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Hypertension: What effect does physical exercise have?

Getting more exercise can help to lower your blood pressure. Whether increased physical activity also effects the risk of developing complications of hypertension has yet to be studied in trials.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 6, 2012

Hypertension: Does losing weight reduce high blood pressure?

Losing weight by dieting (with or without exercise) or by using the drug orlistat can lower high blood pressure in the short term. It is not clear whether weight loss alone can protect against long-term harm from hypertension.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 6, 2012

Hypertension: Does reducing your salt intake help?

Reducing your salt intake can help lower blood pressure in the medium term: one spoon of salt less per day could make a difference. It is not clear how this affects the long-term risk of complications or the use of medication.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 6, 2012

Hypertension: Which drugs are best at preventing complications?

People with hypertension have an increased risk of cardiovascular disease. Drugs designed to work against high blood pressure can lower this risk. Compared with the different drug classes, diuretics can usually be seen as the first line treatment. Which drug is then used in an individual case will also depend on other aspects, for example whether someone has other diseases.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 22, 2013

Tianma Gouteng Yin Formula for primary hypertension

Tianma Gouteng Yin Formula (TGYF) was reported to have a blood pressure lowering effect, improving clinical symptoms and quality of life in hypertensive patients. This review could not find any randomised controlled clinical trials that compared TGYF to placebo or no treatment. Further research to establish its efficacy is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Milrinone for persistent pulmonary hypertension of the newborn

Persistent pulmonary hypertension of the newborn (PPHN) is a condition caused by a failure in the systemic and pulmonary circulation to convert from the antenatal circulation pattern to the normal postnatal pattern. Due to persistent high pressure in the pulmonary vessels, less than normal blood flows to the lungs and thus less oxygen reaches the organs of the body. Milrinone may cause the pulmonary vessels to relax and allow for an increased oxygen supply for the body. However, the review found no trials of the use of milrinone for babies with persistent pulmonary hypertension. Research is needed into the effects of milrinone on PPHN.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions for idiopathic intracranial hypertension

Idiopathic intracranial hypertension is a condition in which there is increased pressure inside the head without any obvious cause. This generally results in swelling of the optic disc (the point where the optic nerve meets the eye). The swelling in turn causes a potential threat to sight. The condition occurs most commonly in young women who are obese. A number of treatments have been advocated. This review could not find enough evidence to indicate the best form of treatment. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Fermented milk for hypertension

High blood pressure is a major health problem as it is one of the main risk factors for cardiovascular disease. Fermented milk has been suggested to reduce blood pressure in humans. This review was conducted to establish whether the intake of fermented milk lowers blood pressure in humans. In 15 studies including 1232 participants a very modest lowering of systolic blood pressure was found, but no effect on diastolic blood pressure was present. The included studies were of a variable quality and the findings do not support the use of fermented milk as antihypertensive treatment or as a lifestyle intervention to reduce blood pressure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Hydralazine for pulmonary hypertension in low birth weight infants with chronic lung disease

In premature infants, pulmonary arterial hypertension (PAH) associated with chronic lung disease (CLD) is associated with high mortality rate. With the exception of oxygen supplementation, no specific interventions have been established as an effective treatment for PAH in premature infants with CLD. Vasodilators could be effective treatments to reduce pulmonary arterial pressure, but little has been proven regarding their clinical effectiveness and concern remains regarding adverse effects. This review found no trials of the use of hydralazine for low birth weight infant with PAH related to CLD. However, since hydralazine is inexpensive and potentially beneficial, randomised controlled trials are recommended.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Coenzyme Q10 for hypertension

Coenzyme Q10 has been studied as a potential treatment for hypertension, a common medical condition. However, there is not enough reliable evidence to show whether or not it can be a useful medication to lower blood pressure. A systematic review was conducted to try and use all available data to answer this question. Databases of clinical trials were searched for any studies that tested the effects of coenzyme Q10 on patients' blood pressure compared to a placebo. The test medications could be added to participants' regular anti‐hypertensive medications or be used alone. Three trials with a total of 96 participants were found in which coenzyme Q10 was used in patients with high blood pressure. The patients took coenzyme Q10 or a placebo daily for up to 8‐12 weeks. Weighted data analysis showed that the systolic blood pressure was reduced by 11 mmHg and the diastolic blood pressure was lowered by 7 mmHg compared to placebo. However, there are questions about the reliability of the available studies. Therefore, it is still uncertain if coenzyme Q10 could be a useful hypertension treatment, and more studies are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Magnesium sulfate for persistent pulmonary hypertension of the newborn

The blood pressure in the arteries of the lungs (pulmonary arteries) is normally much lower than the blood pressure in the rest of the body. Before a baby is born the muscle surrounding the pulmonary arteries is tightly constricted resulting in a very high pressure in these arteries. After birth the arteries dilate and the pressure drops. In persistent pulmonary hypertension of the newborn this drop in pulmonary blood pressure, for a variety of reasons, fails to occur.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Phosphodiesterase 5 (sildenafil) inhibitors for pulmonary hypertension

Pulmonary hypertension (PH) is high blood pressure in the lung circulation. It can occur without a known cause, or it can be caused by another lung disease or be secondary to abnormalities in the left side of the heart. The review sought to determine whether there was evidence that sildenafil (also known as Viagra), a drug which opens up the arteries and increases the flow of blood, could decrease pulmonary artery blood pressure and alleviate symptoms of PH. A limited number of studies of short term i duration indicated that the drug can open up the arteries. One small longer‐term study found some favourable effects in terms of symptoms, but in the absence of longer term outcomes, we could not establish whether this meant that the people given the drug felt that their levels of daily activity were better. Future studies should be longer in duration, and should measure the impact of treatment on daily activities, mortality, quality of life and exercise capacity.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Sildenafil for pulmonary hypertension in neonates

Some babies develop persistent pulmonary hypertension of the neonate (PPHN), a condition where the pressure in the blood vessels that allows blood to flow to the lungs remains abnormally high. Persistent high pressure in these vessels leads to less blood flow to the lungs and therefore less oxygen reaching the blood and all organs of the body. Sildenafil may cause these vessels to relax and allow for improved blood flow and improved oxygen delivery to all organs. This treatment is especially useful in the settings where other treatment approaches are not available. However, in resourceful environment, further studies are needed to compare sildenafil with existing treatment for effect and safety.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Prevention and treatment of postpartum hypertension

Not enough evidence to know how best to treat women with hypertension after birth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Bed rest with or without hospitalisation for hypertension during pregnancy

Not enough evidence to say if bed rest in pregnancy helps women and their babies when women have high blood pressure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Blood pressure lowering drugs reduce stroke and heart attack in elderly people with hypertension

Hypertension (high blood pressure) is common among elderly people and increases the risk of heart attack and stroke. An assessment of all the trials of blood pressure lowering therapy in people with hypertension 60 years and over showed that treatment reduced death, strokes and heart attacks. The benefit was similar if both the upper and lower number was elevated or only the upper number. In people 80 and over treatment did not reduce death but did reduce stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Benefits of antihypertensive drugs for mild hypertension are unclear

Individuals with mildly elevated blood pressures, but no previous cardiovascular events, make up the majority of those considered for and receiving antihypertensive therapy. The decision to treat this population has important consequences for both the patients (e.g. adverse drug effects, lifetime of drug therapy, cost of treatment, etc.) and any third party payer (e.g. high cost of drugs, physician services, laboratory tests, etc.). In this review, existing evidence comparing the health outcomes between treated and untreated individuals are summarized. Available data from the limited number of available trials and participants showed no difference between treated and untreated individuals in heart attack, stroke, and death. About 9% of patients treated with drugs discontinued treatment due to adverse effects. Therefore, the benefits and harms of antihypertensive drug therapy in this population need to be investigated by further research.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antenatal abdominal decompression for maternal hypertension or impaired fetal growth

Abdominal decompression was first used to increase blood flow and the forward movement of the uterus during labour contractions as a way of relieving pain. A rigid covered dome is placed about the abdomen and the space around the abdomen is decompressed to ‐50 to ‐100 mm Hg for 15 to 30 seconds out of each minute for 30 minutes once to thrice daily, or continuously during labour. Observations that fetal wellbeing appeared to be improved led to its investigation for complications of pregnancy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Prostacyclin for pulmonary hypertension in adults

Prostacyclin may benefit patients with pulmonary hypertension (raised blood pressure in the lungs) in the short term but studies longer in duration are required. Pulmonary hypertension occurs when blood is pumped through arteries in the lungs at an increased pressure. The condition can lead to heart failure and death. Once the diagnosis is made, life expectancy ranges from a few months to a few years. Most current treatments apart from lung transplantation do not improve survival. Over an 8‐12 week period prostacyclin improved exercise capacity and some measures of blood flow when given intravenously or via injection to patients with pulmonary hypertension. However, with intravenous administration there can be serious side effects as the drug has to be given continuously via a pump into a catheter placed into a central vein. It is not clear how long the drug continues to confer benefit without serious side effects. Prostacyclin can also be given by mouth, under the skin or through an inhaler. These forms of administration may be safer than intravenous prostacyclin and there is evidence that these may be effective in the short term.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Treating hypertension greatly reduces the risk of serious health problems such as heart disease or stroke in African American women and in older women

Hypertension (high blood pressure) is a risk factor for heart disease and stroke. Several treatments exist, including many drugs, to try to lower blood pressure and reduce the risk of serious health problems. Hypertension is a significant risk for heart disease in women, and certain groups such as African American women or older women (over 55 years) are more likely to suffer from hypertension. The review found that treating women for hypertension greatly reduced the risk of heart disease and stroke in older women and in African American women of all ages. Treating hypertension in these women is therefore important.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

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