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aldosteron antagonist diabetes

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https://www.readbyqxmd.com/read/27783554/is-the-currently-used-prescription-adjudication-date-a-good-proxy-for-calculating-medication-refill-adherence
#1
Corey A Lester, Kevin A Look, Michelle A Chui
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) adopted the proportion of days covered (PDC) calculation for use in their Five-Star Quality Rating System for Medicare Advantage and Prescription Drug Plans. This calculation uses the prescription adjudication date (i.e., date the prescription is billed to the benefits manager by a pharmacy) as a proxy for medication adherence. Adherence programs, such as automatic refill programs, have become commonplace in community pharmacy and have been identified by industry leaders as interfering with the ability to accurately measure adherence using PDC...
November 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27771983/potassium-supplementation-and-long-term-outcomes-in-chronic-peritoneal-dialysis-patients-with-end-stage-renal-disease-a-propensity-score-matching-study
#2
Yun-Fang Zhang, Qi Wang, Yan-Yan Su, Shen Yang, Jian Guo, Jie Luo, Jia-Min Tang, Hong-Yan Li
OBJECTIVE: In this retrospective matched-cohort study, the association between potassium supplementation and long-term outcomes was determined. METHODS: Chronic peritoneal dialysis (PD) patients, aged ≥ 16 years, being referred to four PD centers in China, with serum potassium levels ≤ 3.5 mEq/L on three consecutive monthly in Q4 2008 and without receiving oral potassium supplementation in the prior three months were included in this study. Patients were divided into two groups, either to receive (test group) or not (control group) oral potassium supplementation in both Q4 2008 and the subsequent follow-up period, until 31 December 2014...
October 24, 2016: Renal Failure
https://www.readbyqxmd.com/read/27754192/me-03-1-role-of-aldosterne-and-mineralocorticoid-receptor-in-salt-sensitive-hypertension
#3
Toshiro Fujita
The aldosterone/mineralocorticoid receptor (MR) pathway regulate renal excretory function and control BP. Notably, we identified Rac1 as a novel ligand-independent modulator of MR (Nat Med 2008), and found involvement of the Rac1-MR pathway in rodent models of salt-sensitive hypertension (JCI 2011). In the clinical trial (EVALUATE study), effects of MR antagonist on urinary albumin excretion were assessed in 304 hypertensive CKD patients receiving renin-angiotensin system (RAS) inhibitors and sub-grouped according to the estimated dietary salt intake (Lancet Endo & Diabetes 2014)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754085/os-19-08-the-activated-intrarenal-renin-angiotensin-systems-and-oxidative-stress-in-tubular-can-be-the-original-mechanism-of-renal-damage-in-primary-aldosteronism
#4
Yoshitsugu Iwakura, Ryo Morimoto, Kumi Kikuchi, Yoshikiyo Ono, Yuta Tezuka, Yasuko Tsukada, Masahiro Nezu, Yasuhiro Igarashi, Masataka Kudo, Akira Nishiyama, Sadayoshi Ito, Fumitoshi Satoh
OBJECTIVE: High prevalence of renal damage has been demonstrated in patients with primary aldosteronism (PA). However, the original mechanism and onset still be elucidated. The purpose of this study is to investigate the possible original mechanisms of renal damages in PA. DESIGN AND METHOD: Consecutive 72 patients with aldosterone producing adenoma (APA) and 70 patients with essential hypertension (EH) participated. No patients had renal damages defined as eGFR (based on Cystatin C) < 60 ml/min/1...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754015/br-04-1management-of-treatment-resistant-hypertension
#5
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753873/ish-aha-2-a-case-of-chronic-indolent-pheochromocytoma-which-caused-medically-controlled-hypertension-but-treatment-resistant-diabetes-mellitus
#6
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753857/sp-01-1-aldosterone-antagonists-for-the-treatment-of-hypertensive-nephropathy
#7
Toshiro Fujita
The aldosterone/mineralocorticoid receptor (MR) pathway regulate renal excretory function and control BP. Notably, we identified Rac1 as a novel ligand-independent modulator of MR (Nat Med 2008), and found involvement of the Rac1-MR pathway in rodent models of salt-sensitive hypertension (JCI 2011). In the clinical trial (EVALUATE study), effects of MR antagonist on urinary albumin excretion were assessed in 304 hypertensive CKD patients receiving renin-angiotensin system (RAS) inhibitors and sub-grouped according to the estimated dietary salt intake (Lancet Endo & Diabetes 2014)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27739264/st-segment-elevated-acute-myocardial-infarction-changing-profile-over-last-24-years
#8
Trinath Kumar Mishra, Biswajit Das
BACKGROUND: Coronary artery disease (CAD) is rising in epidemic proportions with India not being an exception. CAD in Indian scenario has its onset at a younger age with multitude of risk factors. OBJECTIVE: This study was carried out to obtain complete information about demographic profile, risk factors, clinical scenario, therapeutic modalities, natural course, outcome and changing profile of acute ST-segment elevated myocardial infarction (STEMI) patients. METHODS: This cross-sectional study was conducted in 45,122 acute STEMI patients admitted 1st March 1990 to 1st March 2014...
June 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27721847/refractory-and-resistant-hypertension-antihypertensive-treatment-failure-versus-treatment-resistance
#9
David A Calhoun
Resistant hypertension has for many decades been defined as difficult-to-treat hypertension in order to identify patients who may benefit from special diagnostic and/or therapeutic considerations. Recently, the term "refractory hypertension" has been proposed as a novel phenotype of antihypertensive failure, that is, patients whose blood pressure cannot be controlled with maximal treatment. Early studies of this phenotype indicate that it is uncommon, affecting less than 5% of patients with resistant hypertension...
September 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27692135/evaluation-of-chronic-obstructive-pulmonary-disease-copd-and-reduced-ejection-fraction-heart-failure-hrref-discharge-medication-prescribing-is-drug-therapy-concordant-with-national-guidelines-associated-with-a-reduction-in-30-day-readmissions
#10
Amy Richardson, Elizabeth Tolley, Jonathan Hartmann, Jasmine Reedus, Brandi Bowlin, Christopher Finch, Christopher W Sands, Timothy Self
INTRODUCTION: Approximately 1 in 5 hospitalized COPD patients are readmitted within 30 days of discharge. CHF coexists in more than 20% of patients with COPD, and is associated with early readmission for COPD. Reducing 30-day hospital readmissions for COPD is of intense current interest. METHODOLOGY: A retrospective chart review was performed to identify patients discharged with COPD exacerbation and HFrEF. The primary objective was to evaluate if discharge medication prescribing following guidelines for both COPD and HFrEF correlates with reduced 30-day readmission rates...
October 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27643149/me-03-1-role-of-aldosterne-and-mineralocorticoid-receptor-in-salt-sensitive-hypertension
#11
Toshiro Fujita
The aldosterone/mineralocorticoid receptor (MR) pathway regulate renal excretory function and control BP. Notably, we identified Rac1 as a novel ligand-independent modulator of MR (Nat Med 2008), and found involvement of the Rac1-MR pathway in rodent models of salt-sensitive hypertension (JCI 2011). In the clinical trial (EVALUATE study), effects of MR antagonist on urinary albumin excretion were assessed in 304 hypertensive CKD patients receiving renin-angiotensin system (RAS) inhibitors and sub-grouped according to the estimated dietary salt intake (Lancet Endo & Diabetes 2014)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643110/ish-aha-2-a-case-of-chronic-indolent-pheochromocytoma-which-caused-medically-controlled-hypertension-but-treatment-resistant-diabetes-mellitus
#12
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643094/sp-01-1-aldosterone-antagonists-for-the-treatment-of-hypertensive-nephropathy
#13
Toshiro Fujita
The aldosterone/mineralocorticoid receptor (MR) pathway regulate renal excretory function and control BP. Notably, we identified Rac1 as a novel ligand-independent modulator of MR (Nat Med 2008), and found involvement of the Rac1-MR pathway in rodent models of salt-sensitive hypertension (JCI 2011). In the clinical trial (EVALUATE study), effects of MR antagonist on urinary albumin excretion were assessed in 304 hypertensive CKD patients receiving renin-angiotensin system (RAS) inhibitors and sub-grouped according to the estimated dietary salt intake (Lancet Endo & Diabetes 2014)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643010/os-19-08-the-activated-intrarenal-renin-angiotensin-systems-and-oxidative-stress-in-tubular-can-be-the-original-mechanism-of-renal-damage-in-primary-aldosteronism
#14
Yoshitsugu Iwakura, Ryo Morimoto, Kumi Kikuchi, Yoshikiyo Ono, Yuta Tezuka, Yasuko Tsukada, Masahiro Nezu, Yasuhiro Igarashi, Masataka Kudo, Akira Nishiyama, Sadayoshi Ito, Fumitoshi Satoh
OBJECTIVE: High prevalence of renal damage has been demonstrated in patients with primary aldosteronism (PA). However, the original mechanism and onset still be elucidated. The purpose of this study is to investigate the possible original mechanisms of renal damages in PA. DESIGN AND METHOD: Consecutive 72 patients with aldosterone producing adenoma (APA) and 70 patients with essential hypertension (EH) participated. No patients had renal damages defined as eGFR (based on Cystatin C) < 60 ml/min/1...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642926/br-04-1management-of-treatment-resistant-hypertension
#15
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27526033/aldosterone-synthase-inhibition-improves-glucose-tolerance-in-zucker-diabetic-fatty-zdf-rats
#16
Anja Hofmann, Coy Brunssen, Mirko Peitzsch, Melanie Martin, Jennifer Mittag, Anett Jannasch, Felix Engelmann, Nicholas F Brown, Steven M Weldon, Jochen Huber, Rüdiger Streicher, Andreas Deussen, Graeme Eisenhofer, Stefan R Bornstein, Henning Morawietz
Plasma aldosterone is elevated in type 2 diabetes and obesity in experimental and clinical studies and can act to inhibit both glucose-stimulated insulin secretion by the β-cell and insulin signaling. Currently mineralocorticoid receptor antagonism is the best characterized treatment to ameliorate aldosterone-mediated effects. A second alternative is inhibition of aldosterone synthase, an approach with protective effects on end-organ damage in heart or kidney in animal models. The effect of aldosterone synthase inhibition on metabolic parameters in type 2 diabetes is not known...
October 2016: Endocrinology
https://www.readbyqxmd.com/read/27502849/long-term-changes-of-renal-function-in-relation-to-ace-inhibitor-angiotensin-receptor-blocker-dosing-in-patients-with-heart-failure-and-chronic-kidney-disease
#17
Hanna Fröhlich, Christoph Nelges, Tobias Täger, Vedat Schwenger, Rita Cebola, Johannes Schnorbach, Kevin M Goode, Syed Kazmi, Hugo A Katus, John G F Cleland, Andrew L Clark, Lutz Frankenstein
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have become cornerstones of therapy for chronic heart failure (CHF). Guidelines advise high target doses for ACEIs/ARBs, but fear of worsening renal function may limit dose titration in patients with concomitant chronic kidney disease (CKD). METHODS: In this retrospective observational study, we identified 722 consecutive patients with systolic CHF, stable CKD stage III/IV (estimated glomerular filtration rate [eGFR] 15-60 mL min(-1) 1...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27469372/reduced-blood-pressure-lowering-effect-of-catheter-based-renal-denervation-in-patients-with-isolated-systolic-hypertension-data-from-symplicity-htn-3-and-the-global-symplicity-registry
#18
Felix Mahfoud, George Bakris, Deepak L Bhatt, Murray Esler, Sebastian Ewen, Martin Fahy, David Kandzari, Kazuomi Kario, Giuseppe Mancia, Michael Weber, Michael Böhm
AIMS: Catheter-based renal artery denervation (RDN) has been shown to lower blood pressure (BP) in certain patients with uncontrolled hypertension. Isolated systolic hypertension (ISH) (systolic BP [SBP] ≥140 mmHg and diastolic BP <90 mmHg), characterized by increased vascular stiffness, is the predominant hypertensive phenotype in elderly patients. This study compared baseline characteristics and SBP change at 6 months between patients with ISH and combined systolic-diastolic hypertension (CH)...
July 28, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27445099/prevalence-and-characteristics-of-patients-with-resistant-hypertension-and-chronic-kidney-disease
#19
Úrsula Verdalles, Marian Goicoechea, Soledad Garcia de Vinuesa, Borja Quiroga, Isabel Galan, Eduardo Verde, Ana Perez de Jose, José Luño
: Resistant hypertension (RH) is a common problem in patients with chronic kidney disease (CKD). A decline in the glomerular filtration rate (GFR) and increased albuminuria are associated with RH; however, there are few published studies about the prevalence of this entity in patients with CKD. OBJECTIVE: To estimate the prevalence of RH in patients with different degrees of kidney disease and analyse the characteristics of this group of patients. METHODS: A total of 618 patients with hypertension and CKD stages i-iv were enrolled, of which 82 (13...
September 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27415977/therapeutic-modulation-of-aortic-stiffness
#20
Ahmed Muzhir Hussein, Ghazwan Shaaya, Rohit Arora, Ali Al-Khazaali, Khalid Al-Khafaji, Hanan K Helu
Aortic stiffness (AS) is an important predictor of cardiovascular morbidity in humans. The present review discusses the possible pathophysiological mechanisms of AS and focuses on a survey of different therapeutic modalities for decreasing AS. The influence of several nonpharmacological interventions is described: decrease body weight, diet, aerobic exercise training, music, and continuous positive airway pressure therapy. The effects of different pharmacological drug classes on AS are also discussed: antihypertensive drugs-renin-angiotensin-aldosterone system drugs, beta-blockers, alpha-blockers, diuretics, and calcium channel blockers (CCBs)-advanced glycation end product cross-link breakers, statins, oral anti-diabetics, anti-inflammatory drugs, vitamin D, antioxidant vitamins, and endothelin-1 receptor antagonists...
July 12, 2016: American Journal of Therapeutics
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