The American College of Cardiology/American Heart Association (ACC/AHA) have recently published primary prevention cardiovascular disease guidelines. They were originally considered very useful for general practitioners who had no choice but to review separately expert consensus or clinical practice guidelines for hypertension, cholesterol, diabetes, etc. Now, everything is concentrated in a single reference document. But is…
ACC 2019 | The New ACC/AHA Guidelines on Primary Prevention Focus on Life Style, Diet and Socioeconomic Factors.
These guidelines basically remind us that we should focus on life style changes to best prevent heart disease, heart failure and atrial fibrillation. These changes, of course, should be permanent. It is estimated that life style changes translate into 80% risk reduction of heart disease. These recommendations are based on 9 topics: risk estimation,…
TCT 2018 | RADIOSOUND-HTN: Testing Different Renal Ablation Techniques and Devices
The clinical efficacy of renal endothelial sympathetic denervation using both radiofrequency and ultrasound endoscopy in the treatment of hypertension has already been proven. This is the first work comparing different techniques and technologies used to this end, which warranted its publication in Circulation. Patients with resistant hypertension were randomized 1:1:1 to: 1) radiofrequency denervation of…
EuroPCR 2018 | RADIANCE-HTN SOLO: Renal Denervation Guided Through Intravascular Ultrasound
Patients eligible for this study suffered from hypertension, had been treated with up to 2 drugs, and presented a daytime ambulatory blood pressure ≥135/85 mmHg and <170/105 mmHg after a 4-week washout period. The study enrolled 146 patients who were randomized 1:1 to denervation treatment or a sham procedure. The reduction in daytime ambulatory systolic blood pressure was greater…
EuroPCR 2018 | SPYRAL HTN-ON MED: Renal Denervation Comes Back to Life
After several trials with neutral outcomes, renal denervation had been demoted for some time. However, this new study presented at EuroPCR 2018 and simultaneously published in the LANCET brings back the technique with improved devices that seem to yield improved outcomes. The study included patients with uncontrolled arterial hypertension under medical treatment. Eligible patients…
The new HTA guides 2017 could be up to their predecessors
From the first reports, back in 1920, we have studied, recognized and documented the excess of events associated with arterial hypertension. This linear relationship between the level of blood pressure and the risk of stroke, is evident in all adults beyond age, sex or race, transforming high blood pressure into the highest target of global…
SPYRAL HTN-OFF MED: Renal Denervation Reloaded?
This work presented at the ESC Congress 2017 held in Barcelona, simultaneously published in The Lancet, seems to give hope to all those that still believe in renal denervation. Interim outcomes suggest that a more intensive denervation of renal arteries, carried out at the SYMPLICITY HTN-3 trial, could reduce blood pressure in patients with untreated mild to moderate hypertension.…
Patients with Resistant Hypertension: Nearly 50% doesn’t take medication
The DENERHTN trial (Renal Denervation for Hypertension) confirmed the efficacy of renal denervation in addition to antihypertensive standard care in patients with resistant hypertension. This study reports the influence of adherence to treatment to control blood pressure. It included 106 patients with resistant hypertension after four week treatment with indapamide 1.5 mg/day, ramipril 10…
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