Tag Archives: hypertension

In the midst of the first wave of the COVID-19 pandemic in the United Kingdom, we observed new-onset systolic hypertension associated with hypernatraemia and hypokalaemia with normal serum urea among hospitalised patients. We investigated two patients and found elevated urinary potassium (without causal drugs) and hyporeninaemic hypoaldosteronism (plasma renin <0.2 nmol/L/hr [reference range: 0.5–3.5 nmol/L/hr] and aldosterone <60 pmol/L [reference range: 60–250 pmol/L]) in both. Congenital and secondary endocrine causes of hypertension were excluded. We treated one of the patients with amiloride, which resulted in normalisation of

Introduction In late 2019, the first case of a patient with pneumonia of unknown cause was reported in Wuhan, China. The disease, called coronavirus disease 2019 (COVID-19), spread rapidly and caused a pandemic. The virus that causes this infection is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 Besides respiratory tract disease, which is considered the main and most common clinical manifestation of COVID-19, other systems, including the cardiovascular system, could also be affected. Factors, such as tissue hypoxia, which results as the pneumonia progresses, and inflammation of the vessel walls, have been suggested a

Introduction Stroke is defined as an acute neurological deficit of cerebrovascular origin lasting longer than 24 hours. In the UK each year, stroke affects approximately 100,000 people, is a leading cause of mortality, causing over 30,000 deaths in 2020, and is a significant contributor to severe disability.1 Caring for patients with stroke in the UK costs approximately £2.5 million each year and leads to significant production losses. Clearly, preventing stroke has many benefits. Strokes can be ischaemic (85%), where tissue damage is due to occlusion of blood supply, or haemorrhagic (15%), due to a ruptured vessel.2 Ischaemic stroke can be

Introduction High blood pressure (BP) is a major risk factor for reduced healthy life-expectancy and unhealthy ageing. While it is fundamentally treatable, it is currently not optimally managed. To meet national public health targets, patients must play an active role in their decisions about how best to manage their own BP through lifestyle change and drug treatment.1,2 This paper summarises ‘Share The Pressure’ (STP), a project that developed and piloted a scalable model for engaging patients on the benefits of risk factor control for healthy ageing; training healthcare professionals (HCPs) in cardiovascular disease (CVD) risk communica

Measurement Blood pressure measurement is a quintessential part of healthcare, and accurate measurement is paramount for proper diagnosis and treatment of hypertension. However, studies indicate that inaccuracies in blood pressure monitoring are prevalent, even among healthcare professionals.2–5 Flawed measurement techniques, such as relying on a single reading, insufficient time for measurement, and incorrect arm positioning contribute to misdiagnoses. Our prior work has highlighted the inadequate adherence to accurate blood pressure measurement protocols among healthcare professionals, including even cardiologists.2 Key factors contribut

What is the future of cardiovascular health? NHS Medical Director Professor Sir Stephen Powis opened the conference by outlining the growing need to provide high quality cardiovascular care. With a quarter of deaths in England attributable to cardiovascular disease and a wider cost to the economy of £15.8 billion per year,1 there is an urgent need for innovative care pathways and new technologies. He showcased virtual wards as one example of innovation, with over 100,000 patients having been managed remotely in 2022.2 In Liverpool, a Telehealth team has successfully utilised a medical monitoring app to manage patients at home, leading to a 1

Case presentation A 20-year-old woman was being investigated privately for syncope in May 2017. Tilt-test showed that on standing, her heart rate increased by 30 beats/minute from baseline. She was referred to the cardiology team. Her body mass index (BMI) was 23 kg/m2 and average 24-hour ambulatory blood pressure was 141/79 mmHg. She had a normal echocardiogram and 24-hour urinary catecholamines. The patient completed the standard treadmill test. Because of hypertension detected in this patient, aldosterone/renin ratio (ARR) was performed to screen for primary hyperaldosteronism (Conn’s disease). ARR was found to be raised at 156 (referen

Figure 1. Transthoracic echocardiogram showing cessation of flow in the descending aorta Figure 2. Three-dimensional reconstruction of computed tomography (CT) aortogram showing interruption of thoracic aorta Case An asymptomatic 28-year-old man with an incidental finding of hypertension at a routine visa renewal medical presented to outpatients for review and further investigation. Significant radiofemoral delay was found on palpation of pulses, and an ejection systolic murmur heard over the praecordium. Blood pressure was recorded as 190/70 mmHg, despite therapy including irbesartan 300 mg, amlodipine 5 mg and atenolol 50 mg. Transthoracic

Introduction Throughout this supplement, there has been discussion of the epidemiology of cardiovascular disease within people with diabetes, and a focus on the management of glycaemia. Given that the majority of people with diabetes ultimately die a premature cardiovascular death, diabetes management has become synonymous with cardiovascular risk reduction. However, since the United Kingdom Prospective Diabetes Study (UKPDS),1 it has become increasingly clear that the multi-factorial nature of diabetes requires a multi-factorial approach. Initially, much of this was extrapolated from existing cardiovascular data, with diabetes just being re

Introduction Peri-partum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy with symptoms and signs of heart failure, secondary to disorders of ventricular systolic function, in late pregnancy or postpartum, where no other cause of heart failure is found. PPCM is one of the main causes of maternal death worldwide. Data in the US show the incidence of PPCM reaches one in 2,500 to 4,000 pregnancies, while data on the incidence in Indonesia are still unknown. Data from the 2012 IDHS (Indonesian Demographic and Health Survey) showed heart failure, including PPCM, as the cause of a high maternal mortality rate in Indonesia reaching 228 per 100,