Isolated systolic hypertension is the most common hemodynamic form of hypertension in the elderly. With a rapidly aging population, the prevalence of hypertension, particularly isolated systolic hypertension, is increasing steadily. Isolated systolic hypertension is associated with substantial mortality and morbidity, particularly of cerebrovascular disease. It is a rapidly growing public health concern and its management continues to remain a challenge to practicing physicians. Recent studies like the Systolic Blood Pressure Intervention Trial (SPRINT) and Heart Outcomes Prevention Evaluation (HOPE)-3 have implications for antihypertensive therapy in general and for the management of isolated systolic hypertension in particular.
Blood clotting is a well-known phenomenon which is intended to provide protection in case of any external cellular/ tissue injury. However, this phenomenon in COVID-19 patients is leading to unusual thrombotic presentations. Since the emergence of novel coronavirus, World has come across various benign as well as lethal manifestations in COVID-19 patients and one such life-threatening manifestation which needs rigorous attention is the genesis of strange blood clots that can travel and get logged into several parts of the COVID-19 patients leading to various clinical presentations. COVID-19 infection is caused due to interaction of spike glycoproteins of coronavirus with ACE 2 receptors on the host cell surface. This interaction in the arteries, veins or capillaries could lead to injury in the vascular wall of blood vessels that can directly/Indirectly lead to coagulation and clotting cascades activation and subsequent formation of internal blood clots. However, it is undesirable to have the presence of these clots as they could lead to certain fatal complications that need emergency medical intervention or else, they may lead to the death of a patient. Due to the severity of this manifestation, early detection of these blood clots in covid-19 patients become very important intervention which could be done by observing certain specific signs and symptoms and/or with the help of various laboratory biomarkers like D-dimer, platelet count, erythrocyte sedimentation rate (ESR), ferritin, fibrinogen, etc. Once the early diagnosis is made, the patient can be treated appropriately with the help of anticoagulant therapy, which includes use of oral and parenteral anticoagulant drugs. This way the complications of blood coagulation like thrombo-embolism, could be prevented.
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