Renata Cifkova

Bio: Renata Cifkova is an academic researcher from First Faculty of Medicine, Charles University in Prague. The author has contributed to research in topics: Population & Blood pressure. The author has an hindex of 68, co-authored 305 publications receiving 80868 citations. Previous affiliations of Renata Cifkova include Masaryk University & Czechoslovak Academy of Sciences.

Epidemiology of Hypertension and Brain Disease

Abstract: Hypertension is the most prevalent cardiovascular disorder affecting 20–50 % of the adult population in developed countries. There are considerable differences in the prevalence, awareness, treatment, and control of hypertension worldwide. Elevated BP is the strongest modifiable risk factor for stroke, both ischemic and hemorrhagic. About 54 % of strokes all over the world are attributed to high BP (systolic BP > 115 mmHg). The prevalence and incidence of stroke in the general population increases with age and is directly related to BP levels. The prevalence of dementia shows a strong increase with age from 5 % at the age of 65 years to 20 % at the age of 80 years and 40 % at the age of 90 years. However, the link between BP and cognitive function is complex. Hypertension predisposes to cognitive decline and dementia, although BP commonly decreases when dementia develops.

Why COLM and ACCOMPLISH study results differ.

Abstract: A total of 70–80% of patients require a combination of antihypertensive drugs to achieve goal blood pressure. The current European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines [1] suggest initiating drug treatment either with a single agent or with a combination of two drugs. The latter approach is recommended particularly in patients with marked blood pressure (BP) elevations, or in individuals with high or very high cardiovascular risk. According to the current European guidelines [1], combinations of an angiotensin receptor blocker with a calcium antagonist or a thiazide diuretic belong to the preferred drug combinations. ACCOMPLISH (Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension) [2] is so far the only trial directly comparing two fixed combinations in all patients, finding significant superiority of the ACE inhibitor benazepril plus the calcium antagonist amlodipine over benazepril plus hydrochlorothiazide. There was a 19.6% relative risk reduction of primary outcome event in the benazepril-amlodipine group (hazard ratio 0.80; 95% confidence interval 0.72–0.90; P< 0.001). These unexpected results deserve to be replicated. The COLM (Combinations of OLMesartan) study, published in this issue of Journal of Hypertension, is a prospective, randomized, open-label, blinded-endpoint study in elderly Japanese hypertensive patients with a history of cardiovascular disease or cardiovascular risk factors combining olmesartan with a calcium channel blocker (amlodipine 2.5–5mg/day or azelnidipine 8–16mg/day) or olmesartan with a low-dose diuretic (trichlormethiazide 1 mg, hydrochlorothiazide 12.5 mg, or indapamide 1 mg, and other diuretics) [3]. There was no significant difference in cardiovascular events between the two arms. In other words, the COLM study does not confirm the unexpected results of the ACCOMPLISH study.

Adherence to cardiovascular prevention principles in subjects at high risk.

Abstract: Východisko: Asymptomaticke osoby se zvýseným kardiovaskularnim rizikem představuji jednu z priorit kardiovaskularni prevence, v praxi ale casto opomijenou. Nasim cilem bylo objektivizovat, jak vysokorizikove osoby dosahuji lecebných cilů v primarni peci. Metoda: Analýza zahrnovala nahodný vzorek obecne populace, vysetřený v ramci populacniho průzkumu postMONICA v letech 2016-2017. Probandi byli kategorizovani podle sveho individualniho kardiovaskularniho rizika na zakladě principů 6. spolecných evropských doporuceni a porovnana byla jejich skutecna kontrola rizikoveho profilu s teoretickými doporucenými cili kardiovaskularni prevence. Výsledky: Celkem bylo do analýzy zařazeno 898 subjektů ve věku 25-75 let (47 % mužů). Mezi nimi, 16,7 % subjektů bylo klasifikovano do kategorie "velmi vysoke riziko", 36,8 % jako "vysoke riziko", zatimco zbylých 46,5 % jako jen mirně zvýsene nebo nizke celkove individualni riziko. Z hlediska adherence k doporuceným principům, ve skupině s "velmi vysokým rizikem" abstinovalo od tabaku v jakekoliv podobě jen 58,7 %, naležitou fyzickou aktivitu (≥ 150 min alespoň mirne aktivity týdně) nahlasilo 38 %, doporucenou tělesnou konstituci (BMI 20-25 kg/m2) vykazovalo 16,7 %, naležitý krevni tlak (< 140/90 mm Hg) 39,3 % a cilove hodnoty LDL-cholesterolu (< 1,8 mmol/l) dosahlo jen 8,7 % subjektů. V kategorii "vysokeho rizika" byla adherence k těmto cilům nasledujici: 83,9 % (abstinence od tabaku), 32,7 % (fyzicka aktivita), 17 % (tělesna konstituce), 58,2 % (krevni tlak) a 30,8 % (LDL-cholesterol < 2,5 mmol/l). Přijatelnějsi byla v obou rizikových kategoriich kontrola glukozoveho metabolismu (HbA1c < 53 mmol/mol u diabetiků), tj. 75 % a 81 %, respektive. Zavěr: Celkova adherence k doporuceným principům kardiovaskularni prevence vysokorizikových osob je v primarni peci velmi daleko od sveho optima a markantni je toto zejmena u subjektů s velmi vysokým rizikem

Assessment of Total Cardiovascular Risk in Hypertension: The Role of Subclinical Organ Damage

Abstract: The estimation of total cardiovascular risk is essential for guiding the management of hypertension. Computerized methods have been developed for estimating total cardiovascular risk (i.e., the likelihood of developing a cardiovascular event, usually within the ensuing 10 years), most of which are based either on the Framingham risk score or the European Systemic Coronary Risk Evaluation project. The 2007 European Society of Hypertension–European Society of Cardiology guidelines suggest subclinical organ damage as an integral part of the risk stratification and evaluation of hypertensive patients. Subclinical organ damage is considered an intermediate stage in the continuum of vascular disease and a determinant of overall cardiovascular risk. The search for subclinical organ damage should be performed carefully using the appropriate techniques depending on the availability and resources. Electrocardiography and evaluation of urinary albumin excretion should be part of the routine assessment of hypertensive patients. Subclinical organ damage should be also measured during treatment because there is evidence that regression of left ventricular hypertrophy and reduction of proteinuria are associated with improved prognosis. The search for subclinical organ damage should be made simultaneously in various organs because multiorgan subclinical organ damage is associated with a worse prognosis.).

2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

Abstract: ABCD : Appropriate Blood pressure Control in Diabetes ABI : ankle–brachial index ABPM : ambulatory blood pressure monitoring ACCESS : Acute Candesartan Cilexetil Therapy in Stroke Survival ACCOMPLISH : Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension ACCORD : Action to Control Cardiovascular Risk in Diabetes ACE : angiotensin-converting enzyme ACTIVE I : Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events ADVANCE : Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation AHEAD : Action for HEAlth in Diabetes ALLHAT : Antihypertensive and Lipid-Lowering Treatment to Prevent Heart ATtack ALTITUDE : ALiskiren Trial In Type 2 Diabetes Using Cardio-renal Endpoints ANTIPAF : ANgioTensin II Antagonist In Paroxysmal Atrial Fibrillation APOLLO : A Randomized Controlled Trial of Aliskiren in the Prevention of Major Cardiovascular Events in Elderly People ARB : angiotensin receptor blocker ARIC : Atherosclerosis Risk In Communities ARR : aldosterone renin ratio ASCOT : Anglo-Scandinavian Cardiac Outcomes Trial ASCOT-LLA : Anglo-Scandinavian Cardiac Outcomes Trial—Lipid Lowering Arm ASTRAL : Angioplasty and STenting for Renal Artery Lesions A-V : atrioventricular BB : beta-blocker BMI : body mass index BP : blood pressure BSA : body surface area CA : calcium antagonist CABG : coronary artery bypass graft CAPPP : CAPtopril Prevention Project CAPRAF : CAndesartan in the Prevention of Relapsing Atrial Fibrillation CHD : coronary heart disease CHHIPS : Controlling Hypertension and Hypertension Immediately Post-Stroke CKD : chronic kidney disease CKD-EPI : Chronic Kidney Disease—EPIdemiology collaboration CONVINCE : Controlled ONset Verapamil INvestigation of CV Endpoints CT : computed tomography CV : cardiovascular CVD : cardiovascular disease D : diuretic DASH : Dietary Approaches to Stop Hypertension DBP : diastolic blood pressure DCCT : Diabetes Control and Complications Study DIRECT : DIabetic REtinopathy Candesartan Trials DM : diabetes mellitus DPP-4 : dipeptidyl peptidase 4 EAS : European Atherosclerosis Society EASD : European Association for the Study of Diabetes ECG : electrocardiogram EF : ejection fraction eGFR : estimated glomerular filtration rate ELSA : European Lacidipine Study on Atherosclerosis ESC : European Society of Cardiology ESH : European Society of Hypertension ESRD : end-stage renal disease EXPLOR : Amlodipine–Valsartan Combination Decreases Central Systolic Blood Pressure more Effectively than the Amlodipine–Atenolol Combination FDA : U.S. Food and Drug Administration FEVER : Felodipine EVent Reduction study GISSI-AF : Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation HbA1c : glycated haemoglobin HBPM : home blood pressure monitoring HOPE : Heart Outcomes Prevention Evaluation HOT : Hypertension Optimal Treatment HRT : hormone replacement therapy HT : hypertension HYVET : HYpertension in the Very Elderly Trial IMT : intima-media thickness I-PRESERVE : Irbesartan in Heart Failure with Preserved Systolic Function INTERHEART : Effect of Potentially Modifiable Risk Factors associated with Myocardial Infarction in 52 Countries INVEST : INternational VErapamil SR/T Trandolapril ISH : Isolated systolic hypertension JNC : Joint National Committee JUPITER : Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin LAVi : left atrial volume index LIFE : Losartan Intervention For Endpoint Reduction in Hypertensives LV : left ventricle/left ventricular LVH : left ventricular hypertrophy LVM : left ventricular mass MDRD : Modification of Diet in Renal Disease MRFIT : Multiple Risk Factor Intervention Trial MRI : magnetic resonance imaging NORDIL : The Nordic Diltiazem Intervention study OC : oral contraceptive OD : organ damage ONTARGET : ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial PAD : peripheral artery disease PATHS : Prevention And Treatment of Hypertension Study PCI : percutaneous coronary intervention PPAR : peroxisome proliferator-activated receptor PREVEND : Prevention of REnal and Vascular ENdstage Disease PROFESS : Prevention Regimen for Effectively Avoiding Secondary Strokes PROGRESS : Perindopril Protection Against Recurrent Stroke Study PWV : pulse wave velocity QALY : Quality adjusted life years RAA : renin-angiotensin-aldosterone RAS : renin-angiotensin system RCT : randomized controlled trials RF : risk factor ROADMAP : Randomized Olmesartan And Diabetes MicroAlbuminuria Prevention SBP : systolic blood pressure SCAST : Angiotensin-Receptor Blocker Candesartan for Treatment of Acute STroke SCOPE : Study on COgnition and Prognosis in the Elderly SCORE : Systematic COronary Risk Evaluation SHEP : Systolic Hypertension in the Elderly Program STOP : Swedish Trials in Old Patients with Hypertension STOP-2 : The second Swedish Trial in Old Patients with Hypertension SYSTCHINA : SYSTolic Hypertension in the Elderly: Chinese trial SYSTEUR : SYSTolic Hypertension in Europe TIA : transient ischaemic attack TOHP : Trials Of Hypertension Prevention TRANSCEND : Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease UKPDS : United Kingdom Prospective Diabetes Study VADT : Veterans' Affairs Diabetes Trial VALUE : Valsartan Antihypertensive Long-term Use Evaluation WHO : World Health Organization ### 1.1 Principles The 2013 guidelines on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology …

Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity

Abstract: A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.