International Journal of Cardiology: Hypertension最新文献

{"title":"Ageing, hypertension and aortic valve stenosis – Understanding the series circuit using cardiac magnetic resonance and applanation tonometry","authors":"S.L. Hungerford ,&nbsp;A.I. Adji ,&nbsp;N.K. Bart ,&nbsp;L. Lin ,&nbsp;N. Song ,&nbsp;A. Jabbour ,&nbsp;M.F. O'Rourke ,&nbsp;C.S. Hayward ,&nbsp;D.W.M. Muller","doi":"10.1016/j.ijchy.2021.100087","DOIUrl":"10.1016/j.ijchy.2021.100087","url":null,"abstract":"<div><h3>Background</h3><p>Aortic stenosis (AS) is no longer considered to be a disease of fixed left ventricular (LV) afterload, but rather, functions as a series circuit, with important contributions from both the valve and vasculature. Patients with AS are typically elderly, with hypertension and a markedly remodelled aorta. The arterial component is sizeable, and yet, quantifying this to-date has been difficult to determine. We compared measurement of aortic pressure, flow and global LV load using a cardiac magnetic resonance (CMR)/applanation tonometry (AT) technique to uncouple ventriculo-arterial (VA) interactions.</p></div><div><h3>Methods</h3><p>20 healthy elderly patients and 20 with AS underwent a CMR/AT protocol. CMR provided LV volume and aortic flow simultaneously with AT pressure acquisition. Aortic pressure was derived by transformation of the AT waveform. Systemic vascular resistance (SVR) and global LV load were determined as the relationship of pressure to flow in the frequency domain. Values from both cohorts were compared.</p></div><div><h3>Results</h3><p>AS patients were older (p ​&lt; ​0.01) albeit with no significant difference in brachial or central aortic pressure. SVR (14228 vs 19906 ​dyne ​s.cm⁻³; p ​= ​0.02) and load (740 vs 946 ​dyne ​s.cm⁻³; p ​= ​0.02) were higher in patients with AS, whilst aortic peak flow velocity was lower (38 vs 58 ​cm/s; p ​&lt; ​0.01).</p></div><div><h3>Conclusions</h3><p>Quantification of aortic pressure, flow velocity and global LV load using a simultaneous CMR/AT technique is able to demonstrate the progressive effects of hypertension and aortic stiffening with advanced age and valvular stenosis. This technique may help to better identify future patients at risk of VA coupling mismatch after correction of AS.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39091634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with antihypertensive treatment intensification and deintensification in older outpatients","authors":"Carole E. Aubert ,&nbsp;Jin-Kyung Ha ,&nbsp;Eve A. Kerr ,&nbsp;Timothy P. Hofer ,&nbsp;Lillian Min","doi":"10.1016/j.ijchy.2021.100098","DOIUrl":"10.1016/j.ijchy.2021.100098","url":null,"abstract":"<div><h3>Background</h3><p>New hypertension performance measures encourage more intensive treatment in older adults. Treatment intensification includes starting new medications and increasing the dose of old ones. Medication dose is particularly important to older adults, given their vulnerability to dose-related side effects. We previously validated a standardized measure of beneficial doses tested in hypertension trials, Hypertension Daily Dose (HDD).</p></div><div><h3>Aim of the study</h3><p>To test whether changes in treatment intensity using HDD was associated with systolic blood pressure (SBP) and patient characteristics.</p></div><div><h3>Methods</h3><p>Longitudinal study of all Veterans aged ≥65 years with a diagnosis of hypertension. We defined 3 groups of risk: 1) cardiovascular risk; 2) geriatric/frail; 3) low-risk (comparator). Using multinomial regression, we assessed the probability of deintensification, intensification, vs. stable treatment, according to SBP and group.</p></div><div><h3>Results</h3><p>Among 1,331,111 Veterans, 19.9% had deintensification, and 29.6% intensification. Deintensification decreased, while intensification increased, with SBP. Compared to low-risk patients, cardiovascular risk patients had 1.11 (95% CI 1.10–1.13) times the odds of intensifying, and geriatric/frail patients 1.45 (95%CI 1.43–1.47) times the odds of deintensifying.</p></div><div><h3>Discussion</h3><p>Patient-level HDD change was consistent with an expected association with cardiovascular risk and geriatric/frail conditions, suggesting that HDD can be used longitudinally to assess hypertension treatment modification in large health systems.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39181243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why is salt-sensitivity of blood pressure, a known cardiovascular risk factor, not treated?","authors":"Fernando Elijovich,&nbsp;Cheryl L. Laffer","doi":"10.1016/j.ijchy.2021.100096","DOIUrl":"10.1016/j.ijchy.2021.100096","url":null,"abstract":"","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of family history with incidence and gestational hypertension outcomes of preeclampsia","authors":"Chia-Tung Wu ,&nbsp;Chang-Fu Kuo ,&nbsp;Chia-Pin Lin ,&nbsp;Yu-Tung Huang ,&nbsp;Shao-Wei Chen ,&nbsp;Hsien-Ming Wu ,&nbsp;Pao-Hsien Chu","doi":"10.1016/j.ijchy.2021.100084","DOIUrl":"10.1016/j.ijchy.2021.100084","url":null,"abstract":"<div><h3>Background</h3><p>Gestational hypertension and preeclampsia are hypertensive disorders related to pregnancy that can cause maternal morbidity and fetal growth retardation. The association of these disorders with family history remains unclear.</p></div><div><h3>Objectives</h3><p>To examine the degree of family aggregation of preeclampsia and gestational hypertension in Taiwan.</p></div><div><h3>Methods</h3><p>The study was conducted using the data from the National Health Insurance Database of Taiwan. Delivery events in Taiwan from 1999 to 2013 were collected. Preeclampsia was identified based on the hospital diagnosis of index delivery. The family aggregation pattern of preeclampsia was assessed and analyzed using the relationship registered in the database with the patients.</p></div><div><h3>Results</h3><p>A total of 60,314 preeclampsia events were identified among 4,091,641 deliveries, accounting for 1.5% of the cohort. The incidence of preeclampsia increased with maternal age. A total of 768 preeclampsia events occurred in mothers who had a sororal history of preeclampsia (n = 20,704), accounting for 1.3% of all preeclampsia events (n = 60,314). Mothers who had a sororal history of preeclampsia had a relative risk (RR) of 2.6 (95% confidence interval [CI]: 2.41–2.80) for preeclampsia compared with mothers who did not have a sororal history of preeclampsia. The RR for gestational hypertension was 2.79 (95% CI: 2.36–3.3) in mothers with a positive sororal history of gestational hypertension.</p></div><div><h3>Conclusions</h3><p>Having a sororal history of preeclampsia was a strong risk factor for preeclampsia and gestational hypertension in mothers in Taiwan. The pattern of family aggregation was similar at all maternal ages.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39012945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 morbidity and mortality associated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers use among 14,129 patients with hypertension from a US integrated healthcare system","authors":"Jaejin An ,&nbsp;Hui Zhou ,&nbsp;Rong Wei ,&nbsp;Tiffany Q. Luong ,&nbsp;Michael K. Gould ,&nbsp;Matthew T. Mefford ,&nbsp;Teresa N. Harrison ,&nbsp;Beth Creekmur ,&nbsp;Ming-Sum Lee ,&nbsp;John J. Sim ,&nbsp;Jeffrey W. Brettler ,&nbsp;John P. Martin ,&nbsp;Angeline L. Ong-Su ,&nbsp;Kristi Reynolds","doi":"10.1016/j.ijchy.2021.100088","DOIUrl":"10.1016/j.ijchy.2021.100088","url":null,"abstract":"<div><h3>Objective</h3><p>Although recent evidence suggests no increased risk of severe COVID-19 outcomes associated with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) use, the relationship is less clear among patients with hypertension and diverse racial/ethnic groups. This study evaluates the risk of hospitalization and mortality among patients with hypertension and COVID-19 in a large US integrated healthcare system.</p></div><div><h3>Methods</h3><p>Patients with hypertension and COVID-19 (between March 1- September 1, 2020) on ACEIs or ARBs were compared with patients on other frequently used antihypertensive medications.</p></div><div><h3>Results</h3><p>Among 14,129 patients with hypertension and COVID-19 infection (mean age 60 years, 48% men, 58% Hispanic), 21% were admitted to the hospital within 30 days of COVID-19 infection. Of the hospitalized patients, 24% were admitted to intensive care units, 17% required mechanical ventilation, and 10% died within 30 days of COVID-19 infection. Exposure to ACEIs or ARBs prior to COVID-19 infection was not associated with an increased risk of hospitalization or all-cause mortality (rate ratios for ACEIs vs other antihypertensive medications ​= ​0.98, 95% CI: 0.88, 1.08; ARBs vs others ​= ​1.00, 95% CI: 0.90, 1.11) after applying inverse probability of treatment weights. These associations were consistent across racial/ethnic groups. Use of ACEIs or ARBs during hospitalization was associated with a lower risk of all-cause mortality (odds ratios for ACEIs or ARBs vs others ​= ​0.50, 95% CI: 0.34, 0.72).</p></div><div><h3>Conclusion</h3><p>Our study findings support continuation of ACEI or ARB use for patients with hypertension during the COVID-19 pandemic and after COVID-19 infection.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9529923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical questions in cardiovascular risk: What nutrition labels should be used on food?","authors":"Roberto Volpe","doi":"10.1016/j.ijchy.2021.100095","DOIUrl":"10.1016/j.ijchy.2021.100095","url":null,"abstract":"","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced global longitudinal strain at rest and inadequate blood pressure response during exercise treadmill testing in male heterozygous familial hypercholesterolemia patients","authors":"Vasiliki Vartela ,&nbsp;Iakovos Armenis ,&nbsp;Dimitra Leivadarou ,&nbsp;Konstantinos Toutouzas ,&nbsp;Konstantinos Makrilakis ,&nbsp;George D. Athanassopoulos ,&nbsp;George Karatasakis ,&nbsp;Genovefa Kolovou ,&nbsp;Sophia Mavrogeni ,&nbsp;Despina Perrea","doi":"10.1016/j.ijchy.2021.100083","DOIUrl":"10.1016/j.ijchy.2021.100083","url":null,"abstract":"<div><h3>Background</h3><p>Heterozygous familial hypercholesterolemia (heFH) is a genetic disorder leading to premature coronary artery disease (CAD). We hypothesized that the subclinical pathophysiologic consequences of hypercholesterolemia may be detected before the occurrence of clinically overt CAD by stress testing and myocardial strain imaging.</p></div><div><h3>Patients-methods</h3><p>We evaluated the treadmill tests (ETTs) of 46 heFH men without known arterial hypertension/diabetes mellitus/vasculopathy like CAD and of 39 healthy men matched for age, baseline systolic/diastolic blood pressure (BP) and heart rate (HR), using Bruce protocol. Global longitudinal strain (GLS) of the left ventricle (LV) additionally to ejection fraction was obtained.</p></div><div><h3>Results</h3><p>heFH men reached a significantly higher peak systolic and diastolic BP compared to controls (p = 0.002 and p &lt; 0.001, respectively). Mean rate pressure product was significantly higher in heFH patients (p = 0.038). Both duration of the ETT and workload in metabolic equivalents was lower in the heFH group (p &lt; 0.001 and p &lt; 0.001, respectively). Baseline to peak rise of systolic and diastolic BP in heFH men was higher (p = 0.008 and p &lt; 0.001 for systolic and diastolic BP, respectively). Furthermore, heFH men had higher rise of HR from baseline to peak, compared to controls; (p = 0.047). GLS in heHF men was slightly decreased (p = 0.014), although the ejection fraction was similar in both groups.</p></div><div><h3>Conclusion</h3><p>heFH men have a higher rise in systolic/diastolic BP during ETT, which may reflect early, preclinical hypertension. Furthermore, slight impairment of LV GLS is present, despite the absence of apparent myocardial dysfunction in conventional 2D echocardiography.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39000811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial strain impairment, heterozygous familial hypercholesterolemia and systemic arterial hypertension: Is there a link?","authors":"Antonio Vitarelli","doi":"10.1016/j.ijchy.2021.100086","DOIUrl":"10.1016/j.ijchy.2021.100086","url":null,"abstract":"<div><p>Dyslipidemia is known as a strong risk factor for premature atherosclerotic cardiovascular disease and increased morbidity and mortality and can have an adverse effect on left ventricular function due to direct or indirect macrovascular and/or microvascular damage. Speckle-tracking echocardiography allows the assessment of subclinical cardiac dysfunction in different diseases on the basis of myocardial deformation indices, and decrease in longitudinal and circumferential strain was shown in patients with heterozygous familial hypercholesterolemia (heFH) without comorbidities. In this issue of the journal a new study presents the results in a well-defined population which included asymptomatic treatment-naive heFH individuals without known coronary/peripheral arterial disease, with normal left ventricular ejection fraction and no other risk factors as formal arterial hypertension or diabetes mellitus. A slight impairment of global longitudinal strain was present, despite normal standard echocardiographic parameters. Also, the higher rise in systolic and diastolic blood pressure of heHF patients during exercise treadmill test might reflect early preclinical hypertension. High cholesterol level may have produced endothelial dysfunction, which has been shown to be related to the extent of atherosclerotic process and cardiovascular damage. Relevant findings are reported on left ventricular strain reduction and increase in systolic/diastolic blood pressure in asymptomatic heFH males. The relationship between myocardial strain impairment and developing systemic arterial hypertension in hypercholesterolemic patients could be the subject of further subsequent investigation.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39067622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial stiffness is associated with cardiovascular and cancer mortality in cancer patients: Insight from NHANESIII","authors":"Shannon K. Parr ,&nbsp;Catherine C. Steele ,&nbsp;Stephen T. Hammond ,&nbsp;Vanessa Rose G. Turpin ,&nbsp;Carl J. Ade","doi":"10.1016/j.ijchy.2021.100085","DOIUrl":"10.1016/j.ijchy.2021.100085","url":null,"abstract":"<div><h3>Background</h3><p>Cancer survivors are at greater risk for cardiovascular disease (CVD) than second malignancy, resulting in a decreased quality of life and increased cost of care. Additional knowledge of CVD prevention by identifying possible risk factors has clinical relevance. Our main objective was to determine the relevance of a clinical index of arterial stiffness, pulse pressure, in predicting CVD mortality in cancer patients, with a second objective to examine its relationship with cancer mortality.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed 781 cancer patients from Third National Health and Nutrition Examination Survey and Linked Mortality File, including demographic, anthropometric, blood pressure, and cause of death. Kaplan-Meier survival curve and Cox hazard regression analyses were performed to assess the relationship between pulse pressure and cardiovascular, cancer, and all-cause mortality.</p></div><div><h3>Results</h3><p>During a mean follow-up time of 8.1 years, 603 deaths, 257 cancer and 151 CVD, occurred. In unadjusted models, the risk of CVD, cancer, and all-cause mortality were 3.8-fold, 5.3-fold, and 1.6-fold higher, respectively, for pulse pressure ≥70 ​mmHg compared to &lt;50 ​mmHg. Adjusted analyses revealed a higher CVD mortality in cancer patients &lt;65 years with a pulse pressure 60–70 ​mmHg (adjusted hazard ratio, 5.26; 95%CI, 1.12–24.78) when compared to pulse pressure of &lt;50 ​mmHg. Pulse pressure was not associated with risk of all-cause, CVD, or cancer in those ≥65 years.</p></div><div><h3>Conclusion</h3><p>Pulse pressure, an index of arterial stiffness, is predictive of CVD mortality in cancer patients. Our findings support non-invasive office-setting measurements of arterial stiffness to identify high risk patients.</p></div>","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39067621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it time we consider treating blood pressure measurement as a real medical test?","authors":"Angela M. McGinnis,&nbsp;John D. Bisognano","doi":"10.1016/j.ijchy.2021.100097","DOIUrl":"10.1016/j.ijchy.2021.100097","url":null,"abstract":"","PeriodicalId":36839,"journal":{"name":"International Journal of Cardiology: Hypertension","volume":"9 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ijchy.2021.100097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39204533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}