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https://www.readbyqxmd.com/read/28925056/elevated-blood-pressure-in-the-developing-world-a-role-for-clinical-pharmacists
#1
Michael T Smith, Megan P Monahan, Paige Nelson, Matthew Moruzzi, Alexander J DeLucenay, Christine R Birnie
OBJECTIVE: The objective of this study was to evaluate the prevalence and patient knowledge of elevated blood pressure amongst a cross-section of patients in underserved communities in three selected low-income countries worldwide: El Salvador, India and Kenya. METHODS: Mobile medical clinics were established as part of medical mission trips in El Salvador, India and Kenya. Willing male and female patients, at least 25 years of age, who presented at each clinic were screened for elevated blood pressure, including 332 patients in El Salvador, 847 patients in India and 160 patients in Kenya...
September 19, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28923007/patients-beliefs-regarding-informed-consent-for-low-risk-pragmatic-trials
#2
Rafael Dal-Ré, Antonio J Carcas, Xavier Carné, David Wendler
BACKGROUND: The requirement to obtain written informed consent may undermine the potential of pragmatic randomized clinical trials (pRCTs) to improve evidence-based care. This requirement could compromise trials statistical power or even force it to close them down prematurely. However, recent data from the U.S. and Spain suggest that a majority of the public endorses written consent for low-risk pRCTs. The present manuscript assesses whether this view is shared by patients. METHODS: This was a cross-sectional, probability-based survey, with a 2 × 2 factorial design, assessing support for written informed consent versus verbal consent or general notification for two low-risk pRCTs in hypertension, one comparing 2 drugs with similar risk/benefit profiles and the other comparing the same drug being taken in the morning or at night...
September 18, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28922440/real-life-use-of-3-direct-acting-antiviral-regimen-in-a-large-cohort-of-patients-with-genotype-1b-hcv-compensated-cirrhosis
#3
Liana Gheorghe, Speranta Iacob, Manuela Curescu, Ciprian Brisc, Cristina Cijevschi, Florin Caruntu, Carol Stanciu, Iulia Simionov, Ioan Sporea, Cristian Gheorghe, Razvan Iacob, Victoria Arama, Roxana Sirli, Anca Trifan
BACKGROUND AND AIMS: Ombitasvir/Paritaprevir/ritonavir/Dasabuvir (OBV/PTV/r+DSV) is one of the elective direct-acting antivirals (DAAs) recommended by international guidelines and the only one covered by the National Insurance System in Romania until November 2016. Our aim was to present the first prospective Romanian cohort evaluating the effectiveness and safety in clinical practice of this 3DAA combination in patients with HCV genotype-1b Child A liver cirrhosis. METHODS: 681 patients received OBV/PTV/r+DSV+RBV for 12 weeks and were assessed clinically and biologically at baseline, week 4, 8, 12 (end of treatment, EOT), and 12 weeks after therapy (sustained viral response, SVR)...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28918335/modern-diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#4
Aileen Kharat, Anne-Lise Hachulla, Stéphane Noble, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) should be suspected in patients presenting persistent dyspnea three months after a pulmonary embolism or in patients presenting with acute pulmonary embolism and suggestive images on the CT-scan. For these patients, a specific diagnostic work-up should be performed. First step consists of the ventilation/perfusion (V/Q) scan which is a good screening test due to its high sensitivity and high negative predictive value. Pulmonary angiography remains the gold standard approach for the confirmation of the diagnosis and pre-surgical evaluation of CTEPH...
September 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28916931/physical-exercise-prescription-in-metabolic-chronic-disease
#5
Laura Stefani, Giorgio Galanti
Metabolic syndrome as a consequence of the association to overweight, hypertension, and diabetes is at high risk of coronary events. Regular physical training has been recently promoted to reduce cardiovascular risks factors, by the improved lifestyle and also by the "anti-inflammatory effectiveness." A positive impact has been shown in case of cancer survived patients either with or without comorbidities and especially in those subjects where the inflammatory process is globally represented. The American College of Sports Medicine (ACSM) guidelines and more recently a new Italian model both support the role of "exercise as therapy" at moderate level of energy expenditure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28916863/intracerebral-hemorrhage-as-a-manifestation-of-cerebral-hyperperfusion-syndrome-after-carotid-revascularization-systematic-review-and-meta-analysis
#6
REVIEW
Pedro Abreu, Jerina Nogueira, Filipe Brogueira Rodrigues, Ana Nascimento, Mariana Carvalho, Ana Marreiros, Hipólito Nzwalo
BACKGROUND: Intracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. METHODS: We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization...
September 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28916152/effects-of-inspiratory-muscle-training-on-cardiovascular-autonomic-control-a-systematic-review
#7
REVIEW
Raphael Martins de Abreu, Patrícia Rehder-Santos, Vinicius Minatel, Gabriela Lopes Dos Santos, Aparecida Maria Catai
PURPOSE: To carry out a systematic review to determine if inspiratory muscle training (IMT) promotes changes in cardiovascular autonomic responses in humans. METHODS: The methodology followed the PRISMA statement for reporting systematic review analysis. MEDLINE, PEDro, SCOPUS and PubMed electronic databases were searched from the inception to March 2017. The quality assessment was performed using a PEDro scale. The articles were included if: (1) primary objective was related to the effects of IMT on the cardiovascular autonomic nervous system, and (2) randomized clinical trials and quasi-experimental studies...
September 7, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5%C3%A2-years-of-the-clarify-registry
#8
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
September 14, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28912026/influence-of-various-therapeutic-strategies-on-right-ventricular-morphology-function-and-hemodynamics-in-pulmonary-arterial-hypertension
#9
Roberto Badagliacca, Amresh Raina, Stefano Ghio, Michele D'Alto, Marco Confalonieri, Michele Correale, Marco Corda, Giuseppe Paciocco, Carlo Lombardi, Massimiliano Mulè, Roberto Poscia, Laura Scelsi, Paola Argiento, Susanna Sciomer, Raymond L Benza, Carmine Dario Vizza
BACKGROUND: In idiopathic pulmonary arterial hypertension (IPAH) treatment goals include improving right ventricular (RV) function, hemodynamics and symptoms to move patients to a low-risk category for adverse clinical outcomes. No data are available on the effect of upfront combination therapy on RV improvement as compared with monotherapy. The aim of this study was to evaluate echocardiographic RV morphology and function in patients affected by IPAH and treated with different strategies...
August 26, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28911936/exercise-training-in-patients-with-pulmonary-and-systemic-hypertension-a-unique-therapy-for-two-different-diseases
#10
REVIEW
Massimo Leggio, Augusto Fusco, Giorgio Limongelli, Luca Sgorbini
Pulmonary hypertension is a potentially life-threatening condition. Given its evolving definition, the incidence and prevalence of the disease is difficult to define, but registries suggest an increased global awareness. The management of patients with pulmonary arterial hypertension is highly specialised and requires multi-disciplinary input from a range of healthcare professionals, including cardiologists, respiratory physicians, rheumatologists, rehabilitation physicians and cardio-pulmonary physiotherapists...
September 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28911310/how-to-treat-patients-with-essential-hypertension-and-peripheral-arterial-disease
#11
Salvatore Santo Signorelli
BACKGROUND: Arterial hypertension (AH) and peripheral arterial disease (PAD) frequently coincide. While significant attention is paid to AH, PAD is often underestimated. It is known that both AH and PAD present high cardiovascular risks for ischemic events. To date, the use of the most common anti-hypertensive drugs in PAD patients is still under debate. METHODS: Data from studies of large populations and minor cohorts of patients show AH and PAD together or PAD alone...
June 7, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28911306/management-of-blood-pressure-and-heart-rate-in-patients-with-diabetes-mellitus
#12
Ioanna Gouni-Berthold, Ruth Hanssen, Lisa Ravarani, Heiner K Berthold
BACKGROUND: In patients with diabetes mellitus (DM) there is a clear association between blood pressure (BP) levels and macrovascular and microvascular complications. However, the BP targets that need to be achieved for optimal outcomes remain controversial. METHODS: The purpose of this narrative review is to discuss BP targets and management in patients with DM. The subject of elevated heart rate, which has been associated with mortality in many populations, and which is observed in some patients with DM will also be addressed...
June 8, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28911302/what-is-the-real-efficacy-of-beta-blockers-for-the-treatment-of-essential-hypertension
#13
Christian Höcht, Facundo M Bertera, Julieta S Del Mauro, Yanina Santander Plantamura, Carlos A Taira, Ariel H Polizio
OBJECTIVE: This review covers the pharmacokinetics and pharmacodynamic of β-blockers, the rationale for their use, some recent controversies in its use for managing hypertension, as well as, the beneficial properties of the third-generation β-blockers beyond hypertension. BACKGROUND: The efficacy and safety of -blockers in the treatment of hypertension and other cardiovascular diseases have been established during more than 50 years of clinical experience. Recent updates of clinical guidelines have downgraded the use of -blockers for the treatment of uncomplicated hypertension to second and third line therapy...
June 7, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28910594/concordance-between-common-hypertension-control-algorithms-in-electronic-medical-record-data
#14
Victoria M Nielsen, Amy Bettano, Mark Josephson, Laura Nasuti, W W Sanouri Ursprung
Because quality improvement metrics and treatment guidelines are used to conduct research, evaluate care quality, and assess population health, they should, ideally, align. We used electronic medical record data to analyze variation between blood pressure control estimates calculated by using thresholds derived from National Quality Forum 0018 (NQF 0018) and Joint National Committee (JNC) treatment guidelines in a cohort of patients with hypertension. Percentage of patients with controlled blood pressure derived from each quality improvement or treatment guideline cutoff varied up to 16...
September 14, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28906541/roadmap-to-achieve-25-hypertension-control-in-africa-by-2025
#15
Anastase Dzudie, Brian Rayner, Dike Ojji, Aletta E Schutte, Marc Twagirumukiza, Albertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter, Bongani Mayosi
BACKGROUND AND AIM: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority for action to reduce heart disease and stroke on the continent. The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025...
July 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28901848/pulmonary-hypertension-secondary-to-left-heart-disease
#16
Ghazal Kabbach, Debabrata Mukherjee
Pulmonary hypertension (PH) related to left heart disease (LHD) is the most common form of PH, accounting for more than two third of all PH cases. The hemodynamic abnormalities seen in PH-LHD are complex, and there are currently minimal evidence-based recommendations for the management of PH-LHD. While it is accepted that PH in the context of left heart disease is a marker of worse prognosis, it remains unclear whether its primary treatment is beneficial or harmful. In this article, we discuss the prevalence and significance of PH in patients with heart failure (HF) with reduced ejection fraction (HFrEF) as well as HF with preserved ejection fraction (HFpEF), and those with valvular heart disease and provide insights into the complex pathophysiology of cardiopulmonary interrelationship in individuals with PH due to left heart disease...
September 12, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28900587/prevalence-and-predictors-of-depression-amongst-hypertensive-individuals-in-karachi-pakistan
#17
Samar Mahmood, Syeda Z Hassan, Muqadus Tabraze, Mohammad O Khan, Iqra Javed, Ameer Ahmed, Omer M Siddiqui, Mehek Narmeen, Maham J Ahmed, Afreen Tariq, Mustafa S Patel, Kaneez Fatima
OBJECTIVE: While studies evaluating the prevalence of depression and hypertension have been extensively carried out in high income countries, there is a paucity of information assessing the prevalence of depression within hypertensive patients in low income nations. The primary objective of this study was to investigate the prevalence of undiagnosed depression in hypertensive patients within a tertiary care facility in Karachi, Pakistan. The secondary objective was to assess factors associated with undiagnosed depression in this group...
June 26, 2017: Curēus
https://www.readbyqxmd.com/read/28895439/preventing-cardiovascular-disease-after-hypertensive-disorders-of-pregnancy-searching-for-the-how-and-when
#18
T Katrien J Groenhof, Bas B van Rijn, Arie Franx, Jeanine E Roeters van Lennep, Michiel L Bots, A Titia Lely
Background Women with a history of a hypertensive disorder during pregnancy (HDP) have an increased risk of cardiovascular events. Guidelines recommend assessment of cardiovascular risk factors in these women later in life, but provide limited advice on how this follow-up should be organized. Design Systematic review and meta-regression analysis. Methods The aim of our study was to provide an overview of existing knowledge on the changes over time in three major modifiable components of cardiovascular risk assessment after HDP: blood pressure, glucose homeostasis and lipid levels...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28895425/predictors-of-subsequent-myocardial-infarction-stroke-and-death-in-stable-post-myocardial-infarction-patients-a-nationwide-cohort-study
#19
Dong-Yi Chen, Chen-Yu Li, Ming-Jer Hsieh, Chun-Chi Chen, I-Chang Hsieh, Tien-Hsing Chen, Shao-Wei Chen, Chao-Yung Wang, Shang-Hung Chang, Cheng-Hung Lee, Ming-Lung Tsai, Ming-Yun Ho, Jih-Kai Yeh, Chee-Jen Chang, Ming-Shien Wen
BACKGROUND: This study investigated the predictors of subsequent cardiovascular events in stable post-myocardial infarction patients in Taiwan. METHODS: A total of 11,183 patients were recruited who had survived one year post-myocardial infarction without subsequent events of recurrent myocardial infarction or stroke from the Taiwan National Health Insurance Research Database. Their composite cardiovascular event rates were identified. RESULTS: The composite cardiovascular events rate in three year follow-up in the post-myocardial infarction population was 13...
September 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28890308/left-ventricular-mass-geometry-and-function-in-diabetic-patients-affected-by-coronary-artery-disease
#20
Maria Maiello, Annapaola Zito, Santa Carbonara, Marco Matteo Ciccone, Pasquale Palmiero
INTRODUCTION: Coronary artery disease (CAD) is quite common among diabetic patients, our study goal is to detect the prevalence of left ventricular (LV) adverse changes in geometry, mass and diastolic function on diabetic, but not hypertensive patients, with coronary artery disease(CAD) and LV ejection fraction(LVEF)>45%, actually unknown, because of current guidelines that do not include echocardiographic assessment for follow up of diabetic patients. PATIENTS AND METHODS: 665 consecutive diabetic patients (443 females, mean age 66±9years), performed a complete echocardiographic assessment according to current ASE echo-guidelines: diastolic dysfunction (DD), eccentric hypertrophy (EH), concentric hypertrophy (CH) and concentric remodeling (CR) of LV were reported...
October 2017: Journal of Diabetes and its Complications
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