The KDIGO 2021 Hypertension Guidelines. We mixed things up and went with a Fantasy Football-style draft. Pick your favorite guideline, and remember not to take a kicker or a defense until the last rounds.
The Filtrate:
Joel Topf
Swapnil Hiremath
Nayan Arora
Sophie Ambruso
Joshua Waitzman
Editor
Joel Topf
Show Notes:
Soccer star Christian Eriksen 'was gone' after on-field cardiac arrest, doctor says (NBC News)
120-sided Die. This was covered in Wired Magazine. Respect. https://www.wired.com/2016/05/mathematical-challenge-of-designing-the-worlds-most-complex-120-sided-dice/
Nephrologists that played D&D: https://twitter.com/kidney_boy/status/1398660927680036865?s=20
Doctors that played D&D (i.e. control group): https://twitter.com/kidney_boy/status/1398661170328899586?s=20
Average sodium intake among Americans is 3,400 mg (147 mEq of Na per day). Sodium and the Dietary Guideline Factsheet (PDF)
DASH Sodium Diet Trial https://www.nejm.org/doi/10.1056/NEJM200101043440101
The PURE Trial as discussed by NephJC and as seen in the NEJM
Formulas to Estimate Dietary Sodium Intake From Spot Urine Alter Sodium-Mortality Relationship https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.119.13117
The Taiwan Nursing Home study: https://pubmed.ncbi.nlm.nih.gov/16762939/
Peruvian Cluster RCT of sodium reduction in Nature (oooh!) https://www.nature.com/articles/s41591-020-0754-2
DASH diet is expensive https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3856355/
DASH Diet in CKD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957723/
A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate https://pubmed.ncbi.nlm.nih.gov/23393104/
ACCORD https://www.nejm.org/doi/full/10.1056/nejmoa1001286
Kidney Damage Biomarkers and Incident CKD During Blood Pressure Reduction: A Case-Control Study within SPRINT https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953744/
Association of Urinary Biomarkers of Inflammation, Injury, and Fibrosis with Renal Function Decline: The ACCORD Trial https://pubmed.ncbi.nlm.nih.gov/27189318/
Lake Wobegon https://en.wikipedia.org/wiki/Lake_Wobegon
BP Validation websites:
USA: https://www.validatebp.org
Europe/International: https://www.stridebp.org
SPRINT https://www.nejm.org/doi/full/10.1056/nejmoa1511939
Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia https://jamanetwork.com/journals/jama/fullarticle/2723256
Characterizing Frailty Status in the Systolic Blood Pressure Intervention Trial https://pubmed.ncbi.nlm.nih.gov/26755682/
Syncope, Hypotension, and Falls in the Treatment of Hypertension: Results from the SPRINT Randomized Clinical Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045467/
The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening
Concordance Between Blood Pressure in the Systolic Blood Pressure Intervention Trial and in Routine Clinical Practice https://pubmed.ncbi.nlm.nih.gov/33044494/
SONG transplant Outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604246/
Chlorthalidone Amlodipine RCT in transplant in AJKD https://pubmed.ncbi.nlm.nih.gov/28259499/
Beta-blockers should not be first line for hypertension https://www.cochrane.org/CD002003/HTN_beta-blockers-hypertension