A new report from the Institute of Medicine finds suggestive but limited evidence that exposure to Agent Orange and other herbicides used during the Vietnam War is associated with an increased chance of developing high blood pressure in some veterans.

Title: In Some Patients, Hypertension Meds Raise Blood Pressure
Category: Health News
Created: 8/25/2010 4:10:00 PM
Last Editorial Review: 8/26/2010 12:00:00 AM

Title: High Blood Pressure Drugs (Hypertension)
Category: Medications
Created: 8/16/2006 12:00:00 AM
Last Editorial Review: 7/1/2022 12:00:00 AM

Pulmonary hypertension (PH) is highly prevalent in patients with interstitial lung disease (ILD) and is associated with increased morbidity and mortality. Widely available noninvasive screening tools are warranted to identify patients at risk for PH, especially severe PH, that could be managed at expert centres. This review summarises current evidence on noninvasive diagnostic modalities and prediction models for the timely detection of PH in patients with ILD. It critically evaluates these approaches and discusses future perspectives in the field. A comprehensive literature search was carried out in PubMed and Scopus, identifying 39 articles that fulfilled inclusion criteria. There is currently no single noninvasive test capable of accurately detecting and diagnosing PH in ILD patients. Estimated right ventricular pressure (RVSP) on Doppler echocardiography remains the single most predictive factor of PH, with other indirect echocardiographic markers increasing its diagnostic accuracy. However, RVSP can be difficult to estimate in patients due to suboptimal views from extensive lung disease. The majority of existing composite scores, including variables obtained from chest computed tomography, pulmonary function tests and cardiopulmonary exercise tests, were derived from retrospective studies, whilst lacking validation in external cohorts. Only two available scores, one based on a stepwise echocardiographic approach and the other on functional parameters, predicted the presence of PH with sufficient accuracy and used a validation cohort. Although several methodological limitations prohibit their generalisability, their use may help physicians to detect PH earlier. Further research on the potential of artificial intelligence may guide a more tailored approach, for timely PH diagnosis.

Chronic hypertension leads to injury and fibrosis in major organs. Fibroblast activation protein (FAP) is one of key molecules in tissue fibrosis, and ⁶⁸Ga-labeled FAP inhibitor-46 (FAPI46) PET is a recently developed method for evaluating FAP. The aim of this study was to evaluate FAP expression and fibrosis in a hypertension model and to test the feasibility of ⁶⁸Ga-FAPI46 PET in hypertension. Methods: Hypertension was induced in mice by angiotensin II infusion for 4 wk. ⁶⁸Ga-FAPI46 biodistribution studies and PET scanning were conducted at 1, 2, and 4 wk after hypertension modeling, and uptake in the major organs was measured. The FAP expression and fibrosis formation of the heart and kidney tissues were analyzed and compared with ⁶⁸Ga-FAPI46 uptake. Subgroups of the hypertension model underwent angiotensin receptor blocker administration and high-dose FAPI46 blocking, for comparison. As a preliminary human study, ⁶⁸Ga-FAPI46 PET images of lung cancer patients were analyzed and compared between hypertension and control groups. Results: Uptake of ⁶⁸Ga-FAPI46 in the heart and kidneys was significantly higher in the hypertension group than in the sham group as early as week 1 and decreased after week 2. The uptake was specifically blocked in the high-dose blocking study. Immunohistochemistry also revealed FAP expression in both heart and kidney tissues. However, overt fibrosis was observed in the heart, whereas it was absent from the kidneys. The angiotensin receptor blocker–treated group showed lower uptake in the heart and kidneys than did the hypertension group. In the pilot human study, renal uptake of ⁶⁸Ga-FAPI46 significantly differed between the hypertension and control groups. Conclusion: In hypertension, FAP expression is increased in the heart and kidneys from the early phases and decreases over time. FAP expression appears to represent fibrosis activity preceding or underlying fibrotic tissue formation. ⁶⁸Ga-FAPI46 PET has potential as an effective imaging method for evaluating FAP expression in progressive fibrosis by hypertension.

BackgroundCOVID-19 pandemic restrictions may have influenced behaviours related to weight.AimTo describe patterns of weight change among adults living in England with type 2 diabetes (T2D) and/or hypertension during the pandemic.Design and settingAn observational cohort study using the routinely collected health data of approximately 40% of adults living in England, accessed through the OpenSAFELY service inside TPP.MethodClinical and sociodemographic characteristics associated with rapid weight gain (>0.5 kg/m2/year) were investigated using multivariable logistic regression.ResultsData were extracted on adults with T2D (n = 1 231 455, 43.9% female, and 76.0% White British) or hypertension (n = 3 558 405, 49.7% female, and 84.3% White British). Adults with T2D lost weight overall (median δ = −0.1 kg/m2/year [interquartile range {IQR} −0.7–0.4]). However, rapid weight gain was common (20.7%) and associated with the following: sex (male versus female: adjusted odds ratio [aOR] 0.78 [95% confidence interval {CI} = 0.77 to 0.79]); age (older age reduced odds, for example, aged 60–69 years versus 18–29 years: aOR 0.66 [95% CI = 0.61 to 0.71]); deprivation (least deprived Index of Multiple Deprivation [IMD] quintile versus most deprived IMD quintile: aOR 0.87 [95% CI = 0.85 to 0.89]); White ethnicity (Black versus White: aOR 0.95 [95% CI = 0.92 to 0.98]); mental health conditions (for example, depression: aOR 1.13 [95% CI = 1.12 to 1.15]); and diabetes treatment (non-insulin treatment versus no pharmacological treatment: aOR 0.68 [95% CI = 0.67 to 0.69]). Adults with hypertension maintained stable weight overall (median δ = 0.0 kg/m2/year [IQR −0.6–0.5]); however, rapid weight gain was common (24.7%) and associated with similar characteristics as in T2D.ConclusionAmong adults living in England with T2D and/or hypertension, rapid pandemic weight gain was more common among females, younger adults, those living in more deprived areas, and those with mental health conditions.

PURPOSE

The impact of digital health on medically underserved patients is unclear. This study aimed to determine the early impact of a digital innovation to grow quality care through an interprofessional care team (DIG IT) on the blood pressure (BP) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk score of medically underserved patients.

Highlights: A shocking survey reveals that 101 million Indians have diabetes and 315 million suffer from hypertensi

Highlights: Five minutes of daily exercise can lower blood pressure Replacing sitting with 20-27 minutes of exer

Researchers have developed a non-invasive method to identify a possible cause of high blood pressure by drastically reducing radiation exposure, as suggested by a recent study.

Arterial stiffness increases blood pressure via an update in insulin resistance but not via an increase in body fat, a paper published in Frontiers in Cardiovascular Medicine concludes.

In mice, high blood pressure/hypertension was linked to bone loss and osteoporosis-related bone damage, according to new research presented at the American

A new study has found that 1 in 8 people aged 40 to 75 years had increased blood pressure (hypertension) in the evening that would be missed by a daytime GP appointment.

Macrophages and microglia, the immune cells of the brain were found to increase hypertension, say researchers. The immune cells encounter the endothelium,

Being overweight and obese can put kids at higher risk for high blood pressure (hypertension), reveals a new study. A Kaiser Permanente study of more

Reducing salt intake to moderate levels may lower high blood pressure (medlinkhypertension/medlink) naturally, reveals a new study. Results from

In youth and adolescents, medlinkunhealthy lifestyle habits/medlink, including obesity, lack of sleep, and the consumption of junk and processed food,

Group of international experts advocates for a crucial change in medlinkhypertension/medlink treatment guidelines, urging the inclusion of recommendations

medlinkSystolic blood pressure/medlink, representing arterial pressure during heartbeats, emerged as a pivotal predictor of medlinkstroke risk/medlink

More than 30% of adults globally suffer from hypertension, a major controllable risk factor for medlinkcardiovascular disease/medlink and mortality.

Health experts at All India Institute of Medical Sciences (AIIMS) find the early onset of medlinkhypertension/medlink among young children (!--ref1--)

Recent advancements in artificial intelligence (AI) have led to the development of a promising algorithm by Anumana, in collaboration with Janssen Research

medlinkPulmonary hypertension/medlink is a critical condition that often results in heart failure and death for many patients. In search of innovative

The risk of developing high blood pressure (medlinkhypertension/medlink) rises with increased levels of tellurium, a contaminant that enters foods through mining and manufacturing activities.

Obesity and diabetes cases increase in urban areas; experts blame it on stress and faulty diet.

According to recent reports by WHO, there are 4,034,567 COVID-19 infected persons around the world, with 276,690 deaths. Researchers and health experts around the globe are ardently focused on studying the novel coronavirus, where new findings and understanding help in the

According to recent reports by WHO, there are 4,034,567 COVID-19 infected persons around the world, with 276,690 deaths. Researchers and health experts around the globe are ardently focused on studying the novel coronavirus, where new findings and understanding help in the

A new report from the Institute of Medicine finds suggestive but limited evidence that exposure to Agent Orange and other herbicides used during the Vietnam War is associated with an increased chance of developing high blood pressure in some veterans.

The Sphenopalatine Ganglion Block has been called "The Miracle Block" due to effectiveness in treating all types of headaches and migraines including TACs. This autonomic block is also useful for a wide variety of eye, nose, and sinus issues.

Margaret Parker, MD, MCCM, speaks with Brett J. Ehrmann, MD, MS

Margaret Parker, MD, MCCM, speaks with Steven L. Shein, MD, about the article, Effectiveness of Pharmacological Therapies for Intracranial Hypertension in Children With Severe Traumatic Brain Injury.

Statement Highlight: Resistant blood pressure affects 12 percent to 15 percent of people currently being treated for high blood pressure.

Research Highlights: Researchers have found a specific bacterial profile in the gut of people with pulmonary arterial hypertension, a chronic and progressive disease that causes constriction of arteries in the lungs. The unique bacterial profile...

A glycerol derivative which is effective to reduce blood pressure and has the formula: ##STR1## wherein R1 is an alkyl group having 10-22 carbon atoms, R2 is a lower acyl group or benzoyl, each of R3 and R4 independently is hydrogen or a straight or branched chain alkyl group having 1-6 carbon atoms; each of R5, R6 and R7 independently is hydrogen, a straight or branched chain alkyl group having 1-6 carbon atoms, an aryl group or an aralkyl group; and each of m and n independently is 0 or a positive integer under the condition of m+n=2-8.

Devices, systems and methods are described which control blood pressure and nervous system activity by stimulating baroreceptors. By selectively and controllably activating baroreceptors and/or nerves, the present invention reduces blood pressure and alters the sympathetic nervous system; thereby minimizing deleterious effects on the heart, vasculature and other organs and tissues. A baroreceptor activation device or other sensory activation device is positioned near a dermal bone to provide the treatment.

The present invention relates to the use of selective adenosine A1 agonists, in particular the dicyanopyridines of formula (I), for the treatment and/or prophylaxis of glaucoma and ocular hypertension as well as the their use for the production of a medicament for the treatment and/or prophylaxis of glaucoma and ocular hypertension.

A system for treating heart disease, such as pulmonary hypertension or right heart failure, including an implantable component and external components for monitoring the implantable component is provided. The implantable component may include a compliant member, e.g., balloon, coupled to a reservoir via a conduit. Preferably, the compliant member is adapted to be implanted in a pulmonary artery and the reservoir is adapted to be implanted subcutaneously. The external components may include a clinical controller component, monitoring software configured to run a clinician's computer, a patient monitoring device, and a mobile application configured to run on a patient's mobile device.

Pasquale Passarella
Aug 1, 2018; 31:218-224
From Research to Practice

(Louisiana State University Health Sciences Center) A study conducted at LSU Health New Orleans has shown for the first time that chronic exposure to inhaled nicotine alone increases blood pressure in both the body's general circulation and in the lungs that can lead to pulmonary hypertension. The study also found that nicotine-induced pulmonary hypertension is accompanied by changes in the size, shape and function (remodeling) of the blood vessels in the lung and the right lower chamber of the heart.

Objectives: The study compared the diagnostic performance of Planar Ventilation/perfusion (V/Q) and V/Q Single-photon computed tomography (SPECT), and determined whether combining perfusion scanning with low-dose computed tomography (Q-LDCT) may be equally effective in a prospective study of patients with chronic thromboembolic pulmonary hypertension (CTEPH) patients. Background: V/Q scanning is recommended for excluding CTEPH during the diagnosis of pulmonary hypertension (PH). However, Planar V/Q and V/Q SPECT techniques have yet to be compared in patients with CTEPH. Methods: Patients with suspected PH were eligible for the study. PH attributable to left heart disease or lung disease was excluded, and patients whose PH was confirmed by right heart catheterization and who completed Planar V/Q, V/Q-SPECT, Q-LDCT, and pulmonary angiography were included. V/Q images were interpreted and patients were diagnosed as instructed by the 2009 EANM guidelines, and pulmonary angiography analyses were used as a reference standard. Results: A total of 208 patients completed the study, including 69 with CTEPH confirmed by pulmonary angiography. Planar V/Q, V/Q-SPECT, and Q-LDCT were all highly effective for diagnosing CTEPH, with no significant differences in sensitivity or specificity observed among the three techniques (Planar V/Q [sensitivity/specificity]: 94.20%/92.81%; V/Q-SPECT: 97.10%/91.37%, Q-LCDT: 95.65%/90.65%). However, V/Q-SPECT was significantly more sensitive (V/Q-SPECT: 79.21%; Planar V/Q: 75.84%, P = 0.012; Q-LDCT: 74.91%, p<0.001), and Planar V/Q was significantly more specific (Planar V/Q: 54.14%; V/Q-SPECT 46.05%, p<0.001; Q-LDCT: 46.05%, P = 0.001) than the other two techniques for identifying perfusion defects in individual lung segments. Conclusion: Both Planar V/Q and V/Q-SPECT were highly effective for diagnosing CTEPH, and Q-LDCT may be a reliable alternative method for patients who are unsuitable for ventilation imaging.

George D. Harris
Jul 1, 2007; 25:115-118
Case Studies

Evan M. Benjamin
Jul 1, 2004; 22:137-138
Case Studies

TODAY Study Group
Jun 1, 2013; 36:1735-1741
TODAY Study

Ehud Grossman
May 1, 2011; 34:S313-S319
Hypertension

OBJECTIVE

In 2017, the American Academy of Pediatrics introduced a new guideline (2017 Clinical Practice Guideline of the American Academy of Pediatrics [AAP 2017]) to diagnose arterial hypertension (HTN) in children that included revised, lower normative blood pressure (BP) values and cut points for diagnosing high BP in adolescents. We studied the impact of the new AAP 2017 guideline on prevalence of HTN in children with type 1 diabetes mellitus (T1DM).

Primary hypertension is a growing concern in adolescents due to its association with the obesity epidemic. Recent studies have examined underdetection and underdiagnosis of hypertension in adolescents but medical management of primary hypertension in adolescents is not well-described.

Our study describes patterns of antihypertensive prescribing for adolescents with primary hypertension including the use of monotherapy versus combination therapy by physicians of different specialties and factors associated with receipt of antihypertensive therapy over a multi-year period. (Read the full article)

Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight infants and contributes to morbidity and mortality.

Pulmonary hypertension affects at least 1 in 6 extremely low birth weight infants and persists to discharge in most survivors. Routine screening of these infants with echocardiography at 4 weeks of age identifies only one-third of those affected. (Read the full article)

The American Academy of Pediatrics and National Heart, Lung, and Blood Institute recommend routine blood pressure measurement in children. Little is known about the frequency with which blood pressure is currently measured in ambulatory pediatric settings in the United States.

Between 2000 and 2009, providers measured blood pressure during only one-third of ambulatory pediatric visits and two-thirds of pediatric preventive visits. The current rate of screening is especially low for children aged 3 to 7 years. (Read the full article)

Knowledge is limited regarding the epidemiology of persistent pulmonary hypertension of the newborn (PPHN). Previous work has implicated a host of perinatal risk factors and a few antenatal antecedents of PPHN, including maternal consumption during pregnancy of nonsteroidal antiinflammatory medications.

In contrast to results of previous studies, we found no association between PPHN and maternal consumption during late pregnancy of nonsteroidal antiinflammatory drugs in general or ibuprofen in particular. (Read the full article)