Search results for "Resistant hypertension"
showing 10 items of 12 documents
Prevalence and clinical characteristics of patients with true resistant hypertension in central and Eastern Europe
2013
Objective Scanty information is available on the clinical characteristics of resistant hypertension in Central and East European countries. The Blood Pressure (BP) control rate and CArdiovascular Risk profilE (BP-CARE) study allowed us to assess the prevalence and the main clinical features of resistant hypertension in this population. Design and method The study was carried out in 1312 treated hypertensive patients living in nine Central and East European countries. Results Four hundred and twenty-three patients had apparent resistant hypertension, of whom 168 had pseudo-resistant hypertension (noncompliant/white-coat) and 255 were true treatment-resistant hypertension patients (TRH). Clin…
Respuesta antihipertensiva a la espironolactona en pacientes con hipertensión arterial refractaria
2008
Fundamento y objetivo Valorar el efecto de anadir espironolactona al tratamiento de pacientes con hipertension arterial (HTA) refractaria e intentar caracterizar a los que consiguen buena respuesta. Pacientes y metodo Se ha realizado un estudio observacional y retrospectivo en pacientes con HTA refractaria –definidos como tratados con 3 farmacos a las dosis habituales, uno de ellos diuretico, sin alcanzar el control de la presion arterial (PA)– y valores de creatinina inferiores a 1,6 mg/dl en varones y a 1,4 mg/dl en mujeres. Resultados A un total de 95 pacientes (un 70% varones y un 40% diabeticos), con una edad media (desviacion estandar) de 66 (12) anos, se les anadio espironolactona al…
Improving Knowledge of Arterial Resistant Hypertension: What Is Relevant?
2013
Resistant hypertension, also known as refractory hypertension in the literature, is a relatively common disease that is associated with elevated cardiovascular and renal risk. Clinical trials suggest that its prevalence is around 35% in hypertensive patients with a baseline blood pressure (BP) > 160/100 mmHg. However, data obtained from registries or from the physician’s office suggest that its prevalence is around 12%. The recent National Health and Nutrition Examination Survey suggests a similar prevalence of 12.3% in diagnosed and treated hypertensive patients. An incidence study conducted at Kaiser Permanente Colorado and Kaiser Permanente Northern California followed up more than 200 0…
Evaluation of a multicomponent grading system for obstructive sleep apnoea: the Baveno classification
2021
New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea–hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated whether this system reflects the OSA population, whether it translates into differences in outcomes, and whether the addition of AHI improves the scheme. A total of 14 499 OSA patients from the European Sleep Apnoea Database cohort were analysed. The groups were homogeneously distributed and were…
Blood Pressure Measurement Before and After Intervention
2016
The complexity and the uncertainties about long-term effect of the invasive interventions to treat essential hypertension (HTN) require a precise diagnosis about the real “resistance” to the antihypertensive treatment given, and it is defined when a therapeutic strategy that includes appropriate lifestyle measures plus a diuretic and two other antihypertensive drugs belonging to different classes at adequate doses fails to lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) values to <140 and 90 mmHg, respectively. Consequently, in the process of diagnosis and follow-up, blood pressure (BP) measurement is the first step that is not exempt of difficulties due to the variab…
24-hour Ambulatory BP Monitoring and Home BP Measurements in Resistant Hypertension
2013
Out-of-office BP measurements, ambulatory BP monitoring (ABPM), and self-BP measurement play an important role in the evaluation of resistant hypertension. In fact 24 h ABPM has been considered mandatory at the time to evaluate resistant hypertension from the beginning of clinical use. Furthermore, clinical research has expanded the potential role of out-of-office measurements not only to the initial evaluation of resistant hypertension but also to refine cardiovascular and renal risk stratification and for a better follow-up. The widespread use of self-BP measurement at home introduced a new tool to properly assess out-of-office BP, and it has also been recommended in these patients althou…
What the interventionalist should know about renal denervation in hypertensive patients: a position paper by the ESH WG on the interventional treatme…
2014
Percutaneous catheter-based transluminal renal denervation (RDN) has emerged as a new approach to achieve sustained blood pressure reduction in patients with drug-resistant hypertension. Experts from ESH and ESC in their recently released position papers and consensus document have summarised the current evidence, unmet needs and practical recommendations for the application of this therapeutic strategy in clinical practice. Experts of the ESH Working Group for the interventional treatment of hypertension prepared this position paper in order to provide interventionalists with guidance through the procedure of RDN. Given that there is no established intraprocedural control of ablation succe…
Executive summary of the joint position paper on renal denervation of the Cardiovascular and Interventional Radiological Society of Europe and the Eu…
2016
Renal denervation (RDN) was reported as a novel exciting treatment for resistant hypertension in 2009. An initial randomized trial supported its efficacy and the technique gained rapid acceptance across the globe. However, a subsequent large blinded, sham arm randomized trial conducted in the USA (to gain Food and Drug Administration approval) failed to achieve its primary efficacy end point in reducing office blood pressure at 6 months. Published in 2014 this trial received both widespread praise and criticism. RDN has effectively stopped out with clinical trials pending further evidence. This joint consensus document representing the European Society of Hypertension and the Cardiovascular…
Renal artery denervation for treating resistant hypertension: Definition of the disease, patient selection and description of the procedure
2012
Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below…
ESH position paper: renal denervation - an interventional therapy of resistant hypertension
2012
Experts from the European Society of Hypertension prepared this position paper in order to summarize current evidence, unmet needs and practical recommendations on the application of percutaneous transluminal ablation of renal nerves [renal denervation (RDN)] as a novel therapeutic strategy for the treatment of resistant hypertension. The sympathetic nervous activation to the kidney and the sensory afferent signals to the central nervous system represent the targets of RND. Clinical studies have documented that catheter-based RDN decreases both efferent sympathetic and afferent sensory nerve traffic leading to clinically meaningful systolic and diastolic blood pressure (BP) reductions in pa…