Hypertension

Obese diabetics at risk of kidney disease

CAPE TOWN: Are you suffering from Type 1 diabetes? You better watch that weight around your waist. Researchers from the University of Washington, Seattle, have found that adults with Type 1 diabetes who are obese, especially those who carry excess weight around the waist, are at an increased risk of developing kidney disease.

Netcare to give free screenings for heart conditions

September is 'Heart-awareness Month and, in the interest of keeping the nations collective hearts pumping, private hospital group Netcare will be conducting free screening tests for anyone visiting one of their medical facilities on Thursday 28 September!

Doctors told how to manage hypertension in sub-Saharan Africa

Guidelines published this week on the management of hypertension and cardiovascular risk factors in sub-Saharan Africa aim to deal with the growing epidemic of cardiovascular disease in the area with the limited resources available. Hypertension was placed second only to AIDS in the health challenges facing countries in Africa at a meeting of the African Union in 2001. This resulted in the Durban Decision being adopted by African heads of state and governments, which emphasised the need to tackle hypertension and cardiovascular risk factors in the face of the emerging epidemic of cardiovascular disease in African countries. Figures from the World Health Organization predict that cardiovascular disease will be the commonest cause of death in developing countries by the year 2020. As a result, the European Commission has provided funding and resources to develop guidelines for the management of cardiovascular risk factors. The new guidelines, published in the Journal of Hypertension ( 2003;21: 1993-2000)[Medline], argue that particular consideration has to be given to cost effectiveness and affordability because many countries in sub-Saharan Africa have severe resource constraints. In some countries, the health budget per person is less than $10 (£5.80; €8.35) a year. As a result, the panel that developed the guidelines—including clinicians from several African countries—followed the main recommendations made in previous relevant guidelines (including the 2003 statement of management of hypertension by WHO and the International Society of Hypertension) but adapted them to make them more appropriate to the resources available in many sub-Saharan African countries.The guidelines recommend that low dose thiazide diuretics (for example, hydrochlorothiazide 12.5 mg daily) should generally be used as first line drug treatment for hypertension, with the target blood pressure being <140 mm Hg systolic and <90 mm Hg diastolic in patients with uncomplicated hypertension. A lower target of <130 mm Hg and <80 mm Hg should be the aim in patients with established cardiovascular disease, diabetes, or chronic renal disease. Other drugs should only be used when there are compelling reasons, such as the use of angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor antagonists in patients who also have diabetes. Generic drugs should be used whenever possible. (Source: Susan Mayor BMJ  2003;327:1305, 6 December)

Standards of antenatal care for primary health care (PHC): midwives in the management of pregnant woment with gestational hypertention (GH) and gestational proteinuric hypertension (GPH)

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University of Natal
Pre-eclampsia is a hypertensive, multi-system disorder of pregnancy. This is a hazardous and potentially fatal condition. It affects all body systems and remains a major cause of maternal and perinatal morbidity and mortality in KwaZulu-Natal and worldwide.