It is the best of times and the worst of times in the battle against cardiovascular disease. On the one hand, mortality rates from cardiovascular disease in the US have dropped by more than half in the last 30 years, likely due in large part to improvements in treatment for elevated blood pressure and cholesterol…
Prevalence Of Cardiovascular Disease Likely To Increase Despite Gains In Treatment
October 9, 2013 by Leave a Comment
Realistic Expectations For New ‘Breakthrough’ Blood Pressure Technology
September 10, 2013 by Leave a Comment
Early trials of renal denervation, the innovative new catheter-based blood pressure lowering technology, have resulted in extremely impressive drops in systolic blood pressure in the range of 30 mm Hg. These results have sparked a great deal of excitement in the hypertension community and stirred the interest of a multitude of medical device companies. Some…
New Actelion Drug Found Safe And Effective In Pulmonary Arterial Hypertension– But Does It Save Lives?
August 28, 2013 by Leave a Comment
Macitentan, a new drug for pulmonary arterial hypertension (PAH), appears to be safe and effective, but it is unclear whether it offers any significant advantages over currently available drugs. The drug, a dual endothelin-receptor antagonist, is under development from Actelion as an enhanced version of bosentan (Tracleer). The results of a phase 3 trial, SERAPHIN (Study with an Endothelin…
Kaiser Program Yields Big Improvements In Hypertension Control
August 20, 2013 by Leave a Comment
A large percentage of the 65 million people with high blood pressure in the United States do not know they have hypertension or have not succeeded in controlling their hypertension. Although many programs have been proposed, there is little evidence that any method can produce long term improvement in hypertension control. In a paper published in JAMA,…
The Guidelines Are Dead. Long Live The Guidelines.
August 9, 2013 by Leave a Comment
Following last month’s surprising announcement that the National Heart, Lung, and Blood Institute would no longer issue guidelines, leaders of the American Heart Association and the American College of Cardiology have now announced that are “officially assuming the joint governance, management and public distribution” of the enormously influential cardiovascular prevention guidelines, including the much-delayed and much-anticipated hypertension and cholesterol guidelines (formerly…
Deja Vu All Over Again: Study Links Calcium-Channel Blockers To Breast Cancer
August 5, 2013 by Leave a Comment
A new observational study raises the possibility that calcium-channel blockers (CCBs) may be associated with a higher risk for breast cancer. Although previous studies examining this relationship have failed to turn up convincing evidence of a link, the authors of a paper published in JAMA Internal Medicine state that their study is the first to look at…
Hypertension And Cholesterol Guidelines Delayed Again As NHLBI Gets Out Of The Guidelines Business
June 19, 2013 by Leave a Comment
The National Heart, Lung, and Blood Institute (NHLBI) will no longer issue guidelines, including the much-delayed and much-anticipated hypertension (JNC 8) and cholesterol (ATP IV) guidelines. Instead, the NHLBI will perform systematic evidence reviews that other organizations, including the American Heart Association and the American College of Cardiology, will use as a resource for their own guidelines….
New European Hypertension Guidelines Released With Simplified Blood Pressure Target
June 14, 2013 by Leave a Comment
New hypertension guidelines from the European Society of Hypertension and the European Society of Cardiology were released in Milan today at the European Meeting on Hypertension & Cardiovascular Protection. The authors of the guidelines write that “despite overwhelming evidence that hypertension is a major cardiovascular risk, studies show that many are still unaware of the condition,…
European Medicines Agency Starts Review of Combined Use Of Drugs That Block The Renin-Angiotensin System
May 20, 2013 by 1 Comment
The European Medicines Agency said last week that it was initiating a review of the combined use of agents that block the renin-angiotensin system (RAS). The three classes of RAS-blocking drugs (ACE inhibitors, ARBs, and direct renin inhibitors) are used to treat hypertension and congestive heart failure. The EMA said that the review was being performed to…
St. Jude Raises The Stakes In Renal Denervation With An Outcomes Study
February 15, 2013 by Leave a Comment
The already hot field of renal denervation for resistant hypertension just got a little hotter. With the announcement of a clinical trial powered to detect improvements in cardiovascular outcomes, St. Jude Medical has raised the stakes. … “To date, the renal denervation studies that have been conducted only looked at reducing blood pressure in…
Study Warns Against Dual Blockade of Renin-Angiotensin System In Heart Failure And Hypertension
January 28, 2013 by 1 Comment
The enormous success of ACE inhibitors in hypertension and heart failure spurred hope that adding a second drug to block the renin-angiotensin system would yield improved outcomes. Although definitive evidence supporting dual blockade of the renin-angiotensin system has never been found, more than 200,000 patients in the US currently receive this therapy. Now a large…
Renal Denervation: Delineating Its Uses, Misuses, and Possibilities
January 22, 2013 by Leave a Comment
Over on CardioExchange, Murray Essler, the chief investigator of the Symplicity HTN-2 trial, answers questions from John Ryan about renal denervation: Non-pharmacologic antihypertensive measures must remain the starting point for patients with hypertension, but will often not be enough. Renal denervation should be reserved for patients in whom behavior modification combined with adequate and skillful antihypertensive…
Promising One Year Results For Renal Denervation In Resistant Hypertension Spark Hype
December 18, 2012 by Leave a Comment
Denervation of the renal sympathetic nerve may become an important new tool in the fight against resistant hypertension. Previously, the main results of the Symplicity HTN-2 trial demonstrated that in selected patients renal denervation resulted in a large and highly significant reduction in systolic blood pressure (BP) at six months. Now, longer followup from the trial, published…
Hypertension And Smoking Top List Of Global Risk Factors
December 13, 2012 by 1 Comment
Worldwide, hypertension and tobacco smoking are the single largest causes of death and disability, according to findings from the Global Burden of Disease Study 2010 (GBD 2010), the largest ever assessment and analysis of global health and disease. In an unprecedented move, the Lancet devoted an entire issue to the study, including seven separate articles and eight comments….
Should Body Weight Influence Choice of Antihypertensive Therapy?
December 6, 2012 by 1 Comment
The hypertension field has been troubled by repeated observations that normal weight patients have more cardiovascular (CV) events than obese patients. Now a new analysis of a large hypertension trial confirms this finding but also suggests that it may be explained by either an adverse effect of diuretics or a protective effect of calcium-channel blockers in non-obese…
Investigator Defends Controversial Transcendental Meditation Paper
November 20, 2012 by 5 Comments
Editor’s Note: Here is a response by Dr. Robert Schneider to my story last week about his controversial paper on Transcendental Meditation that appeared in Circulation: Cardiovascular Quality & Outcomes. I will respond to Dr. Schneider’s post later this week. Response from Dr. Robert Schneider We appreciate the interest in our article published in Circulation: Cardiovascular Outcomes…
Mysterious Disappearing Paper Finally Reappears In Another Journal
November 13, 2012 by 34 Comments
Updated– Last year, in what may have been an unprecedented action, a paper on the effects of Transcendental Mediation (TM) in African Americans was withdrawn by the editors only 12 minutes before the paper’s scheduled publication in Archives of Internal Medicine. No definitive explanation was ever provided, though the editors and authors said that the action…
Antihypertensive Use Among Pregnant Women on the Rise
September 10, 2012 by Leave a Comment
Growing numbers of pregnant women are taking antihypertensive drugs that may harm themselves or their babies, according to a new study published in Hypertension. Brian Bateman and colleagues analyzed Medicaid data from more than 1.1 million pregnant women. Overall, 4.4% of the women received antihypertensive medications at some point during their pregnancy. From 2000 to 2007…
CDC: 35 Million Americans Have Uncontrolled Hypertension
September 4, 2012 by 2 Comments
According to the Centers for Disease Control, new data from the National Health and Nutrition Examination Survey (NHANES) shows: 30.4% of US adults (about 66.9 million people) have hypertension. 53.5% have uncontrolled hypertension (about 35.8 million people). 39.4% with uncontrolled hypertension (about 14.1 million) are unaware that they have hypertension. 89.4% with uncontrolled hypertension have a “usual source…
Studies Probe Effect Of CPAP And Sleep Apnea On Hypertension
May 22, 2012 by Leave a Comment
Two studies published in JAMA provide additional but not surprising information about the relationship between obstructive sleep apnea (OSA), hypertension, and the role of continuous positive airway pressure (CPAP). In the first study, Ferran Barbé and colleagues randomized 725 people with OSA but no daytime sleepiness to either CPAP or no active treatment. Although there were…
A Case of Plagiarism Raises Blood Pressures
March 18, 2012 by 1 Comment
Plagiarism: it’s enough to raise your blood pressure. An article in Korean Circulation Journal appears to plagiarize from a similar article in the Journal of the American College of Cardiology (JACC). In 2009, Franz Messerli, a well-known hypertension expert at St Luke’s Roosevelt Hospital Center in New York, and Gurusher Panjrath, at Johns Hopkins Hospital, published a Viewpoint and Commentary…
Recent Comments