2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

Whelton, Paul K.; Carey, Robert M.; Aronow, Wilbert S.; Casey, Donald E.; Collins, Karen J.; Himmelfarb, Cheryl Dennison; DePalma, Sondra M.; Gidding, Samuel S.; Jamerson, Kenneth; Jones, Daniel W.; MacLaughlin, Eric J.; Muntner, Paul; Ovbiagele, Bruce; Smith, Sidney C.; Spencer, Crystal C.; Stafford, Randall S.; Taler, Sandra J.; Thomas, Randal J.; Williams, Kim A.; Williamson, Jeff D.; Wright, Jackson T.

doi:10.1016/j.jacc.2017.11.006

Cited by 4,940 publications

(3,277 citation statements)

References 818 publications

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“…Considering the present stage of knowledge, it may thus be appropriate that in individuals with type 2 diabetes, guidelines recommend an SBP target close to but not less than 130 mmHg, with a DBP <80 mmHg and >70 mmHg. It should be emphasised, however, that data on the optimal blood pressure target for patients with diabetes do not cover the entire diabetic population and are sometimes inconsistent [44], explaining the different interpretations of data and conclusions drawn. Moreover, the database on which conclusions have been drawn is not scientifically impeccable [1] since, in most trials, antihypertensive agents were used for purposes different from those of determining the benefit of blood pressure-lowering interventions, an approach that may generate confounding.…”

Section: Resultsmentioning

confidence: 99%

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Mancia

2018

Diabetologia

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When associated with high blood pressure, type 2 diabetes mellitus is characterised by a high risk of adverse cardiovascular (CV) and renal outcomes. However, both can be effectively reduced by antihypertensive treatment. Current guidelines on the treatment of hypertension emphasize the need to effectively treat high blood pressure in diabetic individuals, but their recommendations differ in terms of the optimal target blood pressure value to aim for in order to maximise CV and renal protection. In some guidelines the recommended target blood pressure values are <140/90 mmHg (systolic/diastolic), whereas in others, blood pressure values close or even less than 130/80 mmHg are recommended. This paper will discuss the evidence for and against a conservative or more aggressive blood pressure target for treated diabetic hypertensive individuals based on the evidence provided by randomised trials, trial meta-analyses and large observational studies. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg.

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Section: Resultsmentioning

confidence: 99%

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Mancia

2018

Diabetologia

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“…Perkembangan penyakit ini dapat ditekan tidak hanya dengan pengobatan/kuratif tetapi juga dengan tindakan preventif. 3,4 Upaya penanganan penyakit hipertensi dan komplikasi yang mungkin terjadi perlu ditingkatkan untuk menurunkan tingkat morbiditas dan mortalitas, dan oleh karena itu dibutuhkan suatu upaya preventif yang diberikan melalui pemahaman, pengetahuan, dan pengaturan pola hidup pasien hipertensi. Tingkat pengetahuan serta pemahaman pasien hipertensi terkait penyakitnya dapat menunjang keberhasilan terapi sehingga tekanan darah pasien dapat terkontrol dengan baik.…”

Section: Pendahuluanunclassified

Assessment of Knowledge on Hypertension among Hypertensive Patients in Bandung City: A Preliminary Study

Sinuraya¹,

Siagian

Taufik

et al. 2017

Indones J Clin Pharm

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AbstrakHipertensi merupakan penyebab umum dalam peningkatan angka mortalitas dan mobiditas di masyarakat. Selain merupakan silent killer, prevalensi penyakit ini semakin meningkat di seluruh dunia. Prevalensi hipertensi di Indonesia 25,8% dan Jawa Barat berada di peringkat keempat dengan prevalensi 29,4%. Penelitian ini bertujuan untuk mengukur tingkat pengetahuan pasien hipertensi terkait penyakit yang dideritanya. Studi ini merupakan penelitian observasional menggunakan rancangan potong lintang dan dilakukan pada bulan Juni-Oktober 2017 di Apotek Pendidikan Universitas Padjadjaran, Kota Bandung. Sejumlah seratus lima puluh responden mengisi kuesioner yang telah divalidasi setelah menandatangani informed consent terlebih dahulu. Hasil penelitian menunjukkan bahwa sebanyak 56,7% dari responden memiliki tingkat pengetahuan baik, 40% dari responden memiliki tingkat pengetahuan cukup, dan 3,3% dari responden memiliki tingkat pengetahuan kurang. Data kemudian diolah secara statistik sehingga diperoleh hasil bahwa tidak terdapat perbedaan bermakna (p>0,05) antara setiap kelompok responden terhadap sosiodemografi dan karakteristik klinis pasien. Hanya sekitar 50% responden yang memiliki tingkat pengetahuan baik, pasien yang memiliki tingkat pengetahuan cukup dan kurang umumnya adalah pasien dengan tingkat pendidikan rendah dan menderita hipertensi kurang dari lima tahun. Kata kunci: Fasilitas kesehatan primer, hipertensi, tingkat pengetahuan Assessment of Knowledge on Hypertension among Hypertensive Patients in Bandung City: A Preliminary Study AbstractHypertension is a common health problems that can increase the mortality and mobility rate in the community. As a silent killer, the prevalence of this disease is increasing worldwide. The prevalence of hypertension in Indonesia is 25.8% and West Java is ranked at top four with prevalence of 29.4%. This study aimed to measure the level of knowledge of hypertensive patients about their disease. This study was an observational study using cross-sectional design in June-October 2017 at Apotek Pendidikan Universitas Padjadjaran, Bandung City. A total of one hundred and fifty respondents completed a validated questionnaire after signing informed consent. The results showed that 56.7% of respondents have "good" level of knowledge, 40% of respondents have "moderate" level of knowledge, and 3.3% of respondents have "poor" level of knowledge. Data were analyzed statistically, the results showed that there was no significant difference (p>0.05) between each group of respondents to sociodemographic and clinical characteristics of the patients. Only fifty percent of respondents have "good" level of knowledge, patients who have "moderate" and "poor" level of knowledge generally are patients with low levels of education and suffer from hypertension less than five years.

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“…No existen guías basadas en evidencia firme para orientar el tratamiento de la HTA en el paciente con cáncer y las principales normativas sobre HTA (procedentes del American College of Cardiology/American Heart Association y European Society of Cardiology/European Society of Hypertension) apenas mencionan el tema (28,29) . De modo que si bien los lineamientos generales que establecen las mencionadas guías sobre diagnóstico y tratamiento tienen plena vigencia en los pacientes con cáncer, en aspectos más específicos del manejo debemos basarnos en opiniones de expertos.…”

Section: Manejo De La Hipertensión Arterial En El Paciente Con Cáunclassified

Hipertensión arterial y tratamiento del cáncer

Paganini

2018

Rev.Urug.Cardiol.

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ResumenLa hipertensión arterial (HTA) tiene alta prevalencia y es la comorbilidad más frecuente al momento del diagnóstico de cáncer. La nueva aparición o el agravamiento de la HTA durante el tratamiento oncológico es también común, sobre todo durante los períodos de quimioterapia. Si bien varias drogas utilizadas en quimioterapia tienen potencial pro hipertensivo, los fármacos inhibidores de la angiogénesis tienen un efecto de clase sobre la presión arterial (PA) y son los que plantean mayores problemas al médico. Los tratamientos de sostén también pueden incrementar la PA, sobre todo la eritropoyetina, los antiinflamatorios no esteroideos y los corticoesteroides. No existe una guía específica basada en evidencia para el manejo de la HTA durante el tratamiento del cáncer, por tanto se revisan las recomendaciones de expertos para enfrentar este problema frecuente. Palabras clave: Hypertension and cancer treatment SummaryHypertension is highly prevalent and the most frequent comorbidity at the initial diagnosis of cancer. New onset or worsening hypertension is also common during cancer treatment, in particular during chemotherapy periods. Several drugs used in chemotherapy could have an hypertensive effect, for instance angiogenesis inhibitors have a class effect on blood pressure and frequently clinicians confront this problem. Adjuvant drugs in cancer treatment could also increase blood pressure, especially erythropoietin, non-steroidal anti-inflammatory drugs and corticosteroids. There are not specific evidence based guidelines for the management of hypertension during cancer treatment, for that reason we review expert suggestions to deal with this frequent issue. Key words: HYPERTENSION NEOPLASMS CHEMOTHERAPY ANGIOGENESIS INHIBITORS I. Convergencia epidemiológicaLa prevalencia promedio de hipertensión arterial (HTA) en la población adulta (mayor de 25 años) de las Américas ha sido estimada en 35%, según un reporte de la Organización Mundial de la Salud del año 2013 (1) . Esta prevalencia es creciente con la edad, por lo que se encuentra presente en la mayoría de las personas que tienen más de 60 años. La prevalencia de cáncer también aumenta con la edad y comparte varios factores de riesgo con la enfermedad cardiovascular (tabaco, dieta inadecuada, obesidad, sedentarismo). La HTA constituye la comorbilidad más frecuente entre los pacientes con diagnóstico inicial de cán-cer, con una prevalencia que se ha estimado próxima a 40% o mayor en esa población (2)(3)(4) . Asimismo, estudios epidemiológicos recientes ajustados por edad y otras variables han encontrado un riesgo aumentado de cáncer y de mortalidad por esta causa entre los pacientes hipertensos (5,6) .La aparición de nuevos casos de HTA o el agravamiento de la misma en quienes ya la padecen es muy común durante el tratamiento del cáncer. En un estudio retrospectivo de más de 25.000 pacientes con varios tipos de cáncer, que registraron una presión arterial (PA) normal al momento del diagnóstico (independientemente de sus anteceden- 43MP Medicina Personali...

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2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

Cited by 4,940 publications

References 818 publications

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Assessment of Knowledge on Hypertension among Hypertensive Patients in Bandung City: A Preliminary Study

Hipertensión arterial y tratamiento del cáncer

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