Fundus EDucation: Analysing the utility of an online education tool in improving the diagnostic accuracy of non-mydriatic fundus photography image interpretation amongst Emergency Doctors and Medical Students

Start Date19 Jul 2021

Sponsor / Collaborator

The University of New South Wales

NCT02808026 / CompletedPhase 3

A Study to Evaluate Efficacy and Safety of CS-3150 in Japanese Patients With Severe Hypertension (Grade III)

To examine antihypertensive effect and safety of administration of CS-3150 in patients with severe hypertension (Grade III).

Start Date01 Jun 2016

Sponsor / Collaborator

Daiichi Sankyo Co., Ltd.

JPRN-jRCT2080221859 / Unknown statusPhase 3

A Multi-center, Open Label Study for Evaluation of the Safety, Tolerability and Efficacy of 8-week Treatment With LCZ696 in Japanese Patients With Severe Hypertension

Start Date23 Jul 2012

Sponsor / Collaborator

Novartis Pharma KK

100 Clinical Results associated with Hypertension, severe

100 Translational Medicine associated with Hypertension, severe

0 Patents (Medical) associated with Hypertension, severe

152

Literatures (Medical) associated with Hypertension, severe

01 Sep 2024·American Journal of Obstetrics & Gynecology MFM

Implementing a nurse-initiated protocol to improve response to perinatal severe hypertension

Article

Author: Young, Megan Lacy ; Mccarley, Charlotte B ; Swaggerty, Robin ; White, Carrie ; Nelson, Cecil H ; Heidel, Robert E ; Otten, Kelsie J ; Zite, Nikki B ; Edwards, Tanika N

BACKGROUNDAn institutional standardized, nurse-initiated protocol was implemented to improve the recognition of and response to perinatal hypertensive emergency.OBJECTIVE(S)The primary aim was to evaluate if the rate of guideline-based treatment of perinatal hypertensive emergency improved with implementation of the protocol.STUDY DESIGNThis quality improvement initiative was developed by a multidisciplinary team and consisted of clinician and nursing education and the implementation of a standardized, nurse-initiated severe hypertension protocol. The project took place in three phases: pre-implementation (July 2020-October 2020), implementation (November 2020-June 2021), and sustainment (July 2021-May 2022). The primary aim was to increase guideline-based treatment of hypertensive emergency among pregnant and postpartum persons. Guideline-based treatment was defined as repeat blood pressure within 30 minutes of severe hypertension to diagnose hypertensive emergency, antihypertensive medication administration within 30 minutes of diagnosis, and appropriately timed repeat blood pressure following treatment. Process measures included time to confirm the diagnosis, initiate the protocol, antihypertensive medication administration, repeat blood pressure after antihypertensive medication administration, and administration of a secondary dose as appropriate. Balancing measures included maternal intensive care unit admission, clinically significant maternal hypotension, fetal demise, neonatal birthweight, and Apgar <7 at 5 minutes. Data were evaluated using between-subjects statistics and a run chart was developed to assess relationship between the protocol and changes in guideline-based treatment over time.RESULTSOverall, 503 hypertensive emergency encounters were identified during the project period (98 [20%] pre-implementation, 172 [34%] implementation, 233 [46%] sustainment). There were higher rates of persons with chronic hypertension and who self-identified as non-Hispanic Black race in the sustainment phase compared to the other phases. Guideline-based treatment increased from 18.4% pre-implementation to 75.1% in sustainment (p<0.001). Each component of guideline-based treatment also improved significantly from pre-implementation to sustainment (p<0.001). No episodes of clinically significant maternal hypotension occurred in any phase. There were four maternal intensive care unit admissions and three fetal demises during the initiative; none were related to hypertensive emergency.CONCLUSION(S)The nurse-initiated protocol for treatment of hypertensive emergency significantly increased guideline-based treatment of perinatal hypertensive emergency, reduced time to diagnose and treat hypertensive emergency, and increased the number of patients receiving treatment when indicated. This protocol was pragmatic, utilizing resources already available on obstetric units. Use of similar protocols may be considered at institutions providing obstetric care to improve recognition of and response to hypertensive emergency which may decrease maternal and neonatal morbidity and mortality related to hypertensive emergency.

12 Aug 2024·Cureus

Management Strategies for Hypertensive Crisis: A Systematic Review

Review

Author: Jurays, Najwa S ; Alqahtani, Mohammed A ; Althabet, Abdullah A ; Alghamdi, Sara F ; Khan, Naveed N ; Alghamdi, Afyaa M ; Abdalla, Esra M ; Althabet, Abdullah A ; Alassiri, Abdullah M ; Alassiri, Abdullah M ; Zurayyir, Elaf J ; Abdalla, Esra M ; Alzahrani, Hatoon A

A hypertensive crisis is defined as a sudden and significant rise in blood pressure. The blood pressure reading is 180/120 mmHg or higher. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke, or other life-threatening medical problems. Investigating the management of the hypertensive crisis was the goal of this study. English-language articles were collected from 2010 to 2024 demonstrating the management of the hypertensive crisis. Overall, there were 15 articles. Surveys and analyses of national databases were the most widely used methods (n=15). The scientific studies documented (1) all investigative studies or reports that included a hypertensive crisis diagnosis, (2) data integrity and reproducibility, and (3) management studies. Other studies show that acute severe hypertension in the hospital is associated with high rates of mortality and morbidity, particularly with new or worsening end-organ damage. The problem is linked to poor medical adherence, but alarmingly low follow-up rates are likely to contribute to a high recurrence rate. The treatment of acute severe hypertension varies according to the hospital unit (medical ward or intensive care unit), medication, and blood pressure targets or thresholds. Because of a lack of evidence-based guidance, arbitrary blood pressure control targets are used, or blood pressure targets are crudely extrapolated from guidelines intended primarily for outpatient management. Patients with acute aortic dissection need to be administered intravenous esmolol within 5 to 10 minutes in order to lower their blood pressure right away. The goal is to maintain a systolic reading of less than 120 mm Hg. Vasodilators such as nitroglycerin or nitroprusside may be administered if the blood pressure persists following beta blocking. Intravenous administration of clevidipine, nicardipine, or phentolamine is required; the initial dose is 5 mg, with subsequent doses given every 10 minutes as necessary to achieve the desired reduction in blood pressure.

01 Aug 2024·American Journal of Obstetrics and Gynecology

Magnesium sulfate prophylaxis for late-postpartum severe hypertension

Letter

Author: Sibai, Baha ; Cagino, Kristen ; Prabhu, Malavika

We acknowledge that in certain cases, cerebral symptoms may persist for >24 h.In these cases, magnesium sulfate should continue until a full neurol. workup with imaging is complete.

News (Medical) associated with Hypertension, severe

01 Feb 2024

·www.businesswire.com

Jason Colodne and Colbeck Capital Support the Weill Cornell Hypertension Center

NEW YORK--( BUSINESS WIRE )--Colbeck Capital Management (“Colbeck”) today announced its support of the Weill Cornell Hypertension Center (the “Hypertension Center”), one of the few U.S. practices dedicated to investigating all forms of hypertension, while providing the most comprehensive and personalized care to patients. Affecting more than one billion people, hypertension, also known as high blood pressure, is the leading cause of death worldwide. The Hypertension Center, part of New York-Presbyterian/Weill Cornell Medicine’s Division of Nephrology and Hypertension, was established over 35 years ago by Dr. John Laragh and offers patients the unique benefits of collaboration between researchers and specialists striving to deliver the latest breakthroughs in medicine. Providing treatment tailored to each patient, the Hypertension Center is committed to understanding the condition’s heterogeneity through ongoing research and innovative clinical therapies. Support from Colbeck, Founding Partner Jason Colodne and his wife Anita, and other donors will help advance the Hypertension Center’s ultimate mission of reducing morbidity and mortality associated with hypertension and ending hypertension-related organ damage which afflicts more than 60% of the U.S. population. Under the Hypertension Center’s world-class care, patients perform much better than the national average with respect to blood pressure control and are significantly better protected from the damaging effects of uncontrolled blood pressure. More information can be found at https://weillcornell.org/hypertension-center . About Colbeck Capital Management Colbeck Capital Management ( colbeck.com ) is a leading, middle-market private credit manager focused on strategic lending. Colbeck lends to companies going through periods of transition, providing creative capital solutions and risk mitigation strategies. Leveraging its deep relationships, Colbeck sponsors its portfolio companies through consistent engagement with management teams in areas such as finance, capital markets and growth strategies, distinguishing itself from traditional lenders. Colbeck was founded in 2009 by Jason Colodne and Jason Beckman, and its principals have extensive experience investing through different market cycles at leading institutions, including Goldman Sachs and Morgan Stanley.

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