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Fred Stephen Sarfo, Osei Sarfo-Kantanka, Sheila Adamu, Vida Obese, Jennifer Voeks, Raelle Tagge, Vipin Sethi, Bruce Ovbiagele
BACKGROUND: There is an unprecedented rise in the prevalence of stroke in sub-Saharan Africa (SSA). Secondary prevention guidelines recommend that antihypertensive, statin and antiplatelet therapy be initiated promptly after ischemic stroke and adhered to in a persistent fashion to achieve optimal vascular-risk reduction. However, these goals are seldom realized in routine clinical care settings in SSA due to logistical challenges. We seek to assess whether a polypill containing fixed doses of three antihypertensive agents, a statin and antiplatelet therapy taken once daily per os for 12 months among recent stroke survivors would result in carotid intimal thickness regression compared with usual care (UC)...
March 14, 2018: Trials
Esther Oluwasola Aluko, Temidayo Olutayo Omobowale, Ademola Adetokunbo Oyagbemi, Olumuyiwa Abiola Adejumobi, Temitayo Olabisi Ajibade, Adesoji Adedipe Fasanmade
Nitric oxide (NO) is major endothelial relaxing factor and reduction in its bioavailabilty has been linked to hypertension. Furthermore, high lipid content is a strong risk factor predisposing to cardiovascular diseases. The principal focus of this study was to investigate the effect of blockade of nitric oxide synthase (NOS) on serum lipid content in rats. Male Wistar rats (150-170 g, n = 15) were randomly divided into two groups designated control (n = 5), and L-Name group (n = 10) and were gavage with distilled water and 60 mg/kg of L-NAME respectively daily for three weeks...
March 8, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Qing-Qing Fang, Xiao-Feng Wang, Wan-Yi Zhao, Shi-Li Ding, Bang-Hui Shi, Ying Xia, Hu Yang, Li-Hong Wu, Cai-Yun Li, Wei-Qiang Tan
Angiotensin-converting enzyme inhibitors (ACEIs) can improve the fibrotic processes in many internal organs. Recent studies have shown a relationship between ACEI with cutaneous scar formation, although it has not been confirmed, and the underlying mechanism is unclear. In this study, we cultured mouse NIH 3T3 fibroblasts with different concentrations of ACEI. We measured cell proliferation with a Cell Counting Kit-8 and collagen expression with a Sirius Red Collagen Detection Kit. Flow cytometry and western blotting were used to detect transforming growth factor β1 (TGF-β1) signaling...
February 20, 2018: Scientific Reports
Peter Bramlage, Stefanie Schmidt, Helen Sims
Fixed-dose combinations (FDC) have been developed to reduce the pill burden for hypertensive patients. Data on fixed-dose or free-dose (freeDC) ramipril/amlodipine (R/A) or candesartan/amlodipine (C/A) combination treatment initiation were assessed. 71 463 patients were prescribed R/A and 10 495 C/A. For both R/A and C/A, FDC patients were younger (both P < .001) and less comorbid. Prior MI (OR: 0.61 and 0.60), prior stroke (OR: 0.68 and 0.70) and CHD (OR: 0.68 and 0.64) were negatively associated with FDC use, whereas hyperlipidemia was positively associated (OR: 1...
February 19, 2018: Journal of Clinical Hypertension
Ignacio J Amat-Santos, Pablo Catalá, Felipe Diez Del Hoyo, Jose A Fernandez-Diaz, Juan H Alonso-Briales, María Del Trigo, Ander Regueiro, Pablo Juan-Salvadores, Vicenç Serra, Enrique Gutierrez-Ibanes, Antonio J Muñoz-García, Luis Nombela-Franco, Manel Sabate, Victor A Jimenez-Diaz, Bruno García Del Blanco, Javier López, Luis H Varela-Falcón, Teresa Sevilla, Roman Arnold, Ana Revilla, J Alberto San Roman
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement. METHODS AND ANALYSIS: The RAS blockade after TAVI (RASTAVI) trial aims to detect if there is a benefit in clinical outcomes and ventricular remodelling with this therapeutic strategy following the TAVI procedure...
February 13, 2018: BMJ Open
Nicholas A Fergusson, Tim Ramsay, Michaël Chassé, Shane W English, Greg A Knoll
OBJECTIVE: Determine the impact of using the win ratio approach and investigate whether this approach alters the interpretations or conclusions of a randomized trial in kidney transplantation. STUDY DESIGN AND SETTING: We present an application of the win ratio approach in a kidney transplant trial that assessed the clinical effectiveness of ramipril treatment versus placebo. The primary composite outcome included the time to death, kidney transplant failure, or doubling of serum creatinine...
February 8, 2018: Journal of Clinical Epidemiology
Stephan Knöchner, K Kronberg, U Schumann
ANAMNESIS:  A 47-year-old recreational sportsman showed in a routine ergometry polymorphic ventricular extrasystoles with good physical performance. INVESTIGATIONS:  In resting ECG impressed ventricular extrasystoles (VES) predominantly right-hand-block-like with superior axis, a long-term ECG yielded up to 100 VES per hour. Echocardiographically imposing 4 - 5 trabeculae, feathered, reticular structures apically in the left and lower in the right ventricle...
February 2018: Deutsche Medizinische Wochenschrift
M Ekholm, A Jekell, N H Wallén, B Gigante, T Kahan
Drugs blocking the renin-angiotensin-aldosterone system may offer benefit on endothelial function, inflammation, and hemostasis in addition to the effects of reducing blood pressure. We examined the contribution of the angiotensin converting enzyme inhibitor ramipril and the alpha 1-adrenergic receptor blocker doxazosin on blood pressure and on markers of inflammation and hemostasis in 59 individuals with mild-to-moderate hypertension randomized to receive double blind ramipril 10 mg od or doxazosin 8 mg od for 12 weeks...
January 30, 2018: Journal of Cardiovascular Pharmacology
Maria Saager, Peter Peschke, Thomas Welzel, Lifi Huang, Stephan Brons, Rebecca Grün, Michael Scholz, Jürgen Debus, Christian P Karger
BACKGROUND: The present work summarizes the research activities on radiation-induced late effects in the rat spinal cord carried out within the "clinical research group ion beam therapy" funded by the German Research Foundation (DFG, KFO 214). METHODS AND MATERIALS: Dose-response curves for the endpoint radiation-induced myelopathy were determined at 6 different positions (LET 16-99 keV/μm) within a 6 cm spread-out Bragg peak using either 1, 2 or 6 fractions of carbon ions...
January 11, 2018: Radiation Oncology
Sidy Mohamed Seck, Dominique Doupa, Diatou Guéye Dia, ElHadji Assane Diop, Denis-Luc Ardiet, Renata Campos Nogueira, Bertrand Graz, Boucar Diouf
Medicinal plants are widely used as a first-line therapy for hypertension, often without comparative clinical data. A prospective, randomized controlled trial was conducted to assess efficacy of Combretum micranthum (kinkeliba) and Hibiscus sabdariffa (bissap), in the galenic form of capsules of plant powder, on blood pressure in adult patients with non-complicated hypertension ( > 140/90 mm Hg). One hundred and twenty five patients were randomly allocated into group 1 (kinkeliba leaves 190 mg × 2/day), or group 2 (bissap calyx 320 mg × 2/day), or group 3 (ramipril 5 mg /day) during four consecutive weeks...
December 2017: Journal of Human Hypertension
Michael Fralick, Aaron S Kesselheim, Jerry Avorn, Sebastian Schneeweiss
Importance: Manufacturers of US Food and Drug Administration-approved prescription drugs often apply for additional indications based on randomized clinical trials. Real-world database analyses on a medication's use and outcomes in routine settings of care might help to inform decision making regarding such supplemental indications. Objective: To examine whether longitudinal data from a health care database can support the results of a randomized clinical trial that led to a supplemental indication for telmisartan...
November 20, 2017: JAMA Internal Medicine
Betty S Chan, Therese Becker, Angela L Chiew, Ahmed M Abdalla, Tom A Robertson, Xin Liu, Michael S Roberts, Nicholas A Buckley
INTRODUCTION: Management of severe vasoplegic shock in overdose can be very challenging. We describe a case of severe refractory vasodilatory shock in poisoning where methylene blue (MB) was used with success. However, the patient subsequently developed severe Serotonin Syndrome (SS) as a result of an interaction between serotonergic drugs and MB. CASE REPORT: A 15-year-old male developed severe vasoplegic shock 1.5 hours after overdosing on several different medications including quetiapine slow release, quetiapine immediate release, desvenlafaxine slow release, venlafaxine, amlodipine, ramipril, fluoxetine, promethazine and lithium...
November 13, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Micheal S Ward, Nicole B Flemming, Linda A Gallo, Amelia K Fotheringham, Domenica A McCarthy, Aowen Zhuang, Peter H Tang, Danielle J Borg, Hannah Shaw, Benjamin Harvie, David R Briskey, Llion A Roberts, Manuel R Plan, Michael P Murphy, Mark P Hodson, Josephine M Forbes
Mitochondrial dysfunction is a pathological mediator of diabetic kidney disease (DKD). Our objective was to test the mitochondrially targeted agent, MitoQ, alone and in combination with first line therapy for DKD. Intervention therapies (i) vehicle (D); (ii) MitoQ (DMitoQ;0.6 mg/kg/day); (iii) Ramipril (DRam;3 mg/kg/day) or (iv) combination (DCoAd) were administered to male diabetic db/db mice for 12 weeks (n = 11-13/group). Non-diabetic (C) db/m mice were followed concurrently. No therapy altered glycaemic control or body weight...
November 9, 2017: Scientific Reports
Andreas Jekell, Thomas Kahan
PURPOSE: Inhibition of the renin-angiotensin system may have effects on vascular structure and function beyond the effects on blood pressure (BP) reduction. We studied the ability of a single arm cuff oscillometric method (Arteriograph, TensioMed, Hungary) to assess effects of antihypertensive treatment on BP and arterial stiffness. Furthermore, this technique was compared to pulse wave analysis and applanation tonometry (SphygmoCor, AtCor Medical, Australia). MATERIALS AND METHODS: Brachial and aortic BP, augmentation index (AIx), and carotid-femoral pulse wave velocity (PWV) was simultaneously assessed by both techniques in 71 untreated hypertensive patients...
October 26, 2017: Blood Pressure
Gábor Simonyi, Tamás Ferenci
INTRODUCTION: In the treatment of hypertension avoiding adverse cardiovascular complications to achieve target blood pressure is essential. The appropriate drug selection, and if necessary to change to combination therapy, patients adherence is important which may help fixed dose combination. AIM: The aim of the authors was to investigate the one year adherence of the ramipril and ramipril/amlodipine fixed dose combination in hypertensive patients. METHOD: Prescriptions database of the National Health Insurance Fund in Hungary on pharmacy-claims was analysed between October 1, 2012 and September 30, 2013...
October 2017: Orvosi Hetilap
Antonios Douros, Elisabeth Bronder, Andreas Klimpel, Christiane Erley, Edeltraut Garbe, Reinhold Kreutz
OBJECTIVES: Drug-induced kidney injury (DIKI) may affect patients regardless of their baseline kidney function. Therefore, this study evaluated DIKI in patients with or without previous chronic kidney disease (CKD). MATERIALS AND METHODS: Potential DIKI cases were ascertained using the network of the Berlin Case-Control Surveillance Study in all 51 Berlin hospitals from April 2010 until December 2011. Via face-to-face interviews and medical chart reviews, information on all previous drug intake, comorbidities, and demographics was gathered...
January 2018: Clinical Nephrology
Klaus K Witte, Michael Drozd, Andrew M N Walker, Peysh A Patel, Jessica C Kearney, Sally Chapman, Robert J Sapsford, John Gierula, Maria F Paton, Judith Lowry, Mark T Kearney, Richard M Cubbon
OBJECTIVE: Diabetes increases mortality in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction. Studies have questioned the safety of β-adrenoceptor blockers (β-blockers) in some patients with diabetes and reduced left ventricular ejection fraction. We examined whether β-blockers and ACE inhibitors (ACEIs) are associated with differential effects on mortality in CHF patients with and without diabetes. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort study of 1,797 patients with CHF recruited between 2006 and 2014, with mean follow-up of 4 years...
January 2018: Diabetes Care
Giuseppe Mancia, Helmut Schumacher, Michael Böhm, Josep Redon, Roland E Schmieder, Paolo Verdecchia, Peter Sleight, Koon Teo, Salim Yusuf
In 28 790 patients recruited for the ONTARGET (Ongoing Treatment Alone and in Combination With Ramipril Global End Point Trials) and TRANSCEND (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease) trials, we investigated the prognostic value for cardiovascular events (primary outcome) of (1)on-treatment visit-to-visit systolic blood pressure (SBP) variability versus mean SBP and (2) the 2 measures together. SBP variability was measured by the coefficient of variation (CV) of mean SBP to which it was unrelated...
November 2017: Hypertension
Simona Censi, Maria Paola Albergoni, Nicoletta Gallo, Mario Plebani, Marco Boscaro, Corrado Betterle
We describe the case of a 54-year-old Caucasian Italian male experiencing episodes of hypoglycemia, occurring mainly after meals. He had never been exposed to insulin and was taking ramipril, flecainide and acetylsalicylic acid. An oral glucose tolerance test (OGTT) showed high blood glucose levels diagnostic for diabetes mellitus at 120 min and hypoglycemia with inappropriately high insulin levels at 240 min. The 72-h fasting test, abdominal computed tomography (CT) and positron emission tomography-CT were normal...
September 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
Flavien Bessaguet, Aurore Danigo, Laurent Magy, Franck Sturtz, Alexis Desmoulière, Claire Demiot
Sensory defects associated with small-fiber neuropathy (SFN) can lead to profound disabilities. The relationship between the sensory nervous system and modulation of the renin-angiotensin system (RAS) has been described and focused on pain and neurodegeneration in several animal models. We have recently developed an experimental model of functional sensory neuropathy showing thermal hypoalgesia and neuropeptide depletion without nerve fiber degeneration. Here, we aimed to determine whether the modulation of angiotensin II (Ang II) activity could prevent sensory neuropathy induced by RTX...
September 5, 2017: Neuropharmacology
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