The epidemiology and management of severe hypertension

Hypertension guidelines stress that patients with severe hypertension (systolic blood pressure (BP)⩾180 or diastolic BP⩾110 mm Hg) require multiple drugs to achieve control and should have close follow-up to prevent adverse outcomes. However, little is known about the epidemiology or actual management of these patients. We retrospectively studied 59 207 veterans with hypertension. Patients were categorized based on their highest average BP over an 18-month period (1 July 1999 to 31 December 2000) as controlled (<140/90 mm Hg), mild (140–159/90–99 mm Hg), moderate (160–179/100–109 mm Hg) and severe hypertension. We examined severe hypertension prevalence, pattern, duration, associated patient characteristics, time to subsequent visit, percentage of visits with a medication increase, and final BP control and antihypertensive medication adequacy. Twenty-three per cent had ⩾1 visit with severe hypertension, 42% of whom had at least two such visits; median day with severe hypertension was 80 (range 1–548). These subjects were significantly older, more likely black, and with more comorbidities than other hypertension subjects. Medication increases occurred at 20% of visits with mild hypertension compared to 40% with severe hypertension; P<0.05). At study end, 76% of patients with severe hypertension remained uncontrolled; severe hypertension subjects with uncontrolled BP were less likely to be on adequate therapy than those with controlled BP (43.7 vs 45.4%). Among hypertensive veterans, severe hypertension episodes are common. Many subjects had relatively prolonged elevations, with older, sicker subjects at highest risk. Although, follow-up times are shorter and antihypertensive medication use greater in severe hypertension subjects, they are still not being managed aggressively enough. Interventions to improve providers' management of these high-risk patients are needed

Determination of ions, amino acids amines in the haemolymph of fairy shrimps by capillary electrophoresis with indirect UV and laser-induced fluorescence detection.

A

A review on the beneficial aspects of food processing

The manuscript reviews beneficial aspects of food processing with main focus on cooking/heat treatment, including other food-processing techniques (e.g. fermentation). Benefits of thermal processing include inactivation of food-borne pathogens, natural toxins or other detrimental constituents, prolongation of shelf-life, improved digestibility and bioavailability of nutrients, improved palatability, taste, texture and flavour and enhanced functional properties, including augmented antioxidants and other defense reactivity or increased antimicrobial effectiveness. Thermal processing can bring some unintentional undesired consequences, such as losses of certain nutrients, formation of toxic compounds (acrylamide, furan or acrolein), or of compounds with negative effects on flavour perception, texture or colour. Heat treatment of foods needs to be optimized in order to promote beneficial effects and to counteract, to the best possible, undesired effects. This may be achieved more effectively/sustainably by consistent fine-tuning of technological processes rather than within ordinary household cooking conditions. The most important identified points for further study are information on processed foods to be considered in epidemiological work, databases should be built to estimate the intake of compounds from processed foods, translation of in-vitro results to in-vivo relevance for human health should be worked on, thermal and non-thermal processes should be optimized by application of kinetic principles

A review on the beneficial aspects of food processing.

The manuscript reviews beneficial aspects of food processing with main focus on cooking/heat treatment, including other food-processing techniques (e.g. fermentation). Benefits of thermal processing include inactivation of food-borne pathogens, natural toxins or other detrimental constituents, prolongation of shelf-life, improved digestibility and bioavailability of nutrients, improved palatability, taste, texture and flavour and enhanced functional properties, including augmented antioxidants and other defense reactivity or increased antimicrobial effectiveness. Thermal processing can bring some unintentional undesired consequences, such as losses of certain nutrients, formation of toxic compounds (acrylamide, furan or acrolein), or of compounds with negative effects on flavour perception, texture or colour. Heat treatment of foods needs to be optimized in order to promote beneficial effects and to counteract, to the best possible, undesired effects. This may be achieved more effectively/sustainably by consistent fine-tuning of technological processes rather than within ordinary household cooking conditions. The most important identified points for further study are information on processed foods to be considered in epidemiological work, databases should be built to estimate the intake of compounds from processed foods, translation of in-vitro results to in-vivo relevance for human health should be worked on, thermal and non-thermal processes should be optimized by application of kinetic principle