Hypertension Journal

1.Editorial

From the Editor-in-Chief

C Venkata S Ram

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:iv] [No. of Hits: 56859]


ABSTRACT

I am pleased to inform the readers that the inaugural issue of the Hypertension Journal was very well received. The feedback was extremely positive. The current issue covers several important dimensions of hypertension which are of practical importance to the clinicians.


2.Continuing medical education (CME)

Medical Statistics Made Easy for the Medical Practitioner

Tiny Nair

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:63-67] [No. of Hits: 23489] [No. of Citation: 1]


ABSTRACT

Understanding basic medical statistics is important in today’s medical practice, not merely as an academic exercise but to translate medical information into day-to-day patient care. This review article tries to address basics of medical statistics to the end user.

Keywords: Clinical trial, Probability, Standard deviation, Statistics.

How to cite this article: Nair T. Medical Statistics Made Easy for the Medical Practitioner. Hypertens J 2015;1(2):63-67.

Source of support: Nil

Conflict of interest: None


How to cite this article: Nair T. Medical Statistics Made Easy for the Medical Practitioner. Hypertens J 2015;1(2):63-67.

Source of support: Nil

Conflict of interest: None

3.Lifestyle changes

A Sensible Reappraisal of Lifestyle Modifications to Treat Hypertension

Aashish Contractor, Abraham Samuel Babu

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:68-72] [No. of Hits: 13626]


ABSTRACT

The prevalence of hypertension worldwide is rapidly increasing and is projected to cross 1.5 billion adults by 2025. Reduction in hypertension will provide the largest benefit for premature cardiovascular disease mortality. Lifestyle modification, which primarily includes an increase in physical activity and alterations in diet can contribute greatly to both, prevention and management of hypertension. However, in terms of specific recommendations for these lifestyle interventions, there is still a need for greater evidence from randomized controlled trials. This article reviews some of the new data in the area of lifestyle modification, for the control and management of hypertension. Regular aerobic exercise, along with dynamic resistance training has shown to have a beneficial effect in the management of hypertension. Besides structured exercise, an increase in daily physical activity has proven benefits. An increase in cardiorespiratory fitness, has shown to have a positive impact on both hypertension, and reducing cardiovascular disease morbidity and mortality. Current dietary guidelines for the management of hypertension, included a reduction in daily sodium intake and processed foods. In addition, smoking cessation, control of weight and limitation of alcohol intake contribute to a healthy lifestyle for hypertension management.

Keywords: Diet, Exercise, Hypertension, Lifestyle, Physical activity.

How to cite this article: Contractor A, Babu AS. A Sensible Reappraisal of Lifestyle Modifications to Treat Hypertension. Hypertens J 2015;1(2):68-72.

Source of support: Nil

Conflict of interest: None


How to cite this article: Contractor A, Babu AS. A Sensible Reappraisal of Lifestyle Modifications to Treat Hypertension. Hypertens J 2015;1(2):68-72.

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 No:73-82] [No. of Hits: 20025] [No. of Citation: 1]


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


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.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 No:83-87] [No. of Hits: 25660] [No. of Citation: 1]


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


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

6.Review Article

Hypertension in Children and Adolescents

IB Vijayalakshmi, Chitra Narasimhan

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:88-93] [No. of Hits: 12544] [No. of Citation: 1]


ABSTRACT

Introduction: Pediatric hypertension has been recognized as an important health issue over the past years. In children though the etiology of hypertension is predominantly secondary, the prevalence of primary hypertension has been increasing at an alarming rate, particularly in adolescents and older children.

Discussion: The prevalence of hypertension in children increases with increasing body mass index percentile, placing obese children at three times higher risk of becoming hypertensive. It has been shown that weight loss by itself can decrease blood pressure and other associated cardiovascular risk factors should also be expected to regress or improve with weight loss. Dietary changes can involve portion-size control, decrease in consumption of sugar-containing beverages, energy-dense snacks, increase in consumption of fresh fruits, vegetables, low-fat dairy, stopping smoking and abstinence from alcohol use. Secondary hypertension due to specific conditions can be controlled and treated successfully by appropriate timely interventions both surgical and nonsurgical.

Conclusion: Pediatric hypertension is a serious disease that should be neither overlooked nor ignored. The evaluation and treatment of hypertension in childhood has continued to evolve over the past four decades. There is a great need to diagnose and treat hypertension when it develops in childhood to decrease the risk of cardiovascular morbidity in adulthood.

Keywords: Aortic stenting, Aortoarteritis, Coarctoplasty, Coil occlusion of renal artery, Renal artery angioplasty.

How to cite this article: Vijayalakshmi IB, Narasimhan C. Hypertension in Children and Adolescents. Hypertens J 2015;1(2):88-93.

Source of support: Nil

Conflict of interest: None


How to cite this article: Vijayalakshmi IB, Narasimhan C. Hypertension in Children and Adolescents. Hypertens J 2015;1(2):88-93.

Source of support: Nil

Conflict of interest: None

7.Review Article

Risk Assessment in Young Hypertensives

Niteen V Deshpande

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:94-99] [No. of Hits: 18177]


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


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

8.Review Article

Hypertension in the Old and Very Old: Current Concepts

Saumitra Ray

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:100-105] [No. of Hits: 12354]


ABSTRACT

Old age is defined variably in medical parlor. Blood pressure (BP) increases with age as a continuous variable. Hypertension is the single most attributable risk factor for death worldwide and accounts for considerable morbidity. Control of BP reverses this process. However, when to treat the elderly and how, is sometimes a confusing area. Due to high rates of comorbidities and drug adverse effects, often the elderly are undertreated. But, it should be made clear that the benefit of treatment of BP in the elderly is very high and if treatment is provided with reasonable standard of care, the benefit far outweighs the risk.

Keywords: Elderly, Guidelines, Hypertension.

How to cite this article: Ray S. Hypertension in the Old and Very Old: Current Concepts. Hypertens J 2015;1(2):100-105.

Source of support: Nil

Conflict of interest: None


How to cite this article: Ray S. Hypertension in the Old and Very Old: Current Concepts. Hypertens J 2015;1(2):100-105.

Source of support: Nil

Conflict of interest: None

9.Review Article

Treatment Resistant Hypertension: A Pragmatic Management Approach

Brent M Egan

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:106-110] [No. of Hits: 17233] [No. of Citation: 1]


ABSTRACT

Treatment resistant hypertension (TRH) is defined by office blood pressure (BP) uncontrolled on ≥ 3 or controlled on ≥ 4 antihypertensive medications, preferably at optimal doses and including a diuretic. Among treated hypertensives, ~30% of uncontrolled and 10% of controlled individuals have apparent treatment resistant hypertension (aTRH). Apparent treatment resistant hypertension is used when optimal therapy, patient adherence, and BP measurement artifacts are unknown. In . 50% of aTRH patients, BP measurement artifacts (‘office’ TRH), suboptimal regimens, or suboptimal adherence are present, i.e. pseudoresistance. Patients with ‘office’ TRH have fewer cardiovascular events (CVE) than those with persistent hypertension. Patients with suboptimal regimens or adherence and persistent hypertension appear to have excess CVE. ‘Office’ TRH is minimized by averaging several BP values obtained with an accurate, automated monitor, while the patient is alone in the examination room’. Home or ambulatory BP monitoring directly confirm ‘office’ TRH or persistent hypertension. Optimal therapy is reasonably defined by ≥3 different antihypertensive medication classes, e.g. thiazide-type diuretic, renin-angiotensin blocker and calcium antagonist at ≥50% of maximum recommended doses. Intensifying diuretic therapy is effective for controlling many TRH patients who are volume expanded. Personalized strategies, e.g. renin or hemodynamics, can inform successful therapy. Patient blood pressure self-monitoring and attention to adverse effects, medication costs, and pill burden can improve adherence. Suspected secondary hypertension should be evaluated and interfering substances or medications discontinued. These approaches will identify or correct the problem in ~80% of aTRH patients. Referral to a hypertension specialist is recommended for TRH patients not successfully managed with the pragmatic approach outlined.

Keywords: Cardiovascular disease, Nonadherence, Office resistance, Pseudoresistant hypertension, Spironolactone, Treatment resistant hypertension.

How to cite this article: Egan BM. Treatment Resistant Hypertension: A Pragmatic Management Approach. Hypertens J 2015;1(1):106-110.

Source of support: Nil

Conflict of interest: None


How to cite this article: Egan BM. Treatment Resistant Hypertension: A Pragmatic Management Approach. Hypertens J 2015;1(1):106-110.

Source of support: Nil

Conflict of interest: None

10.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 No:111-117] [No. of Hits: 27309]


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


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

11.Case Report

Primary Hyperaldosteronism: An Unusual but not a Rare Entity

GS Karthik, B Dixit, PC Rath

[Year:2015] [Month:October-December] [Volume:1 ] [Number:2] [Pages No:118-120] [No. of Hits: 13654]


ABSTRACT

A 36 years old gentleman presented to hospital with symptoms of viral illness. In addition to fever, he was found to have blood pressure of 240/160 mm Hg which was confirmed by repeated measurements. There was no evidence of target organ damage. His febrile illness turned out to be due to swine flu. Due to severe hypertension, he was admitted to the intensive care unit (ICU) for parenteral antihypertensive drug therapy. He had unexplained severe hypokalemia and metabolic alkalosis. The possibility of primary hyperaldosteronism was considered, plasma aldosterone level was high and plasma renin activity was low, confirming the (biochemical) diagnosis of hyperaldosteronism. He underwent additional work-up and was given specific antihypertensive drugs. The case illustrates classical features of primary hyperaldosteronism, diagnostic and therapeutic considerations.

Keywords: Adrenal glands, Aldosterone-renin ratio, Hypertension, Hypokalemia, Primary hyperaldosteronism.

How to cite this article: Karthik GS, Dixit B, Rath PC. Primary Hyperaldosteronism: An Unusual but not a Rare Entity. Hypertens J 2015;1(2):118-120.

Source of support: Nil

Conflict of interest: None


How to cite this article: Karthik GS, Dixit B, Rath PC. Primary Hyperaldosteronism: An Unusual but not a Rare Entity. Hypertens J 2015;1(2):118-120.

Source of support: Nil

Conflict of interest: None