Blood pressure target in neurosurgical patients: How high and how low should we go?

2021 ◽  
Vol 429 ◽  
pp. 118228
Author(s):  
Stanlies D'Souza
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Target ◽  
Neurosurgical Patients

ASSESSING THE OUTCOMES OF TREATMENT AND MANAGEMENT, 400 HYPERTENSIVE PATIENTS IN BONG SON GENERAL HOSPITAL, BINH DINH PROVINCE

2016 ◽  
pp. 31-40
Author(s):  
Long Nhon Phan ◽  
Van Minh Huynh ◽  
Thi Kim Nhung Hoang ◽  
Van Nham Truong
Keyword(s):  
Blood Pressure ◽  
Risk Stratification ◽  
Hypertensive Patient ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Target ◽  
Average Risk ◽  
Hypertensive Patients ◽  
Average Systolic Blood Pressure ◽  
Complications Of Stroke

Objective: To evaluate the results of treatment achieved blood pressure goal (BP goal) and results of hypertensive patient management. Subjects and methods: A study of 400 hypertensive patient intervention, treatment and management after 2 year. To assess the results of BP target, monitor the use of medicines, the situation of hospitalization and complications of stroke. Results: Treatment: -100% of patients using diuretics and angiotensin-converting enzyme inhibitors (ACEIs), 33% of patients using angiotensin receptor blockers (ARBs), 46.25% of patients using calcium channel blockers (CCBs) and 19.5% of patients using beta-blocker. After 24 months of treatment: 50.5% of patients using 1 antihypertensive drug, 22% of patients using 2 drugs, 20.5% of patients using 3 drugs and 7% of patients taking more than 3 drugs. After 24 months of treatment: 91.75% achieved BP target and 8.25% fail. -Average risk stratification: 97.32% achieved BP target, hight risk stratification: 95.91% and very hight risk stratification: 73.03%. After 24 months of treatment. -Stage 1: 88.48% achieved BP target, stage 2: 92.85% achieved BP target and stage 3: 71.08% achieved BP target. After 24 months of treatment. -Hypertesive results before treatment were: 159.80 ± 20,22mmHg average systolic blood pressure and 82.97 ± 5,82mmHg average diastolic blood pressure. After treatment: average systolic blood pressure 125.38 ± 6,88mmHg and average diastolic blood pressure 79.83 ± 1,79mmHg. No adverse change in the index of tests about lipidemia, liver, kidney, glucomia and no recorded cases of drug side effects. Management of patients: -There were 89% non-medical examinational patients 1 month, 5.25% non-medical examinational patients 2 months, 4.25% non-medical examinational patients 3 months and 1.5% non-medical examinational patients 4 months. There were 93.5% drop pill 1 month, 3.25% drop pill 2 months, 4.25% drop pill 3 months and no patient drop pill over 3 months. In 24 months follow-up, 47% hospitalized inpatients <5 times, 44.5% hospitalized inpatients 5-10 times, 3% hospitalized inpatients 11-15 times, 4.75% hospitalized inpatients from 16-20 times and 0.75% hospitalized inpatients > 20 times. -There were 32.75% hospitalized inpatients for reasons of hypertension and 63.75% hospitalized inpatients for other common diseases. -There were a total of 11592 contacts directly by phone for medical advice, medical reminders and examinational reminders during 24 months of management. -There were 0.5% of patients stroked during 24 months of treatment and management. Conclusion: Treatment by protocol and management by phone directly for medical taking and re-examinational reminders is the best resulted method of achieving blood pressure target and reducing complications of stroke for hypertensive patients. Key word: : blood pressure target; risk stratification; treatment; management; stage; phone.

Hypertensive Disorders in Pregnancy

2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
The United States ◽  
Blood Pressure Target ◽  
Maternal Complications ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Few Data ◽  
In Pregnancy ◽  
New Onset

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.

scholarly journals Identifying the optimal blood pressure target for ideal health

2016 ◽  
Vol 4 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Xianglin Zhang ◽  
Fangfang Fan ◽  
Yong Huo ◽  
Xiping Xu
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Target ◽  
Optimal Blood Pressure

scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2020 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2019 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

Ambulatory blood pressure, target organ damage and left atrial size in never-treated essential hypertensive individuals

2005 ◽  
Vol 23 (8) ◽  
pp. 1589-1595 ◽  
Author(s):  
Cesare Cuspidi ◽  
Stefano Meani ◽  
Cristiana Valerio ◽  
Veronica Fusi ◽  
Eleonora Catini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Left Atrial ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Blood Pressure Target ◽  
Left Atrial Size ◽  
Atrial Size
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