The Management of Hypertension in 2018: What Should the Targets Be?

Ali, Waleed; Bakris, George L.

doi:10.1007/s11906-019-0946-7

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…The monitoring of maternal haemodynamics has demonstrated promising results for the early identification and patient precise targeting of treatment of maternal hypertension [ 31 •, 35 , 36 , 37 •]. We present a series of three consecutive case studies to demonstrate the principles supporting this promising and rapidly evolving clinical approach to maternal hypertension.…”

Section: Introductionmentioning

confidence: 99%

Maternal Hypertension, Advanced Doppler Haemodynamics and Therapeutic Precision: Principles and Illustrative Cases

Phillips

Kong

et al. 2020

Curr Hypertens Rep

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Purpose of Review Maternal hypertension is a common and serious condition associated with increased maternal and foetal morbidity and mortality, with early detection and management improving outcomes. Recent Findings Blood pressure (BP) changes of pre-eclampsia are defined after 20 gestational weeks, while haemodynamic changes can be detected at 5-11 weeks using a specialised non-invasive Doppler stroke volume (SV) monitor. Thus, advanced haemodynamic monitoring allows for physiologically precise identification of circulatory abnormalities, and implementation of appropriate therapy within the first trimester. We measured the oscillometric BP and advanced haemodynamics (USCOM 1A) of 3 unselected women with singleton pregnancies, consecutively listed for therapeutic induction for maternal hypertension at 32-41 weeks gestational age. While the BP's of the patients varied, it was the haemodynamics, particularly SV, cardiac output, systemic vascular resistance, Smith Madigan Inotropy Index, and oxygen deliver, that identified differing patterns of circulatory dysfunction, therapeutic objectives, and predicted post-partum complications of the mother and child. Summary First trimester screening of maternal haemodynamics may allow for earlier detection of circulatory derangements, selection of patient precise interventions, and improved maternal-foetal outcomes.

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Section: Introductionmentioning

confidence: 99%

Maternal Hypertension, Advanced Doppler Haemodynamics and Therapeutic Precision: Principles and Illustrative Cases

Phillips

Kong

et al. 2020

Curr Hypertens Rep

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“…These data also confirm the long‐standing association of hypertension with risk of brain structural changes and cognitive decline in women and men, and emphasise the need to monitor women with histories of pre‐eclampsia regularly after their pregnancy to treat hypertension at its earliest stage. Changes in recent guidelines in the USA for defining hypertension will help to reduce the adverse effects of hypertension on cerebrovascular function in women by having treatments initiated earlier at lower values of systolic pressure …”

Section: Pregnancy Historymentioning

confidence: 99%

Risk factors of neurovascular ageing in women

Miller

Jayachandran

Barnes

et al. 2019

J Neuroendocrinology

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Biological sex and changes in sex hormones throughout life influence all aspects of health and disease. In women, changes in sex hormonal status reflect ovarian function, pregnancy and the use of exogenous hormonal treatments. Longitudinal data from defined cohorts of women will help to identify mechanisms by which the hormonal milieu contributes to cerebrovascular ageing, brain structure and ultimately cognition. This review summarises the phenotypes of three cohorts of women identified through the medical records‐linkage system of the Rochester Epidemiology Project and the Mayo Clinic Specialized Center of Research Excellence (SCORE) on Sex Differences: (i) menopausal women with histories of normotensive or hypertensive pregnancies; (ii) women who had bilateral oophorectomy ≤45 years of age; and (iii) women who experienced natural menopause and used menopausal hormone treatments for 4 years. Data from these cohorts will influence the design of follow‐up studies concerning how sex hormonal status affects neurovascular ageing in women.

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“…In 2018, the American College of Cardiology (ACC) and the American Heart Association (AHA) also released a new clinical practice guideline for the prevention, detection, evaluation, and treatment of high blood pressure (BP) in adults (Whelton et al, 2018). Ali and Bakris (2019) provide an overview of the different guidelines for hypertension management from around the world. Despite the availability of many effective antihypertensive drugs and the effectiveness of the treatment of hypertension, the prevalence of hypertension is increasing in the world.…”

Section: Introductionmentioning

confidence: 99%

Study on Risk and Influencing Factors of Hypertension in Chinese Elderly

Song

2019

Gerontology and Geriatric Medicine

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Objective: The incidence of hypertension in elderly patients in China and influencing factors. Method: Based on the baseline data in 2013 from the China Health and Retirement Longitudinal Study (CHARLS), this study used the practical incidence estimator (PIE) method to estimate incidence of hypertension, and applied Cox regression to determine the relationship between the hypertension and influencing factors. Results: In general, the incidence of hypertension in elderly patients decreased with age, and the risk of hypertension in females was significantly higher than that in males. The cumulative incidence of hypertension for an individual, who is hypertension-free before the age of 65 years, could reach 86.21% (95% confidence interval [CI] = [85.09%, 87.87%]) during one’s survival time. The status of drinking, pension and work, education background, place of residence, and gender were verified to influence the onset of hypertension. Conclusion: For Chinese elderly, developing hypertension during their life span has almost become an inevitable event, which may become a huge social burden in China.

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The Management of Hypertension in 2018: What Should the Targets Be?

Cited by 13 publications

References 18 publications

Maternal Hypertension, Advanced Doppler Haemodynamics and Therapeutic Precision: Principles and Illustrative Cases

Maternal Hypertension, Advanced Doppler Haemodynamics and Therapeutic Precision: Principles and Illustrative Cases

Risk factors of neurovascular ageing in women

Study on Risk and Influencing Factors of Hypertension in Chinese Elderly

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