New research from @jordybc.bsky.social (@dbei-upenn.bsky.social) out in @jama.com provides insight into the impact of a smartwatch hypertension notification feature for population screening jamanetwork.com/journals/jam...

What high blood pressure does to your body Hypertension can affect your mind, heart, eyes and more, often without causing any obvious symptoms at all.

Excellent overview in The Washington Post on the systemic impact of sustained hypertension — from LVH to CKD and cognitive decline.

Kudos to Drs. @drwanpen.bsky.social , John B, and @jordybc.bsky.social for evidence base insight.

🔗 www.washingtonpost.com/wellness/202...

#Hypertension #Cardiology

I agree — thanks, Wanpen!

Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association | Hypertension Conventional cuff-based blood pressure (BP) monitoring has several limitations, including patient discomfort with arm cuff inflation, inconvenience, and limited frequency of readings. Cuffless BP devi...

Thank you to my coauthors for such amazing work on this (and rapid turn around)!

See more on this here:

www.ahajournals.org/doi/10.1161/...

www.ahajournals.org/doi/10.1161/...

/n

The Apple Watch has the potential to capture many undetected cases of hypertension, but with 200 million Apple Watch users worldwide, a HUGE number of people with hypertension will remain unaware… and potentially falsely reassured 🤷‍♀️

4/n

We used NHANES data to look at the impact of an alert on the likelihood of someone having hypertension.

Across several subgroups like age and obesity status, an alert substantially increases the likelihood of someone having hypertension…

But lack of an alert hardly tips the scale ⚖️

3/n

This new feature provides users with a notification if it sense evidence of hypertension. The sensitivity in Apple’s validation test was 41%, specificity 92%

So, among people with unknown hypertension, 41% will receive an alert but 59% will not receive an alert 🩺

2/n

Smartwatch and Hypertension Notification This cross-sectional study assesses the potential impact of a smartwatch hypertension notification feature for US adults who have not been diagnosed with hypertension.

Excited to share our research letter published today in JAMA on the new Apple Watch Hypertension Notification Feature! jamanetwork.com/journals/jam...

1/n

Apple Watch for Hypertension Screening | Hypertension

Excited to share our thoughts on the Apple Watch Hypertension alert!
@jordybc.bsky.social @deanpicone.bsky.social @alta-schutte.bsky.social

Apple Watch for Hypertension Screening | Hypertension www.ahajournals.org/doi/10.1161/...

🚨 Fresh Hypertension Guidelines Alert 🚨

Don’t get caught treating high blood pressure like it’s 2024 👀

In Episode #509, West Philly doc Dr. Jordy Cohen @jordybc.bsky.social
keeps our hypertension management fresh with a clear walk-through of the new HTN guidelines & more!

www.thecurbsiders.com

Hydralazine inhibits cysteamine dioxygenase to treat preeclampsia and senesce glioblastoma The decades-old preeclampsia drug hydralazine vasodilates and senesces glioblastoma cells via the same enzyme target, ADO.

Woah, it’s possible hydralazine may be (rarely) useful outside of preeclampsia! www.science.org/doi/10.1126/... 🤯

H/t @jbrianbyrd.bsky.social

Huge team effort — thanks for having such a major part in this — hope it promotes critical research in this area!

Happy to contribute to this important statement
@ahascience.bsky.social on cuffless devices led by @jordybc.bsky.social !

Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association | Hypertension ahajournals.org/doi/10.1161/...

ESC Guidelines for the management of elevated blood pressure and hypertension ESC Clinical Practice Guidelines aim to present all the relevant evidence to help physicians weigh the benefits and risks of a particular diagnostic or therapeutic procedure for the management of ele...

Agree with your comments

It mostly seems an extension/explanation of the ridiculous 2023 ESH guidelines (not to be confused with the superb 2024 ESC guidelines www.escardio.org/Guidelines/C...)

A whole section to renal denervation 🤔
And such strong language against BP < 120

Mind blown emoji

@jordybc.bsky.social this you?
Looks like an issue of JACC that needs to be read!

An article in print in the wild 🤯

(Thanks!)

The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association | Hypertension Over the past 3 decades, a substantial body of high-quality evidence has guided the diagnosis and management of elevated blood pressure (BP) in the outpatient setting. In contrast, there is a lack of ...

There you go:

www.ahajournals.org/doi/10.1161/...

@ahascience.bsky.social statement from HT heavyweights

The silent killer increases your risk of stroke and dementia. Here's how to control it New recommendations for early treatment of hypertension to prevent strokes, heart attacks and dementia come as an experimental medication is shown to lower blood pressure in hard-to-treat patients.

High blood pressure often shows no symptoms, but raises risk of stroke, heart disease, kidney damage, and dementia.
New American Heart Association guidelines: treat it early with diet & exercise.
“If you catch it early, you can gain many more years of healthy life,” says Penn’s Dr. Jordana Cohen.

And that’s a wrap!
In summary: screen carefully, stratify by risk, account for kidney health, and individualize therapy.
For nephrology, the wins are undeniable: albuminuria testing is mainstream, CKD visibility is heightened, and aldosterone is on the radar.

#NephJC

Tried to keep up on my phone while being held hostage in my toddler’s room 😳

Great chat!

#nephjc

T4l
1️⃣2️⃣No aggressive IV treatment for severe asymptomatic HTN - avoid acute inpatient lowering if no target-organ damage (COR III: Harm, LOE C-LD).
📝Treat the patient (situation) not the number for acute HTN during hospitalization. I have trouble convincing nocturnists of this. #NephJC

Preventing Microalbuminuria in Type 2 Diabetes | NEJM The multicenter double-blind, randomized Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) was designed to assess whether angiotensin-converting–enzyme inhibitors and non-dihydropyridine ...

www.nejm.org/doi/full/10....

There’s some trial data on prevention of albuminuria

#nephjc

a woman is holding a red megaphone in front of her mouth Alt: a woman is holding a red megaphone in front of her mouth

#nephjc

T4j
🔟CKD with albuminuria - ACEi/ARB strongly recommended to delay CKD progression and reduce CVD (COR I, LOE A).
📝Still only 35-50% of eligible patients get them. How do we move the needle on this? #NephJC

Cognitive impairment data

Yes! Slide care of Paul Whelton at this year’s #Hypertension25

#nephjc

T4i
9️⃣Cognitive protection🧠 - treat to SBP <130 to prevent mild cognitive impairment/dementia (COR I, LOE B-R).
📝Do you think BP control has a significant role in dementia? #NephJC

Table

Even when we say we will use MRAs earlier, we don’t! We showed this. Screening is associated with WAY more MRA use (probably in part because those who think to screen are more likely to treat based on best evidence)

pmc.ncbi.nlm.nih.gov/articles/PMC...

#nephjc

Proposed mechanism in Nature #NephJC
www.nature.com/articles/s41...

a black background with a gold circle and a la logo Alt: Pendulum

That was the goal with the encouragement without saying it’s absolutely required. It’s not feasible or appropriate in everyone/should be tailored to the individual.

Overall, it’s to swing the pendulum to aim lower when possible

#nephjc