European guidelines on the diagnostics,  management and prevention of arterial  hypertension 2018: opinion of the members  of the Russian Society of cardiology

In 2018, at the annual congresses of the European Society of Hypertension and European Society of Cardiology, the updated guidelines on the diagnostics, management and prevention of arterial hypertension were announced, followed by their publication in the European Heart Journal. The guidelines present a comprehensive overview on the definition and classification of arterial hypertension, approaches to the blood pressure measurement, assessment of the target organ damage, special patient subgroups and other issues. Despite a detailed analysis of various issues of the diagnostics and treatment of hypertension, some of the statements appear to be disputable and raise discussion among specialists in hypertension field. The diagnostic criteria, threshold and target blood pressure levels are the most debatable issues involving comparisons with the guidelines of the American Heart Association (2017). This paper gathers a number of comments on the less discussed questions of the diagnostics, treatment and prevention of hypertension. This collection of letters of the specialists, members of the Russian Society of Cardiology includes both personal expert opinions and well-known facts, reflects the controversy of the available evidence and indicates the blanks and gaps in hypertensiology giving perspective for potential future studies.

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Circadian blood pressure rhythm and intimal media thickness changes in non-dipper normotensives patients

Italian Journal of Medicine ◽

10.4081/itjm.2017.819 ◽

2017 ◽

Vol 11 ◽

Author(s):

Massimiliano Rocchietti March ◽

Claudia Maggiore ◽

Gerardo Salerno ◽

Agostino De Venanzi ◽

Elena Scaramucci ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Measurement ◽

Target Organ Damage ◽

Pressure Profile ◽

Organ Damage ◽

Profile Measurement ◽

Circadian Blood Pressure ◽

Intimal Medial Thickness ◽

Carotid Intimal Medial Thickness ◽

Increased Risk

We investigated 25 non-dipper normotensive vs 25 dipper normotensive patients. The aim of our study was to evaluate carotid intimal-medial thickness (IMT) in the two groups. At the admission patients underwent anamnesis and general examination, blood sampling for lipid profile measurement, glycemia, homocysteine, ambulatory blood pressure measurement to assess the circadian blood pressure profile, and Doppler ultrasound to measure carotid intimal-medial thickness (IMT). Our results showed that IMT is significantly higher in the non-dipper group (P<0.006) vs dippers. Non-dipper status has been recognized in several studies a condition with increased risk for target organ damage in hypertensive and normotensive subjects. However, to our knowledge, a possible relationship between IMT and normotensive non-dipper patients has not yet clearly investigated. Our study instead has clearly demonstrated a significant relationship between IMT and the non-dipper status.

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Feline blood pressure measurement: when is it needed?

Companion Animal ◽

10.12968/coan.2021.0063 ◽

2021 ◽

Vol 26 (11) ◽

pp. 222-228

Author(s):

Sarah Caney

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Systemic Hypertension ◽

Ophthalmological Examination ◽

Target Organs

Systemic hypertension is a common disorder, primarily affecting older cats. Most cases are secondary to underlying medical conditions, such as chronic kidney disease. If left untreated, systemic hypertension has the potential to cause serious damage to certain target organs and can be fatal. Target organs include the nervous system, cardiovascular system, eyes and kidneys. Target organ damage to the eyes is often pathognomonic and is detected on ophthalmological examination in up to 80% of cats with systemic hypertension. Blood pressure measurement is essential in confirming a diagnosis and should be prioritised in cats showing evidence of target organ damage. Blood pressure screening of apparently healthy older cats is justified, since the risk of hypertension increases with age. Systemic hypertension is diagnosed in cats with persistent elevation in their systolic blood pressure of 160 mmHg or higher. Stress and anxiety can cause a transient increase in systolic blood pressure so measurements should be collected in a manner that is as calm and ‘cat friendly’ as possible. In the presence of confirmed target organ damage, a single high systolic blood pressure reading confirms systemic hypertension. Where no target organ damage is detectable, evidence of elevated systolic blood pressure on two or more occasions is needed to confirm the diagnosis.

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Heart rate and blood pressure variability are predictors of target organ damage in arterial hypertension

American Journal of Hypertension ◽

10.1016/s0895-7061(03)00747-7 ◽

2003 ◽

Vol 16 (5) ◽

pp. A246 ◽

Cited By ~ 1

Author(s):

A MARINAKIS

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Arterial Hypertension ◽

Blood Pressure Variability ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ

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New АСС/AHA and ESC/ESH arterial hypertension guidelines

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2018-5-99-119 ◽

2018 ◽

Vol 17 (5) ◽

pp. 99-119 ◽

Cited By ~ 2

Author(s):

E. V. Reznik ◽

I. G. Nikitin

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

European Society ◽

American Heart Association ◽

American Heart ◽

Heart Association ◽

National Guidelines ◽

Hypertension Guidelines ◽

European Society Of Cardiology ◽

Detection Evaluation

The American College of Cardiology and the American Heart Association updated the guideline for the prevention, detection, evaluation and management of high blood pressure in adults in 2017 The European Society of Cardiology and the European Society оf Hypertension updated guidelines for the management of arterial hypertension in 2018. This article reviews new positions of these documents, compares approaches to current issues of managing of the patients with arterial hypertension, pro and contra with previous versions of similar documents. It is necessary to update the National guidelines for management of patients with arterial hypertension, which should include the dignity of both European and American approaches.

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Physicians’ assessment of the high blood pressure risk and their attitude towards the prevention of arterial hypertension

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2012-6-63-67 ◽

2012 ◽

Vol 11 (6) ◽

pp. 63-67

Author(s):

A. E. Manoylov

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

High Blood Pressure ◽

Target Organ Damage ◽

Disease Model ◽

Organ Damage ◽

Preventive Strategy ◽

Prediction And Prevention ◽

Hypertensive Crises ◽

And Training

Aim. To study the physicians’ knowledge of the high blood pressure (BP) risk and to assess their attitude towards the prevention of arterial hypertension (AH). Material and methods. In total, 118 internal disease specialists from three Russian regions participated in an anonymous questionnaire survey on the knowledge of high BP risk and the attitude towards the prevention of AH and its complications. The mean age of participants (13 men and 105 women) was 46,53±11,64 years. The respondents’ answers were compared to the information in the current clinical AH guidelines. Results. More than one-half of the respondents demonstrated inadequate professional knowledge on prediction and prevention of AH complications. These physicians use the “traditional” disease model and do not consider elevated BP as a risk factor; predict the risk of AH complications using subjective complaints of their patients; do not realise the importance of the target organ damage (TOD) prevention; and limit their preventive strategy only to the prevention of hypertensive crises. Conclusion. The demonstrated attitude towards AH management could be a serious barrier for effective AH prevention. This group of physicians needs extensive education and training, in order to modify their attitude and to increase their commitment to preventive strategies.

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P5470Studying target organ damage indices in newly diagnosed and never treated extreme dipper patients with essential hypertension

European Heart Journal ◽

10.1093/eurheartj/ehz746.0424 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Triantafyllidi ◽

A Schoinas ◽

D Benas ◽

M Varoudi ◽

D Birba ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Newly Diagnosed ◽

Night Time ◽

Hypertensive Patients ◽

Blood Pressure Decrease ◽

Damage Indices

Abstract Background Cardiovascular risk estimation in arterial hypertension includes the investigation for target organ damage indices (TOD). 24h ambulatory blood pressure monitoring (ABPM) represents the gold standard method for the confirmation of the arterial hypertension disease. Dipping phenomenon, defined as blood pressure decrease >10% during night-time measurements, leads to hypertension burden reduce during night and carries a positive prognostic significance. However, there are doubts regarding its prognosis when it becomes augmented (extreme dipping defined as blood pressure decrease >20% during night-time measurements). Aim of our study is to explore TOD existence between extreme dipper and dipper hypertensive patients with newly diagnosed and never treated arterial hypertension. Methods From the 480 total patients with newly diagnosed and never treated arterial hypertension who subjected to ABPM, we excluded 190 non-dipper patients and we divided the rest 290 hypertensives (mean age 49±11 years, 193 males) in normal dippers (n=245, mean age 49±11 years, 160 males) and extreme dippers (n=45, mean age 49±10 years, 33 males). Both groups were subjected to the following measurements: arterial stiffness (PWV), 24h microalbumin levels (MAU), carotid intima-media thickness (IMT), diastolic dysfunction (E/Ea), left ventricular mass index (LVMI) and coronary flow reserve (CFR). Results We did not find any differences within groups regarding age, sex distribution, BMI, office SBP/DBP, cenrtal SBP/DBP and daytime average SBP/DBP as well as PWV, MAU, IMT, E/Ea and CFR. We noticed that extreme dippers had reduced 24h average SBP/DBP (p=0.001 and p=0.02, respectively) and increased LVMI (86±18 vs. 79±20 gr/m2, p=0.04) compared to normal dippers. Differences in LVMI Conclusions Extreme dipper hypertensive patients have an increased LVMI, probably as a result of myocardial hypoxia due to severe blood pressure reduction over night. Our results point to the possible increased cardiovascular risk in this group of hypertensive patients.

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