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  1. Article ; Online: Decisions about antihypertensive treatment should focus on reducing cardiovascular risk.

    Kahan, Thomas

    Lancet (London, England)

    2021  Volume 397, Issue 10285, Page(s) 1598–1599

    MeSH term(s) Antihypertensive Agents/therapeutic use ; Blood Pressure/drug effects ; Cardiovascular Diseases/drug therapy ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Heart Disease Risk Factors ; Humans ; Hypertension/drug therapy ; Hypertension/epidemiology ; Risk Factors
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2021-04-28
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(21)00877-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Low-dose combination of blood pressure-lowering medicines.

    Kahan, Thomas

    Lancet (London, England)

    2021  Volume 398, Issue 10305, Page(s) 1022–1023

    MeSH term(s) Antihypertensive Agents/therapeutic use ; Blood Pressure/drug effects ; Humans ; Hypertension/drug therapy
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2021-08-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(21)01964-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Strategies to identify patients for antihypertensive treatment.

    Kahan, Thomas

    Lancet (London, England)

    2019  Volume 394, Issue 10199, Page(s) 615–617

    MeSH term(s) Antihypertensive Agents ; Blood Pressure/drug effects ; Cardiovascular Diseases ; Humans ; Hypertension ; Retrospective Studies
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2019-07-25
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(19)31665-4
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  4. Article ; Online: Lack of associations between hospital rating and outcomes in patients with an acute coronary syndrome.

    Aspberg, Sara / Kahan, Thomas / Johansson, Fredrik

    BMJ open quality

    2024  Volume 13, Issue 1

    Abstract: Background: Public reporting of performance data has become a common tool in evaluation of healthcare providers. The rating may be misleading if the association between the measured variables and the outcome is weak.: Methods and results: Nationwide, ...

    Abstract Background: Public reporting of performance data has become a common tool in evaluation of healthcare providers. The rating may be misleading if the association between the measured variables and the outcome is weak.
    Methods and results: Nationwide, register-based, cohort study. All Swedish patients hospitalised with an acute coronary syndrome during the time periods 2006-2010 and 2015-2017 were included in the study. Possible associations between cardiovascular morbidity and mortality for these patients and ranking scores for each hospital in a Swedish healthcare quality register for acute coronary syndromes were analysed. We found no association between the ranking score and mortality, and no or weak associations between the ranking score and readmissions.
    Conclusions: Lack of associations between quality measurements and patient outcomes warrants improvement in ranking scores. Cautious use of the ranking results is necessary in comparisons between healthcare providers.
    MeSH term(s) Humans ; Acute Coronary Syndrome ; Cohort Studies ; Hospitals ; Quality of Health Care
    Language English
    Publishing date 2024-03-21
    Publishing country England
    Document type Journal Article
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2023-002475
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Guest Editorial Challenges in Resistant Hypertension.

    Kahan, Thomas

    European cardiology

    2018  Volume 11, Issue 1, Page(s) 18–19

    Abstract: Hypertension is the major risk factor for disease and premature death. Although the efficacy of antihypertensive therapy is undisputed, few patients reach target blood pressure. Steps to improve treatment and control include assessment of global ... ...

    Abstract Hypertension is the major risk factor for disease and premature death. Although the efficacy of antihypertensive therapy is undisputed, few patients reach target blood pressure. Steps to improve treatment and control include assessment of global cardiovascular risk for the individual patient, improving caregiver support, education and organisation, increasing treatment persistence, using out of office blood pressure monitoring more often, detecting secondary hypertension forms, and referring patients with remaining uncontrolled hypertension to a specialist hypertension centre. In conclusion, there is room for improvement of blood pressure control in hypertensive patients. The clinical benefit of improved blood pressure control may be considerable. This may be particularly true for patients with resistant hypertension.
    Language English
    Publishing date 2018-09-27
    Publishing country England
    Document type Journal Article ; Review
    ISSN 1758-3764
    ISSN (online) 1758-3764
    DOI 10.15420/ecr.2016:20:1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Estimation of aortic stiffness by finger photoplethysmography using enhanced pulse wave analysis and machine learning.

    Hellqvist, Henrik / Karlsson, Mikael / Hoffman, Johan / Kahan, Thomas / Spaak, Jonas

    Frontiers in cardiovascular medicine

    2024  Volume 11, Page(s) 1350726

    Abstract: Introduction: Aortic stiffness plays a critical role in the evolution of cardiovascular diseases, but the assessment requires specialized equipment. Photoplethysmography (PPG) and single-lead electrocardiogram (ECG) are readily available in healthcare ... ...

    Abstract Introduction: Aortic stiffness plays a critical role in the evolution of cardiovascular diseases, but the assessment requires specialized equipment. Photoplethysmography (PPG) and single-lead electrocardiogram (ECG) are readily available in healthcare and wearable devices. We studied whether a brief PPG registration, alone or in combination with single-lead ECG, could be used to reliably estimate aortic stiffness.
    Methods: A proof-of-concept study with simultaneous high-resolution index finger recordings of infrared PPG, single-lead ECG, and finger blood pressure (Finapres) was performed in 33 participants [median age 44 (range 21-66) years, 19 men] and repeated within 2 weeks. Carotid-femoral pulse wave velocity (cfPWV; two-site tonometry with SphygmoCor) was used as a reference. A brachial single-cuff oscillometric device assessed aortic pulse wave velocity (aoPWV; Arteriograph) for further comparisons. We extracted 136 established PPG waveform features and engineered 13 new with improved coupling to the finger blood pressure curve. Height-normalized pulse arrival time (NPAT) was derived using ECG. Machine learning methods were used to develop prediction models.
    Results: The best PPG-based models predicted cfPWV and aoPWV well (root-mean-square errors of 0.70 and 0.52 m/s, respectively), with minor improvements by adding NPAT. Repeatability and agreement were on par with the reference equipment. A new PPG feature, an amplitude ratio from the early phase of the waveform, was most important in modelling, showing strong correlations with cfPWV and aoPWV (
    Conclusion: Using new features and machine learning methods, a brief finger PPG registration can estimate aortic stiffness without requiring additional information on age, anthropometry, or blood pressure. Repeatability and agreement were comparable to those obtained using non-invasive reference equipment. Provided further validation, this readily available simple method could improve cardiovascular risk evaluation, treatment, and prognosis.
    Language English
    Publishing date 2024-03-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2024.1350726
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  7. Article ; Online: Target blood pressure in patients at high cardiovascular risk.

    Kahan, Thomas

    Lancet (London, England)

    2017  Volume 389, Issue 10085, Page(s) 2170–2172

    MeSH term(s) Antihypertensive Agents ; Blood Pressure/drug effects ; Blood Pressure Determination ; Blood Pressure Monitoring, Ambulatory ; Cardiovascular Diseases ; Humans ; Hypertension ; Risk Factors
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2017-04-05
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(17)30935-2
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  8. Article ; Online: Blood pressure in atrial fibrillation and in sinus rhythm during ambulatory blood pressure monitoring: data from the TEMPLAR project.

    Lundwall, Kristina / Kahan, Thomas / Omboni, Stefano

    Hypertension research : official journal of the Japanese Society of Hypertension

    2023  Volume 47, Issue 2, Page(s) 435–444

    Abstract: The coexistence of hypertension and atrial fibrillation (AF) is common and accounts for a worse prognosis. Uncertainties exist regarding blood pressure (BP) measurements in AF patients by automated oscillometric devices. The Microlife WatchBP 03 AFIB ... ...

    Abstract The coexistence of hypertension and atrial fibrillation (AF) is common and accounts for a worse prognosis. Uncertainties exist regarding blood pressure (BP) measurements in AF patients by automated oscillometric devices. The Microlife WatchBP 03 AFIB ambulatory BP monitoring (ABPM) device including an AF algorithm with each measurement was used in 430 subjects aged >65 years referred for ABPM and with assumed paroxysmal AF to perform intra-individual comparisons of BP during both AF-indicated and sinus rhythm. Only subjects with >30% of measurements indicating AF and episodes >30 min for assumed AF and for sinus rhythm were included. Mean age was 78 ± 7 years, 43% were male, 77% hypertensive, and 72% were treated. Compared to sinus rhythm, 24-h mean arterial pressure was similar (87.2 ± 9.5 vs 87.5 ± 10.6 mm Hg, p = 0.47), whereas 24-h systolic BP tended to be lower (123.6 ± 13.9 vs 124.7 ± 16.1 mm Hg, p = 0.05) and night-time diastolic BP higher (64.6 ± 10.9 vs 63.3 ± 10.4 mm Hg, p = 0.01) in assumed AF. Diastolic (not systolic) BP variability was higher in AF (p < 0.001). Results were similar with heart rates <90 and ≥90 bpm. In conclusion, this is the first study to use intra-individual comparisons of averaged BP during an ABPM in assumed paroxysmal AF and sinus rhythm. Our results imply that ABPM is feasible and informative also in patients with AF. We also suggest that an AF detection algorithm offers a new approach to evaluate the reliability of averaged BP values in AF compared to SR during an ABPM.
    MeSH term(s) Humans ; Male ; Aged ; Aged, 80 and over ; Female ; Blood Pressure/physiology ; Atrial Fibrillation ; Blood Pressure Monitoring, Ambulatory ; Reproducibility of Results ; Hypertension
    Language English
    Publishing date 2023-10-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 1175297-x
    ISSN 1348-4214 ; 0916-9636
    ISSN (online) 1348-4214
    ISSN 0916-9636
    DOI 10.1038/s41440-023-01473-x
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  9. Article ; Online: Safety of digoxin use in patients with hypertensive heart disease and atrial fibrillation.

    Kahan, Thomas

    Journal of hypertension

    2015  Volume 33, Issue 7, Page(s) 1371–1372

    MeSH term(s) Anti-Arrhythmia Agents/adverse effects ; Atrial Fibrillation/drug therapy ; Digoxin/adverse effects ; Female ; Humans ; Hypertension/mortality ; Male
    Chemical Substances Anti-Arrhythmia Agents ; Digoxin (73K4184T59)
    Language English
    Publishing date 2015-07
    Publishing country England
    Document type Comment ; Editorial
    ZDB-ID 605532-1
    ISSN 1473-5598 ; 0263-6352 ; 0952-1178
    ISSN (online) 1473-5598
    ISSN 0263-6352 ; 0952-1178
    DOI 10.1097/HJH.0000000000000628
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  10. Article ; Online: Pågående RAAS-blockad bör behållas vid covid-19.

    Spaak, Jonas / Kahan, Thomas

    Lakartidningen

    2020  Volume 117

    Abstract: SARS-coronavirus 2 (SARS-CoV-2) enters the host-cells by binding the transmembraneous angiotensin converting enzyme 2 (ACE2) when causing coronavirus disease 2019 (COVID-19). The role of angiotensin converting enzyme inhibitors (ACE) and angiotensin II ... ...

    Title translation Hypertension, RAAS blockade and risk in COVID-19 patients.
    Abstract SARS-coronavirus 2 (SARS-CoV-2) enters the host-cells by binding the transmembraneous angiotensin converting enzyme 2 (ACE2) when causing coronavirus disease 2019 (COVID-19). The role of angiotensin converting enzyme inhibitors (ACE) and angiotensin II receptor blockers (ARB) in COVID-19 is debated. Several well-conducted observational studies show no increased risk from RAAS blockade in COVID-19 patients and are detailed in this brief review. The Swedish Society of Hypertension, Stroke and Vascular Medicine supports current recommendations that ongoing RAAS blockade should be maintained in patients with COVID-19.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections ; Humans ; Hypertension ; Pandemics ; Pneumonia, Viral ; Renin-Angiotensin System/drug effects ; SARS-CoV-2
    Keywords covid19
    Language Swedish
    Publishing date 2020-06-23
    Publishing country Sweden
    Document type Journal Article ; Review
    ZDB-ID 391010-6
    ISSN 1652-7518 ; 0023-7205
    ISSN (online) 1652-7518
    ISSN 0023-7205
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