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https://www.readbyqxmd.com/read/29233053/evaluation-of-a-pharmacist-driven-aldosterone-antagonist-stewardship-program-in-patients-with-heart-failure
#1
Eric R Sparks, Janna C Beavers
OBJECTIVE: To evaluate the impact of a pharmacist-driven initiative to optimize aldosterone antagonist use in patients with heart failure with reduced ejection fraction (HFrEF) at a large community hospital. METHODS: This single-center, retrospective cohort study compared patients with heart failure before and after the implementation of the initiative. Data for pre- and postinitiative patients were retrospectively collected to assess patient characteristics and aldosterone antagonist use...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29227582/role-of-the-sodium-hydrogen-exchanger-in-mediating-the-renal-effects-of-drugs-commonly-used-in-the-treatment-of-type-2-diabetes
#2
REVIEW
Milton Packer
Diabetes is characterized by an increased activity of the sodium-hydrogen exchanger (NHE) in the glomerulus and renal tubules, which contributes importantly to the development of nephropathy. Despite the established role played by the exchanger in experimental studies, it has not been specifically targeted by those seeking to develop novel pharmacological treatments for diabetes. This review demonstrates that many existing drugs that are commonly prescribed to patients with diabetes act on the NHE1 and NHE3 isoforms in the kidney...
December 11, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29212952/dysregulated-aldosterone-secretion-in-persons-of-african-descent-with-endothelin-1-gene-variants
#3
Jia W Tan, Tina Gupta, Worapaka Manosroi, Tham M Yao, Paul N Hopkins, Jonathan S Williams, Gail K Adler, Jose R Romero, Gordon H Williams
Compared with persons of European descent (ED), persons of African descent (AD) have lower aldosterone (ALDO) levels, with the assumption being that the increased cardiovascular disease (CVD) risk associated with AD is not related to ALDO. However, the appropriateness of the ALDO levels for the volume status in AD is unclear. We hypothesized that, even though ALDO levels are lower in AD, they are inappropriately increased, and therefore, ALDO could mediate the increased CVD in AD. To test this hypothesis, we analyzed data from HyperPATH - 1,788 individuals from the total cohort and 765 restricted to ED-to-AD in a 2:1 match and genotyped for the endothelin-1 gene (EDN1)...
December 7, 2017: JCI Insight
https://www.readbyqxmd.com/read/29202493/health-related-quality-of-life-and-mental-health-in-primary-aldosteronism-a-systematic-review
#4
Marieke S Velema, Aline H de Nooijer, Vivian W G Burgers, Ad R M M Hermus, Henri J L M Timmers, Jacques W M Lenders, Olga Husson, Jaap Deinum
The aim of this review was to determine the impact of primary aldosteronism on health-related quality of life (HRQoL) and mental health. We performed a systematic literature search up to July 2017 in six electronic databases. First, we screened the articles derived from this search based on title and abstract. Second, the selected studies were systematically reviewed and checked for our predefined inclusion criteria. The search yielded 753 articles, of which 15 studies met our inclusion criteria. Untreated patients with primary aldosteronism showed an impaired physical and mental HRQoL as compared to the general population...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29191321/abdominal-obesity-is-associated-with%C3%A2-an%C3%A2-increased-risk-of-all-cause-mortality-in-patients-with-hfpef
#5
RANDOMIZED CONTROLLED TRIAL
Tetsuro Tsujimoto, Hiroshi Kajio
BACKGROUND: There is a lack of studies that evaluate the association between abdominal obesity and subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: The present study aimed to assess the association between abdominal obesity and risk of all-cause mortality in patients with HFpEF. METHODS: The present study used data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial...
December 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29188356/-antihypertensive-therapy-in-the-elderly
#6
REVIEW
J Schrader, B Schrader
Arterial hypertension is the most common modifiable risk factor for cerebrovascular and cardiovascular morbidity and mortality in old age. The prevention of cognitive brain disorders is also a therapeutic goal of long-term treatment of hypertension. Older patients also have a higher risk of developing cardiovascular diseases and therefore benefit from a relatively moderate reduction in blood pressure. With respect to the high prevalence of hypertension in old age and the increasing incidence with time, the therapy of hypertension is becoming increasingly more important to achieve an improved prognosis for patients along with a reduction of costs...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29164516/mineralocorticoid-receptor-antagonism-protects-the-aorta-from-vascular-smooth-muscle-cell-proliferation-and-collagen-deposition-in-a-rat-model-of-adrenal-aldosterone-producing-adenoma
#7
Yongji Yan, Chao Wang, Yiqin Lu, Huijie Gong, Zhun Wu, Xin Ma, Hongzhao Li, Baojun Wang, Xu Zhang
The number of patients with adrenal aldosterone-producing adenomas (APAs) has gradually increased. However, even after adenoma resection, some patients still suffer from high systolic blood pressure (SBP), which is possibly due to great arterial remodeling. Moreover, mineralocorticoid receptors (MRs) were found to be expressed in vascular smooth muscle cells (VSMCs). This study aims to determine whether MR antagonism protects the aorta from aldosterone-induced aortic remolding. Male rats were subcutaneously implanted with an osmotic minipumps and randomly divided into four groups: control; aldosterone (1 μg/h); aldosterone plus a specific MR antagonist, eplerenone (100 mg/kg/day); and aldosterone plus a vasodilator, hydralazine (25 mg/kg/day)...
November 21, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/29154425/influence-of-renal-impairment-on-aldosterone-status-calcium-metabolism-and-vasopressin-activity-in-outpatients-with-systolic-heart-failure
#8
Helle Bosselmann, Niels Tonder, György Sölétormos, Freja Gaborit, Kasper Rossing, Kasper Iversen, Jens Peter Goetze, Finn Gustafsson, Morten Schou
AIMS: Renal dysfunction (RD) is associated with increased morbidity and mortality in heart failure (HF). At present, no specific treatment for patients with RD, to prevent progression of HF, has been developed. How different hormone axes-and thereby potential treatment options-are affected by RD in HF warrants further investigations. METHODS AND RESULTS: Patients with left ventricular ejection fraction (LVEF) <0.45% were enrolled prospectively from an outpatient HF clinic...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29150654/primary-aldosteronism-patients-show-skin-alterations-and-abnormal-activation-of-glucocorticoid-receptor-in-keratinocytes
#9
Julia Boix, Judit Bigas, Lisa M Sevilla, Maurizio Iacobone, Marilisa Citton, Francesca Torresan, Brasilina Caroccia, Gian Paolo Rossi, Paloma Pérez
Primary aldosteronism (PA) is a disease characterized by high aldosterone levels caused by benign adrenal tumors being the most frequent cause of secondary hypertension. Aldosterone plays vital physiological roles through the mineralocorticoid receptor (MR) but in certain cell types, it can also activate the glucocorticoid (GC) receptor (GR). Both MR and GR are structurally and functionally related and belong to the same family of ligand-dependent transcription factors that recognize identical GC regulatory elements (GREs) on their target genes...
November 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29150471/biochemical-monitoring-after-initiation-of-aldosterone-antagonist-therapy-in-users-of-renin-angiotensin-system-blockers-a-uk-primary-care-cohort-study
#10
Sarah-Jo Sinnott, Kathryn E Mansfield, Morten Schmidt, Krishnan Bhaskaran, Liam Smeeth, Dorothea Nitsch, Laurie A Tomlinson
OBJECTIVE: To determine the frequency of biochemical monitoring after initiation of aldosterone antagonists(AA) in patients also using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB). SETTING: UK primary care. PARTICIPANTS: ACEI/ARB users who initiated AA between 2004 and 2014. OUTCOMES: We calculated the proportions with: (1) biochemical monitoring ≤2 weeks post initiation of AA, (2) adverse biochemical values ≤2 months (potassium ≥6 mmol/L, creatinine ≥220 µmol/L and ≥30% increase in creatinine from baseline) and (3) discontinuers of AA in those with an adverse biochemical value...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29149346/novel-pathways-of-endocrine-disruption-through-pesticides-interference-with-human-mineralocorticoid-receptors
#11
Jianyun Zhang, Xin Huang, Hongling Liu, Weiping Liu, Jing Liu
Mineralocorticoid receptor (MR) is one member of the steroid receptor family. In addition to its important role in Na+/K+ homeostasis, MR is reported as a tumor-suppressor in carcinogenesis. So far, little was known about the ability of pesticides to interfere with MR. In this study, a total of 43 pesticides and/or metabolites were investigated for their potential effects on human MR. None of the tested pesticides exhibited MR agonistic potency, while 16 compounds showed antagonistic activities. Further investigations indicated that these 16 chemicals individually antagonized aldosterone-induced alkaline phosphatase expression in vascular smooth muscle cells and aldosterone-inhibited hepatocellular carcinoma cell proliferation at higher concentrations, and the mixture of these 16 pesticides at environmentally relevant concentrations significantly disrupted MR activity...
November 15, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29148144/systolic-blood-pressure-and-cardiovascular-outcomes-in-heart-failure-with-preserved-ejection-fraction-an-analysis-of-the-topcat-trial
#12
Senthil Selvaraj, Brian Claggett, Sanjiv J Shah, Inder Anand, Jean L Rouleau, Akshay S Desai, Eldrin F Lewis, Bertram Pitt, Nancy K Sweitzer, Marc A Pfeffer, Scott D Solomon
AIMS: Recent guidelines have advocated for stricter systolic blood pressure (SBP) control in heart failure with preserved ejection fraction (HFpEF), though data regarding the optimal SBP in HFpEF are sparse. METHODS AND RESULTS: We analysed participants from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study with available baseline and 8-week visit SBP data (n = 1645). We related baseline SBP to several efficacy and safety outcomes...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29140411/effect-of-angiotensin-ii-and-acth-on-adrenal-blood-flow-in-the-male-rat-adrenal-gland-in-vivo
#13
Abdul J Shah, Tamas Kriska, Kathryn M Gauthier, John R Falck, William B Campbell
Angiotensin II (Ang II) and adrenocorticotropic hormone (ACTH) regulate adrenal vascular tone in vitro through endothelial and/or zona glomeulosa cell-derived mediators. The role of these mediators in regulating adrenal blood flow (ABF) and mean arterial pressure (MAP) was examined in anesthetized rats. Ang II (0.01-100 ng/kg) increased ABF (maximal increase of 97.2 ± 6.9 perfusion units (PU) at 100 ng/kg) and MAP (basal, 115 ± 7 mm Hg; Ang II, 163 ± 5 mm Hg). ACTH (0.1-1000 ng/kg) also increased ABF (maximum increase of 91...
November 13, 2017: Endocrinology
https://www.readbyqxmd.com/read/29129576/cardiometabolic-outcomes-and-mortality-in-medically-treated-primary-aldosteronism-a-retrospective-cohort-study
#14
Gregory L Hundemer, Gary C Curhan, Nicholas Yozamp, Molin Wang, Anand Vaidya
BACKGROUND: Mineralocorticoid receptor (MR) antagonists are the recommended medical therapy for primary aldosteronism. Whether this recommendation effectively reduces cardiometabolic risk is not well understood. We aimed to investigate the risk of incident cardiovascular events in patients with primary aldosteronism treated with MR antagonists compared with patients with essential hypertension. METHODS: We did a cohort study using patients from a research registry from Brigham and Women's Hospital, Massachusetts General Hospital, and their affiliated partner hospitals...
November 9, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29119585/effects-of-dopamine-receptor-antagonist-antipsychotic-therapy-on-blood-pressure
#15
REVIEW
N H Gonsai, V H Amin, C G Mendpara, R Speth, G M Hale
WHAT IS KNOWN AND OBJECTIVE: Hypertension, a major risk factor for adverse cardiovascular events, such as stroke and myocardial infarction, affects 80 million American adults. The aetiology of hypertension is multifaceted and difficult to identify. Dopamine receptors, especially those in the kidneys, play a role in blood pressure regulation, and alterations in their function can cause hypertension. The objective of this review was to investigate the association between the use of dopamine antagonists with hypertension focusing especially on second-generation antipsychotics, like clozapine that is D4 receptor antagonist...
November 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29105958/additivity-of-nebivolol-valsartan-single-pill-combinations-versus-other-single-pill-combinations-for-hypertension
#16
Jack Ishak, Michael Rael, Henry Punzi, Alan Gradman, Lynn M Anderson, Mehul Patel, Sanjida Ali, William Ferguson, Joel Neutel
The single-pill combination (SPC) comprising nebivolol (5 mg), a vasodilatory β1 -selective antagonist/β3 -agonist, and valsartan (80 mg), a renin-angiotensin-aldosterone system inhibitor, is the only Food and Drug Administration-approved β-blocker/renin-angiotensin-aldosterone system inhibitor SPC for hypertension. Additive effects of four nebivolol/valsartan SPC doses (5 mg/80 mg, 5/160 mg, 10/160 mg, 10/320 mg nebivolol/valsartan) were compared with five Food and Drug Administration-approved non-β-blocker/renin-angiotensin-aldosterone system inhibitor SPCs (aliskiren/hydrochlorothiazide, aliskiren/amlodipine, valsartan/amlodipine, aliskiren/valsartan, and telmisartan/amlodipine)...
November 5, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29102378/online-extraction-of-antihypertensive-drugs-and-their-metabolites-from-untreated-human-serum-samples-using-restricted-access-carbon-nanotubes-in-a-column-switching-liquid-chromatography-system
#17
Henrique Dipe de Faria, Carolina Tosin Bueno, Jose Eduardo Krieger, Eduardo Moacyr Krieger, Alexandre Costa Pereira, Paulo Caleb Júnior Lima Santos, Eduardo Costa Figueiredo
A novel analytical method was developed to determine 5 antihypertensive drugs of different pharmacological classes (angiotensin-converting enzyme inhibitors, calcium channel blockers, α-2 adrenergic receptor agonists, angiotensin II receptor blockers, and aldosterone receptor antagonists) and some of their metabolites in human serum. The untreated samples were directly analyzed in a column switching system using an extraction column packed with restricted access carbon nanotubes (RACNTs) in an ultra-high performance liquid chromatography coupled to a mass spectrometer (UHPLC-MS/MS)...
October 31, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/29101146/effect-of-cardiologist-care-on-6-month-outcomes-in-patients-discharged-with-heart-failure-results-from-an-observational-study-based-on-administrative-data
#18
Vera Maria Avaldi, Jacopo Lenzi, Stefano Urbinati, Dario Molinazzi, Carlo Descovich, Anselmo Campagna, Martina Taglioni, Angelo Fioritti, Maria Pia Fantini
OBJECTIVES: To evaluate the effect of cardiologist care on adherence to evidence-based secondary prevention medications, mortality and readmission within 6 months of discharge in patients with heart failure (HF). DESIGN: Retrospective observational study based on administrative data. SETTING: Local Healthcare Authority (LHA) of Bologna, one of the largest LHAs of Italy with ~870 000 inhabitants. PARTICIPANTS: All patients residing in the LHA of Bologna discharged from hospital with a diagnosis of HF between 1 January 2015 and 31 December 2015...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29099925/quality-of-life-in-primary-aldosteronism-a-comparative-effectiveness-study-of-adrenalectomy-and-medical-treatment
#19
Marieke Velema, Tanja Dekkers, Ad Hermus, Henri Timmers, Jacques Lenders, Hans Groenewoud, Leo Schultze Kool, Johan Langenhuijsen, Aleksander Prejbisz, Gert-Jan van der Wilt, Jaap Deinum
Context: In primary aldosteronism (PA) two subtypes are distinguished: aldosterone-producing adenoma and bilateral adrenal hyperplasia. In general these are treated by adrenalectomy and mineralocorticoid receptor antagonists respectively. Objective: To compare the effects of surgical treatment and medical treatment on quality of life (QoL). Design: Post-hoc comparative effectiveness study within the SPARTACUS trial. Setting: Twelve Dutch hospitals and one Polish hospital...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29098619/the-positive-effects-of-exercise-in-chemotherapy-related-cardiomyopathy
#20
Cavarretta Elena, Mastroiacovo Giorgio, Lupieri Annik, Frati Giacomo, Peruzzi Mariangela
Anthracyclines such as doxorubicin, daunorubicin, epirubicin, mitoxantrone and idarubicin, are powerful chemotherapeutic drugs used both in children and adult populations. Their properties made them particularly suitable for a large variety of neoplasms including breast adenocarcinoma, small cell lung cancer and acute leukemia. Early and late anthracycline-induced cardiotoxicity is a well-known phenomenon, and the incidence of heart failure in patients receiving doxorubicin is 2.2%, with a mortality rate over 60% at 2 years...
2017: Advances in Experimental Medicine and Biology
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