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Cardiology Clinics

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https://www.readbyqxmd.com/read/28411904/hypertension-from-pre-hypertension-to-heart-failure
#1
EDITORIAL
Kenneth A Jamerson, James Brian Byrd
No abstract text is available yet for this article.
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411903/left-atrial-appendage-closure-device-in-atrial-fibrillation
#2
REVIEW
Michael C Giudici, Prashant D Bhave
The relationship of stroke and atrial fibrillation seems to become more complex as we gain more knowledge of the issue. Recent studies have questioned the temporal relationship between the two, which also questions causation. Left atrial appendage closure is an attractive, but unproven technology when compared with the 50-year experience with warfarin. In a patient who is on warfarin and having no issues with bleeding, medication intolerance, or lack of efficacy, it is difficult to justify stopping the drug and placing a closure device as sole therapy to prevent a stroke...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411902/contemporary-drug-eluting-stent-platforms-design-safety-and-clinical-efficacy
#3
REVIEW
Ramon A Partida, Robert W Yeh
First-generation drug-eluting stents significantly improved treatment of coronary disease, decreasing rates of revascularization. This was offset by high rates of late adverse events, driven primarily by stent thrombosis. Research and design improvements of individual DES platform components led to next-generation devices with superior clinical safety and efficacy profiles compared with bare-metal stents and first-generation drug-eluting stents. These design improvements and features are explored, and their resulting clinical safety and efficacy reviewed, focusing on platforms approved by the Food and Drug Administration currently widely used in the United States...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411901/the-role-of-implantable-hemodynamic-monitors-to-manage-heart-failure
#4
REVIEW
William T Abraham
Heart failure is associated with high rates of hospitalization and rehospitalization, resulting in substantial clinical and economic burden. Current approaches to monitoring patients with heart failure have done little to reduce these high rates of heart failure hospitalization. Implantable hemodynamic monitors have been developed to remotely provide direct measurement of intracardiac and pulmonary artery pressures in ambulatory patients with heart failure. These devices have the potential to direct day-to-day management of patients with heart failure to reduce hospitalization rates...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411900/contemporary-approaches-to-patients-with-heart-failure
#5
REVIEW
Sumeet S Mitter, Clyde W Yancy
Incident heart failure and the burden of hospitalization may be demonstrating a decline. However, as the population ages, the prevalence of heart failure continues to increase. Mortality among heart failure patients is increasingly due to non-cardiovascular causes. Current evidence-based therapy for heart failure has improved heart failure related mortality. Current efforts should be directed toward optimizing evidence based medical and device therapy, reducing morbidity, and increasing quality of life with heart failure...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411899/device-directed-therapy-for-resistant-hypertension
#6
REVIEW
Sinan S Tankut, Ayhan Yoruk, John D Bisognano
Hypertension remains a significant risk factor for an array of diseases despite advancements in pharmacotherapy. Patients with resistant hypertension who do not respond to conventional medical treatments and lifestyle modifications are especially at risk for poor health outcomes. With the increasing awareness of resistant hypertension, ever-evolving research efforts continue to focus on innovative interventions, including renal denervation, median nerve stimulation, and baroreceptor activation therapy. This article reviews the current evidence and summarizes previous clinical trials for each of these interventions...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411898/balancing-overscreening-and-underdiagnosis-in-secondary-hypertension-the-case-of-fibromuscular-dysplasia
#7
REVIEW
Marcel Ruzicka, Sarah E Kucharski, Swapnil Hiremath
Knowledge about fibromuscular dysplasia (FMD) has broadened over the last several decades. It is no longer considered a rare and benign entity limited to renal arteries and causing just hypertension. It affects other parts of the arterial tree nearly as frequently as the renal arteries. Complications of undiagnosed and untreated extrarenal FMD can be debilitating and life threatening. However, this disease, specifically extrarenal FMD, is not well known to many physicians and patients. Combined with the nonspecific symptoms and signs of the disease, this leads to delayed diagnosis and missed opportunity to prevent serious vascular complications...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411897/management-of-essential-hypertension
#8
REVIEW
Keith C Ferdinand, Samar A Nasser
The treatment of essential hypertension is one of the most critical interventions to decrease cardiovascular morbidity and mortality. The prevalence of hypertension in the US varies across race/ethnicity with African Americans having the highest prevalence and overall less control among racial/ethnic minorities compared with non-Hispanic whites. Therapeutic lifestyle modifications are the bedrock of essential hypertension control, but most patients with hypertension will require pharmacotherapy, usually with multiple medications often in combination...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411896/psychosocial-factors-and-hypertension-a-review-of-the-literature
#9
REVIEW
Adolfo G Cuevas, David R Williams, Michelle A Albert
Black people have the highest prevalence of hypertension in the United States. Evidence suggests that psychosocial factors increase the risks for hypertension and help to account for racial differences in this condition. This article reviews research on psychosocial factors and hypertension, and contextualizes the findings within a health disparities framework. A wide range of psychosocial factors contribute to hypertension but understanding remains limited about how these factors relate to each other and accumulate to contribute to hypertension disparities...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411895/the-environment-and-blood-pressure
#10
REVIEW
Robert D Brook
A host of environmental factors can significantly increase arterial blood pressure (BP) including cold temperature, high altitude, loud noises, and ambient air pollutants. Although brief exposures acutely elevate BP, over the long term, chronic exposures may be capable of promoting the development of sustained hypertension. Given their omnipresent nature, environmental factors may play a role in worsening BP control and heightening overall cardiovascular risk at the global public health level.
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411894/the-effects-of-dietary-factors-on-blood-pressure
#11
REVIEW
Lawrence J Appel
Evidence supports that multiple dietary factors affect blood pressure (BP). Dietary changes that effectively lower BP are weight loss, reduced sodium intake, increased potassium intake, moderation of alcohol intake, and Dietary Approaches to Stop Hypertension-style and vegetarian dietary patterns. In view of the increasing levels of BP in children and adults and the continuing epidemic of BP-related cardiovascular and renal diseases, efforts to reduce BP in both nonhypertensive and hypertensive individuals are warranted...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28411893/genomic-approaches-to-hypertension
#12
REVIEW
Sheriff N Dodoo, Ivor J Benjamin
Genomic insights and analyses of Mendelian hypertension (HTN) syndromes and Genome-Wide Association study (GWAS) on essential hypertension have contributed to the depth of understanding of the genetics origins of hypertension. Mendelian syndromes are important for the field, since such knowledge leads to specific insights about disease pathogenesis and the potential for precision medicine. The clinical impact of findings of on essential hypertension is continuously evolving, and the insights accrued will refine efforts to combat the societal impact of hypertension...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886794/five-reasons-why-global-health-matters-to-cardiologists
#13
EDITORIAL
Gerald S Bloomfield, Melissa S Burroughs Peña
No abstract text is available yet for this article.
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886793/innovative-approaches-to-hypertension-control-in-low-and-middle-income-countries
#14
REVIEW
Rajesh Vedanthan, Antonio Bernabe-Ortiz, Omarys I Herasme, Rohina Joshi, Patricio Lopez-Jaramillo, Amanda G Thrift, Jacqui Webster, Ruth Webster, Karen Yeates, Joyce Gyamfi, Merina Ieremia, Claire Johnson, Jemima H Kamano, Maria Lazo-Porras, Felix Limbani, Peter Liu, Tara McCready, J Jaime Miranda, Sailesh Mohan, Olugbenga Ogedegbe, Brian Oldenburg, Bruce Ovbiagele, Mayowa Owolabi, David Peiris, Vilarmina Ponce-Lucero, Devarsetty Praveen, Arti Pillay, Jon-David Schwalm, Sheldon W Tobe, Kathy Trieu, Khalid Yusoff, Valentin Fuster
Elevated blood pressure, a major risk factor for ischemic heart disease, heart failure, and stroke, is the leading global risk for mortality. Treatment and control rates are very low in low- and middle-income countries. There is an urgent need to address this problem. The Global Alliance for Chronic Diseases sponsored research projects focus on controlling hypertension, including community engagement, salt reduction, salt substitution, task redistribution, mHealth, and fixed-dose combination therapies. This paper reviews the rationale for each approach and summarizes the experience of some of the research teams...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886792/diagnosis-and-management-of-endomyocardial-fibrosis
#15
REVIEW
Andrea Beaton, Ana Olga Mocumbi
Endomyocardial fibrosis (EMF) remains an important cause of restrictive cardiomyopathy worldwide. Patients cluster in specific geographic locations and are almost universally living in extreme poverty. Specific etiology remains elusive and is likely multifactorial. Untreated EMF has a very poor prognosis. Medical management can mitigate symptoms for a time but has no curative benefit. Early surgical interventions may improve survival but are not readily available in most EMF-endemic regions. Increased awareness, advocacy, and research are needed to further understand this neglected tropical cardiomyopathy and to improve survival of those affected...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886791/environmental-exposures-and-cardiovascular-disease-a-challenge-for-health-and-development-in-low-and-middle-income-countries
#16
REVIEW
Melissa S Burroughs Peña, Allman Rollins
Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes, including hypertension, coronary heart disease, stroke, and cardiovascular mortality. Although populations in low- and middle-income countries are disproportionately exposed to environmental pollution, evidence linking these exposures to cardiovascular disease is derived from populations in high-income countries...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886790/cardiac-disease-associated-with-human-immunodeficiency-virus-infection
#17
REVIEW
Gerald S Bloomfield, Claudia Leung
Over the last 2 decades human immunodeficiency virus (HIV) infection has become a chronic disease requiring long-term management. Aging, antiretroviral therapy, chronic inflammation, and several other factors contribute to the increased risk of cardiovascular disease in patients infected with HIV. In low-income and middle-income countries where antiretroviral therapy access is limited, cardiac disease is most commonly related to opportunistic infections and end-stage manifestations of HIV/acquired immunodeficiency syndrome, including HIV-associated cardiomyopathy, pericarditis, and pulmonary arterial hypertension...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886789/electrophysiology-in-the-developing-world-challenges-and-opportunities
#18
REVIEW
Michael Bestawros
As a subset of the growing epidemic of cardiovascular morbidity and mortality in low-income and middle-income countries (LMICs), the significant burdens of heart rhythm disorders also increase. Effective diagnostic and treatment modalities exist, but financial resources and expertise are limited. Cost-effective strategies exist to address most of these limitations, but many surmountable barriers need to be overcome to introduce and improve electrophysiologic care in LMICs. In this article, current and potential solutions are offered for the diagnostic and therapeutic challenges of managing bradyarrhythmias and tachyarrhythmias...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886788/chagas-cardiomyopathy-clinical-presentation-and-management-in-the-americas
#19
REVIEW
Catherine Pastorius Benziger, Gabriel Assis Lopes do Carmo, Antonio Luiz Pinho Ribeiro
The initial infection of Chagas disease is typically asymptomatic, but approximately 30% of people will progress to a chronic cardiac form, and others develop the gastrointestinal form. Death is often sudden due to arrhythmias or progressive heart failure. Prevention through vector control programs and blood bank screening, along with strengthened surveillance systems and rapid information sharing, are key to decreasing disease burden globally. The epidemiology, diagnostic evaluation, diagnosis, and treatment of acute and chronic Chagas cardiac disease are discussed with focus on educating the primary care professionals and general cardiologists in nonendemic areas who have limited experience treating this disease...
February 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/27886787/rheumatic-heart-disease-the-unfinished-global-agenda
#20
REVIEW
Shanti Nulu, Gene Bukhman, Gene F Kwan
Primarily affecting the young, rheumatic heart disease (RHD) is a neglected chronic disease commonly causing premature morbidity and mortality among the global poor. Standard clinical prevention and treatment is based on studies from the early antimicrobial era, as research investment halted soon after the virtual eradication of the disease from developed countries. The emergence of new global data on disease burden, new technologies, and a global health equity platform have revitalized interest and investment in RHD...
February 2017: Cardiology Clinics
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