WhiteCoat and masked hypertension are both associated with increased aortic stiffness, renal injury, and cardiovascular events
Sorgente: White-Coat, Masked Hypertension Tied to CVD, Kidney Complications – Renal and Urology News
Archivi tag: ipertensione
White-Coat, Masked Hypertension Tied to CVD, Kidney Complications – L’ipertensione e’ sempre dannosa
Blood-Pressure Control — Per gli over 50, abbassando la sistolica sotto i 120mmHg, si riduce di un quarto rischio ictus e infarto –
Clinical Decisions from The New England Journal of Medicine — Blood-Pressure Control
Sorgente: Blood-Pressure Control — NEJM
Ipertensione. Per gli over 50, abbassando la sistolica sotto i 120mmHg, si riduce di un quarto rischio ictus e infarto –
E anche la mortalità si abbatte del 27%. Pubblicati oggi sul NEJM, e presentati in contemporanea ad Orlando al congresso dell’American Heart Association, i risultati dello studio SPRINT, interrotto precocemente lo scorso settembre. Gli esperti riflettono però sulla possibilità di effetti indesiderati a livello delle funzioni cognitive e renali e invitano alla prudenza.
High blood pressure draining Canada’s health-care system, suggests study – Calgary – L’ipertensione come problema che drena cure e soldi.
High blood pressure draining Canada’s health-care system, suggests study – Calgary – CBC News.
#veraspendingreview
Ecco il VERO modo di fare spending review. L’ipertensione e’ un problema ? Si? E’ un problema che ha costi sociali ed economici alti? SI?
allora lo si affronta. Non come in Italia e come qualche direttore generale che non sa quante persone escono dal suo ospedale con ipertensione.
C’e tutto nelle cartelle: gli ICD9 segnati ma non sanno ne’ quanto pesano, ne’ i livelli di ipertensione ne’ i livelli di glicemia dei diabetici ne’ quante insufficienze renali hanno. Tutte cosine che costano tanto sia in termini di vite, di morbilità’ che di vere risorse economiche.
Can BP Go Too Low in Kidney Disease Patients? Quanto deve essere la PA nei pazienti nefropatici?
Can BP Go Too Low in Kidney Disease Patients?.
This has been an interesting year for hypertension, with several papers coming out and perhaps giving us confusing information about what the best targets are for blood pressure control. It began, to some extent, with the Joint National Committee 8 (JNC 8) report[1] that was in JAMA, followed by subsequent discussion about the best targets for blood pressure
Tight Blood Sugar Control Doesn’t Prevent Strokes in Diabetics: Study – WebMD Mentre forse e’ piu favorevole controllare la PA
Un periodo dove gli studi di intervento mostrano tutti propblemi connessi al target
Tight Blood Sugar Control Doesn’t Prevent Strokes in Diabetics: Study – WebMD.
Follow-up of Blood-Pressure Lowering and Glucose Control in Type 2 Diabetes — NEJM.
Antihypertensives Associated with Lower Dialysis Risk for Patients with Advanced CKD – ScienceNewsline
Antihypertensives associated with lower dialysis risk for patients with advanced CKD.
Antihypertensives May Delay Kidney Disease Progression.
dal nostro amico Facebook James Myers
Antihypertensives associated with lower dialysis risk for patients with advanced CKD
December 17, 2013
Patients with stable hypertension and the most advanced stage of chronic kidney disease before initiating dialysis appeared to have a lower risk for long-term dialysis or death if they were treated with the antihypertensive drugs known as angiotensin-converting enzyme inhibitors (ACE) or angiotensin II receptor blockers (ARBs), according to a study published by JAMA Internal Medicine, a JAMA Network publication.
(Certain antihypertensive medications are better at preventing cardiovascular disease in dialysis patients than others)
An ACE inhibitor or ARB is known to delay the progression of CKD in patients with and without diabetes, particularly in those patients with mild to moderate renal insufficiency. But most large clinical trials of ACE inhibitors/ARB exclude patients with the most advanced stage of CKD pre-dialysis, perhaps out of concern that the drugs can cause renal failure and the need for dialysis, so it remains unclear whether that therapy is effective in patients with advanced CKD, according to the study background.
(Research shows association between ACE inhibitors, acute kidney injury)
Researchers in Taiwan examined the association between ACE inhibitor /ARB use and the risk of long-term dialysis and death in a nationwide group of 28,497 patients in a study by Ta-Wei Hsu, MD, of the National Yang-Ming University Hospital, and colleagues. The patients had the most advanced pre-dialysis stage of CKD, hypertension and anemia.
During a median follow-up of seven months, 20,152 patients (70.7 percent) required long-term dialysis and 5,696 (20 percent) died before progressing to ESRD (end-stage renal disease). Study findings indicate that treatment with ACEIs/ARBs in patients with stable hypertension and advanced CKD was associated with a lower risk for long-term dialysis or death by 6%.
(Combining blood pressure drugs linked to serious side effects in type 2 diabetes patients)
Commentary: An ACE in the hole for patients with advanced chronic kidney disease
In a related commentary, Meyeon Park, M.D., M.A.S., and Chi-yuan Hsu, M.D., M.Sc., of the University of California, San Francisco, write: “In the treatment of patients with advanced chronic kidney disease … a paramount goal is preventing or retarding progression to end-stage renal disease and the requirement of dialysis.”
“However, the use of ACEIs or ARBs in advanced CKD remains uncertain. This important clinical question is the subject of a new study by Hsu and colleagues,” the authors continue. “Overall, the study by Hsu and colleagues makes an important contribution to the literature.”
Suboptimal therapy may explain half of treatment-resistant hypertension
Suboptimal therapy may explain half of treatment-resistant hypertension | theheart.org.
ma la compliance e la comunicazione al paziente rimangon ancora sconosciute ai medici
ed anche alcuni che le considerano cavolate, l’importante e’ coprire i turni e fare presto dando il meno possibile.
Insufficienza renale cronica e ipertensione arteriosa
Insufficienza renale cronica e ipertensione arteriosa.
L’insufficienza renale cronica (IRC) è associata all’ipertensione arteriosa (IA) nel 22% dei casi quando è al I stadio e addirittura nell’80% dei casi quando è al IV stadio, ma non è chiaro se le sue manifestazioni cliniche e le sue complicazioni siano diverse in rapporto al fatto che l’IA sia presente o meno. Si è recentemente occupata dell’argomento un’ampia metanalisi, pubblicata su Lancet, che ha raccolto una serie di studi selezionati in accordo ai criteri del Chronic Kidney Disease Prognosis Consortium. È stato analizzato il rischio mortalità e di insufficienza renale ultimo stadio (ESRD) in rapporto al filtrato glomerulare (calcolato come eGFR) e alla proteinuria (calcolata come Rapporto Albumina/Creatinina [ACR]) in soggetti ipertesi e normotesi.
Mahmoodi BK et al. Lancet 2012; 380: 1649’61
CDC Vital Signs – Getting Blood Pressure Under Control
CDC Vital Signs – Getting Blood Pressure Under Control.
in alcuni paesi la PA si misura anche dal barbiere. Dobbiamo assolutamente individuare gli ipertesi, trattarli adeguatamente (che significa che dobbiamo arrivare a target e non solo prescrivere i farmaci). Questa e’ la vera e sola spending review, altro che discutere su dove piazzare la sede della ASL…!
Health systems can help patients get their blood pressure under control by using health information technology, such as electronic health records, to track and follow-up with patients who have had high blood pressure readings. For more tips for health systems, visit:
Measuring Blood Pressure
Blood pressure (BP) traditionally has been measured in the clinic setting with treatment decisions based on these intermittent measurements. Over the past decade, technologic advances have led to improvements in measuring clinic BP and also facilitated measuring BP outside the clinic. This month, AJKD features 2 narrative reviews that discuss BP measurement strategies, one focusing on the general population and the second on hemodialysis patients.
ma non dimenticate le raccomandazioni del gruppo di studio della SIN:
10 ways to control high blood pressure without medication – MayoClinic.com
10 ways to control high blood pressure without medication – MayoClinic.com.
ancora Mayo clinic con consigli sulla ipertensione
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