Tag Archives: blood pressure

Figure 1. Suggested model for hypertension Clinical significance Controlled hypertension is likely clinically significant. Patients often receive prognostication or treatment upon the basis of a diagnosis of systemic hypertension. This is built upon the assumption that the patient risk profile is determined by a once proven diagnosis of systemic hypertension. However, if patients are successfully treated for their systemic hypertension they may in fact move from a higher risk group towards a lower risk group. This could result in some patients ultimately receiving inappropriate treatments. For example, consider a relatively young male patie

Current guidelines state that blood pressure should be monitored routinely at antenatal appointments, with increased frequency in high-risk pregnancy and if problems develop.4 Self-monitoring enables women to monitor their own blood pressure between routine appointments, potentially identifying hypertension earlier and aiding management once it is established.5 Self-monitoring is becoming increasingly popular among patients and healthcare professionals. One US study found that 60% of women with hypertension in pregnancy were self-monitoring.6 However, few studies have assessed its safety and effectiveness and whether it will have any effect o

This publication in the British Journal of Cardiology is part of the need for coordinated publications to ensure that cardiologists are aware of the current consensus. The recommendations are limited to a specific scope – the period prior to planned surgery. Blood pressures that may cause an immediate risk to health are specified, rather than those that may cause risk over the long term. The best method of taking accurate blood pressure measurements is also examined. For the cardiologist who may be contacted to provide advice and management options for hospitalised patients with elevated blood pressure during the pre-operative period, this

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FREEDOM: CABG beats PCI in diabetes patients with multi-vessel disease Coronary artery by-pass graft (CABG) surgery was associated with better outcomes than percutaneous coronary intervention (PCI) in patients with diabetes with multi-vessel coronary artery disease in the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial. Senior FREEDOM investigator, Dr Valentin Fuster (Mount Sinai School of Medicine, New York, USA), said the results (table 1) would change practice. He estimated that patients in this study represent about a quarter of patients undergoing PCI. In

The study, published on July 18 in PLoS One, was conducted by Dr David Wald (Wolfson Institute of Preventive Medicine, London) and colleagues. The polypill used contained three antihypertensive medications – the calcium antagonist, amlodipine 2.5 mg; the angiotensin-receptor blocker, losartan 25 mg; and the diuretic, hydrochlorothiazide 12.5 mg – in addition to the cholesterol-lowering agent simvastatin 40 mg. In the study, 86 individuals were randomised to the polypill or placebo for 12 weeks. They then crossed over and took the other treatment. Mean systolic blood pressure was reduced by 17.9 mmHg, diastolic pressure was reduced by 9.8

Every day practice This year’s meeting examined the importance of both pulse and blood pressure in everyday clinical practice. Professor Tom McDonald (University of Dundee), Vice President of the BHS, welcomed delegates to the symposium on blood pressure and vascular disease, held in conjunction with the BHS. Current interest in the subject results from the publication last year of National Institute for Health and Clinical Excellence (NICE) clinical guideline 127 on the clinical management of primary hypertension in adults, and its recommended approach to hypertension diagnosis and blood pressure management.1 The first speaker, Professor M

When the dentist said: “Be still your beating heart!” Dear Sirs, We all often encounter a patient history and apparent presenting complaint that we can not precisely and cleverly explain. Our patient, Mr BW, a fit and active 53-year-old man, attended a routine appointment as an outpatient. He had done this many times previously as he was experiencing difficuties with heart rate control and troubling symptoms secondary to atrial fibrillation (AF). Coincidentally, he had also had amalgam dental fillings drilled some 18 months previously. Since then, his cardiac problems had escalated. There appeared no clear causality between the fillings a

Highlights of the American Heart Association 2010 meeting held in November 2010, in Chicago, USA, included a breakthrough for the treatment of resistant hypertension, and another oral anticoagulant that could be used instead of warfarin in atrial fibrillation patients, without the need for monitoring. RAFT: CRT reduces deaths and hospitalisations in mild heart failure Adding cardiac-resynchronisation therapy (CRT) to implantable cardioverter defibrillator (ICD) and medication, led to a reduction in deaths and heart failure hospitalistions among patients with mild-to-moderate symptoms of heart failure in the RAFT (Resynchronisation-Defibrilla

ACCORD/INVEST: do not aim for normal blood pressure in diabetes patients with CAD The results of two trials comparing intensive versus more conventional blood pressure lowering in patients with diabetes at high cardiovascular risk have suggested that intensive treatment is not necessary and may be harmful in this population. In the ACCORD BP (Action to Control Cardiovascular Risk in Diabetes – Blood Pressure) trial, while intensive blood pressure treatment did reduce the risk of stroke, it failed to reduce the overall risk of cardiovascular events in patients and was associated with an increase in adverse events due to antihypertensive ther