Hypertension

Isolated systolic hypertension (ISH) in young and middle-aged adults is on the rise. A study in the Journal of the American College of Cardiology found that ISH puts these patients at higher relative risk for heart disease and mortality than their peers with normal blood pressure. That raises the question of whether these younger ISH patients should be getting drug therapy.

The US Food and Drug Administration (FDA) has approved a polypill for hypertension, a combination of perindopril arginine and amlodipine (Prestalia/ Symplmed Pharma-Servier).

An analysis of medical records from 5,311 people indicates that even mildly elevated blood pressure may indicate a dramatically elevated risk of developing atrial fibrillation (AF). Many studies have shown that patients with hypertension - defined as blood pressure above 140/90 mm Hg - are more likely to develop AF than patients with healthy blood pressure, but the new paper may be the first to document a significant association between AF and blood pressure between 120/80 mm Hg and 139/89 mm Hg.

Older people can safely eat just as much salt daily (2300 mg) as younger adults, according to a community-based study reported in JAMAInternal Medicine The current recommendation is 1,500 mg for adults over 50, or a little more than a teaspoon.

Preventing cardiovascular disease (CVD) is an important goal in population health. But according to American Heart Association guidelines on primary prevention of CVD, recommending that all healthy people take aspirin to do that is not the way to go. In a new study in the Journal of the American College of Cardiology, however, Ravi Hira, MD and colleagues find that not all physicians have gotten the message. The researchers looked at the National Cardiovascular Disease Registry's Practice Innovation and Clinical Excellence registry. Of 68,808 patients, 11.6% were taking aspirin inappropriately, the team found.

This 27-year old female medical student with recently diagnosed hypertension is seen following a chest x-ray in work up of a positive PPD. Upon questioning, the patient notes what she described as "gray-out spells" when tired and leg numbness with exercise after periods of sitting.

While rheumatoid arthritis makes the most headlines in the field of rheumatology a recent push has been made to bring more attention to patients with rheumatic heart disease.

Patients with mild hypertension may not be getting the care they need, according to 2 studies and an editorial due to be published Dec. 23 in Annals of Internal Medicine. In the second of the 2 studies in the journal, done for the US Preventive Service Task Force, researchers find office-based blood pressure readings are often less accurate than ambulatory blood pressure screening.

An article published recently in the journal Diabetes Research and Clinical Practice reviews the mechanisms by which microalbuminuria causes renal and cardiovascular disease. The authors also describe appropriate interventions.

Metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease. A new study published online in the Nournal of the International Neuropsychological Society shows that MetS also plays a role in cognitive performance.

A 35 year-old man with a history of hypertension, obstructive sleep apnea and obesity presents to clinic with complaints of non-cardiac chest discomfort. He is requesting refills of his blood pressure medications. His insurance changed 6 months ago and he has not had them since. The nurse performs the intake vital signs and reports that the patient has a blood pressure of 280/150 mmHg.

Patients who have hypertension may be at increased risk for cognitive decline and dementia. According to a study published in the October 2014 issue of JAMA Neurology, researchers have been trying to elucidate the timing and mechanism by which elevated blood pressure robs patients' thinking abilities.

Proper blood pressure monitoring is a matter of life and death for patients diagnosed with hypertension. For many patients, treatment cost and complex testing regimens can make proper adherence a challenge.

The most common cause of sudden cardiac death in young people is hypertrophic cardiomyopathy, an inherited condition that can lead to heart failure, angina, arrhythmia and sudden cardiac death. There is no medical treatment shown to halt or reverse the progression of the disease-just palliative care or surgery.

In the Hollywood version of the heart attack, patients clutch their chests, gasp for air, and often keel over. Real life isn't usually like that. But the problem for cardiologists and other physicians whose patients have cardiac events, is that the patient may not realize he or she has had one.