• MeSH
• antihypertenziva chemie   MeSH
• arterie patologie   MeSH
• hodnocení rizik MeSH
• hypertenze diagnóza   terapie   MeSH
• kardiologie metody   normy   MeSH
• krevní tlak MeSH
• lidé MeSH
• nemoci ledvin komplikace   MeSH
• prognóza MeSH
• rizikové faktory MeSH
• životní styl MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Názvy látek
• antihypertenziva MeSH

OBJECTIVE: The Ambulatory blood pressure Registry TEleMonitoring of hypertension and cardiovascular rISk project was designed to set up an international registry including clinic blood pressure (CBP) and ambulatory blood pressure (ABP) measurements in patients attending hypertension clinics in all five continents, aiming to assess different daily life hypertension types. METHODS: Cross-sectional ABP, CBP and demographic data, medical history and cardiovascular risk profile were provided from existing databases by hypertension clinics. Hypertension types were evaluated considering CBP (≥140/90 mmHg) and 24-h ABP (≥130/80 mmHg). RESULTS: Overall, 14 143 patients from 27 countries across all five continents were analyzed (Europe 73%, Africa 3%, America 9%, Asia 14% and Australia 2%). Mean age was 57 ± 14 years, men 51%, treated for hypertension 46%, cardiovascular disease 14%, people with diabetes 14%, dyslipidemia 33% and smokers 19%. The prevalence of hypertension was higher by CBP than by ABP monitoring (72 vs. 60%, P < 0.0001). Sustained hypertension (elevated CBP and ABP) was detected in 49% of patients. White-coat hypertension (WCH, elevated CBP with normal ABP) was more common than masked hypertension (elevated ABP with normal CBP) (23 vs. 10%; P < 0.0001). Sustained hypertension was more common in Europe and America and in elderly, men, obese patients with cardiovascular comorbidities. WCH was less common in Australia, America and Africa, and more common in elderly, obese women. Masked hypertension was more common in Asia and in men with diabetes. Smoking was a determinant for sustained hypertension and masked hypertension. CONCLUSION: Our analysis showed an unbalanced distribution of WCH and masked hypertension patterns among different continents, suggesting an interplay of genetic and environmental factors, and likely also different healthcare administrative and practice patterns.

• MeSH
• ambulantní monitorování krevního tlaku * MeSH
• dospělí MeSH
• hypertenze klasifikace   diagnóza   epidemiologie   patofyziologie   MeSH
• krevní tlak * MeSH
• lidé středního věku MeSH
• lidé MeSH
• maskovaná hypertenze diagnóza   epidemiologie   MeSH
• obezita epidemiologie   MeSH
• prevalence MeSH
• průřezové studie MeSH
• registrace MeSH
• rizikové faktory MeSH
• senioři MeSH
• syndrom bílého pláště diagnóza   epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Afrika epidemiologie   MeSH
• Asie epidemiologie   MeSH
• Austrálie epidemiologie   MeSH
• Evropa epidemiologie   MeSH
• Spojené státy americké MeSH

PURPOSE: Little is known on the beliefs, perceptions and practices of hypertension specialists in addressing non-adherence to therapy. Therefore, a survey was undertaken amongst healthcare professionals (HCPs) managing hypertension in the European Society of Hypertension (ESH) Centres of Excellence. MATERIALS AND METHODS: Cross-sectional data were obtained between December 2020 and April 2021 using an online anonymous structured questionnaire including 26 questions/136 items, that was sent to all ESH Excellence centres. RESULTS: Overall 67 from 187 centres (37.3%) responded and 200 HCPs from 30 countries answered the questionnaire. Participants (60% men) were mainly physicians (91%) and nurses (8%) from University hospitals (77%). Among physicians, 83% had >10 years professional experience. Average time dedicated to discuss medications was 1-5 min in 48% and 6-10 min in 29% of cases. Interviews with patients about adherence were the most frequently used assessment method. Chemical detection of medications in urine was available in 36% of centres. One third of physicians involved their patients regularly in treatment decisions. The most frequent methods to improve adherence included simplification of medication therapy, more frequent visits, and home blood pressure monitoring. CONCLUSIONS: The level of implementation of tools to detect and improve adherence in hypertension management by HCPs in ESH excellence centres is low. Structured educational activities focussing on adherence management and access to the newest objective measures to detect non-adherence might improve these deficits.

• Klíčová slova
• Adherence, beliefs, chemical detection, healthcare professionals, hypertension, pharmacotherapy, survey,
• MeSH
• adherence k farmakoterapii MeSH
• hypertenze * farmakoterapie   MeSH
• lékaři * MeSH
• lidé MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life-threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks' gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus.

• Klíčová slova
• Hypertensive emergency, Antihypertensive drugs, Gestational hypertension, Low dose of acetylsalicylic acid, Pre-eclampsia, Pre-existing hypertension,
• MeSH
• antihypertenziva škodlivé účinky   terapeutické užití   MeSH
• hypertenze indukovaná těhotenstvím diagnóza   farmakoterapie   patofyziologie   MeSH
• konsensus MeSH
• krevní tlak účinky léků   MeSH
• lidé MeSH
• medicína založená na důkazech normy   MeSH
• měření krevního tlaku normy   MeSH
• náhlé příhody MeSH
• peripartální období MeSH
• rizikové faktory MeSH
• služby zdravotní péče o matku normy   MeSH
• stupeň závažnosti nemoci MeSH
• těhotenství MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• směrnice pro lékařskou praxi MeSH
• Názvy látek
• antihypertenziva MeSH

PURPOSE OF REVIEW: Many aspects of reproduction have been associated with increased blood pressure and impaired glucose metabolism that reveals a subsequent increased risk of cardiovascular disease. The aim of this review is to assess reproductive life factors associated with an increased risk of hypertension and cardiovascular disease, e.g., early life programming, sexual, and reproductive health in men and women. RECENT FINDINGS: Impaired fetal growth, with low birth weight adjusted for gestational age, has been found associated with hypertension in adulthood. Erectile dysfunction, currently considered an early diagnostic marker of cardiovascular disease preceding the manifestation of coronary artery disease by several years, frequently coexisting with hypertension, could also be exacerbated by some antihypertensive drugs. Male hypogonadism or subfertility are associated with increased cardiovascular risk. Hypertensive disorders in pregnancy including preeclampsia represent a major cause of maternal, fetal and neonatal morbidity, and mortality. The risk of developing preeclampsia can be substantially reduced in women at its high or moderate risk with a low dose of acetylsalicylic acid initiated from 12 weeks of gestation. An increased risk of hypertension in women following invasive-assisted reproductive technologies has been newly observed. Blood pressure elevation has been noticed following contraceptive pill use, around the menopause and in postmenopausal age. Furthermore, drug treatment of hypertension has to be considered as a factor with a potential impact on reproduction (e.g., due to teratogenic drug effects). In summary, a deeper understanding of reproductive life effects on hypertension and metabolic abnormalities may improve prediction of future cardiovascular disease.

• Klíčová slova
• Assisted reproductive technologies, Erectile dysfunction, Hypertensive disorders in pregnancy, Low birth weight, Male hypogonadism, Oral contraception,
• MeSH
• antihypertenziva MeSH
• dospělí MeSH
• hypertenze * MeSH
• kardiovaskulární nemoci * MeSH
• lidé MeSH
• novorozenec s nízkou porodní hmotností MeSH
• novorozenec MeSH
• preeklampsie * MeSH
• reprodukční zdraví * MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• antihypertenziva MeSH

OBJECTIVE: To compare capillary diameters, density and reactivity in high-risk pregnancies complicated by pregnancy-induced hypertension (PIH) to other high-risk pregnancies not affecting microcirculation (O). METHODS: Patients hospitalized at a tertiary referral center from January to May 2012 were enrolled in the prospective pilot study. Five microscopic fields were recorded from the nailfold for capillary diameters and functional capillary density assessment. One microscopic field was assessed before and after venous congestion to evaluate the change in capillary diameters. The results were expressed as median (interquartile range). Wilcoxon rank-sum test was used for the analysis of statistical significance (level of significance was set to p < 0.05). RESULTS: In total, 31 patients were available for statistical analysis (PIH = 17;O = 14). Patients in the PIH group had significantly longer capillaries (123(91;182) vs. 72(65;107)μm, p = 0.003) and higher average capillary diameter (12(10;13) vs. 10(9;11)μm, p = 0.017). The difference in mean functional capillary density was not significant (20(17;25) vs. 19(15:21), p > 0.05), however, significantly reduced capillary recruitment (1(0;7) vs. 10(6;17), p = 0.006) was found in PIH. Preeclampsia was observed in 10 patients from the PIH group. These patients did not significantly differ from the rest of the PIH group in the abovementioned variables. CONCLUSION: This is the first pilot study concerning change of capillary diameters after venous congestion in pregnancy. The reduced capillary recruitment and reduced capability of further dilation of capillaries after venous congestion observed in women with PIH may suggest a significantly reduced functional capacity of the microcirculation and increased load on capillary endothelium in pregnancy complicated by gestational hypertension.

• Klíčová slova
• Capillary recruitment, gestational hypertension, microcirculation, pregnancy-induced hypertension, video capillary microscopy.,
• MeSH
• dospělí MeSH
• hospitalizace MeSH
• hypertenze indukovaná těhotenstvím patofyziologie   MeSH
• kapiláry patofyziologie   MeSH
• lidé MeSH
• mikrocirkulace fyziologie   MeSH
• pilotní projekty MeSH
• prospektivní studie MeSH
• rizikové těhotenství * MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Klíčová slova
• HYPERTENSION/etiology *,
• MeSH
• esenciální hypertenze MeSH
• hypertenze etiologie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Hypertensive disorders in pregnancy (HDP), remain the leading cause of adverse maternal, fetal, and neonatal outcomes. Epidemiological factors, comorbidities, assisted reproduction techniques, placental disorders, and genetic predisposition determine the burden of the disease. The pathophysiological substrate and the clinical presentation of HDP are multifarious. The latter and the lack of well designed clinical trials in the field explain the absence of consensus on disease management among relevant international societies. Thus, the usual clinical management of HDP is largely empirical. The current position statement of the Working Group 'Hypertension in Women' of the European Society of Hypertension (ESH) aims to employ the current evidence for the management of HDP, discuss the recommendations made in the 2023 ESH guidelines for the management of hypertension, and shed light on controversial issues in the field to stimulate future research.

• MeSH
• antihypertenziva terapeutické užití   MeSH
• hypertenze indukovaná těhotenstvím * terapie   MeSH
• kardiovaskulární komplikace v těhotenství terapie   patofyziologie   MeSH
• lidé MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• společnosti lékařské normy   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• antihypertenziva MeSH

Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality. It is important to distinguish between pre-existing (chronic) hypertension and gestational hypertension, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum. There is a consensus that systolic blood pressure ≥ 170 or diastolic blood pressure ≥ 110 mmHg is an emergency and hospitalization is indicated. The selection of the antihypertensive drug and its route of administration depend on the expected time of delivery. The current European guidelines recommend initiating drug treatment in pregnant women with persistent elevation of blood pressure ≥ 150/95 mmHg and at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria), with pre-existing hypertension with the superimposition of gestational hypertension, and with hypertension with subclinical organ damage or symptoms at any time during pregnancy. Methyldopa, labetalol, and calcium antagonists (the most data are available for nifedipine) are the drugs of choice. The results of the CHIPS and CHAP studies are likely to reduce the threshold for initiating treatment. Women with a history of hypertensive disorders in pregnancy, particularly those with pre-eclampsia, are at high risk of developing cardiovascular disease later in life. Obstetric history should become a part of the cardiovascular risk assessment in women.

• Klíčová slova
• Cardiovascular risk after hypertensive disorders in pregnancy, Classification of hypertensive disorders in pregnancy, Drug treatment of hypertension in pregnancy, Pre-conception counselling, Prevention of pre-eclampsia,
• MeSH
• antihypertenziva škodlivé účinky   MeSH
• hypertenze indukovaná těhotenstvím * diagnóza   farmakoterapie   epidemiologie   MeSH
• hypertenze * diagnóza   farmakoterapie   epidemiologie   MeSH
• krevní tlak MeSH
• labetalol * škodlivé účinky   MeSH
• lidé MeSH
• novorozenec MeSH
• preeklampsie * MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antihypertenziva MeSH
• labetalol * MeSH

Systemic arterial hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and is associated with an increased risk of cardiovascular disease (CVD). Fewer than half of those with hypertension are aware of their condition, and many others are aware but not treated or inadequately treated, although successful treatment of hypertension reduces the global burden of disease and mortality. The aetiology of hypertension involves the complex interplay of environmental and pathophysiological factors that affect multiple systems, as well as genetic predisposition. The evaluation of patients with hypertension includes accurate standardized blood pressure (BP) measurement, assessment of the patients' predicted risk of atherosclerotic CVD and evidence of target-organ damage, and detection of secondary causes of hypertension and presence of comorbidities (such as CVD and kidney disease). Lifestyle changes, including dietary modifications and increased physical activity, are effective in lowering BP and preventing hypertension and its CVD sequelae. Pharmacological therapy is very effective in lowering BP and in preventing CVD outcomes in most patients; first-line antihypertensive medications include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, dihydropyridine calcium-channel blockers and thiazide diuretics.

• MeSH
• antihypertenziva farmakokinetika   terapeutické užití   MeSH
• blokátory kalciových kanálů terapeutické užití   MeSH
• diuretika terapeutické užití   MeSH
• hypertenze komplikace   epidemiologie   patofyziologie   MeSH
• kardiovaskulární nemoci etiologie   patofyziologie   MeSH
• kvalita života MeSH
• lidé MeSH
• renin-angiotensin systém účinky léků   MeSH
• sympatický nervový systém účinky léků   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• antihypertenziva MeSH
• blokátory kalciových kanálů MeSH
• diuretika MeSH