(Press-News.org) A new review article on resistant hypertension, which affects about 1 in 10 people with high blood pressure, is aimed at helping physicians assess and manage patients with the condition. The review, published in CMAJ (Canadian Medical Association Journal) includes information on emerging therapies for the condition.
The authors note that high-quality evidence is lacking. "We found few randomized controlled trials (RCTs) and no systematic reviews to guide decision-making. Thus, we have made management recommendations based primarily on expert consensus unless otherwise specified," writes Dr. Raj Padwal, Department of Medicine, University of Alberta, with coauthors.
About 20% of Canadian adults have hypertension (high blood pressure.) Resistant hypertension is defined as blood pressure levels that exceed the target level despite treatment with three or more hypertension drugs. Obesity, especially a large waist circumference, and sleep apnea are the top contributing factors to resistant hypertension. Patients with resistant hypertension are at higher risk of heart disease and death.
Before treating patients for resistant hypertension, physicians must rule out "pseudoresistance." Elevated blood pressure during physician visits ("white coat effect"), not taking recommended medications and inaccurate blood pressure measurements can contribute to apparently resistant hypertension.
The review recommends structured approaches to managing this condition:
optimizing current medication regimen and strategies to improve adherence
counselling patients to reduce salt intake, limit alcohol, exercise and strive for a healthy weight
treating obstructive sleep apnea with continuous positive airway pressure
adding drugs when current drugs are not effective — spironolactone, a-blockers, b-blockers and others
referring patients to clinics with hypertension specialists
The authors close by emphasizing the need for more rigorous studies in the field to address knowledge gaps and clarify uncertainties.
INFORMATION:
Resistant hypertension: A review for physicians
2014-08-18
ELSE PRESS RELEASES FROM THIS DATE:
Engineering long-lasting joint lubrication by mimicking nature
2014-08-18
By finding a way to bind a slippery molecule naturally found in the fluid that surrounds healthy joints, Johns Hopkins researchers have engineered surfaces that have the potential to deliver long-lasting lubrication at specific spots throughout the body. The finding, described in the Aug. 3 online edition of Nature Materials, could eventually offer a new way to ease the pain of arthritic joints, keep artificial joints working smoothly or even make contact lenses more comfortable.
According to the investigators, scientists have long known that a biochemical known as hyaluronic ...
Quasi-legal drug 15 times stronger than heroin hides in plain sight
2014-08-18
Quasi-Legal Drug Fifteen Times Stronger Than Heroin Hides in Plain Sight
WASHINGTON – Emergency physicians should expect "an upswing in what on the surface appear to be heroin overdoses," but are actually overdoses tied to acetyl fentanyl, an opiate that is mixed into street drugs marketed as heroin. The looming threat of another unregulated quasi-legal drug is detailed today online in Annals of Emergency Medicine ("The Potential Threat of Acetyl Fentanyl: Legal Issues, Contaminated Heroin, and Acetyl Fentanyl 'Disguised' as Other Opiates") bit.ly/1sPiqUw.
"What's ...
New research explores the red v. blue state knowledge about abortion
2014-08-18
A new national survey reveals that the political divide among red-versus-blue states does not support the hypothesis that knowledge about abortion and health is shaped by the state in which one lives. Research led by Danielle Bessett, a University of Cincinnati assistant professor of sociology, was presented at the 109th Meeting of the American Sociological Association in San Francisco.
Bessett says that regardless of political viewpoints, only 13 percent of the 569 people polled in the national survey demonstrated high knowledge of abortion, correctly answering four ...
Applying new cholesterol guidelines to a patient population reduces heart attacks, strokes, study finds
2014-08-18
DALLAS – August 18, 2014 – A study from UT Southwestern researchers found that recently introduced cholesterol guidelines would significantly reduce new cardiovascular events, when compared to treatment based on previous cholesterol guidelines.
The research identified Dallas Heart Study participants in the 30 to 65 age range who would have newly qualified for statin use under the new cholesterol guidelines introduced in 2013 by the American College of Cardiology (ACC) and the American Heart Association (AHA).
In this subset of patients, the study predicted that 3.6 ...
Red eye feels endless? Blame the internet
2014-08-18
Once upon a time people planned their vacations by booking flights and hotel at local travel agencies. But with the Internet launching of hundreds of online flight vendors, travel agencies have virtually disappeared into the ether — and shorter flights have disappeared with them.
In a study scheduled for publication in The Review of Economics and Statistics, Dr. Itai Ater of Tel Aviv University's Recanati Business School and Dr. Eugene Orlov of Compass Lexecon examine how the Internet has affected performance and product quality in the airline industry, especially flight ...
Ten-hut: New discoveries on how military organization affects civilians
2014-08-18
Researchers are reporting new discoveries about how militarization affects the general, civilian population, and the biggest positive impact is adequate sanitation and access to education. The research led by Steve Carlton-Ford, professor and head of the University of Cincinnati Sociology Department, was presented at the 109th meeting of the American Sociological Association in San Francisco.
Pooling data from UNICEF, the World Bank, the Peace Research Institute of Oslo (PRIO) the Integrated Network for Societal Conflict Research and the Quality of Government Institute, ...
Dress for success: Research examines male influences on 'looking' middle class
2014-08-18
They might be called a chip off the old block, but when it comes to upward social mobility, they might call Dad a lesson in what not to wear. University of Cincinnati research takes a new approach to examining the socialization of male children into the middle class. The research by Erynn Masi de Casanova, a University of Cincinnati assistant professor of sociology, was presented at the 109th Meeting of the American Sociological Association in San Francisco.
Based on interviews with 71 male, white-collar workers in three major metropolitan cities, Casanova explores how ...
Family members of victims pose a growing challenge for capital punishment
2014-08-18
An examination of the nation's history in carrying out executions is encountering a new challenge for modern-day capital punishment.
Bringing in family members of victims to witness executions brings about a new source of pressure on the execution, complicating actual execution arrangements and the position of capital punishment in the public imagination, according to Annulla Linders, a University of Cincinnati associate professor of sociology. Linders' research, titled, "Bearing Witness: Victim's Relatives and Challenges to the Execution Narrative," was presented at ...
Rheumatologic diseases like lupus can initially look like neurological disorders
2014-08-18
MAYWOOD, Ill. – Lupus and other rheumatologic diseases can initially present as neurological disorders such as headaches and seizures, and thus delay diagnosis for many months, according to Loyola University Medical Center neurologists.
Moreover, treatments for rheumatologic disorders can cause adverse neurological effects, Dr. Sean Ruland and colleagues report in the journal Current Neurology and Neuroscience Reports.
Rheumatologic diseases include autoimmune and inflammatory disorders of the joints and soft tissues, such as lupus, systemic vasculitis and ankylosing ...
Despite academic achievement, pay gaps likely continue between the races
2014-08-18
A nationally representative comparison of salary, academic achievement and race finds that racial and gender inequality continue to exist regardless of academic success. The study by Ervin (Maliq) Matthew, a University of Cincinnati assistant professor of sociology, was presented at the 109th Meeting of the American Sociological Association in San Francisco.
Matthew's research paper, titled"Making the (Pay) Grade: Racial Variance in Financial Payoff to Academic Success," examined data from the National Education Longitudinal Survey from 1988-2000. The study followed approximately ...