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Hypertension

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)

 


M-A | Blood pressure, hypertension and the risk of atrial fibrillation

1 Feb, 2023 | 13:22h | UTC

Blood pressure, hypertension and the risk of atrial fibrillation: a systematic review and meta-analysis of cohort studies – European Journal of Epidemiology

 


Guidelines for the management of hypertension in patients with diabetes mellitus

1 Feb, 2023 | 13:17h | UTC

RSSDI Guidelines for the management of hypertension in patients with diabetes mellitus – International Journal of Diabetes in Developing Countries

 


Perspective | Is it time to retire the diagnosis “hypertensive emergency”?

27 Jan, 2023 | 12:26h | UTC

Is it Time to Retire the Diagnosis “Hypertensive Emergency”? – Journal of the American Heart Association

 


SR | Does reducing your salt intake help to prevent and treat chronic kidney disease in people with diabetes?

25 Jan, 2023 | 11:30h | UTC

Altered dietary salt intake for preventing diabetic kidney disease and its progression – Cochrane Library

Summary: Does reducing your salt intake help to prevent and treat chronic kidney disease in people with diabetes? – Cochrane Library

 


RCT | Home vs. kiosk vs. clinic blood pressure measurement compared to 24-h ambulatory monitoring

25 Jan, 2023 | 11:28h | UTC

Acceptability and Adherence to Home, Kiosk, and Clinic Blood Pressure Measurement Compared to 24-H Ambulatory Monitoring – Journal of General Internal Medicine

Original Study: Randomized Diagnostic Study: home blood pressure measurements correlate better with 24-h ambulatory monitoring measurements compared to clinic, and kiosk measurements.

Related:

Home blood pressure monitoring: a position statement from the Korean Society of Hypertension Home Blood Pressure Forum – Clinical Hypertension

2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement – Journal of Hypertension

Current applications and limitations of European guidelines on blood pressure measurement: implications for clinical practice – Internal and Emergency Medicine

Study suggests a 30-second interval between automated office blood pressure measurements is as accurate and reliable as a 60-second interval.

USPSTF Statement recommends screening for hypertension in adults 18 years or older with office blood pressure measurement – diagnostic confirmation with blood pressure measurements outside of the clinical setting is advised before starting treatment

Study suggests that 7 days of home blood pressure monitoring is likely better than 24h ambulatory monitoring or 3 office measurements

 


RCT | Effect of a multicomponent intervention delivered on a web-based platform on hypertension control

24 Jan, 2023 | 14:12h | UTC

Effect of a Multicomponent Intervention Delivered on a Web-Based Platform on Hypertension Control: A Cluster Randomized Clinical Trial – JAMA Network Open

 

Commentary on Twitter

 


AHA Statement | Cancer therapy-related hypertension

23 Jan, 2023 | 13:46h | UTC

Cancer Therapy–Related Hypertension: A Scientific Statement From the American Heart Association – Hypertension

Top Things to Know: Cancer Therapy-Related HTN – American Heart Association

Commentary: Cancer and hypertension induced by anticancer drugs: The need for increased awareness, improved detection and proactive management – American Heart Association

 


Cohort Study | Increased coffee consumption linked to increased CVD risk in patients with severe hypertension

20 Jan, 2023 | 14:53h | UTC

Coffee and Green Tea Consumption and Cardiovascular Disease Mortality Among People With and Without Hypertension – Journal of the American Heart Association

News Release: Drinking 2 or more cups of coffee daily may double risk of heart death in people with severe hypertension – American Heart Association

Commentaries:

Expert reaction to study looking at coffee and green tea consumption and heart deaths in people with severe high blood pressure – Science Media Centre

Hypertension and Heavy Coffee Consumption a Bad Combo, Study Finds – TCTMD

 


Metomidate PET-CT vs. adrenal vein sampling for diagnosing surgically curable primary aldosteronism: a prospective, within-patient trial

19 Jan, 2023 | 14:19h | UTC

[11C]metomidate PET-CT versus adrenal vein sampling for diagnosing surgically curable primary aldosteronism: a prospective, within-patient trial – Nature Medicine

News Release: Ten-minute scan enables detection and cure of the commonest cause of high blood pressure – Queen Mary University of London

 


RCT | Chlorthalidone (12.5-25 mg) and Hydrochlorothiazide (25-50 mg) are similarly effective for the prevention of CVD in hypertensive patients.

16 Dec, 2022 | 13:49h | UTC

Chlorthalidone vs. Hydrochlorothiazide for Hypertension–Cardiovascular Events – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: ‘Burden-free’ study method finds two blood pressure drugs equally effective – Veterans Affairs Research Communications

Related (news release and commentaries before publication): RCT | Chlortalidone and Hydrochlorothiazide resulted in similar reductions of CVD in older patients with hypertension.

 

Commentary on Twitter

 


Cluster RCT | Effect of a multicomponent intervention delivered on a web-based platform on hypertension control.

8 Dec, 2022 | 13:02h | UTC

Effect of a Multicomponent Intervention Delivered on a Web-Based Platform on Hypertension Control: A Cluster Randomized Clinical Trial – JAMA Network Open

 

Commentary on Twitter

 


Cohort Study | Adding salt to foods linked to increased risk of cardiovascular disease.

6 Dec, 2022 | 14:04h | UTC

Adding Salt to Foods and Risk of Cardiovascular Disease – Journal of the American College of Cardiology (link to abstract – $ for full-text)

News Release: Shaking less salt on your food at the table could reduce heart disease risk – American College of Cardiology

Commentaries:

Adding Salt to Food and Risk of Cardiovascular Disease – American College of Cardiology

Lower Frequency of Adding Salt to Food Linked to Lower CVD Risk – HealthDay

 


Review | Blood pressure elevations in hospital.

6 Dec, 2022 | 13:31h | UTC

Blood pressure elevations in hospital – Australian Prescriber

Commentary: Overuse of in-hospital blood pressure medications – Flinders University

Related: Hypertension in the hospitalized patient: An update – Nefrología 

 


M-A | Thiazide diuretics and fracture risk.

29 Nov, 2022 | 14:23h | UTC

Thiazide Diuretics and Fracture Risk: A Systematic Review and Meta-Analysis of Randomized Clinical Trials – JBMR Plus

 


SR | Blood pressure targets for the treatment of people with hypertension and cardiovascular disease.

22 Nov, 2022 | 13:39h | UTC

Blood pressure targets for the treatment of people with hypertension and cardiovascular disease – Cochrane Library 

Summary: Blood pressure targets in people with cardiovascular disease – Cochrane Library 

 

Commentary on Twitter 

 


RCT | Dual endothelin antagonist Aprocitentan is effective for resistant hypertension.

11 Nov, 2022 | 13:59h | UTC

Dual endothelin antagonist aprocitentan for resistant hypertension (PRECISION): a multicentre, blinded, randomised, parallel-group, phase 3 trial – The Lancet (link to abstract – $ for full-text)

Commentaries:

Endothelin Receptor Antagonist Effective in Resistant Hypertension: PRECISION – TCTMD

Parallel-Group, Phase 3 Study With Aprocitentan in Subjects With Resistant Hypertension – PRECISION – American College of Cardiology

 


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