Posts Tagged ‘hypertension’

Blood Pressure Control: SPRINTing Towards a Lower Blood Pressure Target

Posted by • November 9th, 2015

Mrs. Weymouth has hypertension and she is at your office for a check-up. Her blood pressure is 136/72 mm Hg. What do you tell her about her blood pressure control? Hypertension affects nearly 1 out of 2 individuals world-wide between the ages of 35 and 70. The goal of blood pressure control is to reduce cardiovascular… Read More…

Control of Hypertension in Pregnancy

Posted by • January 30th, 2015

In a trial comparing less-tight control of hypertension (target diastolic blood pressure, 100 mm Hg) with tight control (85 mm Hg) among pregnant women, rates of pregnancy loss, high-level neonatal care, and serious maternal complications were similar between groups. Blood-pressure targets for women with nonsevere hypertension during pregnancy are much debated. Relevant randomized, controlled trials have been small… Read More…

Scorpion Envenomation

Posted by • August 1st, 2014

Each year more than a million cases of scorpion envenomation occur worldwide, causing substantial morbidity and, among children, a risk of death. A new brief review discusses the effects and treatment of scorpion envenomation. Every year, more than 1 million cases of scorpion envenomation are reported worldwide. Although the resultant mortality is lower than that… Read More…

The Child or Adolescent with Elevated Blood Pressure

Posted by • June 13th, 2014

Evaluation of children and adolescents with hypertension can detect evidence of the secondary systemic effects of hypertension (in particular, renal disease). Initial therapy is usually nonpharmacologic, but pharmacotherapy is used if other methods fail, hypertension is severe, or there are coexisting conditions such as diabetes mellitus.  NEJM Deputy Editor and Massachusetts General Hospital pediatrician Dr…. Read More…

The Case Against Renal Stenting for Treatment of Hypertension and Chronic Kidney Disease

Posted by • January 2nd, 2014

Wouldn’t it be great if medicine could borrow from the science behind percutaneous coronary arterial stenting (used over 600,000 times per year in the United States for coronary ischemia) in order to treat a chronic and widespread disease such as hypertension?  The CORAL trial (Cardiovascular Outcomes in Renal Atherosclerotic Lesions), published in this week’s NEJM,… Read More…

IgA Nephropathy

Posted by • June 21st, 2013

IgA nephropathy is a common glomerular disease that is an important cause of kidney failure. The latest review in our Medical Progress series discusses advances in the therapy and understanding of the molecular basis of IgA nephropathy, a common glomerulopathy that not infrequently leads to kidney failure. IgA nephropathy is the most prevalent primary chronic glomerular… Read More…

Poorly Controlled Diabetes Mellitus and Fatigue

Posted by • May 31st, 2013

In the latest Case Record from the Massachusetts General Hospital, a 56-year-old woman with diabetes mellitus was admitted to the hospital because of hyperglycemia and chest pain. Approximately 4 years earlier, a chest radiograph showed a solitary pulmonary nodule in the right upper lobe.  The differential diagnosis for uncontrolled diabetes includes undertreatment or misdiagnosis of… Read More…

Secondary Stroke Prevention

Posted by • May 16th, 2012

Patients with stroke are at high risk for subsequent vascular events, including recurrent stroke (highest risk), myocardial infarction, and death from vascular causes. The latest article in our Clinical Practice series reviews recommended strategies to reduce the risk of a subsequent stroke in patients with a history of transient ischemic attack (TIA) or stroke. Worldwide, stroke… Read More…

Subclinical Atrial Fibrillation

Posted by • January 13th, 2012

In a study from Healey et al, a cohort of 2580 patients with pacemakers or defibrillators were monitored for 3 months to detect subclinical atrial tachyarrhythmias. Patients with subclinical atrial tachyarrhythmias had a significantly increased risk of subsequent ischemic stroke. Atrial fibrillation may be asymptomatic and consequently subclinical. Epide­miologic studies indicate that many patients with atrial fibrillation on… Read More…

Childhood Adiposity and Cardiovascular Risk

Posted by • November 16th, 2011

Childhood obesity has reached epidemic proportions, and has moved beyond public health discourse and onto the public stage. No doubt, efforts to prevent and treat childhood obesity are critical. But in the face of highly visible social campaigns -from school lunch reform to the elimination of “food deserts,” it can be tough to tell where… Read More…