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https://www.readbyqxmd.com/read/29034321/refractory-versus-resistant-hypertension-novel-distinctive-phenotypes
#1
Tanja Dudenbostel, Mohammed Siddiqui, Nitin Gharpure, David A Calhoun
Resistant hypertension (RHTN) is relatively common with an estimated prevalence of 10-20% of treated hypertensive patients. It is defined as blood pressure (BP) >140/90 mmHg treated with ≥3 antihypertensive medications, including a diuretic, if tolerated. Refractory hypertension is a novel phenotype of severe antihypertensive treatment failure. The proposed definition for refractory hypertension, i.e. BP >140/90 mmHg with use of ≥5 different antihypertensive medications, including a diuretic and a mineralocorticoid receptor antagonist (MRA) has been applied inconsistently...
September 2017: Journal of Nature and Science
https://www.readbyqxmd.com/read/29034087/spironolactone-in-cardiovascular-disease-an-expanding-universe
#2
REVIEW
John W Funder
Spironolactone has been marketed for over half a century as a 'potassium-sparing diuretic', used primarily in patients with ascites. With the realization that primary aldosteronism is the most common (5-13%) form of secondary hypertension, it has become widely used as a mineralocorticoid receptor antagonist. More recently, in the wake of the RALES trial, spironolactone in addition to standard therapy has been shown to be very beneficial in heart failure with a reduced ejection fraction. Despite the failure of the TOPCAT trial, spironolactone is being increasingly used in diastolic heart failure (i...
2017: F1000Research
https://www.readbyqxmd.com/read/29033789/stress-and-corticosteroids-modulate-muscarinic-long-term-potentiation-mltp-in-the-hippocampus
#3
Efrat Shavit Stein, Ze'Ev Itsekson Hayosh, Andreas Vlachos, Nicola Maggio
Stress influences synaptic plasticity, learning and memory in a steroid hormone receptor dependent manner. Based on these findings it has been proposed that stress could be a major risk factor for the development of cognitive decline and dementia. Interestingly, evidence has been provided that stress also affects muscarinic, i.e., acetylcholine (ACh)-mediated neurotransmission. To learn more about the impact of stress and steroids on synaptic plasticity, in this study, we investigated the effects of stress on muscarinic long term potentiation (mLTP)...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/29033112/gap-between-guidelines-and-clinical-practice-in-heart-failure-with-reduced-ejection-fraction-results-from-tsoc-hfref-registry
#4
Hung-Yu Chang, Chun-Chieh Wang, Jeng Wei, Chong-Yi Chang, Yi-Cheng Chuang, Chien-Long Huang, Eric Chong, Jiunn-Lee Lin, Guang-Yuan Mar, Kuei-Chuan Chan, Jen-Yuan Kuo, Ji-Hung Wang, Zhih-Cherng Chen, Wei-Kung Tseng, Wen-Jin Cherng, Wei-Hsian Yin
BACKGROUND: Heart failure (HF) is a global health problem. Guidelines for the management of HF have been established in Western countries and in Taiwan. However, data from the Taiwan Society of Cardiology-Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry showed suboptimal prescription of guideline-recommended medications. We aimed to analyze the reason of non-prescription and clinical outcomes as a result of under-prescription of medications. METHODS: A total of 1509 patients hospitalized for acute HFrEF were recruited in 21 hospitals in Taiwan by the end of October 2014...
October 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29030109/social-information-changes-stress-hormone-receptor-expression-in-the-songbird-brain
#5
Jamie M Cornelius, Gillian Perreau, Valerie R Bishop, Jesse S Krause, Rachael Smith, Thomas P Hahn, Simone L Meddle
Social information is used by many vertebrate taxa to inform decision-making, including resource-mediated movements, yet the mechanisms whereby social information is integrated physiologically to affect such decisions remain unknown. Social information is known to influence the physiological response to food reduction in captive songbirds. Red crossbills (Loxia curvirostra) that were food reduced for several days showed significant elevations in circulating corticosterone (a "stress" hormone often responsive to food limitation) only if their neighbors were similarly food restricted...
October 10, 2017: Hormones and Behavior
https://www.readbyqxmd.com/read/29029965/contemporary-epidemiology-management-and-outcomes-of-patients-hospitalized-for-heart-failure-in-china-results-from-the-china-heart-failure-china-hf-registry
#6
Yuhui Zhang, Jian Zhang, Javed Butler, Xiaomin Yang, Peiyi Xie, Dongshuang Guo, Tiemin Wei, Jing Yu, Zhenli Wu, Yingchun Gao, Xiumin Han, Xuelian Zhang, Susheng Wen, Stefan D Anker, Gerasimos Filippatos, Gregg C Fonarow, Tianyi Gan, Rongcheng Zhang
BACKGROUND: Contemporary data on the epidemiology of heart failure (HF) in China are scarce. The China HF Registry was designed to investigate clinical characteristics, management, and outcomes of patients hospitalized for HF in China. DESIGN AND SUBJECTS: Data were collected prospectively on 13687 patients with a primary discharge diagnosis of HF who were enrolled from 132 participating hospitals between January 2012 to September 2015. Data from the China HF registry was compared with previously published literature...
October 10, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29025750/fludrocortisone-is-associated-with-a-higher-risk-of-all-cause-hospitalizations-compared-with-midodrine-in-patients-with-orthostatic-hypotension
#7
Carlos G Grijalva, Italo Biaggioni, Marie R Griffin, Cyndya A Shibao
BACKGROUND: Orthostatic hypotension causes ≈80 000 hospitalizations per year in the United States. Treatments for orthostatic hypotension include fludrocortisone, a mineralocorticoid analog that promotes sodium reabsorption; and midodrine, an α-1 adrenergic agonist that is a direct vasoconstrictor. Although both medications are used to treat orthostatic hypotension, few studies have compared their relative safety. METHODS AND RESULTS: We compared incidence rates of hospitalizations for all causes, and for congestive heart failure between users of fludrocortisone and users of midodrine in a retrospective cohort study of Tennessee Medicaid adult enrollees (1995-2009)...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29021385/aldosterone-is-essential-for-angiotensin-ii-induced-upregulation-of-pendrin
#8
Daigoro Hirohama, Nobuhiro Ayuzawa, Kohei Ueda, Mitsuhiro Nishimoto, Wakako Kawarazaki, Atsushi Watanabe, Tatsuo Shimosawa, Takeshi Marumo, Shigeru Shibata, Toshiro Fujita
The renin-angiotensin-aldosterone system has an important role in the control of fluid homeostasis and BP during volume depletion. Dietary salt restriction elevates circulating angiotensin II (AngII) and aldosterone levels, increasing levels of the Cl(-)/HCO3(-) exchanger pendrin in β-intercalated cells and the Na(+)-Cl(-) cotransporter (NCC) in distal convoluted tubules. However, the independent roles of AngII and aldosterone in regulating these levels remain unclear. In C57BL/6J mice receiving a low-salt diet or AngII infusion, we evaluated the membrane protein abundance of pendrin and NCC; assessed the phosphorylation of the mineralocorticoid receptor, which selectively inhibits aldosterone binding in intercalated cells; and measured BP by radiotelemetry in pendrin-knockout and wild-type mice...
October 11, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29017166/the-role-of-the-mineralocorticoid-receptor-in-inflammation-focus-on-kidney-and-vasculature
#9
Zachary Belden, Jeffrey A Deiuliis, Mirela Dobre, Sanjay Rajagopalan
BACKGROUND: The remarkable success of clinical trials in mineralocorticoid receptor (MR) inhibition in heart failure has driven research on the physiological and pathological role(s) of nonepithelial MR expression. MR is widely expressed in the cardiovascular system and is a major determinant of endothelial function, smooth muscle tone, vascular remodeling, fibrosis, and blood pressure. An important new dimension is the appreciation of the role MR plays in immune cells and target organ damage in the heart, kidney and vasculature, and in the development of insulin resistance...
October 10, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29016737/diverging-effects-of-enalapril-or-eplerenone-in-primary-prevention-against-doxorubicin-induced-cardiotoxicity
#10
Roger Hullin, Mélanie Métrich, Alexandre Sarre, Denis Basquin, Marc Maillard, Julien Regamey, David Martin
Aims: Clinical studies suggest beneficial effects of renin-angiotensin system blockade for prevention of left ventricular (LV) dysfunction after chemotherapy. However, the efficacy of this strategy as primary prevention has been poorly studied. This study aimed at identifying the pathophysiological mechanisms by which mineralocorticoid receptor antagonism (MRA) or angiotensin converting enzyme inhibition (ACEi) provide protection against doxorubicin-induced cardiotoxicity (DIC) in mouse models of acute and chronic toxicity...
September 7, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28993930/in-search-of-a-standard-when-analyzing-medication-adherence-in-patients-with-heart-failure-using-claims-data-a-systematic-review
#11
REVIEW
Katrin Krueger, Nina Griese-Mammen, Ingrid Schubert, Marita Kieble, Lea Botermann, Ulrich Laufs, Charlotte Kloft, Martin Schulz
To determine and address medication non-adherence is important and may improve patient outcomes. Our aim was to perform a systematic review on the operationalization of adherence measures in patients with heart failure using claims data. We searched the MEDLINE, EMBASE, and Cochrane databases. A quality check of the full-text articles was performed using the Quality in Prognosis Studies tool. We included 28 studies. Eleven studies used the medication possession ratio, 15 the proportion of days covered, and six studies used own methods to calculate medication adherence...
October 9, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28989892/management-of-primary-adrenal-insufficiency-review-of-current-clinical-practice-in-a-developed-and-a-developing-country
#12
Uzma Khan, Om J Lakhani
Treatment of primary adrenal insufficiency (PAI) requires lifelong hormone replacement with glucocorticoids (GCs) and mineralocorticoids. Impaired quality of life and increased standardized mortality ratio in these patients emphasize the importance of tailoring therapy to individual needs. Role of education is paramount in improving patient compliance and in anticipating and preventing adrenal crises. Although discovery of synthetic GCs was a major breakthrough in treatment of patients with this life-threatening condition, management of PAI continues to be challenging...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28989575/antihypertensive-effect-of-ganjang-traditional-korean-soy-sauce-on-sprague-dawley-rats
#13
Eun-Gyung Mun, Hee-Sook Sohn, Mi-Sun Kim, Youn-Soo Cha
BACKGROUND/OBJECTIVES: Although Korean fermented foods contain large amounts of salt, which is known to exacerbate health problems, these foods still have beneficial effects such as anti-hypertension, anti-cancer, and anti-colitis properties. We hypothesized that ganjang may have different effects on blood pressure compared to same concentrations of salt. MATERIALS/METHODS: Sprague-Dawley rats were divided into control (CT), NaCl (NC), and ganjang (GJ) groups and orally administered with 8% NaCl concentration for 9 weeks...
October 2017: Nutrition Research and Practice
https://www.readbyqxmd.com/read/28987848/prevention-and-treatment-for-hyponatremia-in-patients-with-subarachnoid-hemorrhage-a-systematic-review
#14
REVIEW
Kieran Shah, Ricky Turgeon, Peter A Gooderham, Mary H H Ensom
BACKGROUND: Current guidelines have not systematically assessed the literature for the management of hyponatremia in patients with subarachnoid hemorrhage. OBJECTIVE: To evaluate the efficacy and safety of current preventative and treatment strategies of hyponatremia in patients with subarachnoid hemorrhage. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, MEDLINE, and PubMed for relevant studies. Primary outcomes of interest included neurological functional outcomes, symptomatic vasospasm, and others...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985390/roles-and-mechanistic-bases-of-glucocorticoid-regulation-of-avian-reproduction
#15
Pierre Deviche, Stephanie Bittner, Sisi Gao, Shelley Valle
To maximize fitness, organisms must invest energetic and nutritional resources into developing, activating, and maintaining reproductive physiology and behavior. Corticosterone (CORT), the primary avian glucocorticoid, regulates energetic reserves to meet metabolic demands. At low (baseline) plasma levels, CORT activates avian mineralocorticoid receptors and may stimulate lipid mobilization, foraging activity, and feeding behavior. During stress in birds, elevated plasma CORT also stimulates glucocorticoid receptors and may promote glycemia, lipolysis, and proteolysis...
August 8, 2017: Integrative and Comparative Biology
https://www.readbyqxmd.com/read/28974571/endothelial-mineralocorticoid-receptor-mediates-parenchymal-arteriole-and-posterior-cerebral-artery-remodeling-during-angiotensin-ii-induced-hypertension
#16
Janice M Diaz-Otero, Courtney Fisher, Kelsey Downs, M Elizabeth Moss, Iris Z Jaffe, William F Jackson, Anne M Dorrance
The brain is highly susceptible to injury caused by hypertension because the increased blood pressure causes artery remodeling that can limit cerebral perfusion. Mineralocorticoid receptor (MR) antagonism prevents hypertensive cerebral artery remodeling, but the vascular cell types involved have not been defined. In the periphery, the endothelial MR mediates hypertension-induced vascular injury, but cerebral and peripheral arteries are anatomically distinct; thus, these findings cannot be extrapolated to the brain...
October 3, 2017: Hypertension
https://www.readbyqxmd.com/read/28974501/longitudinal-heart-failure-medication-use-and-adherence-following-left-ventricular-assist-device-implantation-in-privately-insured-patients
#17
Nicholas Y Tan, Lindsey R Sangaralingham, Stephanie R Schilz, Shannon M Dunlay
BACKGROUND: There are few data describing the longitudinal use of and adherence to heart failure medications following left ventricular assist device (LVAD) implantation. METHODS AND RESULTS: Using a large US commercial insurance database, patients who received an LVAD (International Classification of Diseases, 9th Revision, Clinical Modification code 37.66) and survived to hospital discharge without heart transplantation between January 1, 2006, and March 31, 2015, were identified...
October 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28973103/genetic-causes-of-functional-adrenocortical-adenomas
#18
Maria-Christina Zennaro, Sheerazed Boulkroun, Fabio Fernandes-Rosa
Aldosterone and cortisol, the main mineralocorticoid and glucocorticoid hormones in humans, are produced in the adrenal cortex, which is composed of three concentric zone with specific functional characteristics. Adrenocortical adenomas (ACA) may lead to the autonomous secretion of aldosterone responsible for primary aldosteronism, the most frequent form of secondary arterial hypertension. In the case of cortisol production, ACA lead to overt or subclinical Cushing syndrome. Genetic analysis driven by next generation sequencing technology has enabled the discovery, during the last seven years, of the genetic causes of a large subset of ACA...
August 2, 2017: Endocrine Reviews
https://www.readbyqxmd.com/read/28966330/high-glucose-stimulates-mineralocorticoid-receptor-transcriptional-activity-through-the-protein-kinase-c-%C3%AE-signaling
#19
Takeshi Hayashi, Hirotaka Shibata, Isao Kurihara, Kenichi Yokota, Yuko Mitsuishi, Kennosuke Ohashi, Ayano Murai-Takeda, Rie Jo, Takako Ohyama, Masaya Sakamoto, Katsuyoshi Tojo, Naoko Tajima, Kazunori Utsunomiya, Hiroshi Itoh
Activation of mineralocorticoid receptor (MR) is shown in resistant hypertension including diabetes mellitus. Although protein kinase C (PKC) signaling is involved in the pathogenesis of diabetic complications, an association between PKC and MR is not known. Activation of PKCα and PKCβ by TPA (12-O-Tetradecanoylphorbol 13-acetate) increased MR proteins and its transcriptional activities in HEK293-MR cells. In contrast, a high glucose condition resulted in PKCβ but not PKCα activation, which is associated with elevation of MR protein levels and MR transcriptional activities...
September 30, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28966243/the-aldosterone-receptor-antagonist-eplerenone-inhibits-isoproterenol-induced-collagen-i-and-11%C3%AE-hsd1-expression-in-rat-cardiac-fibroblasts-and-the-left-ventricle
#20
Yasutomo Hori, Daisuke Touei, Ryuta Saitoh, Maki Yamagishi, Kazutaka Kanai, Fumio Hoshi, Naoyuki Itoh
β-Adrenergic receptor (β-AR)-induction of collagen-I synthesis is partially mediated by the cardiac mineralocorticoid receptor (MR) system. However, it remains unclear whether the selective MR antagonist, eplerenone, inhibits collagen-I synthesis induced by β-AR stimulation. We investigated the effects of eplerenone on the responses to a non-selective β-AR agonist, isoproterenol, which induced collagen-I synthesis in primary cardiac fibroblasts (CFs) and the left ventricle. mRNAs encoding the MR and 11β-hydroxysteroid dehydrogenase type I (11β-HSD1) were evident in the left ventricle and primary CFs...
2017: Biological & Pharmaceutical Bulletin
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