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https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#1
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28641684/novel-indications-for-commonly-used-medications-as-radiation-protectants-in-spaceflight
#2
Mark F McLaughlin, Dorit B Donoviel, Jeffrey A Jones
In the space environment, the traditional radioprotective principles of time, distance, and shielding become difficult to implement. Additionally, the complex radiation environment inherent in space, the chronic exposure timeframe, and the presence of numerous confounding variables complicate the process of creating appropriate risk models for astronaut exposure. Pharmaceutical options hold tremendous promise to attenuate acute and late effects of radiation exposure in the astronaut population. Pharmaceuticals currently approved for other indications may also offer radiation protection, modulation, or mitigation properties along with a well-established safety profile...
July 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28641545/role-of-bradykinin-in-the-regulation-of-endothelial-nitric-oxide-synthase-expression-by-cardiovascular-drugs
#3
Jin Bo Su
NO produced by eNOS plays important roles in the cardiovascular system. Alterations in eNOS activity and expression occur in various cardiovascular disorders and eNOS constitutes a therapeutic target. In addition to posttranslational modifications of eNOS that affect eNOS activity, transcriptional and post-transcriptional regulation of eNOS expression also controlls eNOS-derived NO production. Bradykinin is an important determinant of vascular function and participates in the regulation of eNOS activity and expression...
June 22, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28641333/validation-of-brain-angiotensin-system-blockade-as-a-novel-drug-target-in-pharmacological-treatment-of-neuropsychiatric-disorders
#4
Dominik Wincewicz, Jan J Braszko
Retreat in psychiatric drug development results in innovative medication decline that might be at least partially overcome by adjunct therapy. New evidence from clinical studies has shown a possible role for brain Renin-Angiotensin System (RAS) in both affective and psychotic disorders. Simultaneously, rapidly accumulating data from basic studies indicate effectiveness of central RAS blockade in much broader range of neuropsychiatric disease. Recent findings implicate brain RAS, especially Angiotensin II (Ang II), in neural pathophysiology of mental disorders through neuroendocrine modulation and effects on neurotransmitter release, mostly noradrenaline, acetylcholine and dopamine...
June 22, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28629525/erythropoietin-regulation-by-angiotensin-ii
#5
Yong-Chul Kim, Ognoon Mungunsukh, Regina M Day
The renin-angiotensin system (RAS) is a key regulator of blood pressure and blood volume homeostasis. The RAS is primarily comprised of the precursor protein angiotensinogen and the two proteases, renin and angiotensin-converting enzyme (ACE). Angiotensin I (Ang I) is derived from angiotensinogen by renin, but appears to have no biological activity. In contrast, angiotensin II (Ang II) that has a variety of biological functions in the cells is converted from Ang I through removal of two-C-terminal residues by ACE...
2017: Vitamins and Hormones
https://www.readbyqxmd.com/read/28627932/short-term-prognostic-effect-of-prior-cerebrovascular-and-peripheral-artery-disease-in-patients-with-acute-coronary-syndrome-can-we-do-better
#6
Filipa Cordeiro, Pedro S Mateus, Alberto Ferreira, Silvia Leao, Miguel Moz, J Ilidio Moreira
BACKGROUND: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. METHODS: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28626088/secondary-prevention-of-cardiovascular-disease-in-patients-with-type-2-diabetes-international-insights-from-the-tecos-trial
#7
Neha J Pagidipati, Ann Marie Navar, Karen S Pieper, Jennifer B Green, M Angelyn Bethel, Paul W Armstrong, Robert G Josse, Darren K McGuire, Yuliya Lokhnygina, Jan H Cornel, Sigrun Halvorsen, Timo E Strandberg, Tuncay Delibasi, Rury R Holman, Eric D Peterson
Background -Intensive risk factor modification significantly improves outcomes for patients with diabetes and cardiovascular disease (CVD). However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Methods -Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mmHg systolic, <90 mmHg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and non-smoking status-was evaluated among 13,616 patients from 38 countries with diabetes and known CVD at entry into TECOS...
June 16, 2017: Circulation
https://www.readbyqxmd.com/read/28625505/bioequivalence-study-of-a-new-fixed-dose-combination-tablet-containing-s-amlodipine-nicotinate-and-olmesartan-medoxomil-in-healthy-korean-male-subjects
#8
Mi Jin Oh, Hyun Hwan Hwang, Hyun Gyu Kim, Geun Hyeog Lee, Yun-Seok Cho, Sun Young Lee, Soo Yeon Kang, Kyung Hee Cho, Yun Young Lee, Yun Jeong Lee, Choon-Gon Jang, Seok-Yong Lee
PURPOSE: A fixed-dose combination (FDC) pill of amlodipine (relatively old calcium channel blocker as dihydropyridine) and olmesartan (relatively new angiotensin II receptor blocker) is used for hypertension that is not adequately controlled with a single-formulation drug. Because the FDC is a one-pill formulation, and amlodipine and olmesartan have different mechanisms of action, it is expected to improve patients' medication compliance and have an increased blood pressure-lowering efficacy...
June 15, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#9
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28623899/renin-angiotensin-system-blockers-and-residual-kidney-function-loss-in-patients-initiating-peritoneal-dialysis-an-observational-cohort-study
#10
Jenny I Shen, Anjali B Saxena, Sitaram Vangala, Satvinder K Dhaliwal, Wolfgang C Winkelmayer
BACKGROUND: Although angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB) have been shown to preserve residual kidney function in a select group of Asian patients undergoing continuous ambulatory peritoneal dialysis (PD) in two small randomized clinical trials, the effectiveness of these drugs has yet to be demonstrated in a more diverse population of patients with multiple comorbid conditions. We investigated the association between ACEI/ARB use and development of recorded anuria in a cohort of patients initiating PD in the U...
June 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28622402/prevalence-of-concurrent-prescribing-of-ace-is-and-arbs-among-beneficiaries-of-puerto-rico-s-government-sponsored-health-care-plan-during-2012-and-2013
#11
Denise Figueroa-Ríos, José J Hernández-Muñoz, Aileen García-Albarrán, Emily A García-Rodríguez, Glendaliz Méndez-Hernández, Suzette M Vélez-Rivera
OBJECTIVE: Cardiovascular conditions are the second cause of death in Puerto Rico. The individual use of angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) is considered the first-line therapy for the treatment of several cardiovascular-related medical conditions. However, the concurrent use of these 2 therapeutic classes of drugs is not supported by treatment guidelines. Studies have shown that their concurrent use represents a potential health risk...
June 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28619367/the-vasoprotective-axes-of-the-renin-angiotensin-system-physiological-relevance-and-therapeutic-implications-in-cardiovascular-hypertensive-and-kidney-diseases
#12
REVIEW
Xiao C Li, Jianfeng Zhang, Jia L Zhuo
The renin-angiotensin system (RAS) is undisputedly one of the most prominent endocrine (tissue-to-tissue), paracrine (cell-to-cell) and intracrine (intracellular/nuclear) vasoactive systems in the physiological regulation of neural, cardiovascular, blood pressure, and kidney function. The importance of the RAS in the development and pathogenesis of cardiovascular, hypertensive and kidney diseases has now been firmly established in clinical trials and practice using renin inhibitors, angiotensin-converting enzyme (ACE) inhibitors, type 1 (AT1) angiotensin II (ANG II) receptor blockers (ARBs), or aldosterone receptor antagonists as major therapeutic drugs...
June 12, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28618427/matrix-metalloproteases-in-arterial-hypertension-and-their-trend-after-antihypertensive-treatment
#13
Eugenia Hopps, Rosalia Lo Presti, Gregorio Caimi
BACKGROUND/AIMS: Arterial hypertension is characterized by vascular remodelling, atherosclerosis and cardiovascular complications. Matrix metalloproteases (MPPs) are endopeptidases produced by all the cells present in the vascular wall and are involved in the regulation of the extracellular matrix protein turnover. MMPs contribute to blood vessel formation, remodelling, angiogenesis; whereas an altered expression or activity of MMPs or their tissue inhibitors (TIMPs) results correlated with the development and progression of cardiovascular complications...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28618426/renoprotective-effect-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-ii-receptor-blockers-in-diabetic-patients-with-proteinuria
#14
Feng-Yi Hsu, Fang-Ju Lin, Huang-Tz Ou, Shih-Hui Huang, Chi-Chuan Wang
BACKGROUND/AIMS: Limited evidence exists on the choice of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in diabetic patients with nephropathy. We aim to assess the renal effectiveness and safety of these drugs among diabetic nephropathy patients. METHODS: This retrospective cohort study was conducted with diabetic nephropathy patients who initiated ACEI or ARB monotherapy. The primary outcome was a composite of end stage of renal disease and renal transplantation, and the secondary outcome was all-cause mortality...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28618134/potentially-inappropriate-use-of-furosemide-in-a-very-elderly-population-an-observational-study
#15
Carla Rodriguez-Cillero, Didier Menu, Philippe d'Athis, Sophie Perrin, Mélanie Dipanda, Sanaa Asgassou, Hélène Guepet, Emmanuel Mazen, Patrick Manckoundia, Alain Putot
OBJECTIVE: Little is known about furosemide prescription modalities in elderly people. We describe furosemide prescription in ambulatory elderly patients. METHODS: All patients aged over 80 years, affiliated to Mutualité Sociale Agricole de Bourgogne, a French regional health insurance plan, with a medical prescription delivered in March 2015, were retrospectively included. RESULTS: Among 15 141 patients with a median age of 86 years, comprising 61...
June 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28616249/quality-of-care-for-patients-with-chronic-kidney-disease-in-the-primary-care-setting-a-retrospective-cohort-study-from-ontario-canada
#16
Danielle M Nash, Scott Brimble, Maureen Markle-Reid, Eric McArthur, Karen Tu, Gihad E Nesrallah, Allan Grill, Amit X Garg
BACKGROUND: Patients with chronic kidney disease may not be receiving recommended primary renal care. OBJECTIVE: To use recently established primary care quality indicators for chronic kidney disease to determine the proportion of patients receiving recommended renal care. DESIGN: Retrospective cohort study using administrative data with linked laboratory information. SETTING: The study was conducted in Ontario, Canada, from 2006 to 2012...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28616215/the-impact-of-renal-protection-clinics-on-prescription-of-and-adherence-to-cardioprotective-drug-therapy-in-chronic-kidney-disease-patients
#17
Fanny Lepeytre, Héloise Cardinal, Lorraine Fradette, Jacobien Verhave, Marc Dorais, Jacques LeLorier, Vincent Pichette, François Madore
Background: The aim of this study was to assess the impact of follow-up in renal protection clinics on the prescription of and adherence to cardioprotective drugs in patients with chronic kidney disease (CKD). Methods: We studied stage 4 and 5 CKD patients who initiated follow-up in three renal protection clinics. The prescription pattern of antihypertensive agents (AHA) and lipid-lowering agents (LLAs) was measured as the percentage of patients who are prescribed the agents of interest at a given time. Adherence to drug therapy was defined as the percentage of days, during a pre-defined observation period, in which patients have an on-hand supply of their prescribed medications...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28611863/effect-of-azilsartan-on-day-to-day-variability-in-home-blood-pressure-a-prospective-multicenter-clinical-trial
#18
Toru Miyoshi, Ryoji Suetsuna, Naoto Tokunaga, Masayasu Kusaka, Ryuichiro Tsuzaki, Kazuya Koten, Kohno Kunihisa, Hiroshi Ito
BACKGROUND: The blood pressure variability (BPV) such as visit-to-visit, day-by-day, and ambulatory BPV has been also shown to be a risk of future cardiovascular events. However, the effects of antihypertensive therapy on BPV remain unclear. The purpose of this study was to evaluate the effect of azilsartan after switching from another angiotensin II receptor blocker (ARB) on day-to-day BPV in home BP monitoring. METHODS: This prospective, multicenter, open-labeled, single-arm study included 28 patients undergoing treatment with an ARB, which was switched to azilsartan after enrollment...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28611661/discovery-and-development-of-calcium-channel-blockers
#19
REVIEW
Théophile Godfraind
In the mid 1960s, experimental work on molecules under screening as coronary dilators allowed the discovery of the mechanism of calcium entry blockade by drugs later named calcium channel blockers. This paper summarizes scientific research on these small molecules interacting directly with L-type voltage-operated calcium channels. It also reports on experimental approaches translated into understanding of their therapeutic actions. The importance of calcium in muscle contraction was discovered by Sidney Ringer who reported this fact in 1883...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28608026/monotherapy-and-dual-combination-therapies-based-on-olmesartan-a-comprehensive-strategy-to-improve-blood-pressure-control
#20
REVIEW
Massimo Volpe, Caterina Santolamazza, Vittoria Mastromarino, Roberta Coluccia, Allegra Battistoni, Giuliano Tocci
Olmesartan medoxomil is an antihypertensive drug of the class of angiotensin II type 1 (AT1) receptor antagonists (or blockers), characterized by tight and prolonged binding to AT1 receptor compared to other molecules within the same class. These characteristics produce effective and sustained blood pressure reductions in hypertensive patients at different cardiovascular risk profile with a good tolerability profile. After a brief description of the pharmacological characteristics of olmesartan, we will provide a thorough overview of the clinical studies that investigated its efficacy and safety in the clinical management of hypertensive patients both in monotherapy and in dual combination therapies with either thiazide diuretics or calcium channel blockers...
June 12, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
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