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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 : 852]
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.  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 : 985]
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

 
3.  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 : 724]
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

 
4.  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 : 574]
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

 
5.  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 : 554]
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

 
6.  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 : 5]
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

 
7.  TRENDS IN HYPERTENSION TREATMENT GOALS
Controlling Systolic Blood Pressure below 140 mm Hg in Most Hypertensive Patients matches Systolic Blood Pressure Intervention Trial Intensive Treatment: Practical Implications for Patient Care?.
Brent M Egan, Jiexiang Li, C Shaun Wagner
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:47] [Pages No:12-19] [No of Hits : 4]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0064 | FREE

ABSTRACT

The Systolic Blood Pressure Intervention Trial (SPRINT) investigators concluded that most hypertensive patients would benefit from treating systolic blood pressure (SBP, mm Hg) to a target below 140 benchmark, as intensive treatment (SBP, 121.5) led to 25% fewer cardiovascular endpoints than standard treatment (SBP, 134.6) in high-risk patients. This conclusion reflects at least three assumptions addressed in this report. First, SBP with SPRINT standard was similar to or lower than SBP of treated adults in usual care. Second, SBP with SPRINT intensive treatment was lower than in adults with treated hypertension controlled to <140 with usual care. Third, SPRINTs rigorous blood pressure (BP) measurement methods translate to most care settings. Systolic blood pressure in a representative sample of US adults [National Health and Nutrition Examination Survey .18 years with treated hypertension fell from 137.1 in 1999.2002 to 130.1 in 2009.2012 as control to SBP <140 rose from 60 to 72%. Over the time, SBP in treated adults controlled to <140 fell from 123.0 to 120.9 as percentages with SBP <130 rose from 66.1 to 74.7%. The SPRINT BP measurement protocol led to SBP ~3 and ~7 below daytime ambulatory SBP for standard and intensive treatment respectively, whereas usual clinic SBP is ~5 above daytime ambulatory SBP. Thus, SBP 134.6 and 121.5 with SPRINT standard and intensive treatment are comparable to usual clinic SBP of 142.6 and 133.5 respectively. Systolic blood pressure intervention trial Intensive Treatment standard and intensive treatment fall short of SBP with usual care, especially when measurement methodologies are considered. Systolic blood pressure intervention trial supports the current SBP goal <140 based on usual clinic measurement methods.

Keywords: Blood pressure, Cardiovascular disease, Hypertension.

How to cite this article: Egan BM, Li J, Wagner CS. Controlling Systolic Blood Pressure below 140 mm Hg in Most Hypertensive Patients matches Systolic Blood Pressure Intervention Trial Intensive Treatment: Practical Implications for Patient Care. Hypertens J 2017;3(1):12-19.

Source of support: This work was supported in part by contracts from the CDC through the South Carolina Department of Health and Environmental Control.

Conflict of interest: None

 
8.  Editorial
Editorial
Mark Niebylski
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:47] [Pages No:iv] [No of Hits : 4]
Full Text PDF | Abstract | FREE

ABSTRACT

Congratulations on your team’s tremendous work in supporting the mission of the World Hypertension League in the detection and control of hypertension globally, through your blood pressure screening offered in conjunction with World Hypertension Day 2017.

 
9.  THERAPEUTIC
Device-based Therapies for Resistant Hypertension: Current Status
Mohsin Wali, C Venkata S Ram
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:47] [Pages No:42-47] [No of Hits : 3]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0070 | FREE

ABSTRACT

Resistant hypertension is a serious consequence of uncontrolled hypertension. This condition can lead to significant target organ damage. Individuals with resistant hypertension are highly vulnerable to excessive morbidity and premature mortality. Hence, it is important to recognise resistant hypertension as a distinct clinical entity. Whereas aggressive medical therapy is indicated to control resistant hypertension, there is a growing interest and considerable ongoing research on the role of mechanical device based approaches to control hypertension. Although the results of device based therapy of resistant hypertension are inconsistent, this alternative approach should be pursued further by newer research protocols and novel methodology.

Keywords: Baroreceptor activation therapy, Resistant hypertension, Renal denervation therapy, Uncontrolled hypertension.

How to cite this article: Wali M, Ram CVS. Device-based Therapies for Resistant Hypertension: Current Status. Hypertens J 2017;3(1):42-47.

Source of support: Nil

Conflict of interest: None

 
10.  REVIEW ARTICLE
Recommended Standards for assessing Blood Pressure in Human Research where Blood Pressure or Hypertension is a Major Focus
Norm RC Campbell
[Year:2017] [Month:January-March] [Volume:3 ] [Number:1] [Pages:47] [Pages No:1-6] [No of Hits : 2]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10043-0062 | FREE

ABSTRACT

National and international recommendations for assessing blood pressure advocate for specific training and accuracy assessment of observers, use of a standardized technical procedure, as well as use of accurate and appropriate equipment. However, these recommendations are often not adhered to even in research studies that relate directly to blood pressure or antihypertensive therapies. Inaccurate, nonreproducible blood pressure values can result from nonstandardized assessments, and impair the ability to define the population being studied; fail to identify people who are susceptible to hypotensive adverse events; and reduce the ability to assess the impact of interventions on blood pressure. A consortium of national and international health and scientific organizations oversaw an expert review and consensus process to develop minimum standards for assessing blood pressure in human clinical and epidemiological research patients where (1) blood pressure or hypertension is a major endpoint, or (2) blood pressure or hypertension is thought to be a major mediator of the research outcome (e.g., a study on an antihypertensive therapy or lifestyle change with a cardiovascular outcome). Minimum standards are presented for training of observers, technical aspects of assessing blood pressure, and equipment used, based on existing national and international recommendations. A limitation is that some existing recommendation processes were not systematic or did not assess the strength of evidence supporting specific recommendations. Funding agencies, journal editors, and reviewers should require adherence to these minimum standards for all new research on the patient populations described above. Researchers should modify their study designs to meet the minimum standards. Readers need to use caution in interpreting studies if the standards are not met.

Keywords: Blood pressure, Blood pressure measurement, Epidemiology, Hypertension, Research, Research standards.

How to cite this article: Campbell NRC. Recommended Standards for assessing Blood Pressure in Human Research where Blood Pressure or Hypertension is a Major Focus. Hypertens J 2017;3(1):1-6.

Source of support: Funding was provided by the Heart and Stroke Foundation (Canada), Canadian Institute for Health Research Chair in Hypertension Prevention and Control with kind support from the World Hypertension League.

Conflict of interest: Specific conflicts of interest for each member of the TRUE Consortium can be found in Appendix A. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

 
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