Patterns and Predictors of Blood Pressure Treatment, Control, and Outcomes among Stroke Survivors in the United States

2016 ◽  
Vol 25 (4) ◽  
pp. 857-865 ◽  
Author(s):  
Ali Razmara ◽  
Bruce Ovbiagele ◽  
Daniela Markovic ◽  
Amytis Towfighi
Keyword(s):  
United States ◽  
Blood Pressure ◽  
The United States ◽  
Stroke Survivors ◽  
Pressure Treatment ◽  
Treatment Control ◽  
Blood Pressure Treatment

scholarly journals Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association

Hypertension ◽  
2021 ◽  
Author(s):  
Vesna D. Garovic ◽  
Ralf Dechend ◽  
Thomas Easterling ◽  
S. Ananth Karumanchi ◽  
Suzanne McMurtry Baird ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
The United States ◽  
In Utero ◽  
Pressure Treatment ◽  
Placental Perfusion ◽  
Blood Pressure Treatment ◽  
Disease Risks ◽  
In Pregnancy

Hypertensive disorders of pregnancy (HDP) remain one of the major causes of pregnancy-related maternal and fetal morbidity and mortality worldwide. Affected women are also at increased risk for cardiovascular disease later in life, independently of traditional cardiovascular disease risks. Despite the immediate and long-term cardiovascular disease risks, recommendations for diagnosis and treatment of HDP in the United States have changed little, if at all, over past decades, unlike hypertension guidelines for the general population. The reasons for this approach include the question of benefit from normalization of blood pressure treatment for pregnant women, coupled with theoretical concerns for fetal well-being from a reduction in utero-placental perfusion and in utero exposure to antihypertensive medication. This report is based on a review of current literature and includes normal physiological changes in pregnancy that may affect clinical presentation of HDP; HDP epidemiology and the immediate and long-term sequelae of HDP; the pathophysiology of preeclampsia, an HDP commonly associated with proteinuria and increasingly recognized as a heterogeneous disease with different clinical phenotypes and likely distinct pathological mechanisms; a critical overview of current national and international HDP guidelines; emerging evidence that reducing blood pressure treatment goals in pregnancy may reduce maternal severe hypertension without increasing the risk of pregnancy loss, high-level neonatal care, or overall maternal complications; and the increasingly recognized morbidity associated with postpartum hypertension/preeclampsia. Finally, we discuss the future of research in the field and the pressing need to study socioeconomic and biological factors that may contribute to racial and ethnic maternal health care disparities.

scholarly journals Antihypertensive drug use and blood pressure control among stroke survivors in the United States: NHANES 2003‐2014

2019 ◽  
Vol 21 (6) ◽  
pp. 766-773
Author(s):  
Kalyani Sonawane ◽  
Yenan Zhu ◽  
Rajesh Balkrishnan ◽  
Ryan Suk ◽  
Anjail Sharrief ◽  
...  
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Drug Use ◽  
Antihypertensive Drug ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
The United States ◽  
Stroke Survivors

scholarly journals IMPROVING HYPERTENSION CONTROL IN THE UNITED STATES: UNDERSTANDING RACIAL/ETHNIC DIFFERENCES IN THE BLOOD PRESSURE CASCADE

2021 ◽  
Vol 77 (18) ◽  
pp. 1475
Author(s):  
Rahul Aggarwal ◽  
Nicholas Chiu ◽  
Rishi Wadhera ◽  
Andrew Moran ◽  
Changyu Shen ◽  
...  
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Ethnic Differences ◽  
The United States ◽  
Hypertension Control ◽  
Racial Ethnic

Controversies Among the Hypertension Guidelines

2015 ◽  
Vol 29 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Toni L. Ripley ◽  
Mary Baumert
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Antihypertensive Agents ◽  
The United States ◽  
Current Debate ◽  
Hypertension Management ◽  
Patient Needs ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines

Hypertension affects 80 million people in the United States. It remains poorly controlled, with only 54% of diagnosed patients treated to blood pressure targets. Hypertension management is complex in part due to the volume of antihypertensive agents, variable patient needs and responses, and inconsistent design and outcomes from clinical trials. Therefore, trustworthy clinical practice guidelines have a key role in hypertension management. The United States experienced a 10-year gap in publication of hypertension guidelines, followed by multiple guideline publications in 2013. These guidelines led to more controversy than clarity, as there was discordance among them. This review summarizes the guidelines and clinical statements influencing the current debate in order to facilitate appropriate application.

Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older

2017 ◽  
Vol 167 (4) ◽  
pp. 288
Author(s):  
Gulistan Bahat ◽  
Birkan Ilhan ◽  
Asli Tufan ◽  
Mehmet Akif Karan
Keyword(s):  
Blood Pressure ◽  
Pressure Treatment ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

scholarly journals Risk–benefit profile of intensive blood pressure treatment

2018 ◽  
Vol 6 (8) ◽  
pp. 601-602 ◽  
Author(s):  
João Sérgio Neves ◽  
Lia Leitão ◽  
Rita Magriço ◽  
Catarina Viegas Dias ◽  
Miguel Bigotte Vieira
Keyword(s):  
Blood Pressure ◽  
Pressure Treatment ◽  
Blood Pressure Treatment ◽  
Intensive Blood Pressure

Abstract T P139: Rising Rates of the Metabolic Syndrome Among Stroke Survivors in the United States

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Michael McManus ◽  
Daniela Markovic ◽  
Natalie Valle ◽  
Bruce Ovbiagele ◽  
Amytis Towfighi
Keyword(s):  
United States ◽  
Metabolic Syndrome ◽  
Stroke Risk ◽  
Recurrent Stroke ◽  
Temporal Trends ◽  
The United States ◽  
Self Report ◽  
Stroke Survivors ◽  
Middle Aged ◽  
The Metabolic Syndrome

BACKGROUND: Metabolic syndrome (MetS), a constellation of cardiometabolic risk factors clustering together, affects >47 million US adults and has been independently linked to primary and recurrent stroke risk. Prevalence and trends in MetS among stroke survivors in the United States are unknown. OBJECTIVES: To evaluate recent temporal trends in age and sex-specific MetS prevalence among adults with/without stroke in the US. METHODS: Prevalence of MetS was assessed among fasting adults ≥35 years who participated in National Health and Nutrition Examination Surveys 1999-2010 (n=9,343). Prevalence estimates were weighted to obtain nationally representative estimates (n=430,371,669). MetS was defined by the 2009 harmonized definition. Stroke was determined by self-report. RESULTS: In all groups except men 35-64 years, MetS prevalence was similar among adults with and without stroke in 1999-2002 (Table). MetS prevalence rates were flat from 1999 to 2010 among those without stroke, but increased among stroke survivors, such that up to 80% of men and 86% of women with stroke had MetS, with the greatest rise among the middle-aged. Stroke survivors aged 35-64 years were ~3 times more likely to have MetS than their counterparts without stroke (OR 3.24, 95% CI 1.60-6.55 for men and OR 2.55, 95% CI 1.45-4.50 for women). DISCUSSION: Due to a differential rise in MetS in stroke survivors over the last 10 years, as many as 9 out of 10 stroke survivors now have MetS, suggesting that Mets may increasingly be placing people at risk for stroke. Intensified efforts aimed at identifying and treating MetS, especially among middle-aged individuals, may be warranted to avert stroke risk.

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