Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Hypertension: HELP
Articles by John D. Bisognano
Based on 39 articles published since 2010
(Why 39 articles?)
||||

Between 2010 and 2020, J. Bisognano wrote the following 39 articles about Hypertension.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. 2014

Weber, Michael A / Schiffrin, Ernesto L / White, William B / Mann, Samuel / Lindholm, Lars H / Kenerson, John G / Flack, John M / Carter, Barry L / Materson, Barry J / Ram, C Venkata S / Cohen, Debbie L / Cadet, Jean-Claude / Jean-Charles, Roger R / Taler, Sandra / Kountz, David / Townsend, Raymond R / Chalmers, John / Ramirez, Agustin J / Bakris, George L / Wang, Jiguang / Schutte, Aletta E / Bisognano, John D / Touyz, Rhian M / Sica, Dominic / Harrap, Stephen B. ·State University of New York, Downstate College of Medicine, Brooklyn, NY. ·J Clin Hypertens (Greenwich) · Pubmed #24341872.

ABSTRACT: -- No abstract --

2 Guideline Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. 2014

Weber, Michael A / Schiffrin, Ernesto L / White, William B / Mann, Samuel / Lindholm, Lars H / Kenerson, John G / Flack, John M / Carter, Barry L / Materson, Barry J / Ram, C Venkata S / Cohen, Debbie L / Cadet, Jean-Claude / Jean-Charles, Roger R / Taler, Sandra / Kountz, David / Townsend, Raymond / Chalmers, John / Ramirez, Agustin J / Bakris, George L / Wang, Jiguang / Schutte, Aletta E / Bisognano, John D / Touyz, Rhian M / Sica, Dominic / Harrap, Stephen B. ·aState University of New York, Downstate College of Medicine, Brooklyn, New York, USA bDepartment of Medicine, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Canada cCalhoun Cardiology Center, University of Connecticut, Farmington, Connecticut dDepartment of Medicine, Weil Cornell College of Medicine, New York, New York, USA eDepartment of Public Health and Clinical Medicine, Umea University, Umea, Sweden fCardiovascular Associates, Virginia Beach, Virginia gDepartment of Medicine, Wayne State University, Detroit, Michigan hDepartment of Pharmacy Practice and Science, University of Iowa, Iowa City, Iowa iDepartment of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA jMediCiti Institutions, Hyderabad, India kDepartment of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA lState University School of Medicine mHypertension Center of Haiti, Port-au-Prince, Haiti nDepartment of Medicine, Mayo Clinic, Rochester, Minnesota oJersey Shore University Medical Center, Neptune, New Jersey pHypertension Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA qGeorge Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia rArterial Hypertension and Metabolic Unit, University Hospital, Favaloro Foundation, Buenos Aires, Argentina sASH Comprehensive Hypertension Center, University of Chicago Medicine, Chicago, Illinois, USA tThe Shanghai Institute of Hypertension, Shanghai Jiaotong University School of Medicine, Shanghai, China uHypertension in Africa Research Team, North West University, Potchefstroom, South Africa vDepartment of Medicine, University of Rochester Medical Center, Rochester, New York, USA wInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Lanarkshire, UK xVirginia Commonwealth University, Richmond, Virginia, USA yDepartment of Physiology, University of Melbourne, Melbourne, Australia. ·J Hypertens · Pubmed #24270181.

ABSTRACT: -- No abstract --

3 Editorial Masked Hypertension: Finding Trouble Under the Disguise. 2017

Morris, Jacqueline H / Bisognano, John D. ·From the Division of Cardiology, Department of Internal Medicine, University of Rochester Medical Center, Rochester, New York. · From the Division of Cardiology, Department of Internal Medicine, University of Rochester Medical Center, Rochester, New York. John_Bisognano@URMC.Rochester.edu. ·Circ Cardiovasc Qual Outcomes · Pubmed #28698193.

ABSTRACT: -- No abstract --

4 Editorial Unilateral Carotid Body Resection in Resistant Hypertension: An Exciting First Step Toward a New Therapy? 2016

Paivanas, Nicholas / Bisognano, John. ·Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York. ·JACC Basic Transl Sci · Pubmed #30167522.

ABSTRACT: -- No abstract --

5 Editorial Baroreflex activation therapy: future use as therapy for severe or resistant hypertension? 2016

Bisognano, John D. ·Department of Internal Medicine, Cardiology Division, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: John_Bisognano@urmc.rochester.edu. ·J Am Soc Hypertens · Pubmed #27189797.

ABSTRACT: -- No abstract --

6 Editorial "Translational" medicine: transforming SPRINT findings into clinical practice. 2016

Sica, Domenic A / Phillips, Robert A / White, William B / Bisognano, John D / Townsend, Raymond R. ·Section of Clinical Pharmacology and Hypertension, Virginia Commonwealth University Health System, Richmond, VA, USA. · Institute of Academic Medicine, Houston Methodist, Houston, TX, USA; Weill Cornell Medical College, New York, NY, USA. · Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT, USA. · Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. · Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: townsend@upenn.edu. ·J Am Soc Hypertens · Pubmed #27155246.

ABSTRACT: -- No abstract --

7 Editorial Remarks from the new President of the American Society of Hypertension. 2016

Bisognano, John D. ·Division of Cardiology, Department of Internal Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. Electronic address: John_Bisognano@urmc.rochester.edu. ·J Am Soc Hypertens · Pubmed #27061045.

ABSTRACT: -- No abstract --

8 Editorial The role of baroreflex activation therapy in sympathetic modulation for the treatment of resistant hypertension. 2012

Gassler, John P / Lynch, Petra S / Bisognano, John D. · ·Heart · Pubmed #22895643.

ABSTRACT: -- No abstract --

9 Review An Evidence-Based Review of Elevated Blood Pressure for the Inpatient. 2020

Stanistreet, Bryan / Nicholas, Joseph A / Bisognano, John D. ·Department of Internal Medicine, Division of Geriatrics, University of Rochester Medical Center, Rochester, NY. Electronic address: Bryan.Stanistreet@iorahealth.edu. · Department of Internal Medicine, Division of Geriatrics, University of Rochester Medical Center, Rochester, NY. · Department of Internal Medicine, Division of Cardiology, University of Rochester Medical Center, Rochester, NY. ·Am J Med · Pubmed #31705851.

ABSTRACT: Elevated blood pressure is common in patients who are hospitalized. There are no guidelines and few recommendations to help inpatient providers manage patients with elevated blood pressure. There are no normal reported values for blood pressure in the inpatient and recording circumstances often widely vary. Many factors may influence blood pressure such as pain, anxiety, malaise, nicotine withdrawal, or withholding home medications. This review of available literature suggests potential harm and little to no potential benefit in treating asymptomatic patients with elevated blood pressure. This review also found no evidence that asymptomatic elevated blood pressure progresses to lead to end-organ damage. However, there are clear instances of hypertensive emergency where treatment is indicated. Conscientious adjustment of an anti-hypertensive regimen should be undertaken during episode of elevated blood pressure associated with end-organ damage.

10 Review Device-Directed Therapy for Resistant Hypertension. 2017

Tankut, Sinan S / Yoruk, Ayhan / Bisognano, John D. ·University of Rochester Medical Center, 601 Elmwood Avenue, PO Box MED, Rochester, NY 14642, USA. Electronic address: Sinan_Tankut@urmc.rochester.edu. · University of Rochester Medical Center, 601 Elmwood Avenue, PO Box MED, Rochester, NY 14642, USA. ·Cardiol Clin · Pubmed #28411899.

ABSTRACT: Hypertension remains a significant risk factor for an array of diseases despite advancements in pharmacotherapy. Patients with resistant hypertension who do not respond to conventional medical treatments and lifestyle modifications are especially at risk for poor health outcomes. With the increasing awareness of resistant hypertension, ever-evolving research efforts continue to focus on innovative interventions, including renal denervation, median nerve stimulation, and baroreceptor activation therapy. This article reviews the current evidence and summarizes previous clinical trials for each of these interventions.

11 Review Present and Future of Interventional Treatment of Resistant Hypertension. 2017

Yoruk, Ayhan / Tankut, Sinan S / Gassler, John P / Bisognano, John D. ·University of Rochester Medical Center, Rochester, NY, USA. · University of Rochester Medical Center, Rochester, NY, USA. john_bisognano@urmc.rochester.edu. ·Curr Hypertens Rep · Pubmed #28102522.

ABSTRACT: The increasing prevalence of hypertension, a significant cause of disability and premature death throughout the world, is a major public health concern. This is especially true for the subset of patients who suffer from resistant hypertension, which is associated with a fourfold greater risk of cardiovascular events as compared to those hypertensive patients able to achieve target blood pressure. Though quite daunting in number and ill effect, hypertension remains the most common and the most important modifiable risk factor for coronary heart disease, congestive heart failure, peripheral vascular disease, stroke, and chronic kidney disease. Therefore, the ongoing development of novel therapies for the management of hypertension is of utmost importance. This review evaluates the present and future of interventional treatment of resistant hypertension, most of which remains investigational and warrants critical assessment.

12 Review Baroreceptor Stimulation for Resistant Hypertension. 2016

Yoruk, Ayhan / Bisognano, John D / Gassler, John P. ·University of Rochester Medical Center, Rochester, New York, USA. ·Am J Hypertens · Pubmed #27444637.

ABSTRACT: Hypertension (HTN) is a worldwide epidemic. When untreated, HTN places patients at an elevated risk for several health conditions, including cardiovascular disease and end-organ damage. This effect is particularly pronounced in a subset of patients who experience treatment-resistant HTN despite the utilization of conventional medication and lifestyle interventions. For these challenging patients, ongoing research efforts continue to explore and develop novel nonpharmacologic therapies for resistant HTN. One such avenue is the regulation of the sympathetic nervous system, a large component of circulatory physiology. Innovative therapies have evolved to harness the ability to deliver electrical stimulation to baroreceptors in an effort to modulate the sympathetic system involvement in HTN. This review discusses baroreflex activation therapy and its role in the management of resistant HTN.

13 Review Neural modulation for hypertension and heart failure. 2016

Smith, S / Rossignol, P / Willis, S / Zannad, F / Mentz, R / Pocock, S / Bisognano, J / Nadim, Y / Geller, N / Ruble, S / Linde, C. ·The Ohio State University Wexner Medical Center, Department of Internal Medicine and Division of Cardiology, Columbus, OH, USA. Electronic address: sakima.smith@osumc.edu. · Inserm, CIC 1433, Centre Hospitalier Universitaire, Universite´ de Lorraine, F-CRIN INI-CRCT, Nancy, France. · The Ohio State University Wexner Medical Center, Department of Internal Medicine and Division of Cardiology, Columbus, OH, USA. · Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, USA. · Medical Statistics Unit LSHTM, London, UK. · University of Rochester Medical Center, Department of Medicine, Cardiology, Rochester, NY, USA. · CVRx, Inc, Minneapolis, MN, USA. · Office of Biostatistics Research, Division of Cardiovascular Sciences, NHLBI, National Institutes of Health, Bethesda, MD, USA. · Boston Scientific CRV, St. Paul, MN, USA. · Institution of Internal Medicine, Karolinska Institutet and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. Electronic address: cecilia.linde@ki.se. ·Int J Cardiol · Pubmed #27085120.

ABSTRACT: Hypertension (HTN) and heart failure (HF) have a significant global impact on health, and lead to increased morbidity and mortality. Despite recent advances in pharmacologic and device therapy for these conditions, there is a need for additional treatment modalities. Patients with sub-optimally treated HTN have increased risk for stroke, renal failure and heart failure. The outcome of HF patients remains poor despite modern pharmacological therapy and with established device therapies such as CRT and ICDs. Therefore, the potential role of neuromodulation via renal denervation, baro-reflex modulation and vagal stimulation for the treatment of resistant HTN and HF is being explored. In this manuscript, we review current evidence for neuromodulation in relation to established drug and device therapies and how these therapies may be synergistic in achieving therapy goals in patients with treatment resistant HTN and heart failure. We describe lessons learned from recent neuromodulation trials and outline strategies to improve the potential for success in future trials. This review is based on discussions between scientists, clinical trialists, and regulatory representatives at the 11th annual CardioVascular Clinical Trialist Forum in Washington, DC on December 5-7, 2014.

14 Review Carotid Baroreceptor Stimulation and Arteriovenous Shunts for Resistant Hypertension. 2015

Paivanas, Nicholas / Bisognano, John D / Gassler, John P. ·University of Rochester Medical Center, Rochester, New York. ·Methodist Debakey Cardiovasc J · Pubmed #27057291.

ABSTRACT: Pharmacologic therapy for hypertension is effective for the majority of patients with hypertension, but there is a subset of the population with treatment-resistant hypertension who cannot achieve their blood pressure goal despite taking multiple medications. Since these patients are at increased risk of cardiovascular disease and end-organ damage, additional therapies must be considered. This review discusses several novel interventional therapies-including baroreflex activation therapy, baroreceptor stenting, and creation of an arteriovenous shunt-that may provide alternative options for blood pressure control in those with treatment-resistant hypertension. All of these therapies remain investigational, and each has its own strengths and weaknesses that will be critical to assess as they come to market.

15 Review Detection, evaluation, and treatment of severe and resistant hypertension: proceedings from an American Society of Hypertension Interactive forum held in Bethesda, MD, U.S.A., October 10th 2013. 2014

White, William B / Turner, J Rick / Sica, Domenic A / Bisognano, John D / Calhoun, David A / Townsend, Raymond R / Aronow, Herbert D / Bhatt, Deepak L / Bakris, George L. ·Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT, USA. Electronic address: wwhite@nso1.uchc.edu. · Clinical Communications, Quintiles, Durham, NC, USA. · Virginia Commonwealth University Medical Center, Richmond, VA, USA. · University of Rochester Medical Center, Rochester, NY, USA. · University of Alabama School of Medicine, Birmingham, AL, USA. · Clinical & Translational Research Center at the University of Pennsylvania, Philadelphia, PA, USA. · St Joseph Mercy Health System, Ann Arbor, MI, USA. · Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. · University of Chicago Medicine, Chicago, IL, USA. ·J Am Soc Hypertens · Pubmed #25418497.

ABSTRACT: The epidemiology, evaluation, and management of severe and resistant hypertension in the United States (US) are evolving. The American Society of Hypertension held a multi-disciplinary forum in October 2013 to review the available evidence related to the management of resistant hypertension with both drug and device therapies. There is strong evidence that resistant hypertension is an important clinical problem in the US and many other regions of the world. Complex drug therapy is effective in most of the patients with severe and resistant hypertension, but there are certain individuals who may be refractory to multiple-drug regimens or have adverse effects that make adherence to the regimen difficult. When secondary forms of hypertension and pseudo-resistance, such as medication nonadherence, or white-coat hypertension based on marked differences between clinic and 24-hour ambulatory blood pressure monitoring, have been excluded, the impact of device therapy is under evaluation through clinical trials in the US and from clinical practice registries in Europe and Australia. Clinical trial data have been obtained primarily in patients whose resistant hypertension is defined as systolic clinic blood pressures of ≥160 mm Hg (or ≥ 150 mm Hg in type 2 diabetes) despite pharmacologic treatment with at least three antihypertensive drugs (one of which is a thiazide or loop diuretic). Baroreceptor stimulation therapy has shown modest benefit in a moderately sized sham-controlled study in drug-resistant hypertension. Patients selected for renal denervation have typically been restricted to those with preserved kidney function (estimated glomerular filtration rate ≥ 45 mL/min/1.73 m2). The first sham-controlled safety and efficacy trial for renal denervation (SYMPLICITY HTN-3) did not show benefit in this population when used in addition to an average of five antihypertensive medications. Analyses of controlled clinical trial data from future trials with novel designs will be of critical importance to determine the effectiveness of device therapy for patients with severe and resistant hypertension and will allow for proper determination of patient selection and whether it will be acceptable for clinical practice. At present, the focus on the management of severe and resistant hypertension will be through careful evaluation for pseudo-resistance and secondary forms of hypertension, appropriate use of combination pharmacologic therapy, and greater utility of specialists in hypertension.

16 Review The prevalence, incidence, prognosis, and associated conditions of resistant hypertension. 2014

Vega, Joshua / Bisognano, John D. ·Department of Internal Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York. · Department of Internal Medicine, Division of Cardiology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York. Electronic address: John_Bisognano@URMC.Rochester.edu. ·Semin Nephrol · Pubmed #25016397.

ABSTRACT: Resistant hypertension is a relevant condition gaining special attention given its clinical and economic impact. Although the true prevalence is unknown, clinical trials and population-based studies have shown that it is a common clinical problem that likely will increase in incidence with an aging and more obese population. A complex interaction of various risk factors including lifestyle, associated conditions, and identifiable secondary causes can lead to uncontrolled hypertension. Important factors including improper blood pressure measuring technique, poor medication adherence, and the white coat phenomenon can lead to pseudoresistance, or a false impression of treatment resistance, which must be excluded. Patients with true resistant hypertension have a greater risk for developing adverse cardiovascular events compared with those with controlled blood pressure, leading to an unfavorable prognosis without adequate treatment. This article reviews the current understanding of the epidemiology of resistant hypertension.

17 Review Baroreflex activation therapy in hypertension. 2014

Gassler, J P / Bisognano, J D. ·Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. ·J Hum Hypertens · Pubmed #24477209.

ABSTRACT: The sympathetic nervous system is an effective homeostatic mechanism for modulating hemodynamics in times of stress and illness. Unfortunately, in some patients, this mechanism escapes physiologic control and through various mechanisms leads to resistant hypertension. Antihypertensive drug therapy is successful only to a point, leaving a significant percentage of patients nationwide with blood pressure measurements above guidelines despite being treated with at least three agents at maximally tolerated doses, consistent with a diagnosis of resistant hypertension. Novel methods of modifying the activity of the sympathetic nervous system have been studied in animals, and this review discusses the data in support of one of the techniques at the forefront of non-pharmacologic blood pressure therapy.

18 Review The role of obesity and obstructive sleep apnea in the pathogenesis and treatment of resistant hypertension. 2014

Marcus, Jonathan A / Pothineni, Aravind / Marcus, Carolina Z / Bisognano, John D. ·Department of Neurology, University of Rochester Sleep Disorders Center, 2337 South Clinton Avenue, Rochester, NY, 14618, USA, jonathan_marcus@urmc.rochester.edu. ·Curr Hypertens Rep · Pubmed #24346827.

ABSTRACT: The incidence of resistant hypertension, obesity, and obstructive sleep apnea (OSA), three highly prevalent conditions in the United States, is rising. Approximately one in three adults in the US has hypertension, and a significant proportion of these individuals have hypertension that is difficult to treat, or resistant. Obesity and OSA are well-established risk factors for resistant hypertension, a condition that portends significant cardiovascular risk. Awareness of the various mechanisms by which obesity and OSA impact systemic blood pressure is essential to better understand how best to effectively care for patients with resistant hypertension. In this review, we discuss the clinical and pathophysiologic associations between obesity, OSA, and resistant hypertension. Furthermore, we will explore the effect of continuous positive airway pressure therapy (CPAP) and other therapeutic interventions on blood pressure control in patients with resistant hypertension.Key Points• Obesity, obstructive sleep apnea, and resistant hypertension are highly prevalent conditions, with increasing overall incidence [1-3].• Both obesity and obstructive sleep apnea are independent risk factors for the development of resistant hypertension.• OSA is characterized by a physiologic cascade of collapse of the upper airway, which can lead to intermittent hypoxia, hypercapnia, significant negative intra-thoracic pressure, and increased SNS output.• Intermittent hypoxia leads to activation of the endothelin system [17, 18, 19•], which can lead to the development of resistant hypertension.• Intermittent hypoxia can lead to the over activation of the SNS, which can also contribute to the development of resistant hypertension [20, 21].• OSA leads to state of elevated adrenergic tone, which in turn may contribute to resistant hypertension [25-27].• OSA patients have a higher incidence of "non-dipping" of nocturnal systolic blood pressure, a marker of increased adrenergic tone. This potentially represents a risk factor for hypertensive end organ disease [31, 32].• The prevalence of OSA is significantly higher in patients predisposed to fluid accumulation: including kidney disease, heart failure and resistant hypertension [33].• Interventions (such as the daytime use of compression stocking) which reduce daytime lower extremity fluid accumulation can significantly reduce the severity of OSA, particularly in patients with comorbid resistant hypertension [35, 36].• CPAP therapy can significantly reduce blood pressure in patients with comorbid hypertension and OSA. The treatment effect is most pronounced in those with resistant hypertension and OSA [16••, 38-42].

19 Review Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association. 2013

Brook, Robert D / Appel, Lawrence J / Rubenfire, Melvyn / Ogedegbe, Gbenga / Bisognano, John D / Elliott, William J / Fuchs, Flavio D / Hughes, Joel W / Lackland, Daniel T / Staffileno, Beth A / Townsend, Raymond R / Rajagopalan, Sanjay / Anonymous3690756. · ·Hypertension · Pubmed #23608661.

ABSTRACT: Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential ancillary health benefits, and practicality in a real-world setting. Finally, recommendations for future research priorities are outlined.

20 Review Perioperative hypertension: defining at-risk patients and their management. 2012

Lien, Susan F / Bisognano, John D. ·Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA. susan_lien@urmc.rochester.edu ·Curr Hypertens Rep · Pubmed #22864917.

ABSTRACT: Hypertension is an extremely pervasive condition that affects a large percentage of the world population. Although guidelines exist for the treatment of the patient with elevated blood pressure, there remains a paucity of literature and accepted guidelines for the perioperative evaluation and care of the patient with hypertension who undergoes either cardiac or noncardiac surgery. Of particular importance is defining the patients most vulnerable to complications and the indications for immediate and rapid antihypertensive treatment and/or cancellation of surgery to reduce these risks in each of the three perioperative settings: preoperative, intraoperative, and postoperative. This review also examines the parenteral antihypertensive medications most commonly administered in the perioperative setting.

21 Review Interventional approaches for resistant hypertension. 2012

Davidson, Andrew C / Bisognano, John D. ·Department of Medicine, Cardiology Division, University of Rochester Medical Center, Rochester, New York 14642-8679, USA. ·Curr Opin Nephrol Hypertens · Pubmed #22801445.

ABSTRACT: PURPOSE OF REVIEW: The number of Americans with hypertension is growing, and within that group there remain a growing number of patients with resistant hypertension. This growth has occurred despite numerous pharmacologic advancements and innovative therapies. Resistant hypertension carries a significant risk of morbidity and mortality. An interventional approach to treating patients with resistant hypertension may provide a supplementary aid to those with difficult-to-control blood pressure on medications alone. RECENT FINDINGS: An interventional approach to patients with resistant hypertension is effective and likely well tolerated. Baroreceptor stimulation was shown to increase the likelihood of reaching a normal blood pressure in patients whose hypertension was previously uncontrolled using pharmacotherapy alone. Renal sympathetic denervation was likewise shown to successfully treat hypertension in a previously uncontrolled population. With both of these therapies, statistically significant endpoints were reached, and there were likely low risks of procedural complications, though further investigation continues to examine safety and effectiveness. SUMMARY: Interventional therapies may be an increasingly important adjunct therapy for patients with resistant hypertension that fails to be controlled with pharmacotherapy alone. Two exciting interventions that are under investigation and are likely effective are electrical stimulation of carotid baroreceptors and catheter denervation of renal sympathetic nerves.

22 Review Nondrug interventions for treatment of hypertension. 2011

Woolf, Kevin J / Bisognano, John D. ·Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA. ·J Clin Hypertens (Greenwich) · Pubmed #22051428.

ABSTRACT: The treatment of hypertension is no longer limited to the simple prescription of pharmaceuticals. For many patients, maximal medical therapy is insufficient to adequately treat refractory hypertension. In addition, some patients may prefer to explore therapies that do not involve drugs as an initial step. Utilizing our broadening understanding of the physiology of hypertension, new technology and interventions have been developed that allow for treatments that do not rely on medications. In addition, dietary supplements and modification, as well as herbal supplements, may be useful under the right circumstances. Lifestyle modification remains a necessary part of treatment for all patients with hypertension. This article will review the evidence behind some available nondrug interventions for the treatment of hypertension.

23 Review Catheter-based renal sympathetic denervation: a targeted approach to resistant hypertension. 2011

Gewirtz, Janna R / Bisognano, John D. ·Department of Internal Medicine, University of Rochester Medical Center,Cardiology Division, Rochester, NY, USA. ·Cardiol J · Pubmed #21305496.

ABSTRACT: -- No abstract --

24 Review Allergic respiratory disease as a potential co-morbidity for hypertension. 2010

Aung, Tania / Bisognano, John D / Morgan, Mary Anne. ·Department of Internal Medicine, University of Rochester Medical Center, Rochester, New York, USA. ·Cardiol J · Pubmed #20865673.

ABSTRACT: This article examines the relationships between allergic rhinitis and hypertension, chronic sinusitis and hypertension, and asthma and hypertension. Previous studies have demonstrated that men reporting seasonal or chronic rhinitis had on average a 3.5 mm Hg higher systolic blood pressure than those without allergic rhinitis. Proposed mechanisms to the relationship between allergic rhinitis and sinusitis with hypertension may lie in the pathway of obstructive sleep apnea via neurohumoral responses to hypoxemia. Asthmatics were 1.4 times more likely to have heart disease, and 1.3 times more likely to have high blood pressure, than non-asthmatics. The commonality of immunological dysfunction and inflammation between diseases of allergy and those mediated by hypertension and other vascular disorders may explain the correlations observed. Interestingly, obese individuals have higher levels of circulating IL-6, leptin and TNF-alpha skewing the immune system toward the allergen-reactive type 2 helper T-cell. This would mean that obese individuals were predisposed to diseases of chronic inflammation. The implications of allergic rhinitis, chronic sinusitis, and asthma deserve closer attention, especially into the possibility of co-morbidity for hypertension. Although associations between allergic diseases and hypertension have been reported, more studies need to be performed to elucidate the mechanisms behind such associations.

25 Review Baroreflex stimulation in antihypertensive treatment. 2010

Taylor, Jeremy G / Bisognano, John D. ·Department of Internal Medicine, Nephrology Division, University of Rochester, 601 Elmwood Avenue, Box 679-7, Rochester, NY 14642-8679, USA. ·Curr Hypertens Rep · Pubmed #20424952.

ABSTRACT: Hypertension is a leading cause of morbidity and mortality worldwide. Despite the development of new medications, an alarmingly high proportion of patients are not reaching their target blood pressure goals, so nonpharmacologic therapies have been attracting more interest. Chronic baroreceptor stimulation of the carotid sinus has been shown to reduce blood pressure by inhibiting the sympathetic nervous system, particularly the renal sympathetic tone. This finding has led to the development of implantable carotid sinus stimulators, which have now been studied in both animals and humans, as a means for treating chronic hypertension. The enthusiasm for this modality has led to ongoing studies, which will provide more information on its safety and efficacy in patients with resistant hypertension. The early study results using baroreflex stimulation therapy are promising and suggest that it may play a significant role in controlling blood pressure in the future.

Next