Essential Hypertension in the Elderly: To Treat or Not to Treat? A Therapeutic Dilemma for the Geriatric Cardiologist_ Crimson Publishers

Essential Hypertension in the Elderly: To Treat or Not to Treat? A Therapeutic Dilemma for the Geriatric Cardiologist by Akhtar Khan* in Open Journal of Cardiology & Heart Diseases_ journal of cardiology & heart diseases

 

Abstract

Essential hypertension, the most common type, is an important cause of morbidity and mortality in the elderly, a rapidly growing section of the population. It is a sad reality that until the 1950s treating benign hypertension was not thought to be necessary. The tragic death of Franklin Delano Roosevelt on April 12, 1945 at the age of 63 years, with a blood pressure of 350/195mmHg, and without treatment shocked the healthcare community. Now, with extensive research, the availability of affordable and effective treatments and lifestyle measures, freedom from unfounded phobias of adverse drug effects, and new approaches such as aroma, colour and music therapy have improved the quality of life for hypertensives generally and especially the elderly.

Introduction

“There are few stories in the history of medicine that are filled with more errors or misconceptions than the story of hypertension and its treatment.“_ Prof Marvin Moser (1925-2015)-Yale University School of Medicine.

Hypertension (HTN) is defined as: Having a systolic blood pressure (SBP) of 140mmHg or greater OR having a diastolic blood pressure (DBP) of 90mmHg or greater OR taking antihypertensive medication OR having been told at least twice by a physician or other health professional that one has HTN [1]. Prof. John Hay (University of Liverpool), while delivering a lecture in Bradford on February 25th, 1931, under the auspices of the British Medical Association, remarked “It is agreed that a high arterial pressure is essential for the efficient performance of muscular work”. He added “There is some truth in the saying that the greatest danger to a man with high blood pressure lies in its discovery, because then some fool is certain to try and reduce it [2]. However, research has since established that HTN (“The Silent Killer”) is a persistent non-physiologic elevation in blood pressure necessitating timely pharmacological and non-pharmacological interventions. Essential hypertension (‘Essentielle hypertonie’) is the most common type of HTN accounting for 95% of hypertensives.

https://crimsonpublishers.com/ojchd/fulltext/OJCHD.000547.php

For more Open access journals in Crimson Publishers,

Please click on the link: https://crimsonpublishers.com/

For more articles in journal of cardiology & heart diseases,

Please click on below link: https://crimsonpublishers.com/ojchd/

Follow On Publons: https://publons.com/publisher/6342/crimson-publishers/

Follow On Linkedin: https://www.linkedin.com/company/crimsonpublishers/

High impact journals in Crimson Publishers?

https://www.quora.com/What-are-the-high-impact-journals-in-Crimson-Publishers

An Artificial Neural Network Predicts the Excessive Radiation Risk in Epidural Pulsed Radiofrequency (Eprf) Interventions- A Pilot Study_ Crimson Publishers

An Artificial Neural Network Predicts the Excessive Radiation Risk in Epidural Pulsed Radiofrequency (Eprf) Interventions- A Pilot Study by Ahmed Nassar and Georgios Matis* in Techniques in Neurosurgery & Neurology_ Journal of Neurosurgery

Abstract

Objectives: Epidural pulsed radiofrequency (ePRF) interventions are successfully used in the treatment of patients with cervical, thoracic, and lumbar pain but they can be associated with high radiation doses. The scope of this study was to evaluate the ability of an artificial neural network (ANN) to predict preoperatively an excessive radiation risk in such procedures.

Materials and Methods: For 46 patients treated with ePRF, the dose area product (DAP) and procedure times were retrospectively analyzed. Additional patient, symptom, and surgical characteristics were collected based on the surgery protocols. An ANN was constructed to predict the excessive radiation as compared to the mean DAP value.

Results: Twenty-one patients were male (45.7%) and 25 females (54.3%). Mean values and ranges: age (61.76±2.2; 29-86 years), duration (26.65±1.43; 12-53 minutes), and DAP (694.63±113.83; 130.71- 3,711.64 Gy/cm2). The resulted ANN contained 7 scaling neurons (inputs), 3 hidden neurons, and one probabilistic neuron (target). Important inputs for the acquired ANN were age, sex, diagnosis, side, and level of intervention. The experience of the surgeon and the duration of the surgery were not significant contributors in this ANN. The network exhibited a sensitivity of 1, a specificity of 0.43, an AUC (Area Under Curve, ROC chart) of 0.714.

Conclusion: It was possible to construct an ANN, which could predict if the radiation burden during an ePRF procedure would be higher than the average one. This could prove useful in optimizing the planning of ePRF procedures. Further studies with a larger series of patients are warranted.

https://crimsonpublishers.com/tnn/fulltext/TNN.000557.php

For more Open access journals in Crimson Publishers,
Please click on the link: https://crimsonpublishers.com/

For more articles in Journal of Neurosurgery,
Please click on below link: https://crimsonpublishers.com/tnn/

Follow On Publons: https://publons.com/publisher/6342/crimson-publishers/

Follow On Linkedin: https://www.linkedin.com/company/crimsonpublishers/

High impact journals in Crimson Publishers?

https://www.quora.com/What-are-the-high-impact-journals-in-Crimson-Publishers