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https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#1
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28431150/the-natural-history-of-children-with-joint-hypermobility-syndrome-and-ehlers-danlos-hypermobility-type-a-longitudinal-cohort-study
#2
Mark C Scheper, Lesley L Nicholson, Roger D Adams, Louise Tofts, Verity Pacey
Objectives.: The objective of the manuscript was to describe the natural history of complaints and disability in children diagnosed with joint hypermobility syndrome (JHS)/Ehlers-Danlos-hypermobility type (EDS-HT) and to identify the constructs that underlie functional decline. Methods.: One hundred and one JHS/EDS-HT children were observed over 3 years and assessed at three time points on the following: functional impairments, quality of life, connective tissue laxity, muscle function, postural control and musculoskeletal and multi-systemic complaints...
April 18, 2017: Rheumatology
https://www.readbyqxmd.com/read/28429690/-our-experience-in-the-diagnosis-and-treatment-of-postural-orthostatic-tachycardia-syndrome-vasovagal-syncope-and-inappropriate-sinus-tachycardia-in-children
#3
Sezen Ugan Atik, Reyhan Dedeoğlu, Aida Koka, Funda Öztunç
OBJECTIVES: The aim of this study was to share our experience in the diagnosis and treatment of patients who presented at our clinic with syncope, pre-syncope, dizziness, and palpitations. STUDY DESIGN: Patients who were treated at pediatric cardiology clinic for complaints of syncope, dizziness, and palpitations between 2014 and 2016 were enrolled in the study. Detailed history of the patients, physical examination findings, laboratory and electrocardiogram results were recorded...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28429687/postural-orthostatic-tachycardia-a-syndrome-requiring-detailed-search-for-associated-conditions
#4
EDITORIAL
Farid Aliyev
No abstract text is available yet for this article.
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28428900/asymptomatic-severe-vagal-and-sympathetic-cardiac-denervation-in-holmes-adie-s-syndrome
#5
B Estañol, R C Callejas-Rojas, S Cortés, R Martínez-Memije, O Infante-Vázquez, G Delgado-García
A 40-year-old woman was found to have bilateral Adie's pupils and generalized muscle stretch areflexia. She did not have orthostatic hypotension but, in an ECG strip in the office, she appeared to have an almost fixed heart rate. We thus studied the heart rate variability (HRV) and the systolic blood pressure variability (SBPV) in supine and standing position and also during rhythmic breathing. We found a decreased HRV in the time domain with very low standard deviation in supine and standing position and during rhythmic breathing...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28421033/orthostatic-hypotension-predicts-cognitive-impairment-in-the-elderly-findings-from-a-cohort-study
#6
Haixia Huang, Tianheng Zheng, Fang Liu, Zhuoli Wu, Huazheng Liang, Shaoshi Wang
BACKGROUND: Orthostatic hypotension (OH) is a known risk factor for cerebral ischemia, but its correlation with cognitive impairment (CI) is not well established. OBJECTIVE: The aim of this study is to explore the relationship between OH and CI in the elderly. METHODS: The study group consisted of 44 OH patients who presented with drowsiness, vertigo, and fatigue between January 2009 and December 2011 (OH group). Eighty-eight healthy elderly were paired with those in the OH group in a 1:2 based on their education levels (NOH group)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28417649/internal-dysregulation-of-the-renin-system-in-patients-with-stable-liver-cirrhosis
#7
Annette Dam Fialla, Helle C Thiesson, Peter Bie, Ove B Schaffalitzky de Muckadell, Aleksander Krag
Sodium retention in cirrhosis is associated with changes in the renin-angiotensin-aldosterone system (RAAS), the sympathetic nervous system (SNS), and the glomerular filtration rate (GFR). We hypothesized that in cirrhosis the acute reactions of RAAS and SNS to volume expansion are qualitatively intact, but occurring from elevated baseline levels. Acute cardiovascular, neurohumoral and renal responses to central blood volume changes were studied in cirrhotic patients and healthy controls. In patients, baseline plasma renin concentration (PRC) was elevated 5-fold compared to controls (p < ...
April 18, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28414396/postural-tachycardia-syndrome-diagnosis-and-management-in-adolescents-and-young-adults
#8
Geoffrey L Heyer
Postural tachycardia syndrome (POTS) represents a common form of orthostatic intolerance that disproportionately affects young women from puberty through adulthood. Patients with POTS have day-to-day orthostatic symptoms with the hallmark feature of an excessive, sustained, and symptomatic rise in heart rate during orthostatic testing. Although considerable overlap exists, three subtypes of POTS have been described: neuropathic, hyperadrenergic, and hypovolemic forms. The wide spectrum of symptoms and comorbidities can make treatment particularly challenging...
April 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28408809/assessment-of-effects-of-differences-in-trunk-posture-during-fowler-s-position-on-hemodynamics-and-cardiovascular-regulation-in-older-and-younger-subjects
#9
Satoshi Kubota, Yutaka Endo, Mitsue Kubota, Tomohiko Shigemasa
BACKGROUND: Downward shifts in blood volume with changing position generally cause tachycardic responses. Age-related decreases in vagal nerve activity could contribute to orthostatic hypotension in older individuals. Fowler's position is a reclined position with the back between 30° and 60°, used to facilitate breathing, eating, and other routine daily activities in frail and elderly patients. OBJECTIVE: This study examined whether stroke volume (SV) was higher and heart rate (HR) lower in Fowler's position with an upright upper trunk than in Fowler's position with the whole trunk upright in both older and younger subjects, based on the assumption that lower HR would result from reduced sympathetic activation in older individuals...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28406700/moderate-exercise-based-on-artificial-gravity-preserves-orthostatic-tolerance-and-exercise-capacity-during-short-term-head-down-bed-rest
#10
Xiao-Tao Li, Chang-Bin Yang, Yong-Sheng Zhu, Jing Sun, Fei Shi, Yong-Chun Wang, Yuan Gao, Jiang-Dong Zhao, Xi-Qing Sun
Numerous countermeasures have been proposed to minimize microgravity-induced physical deconditioning, but their benefits are limited. The present study aimed to investigate whether personalized aerobic exercise based on artificial gravity (AG) mitigates multisystem physical deconditioning. Fourteen men were assigned to the control group (n=6) and the countermeasure group (CM, n=8). Subjects in the CM group were exposed to AG (2Gz at foot level) for 30 min twice daily, during which time cycling exercise of 80-95% anaerobic threshold (AT) intensity was undertaken...
April 12, 2017: Physiological Research
https://www.readbyqxmd.com/read/28401995/orthostatic-dizziness-in-parkinson-s-disease-is-attributed-to-cerebral-hypoperfusion-a-transcranial-doppler-study
#11
Jinse Park, Hee-Tae Kim, Kang Min Park, Sam Yeol Ha, Sung Eun Kim, Kyong Jin Shin, Si Eun Kim, Wooyoung Jang, Ji Sun Kim, Jinyoung Youn, Engsoek Oh, Suyeon Park
OBJECTIVES: Orthostatic hypotension (OH) is controversially regarded as the cause of orthostatic dizziness in Parkinson's disease (PD). We sought to evaluate whether cerebral autoregulation is an alternative cause for orthostatic dizziness in PD patients, using transcranial Doppler monitoring during head-up tilting. METHODS: Forty-five PD patients with dizziness, 13 PD patients without dizziness, and 10 age-matched healthy controls were enrolled. Participants were divided into the following four groups: patients with dizziness and OH (group 1, n = 22), patients with dizziness but no OH (n = 23, group 2), patients without dizziness (n = 11, group 3), and age-matched healthy controls (n = 10, group 4)...
April 12, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28398981/effectiveness-of-non-pharmacological-interventions-in-treating-orthostatic-hypotension-in-the-elderly-and-people-with-a-neurological-condition-a-systematic-review-protocol
#12
Angela Logan, Jonathan Marsden, Jennifer Freeman, Bridie Kent
The objectives of the review are to determine:Specifically, the review question is:What is the evidence base for non-pharmacological interventions in treating orthostatic hypotension (OH) in elderly people and people with a neurological condition?
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28398383/-right-atrial-appendage-thrombosis-during-atrial-fibrillation-an-element-to-look-for
#13
Giovanni Barbati, Renato De Domenico, Stefania Rossi, Elena Vecchiato, Roberto Zeppellini
Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT...
March 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28389156/response-of-non-motor-symptoms-to-levodopa-in-late-stage-parkinson-s-disease-results-of-a-levodopa-challenge-test
#14
Margherita Fabbri, Miguel Coelho, Leonor Correia Guedes, Ines Chendo, Catarina Sousa, Mario M Rosa, Daisy Abreu, Nilza Costa, Catarina Godinho, Angelo Antonini, Joaquim J Ferreira
BACKGROUND: Non-motor symptoms (NMS) are extremely common among late-stage Parkinson's disease (LSPD) patients. Levodopa (L-dopa) responsiveness seems to decrease with disease progression but its effect on NMS in LSPD still needs to be investigated. OBJECTIVE: To assess the response of blood pressure (BP), pain, fatigue and anxiety to L-dopa in LSPD patients. METHODS: 20 LSPD patients, defined as Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 (MED ON) and 22 PD patients treated with subthalamic deep brain stimulation (advanced PD group) underwent an L-dopa challenge...
February 7, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28385881/quantitative-measurement-of-csf-in-patients-with-spontaneous-intracranial-hypotension
#15
H-C Chen, P-L Chen, Y-H Tsai, C-H Chen, C C-C Chen, J-W Chai
BACKGROUND AND PURPOSE: CSF hypovolemia is a core feature of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is characterized by orthostatic headache and radiologic manifestations, including CSF along the neural sleeves, diffuse pachymeningeal enhancement, and/or venous engorgement. However, these characteristics are only qualitative. Quantifying intraspinal CSF volumes could improve spontaneous intracranial hypotension diagnosis and evaluation of hypovolemic statuses in patients with spontaneous intracranial hypotension...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28383399/poststroke-alterations-in-heart-rate-variability-during-orthostatic-challenge
#16
Joel Rodriguez, Andrew Philip Blaber, Markus Kneihsl, Irhad Trozic, Rebecca Ruedl, David A Green, James Broadbent, Da Xu, Andreas Rössler, Helmut Hinghofer-Szalkay, Franz Fazekas, Nandu Goswami
Older adults following recovery from ischemic stroke have a higher incidence of orthostatic hypotension, syncope, and fall risk, which may be related to impaired autonomic responses limiting the ability to maintain cerebral blood flow. Thus, we investigated cerebrovascular and cardiovascular regulation in 23 adults ≥55 years of age, 10 diagnosed with ischemic stroke, and 13 age-matched healthy controls when sitting at rest and upon standing to compare differences of autonomic variables at ∼7 months (218 ± 41 days) poststroke...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28376495/postural-orthostatic-tachycardia-predicts-early-conversion-to-multiple-sclerosis-after-clinically-isolated-syndrome
#17
Mario Habek, Magdalena Krbot Skorić, Luka Crnošija, Tereza Gabelić, Barbara Barun, Ivan Adamec
BACKGROUND/AIMS: There have been suggestions that interactions exist between the autonomic nervous system (ANS) and the immune system functions in multiple sclerosis (MS). We aimed to evaluate the ANS dysfunction, more specifically postural orthostatic tachycardia syndrome (POTS), as a possible predictor of conversion to MS in patients with clinically isolated syndrome (CIS). METHODS: In this observational, prospective, longitudinal study, 84 patients were enrolled (56 females, mean age 32...
April 5, 2017: European Neurology
https://www.readbyqxmd.com/read/28373993/efficacy-of-administration-of-an-angiotensin-converting-enzyme-inhibitor-for-two-years-on-autonomic-and-peripheral-neuropathy-in-patients-with-diabetes-mellitus
#18
Triantafyllos Didangelos, Konstantinos Tziomalos, Charalambos Margaritidis, Zisis Kontoninas, Ioannis Stergiou, Stefanos Tsotoulidis, Eleni Karlafti, Alexandros Mourouglakis, Apostolos I Hatzitolios
Aim. To evaluate the effect of quinapril on diabetic cardiovascular autonomic neuropathy (CAN) and peripheral neuropathy (DPN). Patients and Methods. Sixty-three consecutive patients with diabetes mellitus [43% males, 27 with type 1 DM, mean age 52 years (range 22-65)], definite DCAN [abnormal results in 2 cardiovascular autonomic reflex tests (CARTs)], and DPN were randomized to quinapril 20 mg/day (group A, n = 31) or placebo (group B, n = 32) for 2 years. Patients with hypertension or coronary heart disease were excluded...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28373858/enhanced-cholinergic-activity-improves-cerebral-blood-flow-during-orthostatic-stress
#19
Jorge M Serrador, Roy Freeman
Cerebral blood flow (CBF) and consequently orthostatic tolerance when upright depends on dilation of the cerebral vasculature in the face of reduced perfusion pressure associated with the hydrostatic gradient. However, it is still unclear if cholinergic activation plays a role in this dilation. To determine if enhancing central cholinergic activity with the centrally acting acetylcholinesterase inhibitor, physostigmine would increase CBF when upright compared to the peripherally acting acetylcholinesterase inhibitor, neostigmine, or saline...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28353545/orthostatic-hypotension-new-views-for-an-old-problem
#20
Edoardo Casiglia, Jens Jordan
No abstract text is available yet for this article.
May 2017: Journal of Hypertension
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