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Uncontrolled Hypertension: The Old ‘Silent Killer’ is Alive and Well

The AHA! Team — Mon, 18 Nov 2024 06:53:13 +0000

Florida Atlantic University via EurekAlert! – In the United States and worldwide, cardiovascular disease is the leading avoidable cause of premature death and disability. Primarily heart attacks and stroke, cardiovascular disease accounts for more than 900,000 annual deaths nationally and about 10 million deaths globally. Uncontrolled hypertension or high blood pressure is a major risk factor for stroke and heart attacks. Prevention and management of cardiovascular disease involves therapeutic lifestyle changes such as diet and exercise and adjunctive drug therapies of proven benefit. In a commentary published in The American Journal of Medicine, researchers from Florida Atlantic University’s Schmidt College of Medicine and colleagues alert health care providers that the old “silent killer” is alive and well. “Health providers should be aware that uncontrolled hypertension is one of the most common, serious and increasing conditions in their patients,” said Stacy Rubin, M.D., senior author and an assistant professor of medicine, FAU Schmidt College of Medicine. “Health providers urgently need to control blood pressure and should be mindful that sudden cardiac death accounts for 50% of deaths from cardiovascular disease and is the first symptomatic event in about 25% of cases. Moreover, for 76% of stroke patients, the initial presenting symptom is the stroke itself.” The authors note that controlling hypertension is effective and, at least in theory, straightforward. Landmark U.S. study in the 1970s, about 50% of patients were aware of their high blood pressure Before the Hypertension Detection and Follow Up Program, a landmark study conducted in the 1970s in the U.S., only about 50% of patients were aware of their high blood pressure. Of those, only 50% were actively treated. Of that group, only 50% received effective treatment. Therefore, only one-eighth of all patients were effectively treated. Today, these figures show that 54% are aware of their high blood pressure, 40% are actively treated and 21% are actively controlled. Guidelines have been developed in many countries worldwide and all tend to emphasize the need for strict control. According to the latest guidelines from the American Heart Association and the American College of Cardiology, healthy individuals should have a systolic blood pressure of 130 millimeters of mercury (mmHg) or less, and a diastolic blood pressure of 80 mmHg or less. “With these latest definitions, hypertension affects about 45% of the U.S. adult population,” said Panagiota “Yiota” Kitsantas, Ph.D., co-author and professor and chair of the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine. “Another clinical challenge is metabolic syndrome, which includes central adiposity, high triglycerides, low high-density lipoprotein cholesterol, elevated fasting blood glucose and hypertension.” Metabolic syndrome is a chief risk factor for heart attacks and stroke in the U.S. The authors caution that metabolic syndrome is a chief risk factor for heart attacks and stroke in the U.S., which is the heaviest society in the world. “For patients with metabolic syndrome, we believe that angiotensin converting enzyme or ACE inhibitors or their more potent next generation drugs, the receptor blockers, are the first drug of choice,” said Charles H. Hennekens, M.D., Dr.PH., co-author, and corresponding author, the first Sir Richard Doll Professor of Medicine, senior academic advisor, and a professor of preventive medicine in the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine. “These drugs have beneficial effects on heart attacks, stroke, and kidney disease, another major consequence of untreated hypertension.” Making positive lifestyle changes like losing weight, being more physically active, and cutting down on salt intake has been shown to be beneficial for managing blood pressure. For those whose blood pressure is above 130/80, a combination of these lifestyle changes along with medications can safely and effectively lower blood pressure. Medications are typically started for individuals whose pressure remains above 140/90 despite these lifestyle changes. The authors suggest that both health providers and patients should be aware of the variability of blood pressure from day-to-day and from morning to night. As such, effective treatment is complicated by the health provider’s need to produce an algorithm to each of their patients. In addition, the patient must take an active role in monitoring their blood pressure. For this reason, the American Heart Association and the American College of Cardiology recommend the Omron blood monitor, which is used to measure blood pressure levels at home. Health providers should counsel their patients to check their blood pressure each morning and night “Health providers should counsel their patients to check their blood pressure each morning and night and whether to administer a particular drug or its dose, which should be adjusted accordingly based on the average of three readings taken about five minutes apart,” said Hennekens. “While uncontrolled hypertension remains alive and well in the U.S. and worldwide, strict attention to these issues by health providers has the potential to ‘kill the old silent killer.’” Co-authors are Barry R. Davis, M.D., Ph.D., professor emeritus of biostatistics and data science, University of Texas – Houston School of Public Health; Jared Greenwald, a high school and pre-medical student; John Dunn and Alexandra Matarazzo, both second-year medical students at FAU; and Katerina Benson, a second-year pre-medical student at FAU. Hennekens served as principal investigator (PI) of the Coordinating Center for the landmark National Heart Lung and Blood Institute (NHLBI) funded Trials of Hypertension Prevention multicenter randomized trials for both phases I and II. Davis served as PI of the Coordinating Center for the landmark NHLBI funded Anti-Hypertensive and Lipid Lowering to Prevent Heart Attack multicenter randomized trials. – FAU – Journal The American Journal of Medicine DOI 10.1016/j.amjmed.2024.07.005 To read the original article click here.

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Johnson & Johnson Pays $1.7b for Innovative Israeli Heart Failure Treatment

The AHA! Team — Mon, 23 Sep 2024 16:53:45 +0000

Zachy Hennessey via Israel21c – Big pharma giant shells out $1.7 billion for Israeli company V-Wave, and expects to earn enough to purchase a gumball — in the short term, at least. Global healthcare giant Johnson & Johnson (J&J) announced on Tuesday that it will acquire Israeli startup V-Wave for up to $1.7 billion, in a strategic move by J&J to bolster its position in the fast-growing congestive heart failure market, which is projected to reach $30 billion globally by 2030. The $1.7b. deal is the 10th biggest acquisition in Israel’s history. It will see J&J pay $600 million upfront, with an additional $1.1 billion in potential milestone payments tied to regulatory approvals and commercial performance targets. The acquisition is expected to provide a modest boost to J&J’s earnings, contributing an estimated 24 cents per share in 2024 and 6 cents per share in 2025. However, the true value of the deal likely lies in the long-term growth potential of V-Wave’s innovative heart failure treatment technology. V-Wave’s flagship product, the Ventura Interatrial Shunt (IAS), is an implantable device designed to alleviate the elevated left atrial pressure that plagues patients with congestive heart failure. The minimally invasive IAS procedure aims to reduce the risk of cardiovascular events and hospitalizations for those suffering from heart failure with reduced ejection fraction – a condition where the heart muscle is unable to effectively pump blood. By creating a shunt between the left and right atriums, the device helps to relieve pressure buildup in the left atrium, potentially improving patient outcomes and quality of life. The acquisition comes at a critical time for J&J, as the company prepares to face increased competition for its blockbuster psoriasis drug Stelara, which is set to lose patent protection next year. In response, the healthcare giant has been actively pursuing mergers and acquisitions to bolster its pipeline and drive future growth. “We know V-Wave well, with our relationship dating back to our original investment in the company in 2016, and we have a deep understanding of the technology and science, as well as the company’s commitment to patients,” said Tim Schmid, Executive Vice President and Worldwide Chairman of Johnson & Johnson MedTech. Earlier this year, J&J announced the $13.1 billion acquisition of Shockwave Medical Earlier this year, J&J announced the $13.1 billion acquisition of Shockwave Medical, a move aimed at expanding its cardiovascular device portfolio. The company has also recently acquired Numab’s skin disorder drug for $1.25 billion and Proteologix for $850 million. “At V-Wave, we are dedicated to achieving our vision to help patients around the world – and we know Johnson & Johnson MedTech shares this mission,” said Dr. Neal Eigler, CEO of V-Wave. “We look forward to continuing to build a world where cardiovascular disease is prevented, treated and cured.” To read the original article click here.

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High Blood Pressure Symptoms You Can Reverse Naturally

AHA Publisher — Wed, 20 Jan 2021 08:00:04 +0000

Dr. Josh Axe, DC, DMN, CNS – What if I told you that a health condition affects about 72 million — or one out of every three — American adults under old guidelines? And what if I told you that under new guidelines, that number will rise to about 103 Americans? I’m talking about a highly common, yet preventable, condition called high blood pressure, also known as hypertension — which is why you need to pay attention if you have high blood pressure symptoms. (1) High blood pressure (HBP) isn’t just a problem in and of itself, but it also leads to other dangerous health conditions, including stroke, heart attack, chronic heart failure and kidney disease. Did you know that most people with high blood pressure or hypertension have no symptoms, even when their blood pressure readings reach dangerously high levels? In fact, about many U.S. adults with high blood pressure still doesn’t know they have it. Scary, I know. The good news is that even mainstream medicine will agree with me when I say that diet and exercise are the most important tools for preventing and treating high blood pressure naturally and successfully. Symptoms and Life Expectancy What is high blood pressure exactly? It’s a common disease in which blood flows through blood vessels and arteries at higher than normal pressures. Hypertension costs the U.S. $46 billion each year, which includes the cost of health care services, medications to treat high blood pressure symptoms and missed days of work — a number that’s expected to rise with the American Heart Association releasing new standards for what constitutes high blood pressure. Standard medical treatment for elevated blood pressure is to prescribe dangerous beta blockers, ACE inhibitor drugs and diuretics, along with convincing the patient to restrict salt in the diet. Although these things can help, they don’t get to the root of the problem and can actually cause more problems. We’ve been encouraged to fear salt when it comes to our health, but this recommendation of extreme salt reduction for high blood pressure symptoms remains controversial, questionable and even destructive for good reason. (2) Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. High blood pressure happens when this force is too high. Scary, but true: Most people who have this condition display zero signs or high blood pressure symptoms, even when their blood pressure readings are at dangerously high levels. When blood pressure is measured, there are two numbers that result, which measures two different pressures. The top number is systolic pressure, the blood pressure when the heart beats while pumping blood. The second or bottom number is diastolic pressure, the blood pressure when the heart is at rest between beats. Under the previous guidelines, blood pressure ranges include: (3) Low blood pressure (hypotension) is anything less than 90/60 Normal: Less than 120/80 Prehypertension: 120–139/80–89. “Prehypertension” means blood pressure is higher than normal but not yet at the point of being considered true “high blood pressure.” Stage 1 high blood pressure: 140–159/90–99 Stage 2 high blood pressure: 160 and above/100 and above If you get a reading that’s very high, above 180/110, chances are this is inaccurate and you should have another reading done. However, now there are new guidelines lowering the threshold of what’s considered high blood pressure. The American Heart Association has now lowered stage 1 high blood pressure from 140/90 to 130/80. What does this mean? It means “that 46 percent of U.S. adults, many of them under the age of 45, now will be considered hypertensive.” (4) That’s not all: (5) Under the guidelines, formulated by the American Heart Association and the American College of Cardiology, the number of men under age 45 with a diagnosis of high blood pressure will triple, and the prevalence among women under age 45 will double. The new guidelines from the American Heart Association are as follows: Normal: Less than 120/80 mm Hg; Elevated: Systolic between 120–129 and diastolic less than 80; Stage 1: Systolic between 130–139 or diastolic between 80–89; Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg; Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage. Frequently, there are no high blood pressure symptoms as blood pressure increases, but some warning signs for very high blood pressure can include chest pains, confusion, headaches, ear noise or buzzing, irregular heartbeat, nosebleeds, tiredness or vision changes. When high blood pressure symptoms do develop, it’s normally because the condition has progressed to a dangerous point. This is called hypertensive crisis which means a systolic/top number higher than 180 OR diastolic/bottom number higher than 110. Hypertensive crisis is considered a medical emergency that requires immediate treatment. Emergency medical treatment is needed. At this point symptoms are usually present including: Severe headaches Severe anxiety Shortness of breath Nosebleeds At the age of 50, total life expectancy is about five years longer for people with normal blood pressure than for those who have hypertension. That’s just another worthwhile reason to get your high blood pressure symptoms under control and keep them under control. Also keep in mind that the readings above are intended for normal adults over 18 years old. If you have diabetes, kidney disease or a short-term serious illness your readings will be interpreted differently. If you have diabetes (another very common problem) or chronic kidney disease then high blood pressure is defined as 130/80 or higher. Root Causes and Risk Factors Knowing what triggers high blood pressure can help you prevent or reverse it. Like with most other chronic diseases, the reason someone develops HBP has to do with several factors. HBP seems to run in families, but it’s also highly dependent upon the type of lifestyle someone leads. Women are at an increased risk when taking control pills, during pregnancy, or if taking hormone therapy medications to control menopause symptoms. Obesity or being overweight increases the odds because this puts more pressure on the heart and arteries. Men and women are equally likely to develop HBP during their lifetimes, but interestingly men are more likely when they’re younger. Before turning 45, men are more likely to have HBP than women but then this flips after age 65, when women’s risk becomes higher than men’s. When children younger than 10 years old have HBP it’s usually a side effect of another condition. This can include a kidney problem, medication use or type 1 diabetes. High blood pressure has a real laundry list of risk factors. The good news is that the majority of these hypertension risk factors are well within your control. They include: (6) Age — High blood pressure risk increases as age increases. It’s more common in men through the age of 45. Women are more likely to develop high blood pressure after age 65. Family history — High blood pressure tends to run in families. Race — High blood pressure is especially common among African-Americans and often develops at an earlier age than it does in Caucasians. Serious complications, such as stroke, heart attack and kidney failure, are more common among African-Americans suffering from high blood pressure. Being overweight — The higher your body weight, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls and your blood pressure. Not being physically active — People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity and exercise also increases the risk of being overweight, which are some of the reasons a sedentary lifestyle is dangerous. Tobacco use — Whether it’s smoking or chewing tobacco, both immediately raise your blood pressure temporarily. Additionally, the chemicals in tobacco damage the lining of your artery walls, which causes your arteries to narrow, increasing your blood pressure. Secondhand smoke can also raise your blood pressure. Too much alcohol — Over time, heavy drinking can damage your heart. Having more than two drinks a day for men and more than one drink a day for women may affect blood pressure negatively. Too much sodium in your diet — Too much salt or sodium in your dietcauses your body to retain more fluid, which increases blood pressure. Too little potassium in your diet — Potassium is a mineral that helps balance the sodium content of your body’s cells. If you don’t consume enough potassium or retain enough potassium, you can accumulate too much sodium in your blood stream. That’s one reason why you want to avoid low potassium. Stress — High levels of stress can lead to a temporary increase in blood pressure. Certain chronic conditions — Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease, diabetes and sleep apnea. Pregnancy — Sometimes pregnancy can contribute to high blood pressure. High blood pressure is most prevalent in the adult population, but children are also at risk. Sometimes children can experience high blood pressure symptoms that are caused by problems with the heart or kidneys. However, more and more children who experience high blood pressure are dealing with this chronic issue at a way too young age because of poor lifestyle habits. When I say poor lifestyle habits, I’m referring to an unhealthy diet and a lack of exercise, which both directly relate to the increase in childhood obesity and childhood hypertension. Complications More than 360,000 American deaths in 2013 included high blood pressure as a primary or contributing cause. That equates to a highly disturbing and concerning nearly 1,000 deaths each day. High blood pressure increases your risk for dangerous health conditions, such as: (7) First heart attack: About 7 of every 10 people having their first heart attacks have high blood pressure. First stroke: About 8 of every 10 people having their first strokes have high blood pressure. Chronic heart failure: About 7 of every 10 people with chronic heart failurehave high blood pressure. Eye problems: High blood pressure can cause thickened, narrowed or torn blood vessels in the eyes, which can result in vision loss. Metabolic syndrome: High blood pressure symptoms increase the risk of metabolic syndrome, a combination of three or more of the following health issues: abdominal obesity, high blood sugar, high triglyceride levels, high blood pressure or low HDL (“good”) cholesterol. Memory issues: Uncontrolled high blood pressure can affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure. Aneurysm: Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening. High Blood Pressure vs. Low Blood Pressure Risk of both low blood pressure and high blood pressure normally increases with age due in part to normal changes during aging. Here are how low and high blood pressure stack up. High Blood Pressure Frequently, there are no high blood pressure symptoms as blood pressure increases. Some warning signs for very high blood pressure, however, can include: chest pains confusion headaches ear noise or buzzing irregular heartbeat nosebleed tiredness vision changes Here are some more alarming facts about high blood pressure and high blood pressure symptoms: About 70 million American adults (29 percent) have high blood pressure — that’s nearly 1 out of every 3 adults. Only about half (52 percent) of people with high blood pressure have the condition under control. Nearly 1 out of 3 American adults has prehypertension — blood pressure numbers that are higher than normal but not yet in the high blood pressure range. Heart disease remains the number one killer in the U.S and many other nations. In the U.S. alone, about 7 million people die each year from various illnesses that are mostly caused by high blood pressure, since this boosts the odds of heart failure/heart attacks and stroke. High blood pressure costs the nation $46 billion each year. This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work. High blood pressure...

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Mental Stress and Anger May Worsen Heart Failure

AHA Publisher — Fri, 14 Aug 2020 07:00:18 +0000

Yale University via News-Medical Net – Mental stress and anger may have clinical implications for patients with heart failure according to a new report published in the Journal of Cardiac Failure. Heart failure is a life-threatening cardiovascular disease in which the heart is damaged or weakened. This can lead to a reduced ejection fraction, in which the heart muscle pumps out a lower amount of blood than is typical with each contraction. In this study of patients who had heart failure with reduced ejection fraction, the authors — including researchers at Yale — evaluated the effects of stress and anger on diastolic function. Diastolic function describes the ability of the heart to relax and refill between muscle contractions and is predictive of mortality risk. For one week, participants completed daily questionnaires about their experiences of stress, anger, and negative emotions during the previous 24 hours. Participants then completed a standardized “mental stress” protocol in which they solved challenging arithmetic problems and described a recent stressful experience. Echocardiograms were performed to assess diastolic function at rest and during the stress task. Patients who reported experiencing anger in the week prior to the laboratory mental stress protocol exhibited worse baseline resting diastolic pressure, the researchers said. Furthermore, most patients demonstrated stress-provoked changes in diastolic function, including decreased early relaxation and increased diastolic pressure. “Mental stress is common in patients with heart failure due in part to the complexities of disease self-management, progressively worsening functional limitations, and frequent symptom exacerbations and hospitalizations,” said the lead author Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale. “We have evidence that patients who experience chronically elevated levels of stress experience a more burdensome disease course with diminished quality of life and increased risk for adverse events. Clarifying the relevant behavioral and physiological pathways is especially important in the era of COVID-19 when the typical stressors of heart failure may be further compounded by pandemic-related stressors,” Harris said. “Factors such as mental stress and anger often go unrecognized and are under-addressed. This study contributes to the extensive literature showing that stress and anger affect clinical outcomes for patients with heart disease, adding chronic heart failure to the list that includes ischemic heart disease (narrowed arteries) and arrhythmic disease.” (Matthew Burg, Yale clinical psychologist and senior author of the study) Burg said that while stress management and related techniques have been shown to reduce risk for adverse events among patients with ischemic heart disease (narrowed arteries), further work is needed to identify factors that increase vulnerability to the effects of stress in heart failure, and to determine whether stress management can improve outcomes for these patients. To read the original article click here.

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