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https://www.readbyqxmd.com/read/28938505/-treatment-targets-in-hypertension
#1
Rainer Düsing
The optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28938338/mortality-implications-of-lower-dbp-with-lower-achieved-systolic-pressures-in-coronary-artery-disease-long-term-mortality-results-from-the-international-verapamil-trandolapril-study-us-cohort
#2
Anita Wokhlu, Steven M Smith, Yan Gong, Eileen M Handberg, Islam Y Elgendy, Anthony A Bavry, Rhonda M Cooper-DeHoff, Carl J Pepine
OBJECTIVES: A goal SBP 120 mmHg or less reduced mortality in high-risk Systolic Blood Pressure Intervention Trial patients; however, mortality implications of concomitant DBP lowering in coronary artery disease (CAD) are uncertain. We examined the relationship between DBP lowering and all-cause mortality with lower achieved SBPs in a large cohort. METHODS: We categorized 17 131 hypertensive patients from the INternational VErapamil-trandolapril STudy US cohort, aged at least 50 years with CAD, by mean achieved SBP (<120, 120 to <130, 130 to <140, and ≥140 mmHg) and DBP tertiles (low, middle, and high per SBP category) during active follow-up...
September 21, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28937582/design-of-the-exercise-mri-evaluation-of-hiv-pulmonary-arterial-hypertension-longitudinal-determinants-exhalted-trial
#3
Mohamad Amer Alaiti, Aditya Goud, Gautam Ramani, Sashwatee Bagchi, Sadeer Al-Kindi, Steven Sawicki, Christopher Longenecker, Trevor Jenkins, David Pauza, Myung Park, Grace McComsey, Orlando Simonetti, Brian Hoit, Sanjay Rajagopalan
BACKGROUND: Pulmonary arterial hypertension (PAH) is a potentially serious cause of dyspnea and exercise limitation in patients with HIV infection. In this trial, we propose using exercise MRI in conjunction with cardiopulmonary testing to delineate PAH from other causes of cardiovascular dysfunction, identify individuals with exercise-induced PAH who are at high risk of developing resting PAH, and provide longitudinal estimates of progression of PAH and right ventricular function. METHODS: In this prospective observational study, HIV patients with dyspnea and exercise limitation in the absence of identifiable causes and those who meet the inclusion criteria will be enrolled based on resting pulmonary artery pressure (≤ or >40 mmHg) on a screening echocardiogram and exercise limitation on the Modified Medical Research Council dyspnea scale...
September 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28937442/orally-active-epoxyeicosatrienoic-acid-analogs
#4
William B Campbell, John D Imig, James M Schmitz, John R Falck
Biologically active epoxyeicosatrienoic acid (EET) regioisomers are synthesized from arachidonic acid by cytochrome P450 epoxygenases of endothelial, myocardial, and renal tubular cells. EETs relax vascular smooth muscle and decrease inflammatory cell adhesion and cytokine release. Renal EETs promote sodium excretion and vasodilation to decrease hypertension. Cardiac EETs reduce infarct size after ischemia-reperfusion injury and decrease fibrosis and inflammation in heart failure. In diabetes, EETs improve insulin sensitivity, increase glucose tolerance, and reduce the renal injury...
September 19, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28936586/role-of-structured-individual-patient-education-in-the-prevention-of-vascular-complications-in-newly-diagnosed-type-2-diabetes-the-individual-therapeutic-education-in-newly-diagnosed-type-2-diabetes-intend-randomized-controlled-trial
#5
Adriana Coppola, Livio Luzi, Tiziana Montalcini, Andrea Giustina, Carmine Gazzaruso
OBJECTIVE: Recent studies showed that a structured patient therapeutic education (PTE) may decrease both mortality and the development of diabetes complications. Nevertheless, no data are available in the literature on the impact of individual PTE on the complications in newly diagnosed type 2 diabetic patients. Aim of the present randomized controlled trial is to evaluate the impact of individual PTE on the occurrence of macrovascular complications in newly diagnosed type 2 diabetic patients when compared to usual care (UC) and group PTE...
September 21, 2017: Endocrine
https://www.readbyqxmd.com/read/28936072/alleviating-stress-response-to-tracheal-extubation-in-neurosurgical-patients-a-comparative-study-of-two-infusion-doses-of-dexmedetomidine
#6
Ankur Luthra, Hemanshu Prabhakar, Girija Prasad Rath
BACKGROUND: Tracheal extubation is almost always associated with increase in sympathoadrenal activity may result in hypertension, tachycardia, and arrhythmias. Attempts have been made to oppose the pressor response by the use of various drugs. Dexmedetomidine decreases norepinephrine which reduces the blood pressure and the heart rate (HR). We hypothesize that the infusion of dexmedetomidine may produce more stable hemodynamics during extubation as compared to boluses. MATERIALS AND METHODS: Ninety adult patients aged 18-65 years, the American Society of Anesthesiologists Grade I-II undergoing intracranial surgeries for various neurologic problem at All India Institute of Medical Sciences were enrolled in this randomized controlled trial...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28935772/the-european-medicines-agency-review-of-carfilzomib-for-the-treatment-of-adult-patients-with-multiple-myeloma-who-have-received-at-least-one-prior-therapy
#7
Kyriaki Tzogani, Jorge Camarero Jiménez, Isabel Garcia, Arantxa Sancho-López, Marc Martin, Alexandre Moreau, Pierre Demolis, Tomas Salmonson, Jonas Bergh, Edward Laane, Heinz Ludwig, Christian Gisselbrecht, Francesco Pignatti
On November 19, 2015, a marketing authorization valid through the European Union was issued for carfilzomib in combination with lenalidomide and dexamethasone for the treatment of adult patients with multiple myeloma (MM) who have received at least one prior therapy.In a phase III trial in patients with relapsed MM, median progression-free survival (PFS) for patients treated with carfilzomib in combination with lenalidomide and dexamethasone (CRd) was 26.3 months versus 17.6 months for those receiving lenalidomide and dexamethasone alone (hazard ratio = 0...
September 21, 2017: Oncologist
https://www.readbyqxmd.com/read/28935081/efficacy-and-safety-of-the-absorb-bioresorbable-vascular-scaffold-in-females-and-males-results-of-an-individual-patient-level-pooled-meta-analysis-of-randomized-controlled-trials
#8
Satya Shreenivas, Dean J Kereiakes, Stephen G Ellis, Runlin Gao, Takeshi Kimura, Yoshinobu Onuma, Karine Piard-Ruster, Yunlong Zhang, Kai Koo, Minh-Thien Vu, Patrick W Serruys, Gregg W Stone
OBJECTIVES: Because females are under-represented in coronary trials, this study sought to assess the relative safety and efficacy of Absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) and the Xience everolimus-eluting stent in females compared with males. BACKGROUND: The Absorb everolimus-eluting BVS provides drug delivery and mechanical support similar to a metallic drug-eluting stent, followed by resorption and restoration of more normal vascular structure with the potential to improve late clinical outcomes...
September 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28934871/idiopathic-intracranial-hypertension-vision-venous-intervention-versus-shunting-in-iih-for-optic-nerve-disc-swelling-trial-patient-perspective-questionnaire
#9
Arun Chandran, Heinke Pulhorn, Catherine McMahon
INTRODUCTION: Headaches, visual problems and tinnitus are symptoms of Idiopathic Intracranial Hypertension (IIH) which resolve with reduction of CSF pressure. Impaired cranial venous outflow has been implicated in the pathogenesis and there is evidence of good treatment results in IIH using venous sinus stenting. We are currently initiating a multi-centre randomised controlled trial, the VISION study (Venous Intervention versus Shunting in IIH for Optic Disc Swelling) comparing radiological (venous sinus stenting) to surgical intervention (CSF shunting)...
September 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28934258/reports-of-unintended-consequences-of-financial-incentives-to-improve-management-of-hypertension
#10
Sylvia J Hysong, Richard SoRelle, Kristen Broussard Smitham, Laura A Petersen
BACKGROUND: Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT) of financial incentives...
2017: PloS One
https://www.readbyqxmd.com/read/28933948/the-value-and-application-of-the-six-minute-walk-test-in-idiopathic-pulmonary-fibrosis
#11
A Whitney Brown, Steven D Nathan
The 6 minute walk test (6MWT) is a commonly employed assessment of performance ability in a variety of cardiopulmonary diseases. It provides important functional information that is not captured in standardized pulmonary function testing. The test may be influenced by factors other than the severity of lung disease, including frailty, deconditioning, and musculoskeletal issues. The primary output measure from the six minute walk test is the distance walked, which appears to confer prognostic information in many diverse disease states...
September 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28933305/epidemiology-of-diabetes-mellitus-in-the-united-arab-emirates
#12
Hira Abdul Razzak, Alya Harbi, Wael Shelpai, Ahmad Qawas
Background/ Objective: Diabetes mellitus is a non-communicable disease which has become a major global public health issue. This systematic review summarized epidemiological studies related to the prevalence, risk factors, complications, incidence, knowledge, attitude and practices of Diabetes Mellitus (DM) among Arab population in the United Arab Emirates (UAE). METHOD: PubMed, Scopus databases, Science direct, Wiley online library, and other local journals were searched to identify relevant literature using appropriate keywords to retrieve studies conducted in the UAE...
September 20, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28933045/a-prospective-single-arm-trial-of-modified-long-biliopancreatic-and-short-alimentary-limbs-roux-en-y-gastric-bypass-in-type-2-diabetes-patients-with-mild-obesity
#13
Abdon José Murad, Ricardo Vitor Cohen, Eudes Paiva de Godoy, Christian Lamar Scheibe, Giuliano Peixoto Campelo, Almino Cardoso Ramos, Roclides Castro de Lima, Luís Eduardo Veras Pinto, Daniel Coelho, Hamilton Belo França Costa, Ígor Marreiros Pereira Pinto, Tiago Pereira, Francisco Raúl Santos Teófilo, José Aparecido Valadão
BACKGROUND: Type-2 diabetes (T2D) patients with body mass index (BMI) below 35 kg/m(2) carry lower remission rates than severely obese T2D individuals submitted to "standard limb lengths" Roux-en-Y gastric bypass (RYGB). Mild-obese patients appear to have more severe forms of T2D, where the mechanisms of glycemic control after a standard-RYGB may be insufficient. The elongation of the biliopancreatic limb may lead to greater stimulation of the distal intestine, alterations in bile acids and intestinal microbiota, among other mechanisms, leading to better metabolic outcomes...
September 20, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28932549/statins-may-be-beneficial-for-patients-with-pulmonary-hypertension-secondary-to-lung-diseases
#14
Ming-Zhou Zhang, De-Hui Qian, Jian-Cheng Xu, Wei Yao, Ye Fan, Chang-Zheng Wang
BACKGROUND: Previous animal studies and clinical trials report inconsistent findings regarding the role of statins in pulmonary hypertension (PH). Systematic reviews have shown no use of statins on pulmonary arterial hypertension (PAH). This is the first meta-analysis of randomized controlled trials (RCTs) determining the clinical impacts of statin therapy on patients with PH secondary to lung diseases. METHODS: Electronic databases and manual bibliographical searches were conducted...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#15
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28931031/reducing-therapeutic-misconception-a-randomized-intervention-trial-in-hypothetical-clinical-trials
#16
Paul P Christopher, Paul S Appelbaum, Debbie Truong, Karen Albert, Louise Maranda, Charles Lidz
BACKGROUND: Participants in clinical trials frequently fail to appreciate key differences between research and clinical care. This phenomenon, known as therapeutic misconception, undermines informed consent to clinical research, but to date there have been no effective interventions to reduce it and concerns have been expressed that to do so might impede recruitment. We determined whether a scientific reframing intervention reduces therapeutic misconception without significantly reducing willingness to participate in hypothetical clinical trials...
2017: PloS One
https://www.readbyqxmd.com/read/28930715/cigarette-smoking-attenuates-kidney-protection-by-angiotensin-converting-enzyme-inhibition-in-nondiabetic-chronic-kidney-disease
#17
Bethany Roehm, Jan Simoni, Jessica Pruszynski, Donald E Wesson
BACKGROUND: Cigarette smoking exacerbates the estimated glomerular filtration rate (eGFR) decline in nondiabetic chronic kidney disease (CKD) despite the kidney protection that is achieved by angiotensin converting enzyme inhibition (ACEI). Whether smoking cessation restores ACEI-related kidney protection is not known. METHODS: This 5-year, prospective, prevention trial recruited 108 smokers and 108 nonsmokers with stage-2 nondiabetic CKD with primary hypertension and urine albumin-to-creatinine ratio (Ualb) >200 mg/g...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28929695/-effects-of-mongolia-astragali-radix-in-protecting-early-cardiac-and-nephritic-functions-of-patients-of-hypertension-with-metabolic-syndrome
#18
Ning-Yin Li, Xiu-Li Li, Xiao-Ping Zhai, Qiong-Ying Wang, Xiao-Wei Zhang, Feng Zhao, Xiao-Feng Wang, Jian-Yun Fan, Feng Bai, Jing Yu
To explore the effect of Mongolia Astragali Radix produced in Longxi of Gansu province in protecting cardiac and nephritic functions of patients of essential hypertension(EH) with metabolic syndrome(MetS). A total of two hundred and twenty-six EH patients with MetS aged above 18 were selected. Patients were randomly divided to control group(adopted conventional medical treatment), Astragali Radix group 1(added Astragali Radix capsules 10 g•d⁻¹ besides conventional medical treatment) and Astragali Radix group 2(added Astragali Radix capsules 5 g•d⁻¹ besides conventional medical treatment)...
November 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28929577/salt-intake-and-blood-pressure-response-to-percutaneous-renal-denervation-in-resistant-hypertension
#19
Esther de Beus, Rosa L de Jager, Martine M Beeftink, Margreet F Sanders, Wilko Spiering, Evert-Jan Vonken, Michiel Voskuil, Michiel L Bots, Peter J Blankestijn
The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24-hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension...
September 19, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28928965/recent-advances-in-understanding-and-managing-cardiomyopathy
#20
REVIEW
Paulino Alvarez, Wh Wilson Tang
Cardiomyopathy is a disease of the heart muscle leading to abnormal structure or function in the absence of coronary artery disease, hypertension, or valvular or congenital heart disease. Currently, cardiomyopathy is the leading diagnosis of heart transplant patients worldwide. Incorporation of next-generation sequencing strategies will likely revolutionize genetic testing in cardiomyopathy. The use of patient-specific pluripotent stem cell-derived cardiomyocytes for disease modeling and therapeutic testing has opened a new avenue for precision medicine in cardiomyopathy...
2017: F1000Research
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