Updates in Hypertension and Cardiovascular Protection – serie

This book provides a critical and comprehensive review of the methodologies available for measuring drug adherence in clinical practice, including those relying on emerging technologies. The authors discuss the risk factors of non-adherence and shed light on how to identify patients at risk of poor adherence. Drug therapies in chronic diseases rely heavily on the patient's adherence, since drugs that are not taken are ineffective and leave the patient at high risk of developing clinical complications. Given the absence of new drugs for the treatment of hypertension, drug adherence is particularly important in these patients to improve blood pressure control. The book further investigates a new aspect, namely the importance of drug adherence in clinical trials and studies and draws attention to the limits of developing drugs without significant information on drug adherence. Several chapters are dedicated to the importance of adherence in specific forms of hypertension, such as resistant hypertension, dyslipidemia and hypertension associated with cardiovascular risk. As experts confronted with drug adherence in their daily practice, the authors analyse the real effectiveness of several interventions aimed at improving drug adherence and put particular emphasis on the importance of an interdisciplinary approach involving nurses and pharmacists. The volume also includes a careful analysis of the health and economic impact of poor adherence. The book is aimed at physicians, pharmacists, students and all health professionals dealing not only with hypertension or dyslipidemia, but also with chronic asymptomatic diseases such as diabetes, HIV or chronic respiratory diseases.

This book is devoted to hypertension in children and adolescents, a clinical issue that – thanks to the strides made in several areas of pathophysiological and clinical research – has received growing interest in cardiovascular medicine over the last several years. Given the increasing prevalence of hypertension in children and adolescents, this book represents an important and useful tool to address what has become a significant public health issue. It covers a diverse range of topics, from advances in the definition of hypertension and the identification of new risk factors, to current treatment strategies.The book also presents an overview of the latest findings, including the clinical significance of isolated systolic hypertension (ISH) in youth, the importance of out-of-office and central blood pressure measurement, new methods for assessing vascular phenotypes, and clustering of CV risk factors.Gathering contributions by international experts and pursuing a practice-oriented approach, the book offers a valuable tool for cardiologists, pediatricians and nephrologists, as well as general practitioners.

This book is devoted to hypertension in children and adolescents, a clinical issue that – thanks to the strides made in several areas of pathophysiological and clinical research – has received growing interest in cardiovascular medicine over the last several years. Given the increasing prevalence of hypertension in children and adolescents, this book represents an important and useful tool to address what has become a significant public health issue. It covers a diverse range of topics, from advances in the definition of hypertension and the identification of new risk factors, to current treatment strategies.The book also presents an overview of the latest findings, including the clinical significance of isolated systolic hypertension (ISH) in youth, the importance of out-of-office and central blood pressure measurement, new methods for assessing vascular phenotypes, and clustering of CV risk factors.Gathering contributions by international experts and pursuing a practice-oriented approach, the book offers a valuable tool for cardiologists, pediatricians and nephrologists, as well as general practitioners.

Hypertension remains a leading cause of disability and death worldwide. Self-monitoring of blood pressure by patients at home is currently recommended as a valuable tool for the diagnosis and management of hypertension. Unfortunately, in clinical practice, home blood pressure monitoring is often inadequately implemented, mostly due to the use of inaccurate devices and inappropriate methodologies. Thus, the potential of the method to improve the management of hypertension and cardiovascular disease prevention has not yet been exhausted.This volume presents the available evidence on home blood pressure monitoring, discusses its strengths and limitations, and presents strategies for its optimal implementation in clinical practice. Written by distinguished international experts, it offers a complete source of information and guide for practitioners and researchers dealing with the management of hypertension.

Hypertension remains a leading cause of disability and death worldwide. Self-monitoring of blood pressure by patients at home is currently recommended as a valuable tool for the diagnosis and management of hypertension. Unfortunately, in clinical practice, home blood pressure monitoring is often inadequately implemented, mostly due to the use of inaccurate devices and inappropriate methodologies. Thus, the potential of the method to improve the management of hypertension and cardiovascular disease prevention has not yet been exhausted.This volume presents the available evidence on home blood pressure monitoring, discusses its strengths and limitations, and presents strategies for its optimal implementation in clinical practice. Written by distinguished international experts, it offers a complete source of information and guide for practitioners and researchers dealing with the management of hypertension.

This book offers an overview of the latest advances in the epidemiological, pathophysiological, diagnostic and therapeutic aspects of secondary hypertension, provided by a group of the most highly respected European experts in this field. It is common belief that secondary forms of hypertension are rare, although in 95% of patients the cause of high blood pressure is unknown – euphemistically referred to as “essential”. There is increasing evidence from epidemiological studies that the prevalence of secondary hypertension is much higher than previously thought, accounting for 20%-25% of all hypertensive patients. There are additional, very good reasons for identifying those patients with secondary hypertension: firstly, they are exposed to a greater risk of suffering major cardiovascular events than patients with essential hypertension who have the same blood pressure level, and for this reason require particular care. Secondly, these patients can be relieved of a lifetime of pharmacological therapy or, at least, have a chance to be treated with more specific and effective medications. A high degree of clinical skill is required to recognize the often vague and subtle symptoms and signs that characterize patients with secondary hypertension, and clinicians need to fully comprehend the mechanisms responsible for the development and maintenance of high blood pressure. Shedding new light on a complex area of cardiovascular medicine, the book enables readers to better treat affected patients.

This book offers an overview of the latest advances in the epidemiological, pathophysiological, diagnostic and therapeutic aspects of secondary hypertension, provided by a group of the most highly respected European experts in this field. It is common belief that secondary forms of hypertension are rare, although in 95% of patients the cause of high blood pressure is unknown – euphemistically referred to as “essential”. There is increasing evidence from epidemiological studies that the prevalence of secondary hypertension is much higher than previously thought, accounting for 20%-25% of all hypertensive patients. There are additional, very good reasons for identifying those patients with secondary hypertension: firstly, they are exposed to a greater risk of suffering major cardiovascular events than patients with essential hypertension who have the same blood pressure level, and for this reason require particular care. Secondly, these patients can be relieved of a lifetime of pharmacological therapy or, at least, have a chance to be treated with more specific and effective medications. A high degree of clinical skill is required to recognize the often vague and subtle symptoms and signs that characterize patients with secondary hypertension, and clinicians need to fully comprehend the mechanisms responsible for the development and maintenance of high blood pressure. Shedding new light on a complex area of cardiovascular medicine, the book enables readers to better treat affected patients.

This book offers an extensive review of the most recent data on the pathophysiological role of structural and functional alterations in the microcirculation, particularly focusing on hypertension and diabetes. It covers several relevant and innovative aspects, including the possible mechanisms involved in the development of microvascular remodeling and rarefaction, the technical approaches available for the detection of microvascular alterations, including non-invasive evaluations, the prognostic role of changes in small resistance artery structure, the possibility of preventing or regressing such alterations with appropriate treatment, and the potential clinical advantages of such intervention. A number of innovative areas of research are considered, including the role of the immune system, inflammation and oxidative stress in the development of microvascular alterations. Lastly, it examines the availability of recent non-invasive methods for the evaluation of small resistance artery morphology in the retina, which in the near future may provide a useful tool for the stratification of cardiovascular risk and even for clinical decisions regarding drug treatment, thus providing physicians with a clinically relevant instrument for improving and optimizing the management of hypertensive and diabetic patients. The book provides valuable, clinically relevant information for specialists (cardiology, internal medicine, and endocrinology) and general practitioners, and also offers novel and stimulating data to basic and clinical researchers.

This book offers an extensive review of the most recent data on the pathophysiological role of structural and functional alterations in the microcirculation, particularly focusing on hypertension and diabetes. It covers several relevant and innovative aspects, including the possible mechanisms involved in the development of microvascular remodeling and rarefaction, the technical approaches available for the detection of microvascular alterations, including non-invasive evaluations, the prognostic role of changes in small resistance artery structure, the possibility of preventing or regressing such alterations with appropriate treatment, and the potential clinical advantages of such intervention. A number of innovative areas of research are considered, including the role of the immune system, inflammation and oxidative stress in the development of microvascular alterations. Lastly, it examines the availability of recent non-invasive methods for the evaluation of small resistance artery morphology in the retina, which in the near future may provide a useful tool for the stratification of cardiovascular risk and even for clinical decisions regarding drug treatment, thus providing physicians with a clinically relevant instrument for improving and optimizing the management of hypertensive and diabetic patients. The book provides valuable, clinically relevant information for specialists (cardiology, internal medicine, and endocrinology) and general practitioners, and also offers novel and stimulating data to basic and clinical researchers.

This book will cover all aspects of hypertension and the manifestations of cardiovascular disease in the Asian population. Asia has the largest population of all the continents, and also has the largest number of people suffering from these diseases. Due to an expanding economy and increasing affluent lifestyles, their incidence is increasing at alarming rates - in fact, this continent is a ticking time bomb for HTN and CVD outbreaks.  The book fills a large gap, as there are currently no volumes on this topic - and provides much-needed information for physicians not only in Asia but globally. Not only physicians, but also all related medical professionals and libraries will benefit from this book, to which renowned international experts contributed.

This book will cover all aspects of hypertension and the manifestations of cardiovascular disease in the Asian population. Asia has the largest population of all the continents, and also has the largest number of people suffering from these diseases. Due to an expanding economy and increasing affluent lifestyles, their incidence is increasing at alarming rates - in fact, this continent is a ticking time bomb for HTN and CVD outbreaks.  The book fills a large gap, as there are currently no volumes on this topic - and provides much-needed information for physicians not only in Asia but globally. Not only physicians, but also all related medical professionals and libraries will benefit from this book, to which renowned international experts contributed.

This book presents the current knowledge on the mechanisms by which exercise lowers blood pressure in hypertension and on its effects on the heart and arteries. In addition, it focuses on the optimal exercise protocols, the international consensus on clinical implementation, and the clinical indications for special populations (obese, diabetic etc). It also addresses possible drawbacks of exercise on left ventricular structure and function. Many experts in epidemiology, patophysiology and clinical research have contributed in preparing the chapters, with the main purpose of guiding clinicians in the optimal application of the present knowledge and to stimulate scientists to fill the gaps in knowledge by performing further research.The book is addressed not only to specialists in Hypertension, Internal Medicine, Cardiology, Metabolism, and Nephrology, but also to general practitioners and all healthcare professionals working in the field of rehabilitation medicine.

This book presents the current knowledge on the mechanisms by which exercise lowers blood pressure in hypertension and on its effects on the heart and arteries. In addition, it focuses on the optimal exercise protocols, the international consensus on clinical implementation, and the clinical indications for special populations (obese, diabetic etc). It also addresses possible drawbacks of exercise on left ventricular structure and function. Many experts in epidemiology, patophysiology and clinical research have contributed in preparing the chapters, with the main purpose of guiding clinicians in the optimal application of the present knowledge and to stimulate scientists to fill the gaps in knowledge by performing further research.The book is addressed not only to specialists in Hypertension, Internal Medicine, Cardiology, Metabolism, and Nephrology, but also to general practitioners and all healthcare professionals working in the field of rehabilitation medicine.

This book provides an in-depth and up-to-date review of the association between blood pressure disorders and diabetes mellitus. In addition, it discusses the specific role of hemodynamic alterations on the vasculature of various target organs (the retina, kidney, brain, and gravid uterus), topics that are infrequently considered and or acknowledged by clinicians.Covering all aspects of the interaction between metabolic and hemodynamic factors, the book presentsthe diverse perspectives of the contributing authors and extensive discussions of issues including diabetic kidney disease, diabetic hypertensive phenotypes and postural hypotension.

This book provides an in-depth and up-to-date review of the association between blood pressure disorders and diabetes mellitus. In addition, it discusses the specific role of hemodynamic alterations on the vasculature of various target organs (the retina, kidney, brain, and gravid uterus), topics that are infrequently considered and or acknowledged by clinicians.Covering all aspects of the interaction between metabolic and hemodynamic factors, the book presentsthe diverse perspectives of the contributing authors and extensive discussions of issues including diabetic kidney disease, diabetic hypertensive phenotypes and postural hypotension.

The second edition of this well-received book will offer both new insights into the intimate mechanisms of transition from hypertension to heart failure and clinical practice advice on the prevention and treatment of heart failure in hypertensive population. Heart failure is the result of the hypertension's effects on the heart and it is a growing public health problem, as it affects  20-50% of the adult population in developed countries.In this context the international scientific community is continuously struggling to develop better strategies in screening, diagnosing and treating hypertension and its deleterious effects. Thus, this field is continuously changing, with new important information being added constantly.   A part of the book dedicated to diagnostics, comprising a chapter on new perspectives on multimodality imaging and a special chapter on diastolic dysfunction. The arrhythmic complications of hypertensive heart disease are  discussed in two chapters on atrial fibrillation and ventricular arrhythmias respectively. Readers will also find new chapters regarding hypertension and heart failure in special populations such as cancer patients, young patients, pregnancy and patients with a history of SARS-CoV2 infection.  This book is a useful tool for clinicians but also to the research community interested in heart failure and consequences of hypertension on heart who want to be up-to-date with the new developments in the field.

​The second edition of this book explores different aspects of the relationship between hypertension and brain damage, providing readers with up-to-date information that will be of interest to clinicians and researchers alike. In recent years, numerous studies have been published that have added new evidence on different aspects of the disease. New recommendations and the latest hypertension guidelines on stroke and dementia will be described in this edition, which will include not only updated content but also new chapters on aspects that have recently emerged in relation to hypertension and brain damage. After an introductory chapter on the epidemiology and burden of neurological disease induced by hypertension, the significance of various comorbidities that represent risk factors for brain damage in the context of hypertension is discussed. The effects of hypertension on small and large cerebral arteries and the consequences on brain damage are then examined in detail. Similarly, the association between hypertension and ischaemic stroke, transient ischaemic attack and haemorrhagic stroke is explored in depth, and the evidence and guidelines for reducing hypertension during the acute phase of each form of stroke are summarised. Both primary and secondary prevention of stroke are addressed, with the results of major studies presented. The reader will also find interesting new perspectives on the role of different imaging techniques, including CT and functional MRI, in detecting and diagnosing brain damage in patients with hypertension. The concluding chapters examine the relationship between hypertension and cognitive decline and dementia associated with hypertension, its pathophysiology, the detection of cognitive impairment in daily practice, and its prevention and treatment.

​The second edition of this book explores different aspects of the relationship between hypertension and brain damage, providing readers with up-to-date information that will be of interest to clinicians and researchers alike. In recent years, numerous studies have been published that have added new evidence on different aspects of the disease. New recommendations and the latest hypertension guidelines on stroke and dementia will be described in this edition, which will include not only updated content but also new chapters on aspects that have recently emerged in relation to hypertension and brain damage. After an introductory chapter on the epidemiology and burden of neurological disease induced by hypertension, the significance of various comorbidities that represent risk factors for brain damage in the context of hypertension is discussed. The effects of hypertension on small and large cerebral arteries and the consequences on brain damage are then examined in detail. Similarly, the association between hypertension and ischaemic stroke, transient ischaemic attack and haemorrhagic stroke is explored in depth, and the evidence and guidelines for reducing hypertension during the acute phase of each form of stroke are summarised. Both primary and secondary prevention of stroke are addressed, with the results of major studies presented. The reader will also find interesting new perspectives on the role of different imaging techniques, including CT and functional MRI, in detecting and diagnosing brain damage in patients with hypertension. The concluding chapters examine the relationship between hypertension and cognitive decline and dementia associated with hypertension, its pathophysiology, the detection of cognitive impairment in daily practice, and its prevention and treatment.

This book is intended to be an in-depth and up-to-date guide to the various aspects of the association between blood pressure disorders and acute/chronic renal diseases. In addition, this work includes discussion of topics rarely considered and or acknowledged by in the clinical practice, namely hypertension in different kidney diseases, pathophysiologic mechanisms underlying blood pressure elevation in renal disorders, cardiorenal associations and therapeutic approaches in hypertensive renal disorders.This book is divided in sections and chapters to cover various phenotypes of renal hypertension and their interactions to kidney disease.

This book is intended to be an in-depth and up-to-date guide to the various aspects of the association between blood pressure disorders and acute/chronic renal diseases. In addition, this work includes discussion of topics rarely considered and or acknowledged by in the clinical practice, namely hypertension in different kidney diseases, pathophysiologic mechanisms underlying blood pressure elevation in renal disorders, cardiorenal associations and therapeutic approaches in hypertensive renal disorders.This book is divided in sections and chapters to cover various phenotypes of renal hypertension and their interactions to kidney disease.

Hypertension, the leading modifiable cause of premature death, affects the great majority of patients with chronic kidney disease (CKD).  The book will cover the epidemiology of CKD and hypertension and provide  an in-depth review of pathophysiological mechanisms linking these conditions, as well as the implications of this association in terms of cardiovascular risk. The reader will also find up-to-date evidence and guidelines for the screening, diagnosis and real-life management of patients with hypertension and chronic kidney disease and more importantly data and critical assessment of latest trials with new disease modifying treatment.Among the topic covered in the book: the usefulness of out of office BP measurement, the role of albuminuria as a marker of risk and as a therapeutic target, the role of serum uric acid and salt intake in the prognosis and clinical management of CKD patients. The expanding therapeutic armamentarium to prevent hypertensive renal damage in diabetic and non diabetic patients will be reviewed, RAAS Is, SGLT2 is, drugs modulating aldosterone pathway  as well as new antihyperglycemic drugs. A chapter will cover resistant hypertension and its treatment by drugs and the use of renal denervation for CV and renal protection. Furthermore, updates on renovascular hypertension and preeclampsia will be provided. This book is a useful tool for clinicians but also to the research community interested in CKD and hypertension related renal damage who want to be up-to-date with the many new developments in the field.

This book aims to describe the role of interventional therapies in various forms of secondary hypertension and to explain the ability of such approaches to address unmet needs in the setting of uncontrolled essential hypertension. The coverage encompasses interventions in the full range of relevant conditions, including the various specific pathologies responsible for secondary hypertension, such as renal artery stenosis, coarctation of the aorta, and adrenal tumors. In each case, up-to-date information is presented on indications, procedural aspects, and patient follow-up. A further focus is the most recent knowledge on the use of invasive neuromodulation, such as renal sympathetic denervation and baroreflex stimulation. The text is supplemented by helpful explanatory diagrams and treatment algorithms. A comprehensive clinical guide of this nature has to date been absent from the literature. The book will be of interest to clinicians managing hypertensive patients, researchers investigating advanced hypertension management, and students on cardiovascular courses.

This book aims to present a comprehensive classification of hypertensive phenotypes based on underlying target organ involvement. Particular emphasis is placed on review and assessment of clinical presentation, pathophysiologic mechanisms, and possible specific therapeutic options for each hypertension phenotype. Several of these phenotypes are well known and well described in the literature, such as prehypertension, white coat and masked hypertension, isolated systolic hypertension, renovascular hypertension, endocrine hypertension, pediatric hypertension, and gestational hypertension. Other hypertension phenotypes, however, are not widely recognized, being reported only in special reviews; examples include hypertension associated with renal calculus disease and other rarer causes such as Turner syndrome, herbal and medicinal compounds, and pharmacologic agents. A detailed account of the various causes of monogenic hypertension is also included. Finally, a section is devoted to general aspects of hypertension, including the significance of blood pressure indices, the natural course of untreated and treated hypertension, hypertension mechanisms, genetics, and guidelines for blood pressure control.

This book sheds new light on the management of patients with borderline cardiovascular risk factors in order to prevent their progression to end organ damage. The book stimulates discussion of this poorly understood condition and lays the groundwork for developing recommendations and guidelines.While the diagnostic and therapeutic approach to full-blown diabetes, hypertension, dyslipidemia and obesity is well defined, there is still a lack of clear understanding and guidelines as far as patients with borderline conditions – especially when multiple – are concerned. Moreover, end-organ damage depends on several factors, including genetic factors, making it difficult to predict its extent. As such, the gradual transition from a healthy subject to one with functional hemodynamic changes, and then one with structurally asymptomatic changes and lastly to overt disease needs further investigation.In order to address these knowledge gaps, the book covers a broad variety of topics, making it a valuable tool for identifying which asymptomatic subjects could profit from being appropriately screened and at what stage. Furthermore it offers insights into better treating these patients to prevent their progression to overt disease. The book appeals to cardiologists, primary care physicians and all those healthcare professional looking to optimize the management of these complex and often undiagnosed cases.

This book provides a critical and comprehensive review of the methodologies available for measuring drug adherence in clinical practice, including those relying on emerging technologies. The authors discuss the risk factors of non-adherence and shed light on how to identify patients at risk of poor adherence. Drug therapies in chronic diseases rely heavily on the patient's adherence, since drugs that are not taken are ineffective and leave the patient at high risk of developing clinical complications. Given the absence of new drugs for the treatment of hypertension, drug adherence is particularly important in these patients to improve blood pressure control. The book further investigates a new aspect, namely the importance of drug adherence in clinical trials and studies and draws attention to the limits of developing drugs without significant information on drug adherence. Several chapters are dedicated to the importance of adherence in specific forms of hypertension, such as resistant hypertension, dyslipidemia and hypertension associated with cardiovascular risk. As experts confronted with drug adherence in their daily practice, the authors analyse the real effectiveness of several interventions aimed at improving drug adherence and put particular emphasis on the importance of an interdisciplinary approach involving nurses and pharmacists. The volume also includes a careful analysis of the health and economic impact of poor adherence. The book is aimed at physicians, pharmacists, students and all health professionals dealing not only with hypertension or dyslipidemia, but also with chronic asymptomatic diseases such as diabetes, HIV or chronic respiratory diseases.

This book aims to describe the role of interventional therapies in various forms of secondary hypertension and to explain the ability of such approaches to address unmet needs in the setting of uncontrolled essential hypertension. The coverage encompasses interventions in the full range of relevant conditions, including the various specific pathologies responsible for secondary hypertension, such as renal artery stenosis, coarctation of the aorta, and adrenal tumors. In each case, up-to-date information is presented on indications, procedural aspects, and patient follow-up. A further focus is the most recent knowledge on the use of invasive neuromodulation, such as renal sympathetic denervation and baroreflex stimulation. The text is supplemented by helpful explanatory diagrams and treatment algorithms. A comprehensive clinical guide of this nature has to date been absent from the literature. The book will be of interest to clinicians managing hypertensive patients, researchers investigating advanced hypertension management, and students on cardiovascular courses.

This book aims to present a comprehensive classification of hypertensive phenotypes based on underlying target organ involvement. Particular emphasis is placed on review and assessment of clinical presentation, pathophysiologic mechanisms, and possible specific therapeutic options for each hypertension phenotype. Several of these phenotypes are well known and well described in the literature, such as prehypertension, white coat and masked hypertension, isolated systolic hypertension, renovascular hypertension, endocrine hypertension, pediatric hypertension, and gestational hypertension. Other hypertension phenotypes, however, are not widely recognized, being reported only in special reviews; examples include hypertension associated with renal calculus disease and other rarer causes such as Turner syndrome, herbal and medicinal compounds, and pharmacologic agents. A detailed account of the various causes of monogenic hypertension is also included. Finally, a section is devoted to general aspects of hypertension, including the significance of blood pressure indices, the natural course of untreated and treated hypertension, hypertension mechanisms, genetics, and guidelines for blood pressure control.