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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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The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

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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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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Device-based Therapy for Hypertension.

Fu L Ng1,2, Manish Saxena1,2, Felix Mahfoud3

  • 1Barts BP Centre of Excellence, Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London, EC1A 7BE, UK.

Current Hypertension Reports
|July 3, 2016
PubMed
Summary
This summary is machine-generated.

Resistant hypertension management is evolving with novel device-based therapies. This review explores seven innovative devices, their evidence, and selection criteria for uncontrolled blood pressure.

Keywords:
Arteriovenous anastomosisBaroreflex activationCarotid sinus stimulationCouplerHypertensionInterventional devicesRenal denervation

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Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Hypertension Research

Background:

  • Hypertension remains a leading cause of global mortality and morbidity.
  • Many patients have uncontrolled blood pressure despite available pharmacological treatments, often due to resistant hypertension, intolerance, or non-adherence.
  • Device-based therapies offer novel non-pharmacological approaches for resistant hypertension.

Purpose of the Study:

  • To review emerging device-based therapies for resistant hypertension.
  • To compare seven novel devices, including their mechanisms, evidence base, and ongoing trials.
  • To discuss factors influencing the selection of appropriate devices for diverse hypertension phenotypes.

Main Methods:

  • Review of current literature on device-based therapies for hypertension.
  • Analysis of seven specific novel devices: renal nerve denervation, baroreflex activation therapy, carotid body ablation, central iliac arteriovenous anastomosis, deep brain stimulation, median nerve stimulation, and vagal nerve stimulation.
  • Evaluation of the varying degrees of evidence and upcoming clinical trials for each device.

Main Results:

  • Seven distinct device-based therapies are presented, each with unique mechanisms of action.
  • The evidence supporting these devices varies, with ongoing trials to further establish efficacy and safety.
  • Factors for selecting devices based on hypertension phenotypes are considered.

Conclusions:

  • Device-based therapies represent a significant advancement in managing resistant hypertension.
  • Further research and clinical trials are crucial to define the role of these devices.
  • Personalized device selection may optimize treatment outcomes for patients with uncontrolled blood pressure.