Neuroimmunology of Cardiovascular Disease
AbstractPurpose of ReviewCardiovascular disease (CVD) is a leading cause of death and chronic disability worldwide. Yet, despite extensive intervention strategies the number of persons affected by CVD continues to rise. Thus, there is great interest in unveiling novel mechanisms that may lead to new treatments. Considering this dilemma, recent focus has turned to the neuroimmune mechanisms involved in CVD pathology leading to a deeper understanding of the brain ’s involvement in disease pathology. This review provides an overview of new and salient findings regarding the neuroimmune mechanisms that contribute to CVD.Rece...
Source: Current Hypertension Reports - April 13, 2024 Category: Primary Care Source Type: research
Endoplasmic Reticulum Stress in Hypertension and Salt Sensitivity of Blood Pressure
AbstractPurpose of ReviewHypertension is a principal risk factor for cardiovascular morbidity and mortality, with its severity exacerbated by high sodium intake, particularly in individuals with salt-sensitive blood pressure. However, the mechanisms underlying hypertension and salt sensitivity are only partly understood. Herein, we review potential interactions in hypertension pathophysiology involving the immune system, endoplasmic reticulum (ER) stress, the unfolded protein response (UPR), and proteostasis pathways; identify knowledge gaps; and discuss future directions.Recent FindingsRecent advancements by our research ...
Source: Current Hypertension Reports - April 11, 2024 Category: Primary Care Source Type: research
Management of Pulmonary Hypertension in the Context of Heart Failure with Preserved Ejection Fraction
AbstractPurpose of ReviewTo review the current evidence and modalities for treating pulmonary hypertension (PH) in heart failure with preserved ejection fraction (HFpEF).Recent FindingsIn recent years, several therapies have been developed that improve morbidity in HFpEF, though these studies have not specifically studied patients with PF-HFpEF. Multiple trials of therapies specifically targeting the pulmonary vasculature such as phosphodiesterase (PDE) inhibitors, prostacyclin analogs, endothelin receptor antagonists (ERA), and soluble guanylate cyclase stimulators have also been conducted. However, these therapies demons...
Source: Current Hypertension Reports - April 1, 2024 Category: Primary Care Source Type: research
The Role of Obesity in the Development of Preeclampsia
AbstractPurpose of ReviewThis comprehensive review provides an in-depth exploration of the complex relationship between obesity and preeclampsia (PE) and emphasizes the clinical implications of this association. It highlights the crucial role of screening tools in assessing individual risk and determining the need for additional antenatal care among women with obesity. The review investigates various markers for identifying the risk of developing PE, while emphasizing the significance of interventions such as exercise, weight management, and a balanced diet in reducing the incidence of preeclampsia and improving outcomes f...
Source: Current Hypertension Reports - March 21, 2024 Category: Primary Care Source Type: research
Screening and Management of Pediatric High Blood Pressure —Challenges to Implementing the Clinical Practice Guideline
AbstractPurpose of ReviewElevated blood pressure (BP) and hypertension in childhood convey risk for hypertension and cardiovascular events in adulthood. Early recognition of abnormal BPs is key to preventing or lessening this risk. However, the process for making the diagnosis of hypertension is complex, and overall adherence to the 2017 American Academy of Pediatrics Clinical Practice Guidelines (CPG) is poor. We will review obstacles to adherence to the CPG and approaches designed to improve the diagnosis and management of hypertension in children.Recent FindingsBaseline data from the multi-center quality improvement int...
Source: Current Hypertension Reports - March 9, 2024 Category: Primary Care Source Type: research
Effect of Continuous Positive Airway Pressure on Blood Pressure in Patients with Resistant Hypertension and Obstructive Sleep Apnea: An Updated Meta-analysis
AbstractPurpose of ReviewThe effect of continuous positive airway pressure (CPAP) on resistant hypertension in patients at high risk with obstructive sleep apnea (OSA) needs further investigation. We aimed to determine the effect of CPAP on blood pressure in patients with resistant hypertension and OSA. Databases including PubMed, EMBASE, MEDLINE, the Cochrane Library, and CMB were searched. Data were pooled using a random-effects or fixed-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs).Recent FindingsA total of 12 trials and 718 participants were included. Compared with control,...
Source: Current Hypertension Reports - March 9, 2024 Category: Primary Care Source Type: research
Screening and Management of Pediatric High Blood Pressure —Challenges to Implementing the Clinical Practice Guideline
AbstractPurpose of ReviewElevated blood pressure (BP) and hypertension in childhood convey risk for hypertension and cardiovascular events in adulthood. Early recognition of abnormal BPs is key to preventing or lessening this risk. However, the process for making the diagnosis of hypertension is complex, and overall adherence to the 2017 American Academy of Pediatrics Clinical Practice Guidelines (CPG) is poor. We will review obstacles to adherence to the CPG and approaches designed to improve the diagnosis and management of hypertension in children.Recent FindingsBaseline data from the multi-center quality improvement int...
Source: Current Hypertension Reports - March 9, 2024 Category: Primary Care Source Type: research
Effect of Continuous Positive Airway Pressure on Blood Pressure in Patients with Resistant Hypertension and Obstructive Sleep Apnea: An Updated Meta-analysis
AbstractPurpose of ReviewThe effect of continuous positive airway pressure (CPAP) on resistant hypertension in patients at high risk with obstructive sleep apnea (OSA) needs further investigation. We aimed to determine the effect of CPAP on blood pressure in patients with resistant hypertension and OSA. Databases including PubMed, EMBASE, MEDLINE, the Cochrane Library, and CMB were searched. Data were pooled using a random-effects or fixed-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs).Recent FindingsA total of 12 trials and 718 participants were included. Compared with control,...
Source: Current Hypertension Reports - March 9, 2024 Category: Primary Care Source Type: research
Genetic Appraisal of RAAS-Associated SNPs: REN (rs16853055), AGT (rs3789678) and ACE (rs4305) in Preeclamptic Women Living with HIV Infection
AbstractPurpose of ReviewThe primary goal of this review article was to determine whether the three RAAS-associated SNPs, Renin-rs16853055, AGT-rs3789678 and ACE-rs4305 are genetically linked to the development of hypertension in preeclampsia. The secondary goal was to establish if there was a link between these SNPs and HIV infection.Recent FindingsThere is a paucity of findings related to the aforementioned SNPs and preeclampsia. There are no recent findings on the rs16853055 renin polymorphism. The rs3789678 angiotensinogen polymorphism correlated significantly with gestational hypertension. The rs4305 ACE polymorphism ...
Source: Current Hypertension Reports - February 27, 2024 Category: Primary Care Source Type: research
Resistant Hypertension: Disease Burden and Emerging Treatment Options
AbstractPurpose of ReviewTo define resistant hypertension (RHT), review its pathophysiology and disease burden, identify barriers to effective hypertension management, and to highlight emerging treatment options.Recent FindingsRHT is defined as uncontrolled blood pressure (BP) ≥ 130/80 mm Hg despite concurrent prescription of ≥ 3 or ≥ 4 antihypertensive drugs in different classes or controlled BP despite prescription of ≥ to 4 drugs, at maximally tolerated doses, including a diuretic. BP is regulated by a complex interplay between the renin–angi otensin–aldosterone system, the sympathetic nervo...
Source: Current Hypertension Reports - February 16, 2024 Category: Primary Care Source Type: research
Strategies for Identifying Patients for Deprescribing of Blood Pressure Medications in Routine Practice: An Evidence Review
AbstractPurpose of ReviewTo summarise the evidence regarding which patients might benefit from deprescribing antihypertensive medications.Recent FindingsOlder patients with frailty, multi-morbidity and subsequent polypharmacy are at higher risk of adverse events from antihypertensive treatment, and therefore may benefit from antihypertensive deprescribing. It is possible to examine an individual ’s risk of these adverse events, and use this to identify those people where the benefits of treatment may be outweighed by the harms. While such patients might be considered for deprescribing, the long-term effects of this treat...
Source: Current Hypertension Reports - February 2, 2024 Category: Primary Care Source Type: research
