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https://www.readbyqxmd.com/read/28765731/combining-potent-statin-therapy-with-other-drugs-to-optimize-simultaneous-cardiovascular-and-metabolic-benefits-while-minimizing-adverse-events
#1
REVIEW
Kwang Kon Koh, Ichiro Sakuma, Kazunori Shimada, Toshio Hayashi, Michael J Quon
Hypercholesterolemia and hypertension are among the most important risk factors for cardiovascular (CV) disease. They are also important contributors to metabolic diseases including diabetes that further increase CV risk. Updated guidelines emphasize targeted reduction of overall CV risks but do not explicitly incorporate potential adverse metabolic outcomes that also influence CV health. Hypercholesterolemia and hypertension have synergistic deleterious effects on interrelated insulin resistance and endothelial dysfunction...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28763548/effect-of-oral-methylprednisolone-on-clinical-outcomes-in-patients-with-iga-nephropathy-the-testing-randomized-clinical-trial
#2
RANDOMIZED CONTROLLED TRIAL
Jicheng Lv, Hong Zhang, Muh Geot Wong, Meg J Jardine, Michelle Hladunewich, Vivek Jha, Helen Monaghan, Minghui Zhao, Sean Barbour, Heather Reich, Daniel Cattran, Richard Glassock, Adeera Levin, David Wheeler, Mark Woodward, Laurent Billot, Tak Mao Chan, Zhi-Hong Liu, David W Johnson, Alan Cass, John Feehally, Jürgen Floege, Giuseppe Remuzzi, Yangfeng Wu, Rajiv Agarwal, Hai-Yan Wang, Vlado Perkovic
Importance: Guidelines recommend corticosteroids in patients with IgA nephropathy and persistent proteinuria, but the effects remain uncertain. Objective: To evaluate the efficacy and safety of corticosteroids in patients with IgA nephropathy at risk of progression. Design, Setting, and Participants: The Therapeutic Evaluation of Steroids in IgA Nephropathy Global (TESTING) study was a multicenter, double-blind, randomized clinical trial designed to recruit 750 participants with IgA nephropathy (proteinuria greater than 1 g/d and estimated glomerular filtration rate [eGFR] of 20 to 120 mL/min/1...
August 1, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28760223/clinical-profile-of-patients-with-type-2-diabetes-mellitus-treated-with-sodium-glucose-cotransporter-2-inhibitors-and-experience-in-real-world-clinical-practice-in-spain
#3
Gabriel Cuatrecasas, Fernando Goñi-Goicoechea
The main aim of the treatment of type 2 diabetes is overall control of cardiovascular risk factors. Almost 50% of patients with type 2 diabetes do not achieve glycaemic targets, and a much higher percentage do not achieve weight and blood pressure targets, despite the therapeutic arsenal that has appeared in the last decade for the treatment of this disease. In addition, antidiabetic secretatogues and insulin are associated with weight gain and an increased risk of hyperglycaemic episodes. Clinical practice guidelines recommend sodium-glucose cotransporter-2 inhibitors (SGLT2i) as an alternative in the same therapeutic step as the other options after initiation of metformin therapy...
November 2016: Medicina Clínica
https://www.readbyqxmd.com/read/28713443/e-healthcare-for-diabetes-mellitus-type-2-patients-a-randomised-controlled-trial-in-slovenia
#4
Rade Iljaž, Andrej Brodnik, Tatjana Zrimec, Iztok Cukjati
BACKGROUND: Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM). A new approach in treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study. METHOD: Fifteen Slovene family practices enrolled 120 DM patients treated only with a diet regime and/or tablets into the study...
September 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28680820/renal-sodium-handling-and-sodium-sensitivity
#5
REVIEW
Alissa A Frame, Richard D Wainford
The pathophysiology of hypertension, which affects over 1 billion individuals worldwide, involves the integration of the actions of multiple organ systems, including the kidney. The kidney, which governs sodium excretion via several mechanisms including pressure natriuresis and the actions of renal sodium transporters, is central to long term blood pressure regulation and the salt sensitivity of blood pressure. The impact of renal sodium handling and the salt sensitivity of blood pressure in health and hypertension is a critical public health issue owing to the excess of dietary salt consumed globally and the significant percentage of the global population exhibiting salt sensitivity...
June 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28660087/a-novel-technique-of-stenting-of-the-renal-artery-in-stent-restenosis-with-guideliner%C3%A2-through-radial-approach
#6
Maheedhar Gedela, Shenjing Li, Tomasz Stys, Adam Stys
In-stent restenosis of the renal arteries is relatively common and its management is not well studied. An 83-year-old female with bilateral renal artery stenosis and balloon angioplasty and stenting bilaterally one year ago was found to have recurrent severe elevations in the blood pressure despite medical management. Renal artery duplex showed 60-99% stenosis of the right renal artery and 20-59% stenosis of the left renal artery. A subsequent angiography of the right renal artery revealed 80% in-stent restenosis at the ostium...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28650917/long-term-changes-in-left-ventricular-mass-echocardiographic-findings-from-a-general-population
#7
Cesare Cuspidi, Fosca Quarti, Raffaella Dell'Oro, Rita Facchetti, Michele Bombelli, Carla Sala, Marijana Tadic, Guido Grassi, Giuseppe Mancia
AIM: We sought to assess the long-term changes in left ventricular (LV) mass in a population-based sample, focusing on new onset, persistence, regression and severity of LV hypertrophy (LVH), as well as on the demographic and clinical variables independently related to this dynamic process. METHODS: A total of 1113 participants with measurable echocardiographic parameters at baseline and after a 10-year follow-up were included in the analysis. Cut points for LVH were derived from current echocardiographic guidelines...
June 24, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28616291/intensive-blood-pressure-control-in-patients-with-acute-type-b-aortic-dissection-raid-study-protocol-for-randomized-controlled-trial
#8
REVIEW
Jian-Cang Zhou, Nan Zhang, Zhong-Heng Zhang, Ting-Ting Wang, Yue-Feng Zhu, Hui Kang, Wei-Min Zhang, Dong-Lin Li, Wei-Dong Li, Zhen-Jie Liu, Xi-Min Qian, Ming-You Zhang, Jue Wang, Mi Zhou, Zhi-Tao Yang, Yun-Xian Yu, Hang-Yang Li, Jian Zhang, Yong-Gang Wang, Jian-Ping Gao, Lin Ling, Kong-Han Pan
BACKGROUND: Blood pressure control is an essential therapy for patients with acute type B aortic dissection (ABAD) and should be maintained throughout the entire treatment. Thus, vast majority current guidelines recommend control the blood pressure to lower than 140/90 mmHg. Theoretically, a much lower target may further decrease the risk of propagation of dissection. However, some argued that too lower blood pressure would compromise the organ perfusion. Thus, there is no unanimous optimal target for blood pressure in patients with ABAD so far...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28566070/reducing-cardiovascular-disease-risk-in-diabetes-a-randomised-controlled-trial-of-a-quality-improvement-initiative
#9
Santhi Chalasani, David P Peiris, Tim Usherwood, Julie Redfern, Bruce C Neal, David R Sullivan, Stephen Colagiuri, Nicholas A Zwar, Qiang Li, Anushka Patel
OBJECTIVES: To describe the management of cardiovascular disease (CVD) risk in Australian patients with diabetes; to compare the effectiveness of a quality improvement initiative for people with and without diabetes. RESEARCH DESIGN AND METHODS: Subgroup analyses of patients with and without diabetes participating in a cluster randomised trial. SETTING AND PARTICIPANTS: Indigenous people (≥ 35 years old) and non-Indigenous people (≥ 45 years old) who had attended one of 60 Australian primary health care services at least three times during the preceding 24 months and at least once during the past 6 months...
June 5, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28559651/the-2017-focused-update-of-the-guidelines-of-the-taiwan-society-of-cardiology-tsoc-and-the-taiwan-hypertension-society-ths-for-the-management-of-hypertension
#10
REVIEW
Chern-En Chiang, Tzung-Dau Wang, Tsung-Hsien Lin, Hung-I Yeh, Ping-Yen Liu, Hao-Min Cheng, Ting-Hsing Chao, Chen-Huan Chen, Kou-Gi Shyu, Kwo-Chang Ueng, Chung-Yin Chen, Pao-Hsien Chu, Shih-Hsien Sung, Kang-Ling Wang, Yi-Heng Li, Kuo-Yang Wang, Fu-Tien Chiang, Wen-Ter Lai, Jyh-Hong Chen, Wen-Jone Chen, San-Jou Yeh, Ming-Fong Chen, Shing-Jong Lin, Jiunn-Lee Lin
Hypertension (HT) is the most important risk factor for cardiovascular diseases. Over the past 25 years, the number of individuals with hypertension and the estimated associated deaths has increased substantially. There have been great debates in the past few years on the blood pressure (BP) targets. The 2013 European Society of Hypertension and European Society of Cardiology HT guidelines suggested a unified systolic BP target of 140 mmHg for both high-risk and low-risk patients. The 2014 Joint National Committee report further raised the systolic BP targets to 150 mmHg for those aged ≥ 60 years, including patients with stroke or coronary heart disease, and raised the systolic BP target to 140 mmHg for diabetes...
May 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28555164/brain-multimodality-monitoring-a-new-tool-in-neurocritical-care-of-comatose-patients
#11
REVIEW
Nudrat Tasneem, Edgar A Samaniego, Connie Pieper, Enrique C Leira, Harold P Adams, David Hasan, Santiago Ortega-Gutierrez
Neurocritical care patients are at risk of developing secondary brain injury from inflammation, ischemia, and edema that follows the primary insult. Recognizing clinical deterioration due to secondary injury is frequently challenging in comatose patients. Multimodality monitoring (MMM) encompasses various tools to monitor cerebral metabolism, perfusion, and oxygenation aimed at detecting these changes to help modify therapies before irreversible injury sets in. These tools include intracranial pressure (ICP) monitors, transcranial Doppler (TCD), Hemedex™ (thermal diffusion probe used to measure regional cerebral blood flow), microdialysis catheter (used to measure cerebral metabolism), Licox™ (probe used to measure regional brain tissue oxygen tension), and continuous electroencephalography...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28529721/the-impact-of-antihypertensives-on-kidney-disease
#12
REVIEW
Diego F Marquez, Gema Ruiz-Hurtado, Luis Ruilope
Arterial hypertension and chronic kidney disease (CKD) are intimately related. The control of blood pressure (BP) levels is strongly recommended in patients with CKD in order to protect the kidney against the accompanying elevation in global cardiovascular (CV) risk. Actually, the goal BP in patients with CKD involves attaining values <140/90 mmHg except if albuminuria is present. In this case, it is often recommended to attain values <130/80 mmHg, although some guidelines still recommend <140/90 mmHg...
2017: F1000Research
https://www.readbyqxmd.com/read/28511070/impact-of-exaggerated-blood-pressure-response-in-normotensive-individuals-on-future-hypertension-and-prognosis-systematic-review-according-to-prisma-guideline
#13
REVIEW
Karsten Keller, Kathrin Stelzer, Mir Abolfazl Ostad, Felix Post
PURPOSE: Arterial hypertension (aHT) is the leading risk factor for morbidity and mortality worldwide. Blood pressure (BP) deviation at rest is well defined and accompanies risk for cardiovascular events and cardiovascular mortality. A growing body of evidence emphasises that an exaggerated blood pressure response (EBPR) in cardiopulmonary exercise testing (CPET) could help to identify seemingly cardiovascular healthy and normotensive subjects, who have an increased risk of developing aHT and cardiovascular events in the future...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28492286/has-the-sprint-trial-introduced-a-new-blood-pressure-goal-in-hypertension
#14
REVIEW
Gema Ruiz-Hurtado, José R Banegas, Pantelis A Sarafidis, Massimo Volpe, Bryan Williams, Luis M Ruilope
SPRINT is the first randomized, controlled trial showing that a systolic blood-pressure goal of <120 mmHg can be attained with cardiovascular benefits in a select group of patients with hypertension and an elevated cardiovascular risk with different origins. Although the patient population with characteristics like those in SPRINT makes up only 20-30% of the total hypertensive population, SPRINT is a landmark study that highlights the need to consider lower blood- pressure goals in the treatment of hypertension...
September 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28481608/risk-factors-for-diabetic-retinopathy-among-homeless-veterans
#15
John A Davis, Irena Tsui, Lillian Gelberg, Sonya Gabrielian, Martin L Lee, Evelyn T Chang
Homeless patients have high rates of visual impairment and lower rates of glycemic control than housed patients. Although diabetic retinopathy (DR) is the most common cause of new visual impairment and legal blindness in the developed world, little is known about differential risk factors for and rates of DR in homeless versus housed populations. This study aimed to compare the rates of DR between homeless and housed patients with diabetes at the Greater Los Angeles Veterans Affairs Health care System (GLA) and identify clinical and psychosocial predictors of DR rates...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28475386/achieving-blood-pressure-targets-for-prolonged-cardiovascular-health-a-historical-perspective
#16
Steven G Chrysant
Hypertension is a major risk factor for coronary artery disease (CAD), stroke, heart failure, and chronic kidney disease (CKD), and its successful control leads to a decrease or prevention of these complications. Areas covered: Over the years the Joint National Committees and the American Heart Association have issued guidelines regarding the treatment of hypertension. Those of 2003 and 2007 respectively, have recommended reduction of blood pressure (BP) to < 140/90 mmHg for uncomplicated hypertension and to < 130/80 mmHg for hypertensive patients with diabetes mellitus, CKD, or CAD...
May 15, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28451445/who-are-patients-classified-within-the-new-terminology-of-heart-failure-from-the-2016-esc-guidelines
#17
Benoit Delepaul, Guillaume Robin, Clément Delmas, Thomas Moine, Adrien Blanc, Pauline Fournier, Aénora Roger-Rollé, Guillaume Domain, Clémence Delon, Charles Uzan, Rabah Boudjellil, Didier Carrié, Jérôme Roncalli, Michel Galinier, Olivier Lairez
AIMS: The main terminology used to describe heart failure (HF) is based on measurement of the left ventricular ejection fraction (LVEF). LVEF in the range of 40-49% was recently defined as HF with mid-range EF (HFmrEF) by the 2016 European Society of Cardiology guidelines. The purpose of our study was to assess the clinical profile and prognosis of patients with HF according to this new classification. METHODS AND RESULTS: A total of 482 patients referred for HF were retrospectively included over a period of 1 year...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28449829/hypertension-canada-s-2017-guidelines-for-the-diagnosis-%C3%A2-assessment-prevention-and-treatment-of%C3%A2-pediatric-hypertension
#18
Janis M Dionne, Kevin C Harris, Geneviève Benoit, Janusz Feber, Luc Poirier, Lyne Cloutier, Meranda Nakhla, Doreen M Rabi, Stella S Daskalopoulou, Anne Fournier
After the 2016 guidelines for blood pressure measurement, diagnosis, and investigation of pediatric hypertension, we now present evidence-based guidelines for the prevention and treatment of hypertension in children. These guidelines were developed by Hypertension Canada's Guideline Committee pediatric subgroup after thorough evaluation of the available literature. Included are 10 guidelines specifically addressing health behaviour management, indications for drug therapy in children with hypertension, choice of therapy for children with primary hypertension, and goals of therapy for children with hypertension...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28449828/hypertension-canada-s-2017-guidelines-for-diagnosis-risk-assessment-prevention-and-treatment-of-hypertension-in-adults
#19
Alexander A Leung, Stella S Daskalopoulou, Kaberi Dasgupta, Kerry McBrien, Sonia Butalia, Kelly B Zarnke, Kara Nerenberg, Kevin C Harris, Meranda Nakhla, Lyne Cloutier, Mark Gelfer, Maxime Lamarre-Cliche, Alain Milot, Peter Bolli, Guy Tremblay, Donna McLean, Sheldon W Tobe, Marcel Ruzicka, Kevin D Burns, Michel Vallée, G V Ramesh Prasad, Steven E Gryn, Ross D Feldman, Peter Selby, Andrew Pipe, Ernesto L Schiffrin, Philip A McFarlane, Paul Oh, Robert A Hegele, Milan Khara, Thomas W Wilson, S Brian Penner, Ellen Burgess, Praveena Sivapalan, Robert J Herman, Simon L Bacon, Simon W Rabkin, Richard E Gilbert, Tavis S Campbell, Steven Grover, George Honos, Patrice Lindsay, Michael D Hill, Shelagh B Coutts, Gord Gubitz, Norman R C Campbell, Gordon W Moe, Jonathan G Howlett, Jean-Martin Boulanger, Ally Prebtani, Gregory Kline, Lawrence A Leiter, Charlotte Jones, Anne-Marie Côté, Vincent Woo, Janusz Kaczorowski, Luc Trudeau, Ross T Tsuyuki, Swapnil Hiremath, Denis Drouin, Kim L Lavoie, Pavel Hamet, Jean C Grégoire, Richard Lewanczuk, George K Dresser, Mukul Sharma, Debra Reid, Scott A Lear, Gregory Moullec, Milan Gupta, Laura A Magee, Alexander G Logan, Janis Dionne, Anne Fournier, Geneviève Benoit, Janusz Feber, Luc Poirier, Raj S Padwal, Doreen M Rabi
Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed. Previous age and frailty distinctions have been removed as considerations for when to initiate antihypertensive therapy. In the presence of macrovascular target organ damage, or in those with independent cardiovascular risk factors, antihypertensive therapy should be considered for all individuals with elevated average systolic nonautomated office blood pressure (non-AOBP) readings ≥ 140 mm Hg...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28431590/delays-in-door-to-needle-time-for-acute-ischemic-stroke-in-the-emergency-department-a-comprehensive-stroke-center-experience
#20
Ashkan Mowla, Jordan Doyle, Navdeep S Lail, Hamidreza Rajabzadeh-Oghaz, Christopher Deline, Peyman Shirani, Marilou Ching, Annemarie Crumlish, Deborah A Steck, David Janicke, Elad I Levy, Robert N Sawyer
BACKGROUND: Current American Stroke Association guidelines recommend initiating intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) within 60min of patient arrival, given the benefits of IVT for AIS are time dependent. This study aimed to identify the delaying factors in door-to-needle time (DTN) in the emergency department of one of the largest comprehensive stroke centers in New York State. We also recommended measures to reduce the delays. METHODS: We retrospectively reviewed the medical charts of all AIS patients who received IVT in our emergency department patients between April 1, 2012 and December 31, 2015 to identify those with a DTN time of >60min...
May 15, 2017: Journal of the Neurological Sciences
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