MedicalResearch.com Interview with Dr. Moa Wolff
Center for Primary Health Care Research
Department of Clinical Sciences in Malmö, Lund University
Jan Waldenströms gata 35, Skåne University Hospital, Malmö 205 02, Sweden
MedicalResearch.com: What are the main findings of the study?Dr. Wolff: We investigated the effects of two yoga interventions on blood pressure and quality of life in patients in primary health care diagnosed with hypertension. Our study showed that a short yoga program practiced daily at home had an antihypertensive effect, as well as a positive effect on self-rated quality of life compared to controls.
MedicalResearch.com Interview with;Dr. Wanpen Vongpatanasin, MD
Professor of Medicine
Director, Hypertension Section, Cardiology Division
UT Southwestern Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Vongpatanasin: We found that more than 50% of patients with resistant hypertension were non-adherent to at least one drug prescribed by their primary care physicians for blood pressure control.
When we provided this information back to the patients, as part of care in our hypertension specialty clinic, we found that many patients report difficulty taking prescribed medications due to either associated side effects or cost of the medication. When we adjusted patient's medications to fit their needs, BP levels were substantially improved during subsequent visits without increasing the number of medications.
MedicalResearch.com Interview with: Dan Nation
Assistant Professor, Department of Psychology at University of Southern California
Veterans Affairs San Diego Healthcare System
MedicalResearch.com: What are the main findings of the study?Answer: The main study findings indicate that high blood pressure, specifically pulse pressure (systolic - diastolic pressure), is associated with increased markers of Alzheimer's disease in the cerebral spinal fluid of healthy middle-aged adults. These results suggest a connection between blood pressure and Alzheimer's disease prior to the onset of any symptoms of the disease.
MedicalResearch.com Interview with:Jeremy Sussman, MD, MS
Division of General Internal Medicine
University of Michigan
Staff Scientist, Center for Clinical Management Research
Ann Arbor Veterans Affairs Healthcare System
MedicalResearch.com: What are the main findings of the study?Dr. Sussman: We could prevent up to 180,000 more heart attacks and strokes in America every year using less medication overall.
MedicalResearch.com InterviewMa, Wei
Department of Epidemiology and Health Statistics
School of Public Health
Jinan, Shandong Province, 250012 China
MedicalResearch.com: What are the main findings of the study?Answer: The results of this meta-analysis suggested that there was an inverse dose-response association between levels of recreational physical activity and risk of hypertension. Individuals who participated in high levels of recreational physical activity had a 19% lower risk of hypertension than those who didn’t exercise much. In addition, those with moderate levels of recreational physical activity had an 11% lower risk of hypertension.
However, there was no significant association between occupational physical activity and risk of hypertension.
MedicalResearch.com Interview with:
Laura A. Petersen, MD, MPH
MEDVAMC Associate Chief of Staff, Research
Director, VA HSR&D Center of Excellence (152)
Houston TX 77030
Professor of Medicine
Chief, Section of Health Services Research
Baylor College of Medicine
HSR&D Center of Excellence
Michael E. DeBakey Veterans Affairs Medical Center
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension. The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups. Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year. The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant. None of the incentives resulted in increased incidence of hypotension compared with controls. While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group. The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000.
MedicalResearch.com Interview with:
Dr Sandosh Padmanabhan Institute of Cardiovascular and Medical Sciences University of Glascow, Scotland
MedicalResearch.com: What are the main findings of the study?Dr. Padmanabhan: In the study "Serum Chloride Is an Independent Predictor of Mortality in Hypertensive Patients" we analysed data on 12,968 patients with hypertension followed up at the Glasgow Blood Pressure Clinic. We found that patients in the lowest quintile of serum Cl− (<100 mmol/L), compared with all other patients, had a 23% higher mortality (all-cause, cardiovascular, and non-cardiovascular). Each 1-mmol/L increase in serum Cl− was associated with a 1.1% to 1.5% lower all-cause mortality, cardiovascular mortality and non-cardiovascular mortality. This was independent of serum concentrations of sodium, bicarbonate or potassium. We did not find any association with longitudinal blood pressure control.
MedicalResearch.com Interview with: Bert Uchino PhD
Department of Psychology and Health Psychology Program
University of Utah, Salt Lake City, Utah,
MedicalResearch.com: What are the main findings of the study?
Dr. Uchino: The main findings from our paper is that independent of one’s own social network quality, the quality of a spouse’s social network was related to daily life ambulatory blood pressure (ABP) levels. More specifically, the more supportive (positive) ties, and the less aversive (negative) or ambivalent (both positive and negative) ties in a spouse’s social network, the lower was one’s own ABP. In addition, looking at the social networks of couples as a whole showed that couples who combined had more supportive ties and less aversive or ambivalent ties showed lower ABP.
MedicalResearch.com Interview with:Dr. Marc Jaffe, MD
Clinical Leader, Kaiser Northern California Cardiovascular Risk Reduction Program
Clinical Leader, Kaiser National Integrated Cardiovascular Health (ICVH) Guideline Development Group
Associate Clinical Professor of Medicine, UCSF
Endocrinology and Internal Medicine
Kaiser South San Francisco Medical Center
1200 El Camino Real
South San Francisco, California 94080
MedicalResearch.com: What are the main findings of the study?Dr. Jaffe: In 2001, we set out to improve blood pressure control in among Kaiser Permanente (KP) members in Northern California, and we ended up creating one of the largest, community-based hypertension programs in the nation. The paper published in JAMA explores how we combined a number of innovations, including a patient registry, single-pill combination therapy drugs and more, to nearly double blood pressure control rates.
If you had told us at the onset that blood pressure control among members would be more than 80 percent, and it was actually almost 90 percent in 2011, we wouldn’t have believed you. These results are truly incredible. During the study period, hypertension control increased by more than 35 percent from 43.6 percent to 80.4 percent in Kaiser Permanente Northern California between 2001 and 2009. In contrast, the national mean control rate increased from 55.4 percent to 64.1 percent during that period.
MedicalResearch.com Interview with: Marcos A Sanchez-Gonzalez, M.D., Ph.D., EPC
Postdoctoral AssociateDepartment of Biomedical Sciences
College of Medicine
The Florida State University
1115 W Call Street BMS 2300-24 &
The Family Institute
Behavioral Cardiology Laboratory
Tallahassee, FL 32306
MedicalResearch.com: What are the main findings of the study?Answer:
The findings of our study were the following:
(1) The low frequency component of systolic blood pressure variability (LFSBP; a marker of sympathovagal tone) was a stronger predictor of depressive symptoms than conventional measures of cardiovascular functioning such as laboratory measurement of blood pressure and heart rate variability as well as home based ambulatory blood pressure monitoring
(2) Depressive symptoms were associated with a blunted LFSBP response to sympathetic stimulation via cold pressor test; and
(3) Participants with acute depression (a score of ≥16 using the CES-D scale) had higher LFSBP than those with normal depressive symptom scores. These findings suggest that depressive symptoms evoke alterations in vascular sympathetic activity, and more importantly, this alteration is occurs early in the progression of the disease. This is fascinating owing to the fact that we have documented a common pathway of disease between depression and cardiovascular diseases.
MedicalResearch.com Interview with: Dr. Axel Bauer, MD, FESC, F-ISHNE
Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany.
MedicalResearch.com: What are the main findings of the study?Dr. Bauer: Catheter-based renal sympathetic denervation is a promising treatment option in patients with resistant arterial hypertension. However, it is invasive and might have presently unknown adverse side effects in the long-term. Therefore, identification of patients who benefit from RDN and, equally importantly, those who do not is of great importance. With assessment of baroreflex sensitivity (BRS) we found a way to do that. Patients with resistant hypertension and impaired BRS at baseline benefited the most from RDN in terms of reduction of mean systolic BP on (ABPM) while RDN had no effect in patients with preserved BRS.
MedicalResearch.com Interview with Dr. Anthony Bavry, MD MPH
Assistant Professor of Medicine
University of Florida
1600 SW Archer Road
Gainesville, FL 32610
MedicalResearch.com: What are the main findings of the study?Dr. Bavry: Among individuals with chronic stable coronary artery disease, it is possible to define a group who are at relatively low risk for adverse cardiovascular events.
MedicalResearch.com:Were any of the findings unexpected?(more…)
MedicalResearch.com Interview with:
Dr.Csaba P. Kovesdy MD FASN.
The Fred Hatch Professor of Medicine
Director, Clinical Outcomes and Clinical Trials Program in Nephrology
University of Tennessee Health Science Center
Chief of Nephrology
Division of Nephrology, Memphis VA Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kovesdy: In this study of >650,000 US veterans with CKD we found that categories of lower SBP/DBP combinations are associated with lower mortality only as long as the DBP component remains above a threshold of approximately 70 mmHg, and that patients with BP values in the range of 130-159/70-89 mmHg had the lowest mortality. Patients who might be considered to have “ideal” blood pressure (<130/80) actually had increased mortality due to the inclusion of individuals with low systolic and diastolic blood pressures.
MedicalResearch.com Interview with: Miles D. Witham, PhD
Aging and Health, University of Dundee, Dundee, United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: We gave high dose vitamin D3 (100,000 units) or placebo every 3 months to people aged 70 or over, who all had isolated systolic hypertension (ISH). The main focus of the trial was to test whether vitamin D supplementation could reduce blood pressure in this group of patients – this pattern of blood pressure, whether the systolic (top number) is high, and the diastolic (bottom number) is normal, is very common in older people. Previous studies have suggested a link between low vitamin D levels and higher blood pressure, but no trial has yet tested this idea in older patients with ISH.
Despite the treatment causing a significant increase in circulating vitamin D levels, we saw no significant reduction in blood pressure with vitamin D supplementation, despite the trial running for a year. We tested whether certain groups might still benefit – e.g. those with very high blood pressure or very low vitamin D levels, but even these groups did not show a reduction in blood pressure.
We also tested whether vitamin D supplementation reduced the health and stiffness of arteries – both important predictors of future heart attack or stroke. Unfortunately, vitamin D did not affect these measures either, and didn’t reduce cholesterol or glucose levels.
On the more positive side, vitamin D supplements did appear safe, and the number of falls in the vitamin D group was slightly lower than in those people who received placebo. This is reassuring, as an earlier study (Sanders et al) had suggested that very high doses of vitamin D might make falls more likely, in contrast to previous low dose studies that show a protective effect of vitamin D against falls.
MedicalResearch.com Interview with:Igor F. Tsigelny, Ph.D.
Department of Neurosciences, University of California at San Diego
San Diego Supercomputer Center, University of California at San Diego
Moores Cancer Center, University of California at San Diego
La Jolla, California 92093
MedicalResearch.com: What are the main findings of the study?Dr. Tsigelny: We find a new set of possible very effective drug-candidates for cure of hypertension. According to our preliminary testing these molecules are not toxic and can start a new series of drugs.
MedicalResearch.com Interview with: Dr. Bernard Rosner
Harvard School of Public Health
Professor in the Department of Biostatistics
Department of Biostatistics
Channing Laboratory 180 Longwood Avenue
Boston, Massachusetts 02115
MedicalResearch.com: What are the Main Findings of this study?Dr. Rosner: The risk of elevated blood pressure (BP) among children has increased 27% over a 13-year period based on a study among 11,636 children ages 8-17 seen in the NHANES study from 1988-2008. In NHANES III (1988-1994) the risk was 15.8% among boys and 8.2% among girls. In NHANES 1999-2008 (1999-2008) the risk was 19.2% among boys and 12.6% among girls.
Important risk factors for elevated BP were BMI, waist-circumference and sodium intake.
Risk approximately doubled for children in the highest age-sex-specific quartile of BMI vs. children in the lowest quartile
Risk approximately doubled for children in the highest age-sex-specific quartile of waist circumference vs. children in the lowest quartile
Risk increased 36% among children with dietary Na intake > 3450 mg/day vs. children with intake <2300 mg/day. Na intake was normalized per 2000 calories.
There were large increases in both mean BMI and mean waist circumference over the 13-year period, especially for girls.
MedicalResearch.com eInterview with:Dr. Jane L Lynch MD
School of Medicine
University of Texas Health Science Center at San Antonio
MedicalResearch.com: What are the main findings of the study?Dr. Lynch: American youth with type 2 diabetes who received the best currently available treatment and close monitoring of their diabetes experienced a more rapid progression of co-morbidities far more aggressive than what is typically seen in adults with type 2 diabetes.
MedicalResearch.com: Were any of the findings unexpected?Dr. Lynch: Youth with type 2 diabetes enrolled in the TODAY study developed early and rapidly progressing signs of heart and kidney disease, poor glycemic control and diabetes-related eye disease; even in the group receiving more intensive two-drug therapy, shown in previously released results to be the most effective treatment for maintenance of glycemic control.
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