The monthly ESH guide through publications – April 2018

Edited by Costas Tsioufis and Alex Kasiakogias

Spring is here along with some good reads. Enjoy!

 

Effect of dietary sodium restriction on arterial stiffness: systematic review and meta-analysis of the randomized controlled trials

Arterial stiffness is an independent cardiovascular risk factor and sodium intake could be a determinant of arterial stiffness. Nevertheless, the studies that investigated the effect of reducing dietary sodium intake on arterial stiffness in humans provided inconsistent results. The results of this meta-analysis indicate that restriction of dietary sodium intake reduces arterial stiffness. This effect seems be at least in part independent of the changes in blood pressure.

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Estimated 24-hour urinary sodium and potassium excretion in US adults.

In 2010, the Institute of Medicine (now the National Academy of Medicine) recommended collecting 24-hour urine to estimate US sodium intake because previous studies indicated 90% of sodium consumed was excreted in urine. In cross-sectional data from a 2014 sample of US adults, estimated mean sodium intake was 3608 mg per day. The findings provide a benchmark for future studies.

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The relationship of all-cause mortality to average on-treatment systolic blood pressure is significantly related to baseline systolic blood pressure: implications for interpretation of the Systolic Blood Pressure Intervention Trial study

The SPRINT study demonstrated that targeting systolic blood pressure (SBP) less than 120 mmHg was associated with lower cardiovascular event and mortality rates. In this analysis of LIFE study data, achievement of an average SBP less than 142 mmHg was associated with reduced mortality in patients with baseline SBP 164 mmHg or less but with increased mortality in those with higher baseline SBP. These findings suggest that the lower mortality associated with a lower targeted SBP in SPRINT may not be applicable to patients with considerably higher baseline SBP than SPRINT patients. Further study is necessary to better understand these findings.

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Association between chronic or acute use of antihypertensive class of medications and falls in older adults. A systematic review and meta-analysis

Twenty-nine studies of cohort, case-control, case-crossover, cross-sectional, or randomized controlled trial (RCT) design examining association between antihypertensives and falls in people older than 60 years were evaluated. There was no significant association between chronic use of antihypertensives and falls in older adults. Risk of falls is highest on day zero for all antihypertensive medications.

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Cocaine exposure increases blood pressure and aortic stiffness via the miR-30c-5p–Malic Enzyme 1–Reactive Oxygen Species pathway

Cocaine abuse increases the risk of cardiovascular mortality and morbidity; however, the underlying molecular mechanisms remain elusive. By using a mouse model for cocaine abuse/use, it was found that repeated cocaine injection led to increased blood pressure and aortic stiffness in mice associated with elevated levels of reactive oxygen species (ROS) in the aortas, a phenomenon similar to that observed in hypertensive humans.

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Cause of renal infarction: a retrospective analysis of 186 consecutive cases

The aim of this study was to analyze various renal infarction causes. Renal artery lesion is the most frequent cause of renal infarction. This result underlines the need for extensive arterial exploration to identify the renal infarction mechanism and, in case of renal artery lesion, the underlying vascular disease.

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Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial

The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in primary care, compared with usual care. Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings.

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A cluster-randomized trial of blood-pressure reduction in black barbershops

Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings. Among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management in barbershops by specialty-trained pharmacists.

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Effects of bariatric surgery in obese patients with hypertension. The GATEWAY randomized trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension)

In this randomized, single-center, nonblinded trial, patients with hypertension and a body mass index between 30.0 and 39.9 kg/m2 were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone. Bariatric surgery represented an effective strategy for blood pressure control in this broad population of patients with obesity and hypertension.

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Echocardiographic left ventricular reverse remodeling after 18 months of antihypertensive treatment in stage I hypertension. Results from the Prever-Treatment Study

Antihypertensive treatment improves echocardiographic parameters of hypertensive target organ damage in stage II hypertension, but less is known about the effects in stage I hypertension. In a cohort study nested in the randomized double-blind trial PREVER-treatment, treatment of patients with stage I hypertension for 18 months promotes favourable effects in the LA and LV remodelling.

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Prognostic value of echocardiography in hypertensive versus nonhypertensive participants from the general population

This study examines the incremental prognostic value of adding echocardiographic parameters to established risk factors in individuals from the general population with and without hypertension. In hypertensive individuals, left ventricular mass index added incremental prognostic value in addition to established risk factors. In nonhypertensive individuals, global longitudinal strain added incremental prognostic value in addition to established risk factors.

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