Association of Uric Acid With Blood Pressure in Hypertension Between Treatment Group and Non-treatment Group

Objective: This study aimed to explore the association between uric acid (UA) and blood pressure (BP) in hypertension treatment and non-treatment groups.Methods: A cross-sectional study with 6,985 individuals from the National Health and Nutrition Examination Survey (NHANES) was performed. Multiple linear regression analysis was performed to explore the relationship of UA and BP in hypertension between the treatment group (n = 5,983) and the non-treatment group (n = 1,002).Results: A significantly negative association was discovered in SBP (β, −0.36 [95% CI, −0.71, −0.01]) and DBP (β, −0.47 [95% CI, −0.69, −0.26]) in the hypertension treatment group. In the hypertension non-treatment group, the associations between UA and BP including SBP, DBP were both an inverted U-shape. The inflection point of SBP and DBP was 7 and 7.5 mg/dl, respectively. For SBP, the association was positively significant (β, 3.11 [95% CI, 1.67, 4.56]) before the inflection point of 7 mg/dl. However, after the inflection point of 7 mg/dl, the association was negative (β, −5.44 [95% CI, −8.6, −2.28]). For DBP, the inflection point was 7.5 mg/dl, and the effect size was positive (β, 1.19 [95% CI, 0.37, 2.01]) before the inflection point. However, after it, the effect size was negative (β, −3.24 [95% CI, −5.72, −0.76]).Conclusion: The association between UA and BP was negative in the hypertension treatment group. In the hypertension non-treatment group, the associations between UA and BP including SBP and DBP were both an inverted U-shape.

Gaps in antihypertensive and statin treatments and benefits of optimisation: a modelling study in a 1 million ethnically diverse urban population in UK

ObjectivesTo characterise gaps in antihypertensive treatment in people with hypertension and statin treatment in people with cardiovascular diseases (CVD) in a large urban population and quantify the health and economic impacts of their optimisation.DesignA cross-sectional population study and a long-term CVD decision model.SettingPrimary care, UK.ParticipantsAll adults with diagnosed hypertension or CVD in a population of about 1 million people, served by 123 primary care practices in London, UK in 2019.InterventionsFollowing UK clinical guidelines, all adults with diagnosed hypertension were categorised into optimal, suboptimal and untreated groups with respect to their antihypertensive treatment, and all adults with diagnosed CVD were categorised in the same manner with respect to their statin treatment.OutcomesProportion of patients suboptimally treated or untreated. Projected cardiovascular events avoided, years and quality-adjusted life years (QALYs) gained and healthcare costs saved with optimised treatments.Results21 954 of the 91 828 adults with hypertension (24%; mean age 59 years; 49% women) and 9062 of the 23 723 adults with CVD (38%; mean age 69 years; 43% women) were not optimally treated with antihypertensive or statin treatment, respectively. Per 1000 additional patients optimised over 5 years, hypertension treatment is projected to prevent 25 (95% CI 16 to 32) major vascular events (MVEs) and 7 (3 to 10) vascular deaths, statin treatment, 28 (22 to 33) MVEs and 6 (4 to 7) vascular deaths. Over their lifespan, a patient with uncontrolled hypertension aged 60–69 years is projected to gain 0.64 (95% CI 0.36 to 0.87) QALYs with optimised hypertension treatment, and a similarly aged patient with previous CVD not optimally treated with statin is projected to gain 0.3 (0.24 to 0.37) QALYs with optimised statin treatment. In both cases, the hospital cost savings minus extra medication costs were about £1100 per person over remaining lifespan.ConclusionsOptimising cardiovascular treatments can cost-effectively reduce cardiovascular risk and improve life expectancy.

The Application of Nitric Oxide for Ocular Hypertension Treatment

Despite of various therapeutic methods for treating ocular hypertension and glaucoma, it still remains the leading cause of irreversible blindness. Intraocular pressure (IOP) lowering is the most effective way to slow disease progression and prevent blindness. Among the ocular hypotensive drugs currently in use, only a couple act on the conventional outflow system, which is the main pathway for aqueous humor outflow and the major lesion site resulting in ocular hypertension. Nitric oxide (NO) is a commendable new class of glaucoma drugs that acts on the conventional outflow pathway. An increasing number of nitric oxide donors have been developed for glaucoma and ocular hypertension treatment. Here, we will review how NO lowers IOP and the types of nitric oxide donors that have been developed. And a brief analysis of the advantages and challenges associated with the application will be made. The literature used in this review is based on Pubmed database search using ‘nitric oxide’ and ‘glaucoma’ as key words.

Comparison of the effectiveness of hypertension treatment with diet, prolonged sleep and acupuncture

In the clinic of hospital therapy of the Sverdlovsk Medical Institute, beginning in 1946, observations were carried out regarding the dietary treatment of 335 patients with essential hypertension.

Hypertension treatment by Rhodan-Calcium-Diuretin

The treatment of hypertension by Rhodan-Calcium-Diuretin, proposed by Askanaz, was tested by Hoffmann (Mnch. Med. Wschr. No. 13, 1929) on a large clinical material and was found to be quite reliable both in terms of reducing blood pressure numbers and in terms of eliminating unpleasant subjective sensations.

Comparison of the effectiveness of hypertension treatment with diet, prolonged sleep and acupuncture

In the clinic of hospital therapy of the Sverdlovsk Medical Institute, beginning in 1946, observations were carried out regarding the dietary treatment of 335 patients with essential hypertension.