Recent advances in hypertension management

Recent advances in hypertension management

1. RECENT ADVANCES IN HYPERTENSION Presented by: DR.SASWATI SATPATHY Department of Community Medicine

2. Introduction: Hypertension is sustained elevation of blood pressure- systolic BP≥140mmhg Diastolic BP≥90mmhg

3. MODERN GADGETS

4. COUPLER DEVICE: A small implant(from Rox Medical) is implanted into the upper thigh where it is used to create a connection between the iliac artery & the iliac vein allowing some blood to flow between the two. It helps reduce peripheral vascular resistance and lead to overall lowering of BP. Total cath lab procedure-40 mins

5. ZONA PLUS DEVICE: Lowers BP by providing a type of low impact exercise known as isometric training. It is recently approved by the U.S. Food & Drug Administration for use in a trial.

6. BAROLOOP: Neurosurgeons from University of Frieburg , developed implanting this cuff with 24 electrodes in the vagus nerve in the neck. It monitors the signals sent through vagus nerve to regulate blood pressure. If it detects a high reading ,it can overwrite the signal lowering the pressure w/o drugs.

7. Monitoring bp in blinds: SPEAKING DEVICE : A voice prompt indicates that the monitor is initiallized , and a simple press of button starts the auto-inflation of the arm in the cuff. When completed the monitor automatically announces the systolic and diastolic B P and pulse rate.

8. SURGICAL PROCEDURES

9. NERVE SURGERY: RENAL DENERVATION: A surgery where nerves which connect the kidney to the brain are disabled. CAROTID BODY DENERVATION: Doctors disable specific nerves connected to the carotid body which continously measures the amount of oxygen in the blood and can raise or lower BP by triggering a response from the nervous system.

10. Removal of carotid body: In some cases carotid body becomes overactive and sends a message to the brain to keep BP high. In human trials,only one carotid body would be removed in order to reduce BP while maintaining the organ’s vital regulatory function. NOTE : Study funded by BRITISH HENET FOUNDATION

11. DIETARY ADVANCES

12. REDUCING CONSUMPTION OF FRUCTOSE: Reduce sugars and grains- any type of bread,pasta,corn,potatoes or rice. Fructose breaks down into a variety of waste products like uric acid which inhibits nitric oxide in blood vessels and increase BP. Have 15 grams of fructose- 2 bananas,1/3 cup of raisins or just 2 medjool dates.

13. Optimize vitamin d levels: By exposure to appropriate amount of sunlight & by supplements. Lack of sunlight vit D deficiency increase parathyroid hormone increase in BP. Vitamin D is a negative inhibitor of RAS which regulates BP. SOURCES- Vitamin D3-Fish oil Vitamin D2-Plant products Sun exposure-about 20 minutes

14. others: Calcium and Magnesium: Vitamin C & E Olive leaf extract Breastfeeding : Babies breastfed for >12 months have low risk of hypertension. Basil leaves Cinnamon Cardamom Garlic :causes blood vessels to relax and dilate lets blood flow freely and BP

15. MISCELLANEOUS

16. ELECTRICAL ACCUPUNCTURE Accupuncture combined with electrical stimulus has shown to temporarily decrease hypertension. Study shown that low frequency stimulation lowers BP by about 40-50% .

17. MEDITATION AND YOGA: TRANSCENDENTAL MEDITATION: It is a simple,natural technique practised 20 minutes twice each day while sitting comfortably with eyes closed.

18. YOGA: SHAVASANA-corpse position SHISU ASANA-child’s pose MAKARASANA-lying down on the stomach PAWANMUKTASANA-circular movements with knees without lifting up the head.

19. TAKE HOME MESSAGE The hypertensive patient has a right to be treated as a unique individual and receive competent health care and medical treatment with the same attention to quality, comfort, safety and dignity as all other patients….