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heart failure ace arb

Cherinne Arundel, Helen M Sheriff, Phillip H Lam, Selma F Mohammed, Linda G Jones, Corrine Y Jurgens, Charity J Morgan, Charles Faselis, Richard M Allman, Gregg C Fonarow, Ali Ahmed
BACKGROUND: Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs-ARBs) improve outcomes in heart failure (HF). Less is known about this association in nursing home (NH) residents. METHODS: Of the 8024 hospitalized HF patients, 542 were NH residents, of whom 252 received ACEIs-ARBs. We assembled a propensity score-matched cohort of 157 pairs of NH residents receiving and not receiving ACEIs-ARBs balanced on 29 baseline characteristics (mean age, 3 years, 74% women, 17% African American), in which we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with ACEI-ARB use...
September 25, 2018: American Journal of Therapeutics
Pei-Yu Liu, Chien-Lin Chen, Min-Chien Yu, Yu-Lin Ko, Shun-Yi Hsu, Hsin-Hua Chou, Kuan-Hung Yeh, De-Min Duan, Ming-Hsin Chen, Jeng-Feng Lin
OBJECTIVES: In patients with ST-elevation myocardial infarction (STEMI), it is not clear whether low-dose renin-angiotensin system inhibitors and beta-blockers can result in the same benefits achievable with higher target doses. This observational study aims to investigate whether higher doses of angiotensin converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB) and beta-blockers can improve outcomes in patients with STEMI. METHODS: We recorded daily doses of ACEI, ARB, and beta-blockers in 331 patients with STEMI...
October 8, 2018: Acta Clinica Belgica
Tatsuya Morimoto, Masafumi Funamoto, Yoichi Sunagawa, Yasufumi Katanasaka, Yusuke Miyazaki, Koji Hasegawa
 Hemodynamic stresses, including hypertension and myocardial infarction, activate neurohumoral factors such as the sympathetic nervous system and the renin-angiotensin system, and can lead to the progression of heart failure. Established pharmacological agents such as angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, and β-blockers target extra-cellular molecules and receptors on the cell membrane. These agents have shown some efficacy for the treatment of heart failure, but the long-term survival rate of patients with heart failure remains low...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Abigail Khan, Emmanuelle Paré, Shimoli Shah
PURPOSE OF REVIEW: This review summarizes the pathophysiology, diagnosis, and treatment of peripartum cardiomyopathy (PPCM), with a focus on recent discoveries of clinical relevance. RECENT FINDINGS: An increase in oxidative stress and anti-angiogenic activity play key roles in the pathophysiology of peripartum cardiomyopathy. Therapies that target this dysregulation may have a future role in treatment. Suppression of prolactin release using bromocriptine, a dopamine-receptor antagonist, has been associated with more favorable outcomes in small studies but more research is needed...
September 29, 2018: Current Treatment Options in Cardiovascular Medicine
Pedro J Tárraga López, M José Villar Inarejos, Ibrahim M Sadek, Fátima Madrona Marcos, Loreto Tárraga Marcos, Miguel Ángel Simón García
OBJECTIVE: To analyse the heart failure situation in a health area, as well quality criteria. METHOD: Cross-sectional observational study of patients diagnosed with heart failure by collecting data from their clinical history in the «Turriano» computer program. The variables analysed were, comorbidities, control of cardiovascular risk factors, treatments, number of chronic diseases, and admissions. The level of adherence to drugs in relation to heart failure by determining the ratio between the percentage of prescribed drugs and drugs withdrawn from pharmacy is also analysed using the Turriano prescription program...
September 24, 2018: Clínica e Investigación en Arteriosclerosis
Ehimare Akhabue, Thanh-Huyen T Vu, Anand Vaidya, Erin D Michos, Ian H de Boer, Bryan Kestenbaum, Matthew Allison, Moyses Szklo, Pamela Ouyang, Clyde W Yancy, Myles Wolf, Tamara Isakova, Mercedes R Carnethon
Background: Higher Fibroblast Growth Factor-23 (FGF23) concentrations have been found to be associated with incident heart failure (HF). Experimental data suggest FGF23 directly stimulates myocardial hypertrophy. FGF23 may also enhance renin-angiotensin-aldosterone system activity. Whether FGF23 is associated with increased HF risk in populations with hypertension and whether this association is weaker in the presence of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy is unknown...
September 25, 2018: American Journal of Hypertension
Caroline Sirois, Carlotta Lunghi, Marie-Laure Laroche, Alicia Maheux, Anissa Frini
BACKGROUND: Clinical practice guidelines are useful to suggest pharmacological therapies for the treatment of single chronic diseases. However, there is little guidance for multimorbidity, and specific quality measures for people with multimorbidity that can be used at a population level are lacking. OBJECTIVE: To describe what pharmacists and geriatricians consider to be an optimal basic pharmacological therapy for an older individual with type 2 diabetes (DM), chronic obstructive pulmonary disease (COPD) and heart failure (HF)...
September 19, 2018: Research in Social & Administrative Pharmacy: RSAP
Monika Wieser, Daniel Rhyner, Michele Martinelli, Thomas Suter, Bruno Schnegg, Claudia Bösch, Olivier Wigger, Stephan Dobner, Lukas Hunziker
Pharmacological therapy of heart failure with reduced ejection fraction Abstract. Pharmacological therapy for heart failure has made great progress over the last three decades and evidence-based therapies have significantly improved survival and quality of life. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and beta-blockers are the cornerstone of the heart failure therapy; indicated in virtually every patient with heart failure and reduced ejection fraction. As soon as the left ventricular ejection fraction decreases below 35 % and / or symptoms are still present (NYHA II-IV), a mineralocorticoid receptor antagonist should be added...
September 2018: Therapeutische Umschau. Revue Thérapeutique
Jonathan A Batty, Mengyao Tang, Marlous Hall, Roberto Ferrari, Martin H Strauss, Alistair S Hall
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs) efficaciously reduce systolic blood pressure (BP), a well-established risk factor for myocardial infarction (MI). Both inhibit the renin-angiotensin system, albeit through different mechanisms, and produce similar reductions in BP. However, in parallel meta-analyses of ACEi and ARB trials, ACEis reduce risk of MI whereas ARBs do not-a phenomenon described as the 'ARB-MI paradox'. In addition, ACEis reduce all-cause mortality, whereas ARBs do not, which appears to be independent of BP lowering...
August 25, 2018: Systematic Reviews
Suzanne V Arnold, Jonathan Yap, Carolyn S P Lam, Fengming Tang, Wan T Tay, Tiew H K Teng, Darren K McGuire, James L Januzzi, Gregg C Fonarow, Frederick A Masoudi, Mikhail Kosiborod
AIMS: To compare the management of patients with diabetes and heart failure with reduced ejection fraction (HFrEF) in the United States and Asia to understand variations in treatment patterns across different healthcare systems. MATERIALS AND METHODS: Our cohort included patients with diabetes and HFrEF (ejection fraction <40%) from a US-based registry of adults with diabetes (2013-2016, electronic health records) and a multi-national Asian registry of adults with heart failure (2010-2016, prospective registry)...
August 23, 2018: Diabetes, Obesity & Metabolism
Ramesh R Dargad, Mahesh R Prajapati, Rohit R Dargad, Jai D Parekh
OBJECTIVE: To describe the efficacy, superiority and safety profile of the first-in-class angiotensin receptor-neprilysin inhibitor "Sacubitril/Valsartan" as compared to angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blocker (ARB) in heart failure (HF) patients, reviewing data available from both clinical and pre-clinical studies. Evidences on health care utilization outcomes such as hospitalizations and emergency department visits were also evaluated...
July 2018: Indian Heart Journal
Tiew-Hwa K Teng, Jasper Tromp, Wan Ting Tay, Inder Anand, Wouter Ouwerkerk, Vijay Chopra, Gurpreet S Wander, Jonathan Jl Yap, Michael R MacDonald, Chang Fen Xu, Yvonne Mf Chia, Wataru Shimizu, A Mark Richards, Adriaan Voors, Carolyn Sp Lam
BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), β blockers, and mineralocorticoid receptor antagonists (MRAs) are of proven benefit and are recommended by guidelines for management of patients with heart failure and reduced ejection fraction (HFrEF). We aimed to examine the first prospective multinational data from Asia on prescribing patterns of guideline-directed medical therapies and analyse its effect on outcomes. METHODS: In the prospective multinational ASIAN-HF registry (with enrolment from 46 centres in 11 countries in Asia), we enrolled patients aged 18 years or older, with symptomatic heart failure (stage C, with at least one episode of decompensated heart failure in the past 6 months that resulted in admission to hospital or was treated in an outpatient clinic) and left ventricular systolic dysfunction (ejection fraction ≤40% on baseline echocardiography, consistent with 2016 European Society of Cardiology guidelines)...
September 2018: Lancet Global Health
Muaamar Al-Gobari, Sinaa Al-Aqeel, François Gueyffier, Bernard Burnand
OBJECTIVES: To summarise and synthesise the current evidence regarding the effectiveness of drug interventions to prevent sudden cardiac death (SCD) and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). DESIGN: Overview of systematic reviews. DATA SOURCES: MEDLINE, Embase, ISI Web of Science and Cochrane Library from inception to May 2017; manual search of references of included studies for potentially relevant reviews...
July 28, 2018: BMJ Open
Stephen J Greene, Javed Butler, Nancy M Albert, Adam D DeVore, Puza P Sharma, Carol I Duffy, C Larry Hill, Kevin McCague, Xiaojuan Mi, J Herbert Patterson, John A Spertus, Laine Thomas, Fredonia B Williams, Adrian F Hernandez, Gregg C Fonarow
BACKGROUND: Guidelines strongly recommend patients with heart failure with reduced ejection fraction (HFrEF) be treated with multiple medications proven to improve clinical outcomes, as tolerated. The degree to which gaps in medication use and dosing persist in contemporary outpatient practice is unclear. OBJECTIVES: This study sought to characterize patterns and factors associated with use and dose of HFrEF medications in current practice. METHODS: The CHAMP-HF (Change the Management of Patients with Heart Failure) registry included outpatients in the United States with chronic HFrEF receiving at least 1 oral medication for management of HF...
July 24, 2018: Journal of the American College of Cardiology
Monica Mu, Sandawana William Majoni, Pupalan Iyngkaran, Mark Haste, Nadarajah Kangaharan
BACKGROUND: Heart failure (HF) is associated with significant morbidity and mortality and recurrent hospitalisations, particularly in the Indigenous Australians of the Northern Territory. In remote Northern Australia, the epidemiology is less clear but anecdotal evidence suggests it may be worse. In addition, some anecdotal evidence suggests that prognostic pharmacological therapy could also be underutilised. Minimal HF data exists in the remote and Indigenous settings, making this study unique...
June 19, 2018: Heart, Lung & Circulation
Nicole Martin, Karthick Manoharan, James Thomas, Ceri Davies, R Thomas Lumbers
BACKGROUND: Beta-blockers and inhibitors of the renin-angiotensin aldosterone system improve survival and reduce morbidity in people with heart failure with reduced left ventricular ejection fraction. There is uncertainty whether these treatments are beneficial for people with heart failure with preserved ejection fraction and a comprehensive review of the evidence is required. OBJECTIVES: To assess the effects of beta-blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, angiotensin receptor neprilysin inhibitors, and mineralocorticoid receptor antagonists in people with heart failure with preserved ejection fraction...
June 28, 2018: Cochrane Database of Systematic Reviews
Seyed Hamidreza Mahmoudpour, Folkert W Asselbergs, Patrick C Souverein, Anthonius de Boer, Anke H Maitland-van der Zee
AIM: Angiotensin-converting enzyme inhibitors (ACEIs) are widely prescribed for several cardiovascular indications. This study investigated patterns of ACEI use for various indications. METHODS: A descriptive, retrospective population-based study was conducted using data from the UK Clinical Practice Research Datalink. Patients starting ACEIs (2007-2014) were selected and ACEI indications were retrieved from electronically recorded medical records. Stratified by indication, we distinguished between persistent and nonpersistent ACEI use, considering a 6-month interval between two prescription periods as a maximum for persistent use...
October 2018: British Journal of Clinical Pharmacology
Hirotake Okazaki, Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Masato Matsushita, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kazutaka Kiuchi, Kuniya Asai, Wataru Shimizu
Atherosclerotic diseases sometimes contribute to acute heart failure (AHF). The aim of the present study is to elucidate the prognostic impact of AHF with atherosclerosis. A total of 1226 AHF patients admitted to the intensive care unit were analyzed. AHF associated with atherosclerosis was defined by the etiology: atherosclerosis-AHF group (n = 708) (patients whose etiologies were ischemic heart disease or hypertensive heart disease) or AHF not associated with atherosclerosis (non-atherosclerosis-AHF) group (n = 518)...
June 26, 2018: Heart and Vessels
T Hirai, R Yamaga, A Fujita, T Itoh
WHAT IS KNOWN AND OBJECTIVE: Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) represent the cornerstones of hypertension and congestive heart failure treatment. Risk factors for hyperkalaemia associated with ACEI and ARB are chronic kidney disease and concomitant medications which increase serum potassium level. Body mass index (BMI) also affects pharmacokinetics of ACEI and ARB and potassium disposition. We evaluated the relationship between BMI and hyperkalaemia associated with ACEI and ARB treatments...
June 16, 2018: Journal of Clinical Pharmacy and Therapeutics
Amol A Verma, Wayne Khuu, Mina Tadrous, Tara Gomes, Muhammad M Mamdani
BACKGROUND: The majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases...
June 2018: PLoS Medicine
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