Hypertension

Despite the fact that prehypertension has been shown to be associated with atherosclerosis and target-organ damage, no studies evaluating coronary flow reserve (CFR) among prehypertensive patients have been done. We assessed CFR in normotensive subjects, in subjects with prehypertension, and in newly diagnosed and never-treated subjects with established hypertension. We found that CFR was decreased in prehypertensive subjects, although not as significantly as in subjects with hypertension.

Hypertension has traditionally been defined by the arbitrary criteria of systolic pressure > 140 mm Hg or diastolic pressure > 90 mm Hg.

Prior studies have shown an association between heart failure and the presence of hypertension and left ventricular hypertrophy (LVH). We investigated the relationship between regression of electrocardiographic (ECG) LVH by Cornell product with antihypertensive regimens and new-onset heart failure in subjects with hypertension and baseline LVH.

As clinical cardiologists, we face an ever-changing landscape with regard to the management and care of hypertensive patients.

We evaluated the differences in higher systolic blood pressure (SBP) between boys and girls in a longitudinal adolescent cohort. Results showed that although boys have a 19% relative increase in the risk of higher SBP annually between the ages of 13 and 17 years, girls do not experience the same risk increase. Among both boys and girls, being overweight increases the likelihood of high SBP almost 3-fold, and every 5 additional hours of "screen time" (television viewing, video game playing, Internet use) is associated with a 4% relative increase in the likelihood of higher SBP levels. For every 5 additional sports-related or other active behaviors over a 7-day recall, there was an 8% relative reduction in high SBP risk. Annual blood pressure assessment in teens that continues into adulthood may facilitate early detection of adult hypertension. Weight control, increased physical activity, and reduced screen time may reduce the likelihood of higher SBP levels developing in adolescents.

Dasgupta has demonstrated that adolescent Canadian boys experience an increased risk of hypertension during longitudinal follow-up compared with girls.

Lifestyle recommendations for the prevention and treatment of hypertension include weight loss, reduced sodium intake, increased physical activity, limited alcohol intake, and the Dietary Approaches to Stop Hypertension (DASH) diet. The 18-month results of the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER) randomized clinical trial showed that individuals with prehypertension and stage 1 hypertension can make and sustain many of these lifestyle changes over the long term, thereby reducing their risk of cardiovascular disease.

Roughly 40% of cases of hypertension are attributable to genetic factors and perhaps 40% to lifestyle factors, particularly diet, salt intake, weight, and exercise.

We recruited 973 patients (mean age, 81 years) with atrial fibrillation from the primary care setting and randomly assigned them to receive anticoagulation with warfarin or aspirin.

We conducted a study to determine whether high lipoprotein(a) levels predicted the risk of myocardial infarction (MI) and ischemic heart disease. Unlike other studies, we measured lipoprotein(a) levels shortly after sampling and corrected for regression dilution bias.

This issue of Cardiology Review includes an article in the Hypertension section by Dr. Robert H. Fagard, who evaluates the effect of low diastolic blood pressure (BP) on prognosis in older patients with systolic hypertension.

Dr. Fagard from Belgium addresses an interesting conundrum in the treatment of high blood pressure (BP): can there be too much of a good thing?

The American Academy of Pediatrics is now recommending cholesterol-reducing medications for high-risk kids.

From the Hypertension and Cardiovascular Rehabilitation Unit, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.

Early detection of cardiovascular disease can reduce the huge human and economic impact of this group of diseases.

A new study demonstrates that pharmacist intervention and home monitoring of BP can help patients manage their condition.

Johns Hopkins conducted a study and found that children who have elevated blood pressure levels often have elevated blood pressure levels as adults.

A Duke University study determined that moderate exercise cubs the symptoms of metabolic syndrome, thus cutting the risk of developing heart disease and diabetes.

The news last Friday came as an utter shock to me. Tim Russert died of a massive heart attack at age 58. The cause? Plaque ripping and causing a blood clot.