ABSTRACT

Accurate measurement of blood pressure (BP) is pre-requisite for diagnosis and therapy of hypertension (HTN). The standard clinical method of estimating BP in office, by inflatable rubber cuff, using Korotkoff sounds is obsolete and is used more often for standardization of other indirect methods. The oscillometric technique is the current standard for the measurement of BP. Alternative methods of indirect estimation of BP – applanation tonometry, vascular clamp method, and pulse transit time, are under evaluation and need refinement, before recommending for routine clinical application. Current clinical standard mandates, blood pressure measurement not only in office but also out of office for the diagnosis and therapy of HTN.

Keywords: Blood pressure, measurement, mercury manometer, oscillometry, out of office measurement

How to cite this article: Rao D. Blood Pressure Measurement in Clinical Practice Methods and Emerging Options. Hypertens 2019;5(3): 92-98.

Received: 4-04-2019;

Accepted: 16-05-2019

ABSTRACT

Several observational studies have demonstrated a link between high blood pressure (BP) and memory decline. The association is more with midlife rather than late-life hypertension and with systolic rather than diastolic BP. Hypertension by causing vessel wall thickening, reduced luminal diameter and vascular obstruction can lead to vascular dementia. Brain infarcts by decreasing the brain reserve lower the threshold for neurofibrillary tangles and amyloid plaques to produce Alzheimer’s disease. Longer and intensive lowering of systolic BP has been shown to reduce the prevalence of mild cognitive impairment and dementia.

Keywords: Dementia, midlife, hypertension

How to cite this article: Kaul S. Hypertension as a Cause of Dementia. Hypertens 2019;5(3):99-103.

Received: 05-05-2019;

Accepted: 20-05-2019

ABSTRACT

HTN is found to have a high prevalence across various states in our country. Latest data have shown that 25-30% of population from urban areas and 10-20% of those in rural India are hypertensive. According to the 2011 census, there are around 95-100 million adults with HTN in India (of the total of 1.21 billion). Pre-HTN and Stage I HTN constitute a major chunk of the hypertensive population in India. There is a dearth of awareness, as well as very low rates of control and appropriate therapy in India, a fact with a rural preponderance. Lower socioeconomic status, living in rural areas and female gender are determinants of poor control and treatment.

Keywords: Cardiovascular trends india, hypertension, hypertension trends

How to cite this article: Garipalli R, Azam MS. Hypertension and Cardiovascular Trends in India. Hypertens 2019;5(3):104-108.

Received: 26-04-2019;

Accepted: 05-05-2019

ABSTRACT

Hypertension is the leading cause of cardiovascular events in the elderly and its prevalence increases with age. Elderly patients have altered biological functions which coupled with multiple comorbidities presents a unique therapeutic challenge. Due to contrasting major society guidelines and data from large trials the optimum target blood pressure is less well defined in elderly. This confusion and the resulting dilemma between whom to label as hypertensive or normotensive may lead to delays in treatment. Hypertension in elderly has certain unique clinical situations like isolated systolic hypertension, “dippers”, orthostatic hypotension and pseudohypertension. The presence of multiple comorbidities like CAD, CVA, gout, cognitive decline and diabetes, their complications and management only further complicate the therapeutic challenge. The management of hypertension in the elderly has to be individualized based on various factors.

Keywords: Hypertension, elderly hypertensive, blood pressure

How to cite this article: Padmanabhan TNC, Azam MS. Hypertension in Elderly – Pathogenesis and Treatment. Hypertens 2019;5(3):109-116.

Received: 04-06-2019;

Accepted: 07-07-2019

ABSTRACT

Systemic hypertension (HTN) is the most common known risk factor for the development of cardiovascular disorders. Epidemiological studies have revealed strong association between elevated arterial blood pressure (BP) and the development of coronary artery disease (CAD), stroke, renal failure, aortic dissection, peripheral arterial disease, and heart failure. There is enough evidence to suggest that lowering BP has a significant impact on mortality and morbidity. Of all cardiovascular disorders, CAD and heart failure contribute to majority of deaths. Management guidelines are well established for heart failure with reduced ejection fraction, but less well established for HTN with preserved systolic function. Prevention, early detection, and control of HTN are of paramount importance. Antihypertensive drugs along with the management of comorbid conditions and adhering to lifestyle measures are considered the backbone of primary and secondary prevention strategies.

Keywords: Coronary artery disease, heart failure, hypertension

How to cite this article: Sudhakar BGK. Therapeutic Principles in Hypertension Management in Patients with Congestive Heart Failure and Coronary Artery Disease. Hypertens 2019;5(3):117-122.

Received: 04-06-2019;

Accepted: 16-06-2019

ABSTRACT

Vasculitis as a cause of renovascular hypertension is not uncommon. However, isolated involvement of the left renal artery without affection of other vascular beds is extremely rare in any vasculitis, including Takayasu arteritis. Here, we present a case of a young girl with resistant hypertension and recurrent flash pulmonary edema secondary to renal artery stenosis (RAS). The cause of the RAS was vasculitis probably Takayasu arteritis. She was managed with immunosuppression with endovascular intervention.

Keywords: Secondary hypertension, Takayasu arteritis, renal artery stenosis

How to cite this article: Gurmukhani SN, Gahlan P, Shah S, Patel T. Isolated Unilateral Renal Artery Stenosis in Young Female with Takayasu Arteritis: Case Report. Hypertens 2019;5(3):123-125.

Received: 14-08-2019;

Accepted: 4-08-2019