A 26-year-old primigravid woman is admitted during her 34th week of pregnancy with severe, refractory hypertension. She was noted to have mild hypertension prior to pregnancy. Her family history is remarkable for pregnancy-related hypertension in her aunt. Her…
What is your approach to the patient with occasional high, or variable, blood pressure readings, or measurements that bounce around above and below the target range? In such situations, the American Heart Association guidelines on measurement of blood…
As this is restaurant week in Durham, NC, I thought it would be fitting to blog about the health benefits of food, in particular the delicacy that is ‘dark chocolate’. This is not a new idea in the…
I recently saw a young hypertensive patient who had suffered a motor vehicle accident complicated by a transected aorta that was successfully repaired several years back. He has had hypertension since then and was referred to us for…
Population-wide salt reduction is gaining increased media and political attention over the last few years. The most notable example is the National Salt Reduction Initiative (NSRI) spearheaded by New York City Mayor Michael Bloomberg. This initiative was unveiled…
The much awaited results from the ACCORD-BP trial were recently presented at the ACC scientific session in Atlanta and published online in the NEJM on March 14th. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) was a…
I’ve recently had the privilege of caring for a patient undergoing chemotherapy for a metastatic malignancy using agents targeting the vascular endothelial growth factor (VEGF) pathway. This patient, having tolerated three cycles of avastin and ipilumimab without any…
The renin-angiotensin system is powerful regulator of blood pressure homeostasis. An article published in the March 24 issue of JASN highlights an emerging area of research into the modulation of AT1 receptors on different tissues. The majority of…
It seems like there have been a lot of recent developments in the management of hypertension, and several sacred cows have become burgermeat. I thought I’d summarize a few of these important developments here: 1. Blood pressure targets…
I was recently asked the mechanism by which insulin resistance causes sodium retention and hypertension, and had to lie. Here’s what I should have said. Serum and glucocorticoid-inducible kinase 1 (SGK1) is an enzymatic central orchestrator of many…
