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Hypertension Management (hypertension + management)
Selected AbstractsHEALTH-RELATED FUNCTIONALITY OF PHENOLIC-ENRICHED PEA SPROUTS IN RELATION TO DIABETES AND HYPERTENSION MANAGEMENTJOURNAL OF FOOD BIOCHEMISTRY, Issue 1 2008ELIZABETH BURGUIERES ABSTRACT The rationale for this investigation is that phenolic content in light-modulated pea seedlings could be enhanced by exogenous elicitors with antioxidant potential such as folic acid and vitamin C. Such phenolic-enriched extracts may have health benefits to consumers. The antioxidant-linked functional attributes of the phenolic-enriched extracts were evaluated for potential health-related benefits. Specifically, effectiveness in inhibiting ,-amylase and ,-glucosidase in relation to hyperglycemia (linked to diabetes management), as well as inhibiting angiotensin-converting enzyme I (ACE I), in relation to hypertension, was evaluated. The results show that phenolic-enriched extracts had the ability to inhibit ,-amylase and ,-glucosidase activity. On the day with the highest total phenolic content, day 8, inhibition of ,-amylase and ,-glucosidase was most prominent. Further, the same extracts showed positive benefits for potential hypertension management reflected in the inhibition of ACE I. These results taken together indicated that light-sprouted pea seedling extracts when incorporated into the diet could contribute to potential management of hyperglycemia linked to diabetes and hypertension related to cardiovascular risk. PRACTICAL APPLICATIONS In this in vitro study results show the positive effect of the different phenolic-enriched pea sprouts on hyperglycemia risk factors. It is clear that phenolic-enriched pea sprouts have high antioxidant activity, ACE 1 inhibitory activity and also good inhibitory activity on carbohydrate-modulating enzyme such as alpha-glucosidase related to glucose absorption in the intestine. The potential for managing both glucose absorption and cellular redox dysfunction for preventing postprandial hyperglycemia linked to type 2 diabetes and hyperglycemia-induced vascular complications leading to hypertension can be designed in part through food systems and therefore provides the rationale basis for further clinical studies. This strategy can be further extended to enhance phenolic-linked health benefits of a wide variety of legumes, fruits and vegetables and therefore can be the basis for food ingredient design for functional food applications. [source] HYPERTENSION MANAGEMENT: LIFESTYLE INTERVENTIONS IN A TRANSCULTURAL CONTEXTJOURNAL OF RENAL CARE, Issue 4 2009Tai Mooi Ho SUMMARY Hypertension is a risk factor for cardiovascular and kidney diseases. According to estimation, the prevalence of hypertension will increase unless extensive and effective preventive measures are implemented. The diversity of languages and cultures of the hypertensive patients requiring adequate blood pressure control make communications difficult in many instances. Nursing intervention for patients to adopt a healthy lifestyle requires effective communication. But the communication problems encountered in a culturally diverse context can result in undesirable outcomes for the patients and the health-care team. This paper describes the production of a document to assist staff address the difficulty in intercultural communication, which could be used anywhere in the world. This document can facilitate nursing intervention to achieve optimal hypertension management in a transcultural context, responding to the challenge regarding preventive measures to halt increase in hypertension prevalence. [source] Masked Hypertension: An Increasingly Common but Often Unrecognized Issue in Hypertension ManagementJOURNAL OF CLINICAL HYPERTENSION, Issue 7 2010Debbie L. Cohen MD No abstract is available for this article. [source] New Insights Into Hypertension Management in Acute Stroke: Let the CHHIPS Fall Where They MayJOURNAL OF CLINICAL HYPERTENSION, Issue 6 2008Clive Rosendorff MD No abstract is available for this article. [source] Insulin resistance, diabetes and cardiovascular risk: approaches to treatmentDIABETES OBESITY & METABOLISM, Issue 6 2005Daniel E. Rosenberg Abstract:, The prevalence of diabetes is increasing worldwide. Insulin resistance and diabetes mellitus are major predictors of cardiovascular ischaemic disease. Other risk factors for cardiovascular death including hypertension, dyslipidaemia, smoking and visceral obesity are especially lethal in diabetics. C-reactive protein, plasminogen activator inhibitor-1, matrix metalloproteinases and other emerging risk factors and their roles are continually being researched and discovered. Treatment of this syndrome must be aimed at lifestyle modification, glycaemic control and management of concomitant risk factors. Diet and exercise play a vital role in the treatment of diabetes and the metabolic syndrome. Weight reduction and increased physical activity will improve insulin resistance, hyperglycaemia, hypertension and dyslipidaemia. Hypertension management has been shown to be especially important in diabetics to prevent cardiovascular events. Likewise, multiple clinical trials show that reduction of cholesterol is even more vital in diabetics than the general population for risk reduction of coronary disease. There is a great deal of evidence that tight control of glycaemia is essential to treatment of this condition. There are a variety of available pharmacological agents available including metformin, insulin secretagogues, alpha-glucosidase inhibitors, thiazolidinediones and insulin. The mechanisms and side effects of these medications are discussed. As macrovascular disease is the major cause of morbidity and mortality, an early, aggressive, multi-factorial approach to treatment of the metabolic syndrome and diabetes is vital to prevent adverse cardiac outcomes. [source] Managing Hypertension: State of the ScienceJOURNAL OF CLINICAL HYPERTENSION, Issue 2006Jerome D. Cohen MD Hypertension management is both routine and a challenge. Updated guidelines emphasize the need to achieve increasingly stringent blood pressure goals to reduce cardiovascular morbidity and mortality; however, the blood pressure of many patients who have been diagnosed with hypertension is not well controlled. Treating prehypertension nonpharmacologically may preempt the progression to hypertension, whereas early and aggressive management of hypertension with antihypertensive agents reduces short- and long-term cardiovascular risk. Treatment decisions should follow current guidelines while evaluating recently published clinical studies. When choosing between agents from different therapeutic classes or combining agents, physicians should consider current and targeted blood pressure levels, the patient's demographic profile, the presence or absence of compelling cardiovascular and metabolic indications, other comorbidities, and concurrent medication(s). [source] Effectiveness of the Electronic Medical Record in Improving the Management of HypertensionJOURNAL OF CLINICAL HYPERTENSION, Issue 6 2002James W. Kinn MD Clinical studies suggest that hypertension is often undiagnosed, undertreated, and poorly controlled. In 1997, the authors developed a comprehensive electronic medical record that interfaces with physicians during each outpatient visit and provides real-time feedback about patient care management, including the management of hypertension. The purpose of this study was to determine whether this interactive electronic medical record results in better detection and control of hypertension. During a 12-month study period, consecutive outpatients (n=1076) were seen for routine follow-up; patient care documentation relied solely on the electronic medical record. Quality indicators for hypertension included: 1) documentation of the diagnosis of hypertension; 2) use of blood pressure-lowering drugs; and 3) successful blood pressure lowering to ,140/90 mm Hg. The authors compared the hypertension management of these patients to a control group of similar patients (n=723) with medical records consisting solely of traditional "pen and paper" charts. Baseline characteristics were similar between the two groups, including the prevalence of hypertension (73 % vs. 70%; p=NS). However, the electronic medical record resulted in higher documentation rates of hypertension (90% vs. 77%; p<0.001), greater use of antihypertensive therapy (94% vs. 90%; p<0.01), and more successful blood pressure lowering to ,140/90 mm Hg (54% vs. 28%; p<0.001). In conclusion, the electronic medical record with real-time feedback improves the physician's ability to detect, treat, and control hypertension. [source] HEALTH-RELATED FUNCTIONALITY OF PHENOLIC-ENRICHED PEA SPROUTS IN RELATION TO DIABETES AND HYPERTENSION MANAGEMENTJOURNAL OF FOOD BIOCHEMISTRY, Issue 1 2008ELIZABETH BURGUIERES ABSTRACT The rationale for this investigation is that phenolic content in light-modulated pea seedlings could be enhanced by exogenous elicitors with antioxidant potential such as folic acid and vitamin C. Such phenolic-enriched extracts may have health benefits to consumers. The antioxidant-linked functional attributes of the phenolic-enriched extracts were evaluated for potential health-related benefits. Specifically, effectiveness in inhibiting ,-amylase and ,-glucosidase in relation to hyperglycemia (linked to diabetes management), as well as inhibiting angiotensin-converting enzyme I (ACE I), in relation to hypertension, was evaluated. The results show that phenolic-enriched extracts had the ability to inhibit ,-amylase and ,-glucosidase activity. On the day with the highest total phenolic content, day 8, inhibition of ,-amylase and ,-glucosidase was most prominent. Further, the same extracts showed positive benefits for potential hypertension management reflected in the inhibition of ACE I. These results taken together indicated that light-sprouted pea seedling extracts when incorporated into the diet could contribute to potential management of hyperglycemia linked to diabetes and hypertension related to cardiovascular risk. PRACTICAL APPLICATIONS In this in vitro study results show the positive effect of the different phenolic-enriched pea sprouts on hyperglycemia risk factors. It is clear that phenolic-enriched pea sprouts have high antioxidant activity, ACE 1 inhibitory activity and also good inhibitory activity on carbohydrate-modulating enzyme such as alpha-glucosidase related to glucose absorption in the intestine. The potential for managing both glucose absorption and cellular redox dysfunction for preventing postprandial hyperglycemia linked to type 2 diabetes and hyperglycemia-induced vascular complications leading to hypertension can be designed in part through food systems and therefore provides the rationale basis for further clinical studies. This strategy can be further extended to enhance phenolic-linked health benefits of a wide variety of legumes, fruits and vegetables and therefore can be the basis for food ingredient design for functional food applications. [source] HYPERTENSION MANAGEMENT: LIFESTYLE INTERVENTIONS IN A TRANSCULTURAL CONTEXTJOURNAL OF RENAL CARE, Issue 4 2009Tai Mooi Ho SUMMARY Hypertension is a risk factor for cardiovascular and kidney diseases. According to estimation, the prevalence of hypertension will increase unless extensive and effective preventive measures are implemented. The diversity of languages and cultures of the hypertensive patients requiring adequate blood pressure control make communications difficult in many instances. Nursing intervention for patients to adopt a healthy lifestyle requires effective communication. But the communication problems encountered in a culturally diverse context can result in undesirable outcomes for the patients and the health-care team. This paper describes the production of a document to assist staff address the difficulty in intercultural communication, which could be used anywhere in the world. This document can facilitate nursing intervention to achieve optimal hypertension management in a transcultural context, responding to the challenge regarding preventive measures to halt increase in hypertension prevalence. [source] Antihypertensives and myocardial infarction risk: the modifying effect of history of drug usePHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2001Chantal Bourgault PhD Abstract Purpose Confounding by indication is common in observational studies of outcomes that treatment is intended to affect. In light of the stepped-care approach to hypertension management, we reexamined the controversy around myocardial infarction (MI) risk in relation to antihypertensive agents by considering past drug history both as a confounder and as an effect modifier. Methods Case,control design nested within a cohort of 19,501 adults initiating therapy with angiotensin-converting enzyme inhibitors (ACEI), calcium channel blockers (CCB) or ,-blockers in Saskatchewan (1990,93) and followed up to 1997. MI cases were identified using death certificates and hospital discharge diagnoses (ICD-9 410). Four controls were matched to each case to account for duration and timing of follow-up. Results 812 MI cases were identified, of which 26% were fatal. At first, current use of CCB and ACEI (versus ,-blockers) appeared to be associated with an increased risk of MI (RR,=,2.2; 95% CI,=,1.8,2.7 and RR,=,1.3; CI,=,1.0,1.6 respectively). Adjustment for drug use history attenuated both associations (RR,=,1.6; CI,=,1.1,2.2 and RR,=,1.0; CI,=,0.7,1.4). Moreover, the risk for CCB use disappeared when restricted to patients who had already used these agents in the past (RR,=,1.1; CI,=,0.77,1.7) whereas a high risk of MI for ACEI was found in digoxin users (RR,=,9.4; CI,=,3.2,27.5). Conclusion Past drug history can be both a confounder and an effect modifier in observational studies. We found adjustment for medication history to attenuate the associations between antihypertensive agents and MI risk. In addition, the estimates significantly varied across drug history profiles thus suggesting the presence of preferential prescribing of specific drug classes to high-risk patients. Copyright © 2001 John Wiley & Sons, Ltd. [source] Clinical trial experience around the globe: Focus on calcium-channel blockersCLINICAL CARDIOLOGY, Issue S2 2003William B. White M.D. Abstract Although certain classes of drugs appear to possess benefits apart from their blood-pressure lowering capability, reduction of blood pressure remains the single most important action of antihypertensive therapy. Calcium-channel blockers (CCBs) have long been recognized as potent agents for hypertension therapy. This is especially true for the prevention of stroke in hypertensive patients as evidenced from the Systolic Hypertension in Europe (Syst-Eur) and Systolic Hypertension in China (Syst-China) trials with a long acting dihydropyridine CCB. The same can be said for beta blockers in patients post myocardial infarction. However, most recent clinical trials have underscored the necessity of multiple drug therapy to achieve the goals of blood pressure reduction coupled with outcomes reduction. For example, the many recent large-scale clinical trials have required an average of three or more agents to achieve goal. Thus, the paradigm for hypertension management has been altered to determine the best treatment regimen rather than the best initial agent. While response rates to individual agents across a wide spectrum of patients vary little, not all drugs are equally suited as companion products. In this article, we discuss the most recent outcome trials with the long acting CCBs alone or in combination with other drugs. The evidence shows that calcium antagonists remain an important part of hypertension management, including in those individuals at risk of cardiac and cerebrovascular events. [source] | ||||||||||