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Cardiovascular disease management

Shereen M Hamza, John E Hall
Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice...
February 14, 2018: Journal of Visualized Experiments: JoVE
Geoff Hackett, Mike Kirby, Kevan Wylie, Adrian Heald, Nick Ossei-Gerning, David Edwards, Asif Muneer
BACKGROUND: This is an update of the 2008 British Society for Sexual Medicine (BSSM) guidelines. AIM: To provide up-to-date guidance for U.K. (and international) health care professionals managing male sexual dysfunction. METHODS: Source information was obtained from peer-reviewed articles, meetings, and presentations. A search of Embase, MEDLINE, and Cochrane Reviews was performed, covering the search terms "hypogonadism," "eugonadal or hypogonadism or hypogonadal or gonadal," and "low or lower testosterone," starting from 2009 with a cut-off date of September 2017...
March 14, 2018: Journal of Sexual Medicine
Belén Pérez-Pevida, Daniela Stefania Trifu, Anna Kamocka, Julia Álvarez Hernández
CONTEXT: Bariatric surgery has beneficial effects on obesity and associated comorbidities such as glycaemic control in type 2 diabetes, dyslipidaemia, hypertension, and renal and hepatic function. Nevertheless, this surgery is not free of complications and possible side effects due to restrictive and/or malabsorptive related components. CASE DESCRIPTION: We report the case of a 60-year-old woman whose past medical history included morbid obesity, hypertension and Scopinaro biliopancreatic diversion (BPD) with duodenal switch in 1998...
March 1, 2018: International Journal of Surgery Case Reports
Michaël R Laurent
An overview of selected papers related to bone published in 2017 is provided. PURPOSE: This paper accompanies a lecture at the 2018 Belgian Bone Club annual Clinical Update Symposium held in Brussels on January 20th, discussing the best papers (in the opinion of the author) published in the previous year. METHODS: A PubMed search using the keyword "bone" and articles published in 2017. RESULTS: Hot topics include screening for osteoporosis, novel anabolic drugs such as romosozumab and abaloparatide for osteoporosis and rare metabolic bone diseases, as well as long-term efficacy of denosumab and possible risk of multiple vertebral fractures following its discontinuation...
March 15, 2018: Archives of Osteoporosis
Lenette M Jones, Kathy D Wright, McKenzie K Wallace, Tiffany Veinot
Nearly half of African-American women have hypertension, which increases their risk for cardiovascular disease and stroke. A plethora of consumer health information products and services exist to inform people with hypertension and to promote self-management among them. Promotion of information sharing by African-American women represents a promising, culturally-applicable strategy for consumer health information services focused on hypertension self-management. Yet, how African-American women share hypertension information with others is unclear...
January 2018: Journal of the Association for Information Science and Technology
Holger Lörchner, Christian Widera, Yunlong Hou, Albrecht Elsässer, Henning Warnecke, Evangelos Giannitsis, Jean-Sebastien Hulot, Thomas Braun, Kai C Wollert, Jochen Pöling
BACKGROUND: Regenerating islet-derived protein 3 beta (Reg3β) is a cardiomyocyte-derived chemokine for macrophages that is upregulated after myocardial infarction (MI) in mice. Here, we hypothesized that monitoring Reg3β expression might provide specific information on the degree of cardiac inflammation, which is a key determinant in disease progression and prognosis of patients with acute coronary syndrome (ACS). METHODS AND RESULTS: The expression of Reg3β and other inflammatory markers including C-reactive protein (CRP) and myeloperoxidase (MPO) was measured by immunoblotting at serial time points in the hearts and serum of mice with acute MI...
May 1, 2018: International Journal of Cardiology
Cho-Kai Wu, Jyh-Ming Jimmy Juang, Jiun-Yang Chiang, Yi-Heng Li, Chia-Ti Tsai, Fu-Tien Chiang
Taiwanese heart registries for the main cardiovascular diseases have been conducted in the past 10 years, with the goal of examining the quality of cardiovascular patient care, which cannot be guaranteed by the universal Taiwan National Health Insurance. The results show suboptimal adherence to guideline recommendations. Door-to-balloon time and dual antiplatelet therapy use in acute coronary syndrome, standard medications for management of heart failure, low-density lipoprotein cholesterol levels in dyslipidemia, anticoagulant agent use in atrial fibrillation, and the understanding of sudden arrhythmia death syndrome were all found to be inadequate...
March 20, 2018: Journal of the American College of Cardiology
Carol Kelly, James D Chalmers, Iain Crossingham, Nicola Relph, Lambert M Felix, David J Evans, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life...
March 15, 2018: Cochrane Database of Systematic Reviews
Eleonore V Grant, Adam H Skolnick, Joshua Chodosh, Michael H Perskin, Nicole M Orr, Caroline Blaum, John A Dodson
More than 13 million persons in the United States aged 65 and older have cardiovascular disease (CVD), and this population is expected to increase exponentially over the next several decades. In the absence of clinical studies that would inform how best to manage this population, there is an urgent need for collaborative, thoughtful approaches to their care. Although cardiologists are traditionally regarded as leaders in the care of older adults with CVD, these individuals have multiple comorbidities, physiological differences, and distinct goals of care than younger patients that require a specialized geriatric lens...
March 15, 2018: Journal of the American Geriatrics Society
Tazeen H Jafar, Ngiap Chuan Tan, John C Allen, Eric A Finkelstein, Paul Goh, Peter Moey, Joanne Hui Min Quah, Siew Wai Hwang, Juliana Bahadin, Anandan Gerard Thiagarajah, Jason Chan, Gary Kang, Agnes Koong
BACKGROUND: Hypertension is a serious public health problem in Singapore and is associated with significant morbidity and mortality from cardiovascular disease (CVD) with considerable implications for health-care resources. The goal of the trial is to compare a multicomponent intervention (MCI) to usual care to evaluate the effectiveness and cost-effectiveness of the MCI for lowering blood pressure (BP) among adults with uncontrolled hypertension in Singapore primary-care clinics. METHODS/DESIGN: The study is a cluster randomized trial in eight polyclinics in Singapore: four deliver a structured MCI and four deliver usual care...
March 14, 2018: Trials
Masaki Okazaki, Daijo Inaguma, Takahiro Imaizumi, Akiko Kada, Takaaki Yaomura, Naotake Tsuboi, Shoichi Maruyama
BACKGROUND: Patients with late referral and positive history of volume overload may have a poor prognosis after initiating dialysis due to insufficient and/or inadequate management of complications of renal failure and the lack of better dialysis preparation. Little is known about the influence of the relationship between history of volume overload and late referral on prognosis. METHODS: We analyzed 1475 patients who had initiated dialysis for the first time from October 2011 to September 2013...
March 14, 2018: BMC Nephrology
Elena Bellosta Diago, Jesús Pérez-Pérez, Sonia Santos Lasaosa, Alejandro Viloria Alebesque, Saül Martínez-Horta, Jaime Kulisevsky, Javier López Del Val
Cardiovascular events are a major cause of early death in the Huntington's disease (HD) population. Dysautonomia as well as deterioration of circadian rhythms can be detected early in the disease progression and can have profound effects on cardiac health. The aim of the present study was to determine if HD patients and premanifest mutation carriers present a higher risk of cardiovascular disease (CVD) than non-mutation carrying controls METHODS: Prospective, cross-sectional, multicentre study of 38 HD mutation carriers (23 premanifest and 15 early-stage patients) compared to 38 age- and gender-matched healthy controls...
March 14, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
M Rroji, G Spasovski
Secondary hyperparathyroidism (SHPT) is common among patients with end-stage renal disease (ESRD). SHPT is associated with high-turnover bone disease, interstitial and vascular calcifications, cardiovascular morbidity and mortality. The pharmacological management of SHPT has progressed in recent years. The introduction of targeted therapies, such as selective vitamin D receptors activators and calcium-sensing receptor modulators, offers an increased opportunity to adequately control elevated parathyroid hormone (PTH), especially in patients with chronic kidney disease under dialysis treatment...
March 12, 2018: International Urology and Nephrology
Jocasta Ball, Maja-Lisa Løchen, Melinda J Carrington, Joshua F Wiley, Simon Stewart
Objective: Mild cognitive impairment (MCI) is prevalent in atrial fibrillation (AF) and has the potential to contribute to poor outcomes. We investigated the influence of MCI on survival and rehospitalisation in patients with chronic forms of AF undergoing a home-based, AF-specific disease management intervention (home-based intervention (HBI)) or standard management (SM). Methods: The Montreal Cognitive Assessment tool was administered at baseline (a score of <26/30 indicated MCI) in patients with AF randomised to HBI versus SM...
2018: Open Heart
Benjamin D Horne, Joseph B Muhlestein, Durgesh Bhandary, Greta L Hoetzer, Naeem D Khan, Tami L Bair, Donald L Lappé
Objective: Post-myocardial infarction (MI) care is crucial to preventing recurrent major adverse cardiovascular events (MACE), but can be complicated to personalise. A tool is needed that effectively stratifies risk of cardiovascular (CV) events 1-3 years after MI but is also clinically usable. Methods: Patients surviving ≥1 year after an index MI with ≥1 risk factor for recurrent MI (ie, age ≥65 years, prior MI, multivessel coronary disease, diabetes, glomerular filtration rate <60 mL/min/1...
2018: Open Heart
Rahul Aggarwal, Jackson Steinkamp, Nicholas Chiu, Benjamin Petrie, Haares Mirzan
Optimal blood pressure (BP) targets for different populations, especially diabetics, remain uncertain after conflicting data on intensive management. We assessed whether a <120 mm Hg systolic target is beneficial and whether certain patient populations differ in response. Individual patient data of 14 094 patients from 2 randomized control trials was pooled. Seven thousand forty patients were assigned to an intensive target of <120 mm Hg and 7054 patients to a standard target of <140 mm Hg in an intention-to-treat analysis...
March 12, 2018: Hypertension
Jessica M Scott, Tormod S Nilsen, Dipti Gupta, Lee W Jones
Cardio-oncology is an emerging discipline focused predominantly on the detection and management of cancer treatment-induced cardiac dysfunction (cardiotoxicity), which predisposes to development of overt heart failure or coronary artery disease. The direct adverse consequences, as well as those secondary to anticancer therapeutics, extend beyond the heart, however, to affect the entire cardiovascular-skeletal muscle axis (ie, whole-organism cardiovascular toxicity). The global nature of impairment creates a strong rationale for treatment strategies that augment or preserve global cardiovascular reserve capacity...
March 13, 2018: Circulation
Kavitha Vellanki, Susan Hou
Most women with dialysis-dependent chronic kidney disease (CKD) stage 5 (CKD stage 5D) are in the postmenopausal age group. Early menopause is reported for all CKD stages (stages 3-5D). The traditional definition of menopause is not applicable in CKD stage 5(D) because menses can resume with hormone replacement therapy or kidney transplantation. Treatment of vasomotor symptoms continues to be the primary indication for hormone replacement therapy, with no dosing studies done specifically for CKD or kidney transplantation populations...
March 9, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Victoria M Pak, Feng Dai, Brendan T Keenan, Nalaka S Gooneratne, Allan I Pack
Sleepiness and cardiovascular disease share common molecular pathways; thus, metabolic risk factors for sleepiness may also predict cardiovascular disease risk. Daytime sleepiness predicts mortality and cardiovascular disease, although the mechanism is unidentified. This study explored the associations between subjective sleepiness and metabolite concentrations in human blood plasma within the oxidative and inflammatory pathways, in order to identify mechanisms that may contribute to sleepiness and cardiovascular disease risk...
April 2018: Sleep Medicine
Georgia Brown, Tilman Humpl
PURPOSE OF REVIEW: Pulmonary vascular disease (PVD) complicates the course of many cardiovascular, pulmonary and other systemic diseases in children. The physiological sequelae (pulmonary hypertension and elevated pulmonary vascular resistance) can overwhelm the right ventricle and lead to circulatory collapse. Despite the common end-point, the preceding pathophysiology is complex and variable and requires a tailored approach to diagnosis and management. In this article, we will review the most recent evidence and explore an approach to current controversies in the diagnosis and management of common or challenging patient subgroups...
March 9, 2018: Current Opinion in Pediatrics
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