The war over the new blood pressure guideline is not a fake war or a childish dispute. It is a real war over genuine differences in how we should think about health and disease and prevention. The publication last November of the new US blood pressure guideline sparked a vigorous and important debate. A central part…
New Blood Pressure Guideline Sets Lower 130/80 Threshold
November 13, 2017 by 11 Comments
Expanded guideline means more than 100 million people have high blood pressure. The new US blood pressure guideline lowers the definition of high blood pressure to 130/80 mm Hg. This means that more than 100 million adults will now have high blood pressure, though many will be unaware of the diagnosis. The 192 page guideline…
Blacks Face Higher Mortality from Heart Disease, Stroke
October 23, 2017 by 1 Comment
–CV disease accounts for large portion of health disparities. Cardiovascular disease led to the loss of more than 2 millions years of life in the African-American population between 1999 and 2010. A new scientific statement from the American Heart Association, Cardiovascular Health in African Americans, makes clear that, compared to whites, African Americans suffer disproportionately…
Upcoming US Guideline Will Likely Set 130/80 As New Blood Pressure Target
October 6, 2017 by 1 Comment
–The highly anticipated AHA/ACC BP guideline will be published in November. The new magic number will be 130 over 80 mm Hg. That’s the new blood pressure goal that many hypertension experts say will be the centerpiece of the new US blood pressure guidelines. The new guideline will be introduced next month in Anaheim during the…
Renal Denervation Resurrected With Modest BP Reduction
August 28, 2017 by Leave a Comment
–Preliminary results from SPYRAL HTN-Off Med BARCELONA – Renal denervation is back from the dead, but only as a faint shadow of its former self. Initial interim results of the SPYRAL HTN-Off Med study suggest that the new and improved version of renal denervation (RDN) produces a real but very modest reduction in blood pressure….
Renal Denervation: Back From The Dead Or Deja Vu All Over Again?
August 14, 2017 by 1 Comment
Renal denervation is back. Or not. The failure of renal denervation (RDN) was one of the most spectacular failures in cardiovascular medicine in recent years. Great expectations for RDN appeared to die with the Simplicity-3 HTN trial, the first rigorous test of the technology, which showed that it was ineffective in the treatment of resistant…
Generic Atenolol in Short Supply
August 10, 2017 by 1 Comment
–The latest sign of turmoil in the generic drug marketplace. The widely prescribed beta-blocker atenolol is in short supply around the country. The FDA first reported an atenolol shortage on July 26. According to the FDA website, three companies that manufacture generic atenolol — Mylan, Sandoz, and Teva — say that the cause is a…
Principal Investigator Defends SPRINT Against Critics
April 20, 2017 by 1 Comment
–Blood pressure experts disagree about the NIH ‘Landmark’ Trial. Since the first announcement of its preliminary results the SPRINT trial has been the focus of intense controversy. One major focus of contention revolves around the precise technique used to measure blood pressure in the trial. As in all recent large outcome trials in hypertension, blood…
Can SPRINT Be Used To Inform Hypertension Treatment?
April 9, 2017 by 3 Comments
–The landmark trial results are not easy to apply to clinical practice. Since the first breathless announcement of its preliminary results, SPRINT trial has been viewed as a landmark trial serving to establish a more aggressive approach to blood pressure management. It is now becoming increasingly clear, however, that the application of SPRINT in the…
Scott Gottlieb’s Sham Ideology Rejects Clinical Trials
March 14, 2017 by 3 Comments
Donald Trump has nominated Scott Gottlieb to be the next FDA Commissioner. To his credit, Gottlieb is not certifiably crazy like several of the other candidates who were reported to be under consideration for the job. But he is is a deeply conservative ideologue who is determined to reduce the government’s role in healthcare. On two occasions in…
International Experts Call Salt Guidelines Far Too Restrictive
February 14, 2017 by 5 Comments
A broad group of international experts are recommending a far more modest and less draconian approach to sodium restriction than current U.S. and international guidelines. In a new paper, published online in the European Heart Journal, they also focused on the broad gaps of knowledge in the field and drew attention to the paucity of…
New Questions Raised About SPRINT
February 8, 2017 by Leave a Comment
More questions are being raised about SPRINT, the enormous NIH-funded blood pressure lowering trial. Two recent developments will likely add more obstacles to the already difficult task of applying the results of the trial in the real world. Even before the full results of the trial were first made public the NIH and the SPRINT…
American Heart Association and American Society Of Hypertension Explore Merger
September 20, 2016 by Leave a Comment
–The two US blood pressure societies want to become ‘a single force multiplier in the fight against hypertension’ The American Heart Association (AHA) and the American Society of Hypertension (ASH) are officially exploring a merger. In a message sent to ASH members, ASH president John Bisognano (University of Rochester) said that “for the past several…
SPRINTing to Lower BP Targets? Not So Fast
September 15, 2016 by 2 Comments
–Hypertension experts disagree about how to apply SPRINT results in the real world. Once again blood pressure experts are disagreeing about how to interpret SPRINT and how its results should be applied in the real world. A new study claims that applying the SPRINT results to US patients who meet SPRINT criteria would prevent more…
SPRINT: More Controversy And Confusion About ‘Landmark’ Trial
September 6, 2016 by 3 Comments
–Blood pressure experts raise new questions and concerns about the controversial trial. More questions and concerns are being raised about SPRINT, the NIH’s “landmark” blood pressure lowering trial. In sharp contrast to the enormous amount of initial hype, many hypertension experts are now saying that the SPRINT trial is difficult to interpret and can’t be readily…
Cardiologists: Thumbs Down To SPRINT
August 28, 2016 by 2 Comments
[Updated, August 29, August 30] –SPRINT should not be used in guidelines to lower blood pressure targets. Should the SPRINT trial be used by guideline committees to lower systolic blood pressure targets? After listening to a high-powered debate at the European Society of Cardiology meeting in Rome on Sunday, most audience members gave thumbs down…
Can 50 Million Blood Pressure Prescriptions Each Year Be Wrong?
August 15, 2016 by 2 Comments
–For decades physicians may have been prescribing the wrong diuretic. Now an innovative new trial will settle the question. A radically innovative large new VA trial will finally shed light on a decades-old unresolved question that could have important public health implications. According to guidelines thiazide diuretics are the first-line treatment for hypertension. Hydrochlorothiazide accounts…
How Should SPRINT Influence High Blood Pressure In Children And Adolescents?
March 28, 2016 by 2 Comments
–Editorialists say pediatric hypertension in children is ready for a ‘paradigm shift’ Last year’s influential— and highly controversial— SPRINT trial should be used to better inform and influence our understanding and management of hypertension in children, write two influential physicians who have played a key role in the cardiovascular guidelines for children and adolescents. They…
Best Selling Smartphone Blood Pressure App Gave Wrong Results
March 2, 2016 by Leave a Comment
A best-selling smartphone app that purported to measure blood pressure actually delivered highly inaccurate results, according to a research letter in JAMA Internal Medicine. The finding could cause genuine medical harm for the large number of people who use the app. In addition, the study adds new fuel to the fiery debate about the reliability…
Study Shows Why Sham Controls Are Necessary For Device Trials
January 12, 2016 by 1 Comment
— If we can melt the ice-caps then surely we can understand our own fallibility, says one UK cardiologist. The strongest known force in the universe is the ability of the human mind to deceive itself. If we know something to be true then we find the evidence to prove it. There is no better…
SPRINT Will Change But Not Revolutionize Blood Pressure Treatment
November 9, 2015 by 1 Comment
After all the hype and hoopla it turns out that the SPRINT trial will in all likelihood really have a significant impact on clinical practice and future guidelines, but it also also seems clear that it will not bring about a revolution, as some have recently speculated, in the treatment of high blood pressure. That’s the broad consensus emerging from hypertension…
Lancet Sprints To The Front With A Blood Pressure Meta-Analysis
November 6, 2015 by 1 Comment
A new meta-analysis published in the Lancet on Friday lends fresh support to calls for more intensive blood pressure treatments. The publication comes only days before the highly anticipated presentation of the NIH’s SPRINT trial at the American Heart Association, which is also expected to offer support for stricter blood pressure control. Blood pressure goals were relaxed after the ACCORD…
Coming Attraction: Looking Forward To SPRINT At The AHA Next Month
October 27, 2015 by Leave a Comment
Back in September the NIH tantalized the medical community with a preliminary announcement of the results of a major clinical trial, SPRINT (Systolic Blood Pressure Intervention Trial). The NIH said SPRINT was a “landmark trial” that could “save lives,” but their claims were impossible to evaluate since they only gave the slightest hint of the actual results. On November…
Study Raises New Questions About Perioperative Beta Blockers
October 5, 2015 by Leave a Comment
A large observational study finds that patients with hypertension who are taking beta blockers have higher rates of cardiovascular complications after noncardiac surgery. The study appears to support current guidelines against using beta blockers in the initial treatment of essential hypertension and may offer a contribution to the ongoing debate over the use of perioperative beta-blockade for noncardiac surgery…
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