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Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

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Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
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Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
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Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
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The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
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Blood Pressure Control Provides Less Cardiovascular Protection in Adults With Than Without Apparent

Brent M Egan1,2, Bo Kai3, C Shaun Wagner2

  • 1Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC.

Journal of Clinical Hypertension (Greenwich, Conn.)
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Summary

Hypertension control offers less cardiovascular disease protection for those with apparent treatment-resistant hypertension (aTRH). Additional strategies are needed to prevent cardiovascular events in aTRH patients.

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Area of Science:

  • Cardiology
  • Hypertension Research
  • Public Health

Background:

  • Hypertension is a major risk factor for cardiovascular disease (CVD).
  • Apparent treatment-resistant hypertension (aTRH) is defined as uncontrolled blood pressure despite multiple medications or controlled BP with four or more medications.
  • The protective effect of hypertension control on CVD incidence in aTRH patients is not well understood.

Purpose of the Study:

  • To compare the effectiveness of hypertension control in preventing incident cardiovascular disease (CVDi) in adults with and without apparent treatment-resistant hypertension (aTRH).

Main Methods:

  • A retrospective cohort study using electronic health data matched with health claims from 2006-2012.
  • Included 118,356 treated hypertensive patients (40,690 with aTRH) with 460,599 observation years.
  • Primary outcome was first CVDi (stroke, coronary heart disease, heart failure) identified from claims data, with adjustments for covariates.

Main Results:

  • Hypertension control provided less protection against CVDi in patients with aTRH (HR, 0.87; 95% CI, 0.82-0.93) compared to those without aTRH (HR, 0.69; 95% CI, 0.65-0.74).
  • The difference in protection was statistically significant (P<.001).

Conclusions:

  • Standard hypertension control measures may be less effective in preventing cardiovascular disease in patients with apparent treatment-resistant hypertension.
  • Novel strategies beyond current hypertension management are likely necessary to reduce cardiovascular risk in this high-risk population.