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The conversion of inorganic nitrite to nitric oxide is facilitated during exercise. In a randomized trial of treatment of 105 patients who had heart failure with preserved ejection fraction, Borlaug and colleagues found that administration of inhaled inorganic nitrite for 4 weeks, compared with placebo, did not result in significant improvement in exercise capacity.
CME and Visual Abstract
It is not clear whether young adults classified as having hypertension under current guidelines are at increased risk of cardiovascular disease. Yano and colleagues followed 4851 participants aged 18 to 30 years and found that young adults with stage 1 and stage 2 hypertension, as defined by the 2017 ACC/AHA guideline, had greater risk for subsequent cardiovascular disease events than young adults with normal blood pressure. In an Editorial, Vasan suggests that investigating subtypes of hypertension in young adults may facilitate treatment decisions.
Editorial 1 and 2 and Related Article
Hypertension is a modifiable risk factor for cardiovascular disease (CVD), but it is unclear whether hypertension in young adulthood is associated with cardiovascular disease in later life. In a population-based cohort study of 2 488 101 men and women aged 20 to 39 years, Son and colleagues found that stage 1 hypertension was associated with an increased risk of subsequent CVD events.
Better cardiovascular health is associated with a lower incidence of cardiovascular disease, but it is unclear whether changes in cardiovascular health are associated with changes in morbidity and mortality. In a prospective cohort study of 9256 adults without prior cardiovascular disease, van Sloten and colleagues found no consistent relationship between changes in cardiovascular health and the risk of cardiovascular disease.
Ambulatory blood pressure monitoring and home blood pressure monitoring can be useful in the clinical management of hypertension for selected patients. This JAMA Insights article by Melville and Byrd discusses the application of out-of-office blood pressure monitoring.
This JAMA Diagnostic Test Interpretation article by Polonsky and Bakris presents a 65-year-old woman treated with antihypertensive medications who was concerned about fluctuations in her blood pressure. A 24-hour ambulatory blood pressure monitor measured sudden increases in blood pressure associated with an episode of anxiety and consumption of a high-salt breakfast. What would you do next?
Highlights. JAMA. 2018;320(17):1721–1723. doi:10.1001/jama.2017.12614
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