Download or read book Renal Denervation written by Richard R. Heuser and published by Springer. This book was released on 2014-11-11 with total page 203 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension remains the leading cause of cardiovascular morbidity and mortality in spite of current medical therapies. It has been estimated that 50% of Western civilization has hypertension and approximately 20% of patients have resistant hypertension. Renal denervation (RDN) is a minimally invasive, endovascular catheter based procedure using radiofrequency ablation aimed at treating resistant hypertension. Early studies show a high degree of effectiveness in renal denervation to treat hypertension. This book examines renal pathophysiology and the rationale for renal denervation, as well as possible long term benefits and risks of this new therapy. The myriad of devices involved in the evolution of this therapy are discussed and the book concludes with analyses of the cost effectiveness and future applications.
Download or read book Renal Denervation for Treatment Resistant Hypertension written by and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Resistant Hypertension in Chronic Kidney Disease written by Adrian Covic and published by Springer. This book was released on 2017-11-08 with total page 371 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive volume provides a detailed review on the general work up of chronic kidney disease-associated resistant hypertension. This title is separated into four parts; the first of which provides definitions, epidemiology, characteristics, risk stratification and outcomes of resistant and apparent treatment resistant hypertension. The next two sections explore pathophysiology and diagnosis, treatment in the light of new guidelines, as well as procedures and devices for neural modulation. Part four discusses public health approaches to resistant hypertension, educational programs, and resistant hypertension for general practitioners. Resistant Hypertension in CKD brings up-to-date information to nephrologists, internists, cardiologists and a wide array of other clinicians and health professionals taking care of chronic kidney disease patients.
Download or read book Renal denervation written by Flavio L. RIBICHINI and published by Edizioni Minerva Medica SpA. This book was released on 2024-02-27 with total page 154 pages. Available in PDF, EPUB and Kindle. Book excerpt: This Renal Denervation handbook is a practical “all you need to know” guide to treating patients with hypertension. Renal Denervation is a revolutionary, minimally invasive trans-catheter intervention that has emerged as a safe and effective therapeutic companion for the limited number of patients with resistant hypertension and the huge population of those who “resist” to take their prescribed medications. Written by the world’s most recognized experts in the field, the handbook provides a review of the scientific bases of the therapy, reveals practical instructions on how to select the right patients and perform the procedure, and analyzes clinical results in a direct, easy to understand style. This guide is the resource for all healthcare providers interested in the modern management of hypertension and successfully managing the number one risk factor for stroke, myocardial infarction, and heart failure worldwide.
Download or read book Treatment resistant Hypertension written by Mohammed A. Hameed and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Effects of Renal Denervation Vs Sham in Resistant Hypertension After Medication Escalation written by Michel Azizi and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Importance Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. Objectives To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. Design, Setting, and Participants This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. Interventions uRDN vs sham procedure in conjunction with added medications to target BP control. Main Outcomes and Measures Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. Results A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of −2.4 [16.6] vs −7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. Conclusions and Relevance In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. Trial Registration ClinicalTrials.gov Identifier: NCT02649426
Download or read book Blood Pressure written by Aise Seda Artis and published by BoD – Books on Demand. This book was released on 2018-11-14 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the discovery of blood pressure by Stephen Hales in 1733, scientific interest in blood pressure regulation, particularly in hypertensive population, has not lost its popularity. The importance of the interactive effects of blood pressure shifts in different clinical conditions is well understood. We know many contributing factors regulate the pressure of the blood within the arteries. However, crucial blood pressure control and the exact mechanisms involved are still under debate. The present book aims to cover blood pressure from its measurement to various factors of its control with valuable contributions from different authors, in the light of contemporary data, from bench to bed.
Download or read book Renal Denervation written by Richard R. Heuser and published by Springer. This book was released on 2023-11-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This extensively revised edition examines renal pathophysiology and the rationale for renal denervation for the management of hypertension, as well as possible long-term benefits and risks of this therapy. Renal denervation is a minimally invasive, endovascular catheter-based procedure that makes use of radiofrequency ablation to treat resistant hypertension, with studies showing a high degree of effectiveness. The devices involved in the continued evolution of this therapy are discussed and the book incorporates analyses of the development of the technique while evaluating its cost effectiveness and future applications. Renal Denervation: A New Approach to Treatment of Resistant Hypertension describes the technique in detail, its advances and its pitfalls. While it has been estimated that 50% of Western civilization has hypertension and approximately 20% of patients have resistant hypertension, hypertension remains the leading cause of cardiovascular morbidity and mortality thus strengthening arguments to consider a wider range of potential solutions to manage these patients.
Download or read book Renal Denervation for Resistant Hypertension written by Ioana Nicolau and published by . This book was released on 2014 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Renal denervation is a technology that uses radio frequency energy to ablate the nerves surrounding the renal arteries in order to reduce blood pressure in patients whose hypertension is resistant to medical therapy. There is evidence, based mainly on observational data that this procedure results in a clinically significant reduction in blood pressure at 6 months. Weaker evidence suggests that the effect is sustained up to 2 years of follow-up. Some side-effects, none unmanageable or permanent, are reported. It is recommended that this technology receive temporary (two-year) and conditional approval for use only in the context of a formal research study to be supported by the manufacturer as specified"--page iv.
Download or read book Resistant Hypertension written by Giuseppe Mancia and published by Springer Science & Business Media. This book was released on 2013-07-23 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: A growing number of people suffer from so-called resistant hypertension, that is to say, high blood pressure that does not respond to treatment. This disorder is of great current interest and importance for public health, being a common clinical problem faced by both primary care clinicians and specialists. Furthermore, as older age and obesity are among the strongest risk factors for uncontrolled hypertension, the incidence of resistant hypertension will likely increase as the population becomes more elderly and heavier. While the prognosis of resistant hypertension is unknown, cardiovascular risk is undoubtedly increased since patients often have a history of long-standing, severe hypertension complicated by multiple other cardiovascular risk factors. This volume, compiled by a panel of world-renowned experts, offers a comprehensive exploration of resistant hypertension, covering epidemiology, complex diagnostic aspects, and the therapeutic options currently available, with due attention to overall treatment strategies. New therapeutic agents and procedures, such as renal denervation and baroreceptor stimulation, are also described. In addition, the book addresses the economic aspects of resistant hypertension and the role of the different professional figures, from GPs to hypertension specialists, in dealing with it.
Download or read book Renal Denervation for Resistant Hypertension written by Amy Burchell and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Diabetes and Hypertension written by Samy I. McFarlane and published by Springer Science & Business Media. This book was released on 2012-10-19 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.
Download or read book PanVascular Medicine written by Peter Lanzer and published by Springer. This book was released on 2015-03-30 with total page 5004 pages. Available in PDF, EPUB and Kindle. Book excerpt: Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.
Download or read book Renal Denervation in High risk Patients with Hypertension written by Felix Mahfoud and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Background Renal denervation (RDN) is under investigation for treatment of uncontrolled hypertension and might represent an attractive treatment for patients with high cardiovascular (CV) risk. It is important to determine whether baseline CV risk affects the efficacy of RDN. Objectives The purpose of this study was to assess blood pressure (BP) reduction and event rates after RDN in patients with various comorbidities, testing the hypothesis that RDN is effective and durable in these high-risk populations. Methods BP reduction and adverse events over 3 years were evaluated for several high-risk subgroups in the GSR (Global proSpective registrY for syMPathetic renaL denervatIon in seleCted IndicatIons Through 3 Years Registry), an international registry of RDN in patients with uncontrolled hypertension (n = 2,652). Comparisons were made for patients age ≥65 years versus age 65 years, with versus without isolated systolic hypertension, with versus without atrial fibrillation, and with versus without diabetes mellitus. Baseline cardiovascular risk was estimated using the American Heart Association (AHA)/American College of Cardiology (ACC) atherosclerosis cardiovascular disease (ASCVD) risk score.brbrResultsbrReduction in 24-h systolic BP at 3 years was −8.9 ± 20.1 mm Hg for the overall cohort, and for high-risk subgroups, BP reduction was −10.4 ± 21.0 mm Hg for resistant hypertension, −8.7 ± 17.4 mm Hg in patients age ≥65 years, −10.2 ± 17.9 mm Hg in patients with diabetes, −8.6 ± 18.7 mm Hg in isolated systolic hypertension, −10.1 ± 20.3 mm Hg in chronic kidney disease, and −10.0 ± 19.1 mm Hg in atrial fibrillation (p 0.0001 compared with baseline for all). BP reduction in patients with measurements at 6, 12, 24, and 36 months showed similar reductions in office and 24-h BP for patients with varying baseline ASCVD risk scores, which was sustained to 3 years. Adverse event rates at 3 years were higher for patients with higher baseline CV risk.br
Download or read book Renal Denervation for Resistant Hypertension written by and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Renal denervation is a technology that uses radio frequency energy to ablate the nerves surrounding the renal arteries in order to reduce blood pressure in patients whose hypertension is resistant to medical therapy. There is evidence, based mainly on observational data that this procedure results in a clinically significant reduction in blood pressure at 6 months. Weaker evidence suggests that the effect is sustained up to 2 years of follow-up. Some side-effects, none unmanageable or permanent, are reported. It is recommended that this technology receive temporary (two-year) and conditional approval for use only in the context of a formal research study to be supported by the manufacturer as specified"--page iv.
Download or read book Neural Control of Renal Function written by Ulla Kopp and published by Morgan & Claypool Publishers. This book was released on 2011 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: The kidney is innervated with efferent sympathetic nerve fibers reaching the renal vasculature, the tubules, the juxtaglomerular granular cells, and the renal pelvic wall. The renal sensory nerves are mainly found in the renal pelvic wall. Increases in efferent renal sympathetic nerve activity reduce renal blood flow and urinary sodium excretion by activation of α1-adrenoceptors and increase renin secretion rate by activation of β1-adrenoceptors. In response to normal physiological stimulation, changes in efferent renal sympathetic nerve activity contribute importantly to homeostatic regulation of sodium and water balance. The renal mechanosensory nerves are activated by stretch of the renal pelvic tissue produced by increases in renal pelvic tissue of a magnitude that may occur during increased urine flow rate. Activation of the sensory nerves elicits an inhibitory renorenal reflex response consisting of decreases in efferent renal sympathetic nerve activity leading to natriuresis. Increasing efferent sympathetic nerve activity increases afferent renal nerve activity which, in turn, decreases efferent renal sympathetic nerve activity by activation of the renorenal reflexes. Thus, activation of the afferent renal nerves buffers changes in efferent renal sympathetic nerve activity in the overall goal of maintaining sodium balance. In pathological conditions of sodium retention, impairment of the inhibitory renorenal reflexes contributes to an inappropriately increased efferent renal sympathetic nerve activity in the presence of sodium retention. In states of renal disease or injury, there is a shift from inhibitory to excitatory reflexes originating in the kidney. Studies in essential hypertensive patients have shown that renal denervation results in long-term reduction in arterial pressure, suggesting an important role for the efferent and afferent renal nerves in hypertension. Table of Contents: Part I: Efferent Renal Sympathetic Nerves / Introduction / Neuroanatomy / Neural Control of Renal Hemodynamics / Neural Control of Renal Tubular Function / Neural Control of Renin Secretion Rate / Part II: Afferent Renal Sensory Nerves / Introduction / Neuroanatomy / Renorenal Reflexes / Mechanisms Involved in the Activation of Afferent Renal Sensory Nerves / Part III: Pathophysiological States / Efferent Renal Sympathetic Nerves / Afferent Renal Sensory Nerves / Conclusions / References
Download or read book The Kidney in Hypertension written by Norman M. Kaplan and published by Lippincott Williams & Wilkins. This book was released on 1987 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt:
