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Hypertension News
July 31, 2024 — Having high blood pressure, specifically high diastolic blood pressure, was linked to a slightly higher odds of ever having migraine in female participants, according to a new study. Diastolic ...
July 23, 2024 — Nearly 40 million adults in the U.S. Have sleep apnea, and more than 30 million of them use a continuous positive airway pressure (CPAP) machine while sleeping. However, the machines tend to be ...
July 23, 2024 — Years of high systolic blood pressure are linked to a greater risk for the two most common types of stroke. The results suggest that early diagnosis and sustained control of high blood pressure over ...
July 19, 2024 — When it comes to community hypertension interventions, a new study found that pharmacists and community health workers had the best success in lowering blood pressure. These findings support the idea ...
July 15, 2024 — According to a new study, both 30-year risk for cardiovascular disease in addition to 10-year risk may be considered in making decisions about when to initiate high blood pressure ...
June 26, 2024 — A study evaluated a cuffless monitor that uses optical sensors to record blood pressure continually and efficiently, without disruption to the ...
June 17, 2024 — The number of individuals in the U.S. Who had chronic hypertension or chronic high blood pressure during pregnancy doubled between 2008 and ...
June 6, 2024 — People with high blood pressure have a higher risk of cognitive impairment, including dementia, but a new study suggests that engaging in vigorous physical activity more than once a week can lower ...
June 5, 2024 — Adolescents with elevated blood pressure and arterial stiffness may experience poorer cognitive functions, according to a recent study. Young people with higher blood pressure performed worse, ...
May 15, 2024 — New research finds a link between common medications and life-threatening ...
May 2, 2024 — Blood vessels in the lungs aren't like the others in the body. This difference becomes clear in pulmonary hypertension, in which only the lungs' blood vessels stiffen progressively, leading ...
Apr. 30, 2024 — Researchers have discovered over a hundred new regions of the human genome, also known as genomic loci, that appear to influence a person's blood pressure. In total, over 2,000 independent ...
Apr. 11, 2024 — A drug approved to treat pulmonary arterial hypertension may be effective at managing hypertension and end-organ damage in patients with sickle cell disease, according to a new study. An early phase ...
Apr. 11, 2024 — Health researchers identify patients at risk for preventable death in the year after ...
Mar. 27, 2024 — Sleeping fewer than seven hours is associated with a higher risk of developing high blood pressure over time, according to a new ...
Mar. 20, 2024 — Using data from both mice and humans, a research team has found that a cell surface protein that senses odors and chemicals may be responsible for -- and help explain -- male/female differences in ...
Feb. 21, 2024 — Raised blood pressure has been the leading risk factor for death in Australia for the past three decades, according to a new study. It is also the main contributor to deaths from cardiovascular ...
Feb. 12, 2024 — The replacement of regular salt with a salt substitute can reduce incidences of hypertension, or high blood pressure, in older adults without increasing their risk of low blood pressure episodes, ...
Feb. 5, 2024 — Weight loss medication reduced both day and nighttime blood pressure levels, finds new ...
Feb. 5, 2024 — Bariatric surgery is more effective in controlling hypertension rates, or high blood pressure, in people with obesity and uncontrolled high blood pressure compared to blood pressure medication alone, ...
Understanding Pulmonary Hypertension: Symptoms & Treatments
When most people hear the word hypertension, they think of high blood pressure. While not as common as high blood pressure, pulmonary hypertension, which affects the lungs, can be harder to diagnose, more challenging to treat, and, tragically, often comes with fatal consequences.
Dr. Talal Dahhan, Division Chief for Pulmonary & Critical Care at Baystate Pulmonary explains, "Nearly 3 to 8% of the world's population is affected by pulmonary hypertension (PH). A serious condition brought on by abnormally high pressure in the blood vessels between the lungs and the heart, most cases of PH cannot be cured. But with early detection and proper treatment, it is possible to improve symptoms and slow the disease's progression."
What is Pulmonary Hypertension?While the signs and symptoms of pulmonary hypertension are felt in the lungs, the cause starts in the heart. Dr. Dahhan explains, "In a healthy body, the heart does its job pumping blood around the body and delivering oxygen to organs and tissue. The oxygen gets taken up by the body and the blood cycles back to the heart. When all things are working well, the blood flows back into the heart and travels to the lungs via the pulmonary artery, picks up fresh oxygen, and the whole cycle begins again. However, in cases of PH, the walls of the pulmonary artery become stiff, damaged and narrow and the amount of oxygen going out to the rest of the body drops to dangerously low levels. Sensing the low levels of oxygen, the heart begins to pump harder to push oxygen-low blood to the lungs. Over time, the low level of oxygen in the blood and the added pressure on the heart can lead to serious complications, including heart failure."
What Causes Pulmonary Hypertension?There are a number of conditions and issues that can lead to PH. Once determined, the cause is used to classify a patient's condition by a Group number (Group 1 PH, Group 2 PH, etc.). This grouping information is later used to help identify appropriate treatment options.
Here's a look at the Groups and causes for PH:
Group 1 PH is due to pulmonary arterial hypertension (PAH), a condition in which the tiny arteries in your lung become thickened and narrowed. While PAH can occur due to unknow reasons (what physicians call idiopathic), some common causes include:
Group 2 PH is due to left-sided heart disease, the most common cause of PH in the United States, left-sided heart disease causes blood to back up in the heart, raising the pressure in the pulmonary arteries.
Group 3 PH is due to lung disease, including interstitial lung disease, chronic obstructive pulmonary disease (COPD), certain sleep apneas, pulmonary fibrosis, and emphysema, all of which reduce the flow of blood through the lungs and oxygen uptake.
Group 4 PH is due to blockages in the lungs and arteries, including clots and scars from chronic thromboembolic pulmonary hypertension (CTEPH).
Group 5 PH is due to other diseases and conditions, including blood disorders, kidney disease, inflammatory disorders, and metabolic disorders.
Dr. Dahhan notes that "PH can also be caused by a specific congenital heart called Eisenmenger syndrome. This occurs when there's a hole, or more than one, between the heart chambers, which causes blood to flow incorrectly in the heart, often increasing the blood flow and pressure in the pulmonary arteries."
No matter the cause, Dr. Dahhan notes that PH in all forms is a very serious condition and left untreated can be life threatening.
What Are the Symptoms of Pulmonary Hypertension?According to Dr. Dahhan, "PH symptoms aren't 'all of the sudden' type symptoms. They develop slowly over the years and are often like symptoms of common heart and lung conditions making them easy to miss."
Pulmonary hypertension symptoms include:
Dr. Dahhan adds, "Most people first recognize a problem when they become short of breath when walking. They may be fine on a flat surface but if there's an incline or they're going up stairs, they may find themselves suddenly out of breath. As the disease progresses, they may even feel out of breath when seated. Typically, that's alarming enough to drive someone to seek medical help."
How is Pulmonary Hypertension Diagnosed?As noted, diagnosing PH can be challenging as its symptoms often resemble those of other lung and heart conditions. In addition to performing a physical exam and reviewing your medical history, your doctor may perform the following:
Diagnostic Tests for raising index of suspicion if we have a possibility of Pulmonary HypertensionThe most definite test for diagnosing PH, right heart catheterization measures the blood pressure in the pulmonary arteries. This information identifies where the high pressure exists in your heart and arteries and the specific type (group) of PH the patient has.
What is the Treatment for Pulmonary Hypertension?While there's no cure for most forms of pulmonary hypertension, various treatments are determined by the type of PH. Treatment can help manage symptoms and improve quality of life.
Among the earliest treatments recommended to consider:The next course of treatment options are medications. "There are a number of medication therapies available to help with different types of PH," says Dr. Dahhan, "Depending upon the type of PH a patient has, we may recommend medications to relax or widen blood vessels and arteries, relax muscles in blood vessels, or to increase blood flow. These don't treat PH, but they can treat and help with complications from PH."
A last resort option, surgery may be recommended for patients with CTEPH, however, as Dr. Dahhan notes, not all PH patients are candidates for thromboendarterectomy. But there are procedures to consider in absence of CTEPH. Options include:
Living with pulmonary hypertension can be challenging, but with proper management and care, it is possible to maintain a good quality of life. "Early diagnosis and treatment are crucial," says Dr. Dahhan. "If you are experiencing persistent shortness of breath or other symptoms, reach out to your doctor to schedule an appointment as soon as possible. The more information you can bring to the appointment—how long have you had symptoms, what makes them worse or better, etc.—the easier it will be to identify if PH is behind your issue and the faster you can begin treatment."
Indian Patients Do Well On Dual-Combination Pills For Hypertension: TOPSPIN
CHICAGO, IL—For hypertensive patients, dual-combination therapies taken as a single pill are similarly effective, safe, and well tolerated irrespective of their exact mix of an ACE inhibitor, calcium channel blocker, or diuretic, according to results from the randomized TOPSPIN trial. Over 70% of patients treated were able to get their blood pressure under 140/90 mm Hg.
Dorairaj Prabhakaran, MD, DM, and Dimple Kondal, PhD (Centre for Chronic Disease Control, New Delhi, India), presented results from the Indian trial here last weekend at the American Heart Association (AHA) 2024 Scientific Sessions.
"In India, there are 300 million people living with hypertension, but the control rates are abysmal," at around 7-11% in rural areas and 11-20% in urban areas, Prabhakaran told the media during an AHA press conference.
Most clinical guidelines, he noted, currently call for initiation of two antihypertensive drugs, which can be chosen from three drug classes: renin-angiotensin-system blockers, calcium channel blockers, and diuretics. Importantly, though, before TOPSPIN, there had not yet been a randomized trial done specifically in India to address the best initial dual therapy for hypertension management.
Shawna D. Nesbitt, MD (UT Southwestern Medical Center, Dallas, TX), at the media briefing, highlighted the fact that while the number of adults with hypertension rose by 41% from 1990 to 2019 in Europe and the Americas, the number shot up by 144% during the same period in Southeast Asia and the Western Pacific. "This is a dramatic increase," she stressed, agreeing with the need to perform an India-based trial.
TOPSPIN
TOPSPIN enrolled 1,981 patients ages 30 to 79 (mean age 52.1 years; 42.1% female) with sitting office systolic BP 140-159 mm Hg on one antihypertensive agent, or 150-179 mm Hg on no treatment. Patients were randomized to one of three daily single-pill combinations at starting doses: amlodipine plus perindopril, amlodipine plus indapamide, or perindopril plus indapamide. All reached full doses at 2 months unless their systolic BP was < 120 mm Hg. Baseline characteristics were similar across the treatment groups.
Mean change in 24-hour ambulatory systolic BP at 6 months, the primary endpoint, was similar with amlodipine plus perindopril (-14.5 mm Hg), amlodipine plus indapamide (-13.9 mm Hg), and perindopril plus indapamide (-13.3 mm Hg). In each group, over 40% of patients achieved a systolic BP of < 130/80 mm Hg and more than 70% had a systolic BP of < 140/90 mm Hg. In all, 51 individuals (2.6%) stopped taking their assigned medication due to typical adverse events associated with the drugs.
The results, said Prabhakaran, are in line with current guidelines that allow for choice among antihypertensive drugs.
Nesbitt, for her part, pointed out that the various drug regimens in TOPSPIN were not only effective and safe, but also well tolerated. Fixed-dose combinations, as suggested by earlier studies, "may facilitate higher adherence to therapy and more efficient achievement of BP goals" in India, she added, though clinicians need additional options for dosing and clarity on how to individualize treatment.
Also, "cost and availability must be considered when using combination therapy," Nesbitt said.
Speaking with TCTMD, Prabhakaran elaborated on the numerous barriers that stand in the way of patients in India getting necessary treatment for high blood pressure. "The most important reason, I think, is low awareness. Second, there are no screening programs," he explained, adding that because hypertension often lacks symptoms, it may go unnoticed. Many people, too, are hesitant to get a diagnosis out of "fear they will have to take the drugs lifelong, which is true."
Misinformation on social media also plays a role, as does clinician inertia. And finally, there's the gap between rural and urban populations, which can impair access to healthcare, as well as the difficulty some may have in affording antihypertensive drugs, Prabhakaran noted.
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