Neurovascular and Cognitive Dysfunction in Hypertension

Circulation Research, Год журнала: 2019, Номер 124(7), С. 1025 - 1044

Опубликована: Март 28, 2019

Hypertension has emerged as a leading cause of age-related cognitive impairment. Long known to be associated with dementia caused by vascular factors, hypertension more recently been linked also Alzheimer disease-the major in older people. Thus, although midlife is risk factor for late-life dementia, may promote the neurodegenerative pathology underlying disease. The mechanistic bases these harmful effects remain established. well alter structure and function cerebral blood vessels, but how cerebrovascular lead impairment disease not understood. Furthermore, critical questions concern whether treatment prevents impairment, pressure threshold treatment, antihypertensive agents used. Recent advances neurovascular biology, epidemiology, brain imaging, biomarker development have started provide new insights into issues. In this review, we will examine progress made date, and, after evaluation evidence, highlight still outstanding seek path forward future studies.

Язык: Английский

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Risk factors and prediction models for cardiovascular complications of hypertension in older adults with machine learning: A cross-sectional study

Heliyon, Год журнала: 2024, Номер 10(6), С. e27941 - e27941

Опубликована: Март 1, 2024

BackgroundHypertension has emerged as a chronic disease prevalent worldwide that may cause severe cardiovascular complications, particularly in older patients. However, there is paucity of studies use risk factors and prediction models for complications associated with hypertension adults.ObjectivesTo identify the develop among patients hypertension.MethodsA convenience sample 476 was recruited from university-affiliated hospital China. Demographic data, clinical physiological indicators, regulatory emotional self-efficacy, medication adherence, lifestyle information were collected participants. Binary logistic regression analysis performed to screen preliminary complications. Two machine learning methods, Back-Propagation neural network, random forest applied study cohort. The sensitivity, specificity, accuracy, receiver operating characteristic curve, area under curve (AUC) values used assess performance models.ResultsBinary identified nine hypertension. displayed excellent predicting model (AUC 0.954) outperforming network 0.811), confirmed by comparison analysis. specificity accuracy compared 74.2% vs. 86.5%, 75.2% 94.3%, 74.7% 90.4%, respectively.ConclusionThe methods employed this demonstrated feasibility hypertension, based on exhibiting performance. These could be high-risk populations suggest early interventions aimed at preventing such cohorts.

Язык: Английский

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New perspectives for hypertension management: progress in methodological and technological developments

European Journal of Preventive Cardiology, Год журнала: 2022, Номер 30(1), С. 48 - 60

Опубликована: Сен. 8, 2022

Abstract Hypertension is the most common and preventable risk factor for cardiovascular disease (CVD), accounting 20% of deaths worldwide. However, 2/3 people with hypertension are undiagnosed, untreated, or under treated. A multi-pronged approach needed to improve management. Elevated blood pressure (BP) in childhood a predictor CVD adulthood; therefore, screening education programmes should start early continue throughout lifespan. Home BP monitoring can be used engage patients control rates. Progress imaging technology allows detection preclinical disease, which may help identify who at greatest CV events. There need optimize use current strategies including lifestyle modifications, antihypertensive agents, devices. Reducing complexity pharmacological therapy using single-pill combinations patient adherence reduce physician inertia. Other that include reassurance address misconceptions, engaging management decisions, digital tools. Strategies therapeutic inertia, such as reminders, education, physician–peer visits, task-sharing Digital health technologies, telemonitoring, wearables, other mobile platforms, becoming frequently adopted tools management, particularly those have undergone regulatory approval. Finally, fight consequences on global scale, healthcare system approaches needed. Government policies promote routine screening, salt-, sugar-, alcohol reduction programmes, encourage physical activity, target obesity control.

Язык: Английский

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Polypill in cardiovascular disease prevention: recent advances

Polskie Archiwum Medycyny Wewnętrznej, Год журнала: 2023, Номер unknown

Опубликована: Март 13, 2023

Triple therapy with lipid‑lowering, antihypertensive, and antiplatelet agents reduces the risk of recurrent cardiovascular fatal nonfatal events, mortality, total mortality in secondary prevention. In real life, however, effective implementation these optimal treatments both primary prevention is low, thus their contribution to much lower than it could be, based on research data. One main barriers adequate strategies low adherence elevated number pills, as adversely affected by complexity prescribed treatment regimen, can be considerably improved simplification. This review updates findings provided recent epidemiological clinical studies favoring a polypill‑based approach The increased prevalence patients multiple factors comorbidities provides rationale for therapeutic strategy combination drugs against different single pill. Pharmacologic have demonstrated that combined pill no loss individual efficacy, this favors persistence treatment, well factor control. Recently, randomized trial SECURE (Secondary Prevention Cardiovascular Disease Elderly) has shown significant, 30% reduction 33% death after myocardial infarction treated polypill, compared usual care, supporting polypill use an integral part any strategy.

Язык: Английский

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When blood pressure refuses to budge: exploring the complexity of resistant hypertension

Frontiers in Cardiovascular Medicine, Год журнала: 2023, Номер 10

Опубликована: Июнь 21, 2023

Resistant hypertension, defined as blood pressure that remains above goal despite using three or more antihypertensive medications, including a diuretic, affects significant proportion of the hypertensive population and is associated with increased cardiovascular morbidity mortality. Despite availability wide range pharmacological therapies, achieving optimal control in patients resistant hypertension challenge. However, recent advances field have identified several promising treatment options, spironolactone, mineralocorticoid receptor antagonists, renal denervation. In addition, personalized management approaches based on genetic other biomarkers may offer new opportunities to tailor therapy improve outcomes. This review aims provide an overview current state knowledge regarding managing epidemiology, pathophysiology, clinical implications condition, well latest developments therapeutic strategies future prospects.

Язык: Английский

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Risk Factors and Pharmacological Interventions Impacting Cerebrovascular Ischemic Events in Giant Cell Arteritis: A Narrative Review

Immunity Inflammation and Disease, Год журнала: 2025, Номер 13(1)

Опубликована: Янв. 1, 2025

ABSTRACT Introduction Giant cell arteritis (GCA) is a common vasculitis predominantly affecting larger vessels, especially in individuals aged 70–79. Cerebrovascular ischemic events (CIE), such as stroke and transient attacks, are serious but rare complications of GCA, with pooled prevalence 4%. Some studies found that within 2 weeks GCA diagnosis, 74% 34% patients experience or severe events, respectively. Aims Our study aims to help physicians better manage reduce GCA‐related CIE by indicating important risk factors pharmacological intervention prevent CIE, particularly the first few days diagnosis when highest. Methods A comprehensive literature search was conducted using Pubmed, Google Scholar, Scopus, other relevant medical databases. As this narrative review, done nonsystematic manner. Studies published from 2000 2024 were reviewed manner for information on incidence, pathology, factors, intervention, management CIE. Results Findings indicate age, male gender, hypertension, smoking significantly increase while anemia, higher body mass index (BMI), elevated inflammatory markers (C‐reactive protein [CRP] erythrocyte sedimentation rate [ESR]) appear have protective effects. Symptoms ischemia ophthalmic artery identified strongest predictors Pharmacological treatments, including glucocorticoids tocilizumab, instrumental managing potentially preventing patients, adjunctive therapies aspirin antiplatelet agents also showing promise. Conclusion can be very debilitating deadly conditions, initially diagnosed. However, early proper prevented its severity reduced. Ischemia strongly predict agent during 3 months may Risk BMI stratifying This review underscores importance further detailed, well‐designed approaches factor analysis strengthen these associations. Identifying crucial reducing morbidity mortality, equipping assess mitigate patients.

Язык: Английский

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Integrating frailty interventions into existing care models: a comprehensive approach to enhancing patient outcomes in chronic disease management

Frontiers in Public Health, Год журнала: 2025, Номер 12

Опубликована: Янв. 21, 2025

Frailty syndrome (FS) is a complex and multifaceted condition commonly observed in old adults patients with chronic diseases, often accompanied by cognitive impairments. This review explores the integration of frailty interventions into existing care models to improve patient outcomes, focusing on four key areas. First, it emphasizes importance comprehensive assessment tools identify impairments early, facilitating targeted planning. Second, highlights value personalized interventions, such as dietary modifications, exercise programs, training, tailored individual needs preferences. Third, underscores critical role multidisciplinary teams providing holistic coordinated care, leveraging expertise diverse healthcare professionals. Finally, examines potential technological innovations caregiver support systems enhancing management addressing challenges posed By integrating these approaches, this presents patient-centered framework aimed at mitigating impact improving long-term outcomes. The findings emphasize need for unified strategy that combines interdisciplinary collaboration, advancements address disease management.

Язык: Английский

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Prevalence, numbers and mortality risk of hypertensive patients with depressive symptom in China

BMC Cardiovascular Disorders, Год журнала: 2025, Номер 25(1)

Опубликована: Фев. 11, 2025

China is currently grappling with the escalating burden of hypertension and depression. This study aimed to assess prevalence number hypertensive patients depressive symptom, evaluate their risk all-cause mortality. Data from Health Retirement Longitudinal Study (CHARLS) were utilized estimate individuals both recommendation rate for antihypertensive medications, blood pressure control rate, corresponding population size. The Cox proportional hazard model was employed mortality associated combined symptom. Overall, 15.01% (95% CI: 13.80, 16.31) adults, 72.06 million 66.91, 77.23) individuals, identified as having Among these, 28.49 27.07, 29.92) recommended initiate medications but did not comply. Furthermore, 19.53 18.01, 21.06) symptom who taking achieve goals. Hypertension an increased (hazard ratio = 2.21, 95% 1.48, 3.31). Our findings indicated a significant in China, low treatment rates. coexistence depression linked heightened Strategies prevention should be integrated considerations Not applicable.

Язык: Английский

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Nitroglycerin-responsive gene switch for the on-demand production of therapeutic proteins

Nature Biomedical Engineering, Год журнала: 2025, Номер unknown

Опубликована: Фев. 14, 2025

Язык: Английский

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Prescribing Profile at a Pharmacy in Yogyakarta During the Period August-October 2024

E3S Web of Conferences, Год журнала: 2025, Номер 622, С. 02010 - 02010

Опубликована: Янв. 1, 2025

A drug prescription profile is a list of drugs prescribed or required by service and one the bases for preparing pharmacy's planning. This study aims to ascertain prescribing habits Yogyakarta pharmacy over August–October 2024 period. The method used in this descriptive-observational. population were all prescriptions use at pharmacies August-October 2024. type data research secondary data, namely taken directly from recipes collecting observational data. results showed that sample size was 168 recipes. Prescriptions with treatment period 5 10 days (75.60%), utilizing 1-3 types medication single recipe sheet, women (55.36%), those 60 (45.24%) are most commonly demographics. frequently an antihypertensive CCB dihydropyridine group, amlodipine (54.76%). Based on results, it can be concluded doctors hypertension patients use, amlodipine. Prescribing as considered quite effective lowering blood pressure.

Язык: Английский

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