Guideline-Driven Management of Hypertension

2021 ◽  
Vol 128 (7) ◽  
pp. 827-846 ◽  
Author(s):  
Robert M. Carey ◽  
Jackson T. Wright ◽  
Sandra J. Taler ◽  
Paul K. Whelton
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Randomized Clinical Trials ◽  
Disease Risk ◽  
Blood Pressure Measurement ◽  
Cardiovascular Disease Risk ◽  
Heart Association ◽  
Blood Pressure Goal ◽  
Pharmacological Management ◽  
Pressure Threshold

Several important findings bearing on the prevention, detection, and management of hypertension have been reported since publication of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. This review summarizes and places in context the results of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics covered include blood pressure measurement, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and blood pressure threshold for drug therapy, lifestyle and pharmacological management, treatment target blood pressure goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches. Presenting new information in each of these areas has the potential to increase hypertension awareness, treatment, and control which remain essential for the prevention of cardiovascular disease and mortality in the future.

scholarly journals Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials

2022 ◽  
Author(s):  
Erand Llanaj ◽  
Gordana M. Dejanovic ◽  
Ezra Valido ◽  
Arjola Bano ◽  
Magda Gamba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Randomized Clinical Trials ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Markers ◽  
Metabolic Disturbances ◽  
Cvd Risk ◽  
Beta Glucan

Abstract Purpose Oat supplementation interventions (OSIs) may have a beneficial effect on cardiovascular disease (CVD) risk. However, dietary background can modulate such effect. This systematic review assesses the effects of OSIs on CVD risk markers among adults, accounting for different dietary backgrounds or control arms. Methods We included randomized clinical trials (RCTs) that assessed the effect of oat, oat beta-glucan-rich extracts or avenanthramides on CVD risk markers. Results Seventy-four RCTs, including 4937 predominantly hypercholesterolemic, obese subjects, with mild metabolic disturbances, were included in the systematic review. Of these, 59 RCTs contributed to the meta-analyses. Subjects receiving an OSI, compared to control arms without oats, had improved levels of total cholesterol (TC) [weighted mean difference and (95% CI) − 0.42 mmol/L, (− 0.61; − 0.22)], LDL cholesterol [− 0.29 mmol/L, (− 0.37; − 0.20)], glucose [− 0.25 nmol/L, (− 0.36; − 0.14)], body mass index [− 0.13 kg/m2, (− 0.26; − 0.01)], weight [− 0.94 kg, (− 1.84: − 0.05)], and waist circumference [− 1.06 cm, (− 1.85; − 0.27)]. RCTs on inflammation and/or oxidative stress markers were scarce and with inconsistent findings. RCTs comparing an OSI to heterogeneous interventions (e.g., wheat, eggs, rice, etc.), showed lowered levels of glycated haemoglobin, diastolic blood pressure, HDL cholesterol and apolipoprotein B. The majority of included RCTs (81.1%) had some concerns for risk of bias. Conclusion Dietary OSIs resulted in lowered levels of blood lipids and improvements in anthropometric parameters among participants with predominantly mild metabolic disturbances, regardless of dietary background or control. Further high-quality trials are warranted to establish the role of OSIs on blood pressure, glucose homeostasis and inflammation markers.

scholarly journals Age modification of ozone associations with cardiovascular disease risk in adults: a potential role for soluble P-selectin and blood pressure

2018 ◽  
Vol 10 (7) ◽  
pp. 4643-4652 ◽  
Author(s):  
Drew B. Day ◽  
Merlise A. Clyde ◽  
Jianbang Xiang ◽  
Feng Li ◽  
Xiaoxing Cui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Potential Role ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Soluble P

scholarly journals Vitamin D Receptor Activation Mitigates the Impact of Uremia on Endothelial Function in the 5/6 Nephrectomized Rats

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
J. Ruth Wu-Wong ◽  
William Noonan ◽  
Masaki Nakane ◽  
Kristin A. Brooks ◽  
Jason A. Segreti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Vitamin D ◽  
Endothelial Function ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Receptor Activation ◽  
The Impact

Endothelial dysfunction increases cardiovascular disease risk in chronic kidney disease (CKD). This study investigates whether VDR activation affects endothelial function in CKD. The 5/6 nephrectomized (NX) rats with experimental chronic renal insufficiency were treated with or without paricalcitol, a VDR activator. Thoracic aortic rings were precontracted with phenylephrine and then treated with acetylcholine or sodium nitroprusside. Uremia significantly affected aortic relaxation (% in NX rats versus % in SHAM at 30 M acetylcholine). The endothelial-dependent relaxation was improved to –%, –%, and –% in NX rats treated with paricalcitol at 0.021, 0.042, and 0.083 g/kg for two weeks, respectively, while paricalcitol at 0.042 g/kg did not affect blood pressure and heart rate. Parathyroid hormone (PTH) suppression alone did not improve endothelial function since cinacalcet suppressed PTH without affecting endothelial-dependent vasorelaxation. N-omega-nitro-L-arginine methyl ester completely abolished the effect of paricalcitol on improving endothelial function. These results demonstrate that VDR activation improves endothelial function in CKD.

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