On Friday the NHLBI declared victory in the SPRINT trial. As was widely reported here and elsewhere, the NHLBI announced that the trial had been stopped early after significant reductions in cardiovascular events and mortality had occurred in the group of hypertensive patients randomized to a more aggressive blood pressure target than is currently recommended today. But there was a…
Doctors Halt Squabbling And Agree How To Manage Hypertension In People With Blocked Arteries
March 31, 2015 by Leave a Comment
There’s been a lot of drama in the hypertension field over the past few years. Initially sparked by the decision of the National Institutes of Health to end its sponsorship of national guidelines, the subsequent appearance of multiple guidelines with divergent recommendations led to even more controversy and discussion. Now, however, the appearance of a new scientific statement…
Medtronic And Boston Scientific Plan To Resume Blood Pressure Trials This Year
February 19, 2015 by Leave a Comment
Medtronic and Boston Scientific have announced plans to start phase 2 clinical trials this year for their updated renal denervation catheters. The once promising new technology is intended to treat hypertension unresponsive to drug therapy. The failure last year of Medtronic’s Symplicity HTN-3, the first large pivotal trial to rigorously test renal denervation, sent manufacturers back to their…
Another Study Raises Questions About Blood Pressure Guidelines
February 10, 2015 by Leave a Comment
Although the general benefits of lowering high blood pressure are widely accepted, there has been intense debate over specific goals for treatment and the threshold at which therapy should be initiated. A large new meta-analsysis published in JAMA helps shed lights on this important controversy. UK and Australian researchers analyzed the effect of lowering blood pressure in people…
Study Tests High Blood Pressure Control During Pregnancy
January 29, 2015 by Leave a Comment
High blood pressure during pregnancy is increasingly common, largely due to older age and obesity. Although there is widespread agreement that hypertension in these women should be treated when it is high enough to raise the risk of stroke, there is little agreement about whether or how to treat mild hypertension. In a study reported in…
New Device to Lower Resistant High Blood Pressure Shows Early Promise
January 22, 2015 by 1 Comment
A novel implantable device appears to show early promise in the treatment of resistant hypertension. The “Coupler” device from privatelyheld ROX Medical is about the size of a paper clip and is delivered via a catheter to the upper thigh, where it creates a connection between the vein and the artery, which lowers blood pressure in the arteries by…
Success For 40-Year Effort In One Rural County To Curb Cardiovascular Disease
January 13, 2015 by Leave a Comment
A 40-year program in one poor rural county to combat cardiovascular disease appears to have been successful, resulting in reduced rates of hospitalization and death compared with other counties in the same state over the same time period. The new findings from the study are described in a paper published in the Journal of the American Medical Association. ……
An Emerging Consensus About Novartis’s New Potential Blockbuster
January 7, 2015 by Leave a Comment
Last year it became clear that Novartis had a potential blockbuster with its new heart failure drug, LCZ696, which is an angiotensin receptor- neprilysin inhibitor (ARNi) consisting of the company’s own well-known angiotensin receptor blocker valsartan (Diovan) and a novel compound, the neprilysin inhibitor sacubitiril. The results of the PARADIGM trial, which was stopped early because of a large and highly significant reduction in…
Why Guidelines Should Be Waged Like War
August 22, 2014 by 1 Comment
(Updated) Here’s a modest proposal: we need fewer and shorter guidelines. In fact, I’d like to propose that guidelines, like war, should be waged only when there is absolute consensus and overwhelming evidence. Anyone interested in the subject is aware that guidelines are in a complete mess. Just in the past two weeks I’ve written about…
An Old Study Fuels Debate Over Blood Pressure Guidelines
August 18, 2014 by Leave a Comment
In the last year new guidelines relating to cardiovascular disease have been the subject of intense criticism and debate. The status of the blood pressure guidelines has been particularly contentious, since several different groups have published contradictory guidelines, while several authors of the most prominent group, the Eighth Joint National Committee, published an impassioned dissent…
New Studies Fuel The Debate Over Sodium
August 13, 2014 by Leave a Comment
Three papers and an editorial in the New England Journal of Medicine are sure to throw fresh fuel on the ongoing fiery debate over sodium recommendations. Current guidelines recommend that people should limit their intake of sodium to 1.5 to 2.4 grams per day, but these recommendations are based on projections and have never been tested in clinical…
Probiotics May Help Reduce Blood Pressure
July 21, 2014 by Leave a Comment
As interest in probiotics has grown in recent years, some evidence has emerged that probiotics may favorably reduce blood pressure, but trials have been small and inconsistent. Now a meta-analysis published in Hypertension suggests that the blood-pressure lowering effects of probiotics may be genuine. … Click here to read the full post on Forbes. …
FDA Once Again Reaches Conclusions At Odds With Its Own Staff
July 14, 2014 by Leave a Comment
Once again the FDA has reached a conclusion that is directly opposed by some of its own scientists. Last month the FDA affirmed the safety of olmesartan, a popular blood pressure lowering drug (sold as Benicar and other names). But that reassuring view is not shared by the FDA scientists who performed the study that provided…
Large Study Uncovers New Details About the Role of Hypertension in CVD
May 30, 2014 by Leave a Comment
Although high blood pressure has long been recognized and studied as a cardiovascular risk factor, a large new study published in the Lancet provides a more detailed, granular view of the specific role of different forms of hypertension. Eleni Rapsomaniki and colleagues in the U.K. analyzed data from 1.25 million people without existing cardiovascular disease age 30 and older. An…
The Walking Dead: Renal Denervation In Europe Just Can’t Be Stopped
May 21, 2014 by Leave a Comment
Earlier this year the only large, well-designed trial of renal denervation– the once highly-promising catheter-based technology that was widely expected to “cure” difficult cases of resistant hypertension– failed spectacularly. Many hypertension experts believe that ultimately the technique will prove to be beneficial, but after the failure of Simplicity HTN-3 it is clear that there’s a great deal…
The Uncertain Future Of A Once Highly Promising Device For Lowering Blood Pressure
April 14, 2014 by Leave a Comment
Following the spectacular crash and burn of the Symplicity HTN-3 trial at the American College of Cardiology two weeks ago, the future of renal denervation (RDN)– the once highly promising catheter technology that many thought would cure resistant hypertension– appears in doubt. Although the device has not been approved in the US– and will not be approved without…
No Benefit Found in First Real Test of Renal Denervation
March 29, 2014 by Leave a Comment
SYMPLICITY HTN-3, the eagerly awaited first rigorous test of renal denervation, shows that the real effect of the novel blood-pressure-lowering technology is dramatically lower than earlier expectations, which had been fueled by data from previous uncontrolled trials. Results of SYMPLICITY HTN-3 were presented at the American College of Cardiology conference in Washington, DC, and published…
Lower Blood Pressure Found In Vegetarians
February 24, 2014 by Leave a Comment
A new study provides the strongest evidence yet that a vegetarian diet is strongly associated with lower blood pressure. Although various health benefits of a vegetarian diet have often been proposed, a rigorous examination of the effect on blood pressure has not been previously performed. In a paper published in JAMA Internal Medicine, Japanese researchers analyzed data from…
Blood Pressure Trajectory Over 25 Years Predicts Atherosclerosis Risk
February 4, 2014 by Leave a Comment
Everyone knows that blood pressure is one of the most important measurements of cardiovascular risk. Less well known is that most studies of blood pressure have relied on single or isolated measurements of blood pressure. Few studies have even attempted to examine the significance of blood pressure patterns over a long period of time. Now,…
More Guideline Controversy: Blood Pressure Expert Decries ‘Political Correctness’
February 3, 2014 by Leave a Comment
Now add “political correctness” to the long list of criticisms directed against the recent publication of new and updated cardiovascular guidelines. One leading hypertension expert writes that the authors of the recent AHA/ACC/CDC Science Advisory on blood pressure control were chosen not for their expertise but for political expediency. … Click here to read the full post on Forbes. Confusion…
Minority Report: Five Guideline Authors Reject Change In Blood Pressure Goal
January 13, 2014 by Leave a Comment
It didn’t seem possible but the guideline situation just got even more confusing. Last December, after years of delay and other twists and turns, the Eighth Joint National Committee (JNC 8) hypertension guideline was published in JAMA. The previous guideline recommended that all adults have a target systolic blood pressure below 140 mm Hg. In the new guideline, the target…
Pivotal Medtronic Trial For ‘Breakthrough’ Blood Pressure Device Goes Down The Tubes
January 9, 2014 by Leave a Comment
The hypertension community woke up this morning to a large dose of reality with an announcement by Medtronic that the novel SYMPLICITY HTN-3 trial of its much-anticipated renal denervation device had failed to meet its primary efficacy endpoint. Renal denervation has been widely touted as a breakthrough product that could dramatically lower blood pressure by as much as 30 mm…
Missing High Blood Pressure Guideline Turns Up In JAMA
December 18, 2013 by Leave a Comment
After years of delay and many twists and turns, the hypertension guideline originally commissioned by the NIH has now finally been published in JAMA. The evidence-based document contains a major revision of hypertension treatment targets and includes new and somewhat simplified recommendations for drug treatment. The previous US hypertension guideline was published more than a decade ago….
No Value For Renal-Artery Stenting In CORAL
November 18, 2013 by Leave a Comment
Previous small studies have failed to find any benefit associated with renal-artery stenting, but the trials have been small and were not powered for clinical outcomes. Now, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) trial, presented at the American Heart Association meeting and published simultaneously in the New England Journal of Medicine, offers strong and persuasive evidence that renal-artery…
FDA Approves New Pulmonary Hypertension Drug From Actelion
October 18, 2013 by Leave a Comment
The FDA today approved macitentan (Opsumit, Actelion), a new oral endothelin-receptor antagonist that is an enhanced version of the company’s bosentan (Tracleer). The drug is indicated to delay disease progression in patients who have pulmonary arterial hypertension (WHO Group I). … Click here to read the full post on Forbes. …
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