scholarly journals Novel approaches for treating hypertension

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 80 ◽  
Author(s):  
Andrew J. Freeman ◽  
Antony Vinh ◽  
Robert E. Widdop

Hypertension, or high blood pressure, is a prevalent yet modifiable risk factor for cardiovascular disease. While there are many effective treatments available to combat hypertension, patients often require at least two to three medications to control blood pressure, although there are patients who are resistant to such therapies. This short review will briefly update on recent clinical advances and potential emerging therapies and is intended for a cross-disciplinary readership.

Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 285-292 ◽  
Author(s):  
Flávio D. Fuchs ◽  
Paul K. Whelton

Fragmented investigation has masked the overall picture for causes of cardiovascular disease (CVD). Among the risk factors for CVD, high blood pressure (BP) is associated with the strongest evidence for causation and it has a high prevalence of exposure. Biologically, normal levels of BP are considerably lower than what has typically been characterized as normal in research and clinical practice. We propose that CVD is primarily caused by a right-sided shift in the population distribution of BP. Our view that BP is the predominant risk factor for CVD is based on conceptual postulates that have been tested in observational investigations and clinical trials. Large cohort studies have demonstrated that high BP is an important risk factor for heart failure, atrial fibrillation, chronic kidney disease, heart valve diseases, aortic syndromes, and dementia, in addition to coronary heart disease and stroke. In multivariate modeling, the presumed attributable risk of high BP for stroke and coronary heart disease has increased steadily with progressive use of lower values for normal BP. Meta-analysis of BP-lowering randomized controlled trials has demonstrated a benefit which is almost identical to that predicted from BP risk relationships in cohort studies. Prevention of age-related increases in BP would, in large part, reduce the vascular consequences usually attributed to aging, and together with intensive treatment of established hypertension would eliminate a large proportion of the population burden of BP-related CVD.


2011 ◽  
Vol 81 (4) ◽  
pp. 240-244 ◽  
Author(s):  
Mary Ward ◽  
Carol P Wilson ◽  
J J Strain ◽  
Geraldine Horigan ◽  
John M. Scott ◽  
...  

Hypertension is a leading risk factor for cardiovascular disease (CVD) and stroke. A common polymorphism in the gene encoding the enzyme methylenetetrahydrofolate reductase (MTHFR), previously identified as the main genetic determinant of elevated homocysteine concentration and also recognized as a risk factor for CVD, appears to be independently associated with hypertension. The B-vitamin riboflavin is required as a cofactor by MTHFR and recent evidence suggests it may have a role in modulating blood pressure, specifically in those with the homozygous mutant MTHFR 677 TT genotype. If studies confirm that this genetic predisposition to hypertension is correctable by low-dose riboflavin, the findings could have important implications for the management of hypertension given that the frequency of this polymorphism ranges from 3 to 32 % worldwide.


2018 ◽  
Vol 10 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Arun Kumar

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.


2006 ◽  
Vol 68 (3) ◽  
pp. 386-397 ◽  
Author(s):  
Patrick R. Steffen ◽  
Timothy B. Smith ◽  
Michael Larson ◽  
Leon Butler

2016 ◽  
Vol 137 (2) ◽  
pp. 114-121 ◽  
Author(s):  
Yelena Bird ◽  
Mark Lemstra ◽  
Marla Rogers

Background: Stroke is a major chronic disease and a common cause of adult disability and mortality. Although there are many known risk factors for stroke, lower income is not one that is often discussed. Aims: To determine the unadjusted and adjusted association of income distribution on the prevalence of stroke in Saskatchewan, Canada. Methods: Information was collected from the Canadian Community Health Survey conducted by Statistics Canada for 2000–2008. In total, 178 variables were analysed for their association with stroke. Results: Prior to statistical adjustment, stroke was seven times more common for lower income residents than higher income residents. After statistical adjustment, only four covariates were independently associated with stroke prevalence, including having high blood pressure (odds ratio (OR) = 2.62; 95% confidence interval (CI) = 2.12–3.24), having a household income below CAD$30,000 per year (OR = 2.49; 95% CI = 1.88–3.29), being a daily smoker (OR = 1.36; 95% CI = 1.16–1.58) and being physically inactive (OR = 1.27; 95% CI = 1.13–1.43). After statistical adjustment, there were five covariates independently associated with high blood pressure prevalence, including having a household income below CAD$30,000 per year (OR = 1.52; 95% CI = 1.41–1.63). After statistical adjustment, there were five covariates independently associated with daily smoking prevalence, including having a household income below CAD$30,000 per year (OR = 1.29; 95% CI = 1.25–1.33). Conclusions: Knowledge of disparities in the prevalence, severity, disability and mortality of stroke is critically important to medical and public health professionals. Our study found that income distribution was strongly associated with stroke, its main disease intermediary – high blood pressure – and its main risk factor – smoking. As such, income is an important variable worthy of public debate as a modifiable risk factor for stroke.


2017 ◽  
Vol 4 (1) ◽  
pp. 5-8
Author(s):  
T.V. Ashcheulova ◽  
O.A Kochubiei O.A ◽  
T.G. Ovrakh

PREVENTIVE CARDIOLOGY, PRECLINICAL DIAGNOSES: OLD PROBLEMS – NEW APPROACHESAshcheulova T.V., Kochubiei O.A., Ovrakh T.GThe article discusses the new Guidelines on cardiovascular disease prevention in clinical practice (2016) which summarized novel approaches of detection of such risk factors as overweigh, obesity, abdominal obesity, smoking, dyslipidemia (cholesterolemia, triglyceridemia), blood pressure (BP) levels, glucose, insulin, insulin resistance, inflammatory markers, such as c-reactive protein, which can be widely used in practice.KeyWords: Cardiovascular disease, preventive cardiology, risk assessment and stratification, strategy for prevention of cardiovascular diseases. ПРЕВЕНТИВНА КАРДІОЛОГІЯ, ДОКЛІНІЧНА ДІАГНОСТИКА: СТАРІ ПРОБЛЕМИ - НОВІ ПІДХОДИАщеулова Т.В., Кочубєй О.А., Оврах Т.Г. У статті розглядаються нові рекомендації з профілактики серцево-судинних захворювань в клінічній практиці (2016 г.), що узагальнюють нові підходи виявлення таких факторів ризику, як надмірна маса тіла, ожиріння, абдомінальне ожиріння, куріння, дисліпідемія (холестеринемія, тригліцеридемія),  артеріальний тиск (АТ), рівень глюкози, інсуліну, резистентність до інсуліну, запальні маркери, такі як С-реактивний білок, які можуть знайти широке застосування у практичній охороні здоров’я.Ключові слова: Серцево-судинні захворювання, профілактична кардіологія, оцінка і стратифікація ризику, стратегія профілактики серцево-судинних захворювань. ПРЕВЕНТИВНАЯ КАРДИОЛОГИЯ, ДОКЛИНИЧЕСКАЯ ДИАГНОСТИКА: СТАРЫЕ ПРОБЛЕМЫ - НОВЫЕ ПОДХОДЫАщеулова Т.В., Кочубей О.А., Оврах Т.Г. В статье рассматриваются новые рекомендации по профилактике сердечно-сосудистых заболеваний в клинической практике (2016 г.), обобщены новые подходы выявления таких факторов риска, как избыточная масса тела, ожирение, абдоминальное ожирение, курение, дислипидемия (холестеринемия, гипертриглицеридемия), повышение артериального давления, уровень глюкозы, инсулина, резистентность к инсулину, маркеры воспаления, такие как С-реактивный белок, которые могут найти широкое применение в практическом здравоохранении.Ключевые слова: сердечно-сосудистые заболевания, профилактическая кардиология, оценка и стратификация риска, стратегия профилактики сердечно-сосудистых заболеваний. 


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