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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  HYPERTENSION AND NEUROGENIC IMPACT
Hypertension and Ischemic Stroke
Sudhir Kumar
[Year:2016] [Month:January-March] [Volume:2 ] [Number:1] [Pages:53] [Pages No:39-43] [No of Hits : 925]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0028 | FREE

ABSTRACT

Stroke is among the leading causes of death and disability worldwide. Ischemic stroke is 3 to 4 times more common than hemorrhagic stroke. Hypertension is the commonest risk factor for ischemic stroke, in addition to diabetes mellitus, dyslipidemia and smoking. Blood pressure (BP) lowering with appropriate antihypertensive agents would lead to reduction of first ever stroke as well as recurrent strokes. This article discusses the epidemiology of strokes in India, role of hypertension in ischemic stroke causation and its recurrence; BP targets to be achieved, and the preferred antihypertensive agents. In addition, management of hypertension in the setting of acute ischemic stroke is also discussed. Blood pressure lowering is generally avoided within the first 24 hours after acute ischemic stroke. Proper BP management is one of the keys to ensure better outcomes in acute stroke setting.

Keywords: Antihyper tensive agents, Epidemiology, Hypertension, India, Ischemic, Prevention, Risk factor, Stroke, Stroke recurrence, Target BP.

How to cite this article: Kumar S. Hypertension and Ischemic Stroke. Hypertens J 2016;2(1):39-43.

Source of support: Nil

Conflict of interest: None

 
2.  SECONDARY HYPERTENSION
Severe Paroxysmal Hypertension: Pseudopheochromocytoma
Samuel J Mann
[Year:2016] [Month:April-June] [Volume:2 ] [Number:2] [Pages:53] [Pages No:96-102] [No of Hits : 808]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0038 | FREE

ABSTRACT

Paroxysmal hypertension always engenders a search for a catecholamine-secreting pheochromocytoma (pheo). However, in 98% of cases, a pheo is not found, and the cause and management of the paroxysmal hypertension have remained a largely unstudied mystery. This review presents an approach to understanding and successfully treating this disorder, which is increasingly known as “pseudopheochromocytoma,” or “pseudopheo.” Patients with this disorder experience sudden, unprovoked, and symptomatic blood pressure elevations that are likely linked to stimulation of the sympathetic nervous system. Psychological characteristics associated with this disorder suggest a basis in repressed emotion related either to prior emotional trauma or to a repressive (nonemotional) coping style. Based on this understanding, successful intervention is possible in most of the cases. Hypertensive paroxysms can usually be managed acutely with an anxiolytic agent, such as alprazolam, an antihypertensive agent that targets the sympathetic nervous system, such as clonidine, or a combination of the two. Severe paroxysms may require an intravenous agent, such as labetalol or nitroprusside. In patients with severe and/or frequent paroxysms, recurrence of paroxysms can be prevented in most of the cases with an antidepressant drug. The importance of reassurance cannot be overstated. The possible role of psychotherapeutic intervention requires further study. Fortunately, with appropriately selected intervention, paroxysms can be effectively treated or eliminated in most patients.

Keywords: Catecholamines, Hypertension, Labile hypertension, Paroxysmal hypertension, Pheochromocytoma, Pseudopheochromocytoma.

How to cite this article: Mann SJ. Severe Paroxysmal Hypertension: Pseudopheochromocytoma. Hypertens J 2016;2(2):96-102.

Source of support: Nil

Conflict of interest: None

 
3.  THERAPEUTIC UPDATE
Therapeutic Role of Beta-blockers in Hypertension: A Pragmatic Reappraisal
Soumitra Kumar
[Year:2016] [Month:April-June] [Volume:2 ] [Number:2] [Pages:53] [Pages No:80-85] [No of Hits : 519]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0036 | FREE

ABSTRACT

Beta-blockers have been used as first-time antihypertensives for decades and such use has also been recommended by guidelines. However, subsequently some meta-analyses questioned this status of beta-blockers by bringing to light their limitation in terms of stroke prevention and their metabolic sideeffects. Following this, several major international hypertension guidelines have removed beta-blockers from the first line of recommended drugs. Some other guidelines, however, have retained them as first-line antihypertensive. Age is an important determinant of choice of antihypertensives and beta-blockers have proven to be very useful in young hypertensives especially if overweight. Amidst these controversies, vasodilatory beta-blockers have emerged with a new promise. They are potent antihypertensives with better reduction of central aortic pressure and a neutral or favorable metabolic profile.

Keywords: Age, Metabolic effects, Stroke, Vasodilatory.

How to cite this article: Kumar S. Therapeutic Role of Betablockers in Hypertension: A Pragmatic Reappraisal. Hypertens J 2016;2(2):80-85.

Source of support: Nil

Conflict of interest: None

 
4.  Hemodynamics of hypertension
Central Aortic Blood Pressure and Pulse Wave Velocity as Additional Markers in Patients with Hypertension
Ravi R Kasliwal, Kushagra Mahansaria, Manish Bansal
[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages:57] [Pages No:73-82] [No of Hits : 1107]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0013 | FREE

ABSTRACT

Arterial stiffness is a pathological manifestation of cumulative vascular damage resulting from various known and unknown vascular risk factors. Central aortic pressure and pulse wave velocity are the two most commonly used and the most informative non-invasive measures of arterial stiffness. Numerous studies have documented incremental value of these measures in a variety of clinical conditions, most notably, hypertension. In hypertensive subjects, assessment of arterial stiffness not only provides incremental information about vascular risk, it also helps in guiding therapeutic decision making and serves as a tool for monitoring response to antihypertensive therapy.

Keywords: Arterial stiffness, Arteriosclerosis, Subclinical atherosclerosis, Vascular damage.

How to cite this article: Kasliwal RR, Mahansaria K, Bansal M. Central Aortic Blood Pressure and Pulse Wave Velocity as Additional Markers in Patients with Hypertension. Hypertens J 2015;1(2):73-82.

Source of support: Nil

Conflict of interest: None

 
5.  Status Report
Hypertension as a Public Health Problem in India
Rajeev Gupta
[Year:2015] [Month:July-September] [Volume:1 ] [Number:1] [Pages:61] [Pages No:1-3] [No of Hits : 855]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0001 | FREE

ABSTRACT

Hypertension is the most important risk factor for global morbidity and mortality. It has assumed epidemic proportions in India with an estimated 100 million patients. In recent decades, the disease is increasing more rapidly in rural than in urban population. Status of hypertension treatment and control is dismal in India with about a third of patients on treatment and only 20% controlled. Innovative system-based strategies using a combination of public health approaches and physician led clinic-based management are required to prevent premature cardiovascular disease burden due to hypertension.

Keywords: Cardiovascular disease, Hypertension epidemiology, Public health approach, Risk factors.

How to cite this article: Gupta R. Hypertension as a Public Health Problem in India. Hypertens J 2015;1(1):1-3.

Source of support: Nil

Conflict of interest: None

 
6.  Lifestyle changes
Yoga and Hypertension
Subhash Chandra Manchanda, Kushal Madan
[Year:2015] [Month:July-September] [Volume:1 ] [Number:1] [Pages:61] [Pages No:28-33] [No of Hits : 720]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0005 | FREE

ABSTRACT

Hypertension is a major public health problem and is an important risk factor for stroke, coronary heart disease and renal failure. The blood pressure is not well controlled with drug therapy in large number of individuals, especially in the developing countries. There is a need for less expensive nonpharmacological alternative methods to control blood pressure. Yoga may be such cost-effective alternative. Several uncontrolled and randomized control trials have evaluated short- and long-term effects of yoga/meditation-based techniques in prehypertension and mild hypertension. Though, the results are mixed and there are several methodological limitations in reported studies, majority of studies demonstrate a modest decrease in both systolic and diastolic blood pressure. This modest decrease may significantly decrease the stroke mortality and coronary heart disease in general population. A recent scientific statement of American Heart Association also suggests that it is reasonable for all individuals with blood pressure levels more than 120/80 mm Hg to consider alternative approaches like transcendental medication as adjunct method to lower blood pressure.

Keywords: Meditation, Prehypertension, Psychosocial stress, Yoga.

How to cite this article: Manchanda SC, Madan K. Yoga and Hypertension. Hypertens J 2015;1(1):28-33.

Source of support: Nil

Conflict of interest: None

 
7.  Therapeutics update
Hypertension Therapeutics Update: A Brief Clinical Summary on Azilsartan, Cilnidipine and Nebivolol
Sanjeev Sharma
[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages:57] [Pages No:111-117] [No of Hits : 705]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0019 | FREE

ABSTRACT

Uncontrolled hypertension is the major risk factor for cardiovascular disease. The economic burden of disease is enormous in developed as well as in developing countries. The epidemiological studies have explained many etiological factors associated with chronic untreated hypertension, which varies according to geography and ethnicity.
In last five decades, many classes and types of antihypertensive drugs have been developed. This pharmacological review provides an update on new molecules belonging to three pharmacological classes of antihypertensives-angiotensin receptor blocker (azilsartan), calcium channel blocker (cilnidipine) and beta blocker (nebivolol) and their clinical implications.

Keywords: Azilsartan, Calcium channel L/N-type, Cilnidipine, Hypertension, Nebivolol, Newer drugs for hypertension, Vasodilation with Nebivolol.

How to cite this article: Sharma S. Hypertension Therapeutics Update: A Brief Clinical Summary on Azilsartan, Cilnidipine and Nebivolol. Hypertens J 2015;1(2):111-117.

Source of support: Nil

Conflict of interest: None

 
8.  Review Article
Risk Assessment in Young Hypertensives
Niteen V Deshpande
[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages:57] [Pages No:94-99] [No of Hits : 645]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0016 | FREE

ABSTRACT

Hypertension (HT) in young (< 40 years) is a significant problem in India. Preventing cardiovascular disease in these young hypertensives is a major challenge as management strategies for young hypertensives are not very clear. Risk assessment in young hypertensives is also limited as most of the risk assessment algorithms apply to population above 40 years. Unfortunately, we do not have a specific algorithm for Indian patients. The algorithm given by Joint British Societies (JBS-3) appears to be most suited for risk assessment in young Indian Hypertensive individuals. Additionally, multiple newer markers may be needed to understand the cardiovascular risk completely in the young hypertensive population.

Keywords: Cardiovascular risk assessment, Risk markers, Young hypertensives.

How to cite this article: Deshpande NV. Risk Assessment in Young Hypertensives. Hypertens J 2015;1(2):94-99.

Source of support: Nil

Conflict of interest: None

 
9.  Hemodynamics of hypertension
Clinical Significance of Blood Pressure Levels during Treadmill Exercise Testing
Sandeep Bansal, Anwar H Ansari
[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages:57] [Pages No:83-87] [No of Hits : 609]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0014 | FREE

ABSTRACT

Treadmill exercise testing is the most common noninvasive test to assess patients with suspected or known cardiovascular disease. Measurement of blood pressure (BP) during exercise stress is cumbersome due to patient motion and hemodynamic changes during exercise. Different population studies give differing levels for abnormal BP response to exercise and there is no unanimity about the level of BP at which exercise test is contraindicated or terminated. However, studies uniformly associate abnormal BP responses to exercise not only with risk of future hypertension but also with cardiovascular events, stroke and mortality. The present article provides a brief account of common precautions in BP measurement, the diagnostic and prognostic significance of different BP responses during exercise stress testing.

Keywords: Exercise stress test, Hypertensive response, Hypotensive response, Recovery phase.

How to cite this article: Bansal S, Ansari AH. Clinical Significance of Blood Pressure Levels during Treadmill Exercise Testing. Hypertens J 2015;1(2):83-87.

Source of support: Nil

Conflict of interest: None

 
10.  BLOOD PRESSURE MECHANISM
Salt Intake and Blood Pressure Levels: Is the Concept Valid?
R Chandni, Uday M Jadhav
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:47] [Pages No:7-11] [No of Hits : 135]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0063 | FREE

ABSTRACT

Globally, sodium intake has increased over the years, and it is seen in all ages, both genders, and in various ethnic groups including Indians. High dietary salt is a major contributor to the increasing incidence of hypertension, with an estimated 30% of hypertension attributed to high salt intake. Salt intake in the developed countries largely comes from prepackaged and processed foods, shelf-stable food, and bakery items. In the Asian communities, the contributing source is in the form of added table salt and in cooking. Sodium balance is maintained by increasing the arterial blood pressure, resulting in a pressure natriuresis and increased urinary sodium excretion in the presence of high sodium chloride intake. Low sodium intake to less than 3 gm/day leads to activation of renin-angiotensin-aldosterone system.
Recently, there have been reports about the deleterious effects of low blood sodium, and there is recognition of the concept of a J-shaped curve. Weak research methodologies with the use of methods like single spot urine samples and single 24-hour urine sodium excretion to estimate usual salt intake have been likely to influence the J curve in the studies so far. In this context, two trials were undertaken in Trials of Hypertension Prevention (TOHP), which implemented sodium reduction. There was no evidence of a J-shaped or nonlinear relationship, and direct relationship with total mortality was demonstrated even at the lowest levels of sodium intake and consistent with a benefit of reduced sodium and sodium/ potassium intake on total mortality over a 20-year period.
This review summarizes an overview of current understanding of the concept of salt in hypertension. Dietary sodium is the most accepted and time-tested intervention in prevention and treatment of hypertension, which needs to be implemented but with an unresolved issue of more aggressive salt intake reduction on cardiovascular events.

Keywords: Blood pressure, Hypertension, Salt, Sodium chloride.

How to cite this article: Chandni R, Jadhav UM. Salt Intake and Blood Pressure Levels: Is the Concept Valid? Hypertens J 2017;3(1):7-11.

Source of support: Nil

Conflict of interest: Nil

 
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