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Hypertension

Joint statement for assessing and managing high blood pressure in children and adolescents

19 Apr, 2023 | 13:26h | UTC

Chapter 1: How to correctly measure blood pressure in children and adolescents – Frontiers in Pediatrics

Chapter 2: How to manage high blood pressure in children and adolescents – Frontiers in Pediatrics

Related:

AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition

AHA Scientific Statement: Ambulatory blood pressure monitoring in children and adolescents.

Hypertension in Children and Adolescents: A Position Statement From a Panel of Multidisciplinary Experts Coordinated by the French Society of Hypertension – Frontiers in Pediatrics

USPSTF Statement: Insufficient evidence to recommend screening for high blood pressure in children and adolescents

 


Cluster RCT | Salt substitute outperforms salt restriction in lowering blood pressure in older patients

18 Apr, 2023 | 13:30h | UTC

Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial – Nature Medicine (if the link is paywalled, try this one)

Commentary: Exploring effectiveness of salt substitutes in elderly care facilities – Medical Xpress

Related:

Salt substitutes vs. regular salt: a quick look.

Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis – Heart (link to abstract – $ for full-text)

Cluster RCT: A household salt substitution intervention is a cost-effective intervention for preventing stroke and improving quality of life.

#ESCCongress – Cluster RCT: Among patients at increased risk for stroke, salt substitution (75% sodium chloride and 25% potassium chloride by mass) reduced the rates of stroke, major cardiovascular events, and death from any cause.

RCT: Reduced-sodium added-potassium salt substitute reduces blood pressure in hypertensive patients

Potassium Enriched Salt Substitution Could Prevent a Large Number of Cardiovascular Deaths

Cluster Randomized Trial: Effect of Salt Substitution on Community-wide Blood Pressure and Hypertension Incidence

 

Commentary on Twitter

 


Podcast | Resistant hypertension

18 Apr, 2023 | 13:16h | UTC

#390 Resistant Hypertension – The Curbsiders

 


RCT | Heterogeneity in blood pressure response to 4 antihypertensive drugs

17 Apr, 2023 | 13:14h | UTC

Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs: A Randomized Clinical Trial – JAMA (free for a limited period)

News Release: Personalized blood pressure treatment more effective – Uppsala University

Commentary: Hypertension: Personalized Treatment May Reduce Need for Higher Doses and Multiple Medications – MedicalResearch.com

 


Twenty‐four-hour ambulatory blood pressure profile in patients with reflex syncope vs. matched controls

12 Apr, 2023 | 13:21h | UTC

Twenty‐Four‐Hour Ambulatory Blood Pressure Profile in Patients With Reflex Syncope and Matched Controls – Journal of the American Heart Association

 


Sodium intake linked to both coronary & carotid atherosclerosis in the Swedish population

10 Apr, 2023 | 13:30h | UTC

The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population – European Heart Journal Open

 

Commentary on Twitter

 


Blood pressure targets in adults with hypertension | A clinical practice guideline from the AAFP

6 Apr, 2023 | 13:30h | UTC

Blood Pressure Targets in Adults With Hypertension: A Clinical Practice Guideline From the AAFP – American Academy of Family Physicians (PDF)

Commentary: AAFP Issues New Clinical Practice Guideline on Hypertension – Annals of Family Medicine

 


ACC/AHA blood pressure categories | Systematic review of adverse pregnancy outcomes in early pregnancy

6 Apr, 2023 | 12:53h | UTC

American College of Cardiology and American Heart Association blood pressure categories—a systematic review of the relationship with adverse pregnancy outcomes in the first half of pregnancy – American Journal of Obstetrics & Gynecology

 

Commentary on Twitter

https://twitter.com/AJOG_thegray/status/1641772214830727168

 


M-A | Impact of antihypertensive therapy on maternal & neonatal outcomes in mild-moderate pregnancy hypertension

6 Apr, 2023 | 12:51h | UTC

The impact of antihypertensive treatment of mild to moderate hypertension during pregnancy on maternal and neonatal outcomes: An updated meta-analysis of randomized controlled trials – Clinical Cardiology

 


Cross-sectional study | Association between sodium intake and coronary and carotid atherosclerosis

4 Apr, 2023 | 13:42h | UTC

The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population – European Heart Journal Open

Editorial: Dietary salt intake and atherosclerosis: an area not fully explored – European Heart Journal Open

News Release: High salt diet associated with hardened arteries even in people with normal blood pressure – European Society of Cardiology

 


AHA Scientific Statement | Pediatric primary hypertension: An underrecognized condition

3 Apr, 2023 | 14:05h | UTC

Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association – Hypertension

Top Things to Know: Pediatric Primary Hypertension: An Underrecognized Condition – American Heart Association

News Release: Children with high blood pressure often become adults with high blood pressure – American Heart Association

Commentaries:

The Birth of Pediatric Primary Hypertension – American Heart Association

AHA Highlights Pediatric Hypertension in Scientific Statement – HCP Live

 


Podcast | Pears in primary aldosteronism, mineralocorticoid receptor antagonists, and renovascular hypertension

29 Mar, 2023 | 13:07h | UTC

#386 Primary Aldosteronism, MRAs, and Renovascular Hypertension: NephMadness Pod Crawl 2023 – The Curbsiders

 


Dissecting coffee’s impact: high consumption lowers blood pressure, raises LDL-cholesterol

27 Mar, 2023 | 13:25h | UTC

Coffee consumption and associations with blood pressure, LDL-cholesterol and echocardiographic measures in the general population – Scientific Reports

 


An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension

23 Mar, 2023 | 12:42h | UTC

An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications – Clinical Hypertension

 


The global burden of metabolic disease: data from 2000 to 2019

13 Mar, 2023 | 14:39h | UTC

The global burden of metabolic disease: Data from 2000 to 2019 – Cell Metabolism (free for a limited period)

 


WHO urges countries to implement comprehensive sodium reduction policies to combat cardiovascular disease

10 Mar, 2023 | 14:43h | UTC

Summary:

A new report from the World Health Organization (WHO) has shown that the world needs to catch up to achieve its global target of reducing sodium intake by 30% by 2025. The report highlights that only 5% of WHO member states have mandatory and comprehensive sodium reduction policies.

Sodium, found in table salt and other condiments, increases the risk of heart disease, stroke, and premature death when eaten in excess. Implementing highly cost-effective sodium reduction policies could save an estimated seven million lives globally by 2030.

WHO suggests a number of policies, such as reducing the amount of sodium in food products, introducing front-of-pack labeling, launching mass media campaigns, and enforcing public policies related to food service and sales.

The report urges member states to implement sodium intake reduction policies without delay, and calls on food manufacturers to set ambitious targets for sodium reduction in their products.

Article: WHO global report on sodium intake reduction – World Health Organization

News Release: Massive efforts needed to reduce salt intake and protect lives – World Health Organization

Related:

Reducing daily salt intake in China by 1 g could prevent almost 9 million cardiovascular events by 2030: a modelling study – BMJ Nutrition Prevention & Health

Adding salt to foods and hazard of premature mortality – European Heart Journal

New WHO benchmarks help countries reduce salt intake and save lives – World Health Organization

WHO global sodium benchmarks for different food categories – World Health Organization

 

Commentary on Twitter

 


Cluster RCT | Effectiveness of a non-physician community health-care provider-led intensive BP intervention vs. usual care on CVD

6 Mar, 2023 | 14:20h | UTC

Summary:

The study evaluated the effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention on cardiovascular disease compared to usual care. The trial randomly assigned 326 villages to the intervention or usual care, and recruited individuals aged at least 40 years with hypertension. Trained non-physician community health-care providers initiated and titrated antihypertensive medications according to a simple stepped-care protocol and delivered health coaching for patients in the intervention group during the 36-month follow-up.

The study found that the intervention effectively reduced the risk of cardiovascular disease and all-cause death. There was a significant reduction in systolic blood pressure (23.1 mm Hg) and diastolic blood pressure (9.9 mm Hg) in the intervention group compared to the usual care group, with an increased risk of hypotension in the intervention group.

 

Article: Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial – The Lancet (link to abstract – $ for full-text)

Related:

Approaches and outcomes of community health worker’s interventions for hypertension management and control in low-income and middle-income countries: systematic review – BMJ Open

Cluster Randomized Trial: A Community-Based Intervention for Managing Hypertension in Rural South Asia

#ESCCongress – Randomized Trial: A Community-based Comprehensive Intervention to Reduce Cardiovascular Risk in Hypertension

Cohort Study: Impact of Community Based Screening for Hypertension in Older Adults

Randomized Trial: Community-Based Interventions to Improve Cardiovascular Risk in High-Risk Patients

Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops

Research: Effect of a Community Health Worker–Led Multicomponent Intervention on Blood Pressure Control

 


Mean systolic blood pressure above the control threshold in people with treated uncontrolled hypertension in 55 countries

2 Mar, 2023 | 12:48h | UTC

Mean systolic blood pressure above the control threshold in people with treated uncontrolled hypertension: a pooled, cross-sectional analysis of 55 national health surveys – eClinicalMedicine

 


RCT | Endovascular ultrasound renal denervation is modestly effective in the treatment of hypertension

1 Mar, 2023 | 14:11h | UTC

Summary: The RADIANCE II randomized clinical trial investigated the efficacy and safety of endovascular ultrasound renal denervation in patients with hypertension without the influence of antihypertensive medications. The trial enrolled 224 patients who were withdrawn from such medications and randomly assigned to receive either ultrasound renal denervation or a sham procedure. Results showed that ultrasound renal denervation reduced ambulatory systolic blood pressure by 6.3 mmHg on average at 2 months, compared to the sham procedure, without any reported adverse events. While these findings suggest that ultrasound renal denervation may be modestly effective in the treatment of hypertension, the short-term follow-up period limits the generalizability of these results to daily practice. Additionally, the clinical relevance of a procedure that reduces blood pressure only after withdrawing blood pressure medications should be considered.

Article: Endovascular Ultrasound Renal Denervation to Treat Hypertension: The RADIANCE II Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Is There a Role for Renal Denervation in the Treatment of Hypertension? – JAMA Cardiology (free for a limited period)

 


Pooled analysis of 3 sham-controlled trials on ultrasound renal denervation for patients with hypertension

1 Mar, 2023 | 14:10h | UTC

Summary: The article reports a patient-level pooled analysis of 3 randomized clinical trials that aimed to determine the effectiveness and safety of ultrasound renal denervation (uRDN) in reducing blood pressure (BP) compared to a sham procedure. The analysis included 506 patients with varying severities of hypertension and found that uRDN was modestly effective in reducing daytime ambulatory systolic BP at 2 months compared to the sham procedure, with a mean difference of 5.9 mmHg. One of the limitations of this analysis is that its findings are restricted to a 2-month follow-up. Additional follow-up from the included trials will be required to examine the durability of the effect and safety data.

Article: Patient-Level Pooled Analysis of Ultrasound Renal Denervation in the Sham-Controlled RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO Trials – JAMA Cardiology

Editorial: Is There a Role for Renal Denervation in the Treatment of Hypertension? – JAMA Cardiology (free for a limited period)

 


[Not published yet] M-A | Too little sodium can be harmful to heart failure patients

24 Feb, 2023 | 13:59h | UTC

Summary: New research presented at the American College of Cardiology’s annual scientific session suggests that heart failure patients restricting their dietary sodium intake to levels below the standard recommended maximum of 2.3 grams per day do not have additional benefits and may be at increased risk of death. The study analyzed nine randomized controlled trials that assessed different levels of sodium restriction and found that patients following a diet with a sodium intake target below 2.5 grams per day were 80% more likely to die than those following a diet with a target of 2.5 grams per day or more. The researchers recommend establishing a safe level of sodium consumption instead of overly restricting sodium.

News release: Too Little Sodium Can be Harmful to Heart Failure Patients – American College of Cardiology

 


Consensus Statement | Renal denervation in the management of hypertension in adults

21 Feb, 2023 | 11:45h | UTC

Renal denervation in the management of hypertension in adults. A clinical consensus statement of the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) – European Heart Journal

 


M-A | Blood pressure lowering effects of B-blockers as add-on or combination therapy

16 Feb, 2023 | 15:10h | UTC

Blood pressure lowering effects of β-blockers as add-on or combination therapy: A meta-analysis of randomized controlled trials – Journal of Clinical Hypertension

Related: Diverse pharmacological properties, trial results, comorbidity prescribing and neural pathophysiology suggest European hypertension guideline downgrading of beta-blockers is not justified – Blood Pressure

 


Resistant hypertension: a stepwise approach

10 Feb, 2023 | 13:58h | UTC

Resistant hypertension: A stepwise approach – Cleveland Clinic Journal of Medicine

 


Phase 2 RCT | Baxdrostat for treatment-resistant hypertension

6 Feb, 2023 | 13:38h | UTC

Phase 2 Trial of Baxdrostat for Treatment-Resistant Hypertension – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: A Study of CIN-107 in Adults With Treatment-Resistant Hypertension – BrigHTN – American College of Cardiology

 

Commentary on Twitter (thread – click for more)

 


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