TY  - CHAP
M1  - Book, Section
TI  - Overview: Systemic Hypertension
A1  - Sutters, Michael
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
PY  - 2022
T2  - Current Medical Diagnosis & Treatment 2022
AB  - Key  Clinical  Updates  in  Overview:  Systemic  HypertensionThe  SPYRAL  HTN-OFF  MED  study  used  a  controlled  ablation  strategy  to  perform  renal  sympathetic  denervation;  clinically  meaningful  blood  pressure  reductions  occurred  in  the  intervention  group  compared  to  the  control  group.Although  not  yet  accepted  in  general  clinical  practice,  renal  sympathetic  nerve  ablation  may  emerge  as  an  alternative  or  adjunctive  modality  in  the  treatment  of  hypertension  and  may  become  useful  in  managing  resistant  hypertension  and  drug  intolerance.The  HYGIA  trial  compared  the  effect  of  nighttime  dosing  of  at  least  one  antihypertensive  medication  with  morning  dosing  of  all  antihypertensive  medications  in  19,000  participants  with  median  follow  up  6.3  years  and  demonstrated  improved  ambulatory  blood  pressure  and  a  significant  decline  in  major  cardiovascular  events  in  the  nighttime  dosing  group.Participants  in  the  HYGIA  were  monitored  via  ambulatory  blood  pressure  measurement,  and  the  incidence  of  nocturnal  hypotension  was  very  low.  However,  profound  nocturnal  hypotension  might  not  be  detected  in  the  absence  of  ambulatory  blood  pressure  monitoring,  and  ischemic  optic  neuropathy  or  other  low  perfusion  complications  would  be  a  concern.Canagliflozin  generally  lowers  blood  pressure  by  3–4  mm  Hg  in  addition  to  better  glycemic  control  through  inhibition  of  the  SGLT2  glucose  transporter  in  patients  with  diabetes.This  drug  was  associated  with  improved  renal  outcomes  and  reduced  cardiovascular  risk  in  the  CREDENCE  trial  of  patients  with  diabetic  nephropathy  and  can  be  considered  when  additional  blood  pressure  control  is  needed  in  patients  with  type  2  diabetes.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/23
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1184192564
ER  -