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Conference Highlights: ASH 2016

Conference Highlights: ASH 2016
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New research was presented at ASH 2016, the annual scientific meeting of the American Society of Hypertension, from May 13 to 17 in New York City. The features below highlight some of the studies that emerged from the conference.
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Hypertension Linked With Nocturia

Previous research has linked nocturia with hypertension and African-American race or ethnicity. However, these studies have not historically included actual measurements of blood pressure (BP), instead using BP numbers from electronic health records or self-reports. For a new analysis, more than 2,000 African-American men aged 35 to 79 were screened for hypertension with repeated oscillometric BP measurement on a single occasion. Participants also completed questionnaires that asked about nocturia and key known determinants. Nocturia was reported by 85% of study participants with hypertension, compared with a rate of 69% for those without hypertension. Men with uncontrolled hypertension despite treatment with antihypertensive agents had a nocturia rate of 91%. This rate was 96% for those with a systolic BP of 160 mm Hg or higher despite antihypertensive treatment.

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The Cost-Effectiveness of Aggressive BP Targets

Experts have hypothesized that a systolic blood pressure (BP) target of less than 120 mm Hg for patients at high risk of cardiovascular disease (CVD) events may help prevent future cardiac events. However, cost-effectiveness studies to confirm these suspicions have been lacking. American investigators analyzed the effect of lowering BP targets to 120 mm Hg with regard to cost-effectiveness for patients aged 50 and older with CVD or chronic kidney disease or 10-year American Heart Association/American College of Cardiology pooled cohorts CVD risk of 15% or greater. The authors estimated that using this target BP threshold would prevent an additional 35,000 CVD events nationally if it were added to existing JNC7 criteria. The research team also estimated that this strategy would have annual healthcare cost savings of $1.22 billion for men and $320 million for women.

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Alcohol, LV Dysfunction, & Hypertension

Prior studies have suggested that moderate alcohol intake may benefit cardiovascular health. Whether these benefits apply to patients with hypertension has yet to be determined. For a study, a team of Italian investigators asked patients with hypertension, normal left ventricular (LV) systolic function, and no history of alcohol addiction to complete a questionnaire focusing on alcohol intake. Overall, LV inner diastolic and systolic diameters, interventricular septum thickness, left atrial diameter, and LV mass index were progressively greater with increasing levels of alcohol consumption. Also, LV diastolic dysfunction was observed in 41% of those who consumed no alcohol, 47% of those who consumed 1 g to 19 g of alcohol per day, 65% of those who consumed 30 g to 39 g per day, and 87% of those who consumed 40 g or more alcohol per day.

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Midday Napping Increases Hypertension Risk

Napping has been shown in previous studies to improve fatigue, mood, and focus, but studies assessing a possible association between napping and hypertension have been less clear. For a new investigation, researchers analyzed data from nine studies that reported relative risks, odds ratios, or hazard ratios for hypertension based on participants’ napping status and then pooled together risk ratios (RRs). The overall RR for hypertension was 1.13 for those who napped regularly when compared with those who did not. The pooled RR rose to 1.19 when the authors looked at studies assessing daytime napping. However, the RR for hypertension was lower (0.79) for night-shift workers who napped at night.

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Predicting Cognitive Impairment in Prehypertension

Advanced glycation end products (AGEs)—measured with simple, noninvasive exams of skin autoflourescence—have been linked with the development of Alzheimer’s disease and with atherosclerosis in patients who have diabetes. Few studies have explored whether AGEs are associated with mild cognitive impairment in prehypertensive, healthy patients. For a study, researchers had prehypertensive patients older than 40 who were otherwise healthy undergo screening for mild cognitive impairment and skin autofluorescence exams. After adjusting for multiple factors, patients with the highest skin autofluorescence levels were about four times more likely to have mild cognitive impairment than those with the lowest levels.

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NEWS FROM ASH 2016

AF Risk Plunges With Improving Cardio Fitness in Patients With Hypertension, Diabetes

More From SPRINT: Intensive BP Targeting Cuts HF-Related Events Without Raising Fall Risk

SPRINT Confuses Ambulatory BP Expectations

Study: Aged Cheese Lowers Blood Pressure

Tighter HTN Control Won’t Hasten Decline for Older Adults

NEJM Quick Take: The SPRINT Trial

 

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