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Hypertension: HELP
Articles from Gainesville
Based on 272 articles published since 2009
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These are the 272 published articles about Hypertension that originated from Gainesville during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11
1 Guideline ACR Appropriateness Criteria 2017

Anonymous7910925 / Harvin, Howard J / Verma, Nupur / Nikolaidis, Paul / Hanley, Michael / Dogra, Vikram S / Goldfarb, Stanley / Gore, John L / Savage, Stephen J / Steigner, Michael L / Strax, Richard / Taffel, Myles T / Wong-You-Cheong, Jade J / Yoo, Don C / Remer, Erick M / Dill, Karin E / Lockhart, Mark E. ·Principal Author, Scottsdale Medical Imaging, Scottsdale, Arizona. Electronic address: h_harvin@yahoo.com. · Co-author, University of Florida, Gainesville, Florida. · Panel Vice Chair (Urologic), Northwestern University, Chicago, Illinois. · Panel Vice Chair (Vascular), University of Virginia Health System, Charlottesville, Virginia. · University of Rochester Medical Center, Rochester, New York. · University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; American Society of Nephrology. · University of Washington, Seattle, Washington; American Urological Association. · Medical University of South Carolina, Charleston, South Carolina; American Urological Association. · Brigham & Women's Hospital, Boston, Massachusetts. · Baylor College of Medicine, Houston, Texas. · George Washington University Hospital, Washington, District of Columbia. · University of Maryland School of Medicine, Baltimore, Maryland. · Rhode Island Medical Imaging Inc., East Providence, Rhode Island. · Specialty Chair (Urologic), Cleveland Clinic, Cleveland, Ohio. · Panel Chair (Vascular), UMass Memorial Medical Center, Worcester, Massachusetts. · Panel Chair (Urologic), University of Alabama at Birmingham, Birmingham, Alabama. ·J Am Coll Radiol · Pubmed #29101991.

ABSTRACT: Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified. The primary imaging modalities used to screen for renal artery stenosis are CT, MRI, and ultrasound, with the selection of imaging dependent in part on renal function. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

2 Editorial American Society of Hypertension position paper: central blood pressure waveforms in health and disease. 2016

Townsend, Raymond R / Rosendorff, Clive / Nichols, Wilmer W / Edwards, David G / Chirinos, Julio A / Fernhall, Bo / Cushman, William C. ·Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: townsend@exchange.upenn.edu. · Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medicine, James J. Peters VA Medical Center, Bronx, NY, USA. · Division of Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA; Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. · Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE, USA. · Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. · Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA. · Department of Medicine Service, Veterans Affairs Medical Center, University of Tennessee College of Medicine, Memphis, TN, USA. ·J Am Soc Hypertens · Pubmed #26612106.

ABSTRACT: A number of devices are available which noninvasively estimate central aortic blood pressure using a variety of approaches such as tonometry or oscillometry. In this position paper, we discuss how the central pressure waveform is generated and measured, how central pressure waveforms appear in health and disease, the predictive value of central blood pressure measurements, the effects of interventions on waveforms, and areas of future need in this field of clinical and research endeavor.

3 Editorial The Good and the Bad: Immune Cells and Hypertension. 2015

Hay, Meredith. ·From the Department of Physiology, Evelyn F. McKnight Brain Institute, Saver Heart Center, University of Arizona, Tucson. mhay@arizona.edu. ·Circ Res · Pubmed #26494923.

ABSTRACT: -- No abstract --

4 Editorial Is natriuretic peptide receptor C a new target for hypertension therapeutics? 2014

Qi, Yanfei / Raizada, Mohan K. ·Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32610. mraizada@ufl.edu. ·Hypertension · Pubmed #24470462.

ABSTRACT: -- No abstract --

5 Review A unified mapping framework of multifaceted pharmacodynamic responses to hypertension interventions. 2019

Wang, Qian / Gan, Jingwen / Wei, Kun / Berceli, Scott A / Gragnoli, Claudia / Wu, Rongling. ·Center for Computational Biology, College of Biological Sciences and Technology, Beijing Forestry University, Beijing 100083, China. · Malcom Randall VA Medical Center, Gainesville, FL 32610, USA; Department of Surgery, University of Florida, Box 100128, Gainesville, FL 32610, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL 32610, USA. · Division of Endocrinology, Diabetes, and Metabolic Disease, Translational Medicine, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; Molecular Biology Laboratory, Bios Biotech Multi Diagnostic Health Center, Rome 00197, Italy. · Center for Computational Biology, College of Biological Sciences and Technology, Beijing Forestry University, Beijing 100083, China; Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; Center for Statistical Genetics, Departments of Public Health Sciences and Statistics, Pennsylvania State University, Hershey, PA 17033, USA. Electronic address: rwu@bjfu.edu.cn. ·Drug Discov Today · Pubmed #30690194.

ABSTRACT: The personalized therapy for hypertension needs comprehensive knowledge about how blood pressures (BPs; systolic and diastolic) and their pulsatile and steady components are controlled by genetic factors. Here, we propose a unified pharmacodynamic (PD) functional mapping framework for identifying specific quantitative trait loci (QTLs) that mediate multivariate response-dose curves of BP. This framework can characterize how QTLs govern pulsatile and steady components through jointly regulating systolic and diastolic pressures. The model can quantify the genetic effects of individual QTLs on maximal drug effect, the maximal rate of drug response, and the dose window of maximal drug response. This unified mapping framework provides a tool for identifying pharmacological genes potentially useful to design the right medication and right dose for patients.

6 Review Optimal medical treatment of hypertension in patients with coronary artery disease. 2018

Mahtta, Dhruv / Elgendy, Islam Y / Pepine, Carl J. ·a Department of Medicine , University of Florida , Gainesville , FL , USA. · b Division of Cardiovascular Medicine , University of Florida , Gainesville , FL , USA. ·Expert Rev Cardiovasc Ther · Pubmed #30295548.

ABSTRACT: INTRODUCTION: Coronary artery disease (CAD) remains the leading cause of mortality and morbidity worldwide, and hypertension is its most prevalent modifiable risk factor. Patients with CAD and concomitant hypertension are a special population with distinct physiologic and structural alterations. Optimal blood pressure (BP) control in this population has been linked with reduction in adverse outcomes, however, excessive lowering of BP could jeopardize myocardial and cerebral perfusion. Areas covered: Authors highlight the prevalence of the CAD and hypertension dyad, as well as the implications of various structural and physiological changes in this population. Subsequently, available data on optimal BP targets in such patients, and lastly the J-curve phenomenon as well as antihypertensive agent use are discussed. Expert commentary: Current guideline recommendations are based on data from trials such as SPRINT and ACCORD which did not specifically focus on the CAD population. Based on data from observational studies and post hoc analyses, the best therapeutic systolic (SBP) and diastolic (DBP) targets may be ~ 130 mmHg and ~ 80 mmHg, respectively. Caution should be taken to not lower SBP below 120 mmHg and DBP below 60 mmHg.

7 Review Hypertension Across a Woman's Life Cycle. 2018

Wenger, Nanette K / Arnold, Anita / Bairey Merz, C Noel / Cooper-DeHoff, Rhonda M / Ferdinand, Keith C / Fleg, Jerome L / Gulati, Martha / Isiadinso, Ijeoma / Itchhaporia, Dipti / Light-McGroary, KellyAnn / Lindley, Kathryn J / Mieres, Jennifer H / Rosser, Mary L / Saade, George R / Walsh, Mary Norine / Pepine, Carl J. ·Division of Cardiology, Emory Heart and Vascular Center, Emory University School of Medicine, Atlanta, Georgia. · Lee Health System, Florida State University School of Medicine, Fort Myers, Florida. · Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, California. · Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, Florida; Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida. · Tulane University Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana. · Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland. · Department of Medicine (Cardiology), University of Arizona-Phoenix, Phoenix, Arizona. · Jeffrey M. Carlton Heart & Vascular Institute, Hoag Memorial Hospital Presbyterian, Newport Beach, California. · Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa. · Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri. · Department of Cardiology, Hofstra Northwell School of Medicine, Hempstead, New York. · Division of General Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York. · Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas. · Heart Failure and Cardiac Transplantation Program, St. Vincent Heart Center, Indianapolis, Indiana. · Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida. Electronic address: pepincj@medicine.ufl.edu. ·J Am Coll Cardiol · Pubmed #29673470.

ABSTRACT: Hypertension accounts for 1 in 5 deaths among American women, posing a greater burden for women than men, and is among their most important risk factors for death and development of cardiovascular and other diseases. Hypertension affects women in all phases of life, with specific characteristics relating to risk factors and management for primary prevention of hypertension in teenage and young adult women; hypertension in pregnancy; hypertension during use of oral contraceptives and assisted reproductive technologies, lactation, menopause, or hormone replacement; hypertension in elderly women; and issues of race and ethnicity. All are detailed in this review, as is information relative to women in clinical trials of hypertension and medication issues. The overarching message is that effective treatment and control of hypertension improves cardiovascular outcomes. But many knowledge gaps persist, including the contribution of hypertensive disorders of pregnancy to cardiovascular disease risk, the role of hormone replacement, blood pressure targets for elderly women, and so on.

8 Review The benefits of physician-pharmacist collaboration. 2017

Hwang, Andrew Y / Gums, Tyler H / Gums, John G. ·Department of Clinical Sciences, Fred Wilson School of Pharmacy, High Point University, NC, USA. · Department of Health Outcomes and Pharmacy Practice, College of Pharmacy, University of Texas, Austin, TX, USA. · Department of Pharmacotherapy and Translational Research, College of Pharmacy, and Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. Email: jgums@ufl.edu. ·J Fam Pract · Pubmed #29202145.

ABSTRACT: Over the past decade, physician-pharmacist collaborative practices have gained traction in primary care as a way to implement team-based-care models. And there is evidence pointing to the effectiveness of this multidisciplinary heath care team approach, in which pharmacists are typically responsible for such things as obtaining medication histories, identifying barriers to adherence, and adjusting medication regimens. Several studies have shown the significant impact that physician-pharmacist collaborative management (PPCM) can have on blood pressure control among patients with hypertension. Additionally, PPCM may have positive effects on HbA1c reduction and diabetes control, suggesting that benefits may extend to other chronic diseases, too.

9 Review Integrative Medicine for Cardiovascular Disease and Prevention. 2017

Aggarwal, Monica / Aggarwal, Brooke / Rao, Jyothi. ·Division of Cardiology, University of Florida, 1600 Southwest Archer Road, PO Box 100288, Gainesville, FL 32610, USA. Electronic address: monica.aggarwal@medicine.ufl.edu. · Division of Cardiology, Department of Medicine, Columbia University Medical Center, 51 Audubon Avenue, Suite 505, New York, NY 10032, USA. · Shakthi Health and Wellness Center, 2702 Back Acre Circle Suite 290C, Mt. Airy, MD 21771, USA. ·Med Clin North Am · Pubmed #28802470.

ABSTRACT: Cardiovascular disease (CVD) is traditionally treated through medications and lifestyle modifications, yet adherence to these treatments is often poor. The use of complementary therapies is increasing, and it is vital for physicians to be aware of the risks and benefits of these options. This article summarizes the current evidence base on integrative therapies for the prevention and treatment of CVD, including hypertension, hyperlipidemia, coronary artery disease, heart failure, and arrhythmias. Where applicable, recommendations are included for therapies that may be used as an adjunct to traditional medical care to improve cardiovascular health and quality of life.

10 Review Global prevalence of hypertension among people living with HIV: a systematic review and meta-analysis. 2017

Xu, Yunan / Chen, Xinguang / Wang, Kai. ·Department of Epidemiology, University of Florida, Gainesville, FL, USA. Electronic address: yunanxu@ufl.edu. · Department of Epidemiology, University of Florida, Gainesville, FL, USA. ·J Am Soc Hypertens · Pubmed #28689734.

ABSTRACT: The purpose of this study was to estimate, through meta-analysis, the global prevalence of hypertension among people living with HIV (PLWH). A total of 49 studies published during 2011-2016 with 63,554 participants were included in analysis. These studies were conducted in America (25), Europe (13), Africa (10), and Asia (1) with data collected during 1996-2014. Prevalence of hypertension and confidence interval was estimated and stratified by participants' age, antiretroviral therapy (ART), and calendar-years using random effects modeling. The quality assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool was high for all included studies. The estimated prevalence (95% confidence interval) of hypertension was 25.2% (21.2%, 29.6%) for the overall sample, 34.7% (27.4%, 42.8%) for ART-experienced, and 12.7% (7.4%, 20.8%) for ART-naïve participants. The estimated prevalence was found increased with age and in studies conducted after 2010. Hypertension among PLWH shows an increasing trend and is associated with receiving ART and older age. Findings of this study provide data for decision makers to incorporate blood pressure assessment in primary prevention and for researchers to further investigate factors and mechanisms related to hypertension among PLWH.

11 Review Resistant Hypertension: Mechanisms and Treatment. 2017

Hwang, Andrew Y / Dietrich, Eric / Pepine, Carl J / Smith, Steven M. ·Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, PO Box 100486, Gainesville, FL, 32610-0486, USA. · Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. · Division of General Internal Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. · Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. · Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, PO Box 100486, Gainesville, FL, 32610-0486, USA. ssmith@cop.ufl.edu. · Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA. ssmith@cop.ufl.edu. ·Curr Hypertens Rep · Pubmed #28597403.

ABSTRACT: PURPOSE OF REVIEW: Emerging evidence suggests that multiple mechanisms may be responsible for the development of treatment-resistant hypertension (TRH). This review aims to summarize recent data on potential mechanisms of resistance and discuss current pharmacotherapeutic options available in the management of TRH. RECENT FINDINGS: Excess sodium and fluid retention, increased activation of the renin-angiotensin-aldosterone system, and heightened activity of the sympathetic nervous system appear to play an important role in development of TRH. Emerging evidence also suggests a role for arterial stiffness and, potentially, gut dysbiosis. Therapeutic approaches for TRH should include diuretic optimization and the addition of aldosterone antagonists as the preferred fourth agent in most patients. Further therapeutic approaches may be guided by the suspected underlying mechanism of TRH in conjunction with other patient-specific factors. The pathophysiology of TRH is multifaceted; however, increasing evidence supports several mechanisms that may be targeted to improve blood pressure control among patients with TRH. Further studies are needed to determine whether such approaches may be more effective than usual care.

12 Review Transcriptional networks in rodent models support a role for gut-brain communication in neurogenic hypertension: a review of the evidence. 2017

Zubcevic, Jasenka / Baker, Ashley / Martyniuk, Christopher J. ·Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida. · University of Florida Interdisciplinary Program in Biomedical Sciences Neuroscience, Gainesville, Florida. · University of Florida Genetics Institute, Gainesville, Florida; and. · Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida; cmartyn@ufl.edu. ·Physiol Genomics · Pubmed #28550087.

ABSTRACT: Hypertension (HTN) is the most prevalent condition observed in primary health care. Hypertension shows complex etiology, and neuroinflammation, overactive sympathetic drive, and the microbiome are each associated with the disease. To obtain mechanistic perspective into neurogenic HTN, we first constructed a framework for transcriptional regulators of the disease using the Comparative Toxicogenomics Database. This approach yielded a core group of 178 transcripts that are prevalent in studies of HTN, including leptin and neuropeptide Y. We then conducted a meta-analysis for transcriptome data generated in brain tissue from HTN studies. Eight expression studies were reanalyzed, in which transcriptomics was conducted in hypertensive animal models [spontaneously hypertensive rats (SHR) and high blood pressure (BPH/2J) Schlager mice] (140 microarrays). Most strikingly, a gut-brain connection was a dominant theme in both rodent models of HTN. The transcriptomic data in the rat CNS converged on processes that included gastrointestinal motility and appetite, among others. In the mouse model, pathways converged on gastrointestinal transit. Thus, our data provide a powerful review of current molecular evidence of the interplay between gut and brain in HTN. Analyses of meta-genome data also suggested that transcriptome networks related to natriuresis, thermoregulation, reproduction (lactation and pregnancy), and vasoconstriction were associated to HTN, supporting physiological observations in independent studies by others. Lastly, we present novel transcriptome networks that may contribute to a neurogenic origin of HTN. Using this framework, new therapeutic targets can be proposed and investigated in treatment strategies.

13 Review Gut Microbiota: Potential for a Unifying Hypothesis for Prevention and Treatment of Hypertension. 2017

Qi, YanFei / Kim, Seungbum / Richards, Elaine M / Raizada, Mohan K / Pepine, Carl J. ·From the Division of Cardiovascular Medicine, Department of Medicine (Y.Q., C.J.P.) and Department of Physiology and Functional Genomics (S.K., E.M.R., M.K.R.), College of Medicine, University of Florida, Gainesville. · From the Division of Cardiovascular Medicine, Department of Medicine (Y.Q., C.J.P.) and Department of Physiology and Functional Genomics (S.K., E.M.R., M.K.R.), College of Medicine, University of Florida, Gainesville. carl.pepine@medicine.ufl.edu mraizada@ufl.edu. ·Circ Res · Pubmed #28546357.

ABSTRACT: -- No abstract --

14 Review Updates on the Recognition, Prevention and Management of Hypertension in Pregnancy. 2017

Jackson, Jessica R / Gregg, Anthony R. ·Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida College of Medicine, PO Box 100294, Gainesville, FL 32610-0294, USA. · Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida Health System, University of Florida College of Medicine, PO Box 100294, Gainesville, FL 32610-0294, USA. Electronic address: greggar@ufl.edu. ·Obstet Gynecol Clin North Am · Pubmed #28499532.

ABSTRACT: Systematic reviews with meta-analysis represent the highest level of evidence used to guide clinical practice. The defining criteria used to diagnose preeclampsia have evolved, and will likely continue to evolve. Proteinuria is sufficient but not necessary when defining preeclampsia. Hypertension without proteinuria but with severe features is diagnostic. The methods used to measure urinary protein have changed. The gold standard remains the 24-hour urine test. The efficacy of low-dose aspirin in preventing preeclampsia is a function of baseline risk. Data suggest that treating mild to moderate blood pressure has clear maternal benefits with little fetal or neonatal risk.

15 Review Protective Angiotensin Type 2 Receptors in the Brain and Hypertension. 2017

de Kloet, Annette D / Steckelings, Ulrike M / Sumners, Colin. ·Department of Physiology and Functional Genomics, College of Medicine, University of Florida, 1600 SW Archer Road, Box 100274, Gainesville, FL, 32610-0274, USA. · IMM - Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense, Denmark. · Department of Physiology and Functional Genomics, College of Medicine, University of Florida, 1600 SW Archer Road, Box 100274, Gainesville, FL, 32610-0274, USA. csumners@ufl.edu. ·Curr Hypertens Rep · Pubmed #28488048.

ABSTRACT: PURPOSE OF REVIEW: The goal of this review is to assess the evidence that activation of angiotensin type 2 receptors (AT2R) in the brain can lower blood pressure and possibly constitute an endogenous anti-hypertensive mechanism. RECENT FINDINGS: Recent studies that detail the location of AT2R in the brain, particularly within or near cardiovascular control centers, mesh well with findings from pharmacological and gene transfer studies which demonstrate that activation of central AT2R can influence cardiovascular regulation. Collectively, these studies indicate that selective activation of brain AT2R causes moderate decreases in blood pressure in normal animals and more profound anti-hypertensive effects, along with restoration of baroreflex function, in rodent models of neurogenic hypertension. These findings have opened the door to studies that can (i) assess the role of specific AT2R neuron populations in depressing blood pressure, (ii) determine the relevance of such mechanisms, and (iii) investigate interactions between AT2R and depressor angiotensin-(1-7)/Mas mechanisms in the brain.

16 Review The Gut, Its Microbiome, and Hypertension. 2017

Richards, Elaine M / Pepine, Carl J / Raizada, Mohan K / Kim, Seungbum. ·Departments of Physiology and Functional Genomics, University of Florida, PO Box 100274, Gainesville, FL, 32610-0274, USA. · Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA. · Departments of Physiology and Functional Genomics, University of Florida, PO Box 100274, Gainesville, FL, 32610-0274, USA. mraizada@ufl.edu. ·Curr Hypertens Rep · Pubmed #28444579.

ABSTRACT: PURPOSE OF THE REVIEW: Evidence is rapidly accumulating implicating gut dysbiosis in hypertension (HTN). However, we are far from understanding whether this is a cause or consequence of HTN, and how to best translate this fundamental knowledge to advance the management of HTN. This review aims to summarize recent advances in the field, illustrate the connections between the gut and hypertension, and establish that the gut microbiota (GM)-gut interaction is centrally positioned for consideration as an innovative approach for HTN therapeutics. RECENT FINDINGS: Animal models of HTN have shown that gut pathology occurs in HTN, and provides some clues to mechanisms linking the dysbiosis, gut pathology, and HTN. Circumstantial evidence links gut dysbiosis and HTN. Gut pathology, apparent in animal HTN models, has not been fully investigated in hypertensive patients. Objective evidence and an understanding of mechanisms could have a major impact for new antihypertensive therapies and/or improved applications of current ones.

17 Review The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. 2017

Gibbons, Christopher H / Schmidt, Peter / Biaggioni, Italo / Frazier-Mills, Camille / Freeman, Roy / Isaacson, Stuart / Karabin, Beverly / Kuritzky, Louis / Lew, Mark / Low, Phillip / Mehdirad, Ali / Raj, Satish R / Vernino, Steven / Kaufmann, Horacio. ·Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA. cgibbons@bidmc.harvard.edu. · National Parkinson Foundation, Miami, FL, USA. · Vanderbilt University Medical Center, Nashville, TN, USA. · Duke University Hospital and Central Carolina Hospital, Durham, NC, USA. · Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA. · Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA. · University of Toledo Medical Center, Toledo, OH, USA. · University of Florida College of Medicine, Gainesville, FL, USA. · Keck/USC School of Medicine, Los Angeles, CA, USA. · Mayo Clinic, Rochester, MN, USA. · Saint Louis University Hospital, St. Louis, MO, USA. · University of Calgary, Calgary, BC, Canada. · University of Texas Southwestern Medical Center, Dallas, TX, USA. · New York University Langone Medical Center, New York, NY, USA. ·J Neurol · Pubmed #28050656.

ABSTRACT: Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members' discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.

18 Review Genome-Wide and Gene-Based Meta-Analyses Identify Novel Loci Influencing Blood Pressure Response to Hydrochlorothiazide. 2017

Salvi, Erika / Wang, Zhiying / Rizzi, Federica / Gong, Yan / McDonough, Caitrin W / Padmanabhan, Sandosh / Hiltunen, Timo P / Lanzani, Chiara / Zaninello, Roberta / Chittani, Martina / Bailey, Kent R / Sarin, Antti-Pekka / Barcella, Matteo / Melander, Olle / Chapman, Arlene B / Manunta, Paolo / Kontula, Kimmo K / Glorioso, Nicola / Cusi, Daniele / Dominiczak, Anna F / Johnson, Julie A / Barlassina, Cristina / Boerwinkle, Eric / Cooper-DeHoff, Rhonda M / Turner, Stephen T. ·From the Department of Health Sciences, University of Milan, Italy (E.S., F.R., M.C., M.B., C.B.) · Human Genetics and Institute of Molecular Medicine, University of Texas Health Science Center, Houston (Z.W., E.B.) · Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, College of Pharmacy (Y.G., C.W.M., J.A.J., R.M.C.-D.) and Division of Cardiovascular Medicine, Department of Medicine (J.A.J., R.M.C.-D.), University of Florida, Gainesville · Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, United Kingdom (S.P., A.F.D.) · Department of Medicine, University of Helsinki and Helsinki University Hospital, Finland (T.P.H., K.K.K.) · Nephrology and Dialysis and Hypertension Unit, San Raffaele Scientific Institute, Università Vita Salute San Raffaele, Milano, Italy (C.L., P.M.) · Hypertension and Related Disease Centre, AOU-University of Sassari, Italy (R.Z., N.G.) · Division of Biomedical Statistics and Informatics, Department of Health Sciences Research (K.R.B.) and Division of Nephrology and Hypertension, Department of Internal Medicine (S.T.T.), Mayo Clinic, Rochester, Minnesota · Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland (A.-P.S) · Department of Clinical Sciences, Lund University, Malmö, Sweden (O.M.) · Section of Nephrology, Department of Medicine, University of Chicago, Illinois (A.B.C.) · Institute of Biomedical Technologies, National Research Centre of Italy, Segrate, Milan, Italy (D.C.) · and Sanipedia srl, Bresso, Italy (D.C.). ·Hypertension · Pubmed #27802415.

ABSTRACT: This study aimed to identify novel loci influencing the antihypertensive response to hydrochlorothiazide monotherapy. A genome-wide meta-analysis of blood pressure (BP) response to hydrochlorothiazide was performed in 1739 white hypertensives from 6 clinical trials within the International Consortium for Antihypertensive Pharmacogenomics Studies, making it the largest study to date of its kind. No signals reached genome-wide significance (P<5×10

19 Review AAV Delivery of Endothelin-1 shRNA Attenuates Cold-Induced Hypertension. 2017

Chen, Peter Gin-Fu / Sun, Zhongjie. ·2 Departments of Medicine and Physiology, College of Medicine, University of Florida , Gainesville, Florida. · 1 Department of Physiology, College of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma. ·Hum Gene Ther · Pubmed #27736201.

ABSTRACT: Cold temperatures are associated with increased prevalence of hypertension. Cold exposure increases endothelin-1 (ET1) production. The purpose of this study is to determine whether upregulation of ET1 contributes to cold-induced hypertension (CIH). In vivo RNAi silencing of the ET1 gene was achieved by adeno-associated virus 2 (AAV2) delivery of ET1 short-hairpin small interfering RNA (ET1-shRNA). Four groups of male rats were used. Three groups were given AAV.ET1-shRNA, AAV.SC-shRNA (scrambled shRNA), and phosphate-buffered saline (PBS), respectively, before exposure to a moderately cold environment (6.7 ± 2°C), while the last group was given PBS and kept at room temperature (warm, 24 ± 2°C) and served as a control. We found that systolic blood pressure of the PBS-treated and SC-shRNA-treated groups increased significantly within 2 weeks of exposure to cold, reached a peak level (145 ± 4.8 mmHg) by 6 weeks, and remained elevated thereafter. By contrast, blood pressure of the ET1-shRNA-treated group did not increase, suggesting that silencing of ET1 prevented the development of CIH. Animals were euthanized after 10 weeks of exposure to cold. Cold exposure significantly increased the left ventricle (LV) surface area and LV weight in cold-exposed rats, suggesting LV hypertrophy. Superoxide production in the heart was increased by cold exposure. Interestingly, ET1-shRNA prevented cold-induced superoxide production and cardiac hypertrophy. ELISA assay indicated that ET1-shRNA abolished the cold-induced upregulation of ET1 levels, indicating effective silencing of ET1. In conclusion, upregulation of ET1 plays a critical role in the pathogenesis of CIH and cardiac hypertrophy. AAV delivery of ET1-shRNA is an effective therapeutic strategy for cold-related cardiovascular disease.

20 Review Women, Hypertension, and the Systolic Blood Pressure Intervention Trial. 2016

Wenger, Nanette K / Ferdinand, Keith C / Bairey Merz, C Noel / Walsh, Mary Norine / Gulati, Martha / Pepine, Carl J / Anonymous2170875. ·Department of Cardiology, Emory University School of Medicine Atlanta, Ga. · Tulane University Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, La. · Department of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, Calif. · St. Vincent Heart Center, Indianapolis, Ind. · Division of Cardiology, University of Arizona-Phoenix. · Division of Cardiovascular Medicine, University of Florida, Gainesville. Electronic address: carl.pepine@medicine.ufl.edu. ·Am J Med · Pubmed #27427323.

ABSTRACT: Hypertension accounts for approximately 1 in 5 deaths in American women and is the major contributor to many comorbid conditions. Although blood pressure lowering reduces cardiovascular disease outcomes, considerable uncertainty remains on best management in women. Specifically, female blood pressure treatment goals have not been established, particularly among older and African American and Hispanic women, for whom hypertension prevalence, related adverse outcomes, and poor control rates are high. The Systolic Blood Pressure Intervention Trial (SPRINT) planned to clarify optimal blood pressure management in both sexes. Although confirming that a lower blood pressure goal is generally better, because female enrollment and event rates were low and follow-up shortened, outcomes differences in women were not statistically significant. Thus optimal blood pressure goals for women have not been established with the highest evidence. This review addresses SPRINT's significance and key remaining knowledge gaps in optimal blood pressure management to improve women's health.

21 Review Ivabradine (Corlanor) for Heart Failure. 2016

Davis, Kyle / Dietrich, Eric. ·Ochsner Medical Center, New Orleans, LA, USA. · University of Florida Colleges of Medicine and Pharmacy, Gainesville, FL, USA. ·Am Fam Physician · Pubmed #27175841.

ABSTRACT: -- No abstract --

22 Review Brain-Gut-Bone Marrow Axis: Implications for Hypertension and Related Therapeutics. 2016

Santisteban, Monica M / Kim, Seungbum / Pepine, Carl J / Raizada, Mohan K. ·From the Department of Physiology and Functional Genomics (M.M.S., S.K., M.K.R.) and Division of Cardiovascular Medicine, Department of Medicine (C.J.P.), College of Medicine, University of Florida, Gainesville. · From the Department of Physiology and Functional Genomics (M.M.S., S.K., M.K.R.) and Division of Cardiovascular Medicine, Department of Medicine (C.J.P.), College of Medicine, University of Florida, Gainesville. mraizada@ufl.edu. ·Circ Res · Pubmed #27081113.

ABSTRACT: Hypertension is the most prevalent modifiable risk factor for cardiovascular disease and disorders directly influencing cardiovascular disease morbidity and mortality, such as diabetes mellitus, chronic kidney disease, obstructive sleep apnea, etc. Despite aggressive attempts to influence lifestyle modifications and advances in pharmacotherapeutics, a large percentage of patients still do not achieve recommended blood pressure control worldwide. Thus, we think that mechanism-based novel strategies should be considered to significantly improve control and management of hypertension. The overall objective of this review is to summarize implications of peripheral- and neuroinflammation as well as the autonomic nervous system-bone marrow communication in hematopoietic cell homeostasis and their impact on hypertension pathophysiology. In addition, we discuss the novel and emerging field of intestinal microbiota and roles of gut permeability and dysbiosis in cardiovascular disease and hypertension. Finally, we propose a brain-gut-bone marrow triangular interaction hypothesis and discuss its potential in the development of novel therapies for hypertension.

23 Review Obesity Statistics. 2016

Smith, Kristy Breuhl / Smith, Michael Seth. ·Department of Community Health and Family Medicine, University of Florida, 200 Southwest 62nd Boulevard, Suite D, Gainesville, FL 32607, USA. Electronic address: kbreuhl@ufl.edu. · Department of Orthopedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL 32611, USA. ·Prim Care · Pubmed #26896205.

ABSTRACT: Obesity is a chronic disease that is strongly associated with an increase in mortality and morbidity including, certain types of cancer, cardiovascular disease, disability, diabetes mellitus, hypertension, osteoarthritis, and stroke. In adults, overweight is defined as a body mass index (BMI) of 25 kg/m(2) to 29 kg/m(2) and obesity as a BMI of greater than 30 kg/m(2). If current trends continue, it is estimated that, by the year 2030, 38% of the world's adult population will be overweight and another 20% obese. Significant global health strategies must reduce the morbidity and mortality associated with the obesity epidemic.

24 Review Hypertension and aging. 2016

Buford, Thomas W. ·Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32611, USA. Electronic address: tbuford@ufl.edu. ·Ageing Res Rev · Pubmed #26835847.

ABSTRACT: Hypertension is a highly prevalent condition with numerous health risks, and the incidence of hypertension is greatest among older adults. Traditional discussions of hypertension have largely focused on the risks for cardiovascular disease and associated events. However, there are a number of collateral effects, including risks for dementia, physical disability, and falls/fractures which are increasingly garnering attention in the hypertension literature. Several key mechanisms--including inflammation, oxidative stress, and endothelial dysfunction--are common to biologic aging and hypertension development and appear to have key mechanistic roles in the development of the cardiovascular and collateral risks of late-life hypertension. The objective of the present review is to highlight the multi-dimensional risks of hypertension among older adults and discuss potential strategies for treatment and future areas of research for improving overall care for older adults with hypertension.

25 Review Sex, the brain and hypertension: brain oestrogen receptors and high blood pressure risk factors. 2016

Hay, Meredith. ·Department of Physiology, Evelyn F. McKnight Brain Institute, Saver Heart Center, University of Arizona, Tucson, AZ, U.S.A. mhay@arizona.edu. ·Clin Sci (Lond) · Pubmed #26621877.

ABSTRACT: Hypertension is a major contributor to worldwide morbidity and mortality rates related to cardiovascular disease. There are important sex differences in the onset and rate of hypertension in humans. Compared with age-matched men, premenopausal women are less likely to develop hypertension. However, after age 60, the incidence of hypertension increases in women and even surpasses that seen in older men. It is thought that changes in levels of circulating ovarian hormones as women age may be involved in the increase in hypertension in older women. One of the key mechanisms involved in the development of hypertension in both men and women is an increase in sympathetic nerve activity (SNA). Brain regions important for the regulation of SNA, such as the subfornical organ, the paraventricular nucleus and the rostral ventral lateral medulla, also express specific subtypes of oestrogen receptors. Each of these brain regions has also been implicated in mechanisms underlying risk factors for hypertension such as obesity, stress and inflammation. The present review brings together evidence that links actions of oestrogen at these receptors to modulate some of the common brain mechanisms involved in the ability of hypertensive risk factors to increase SNA and blood pressure. Understanding the mechanisms by which oestrogen acts at key sites in the brain for the regulation of SNA is important for the development of novel, sex-specific therapies for treating hypertension.

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