From ESH 2016 | POS 4C: A. Power, MD

Slides:

Advertisements

Similar presentations

The ENCORE Study Cardiovascular Benefits Associated With the DASH Diet Alone and in Combination with Exercise and Weight Reduction in Men and Women with.

Advertisements

CVD prevention & management: a new approach for primary care Rod Jackson School of Population Health University of Auckland New Zealand.

Absolute cardiovascular disease risk Assessment and Early Intervention Dr Michael Tam Lecturer in Primary Care

Average ambulatory daytime blood pressure, but not office blood pressure is associated with progression of cerebrovascular disease and cognitive decline.

Effectiveness of interactive web-based lifestyle program on prevention of cardiovascular diseases risk factors in patient with metabolic syndrome: a randomized.

Uncontrolled Hypertension, Systolic and Diastolic Blood Pressure and Development of Symptomatic Peripheral Arterial Disease in the Women’s Health Study.

Health Monitoring Tests

Life Line Screening: Age and gender specific prevalence of AAA, PAD, carotid stenosis and AF and their associations with smoking Sarah Lewington CTSU,

An Automated Internet Behavioral Weight-Loss Program by Physician Referral: A Randomized Controlled Trial Featured Article: J. Graham Thomas, Tricia M.

Tt HRB Centre for Health and Diet Research The burden of hypertension Ivan J Perry, Dept. of Epidemiology and Public Health, University College Cork. Institute.

SERUM VISFATIN CONCENTRATION IS ASSOCIATED WITH AN ATHEROGENIC METABOLIC PROFILE T.D. Filippatos 1, A. Liontos 1, F. Barkas 1, E. Klouras 1, V. Tsimihodimos.

Background  Obesity is an extremely common problem ~ 1/3 of adult Americans are obese  Patients commonly ask physicians for advice on weight loss, yet.

Can pharmacists improve outcomes in hypertensive patients? Sookaneknun P (1), Richards RME (2), Sanguansermsri J(1), Teerasut C (3) : (1)Faculty of Pharmacy,

Copyleft Clinical Trial Results. You Must Redistribute Slides HYVET Trial The Hypertension in the Very Elderly Trial (HYVET)

Aim To determine the effects of a Coversyl- based blood pressure lowering regimen on the risk of recurrent stroke among patients with a history of stroke.

To assess the prognostic value of variability in home-measured blood pressure (BP) and heart rate (HR) in a general population. Objective: Methods: BP.

Lipoatrophy and lipohypertrophy are independently associated with hypertension: the effect of lipoatrophy but not lipohypertrophy on hypertension is independent.

Monocyte damaged endothelium macrophage foam cell lipid thrombocytes plaque oxidative stress smooth muscle cells 4 5 Gaviraghi et al., 1998 Lacidipine:

University of South Florida College of Nursing Tampa, Florida.

Lesotho STEPS Survey 2012 Fact Sheet John Nkonyana Director Disease Control.

1 Journal Club Alcohol, Other Drugs, and Health: Current Evidence September–October 2015.

A Controlled Trial of Renal Denervation for Resistant Hypertension

ALLHAT 6/5/ CARDIOVASCULAR DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED BY BASELINE GLOMERULAR FILTRATION RATE (3 GROUPS by GFR)

Long-term Cardiovascular Effects of 4.9 Years of Intensive Blood Pressure Control in Type 2 Diabetes Mellitus: The Action to Control Cardiovascular Risk.

The Effects of Brisk Walking on Biochemical Risk Factors and Functional Capacity in Healthy, Sedentary 50 to 65 Year Old Patients of Primary Care M.Tully.

6/5/ CARDIOVASCULAR DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED BY BASELINE GLOMERULAR FILTRATION RATE (4 GROUPS by GFR) ALLHAT.

Early Eplerenone Treatment in Patients with Acute ST-elevation Myocardial Infarction without Heart Failure REMINDER* Gilles Montalescot, Bertram Pitt,

Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC Yazid NJ Al Hamarneh, BPharm, PhD Charlotte Jones, MD, PhD, FRCP(C) Brenda Hemmelgarn, MD, PhD, FRCP(C)

Date of download: 5/29/2016 Copyright © The American College of Cardiology. All rights reserved. From: Impact of Renal Denervation on 24-Hour Ambulatory.

Journal Club February 7, 2014 Sadie T. Velásquez, MD.

Date of download: 6/22/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Exercise and Weight Loss Reduce Blood Pressure in.

Baseline characteristics of HPS participants by prior cerebrovascular disease.

Community Teaching Project: Hypertension Presented by: Mariel Alvarez, Michelle Vickers, Andy Nguyen, Lalita Poon, Minh Luong.

Powered by Infomedica Infomedica Conference Coverage* of 26 th European Meeting on Hypertension and Cardiovascular Protection Paris (France), June 10-13,

Powered by Infomedica Infomedica Conference Coverage* of 26 th European Meeting on Hypertension and Cardiovascular Protection Paris (France), June 10-13,

Category Sex Systolic BP (mmHg) Men (n=58) Women (n=106) P value

Dr John Cox Diabetes in Primary Care Conference Cork

ALICE-PROTECT Study Yields Online Risk Prediction Tool in Diabetic Nephropathy From ESH 2016 | LB 1: Jean-Pierre Fauvel, MD CHU Lyon, Hôpital E Herriot,

－ Higher SBP visit-to-visit variability (SBV) has been associated

From ESH 2016 | LB 3: Davide Agnoletti, MD

Hypertension November 2016

Hypertension in the Post SPRINT era

Baseline characteristics and effectiveness results

From ESH 2016 | POS 3C: Chiara Lorenzi, MD

FDA Pathway to Approval: Clinical Requirements for Renal Denervation

Blood Pressure and Age in Controlling Hypertension

Daily Stress, Coping, and Nocturnal Blood Pressure Dipping

Itamar Grotto, Michael Huerta, Ehud Grossman and Yehonatan Sharabi

Exercise Adherence in Patients with Diabetes: Evaluating the role of psychosocial factors in managing diabetes Natalie N. Young,1, 2 Jennifer P. Friedberg,1,

Orthostatic Hypertension: Impact on Cardiovascular Risk

From ESH 2016 | POS 7D: Jan Rosa, MD

Copyright © 2011 American Medical Association. All rights reserved.

From ESH 2016 | POS 3C: Luiz Aparecido Bortolotto, MD, PhD

BEAUTY Trial: Hypertension Control Not Improved with Hemodynamic Monitoring From ESH 2016 | LB 3: Pierre Boutouyrie, MD, PhD INSERM, Université Paris Descartes,

Aliskiren and Valsartan for Antihypertensive Therapy Trial

On behalf of the EXSCEL Study Group

PS Sever, PM Rothwell, SC Howard, JE Dobson, B Dahlöf,

On behalf of the EXSCEL Study Group

Systolic Blood Pressure Intervention Trial (SPRINT)

Progress and Promise in RAAS Blockade

The Hypertension in the Very Elderly Trial (HYVET)

Time point Difference in systolic BP (mm Hg) p

MK-0954 PN948 NOT APPROVED FOR USE (date)

© The Author(s) Published by Science and Education Publishing.

Hypertension November 2016

DENERHTN Trial design: Patients with resistant hypertension were randomized to renal denervation plus standardized stepped-care antihypertensive treatment.

Demographic and Clinical Characteristics (means ± SD or %) of Subjects in Different Office SBP and DBP Categories Mancia G et al Hypertension. 2005;45:1072.

Volume 73, Issue 8, Pages (April 2008)

Volume 75, Issue 1, Pages (January 2009)

Effects of placebo or carvedilol CR on 24-hour mean systolic blood pressure and diastolic blood pressure obtained by ambulatory monitoring in hypertensive.

Presentation transcript:

SLEPT Trial Examined Role of Sleep Intervention to Improve Blood Pressure From ESH 2016 | POS 4C: A. Power, MD HRB-Clinical Research Facility Galway, National University of Ireland, Galway, Ireland

Overview Proof-of-concept trial demonstrated improvement in sleep quality and psychosocial health with a simple, low-cost, Internet-based sleep intervention No improvement in primary outcome of improved blood pressure control in population with mild hypertension at 8 weeks Potential of benefit in patients with higher baseline blood pressure or with longer follow-up cannot be excluded

Overview Investigator-blinded study randomized 67 community- dwelling adults to Internet-based sleep intervention or no sleep intervention All participants received standard CV risk factor education Sleepio, the sleep intervention, consisted of online sleep- hygiene education and a standardized cognitive behavioral therapy (CBT) delivered in weekly sessions over 6-8 weeks by an animated virtual therapist, with automated reminders, and feedback, support, education Participants had self-reported sleep difficulty, defined as taking >30 minutes to go to sleep or waking up >1 time nightly for ≥3 months

Baseline Characteristics in SLEPT Study Variable N (%) Standard care n=67 Sleep intervention Demographics Age, mean (SD), y 58.3 (11.9) 59.7 (9.9) Female 42 (62.7) 40 (59.7) Vascular risk factors Daytime SBP, mean (SD) 141.1 (11.3) 143.0 (11.7) Daytime DBP, mean (SD) 83.9 (9.5) 86.3 (8.6) Resting heart rate, mean 70.7 (12.5) 73.5 (10.6) BMI, mean (SD), kg/m2 27.1 (3.5) 27.0 (4.8) Dyslipidaemia 23 (34.3) 28 (41.8) Atrial fibrillation 2 (3.1) 4 (6.2) Peripheral vascular disease 1 (1.5) 0 (0) Current smoker 5 (7.5) 3 (4.5) BMI, body mass index; DBP, diastolic blood pressure; SBP, systolic blood pressure.

Sleep and Psychosocial Outcomes Variable Mean (SD) Standard care (n=67) Sleep intervention (n=67) Difference in change (treatment vs. control) Week 0 Week 8 Change Estimate (95% CI) p-value SCI 4.9 5.4 +0.5 (1.7) 4.8 6.2 +1.3 (1.8) 0.8 (0.2-1.4) 0.01 ISI 12.0 10.2 1.7 (4.1) 13.0 8.3 4.5 (4.4) 2.8 (1.3-4.4) <0.001 PSQI 9.8 8.4 1.4 (2.6) 9.7 7.2 2.5 (3.1) 1.1 (0.1-2.2) 0.04 BDI 7.9 0.5 (3.7) 9.4 6.5 (5.6) 2.0 (0.3, 3.7) 0.02 BAI 6.9 (3.3) 6.3 4.0 2.2 (4.5) (0.02-2.8) 0.047 ASBP, ambulatory systolic blood pressure; ADBP, ambulatory diastolic blood pressure; NT, nighttime.

Blood Pressure Outcomes in SLEPT Study Variable Mean (SD) Standard care (n=67) Sleep intervention (n=54) Difference in change (treatment vs. control) mmHg Week 0 Week 8 Change Estimate (95% CI) p-value Mean 24-h ASBP 136.8 136.2 0.8 (9.3) 138.0 136.9 0.9 (9.4) 0.1 (-3.4-3.2) 0.95 Mean 24-h ADBP 82.5 81.2 1.5 (6.6) 83.5 83.1 0.6 (6.0) -0.9 (-3.1-1.3) 0.43 Peak daytime SBP 164.2 162.4 2.2 (25.0) 168.8 165.5 2.4 (25.6) 0.2 (-8.7-9.1) 0.97 Peak daytime DBP 102.9 103.3 -0.1 (15.6) 107.0 107.5 (15.2) (-5.2-5.6) 0.94 Peak NT SBP 142.0 140.5 1.8 (18.5) 139.2 140.3 -0.8 (21.3) -2.6 (-9.8-4.7) 0.49 Peak NT DBP 86.3 83.3 3.0 (15.7) 84.7 86.2 -1.4 (16.5) -4.4 (-10.3-1.4) 0.14 ASBP, ambulatory systolic blood pressure; ADBP, ambulatory diastolic blood pressure; NT, nighttime.

SLEPT Trial Examined Role of Sleep Intervention to Improve Blood Pressure From ESH 2016 | POS 4C: A. Power, MD HRB-Clinical Research Facility Galway, National University of Ireland, Galway, Ireland