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 | UTCSummary:
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:
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
Mean systolic blood pressure above the control threshold in people with treated uncontrolled hypertension in 55 countries
2 Mar, 2023 | 12:48h | UTC
RCT | Endovascular ultrasound renal denervation is modestly effective in the treatment of hypertension
1 Mar, 2023 | 14:11h | UTCSummary: 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 The trial enrolled 224 patients who were withdrawn from such medications and randomly assigned to receive either ultrasound renal denervation or a sham procedure.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 | UTCSummary: 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.
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 | UTCSummary: 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
M-A | Blood pressure lowering effects of B-blockers as add-on or combination therapy
16 Feb, 2023 | 15:10h | UTC
Resistant hypertension: a stepwise approach
10 Feb, 2023 | 13:58h | UTCResistant hypertension: A stepwise approach – Cleveland Clinic Journal of Medicine
Phase 2 RCT | Baxdrostat for treatment-resistant hypertension
6 Feb, 2023 | 13:38h | UTCPhase 2 Trial of Baxdrostat for Treatment-Resistant Hypertension – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter (thread – click for more)
Aldosterone has long been a pharmacologic target for the treatment of hypertension. However, a new small-molecule drug called baxdrostat inhibits aldosterone synthase in patients with treatment-resistant hypertension. 1/14 pic.twitter.com/F27WE4Wa1d
— NEJM (@NEJM) February 3, 2023
M-A | Blood pressure, hypertension and the risk of atrial fibrillation
1 Feb, 2023 | 13:22h | UTC
Guidelines for the management of hypertension in patients with diabetes mellitus
1 Feb, 2023 | 13:17h | UTC
Perspective | Is it time to retire the diagnosis “hypertensive emergency”?
27 Jan, 2023 | 12:26h | UTC
SR | Does reducing your salt intake help to prevent and treat chronic kidney disease in people with diabetes?
25 Jan, 2023 | 11:30h | UTC
RCT | Home vs. kiosk vs. clinic blood pressure measurement compared to 24-h ambulatory monitoring
25 Jan, 2023 | 11:28h | UTCRelated:
RCT | Effect of a multicomponent intervention delivered on a web-based platform on hypertension control
24 Jan, 2023 | 14:12h | UTC
Commentary on Twitter
Cluster RCT: A multicomponent intervention aided by web-based platform improved blood pressure control vs. usual care in China. https://t.co/bsfK5TF1hs
— JAMA Network Open (@JAMANetworkOpen) December 7, 2022
AHA Statement | Cancer therapy-related hypertension
23 Jan, 2023 | 13:46h | UTCTop Things to Know: Cancer Therapy-Related HTN – American Heart Association
Cohort Study | Increased coffee consumption linked to increased CVD risk in patients with severe hypertension
20 Jan, 2023 | 14:53h | UTCCommentaries:
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 | UTCNews 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 | UTCChlorthalidone vs. Hydrochlorothiazide for Hypertension–Cardiovascular Events – New England Journal of Medicine (link to abstract – $ for full-text)
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
Patients 65 years or older with hypertension who switched from chlorthalidone to hydrochlorothiazide did not have fewer major cardiovascular events or non–cancer-related deaths than those who continued receiving hydrochlorothiazide. https://t.co/9xAiSZzxio pic.twitter.com/bIVOOiVDve
— NEJM (@NEJM) December 14, 2022
Cluster RCT | Effect of a multicomponent intervention delivered on a web-based platform on hypertension control.
8 Dec, 2022 | 13:02h | UTC
Commentary on Twitter
Cluster RCT: A multicomponent intervention aided by web-based platform improved blood pressure control vs. usual care in China. https://t.co/bsfK5TF1hs
— JAMA Network Open (@JAMANetworkOpen) December 7, 2022
Cohort Study | Adding salt to foods linked to increased risk of cardiovascular disease.
6 Dec, 2022 | 14:04h | UTCAdding 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 | UTCBlood 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
SR | Blood pressure targets for the treatment of people with hypertension and cardiovascular disease.
22 Nov, 2022 | 13:39h | UTCSummary: Blood pressure targets in people with cardiovascular disease – Cochrane Library
Commentary on Twitter
Blood pressure targets in people with cardiovascular disease
Updated @CochraneHTN review looks at the evidence from 7 studies with 9595 people.
? #plainlanguage summary & #systematicreview available on the @CochraneLibrary https://t.co/dKYyoY773f— Cochrane UK (@CochraneUK) November 19, 2022
RCT | Dual endothelin antagonist Aprocitentan is effective for resistant hypertension.
11 Nov, 2022 | 13:59h | UTCDual 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