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Confessions of a SYMPLICITY HTN-3 Trialist

Confessions of a SYMPLICITY HTN-3 Trialist | Heart and Vascular Health | Scoop.it

 Seth Bilazarian from theheart.org on Medscape, reporting from the American College of Cardiology (ACC) meeting in Washington, DC.

I want to make a few comments on the SYMPLICITY HTN-3 trial.[1,2] Briefly, SYMPLICITY is the name of a series of trials sponsored by the Medtronic company that are evaluating the efficacy and safety of therapy with a renal denervation catheter for a variety of problems, but most importantly for hypertension.

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What Patients Say Works for Hypertension

What Patients Say Works for Hypertension | Heart and Vascular Health | Scoop.it
CureTogether, a free resource owned by 23andMe, reports out on what patients say works for them in treating hypertension.

Via 27BloodPressure
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Preventable Deaths from Heart Disease & Stroke infographic

Preventable Deaths from Heart Disease & Stroke infographic | Heart and Vascular Health | Scoop.it

Important progress has been made, but more is needed to continue to save lives, particulalry for people under 65 yeras.  Black men are at the highest risk of dying early fromheart disease and stroke.  Counties in Southern states have the greratest risk overall.

Seth Bilazarian, MD's insight:

Nearly 800,000 Americans die each year from heart disease and stroke.  Most of the major risk factors can be manged or prevented: high blood pressure, high cholesterol, diabetes, smoking, unhealthy diet, physical inactivity and obesity.

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Where the Salt Lurks on Restaurant Menus

Where the Salt Lurks on Restaurant Menus | Heart and Vascular Health | Scoop.it

American adults eat in restaurants an average of five times a week—which means they probably eat way too much salt. Even fine-dining menus offer little escape from sodium overload.

Starting with the bread and salad and ending with the final plate of tiny cookies, many of restaurants' least salty-seeming options are significant sources of dietary salt.

Seth Bilazarian, MD's insight:

From WSJ: More Taste, Less Sodium

Chef Jeremy Bearman's Fresh Herb Tagliatelle with Maine Lobster has 690 milligrams of sodium—far less than the 1,600 milligrams or more found in a typical serving of traditional pasta and shrimp in tomato sauce.

About 60% of the sodium comes from the lobster itself. Colorful vegetables—leek, fennel, broccoli—provide sensory appeal and potassium to balance the lobster's saltiness.Housemade pasta is flavored with saffron but not salt, rolled with fresh herbs and cooked in unsalted water.Minimally salted pasta sauce begins with unsalted fennel stock. It contains leek purée made with saffron, lobster oil, lemon juice, Espellete pepper powder and a pinch of salt.Lobster oil is made by roasting lobster shells with tomato, white wine, chili flake, peppercorns, tarragon, carrot, celery and onion and then steeping them in olive oil.A squeeze of fresh lemon adds bright flavor.
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New Push to Tailor Treatment for High Blood Pressure

New Push to Tailor Treatment for High Blood Pressure | Heart and Vascular Health | Scoop.it

Blood Pressure Myths and Facts

MYTH: High blood pressure is hereditary.

FACT: While heredity increases the risk of developing high blood pressure, many people with no family history also develop it.

MYTH: The only way to control high blood pressure is with medications.

FACT:: About half of adults with high blood pressure can control it with lifestyle changes including weight loss, exercise, avoiding tobacco and limiting intake of salt, alcohol and caffeine.

MYTH: I don't use table salt, so my blood pressure isn't affected.

FACT: Most sodium consumption comes from processed foods like tomato sauce, soups, condiments, canned foods and prepared mixes. Look for 'soda' and 'sodium' and the symbol 'Na' on labels, which show sodium compounds are present. Using kosher or sea salt doesn't make a difference; chemically they are the same as table salt.

MYTH: I feel fine. I don't have to worry about high blood pressure.

FACT: A third of American adults have high blood pressure—and many of them don't know it or don't experience typical symptoms. If uncontrolled, high blood pressure can lead to severe health problems, and is the No. 1 cause of stroke.

MYTH: My doctor checks my blood pressure so I don't have to do it at home.

FACT: Blood pressure can fluctuate so home monitoring can help your doctors determine whether you really have it and, if you do, whether your treatment plan is working.

MYTH: People with high blood pressure have symptoms such as nervousness, sweating, difficulty sleeping and facial flushing. If I don't have symptoms I don't have high blood pressure.

FACT: High blood pressure is often called 'the silent killer' because it has no symptoms, so patients may not be aware that it is damaging arteries, heart and other organs.

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Nearly 1 in 6 Americans has uncontrolled high blood pressure

Nearly 1 in 6 Americans has uncontrolled high blood pressure | Heart and Vascular Health | Scoop.it

Uncontrolled high blood pressure -- defined as having a systolic (top reading) of 140 or above or having a diastolic (bottom reading) of 90 or above -- is “public health enemy number two” behind smoking, said CDC Director Thomas Frieden; it contributes to 1,000 deaths in this country every day and causes $131 billion a year in healthcare costs.  See the Million Hearts Campaign for more info.

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Million Hearts - Team Up. Pressure Down

Million Hearts - Team Up. Pressure Down | Heart and Vascular Health | Scoop.it

Team Up. Pressure Down. is a nationwide program to lower blood pressure and prevent hypertension through patient-pharmacist engagement.

Videos for patients on diagnosis and risks.  Other resources include blood pressure guide, journal and medication tracker.  

Good way for patient to get to know about America's most important silent killer.

See the Facebook Community at : http://goo.gl/Okyp7

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Controlling Hypertension (High Blood Pressure) Via Kidney = Renal Denervation

Controlling Hypertension (High Blood Pressure)  Via Kidney = Renal Denervation | Heart and Vascular Health | Scoop.it

New experimental treatment for stubborn hypertension: Singeing the walls of nerve-lined arteries leading to the kidneys, blocking the organs' ability to raise blood pressure.

 

Medtronic is investigating a renal denervation strategy in a trial called Symplicity.  Procedure takes about 30 - 40 minutes. The study will target 530 patients with systolic blood pressure over 160 despite taking at least three medicines.  "Until now, there were no other options for such patients, other than adding more drugs".

 

For patients with resistant hypertension interested in clinical trial participation in Symplicity contact the clincial research office at (978) 469-5494 or visit the website http://www.pmaonline.com/clinical-trials.htm ;

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My Vlog: Hypertension Guidelines: Clear as Mud!

My Vlog: Hypertension Guidelines: Clear as Mud! | Heart and Vascular Health | Scoop.it

I've been trying to make sense of guidelines now for a couple of months. We had lipid guidelines that came out in November at the American Heart Association (AHA) meeting, and then in December we had the publication of the new Joint National Committee (JNC 8) guidelines, [1] also called the "2014 hypertension guidelines," and I'm trying to make sense of it.

Seth Bilazarian, MD's insight:

After more than a decade the hypertension (high blood pressure) guidelines were updated.  The delay and changes have been criticized.  Clinicians and patients need regular updates for all risk factor categories: hypertension, cholesterol & lipids and diabetes.  The guideline writers needs some practical guidelines to write better guidelines.  My fast take on the subject at theheart.org on Medscape.com 

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Renal Denervation (RDN world)

Renal Denervation (RDN world) | Heart and Vascular Health | Scoop.it
Renal denervation, a new therapy for patients with resistant hypertension: techniques, products and the science
Seth Bilazarian, MD's insight:

Check out RDNworld.org run by @editorRDN.  This Renal Denervation website has patient & physician education & industry news.  It's a good  website & useful follow for those interested in the the  next significant innovation in interventional cardiovascular medicine and the first significant innovation in treatment for hypertension in decades.  This treatment is likely available in the US in 2014 or 2015.

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Trends in Prescribed Drugs Treating Diabetes, Hypertension, and High Cholesterol for Persons under Age 40 in the US

Trends in Prescribed Drugs Treating Diabetes, Hypertension, and High Cholesterol for Persons under Age 40 in the US | Heart and Vascular Health | Scoop.it
From 2000 to 2010, the number of people in the U.S. civilian noninstitutionalized population under age 40 obtaining at least one outpatient prescription anti-diabetic or anti-hypertensive increased.From 2000 to 2010, the total number of outpatient prescriptions for persons under age 40 increased for anti-diabetics, anti-hypertensives, and statins—41%, 49%, & 179%, respectively.Comparing 2000 with 2010, for persons under age 40 in the U.S. civilian noninstitutionalized population inflation adjusted total expenses increased for anti-diabetics (126%) and for statins (97%).From 2000 to 2010, for persons under age 40, the inflation adjusted average cost per drug purchase of a prescription anti-diabetic increased 61% from $77 to $124.From 2000 to 2010, for persons under age 40, the inflation adjusted average cost per drug purchase of a prescription anti-hypertensive and statin decreased.
Seth Bilazarian, MD's insight:

Despite the rise in obesity and incident diabetes and other associated risk factors such as high blood pressure and high cholesterol in children and young adults the treatment rates have increased very little over 10 years. Despite the known long term hazards there is a lack of data on treatment in patients less than 40 years old and therefore real hesitancy to treat by physicians.

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Open Season on Salt: What the Science on Hypertension Really Shows

Open Season on Salt: What the Science on Hypertension Really Shows | Heart and Vascular Health | Scoop.it

My comment:  This article does a good job explaing that the short term risk of high salt intake is being exaggerated in kids. BUT as an adult cardiologist I can attest to many patients who strugle with this in their mid life.  By acquiring a taste (and compulsion) for salty foods may patients suffer lasting and difficult consequences on the  cardiovascular system including congrestive heart failure and kidney disease.  Changing their taste buds is often a major challenge for disease management becasue of what has been learned early in life

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The latest news reports about salt are enough to make a parent ponder a household ban on pizza and cold cuts. A study published last week in Pediatrics found that children eat, on average, 3.4 grams of sodium daily—more than twice the amount recommended for adults by the Institute of Medicine.

 

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Yogurt Linked to Lower BP

Yogurt Linked to Lower BP | Heart and Vascular Health | Scoop.it

My comment: "Smart foods" or "super foods" are very attractive to Americans:  Eat more, get healthier.  The abstract noted here made me recall the Dannon Yogurt commercial suggesting people living in the Republic of Georgia lived long lives due to yogurt consumption.  See it here.  http://www.youtube.com/watch?v=R9RJBgNB1ZI

Adding yogurt (or other healthy foods) is not the answer.  Replacing less healthy foods with more healthy alternatives is sensible and can be recommended.

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Yogurt may help prevent hypertension as part of a healthy diet, an observational study suggested.

People who ate at least the equivalent of one serving every three days were 31% less likely to develop high blood pressure than those who ate no yogurt at all. An even stronger effect was seen among individuals who were not taking antihypertensive drugs, according to their analysis of the Framingham Heart Study Offspring Cohort reported at the AHA's High Blood Pressure Research meeting in Washington, D.C.

The finding reinforces the known role of low-fat dairy products in reducing blood pressure and the association supports the DASH diet recommendation of two to three servings of low-fat dairy per day. However, "when we talk about adding heart healthy foods we always want to think about what will they replace in the diet, not necessarily adding them on top of your existing diet in order to maintain a healthy weight,"  The  study of 2,197 adults in the offspring cohort of the Framingham Heart Study who did not have high blood pressure at baseline. Participants answered dietary questions and were followed for blood pressure along with other measures in the longitudinal study.  44% of the participants reported that they ate yogurt at least once a month. During the 14 years of follow-up, blood pressures rose and 913 of the participants developed hypertension. Yogurt intake rose too, and those with high intake -- more than 2% of their daily calories from yogurt -- were less likely to develop hypertension.  The odds ratio of incident hypertension was 0.69 compared with individuals who didn't eat yogurt, with a significant 95% confidence interval of 0.54 to 0.87 after adjustment for demographic and lifestyle factors and cholesterol-lowering medication use.

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Million Hearts | Facebook

Million Hearts | Facebook | Heart and Vascular Health | Scoop.it

Team Up. Pressure Down. is a nationwide program to lower blood pressure and prevent hypertension through patient-pharmacist engagement.
Videos for patients on diagnosis & risks. Other resources include blood pressure guide, journal and medication tracker.
Good way for patient to get to know about America's most important silent killer. Join the online community.

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Prevent Hypertension - resources for Patients & Physicians

Prevent Hypertension - resources for Patients & Physicians | Heart and Vascular Health | Scoop.it

Information on diagnosis and treatment of Resistant Hypertension defined as blood pressure above goal despite compliance with three maximum dose medications including at least one diuretic.

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What Is High Blood Pressure? - NHLBI, NIH

What Is High Blood Pressure? - NHLBI, NIH | Heart and Vascular Health | Scoop.it
Information in an easy to read and understand format for patients to uderstand the imprtance of high blood pressure treatment. What Is High Blood Pressure?
High blood pressure (HBP) is a serious condition that can lead to coronary heart disease (also called coronary artery disease), heart failure, stroke,
kidney failure, and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.

 

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