Study Shows Why Sham Controls Are Necessary For Device Trials

— If we can melt the ice-caps then surely we can understand our own fallibility, says one UK cardiologist. The strongest known force in the universe is the ability of the human mind to deceive itself. If we know something to be true then we find the evidence to prove it. There is no better…

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SPRINT Will Change But Not Revolutionize Blood Pressure Treatment

After all the hype and hoopla it turns out that the SPRINT trial  will in all likelihood really have a significant impact on clinical practice and future guidelines, but it also also seems clear that it will not bring about a revolution, as some have recently speculated, in the treatment of high blood pressure. That’s the broad  consensus emerging from hypertension…

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Lancet Sprints To The Front With A Blood Pressure Meta-Analysis

A new meta-analysis published in the Lancet on Friday lends fresh support to calls for more intensive blood pressure treatments. The publication comes only days before the highly anticipated presentation of the NIH’s SPRINT trial at the American Heart Association, which is also expected to offer support for stricter blood pressure control. Blood pressure goals were relaxed after the ACCORD…

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Coming Attraction: Looking Forward To SPRINT At The AHA Next Month

Back in September the NIH tantalized the medical community with a preliminary announcement of the results of a major clinical trial, SPRINT (Systolic Blood Pressure Intervention Trial). The NIH said SPRINT was a “landmark trial” that could “save lives,” but their claims were impossible to evaluate since they only gave the slightest hint of the actual results. On November…

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Study Raises New Questions About Perioperative Beta Blockers

A large observational study finds that patients with hypertension who are taking beta blockers have higher rates of cardiovascular complications after noncardiac surgery. The study appears to support current guidelines against using beta blockers in the initial treatment of essential hypertension and may offer a contribution to the ongoing debate over the use of perioperative beta-blockade for noncardiac surgery…

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A Premature SPRINT To The Finish Line

On Friday the NHLBI declared victory in the SPRINT trial. As was widely reported here and elsewhere, the NHLBI announced that the trial had been stopped early after significant reductions in cardiovascular events and mortality had occurred in the group of hypertensive patients randomized to a  more aggressive blood pressure target than is currently recommended today. But there was a…

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Doctors Halt Squabbling And Agree How To Manage Hypertension In People With Blocked Arteries

There’s been a lot of drama in the hypertension field over the past few years. Initially sparked by the decision of the National Institutes of Health to end its sponsorship of national guidelines, the subsequent appearance of multiple guidelines with divergent recommendations led to even more controversy and discussion. Now, however, the appearance of a new scientific statement…

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Medtronic And Boston Scientific Plan To Resume Blood Pressure Trials This Year

Medtronic and Boston Scientific have announced plans to start phase 2 clinical trials this year for their updated renal denervation catheters. The once promising new technology is intended to treat hypertension unresponsive to drug therapy. The failure last year of Medtronic’s Symplicity HTN-3, the first large pivotal trial to rigorously test renal denervation, sent manufacturers back to their…

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Another Study Raises Questions About Blood Pressure Guidelines

Although the general benefits of lowering high blood pressure are widely accepted, there has been intense debate over specific goals for treatment and the threshold at which therapy should be initiated.  A large new meta-analsysis published in JAMA helps shed lights on this important controversy. UK and Australian researchers analyzed the effect of lowering blood pressure in people…

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Study Tests High Blood Pressure Control During Pregnancy

High blood pressure during pregnancy is increasingly common, largely due to older age and obesity. Although there is widespread agreement that hypertension in these women should be treated when it is high enough to raise the risk of stroke, there is little agreement about whether or how to treat mild hypertension. In a study reported in…

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New Device to Lower Resistant High Blood Pressure Shows Early Promise

A novel implantable device appears to show early promise in the treatment of resistant hypertension. The “Coupler” device from privatelyheld ROX Medical is about the size of a paper clip and is delivered via a catheter to the upper thigh, where it creates a connection between the vein and the artery, which lowers blood pressure in the arteries by…

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Success For 40-Year Effort In One Rural County To Curb Cardiovascular Disease

A 40-year program in one poor rural county to combat cardiovascular disease appears to have been successful, resulting in reduced rates of hospitalization and death compared with other counties in the same state over the same time period. The new findings from the study are described in a paper published in the Journal of the American Medical Association. ……

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An Emerging Consensus About Novartis’s New Potential Blockbuster

Last year it became clear that Novartis had a potential blockbuster with its new heart failure drug, LCZ696, which is an angiotensin receptor- neprilysin inhibitor (ARNi) consisting of the company’s own well-known angiotensin receptor blocker valsartan (Diovan) and a novel compound, the neprilysin inhibitor sacubitiril. The results of the PARADIGM trial, which was stopped early because of a large and highly significant reduction in…

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Why Guidelines Should Be Waged Like War

(Updated) Here’s a modest proposal: we need fewer and shorter guidelines. In fact, I’d like to propose that guidelines, like war, should be waged only when there is absolute consensus and overwhelming evidence. Anyone interested in the subject is aware that guidelines are in a complete mess. Just in the past two weeks I’ve written about…

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An Old Study Fuels Debate Over Blood Pressure Guidelines

In the last year new guidelines relating to cardiovascular disease have been the subject of intense criticism and debate. The status of the blood pressure guidelines has been particularly contentious, since several different groups have published contradictory guidelines, while several authors of the most prominent group, the Eighth Joint National Committee, published an impassioned dissent…

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New Studies Fuel The Debate Over Sodium

Three papers and an editorial in the New England Journal of Medicine are sure to throw fresh fuel on the ongoing fiery debate over sodium recommendations. Current guidelines recommend that people should limit their intake of sodium to 1.5  to 2.4 grams per day, but these recommendations are based on projections and have never been tested in clinical…

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Probiotics May Help Reduce Blood Pressure

As interest in probiotics has grown in recent years, some evidence has emerged that probiotics may favorably reduce blood pressure, but trials have been small and inconsistent. Now a meta-analysis published in Hypertension suggests that the blood-pressure lowering effects of probiotics may be genuine. … Click here to read the full post on Forbes.  …

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FDA Once Again Reaches Conclusions At Odds With Its Own Staff

Once again the FDA has reached a conclusion that is directly opposed by some of its own scientists.  Last month the FDA affirmed the safety of olmesartan, a popular blood pressure lowering drug (sold as Benicar and other names). But that reassuring view is not shared by the  FDA scientists who performed the study that provided…

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Large Study Uncovers New Details About the Role of Hypertension in CVD

Although high blood pressure has long been recognized and studied as a cardiovascular risk factor, a large new study published in the Lancet provides a more detailed, granular view of the specific role of different forms of hypertension. Eleni Rapsomaniki and colleagues in the U.K. analyzed data from 1.25 million people without existing cardiovascular disease age 30 and older. An…

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The Walking Dead: Renal Denervation In Europe Just Can’t Be Stopped

Earlier this year the only large, well-designed trial of renal denervation– the once highly-promising catheter-based technology that was widely expected to “cure” difficult cases of resistant hypertension– failed spectacularly. Many hypertension experts believe that ultimately the technique will prove to be beneficial, but after the failure of Simplicity HTN-3 it is clear that there’s a great deal…

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The Uncertain Future Of A Once Highly Promising Device For Lowering Blood Pressure

Following the spectacular crash and burn of the Symplicity HTN-3 trial at the American College of Cardiology two weeks ago, the future of renal denervation (RDN)– the once highly promising catheter technology that many thought would cure resistant hypertension– appears in doubt. Although the device has not been approved in the US– and will not be approved without…

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No Benefit Found in First Real Test of Renal Denervation

SYMPLICITY HTN-3, the eagerly awaited first rigorous test of renal denervation, shows that the real effect of the novel blood-pressure-lowering technology is dramatically lower than earlier expectations, which had been fueled by data from previous uncontrolled trials. Results of SYMPLICITY HTN-3 were presented at the American College of Cardiology conference in Washington, DC, and published…

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Lower Blood Pressure Found In Vegetarians

A new study provides the strongest evidence yet that a vegetarian diet is strongly associated with lower blood pressure. Although various health benefits of a vegetarian diet have often been proposed, a rigorous examination of the effect on blood pressure has not been previously performed. In a paper published in JAMA Internal Medicine, Japanese researchers analyzed data from…

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Blood Pressure Trajectory Over 25 Years Predicts Atherosclerosis Risk

Everyone knows that blood pressure is one of the most important measurements of cardiovascular risk. Less well known is that most studies of blood pressure have relied on single or isolated measurements of blood pressure. Few studies have even attempted to examine the significance of blood pressure patterns over a long period of time. Now,…

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More Guideline Controversy: Blood Pressure Expert Decries ‘Political Correctness’

Now add “political correctness” to the long list of criticisms directed against the recent publication of new and updated cardiovascular guidelines. One leading hypertension expert writes that the authors of the recent AHA/ACC/CDC Science Advisory on blood pressure control were chosen not for their expertise but for political expediency. … Click here to read the full post on Forbes. Confusion…

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