Author Interviews, Blood Pressure - Hypertension, BMJ, Brigham & Women's - Harvard / 17.02.2015

dr-alexander-turchinMedicalResearch.com Interview with: Dr. Alexander Turchin M.D.,M.S. Director of Informatics Research Division of Endocrinology, Brigham and Women’s Hospital Boston, MA Medical Research: What is the background for this study? What are the main findings? Dr. Turchin: Hypertension is the most common risk factor for cardiovascular events. High blood pressure increases the risk for stroke, myocardial infarction, heart failure and kidney failure. Treatment of high blood pressure reduces these risks. However, our understanding of optimal treatment of hypertension is incomplete. In particular, there is little information to guide clinicians on how quickly they should achieve blood pressure control in their patients. There have been no clinical trials focusing on this question. Current guidelines are sparse and are based only on expert opinion. Our study analyzed treatment of nearly 90,000 patients in primary care practices in the U.K. between 1986 and 2010. We found that patients whose blood pressure medications were adjusted within 1.4 months after systolic blood pressure reached over 150 mm Hg and whose blood pressure was re-assessed within 2.7 months after their treatment was adjusted had the lowest risk for acute cardiovascular events and death from any cause. (more…)
Author Interviews, Blood Pressure - Hypertension, Cost of Health Care, NEJM / 29.01.2015

Andrew Moran, MD, MPH Herbert Irving Assistant Professor of Medicine Columbia University Division of General Medicine Presbyterian Hospital 9th floor East room 105 New York, NY 10032MedicalResearch.com Interview with: Andrew Moran, MD, MPH Herbert Irving Assistant Professor of Medicine Columbia University Division of General Medicine Presbyterian Hospital  New York, NY 10032 Medical Research: What is the background for this study? What are the main findings? Response: In 2014, a panel appointed by the Eighth Joint National Committee on the Detection, Evaluation and Treatment of High Blood Pressure (JNC 8) recommended new guidelines for high blood pressure (hypertension ) treatment in U.S. adults.  The guidelines made sweeping changes to the prior guidelines and stirred up controversy among hypertension and public health experts.  Essentially, the panel recommended more conservative treatment targets that narrowed the population eligible for treatment with blood pressure-lowering medications.  Nonetheless, about 28 million U.S. adults have uncontrolled hypertension even under the new more conservative guidelines.  We asked the question:  are the new guidelines cost-effective? That is, does treating this common condition with the available medicines add more health and reduce medical costs?  It is surprising that this question has rarely been answered before. (more…)
Author Interviews, Blood Pressure - Hypertension, McGill, Salt-Sodium / 22.01.2015

Charles Bourque PhD James McGill Professor Centre for Research in Neuroscience Montreal General Hospital Montreal QC, CanadaMedicalResearch.com Interview with: Charles Bourque PhD James McGill Professor Centre for Research in Neuroscience Montreal General Hospital Montreal QC, Canada Medical Research: What is the background for this study? What are the main findings? Dr. Bourque: Previous work has established that there is a link between a high level of dietary salt intake and the development of hypertension. In particular, so-called “salt-sensitive” individuals display increases in blood pressure that correlate with significantly increased levels of serum sodium concentration. Increased sodium levels are known to cause an excitation of vasopressin (VP)-releasing neurons of the hypothalamus. We therefore tested the hypothesis that this increase can contribute to the increase in blood pressure associated with high sodium intake in rats. (more…)
Author Interviews, Blood Pressure - Hypertension, CDC / 21.01.2015

MedicalResearch.com Interview with: Xuefeng (Chris) Liu, PhD Associate Professor, School of Nursing Ann Arbor, MI 48109 MedicalResearch: What is the background for this study? What are the main findings? Dr. Liu: Isolated systolic hypertension (ISH), defined as a systolic blood pressure (SBP) of ≥ 140 mm Hg and a diastolic blood pressure (DBP) of < 90 mm Hg, is an important hypertension subtype. Isolated systolic hypertension is often characterized as a phenomenon of aging and becomes the major form of hypertension for people aged 50 or more. Elevated SBP has been thought to be more important than elevated DBP as a risk factor for adverse cardiovascular and renal outcomes. When combined with other risk factors such as poor diet and lack of exercise, untreated Isolated systolic hypertension can lead to serious health problems (e.g. stroke, heart disease, and chronic kidney disease). The existing studies of pattern changes in rates of Isolated systolic hypertension in the US adult population focus on uncontrolled hypertension subtypes among individuals with uncontrolled blood pressure, and the prevalence and changes of untreated ISH in the general population was not the main focus. In addition, the studies were based on the data collected two decades ago. More recent prevalence estimates and long-term changes of ISH among US untreated adults are needed to fill the gap in the hypertension literature. In our study, we used data from the National Health and Nutrition Examination Survey 1999-2010, conducted by CDC National Center for Health Statistics. We found that the prevalence of untreated ISH significantly decreased from 1999-2004 to 2005-2010. Old persons, females, and non-Hispanic blacks had higher prevalence of untreated Isolated systolic hypertension. Compared with 1999-2004, the prevalence of untreated Isolated systolic hypertension in 2005-2010 declined among older and female individuals. Further stratification analyses showed that treated ISH improved over time for older non-Hispanic whites and blacks, non-Hispanic white females, older individuals with a college education or above and females with a high school education or below. (more…)
Author Interviews, Blood Pressure - Hypertension, Case Western, Dermatology, JAMA, Weight Research / 26.12.2014

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, IllinoisMedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois Medical Research: What is the background for this study? Dr. Silverberg: Previous studies found associations between obesity and atopic dermatitis (AD). However, little was known about the association between AD and metabolic risk factors, such as central obesity and high blood pressure. (more…)
Author Interviews, Blood Pressure - Hypertension / 20.10.2014

Dr. Brent M. Egan MD Adjunct Professor Medical University of South CarolinaMedicalResearch.com Interview with: Dr. Brent M. Egan MD Professor of Medicine University of South Carolina School of Medicine Greenville Senior medical director of the Care Coordination Institute Greenville, South Carolina Medical Research: What are the main findings of the study? Dr. Egan: The study was undertaken to determine progress toward the Healthy People 2020 goals of controlling hypertension or high blood pressure in 61.2% of all adults with the condition. What we found is that hypertension control has changed very little from 2007 through 2012. In 2011-2012, an estimated 51.2% of all hypertensive adults were controlled, which is 10% below the 2020 goal.  The analysis indicated that healthcare insurance and at least two healthcare visits yearly were related to both the likelihood that hypertension would be treated and controlled. (more…)
Author Interviews, Blood Pressure - Hypertension, BMC / 29.09.2014

MedicalResearch.com Interview with: Prof. Dr. med. Alain Nordmann Innere Medizin FMH Basel, Switzerland Medical Research: What are the main findings of the study? Dr. Nordmann: Based on available randomised controlled trials, garlic preparations seem to lower blood pressure in individuals with hypertension in the short term. However, the quality of the studies and the lack of long-term data preclude the routine use of garlic preparations to lower blood pressure in individuals qualifying for antihypertensive drug therapy. (more…)
Author Interviews, Blood Pressure - Hypertension, Protein / 20.09.2014

Lynn L. Moore, DSc, MPH Co-Director, Nutrition and Metabolism Assoc Prof of Medicine Preventive Medicine & Epidemiology Department of Medicine Boston University School of Medicine Boston, MA 02118MedicalResearch.com Interview with: Lynn L. Moore, DSc, MPH Co-Director, Nutrition and Metabolism Assoc Prof of Medicine Preventive Medicine & Epidemiology Department of Medicine Boston University School of Medicine Boston, MA 02118 Medical Research: What are the main findings of the study? Response: Our data were derived from 1,361 adults (aged 30-54 years) enrolled in the Framingham Offspring Study and showed that men and women who consumed higher amounts of protein had lower blood pressures (both systolic and diastolic blood pressures) after four years of follow-up. We then followed them for an average of about 11 years and found that those who consumed the most protein (approximately 103 g/day) had about a 40% lower risk of developing high blood pressure than those consuming about half that amount. These beneficial effects were even more pronounced when higher protein intakes were combined with high fiber intakes. (more…)
Aging, Author Interviews, Blood Pressure - Hypertension / 20.09.2014

Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 Medical Research: What are the main findings of the study? Dr. Sui: First, blood pressure is inversely associated with cardiorespiratory fitness levels among men. People in higher fitness categories had lower blood pressure than those in lower fitness categories. Second, fitness is a strong effect modifier for the systolic blood pressure aging trajectory. A higher fitness level can significantly delay the natural age-associated increase in blood pressure. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 14.09.2014

MedicalResearch.com Interview with: Sourabh Aggarwal, MD University College of Medical Sciences Western Michigan University School of Medicine in Kalamazoo. Medical Research: What are the main findings of the study? Dr. Aggarwal: The main findings were that from 2006 to 2011:
  • ER visits for essential hypertension increased by 25 percent, while the admission percentage for these patients fell by 15 percent.
  • ER visits for hypertension with complication and secondary hypertension increased by 19 percent, while the admission percentage for these patients fell by 12 percent
(more…)
Author Interviews, Blood Pressure - Hypertension / 18.08.2014

Dr. Rodrigo Modolo Department of Pharmacology Faculty of Medical Sciences University of Campinas–UNICAMP Campinas, SP, Brazil;MedicalResearch.com Interview with: Dr. Rodrigo Modolo Department of Pharmacology Faculty of Medical Sciences University of Campinas–UNICAMP Campinas, SP, Brazil; Medical Research: What are the main findings of the study? Dr. Modolo: The main findings of this study are the encounter of a high prevalence of silent myocardial ischemia (assessed by myocardial perfusion scintigraphy) in resistant hypertension and the identification of predictors of this alteration in this population. (more…)
Blood Pressure - Hypertension, JACC, JAMA, Kidney Disease / 05.08.2014

Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles,MedicalResearch.com Interview with: Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles, Medical Research: What are the main findings of the study? Dr. Sim: Among a large diverse population of treated hypertensive people, those who achieved systolic blood pressures (SBP) in the ranges of 130-139mm Hg had the lowest risk for death and end stage renal disease (kidney failure).  Not surprisingly, those with SBP above 139 had incrementally greater risk, but somewhat surprising was that those with SBP under 130 also had a greater risk for death and kidney failure. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA / 19.06.2014

Carlos J. Rodriguez, MD, MPH Department of Medicine and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North CarolinaMedicalResearch.com Interview with Carlos J. Rodriguez, MD, MPH Department of Medicine and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina MedicalResearch: What are the main findings of the study? Dr. Rodriguez: As a clinician there is a notion suggesting that lower blood pressure is better but our current research to date is controversial and not conclusive. We wanted to study a large group of people with hypertension and see whether over 20 years of follow up, if a lower systolic blood pressure would be associated with lower cardiovascular events (heart attack, stroke, heart failure, angina). We hypothesized that there would be a linear association between blood pressure and events, that lower blood pressure would be associated with lower events and that as the blood pressure went up there would be more events. We found this was not the case but that hypertensives with a blood pressure between 120-138mmhg have the greatest benefit and those with a blood pressure less than 120mmhg did not have additional benefit. (more…)
Author Interviews, NEJM, Obstructive Sleep Apnea, University of Pennsylvania, Weight Research / 13.06.2014

Julio A. Chirinos, MD, PhD Assistant Professor of Medicine Director, CTRC Cardiovascular Phenotyping Unit Perelman School of Medicine, University of Pennsylvania Director of Non-Invasive Imaging Philadelphia VA Medical CenterMedicalResearch.com Interview with: Julio A. Chirinos, MD, PhD Assistant Professor of Medicine Director, CTRC Cardiovascular Phenotyping Unit Perelman School of Medicine, University of Pennsylvania Director of Non-Invasive Imaging Philadelphia VA Medical Center MedicalResearch: What are the main findings of the study? Dr. Chirinos: The main findings of the study is that, among patients with obesity and moderate to severe obstructive sleep apnea, obesity, rather than OSA, appears to be the primary cause of inflammation, insulin resistance and dyslipidemia. However, both obesity and obstructive sleep apnea appear to be causally related to hypertension. In this population, weight loss, but not CPAP, can be expected to reduce the burden of inflammation, insulin resistance and dyslipidemia. However, CPAP, among patients who comply with therapy, can be expected to provide a significant incremental benefit on blood pressure. The latter is an important potential benefit of CPAP and should not be disregarded. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Lancet / 03.06.2014

​MedicalResearch.com Interview with: Eleni Rapsomaniki, PhD The Farr Institute of Health Informatics Research Department of Epidemiology & Public Health University College London London MedicalResearch: What are the main findings of the study? Dr. Rapsomaniki: Our data shows that hypertension is associated with considerable reduction in CVD-free life expectancy. Based on our estimates a 30-year old with hypertension suffered from CVD 5 years earlier compared to a similarly aged individual with normal blood pressure. We noted substantial heterogeneity in the associations of blood pressure with specific cardiovascular outcomes. For example a 20 mmHg increase in systolic blood pressure was associated with ~40% higher risk of stable angina, and intracerebral or subarachnoid haemorrhage but less than 10% increase in risk of abdominal aortic aneurysm. In all age groups from 30 to over 80 people with a systolic blood pressure 90–114 mm Hg and a diastolic blood pressure of 60–74 mm Hg had the lowest risk of all cardiovascular diseases, and we found no J-shape associations. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Education / 21.05.2014

Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical School   MedicalResearch: What are the main findings of the study? Dr. Kerfoot: (1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension. (2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders). (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, OBGYNE / 30.04.2014

MedicalResearch.com Interview with: Dr Kate Bramham Division of Women's Health King's College London Women's Health Academic Centre KHP London, SE1 7ER MedicalResearch.com: What are the main findings of the study? Dr. Bramham: This meta-analysis of nearly 800,000 pregnancies from 55 studies has shown that women with chronic hypertension have a significantly increased incidence of pregnancy complications including superimposed pre-eclampsia, preterm delivery, low birth weight infants, perinatal loss and neonatal unit admission. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, NIH, Nutrition, Salt-Sodium / 03.04.2014

MedicalResearch.com Interview with: Niels Graudal, MD, DrMSc Senior Consultant Department of Internal medicine/Infectious Medicine/Rheumatology IR4242 Copenhagen University Hospital, Rigshospitalet Denmark Dr. Graudal: There are no studies, which show what happens with the risk of cardiovascular death or mortality if you change your sodium intake. Our study shows the association of sodium intake as it is with cardiovascular disease and mortality, which is only the second best way to consider the problem, but as the best way does not exist we have accepted this approach. There have been two different assumptions concerning the risks of sodium intake. One is that there is an increasing risk of heart disease, stroke and death of salt intake above 2300 mg, and one is that salt is not dangerous at all. Our study shows that both positions partially may be true, as a salt intake above 4900 mg is associated with increased risk of cardiovascular disease and mortality, whereas the present normal salt intake of most of the world’s populations between 2300 mg and 4900 mg is not associated with any increased risks. In addition our study shows that a low sodium intake below 2300 mg is also associated with increased risk of cardiovascular disease and death. (more…)
Author Interviews, Blood Pressure - Hypertension, Duke, JAMA / 29.03.2014

MedicalResearch.com Interview with: Ann Marie Navar-Boggan, MD, PhD Division of Cardiology, Duke University Medical Center Durham, North Carolina MedicalResearch.com: What are the main findings of the study? Dr. Navar-Boggan: Two groups of adults are really affected by the updated guidelines. First, 13.5 million adults, including one in five adults over the age of 60, were previously considered to have uncontrolled blood pressure but now meet new guideline goals. Next, 14 million adults over the age of 60 (one in four adults in this age group) are currently on blood pressure lowering therapy and meeting the older, more stringent targets. The guidelines state that no changes are necessary in this group, but they may be eligible for reduced therapy, particularly if they have had side effects or difficulty with the therapies they are taking. (more…)
Author Interviews, Blood Pressure - Hypertension, Stroke / 12.03.2014

MedicalResearch.com Interview with: Dingli Xu, MD From Department of Cardiology Nanfang Hospital, Southern Medical University, Guangzhou, China MedicalResearch.com:  What are the main findings of the study? Answer:Our study showed that after controlling for multiple cardiovascular risk factors, the blood pressure range at 120-139/80-89 mm Hg (defined as ‘prehypertension’ in JNC 7), is significant associated with long-term risk of stroke. The results were consistent across stroke type, stroke endpoint, age, study characteristics, follow-up duration, and ethnicity. More importantly, even low-range prehypertension (BP 120-129/80-84mmHg) increased the risk of stroke compared with optimal BP (<120/80 mm Hg), and the risk was higher in individuals with high-range prehypertension (BP 130-139/85-85mmHg). In particular, we found that compared with individuals with optimal blood pressure individuals with low-range prehypertension were 44% more likely to develop stroke, and this risk was even greater (95%) in individuals with high-range prehypertension. (more…)
Author Interviews, Blood Pressure - Hypertension, Nutrition, Weight Research / 06.03.2014

Beverly B. Green, MD, MPH GroupHealth Research Institute Seattle WAMedicalResearch.com Interview with: Beverly B. Green, MD, MPH GroupHealth Research Institute Seattle WA   MedicalResearch.com: What are the main findings of the study? Dr. Green: We found that Group Health patients who were overweight and had hypertension were more likely to have lost 10 pounds in six months if they had secure online access to a dietitian than if they received only information and usual care. The patients really loved this intervention—and having access to a dietitian to work with them toward a healthier lifestyle. Although blood pressure and heart risk trended lower in the intervention group, the differences weren’t significant—unlike their weight. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Genetic Research, University of Pennsylvania / 05.03.2014

MedicalResearch.com Interview with: Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia,Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia Michael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAMichael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA MedicalResearch.com: What are the main findings of the study? Answer: We found that individuals with a genetically-elevated BMI had higher blood pressure, inflammatory markers, metabolic markers and a higher risk of type 2 diabetes, although there was little correlation with coronary heart disease in this study population of over 34,500 European-descent individuals of whom over 6,000 had coronary heart disease. (more…)
Author Interviews, Blood Pressure - Hypertension, Gender Differences, Wake Forest / 02.01.2014

Carlos M Ferrario, MD, FAHA, FASH, FACC Dewitt-Cordelll Professor of Surgical Sciences Professor, Internal Medicine-Nephrology Professor, Physiology-Pharmacology Wake Forest University School of Medicine Winston-Salem, NC 27157-1032 Vice-President, Consortium Southeastern Hypertension Control Editor-in-Chief Therapeutic Advances in Cardiovascular DiseaseMedicalResearch.com Interview with: Carlos M Ferrario, MD, FAHA, FASH, FACC Dewitt-Cordelll Professor of Surgical Sciences Professor, Internal Medicine-Nephrology Professor, Physiology-Pharmacology Wake Forest University School of Medicine Winston-Salem, NC 27157-1032 Vice-President, Consortium Southeastern Hypertension Control Editor-in-Chief, Therapeutic Advances in Cardiovascular Disease MedicalResearch.com: What are the main findings of the study? Dr. Ferrario: A significant and unexpected difference in the hemodynamic mechanisms that account for the elevated blood pressure between untreated hypertensive men and women. The main findings were: "Despite there being no differences between women and men in terms of office blood pressure, heart rate and body mass index, men demonstrated lower values of pulse pressure, systemic vascular resistance, brachial artery pulse wave velocity and augmentation index. In each of the three hypertension categories, the increased blood pressure in men was associated with significant augmentations in stroke volume and cardiac output compared with women. Sex-related hemodynamic differences were associated in women with higher plasma levels of leptin, hs-CRP, plasma angiotensin II and serum aldosterone. In women but not men, hs-CRP correlated with plasma concentrations of transforming growth factor β1 (TGFβ1) and body weight; in addition, plasma TGFβ1 correlated with levels of serum vascular cell adhesion molecule 1." (more…)
Author Interviews, Blood Pressure - Hypertension, Compliance, JACC, Outcomes & Safety, UT Southwestern / 10.12.2013

Dr. Wanpen Vongpatanasin, MD Professor of Medicine Director, Hypertension Section Cardiology Division UT Southwestern Medical CenteMedicalResearch.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. (more…)
Author Interviews, Blood Pressure - Hypertension, University of Michigan / 05.11.2013

Jeremy Sussman, MD, MS Division of General Internal Medicine University of Michigan Staff Scientist, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare SystemMedicalResearch.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. (more…)
Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, JAMA / 03.10.2013

MedicalResearch.com Interview Ma, Wei Department of Epidemiology and Health Statistics School of Public Health Shandong University 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. (more…)
Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Cost of Health Care, JAMA / 16.09.2013

Laura A. Petersen, MD, MPH MEDVAMC Associate Chief of Staff, Research Director, VA HSR&D Center of Excellence (152) 2002 Holcombe Blvd. Houston TX 77030 Professor of Medicine Chief, Section of Health Services Research Baylor College of Medicine www.houston.hsrd.research.va.govAshley Motter HSR&D Center of Excellence Michael E. DeBakey Veterans Affairs Medical CenterMedicalResearch.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. (more…)
Author Interviews, Blood Pressure - Hypertension, JACC, Nature / 23.08.2013

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 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. (more…)