From the Guidelines
Hypertension diagnosis and management should be based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline, which defines hypertension as a blood pressure of 130/80 mm Hg or higher, to reduce long-term morbidity and mortality associated with hypertension. The definition of hypertension is crucial for early detection and treatment, as elevated blood pressure is associated with the development of many comorbid conditions, such as coronary artery disease, heart failure, stroke, peripheral vascular disease, and chronic kidney disease 1. According to the 2020 U.S. Department of Veterans Affairs/U.S. Department of Defense clinical practice guideline, routine screening is important to diagnose hypertension, especially in younger patients and African American persons, who may develop hypertension at a younger age and present with a higher prevalence of complications at the time of diagnosis 1. Key aspects of hypertension management include:
- Nonpharmacologic treatment, such as lifestyle modifications
- Pharmacologic treatment, with target treatment goals based on individual patient risk factors
- Regular monitoring of blood pressure to adjust treatment as needed The 2017 ACC/AHA guideline recommends a more aggressive approach to blood pressure management, with a focus on early detection and treatment to reduce the risk of cardiovascular disease and other complications 1. By adopting this approach, healthcare providers can improve patient outcomes and reduce the morbidity and mortality associated with hypertension. The importance of recognizing, diagnosing, and effectively managing hypertension cannot be overstated, as it is a common health problem that affects a significant portion of the adult population, with an estimated 72 million adult Americans having hypertension, and an additional 31 million meeting the new criteria for hypertension based on the 2017 ACC/AHA guideline 1.
From the Research
HAIP Overview
- HAIP stands for Hepatic Artery Infusion Pump, a specialized therapy for patients with unresectable colorectal liver metastases (uCRLM) 2.
- The effectiveness of HAIP chemotherapy has been demonstrated, but its feasibility and safety at various centers were uncertain until a multicenter retrospective cohort study was conducted 2.
Safety and Feasibility of HAIP
- A study assessed the safety and feasibility of HAIP for the management of uCRLM at six North American centers initiating the HAIP program 2.
- The study found that HAIP programs can be safely and effectively initiated in previously inexperienced centers with good response 2.
- Major complications occurred in 7 (4.6%) patients during their hospitalization, and 13 (8.4%) patients developed biliary sclerosis during follow-up 2.
- A total of 148 patients (96.1%) received at least one-dose of HAIP chemotherapy with a median of 5 (4-7) cycles 2.
Efficacy of HAIP
- The study demonstrated that 78 patients (56.5%) had a complete or partial response, and 12 (7.8%) received a curative liver resection 2.
- The use of HAIP chemotherapy has been shown to be effective in managing uCRLM, with significant response rates and potential for curative liver resection 2.