increases in blood pressure during nighttime hours, Mayo Clinic researchers report in a small study of eight participants. Results of the study will be presented Sunday, March 15, at the American College of Cardiology’s 64th Annual Scientific Session in San Diego. In this study, eight healthy, normal weight participants, ages 19 to 36, participated in a 16-day inpatient protocol, consisting of a four-day acclimation period followed by nine days of either sleep restriction (four hours of sleep per night) or normal sleep (nine hours of sleep per night), and three days of recovery. Twenty-four blood pressure monitoring at regular intervals was measured at each study phase. During the nighttime, in the sleep restriction phase compared to the normal sleep phase, systolic (top number) and diastolic (bottom number) blood pressure averaged 115/64 millimeters of mercury (mm Hg) versus 105/57 mm Hg, respectively, researchers found. Furthermore, the expected fall in blood pressure during the night was suppressed when subjects had inadequate sleep. They also found that nighttime heart rate was higher with sleep restriction than in normal sleep.
2014-09-03T20:08:36+00:00Visceral adipose tissue, rather than body mass index (BMI) or overall subcutaneous fat, was associated with the development of hypertension, researchers found. In a multivariate analysis, BMI initially was associated with incident hypertension, with a relative risk of 1.24 (95% CI 1.12-1.36, P
2014-03-15T05:59:00+00:00The American Thoracic Society has developed clinical practice guidelines to help clinicians identify and manage patients with sickle cell disease who are at increased risk for mortality from pulmonary hypertension. “With the development of new treatments, many patients with sickle cell disease are now surviving long enough to develop pulmonary hypertension, with an estimated prevalence of 6 to 11 percent,” said Elizabeth S. Klings, MD, associate professor of medicine at the Boston University School of Medicine and chair of the committee that produced the guidelines. “Although pulmonary hypertension and elevated tricuspid jet velocity (TRV, an indicator of pulmonary hypertension measured by echocardiography) are both associated with an increased mortality risk, there is currently no standardized approach for identifying and managing these patients.” The guidelines appear in the March 15th issue of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.