MedWorm: Hypertension

[Myocardial necrosis and severe biventricular dysfunction in the context of chronic ephedrine abuse.]

Adicciones — Sun, 21 Mar 2010 16:48:05 +0100

We present the case of a patient, with pre-existing psychiatric conditions, who developed congestive heart failure and pulmonary oedema in the context of severe biventricular dysfunction and myocardial necrosis secondary to longstanding ephedrine abuse. Secondary causes of dilated myocardiopathy such as alcohol abuse, autoimmunity, hemochromatosis, thyroid alterations, viral or bacterial myocarditis and coronary heart disease, were ruled out. Five years after total cessation of use of the drug containing ephedrine, the patient is symptom-free, with partial recovery of left ventricular ejection fraction. PMID: 20300711 [PubMed - in process] (Source: Adicciones)

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Variability as well as high blood pressure holds high risk of stroke

ScienceDaily Headlines — Sun, 21 Mar 2010 15:00:00 +0100

Three new articles show that it is variability in patients' blood pressure that predicts the risk of a stroke most powerfully and not a high average or usual blood pressure level. (Source: ScienceDaily Headlines)

Interventions used to improve control of blood pressure in patients with hypertension.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: Family practices and community-based clinics need to have an organized system of regular follow-up and review of their hypertensive patients. Antihypertensive drug therapy should be implemented by means of a vigorous stepped care approach when patients do not reach target blood pressure levels. Self-monitoring and appointment reminders may be useful adjuncts to the above strategies to improve blood pressure control but require further evaluation. PMID: 20238338 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Clinical Value of the Tissue Doppler S Wave to Characterize Left Ventricular Hypertrophy as Defined by Echocardiography

Echocardiography — Sat, 20 Mar 2010 00:00:00 +0100

Left ventricular hypertrophy (LVH) may be a physiological finding and may also be associated with different disease entities and hence, with different outcomes. Regional myocardial function can be assessed with color Doppler tissue imaging, specifically by the waveform of the isovolumic contraction (IC) period and the regional systolic wave ("s"). Methods and Results: We studied five groups (G): healthy, sedentary young volunteers (G1, n:10); healthy sedentary adult volunteers (G2, n:8); and subjects with LVH (left ventricular mass index >125 g/m2) including: high performance athletes (G3, n:21), subjects with hypertension (G4, n:21), subjects with hypertrophic cardiomyopathy (HCM) (G5, n:18). We measured peak "s" wave velocity (cm/sec) at the basal and mid septum, the IC/s ratio, and basa...

Relationship Between Exercise Heart Rate Recovery and Circadian Blood Pressure Pattern

The Journal of Clinical Hypertension — Sat, 20 Mar 2010 00:00:00 +0100

J Clin Hypertens (Greenwich). The aim of the present cross-sectional study was to evaluate heart rate recovery (HRR) in normotensive and hypertensive individuals with either nondipper or dipper type circadian rhythm of blood pressure. Eighty-five patients were divided into 4 groups according to the presence of hypertension and pattern of circadian blood pressure as follows: (1) normotensive/dipper, n=20; (2) normotensive/nondipper, n=21; (3) hypertensive/dipper, n=22; and (4) hypertensive/nondipper, n=22. HRR indices were calculated by subtracting first, second, and third minute heart rates from the maximal heart rate obtained during stress testing and designated as HRR1, HRR2, and HRR3. Mean HRR1 values (29.7±4.0 vs 26.6±3.7, P=.016) were significantly higher in the normotensive/dipper ...

Estimation of cerebral vascular tone during exercise; evaluation by critical closing pressure in humans

Experimental Physiology — Sat, 20 Mar 2010 00:00:00 +0100

The aim of the present study was to calculate critical closing pressure (CCP) of the cerebral vasculature at rest and during exercise to estimate cerebral vascular tone. Five men and two women were seated upright for 15 min and then performed 15 min of right-legged knee extension exercise at 40, 60 and 75% of their maximal workload (WLmax). Middle cerebral artery blood velocity (MCA V) and blood pressure in the radial artery were recorded. The CCP was calculated by linear extrapolation from 1 min recordings of pairs of systolic and diastolic pressure and MCA V waveforms from both the right and the left MCA. In both arteries, the CCP increased (right MCA, +6.6 ± 8.5 mmHg, P= 0.023; left MCA, +7.3 ± 9.1 mmHg, P= 0.016) during 75% WLmax without changes in resistance[ndash]area product, whil...

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ACE Inhibitor/ARBs Still Used in Pregnancy Despite Teratogenicity

Medscape Today Headlines — Fri, 19 Mar 2010 20:02:18 +0100

New research from the UK has found that doctors are still prescribing ACE inhibitors and angiotensin-receptor blockers in women of child-bearing age, despite evidence that they are teratogenic. Reasons include a lack of awareness of the issue among GPs and obstetricians and ambiguity in hypertension guidelines, says the researcher. Heartwire (Source: Medscape Today Headlines)

Does the coronary disease increase the hospital mortality in patients with aortic stenosis undergoing valve replacement?

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

CONCLUSIONS: In patients undergoing implant isolated from aortic valve prosthesis, the presence of atherosclerotic coronary artery disease associated critical in at least two arteries, influenced the hospital mortality. In patients undergoing surgical treatment combined the number of coronary arteries with critical atherosclerotic disease and extent of coronary artery bypass grafting (complete or incomplete), did not affect the hospital mortality, but the realization of more than three anastomoses in the distal myocardial revascularization interfered. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Gene expression profile in flow-associated pulmonary arterial hypertension with neointimal lesions

AJP: Lung Cellular and Molecular Physiology — Fri, 19 Mar 2010 17:05:33 +0100

Pulmonary arterial hypertension (PAH) is a pulmonary angioproliferative disease with high morbidity and mortality, characterized by a typical pattern of pulmonary vascular remodeling including neointimal lesions. In congenital heart disease, increased pulmonary blood flow has appeared to be a key mediator in the development of these characteristic lesions, but the molecular mechanisms underlying the pulmonary vascular lesions are largely unknown. We employed a rat model of flow-associated PAH, which induced specific pulmonary neointimal lesions. We identified gene expression profiles in rats specifically related to the addition of increased pulmonary blood flow to monocrotaline and the associated occurrence of neointimal lesions. Increased pulmonary blood flow induced the expression of the...

Upregulation of Oct-4 isoforms in pulmonary artery smooth muscle cells from patients with pulmonary arterial hypertension

AJP: Lung Cellular and Molecular Physiology — Fri, 19 Mar 2010 17:05:33 +0100

In conclusion, the data suggest that both Oct-4 isoforms are upregulated and potentially have a significant role in the development of vascular abnormalities associated with the pathogenesis of IPAH and in pulmonary hypertension triggered by chronic hypoxia. (Source: AJP: Lung Cellular and Molecular Physiology)

Reduced mechanical efficiency of rat papillary muscle related to degree of hypertrophy of cardiomyocytes

AJP: Heart and Circulatory Physiology — Fri, 19 Mar 2010 17:01:46 +0100

Isolated rat papillary muscles of the right ventricle were used to discover the origin of reduced myocardial efficiency in chronic heart failure. Right ventricular hypertrophy was induced by monocrotaline injection, causing pulmonary hypertension. Control (n = 7) and hypertrophied (n = 11) papillary muscles were subjected to sinusoidal length changes at 37°C and 5 Hz with a peak-to-peak amplitude of 15% of the length giving maximum force (Lmax) after being stretched to 92.5% of Lmax. Isometric tension at Lmax was similar in control and hypertrophied muscles. Work was assessed from the area encompassed by force-length loops. Work per loop was 0.93 ± 0.11 and 0.84 ± 0.11 µJ/mm3 (means ± SE) for control and hypertrophied muscles, respectively (P = 0.591). Suprab...

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Genomewide RNA expression profiling in lung identifies distinct signatures in idiopathic pulmonary arterial hypertension and secondary pulmonary hypertension

AJP: Heart and Circulatory Physiology — Fri, 19 Mar 2010 17:01:46 +0100

This study shows that PAH and PH secondary to IPF are characterized by distinct gene expression signatures, implying distinct pathophysiological mechanisms. (Source: AJP: Heart and Circulatory Physiology)

Strain-dependent susceptibility for hypertension in mice resides in the natural killer gene complex

AJP: Heart and Circulatory Physiology — Fri, 19 Mar 2010 17:01:46 +0100

In conclusion, we have identified the NK gene complex as an important determinant in the genetically determined sensitivity to develop l-NAME-induced hypertension in mice. (Source: AJP: Heart and Circulatory Physiology)

Ventricular function and natriuretic peptides in sequentially combined models of hypertension

AJP: Heart and Circulatory Physiology — Fri, 19 Mar 2010 17:01:46 +0100

Hemodynamic parameters and natriuretic peptide levels were evaluated in cardiac hypertrophy produced by sequentially applied renovascular (RV) and deoxycorticosterone acetate-salt (DS) models of hypertension. We studied hypertensive rats by RV or DS treatment at 2 and 4 wk, as well as by the combination of 2 wk of each treatment in an inverse sequence: RV 2 wk/DS 2 wk (RV2/DS2) and DS 2 wk/RV 2 wk (DS2/RV2). The in vivo cardiac function, interstitial fibrosis, and synthesis and secretion of types A (ANP) and B (BNP) natriuretic peptides were monitored in hypertensive models compared with their corresponding sham (Sh2, Sh4). There were no differences in relaxation parameters among RV or DS groups and combined treatments. Left ventricular +dP/dtmax increased only in RV4 (P < 0.01 vs. Sh4)...

Lymphadenopathy and systemic lupus erythematosus

Revista Brasileira de Reumatologia — Fri, 19 Mar 2010 16:37:09 +0100

We report the case of a patient with recurrent episodes of lymphadenopathy associated with hepatosplenomegaly, fever, and weight loss since the age of 13 years. The patient also developed arthritis, hypertension, proteinuria, cardiomyopathy, and peripheral neuropathy. His condition was investigated extensively without diagnostic clarification; he was treated, empirically, for tuberculosis. The patient received a diagnosis of SLE only five years after the original presentation and received the specific treatment. Early diagnosis in those cases is difficult because laboratorial exams may not show the presence of auto-antibodies and low complement levels. (Source: Revista Brasileira de Reumatologia)

Alpha-Adrenergic Coronary Vasoconstriction in Humans

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:33 +0100

I read with interest the study of Jensen et al. () and the accompanying editorial (). Jensen et al. demonstrated the abundance of the α1D-adrenoceptor subtype on the mRNA and by radioligand binding on the protein level in epicardial coronary arteries of explanted healthy and diseased human hearts. This information is novel and potentially important for the development of more specific α-adrenoceptor blockers to treat hypertension and/or prostate hyperplasia. The accompanying editorial correctly emphasizes the importance of studies in human rather than animal tissue. The original study and the editorial, however, do not acknowledge the limitations of the in vitro nature of the study. Specifically, no information on the morphological and/or functional status of the analyzed coronary arteri...

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Does Peroxisome Proliferator-activated Receptor-{gamma} (PPAR{gamma}) Protect from Hypertension Directly through Effects in the Vasculature? [Molecular Bases Of Disease]

Journal of Biological Chemistry — Fri, 19 Mar 2010 13:36:02 +0100

Peroxisome proliferator-activated receptor- (PPAR) is a ligand-activated transcription factor of the nuclear hormone receptor superfamily. Increasing evidence suggests that PPAR is involved in the regulation of vascular function and blood pressure in addition to its well recognized role in metabolism. Thiazolidinediones, PPAR agonists, lower blood pressure and have protective vascular effects through largely unknown mechanisms. In contrast, loss-of-function dominant-negative mutations in human PPAR cause insulin resistance and severe early onset hypertension. Recent studies using genetically manipulated mouse models have begun to specifically address the importance of PPAR in the vasculature. In this minireview, evidence for a protective role of PPAR in the endothelium and vascular smooth ...

Identification and brief advice could reduce alcohol harm, survey says

BMJ Online First — Fri, 19 Mar 2010 12:25:34 +0100

(Source: BMJ Online First)

Systematic review of the perioperative risks of stroke or death after carotid angioplasty and stenting

Neurological Conditions Specialist Library — Fri, 19 Mar 2010 12:21:32 +0100

Citation: Touzé E, Trinquart L, Chatellier G, Mas JL. Systematic review of the perioperative risks of stroke or death after carotid angioplasty and stenting. Stroke. 2009 Dec;40(12):e683-93. Epub 2009 Nov 5 Methods: We sought articles published between January 1990 and June 2008 by using MEDLINE, EMBASE, the COCHRANE databases, hand-searching, abstract books from conferences, and official websites. Two reviewers independently and in duplicate selected articles on the risks of CAS, irrespective of the type of treatment, study design, setting, or language. The 2 reviewers abstracted data and assessed the quality of the studies. Results: Two hundred six independent studies (with 54 713 patients) were included. The overall 30-day risk of stroke or death was 4.7% (95% CI, 4.1 to 5.2) with s...

Bet 3

Emergency Medicine Journal — Fri, 19 Mar 2010 11:45:06 +0100

(Source: Emergency Medicine Journal)

'Hearts And Minds' Promotes Wellness; African Americans Living With Mental Illness Have Higher Risk For Other Illnesses

Health News from Medical News Today — Fri, 19 Mar 2010 11:00:00 +0100

The National Alliance on Mental Illness (NAMI) has launched a new health education program to promote sound "mind and body" health practices among individuals who live with serious mental illness. The "Hearts and Minds" initiative focuses on combating risk factors like high blood pressure, high cholesterol, smoking and obesity for major illnesses such as heart disease, cancer and diabetes. The program has significant implications for African Americans living with mental illness, who face these risk factors as well as additional disparities in access to and quality of health care... (Source: Health News from Medical News Today)

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'Hearts And Minds' Promotes Wellness; African Americans Living With Mental Illness Have Higher Risk For Other Illnesses

Mental Health News From Medical News Today — Fri, 19 Mar 2010 11:00:00 +0100

The National Alliance on Mental Illness (NAMI) has launched a new health education program to promote sound "mind and body" health practices among individuals who live with serious mental illness. The "Hearts and Minds" initiative focuses on combating risk factors like high blood pressure, high cholesterol, smoking and obesity for major illnesses such as heart disease, cancer and diabetes... (Source: Mental Health News From Medical News Today)

Loneliness and high blood pressure

NHS News Feed — Fri, 19 Mar 2010 10:37:00 +0100

Conclusion This study used complex statistical modelling with data from a cohort study to suggest that there is a long-term association between loneliness and blood pressure. Though these differences in blood pressure were small, they were statistically significant. There are a number of aspects to the study that should be taken into account when interpreting these observations: The age range of the population sample was 50 to 68. Older individuals may be more likely than younger people to have age-related changes to their cardiovascular system or to be on medications that can affect blood pressure. As such, the study cannot ascertain the effects of loneliness on younger individuals. The study was relatively small and the researchers made a large number of statistical comparisons and...

How a lonely life can lead to high blood pressure

the Mail online | Health — Fri, 19 Mar 2010 09:18:47 +0100

Lonely people are more prone to developing high blood pressure in later life, say researchers. (Source: the Mail online | Health)

'Comfort Dogs' Come to Emotional Rescue

MedicineNet High Blood Pressure General — Fri, 19 Mar 2010 07:00:00 +0100

Title: 'Comfort Dogs' Come to Emotional RescueCategory: Health NewsCreated: 3/18/2010 6:10:00 PMLast Editorial Review: 3/19/2010 (Source: MedicineNet High Blood Pressure General)

Association of inflammation of the left anterior descending coronary artery with cardiovascular risk factors, plaque burden and pericardial fat volume: a PET/CT study

European Journal of Nuclear Medicine and Molecular Imaging — Fri, 19 Mar 2010 06:49:09 +0100

Conclusion FDG uptake measurement in the LAD correlates with hypertension, coronary heart disease, BMI, PFV and CPB. However, due to myocardial FDG uptake these measurements are only feasible in one half of the patients. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00259-010-1432-2Authors Tobias Saam, University of Munich Institute of Clinical Radiology Munich GermanyAxel Rominger, University of Munich Department of Nuclear Medicine Marchioninistr. 15 81377 Munich GermanySarah Wolpers, University of Munich Department of Nuclear Medicine Marchioninistr. 15 81377 Munich GermanyKonstantin Nikolaou, University of Munich Institute of Clinical Radiology Munich GermanyCarsten Rist, University of Munich Institute of Clinical Radiology Munich GermanyMarti...

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Laboratory monitoring and adverse patient outcomes with antihypertensive therapy in primary care

Pharmacoepidemiology and Drug Safety — Fri, 19 Mar 2010 00:00:00 +0100

The monitoring of serum electrolyte and creatinine concentrations in patients treated with antihypertensive therapy is recommended. We wished to examine the relationship between laboratory monitoring and adverse patient outcomes.We carried out a retrospective cohort study using the General Practice Research Database (GPRD). Patients aged 18 years or older with newly diagnosed hypertension and prescribed a single antihypertensive agent were included. Monitoring was defined as any laboratory test for serum electrolyte and creatinine (or urea) concentrations within 6 months of starting treatment.We identified 74 096 patients who were newly diagnosed with hypertension and prescribed a single antihypertensive agent. Twenty six thousand nine hundred forty six (36.4%) patients had any biochemical...

Idiopathic inflammatory myositis is associated with a high incidence of hypertension and diabetes mellitus

APLAR Journal of Rheumatology — Fri, 19 Mar 2010 00:00:00 +0100

Conclusions: We report a novel association of IIM with hypertension, diabetes and ischemic heart disease, indicating that a comprehensive assessment of vascular risk factors is essential in IIM. (Source: APLAR Journal of Rheumatology)

Identification and Functional Analysis of the Vision-Specific BBS3 (ARL6) Long Isoform

PLoS Genetics — Fri, 19 Mar 2010 00:00:00 +0100

In this study we utilized two model systems, the zebrafish and mouse, to evaluate the function of a specific form of BBS (BBS3). We have identified a novel protein product of the BBS3 gene and demonstrated that functional and structural abnormalities of the eye occur when this form of BBS3 is absent. This finding is of significance because it indicates that BBS3 mutations can lead to non-syndromic blindness, as well as blindness associated with other clinical features. This work also indicates that treatment of BBS3 blindness will require replacement of a specific form of the BBS3 gene. (Source: PLoS Genetics)

Predicting Transmembrane Helix Packing Arrangements using Residue Contacts and a Force-Directed Algorithm

PLoS Computational Biology — Fri, 19 Mar 2010 00:00:00 +0100

Author Summary Alpha-helical transmembrane proteins constitute a significant proportion of the proteins encoded in a typical genome and are involved in a wide variety of important biological processes. Many common diseases including diabetes, hypertension and epilepsy have been related to transmembrane protein dysfunction, therefore they represent one of the most important classes of protein for pharmaceutical intervention. However, due to the experimental difficulties of structure determination, this class of protein is severely under-represented in structural databases. Here, we present a novel approach that is able to predict lipid exposure, residue contacts, helix-helix interactions and finally the optimal helical packing arrangement of a transmembrane protein. Under stringent cross-v...

A Comparison of Web Sites Used to Manage and Present Home Blood Pressure Readings

The Journal of Clinical Hypertension — Fri, 19 Mar 2010 00:00:00 +0100

In conclusion, there is considerable variation in available features on Web sites used to manage HBP data. Information presented in this report should be useful to physicians and patients in selecting a Web site for managing and presenting HBP readings and ultimately improving blood pressure control. (Source: The Journal of Clinical Hypertension)

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Poor Blood Pressure and Urinary Albumin Excretion Responses to Home Blood Pressure-Based Antihypertensive Therapy in Depressive Hypertensive Patients

The Journal of Clinical Hypertension — Fri, 19 Mar 2010 00:00:00 +0100

This study was a multicenter prospective study conducted by 7 doctors at 2 institutions. The authors prospectively studied 42 hypertensive patients with home systolic blood pressure >135 mm Hg. Participants were divided into a depression group (Beck Depression Inventory score >10; n=21) and a nondepression group (Beck Depression Inventory score (Source: The Journal of Clinical Hypertension)

A Novel Approach to the Balloon Angioplasty of a Native Discrete Severe Coarctation of the Aorta in the Management of Hypertension

The Journal of Clinical Hypertension — Fri, 19 Mar 2010 00:00:00 +0100

(Source: The Journal of Clinical Hypertension)

The Clock Is Ticking: The Case for Achieving More Rapid Control of Hypertension

The Journal of Clinical Hypertension — Fri, 19 Mar 2010 00:00:00 +0100

(Source: The Journal of Clinical Hypertension)

Surgical Cure of Hypertension in a Patient With MEN 2A Syndrome and Mixed Dopamine, Metanephrine Pheochromocytoma

The Journal of Clinical Hypertension — Fri, 19 Mar 2010 00:00:00 +0100

(Source: The Journal of Clinical Hypertension)

Spironolactone and hydrochlorothiazide exert antioxidant effects and reduce vascular matrix metalloproteinase-2 activity and expression in a model of renovascular hypertension

British Journal of Pharmacology — Fri, 19 Mar 2010 00:00:00 +0100

Conclusions and implications: SPRL or HCTZ, alone or combined, exerted antioxidant effects, and decreased renovascular hypertension-induced MMP-2 up-regulation, thus improving the vascular dysfunction and remodelling found in this model of hypertension. (Source: British Journal of Pharmacology)

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A community-based study of hypertension and cardio-metabolic syndrome in semi-urban and rural communities in Nigeria

BMC Health Services Research — Fri, 19 Mar 2010 00:00:00 +0100

Conclusion: The high prevalence of CMS in the semi-urban population especially for the population with hypertension underscores the double burden of disease in developing countries. The lesson is while infections and infestations are being tackled in these countries the non-communicable diseases should not be neglected. (Source: BMC Health Services Research)

NICE Bites - March 2010/15; Hypertension/Atrial Fibrillation

NeLM - Health In Focus — Fri, 19 Mar 2010 00:00:00 +0100

Source: North West Medicines Information Centre Area: Health In Focus NICE Bites is a monthly bulletin which summarises key prescribing points from NICE guidance. This edition includes two clinical topics; hypertension and atrial fibrillation. (Source: NeLM - Health In Focus)

New Omapatrilatlike Drug Impressive in Hypertension

Medscape Today Headlines — Thu, 18 Mar 2010 22:17:53 +0100

A new BP-lowering drug that acts in a similar way to omapatrilat--an agent that never quite made it to the market--has shown promise in a preliminary trial. Crucially, this dual inhibiting agent, named LCZ696, blocks angiotensin II rather than angiotensin-converting enzyme; there was no indication of angioedema in the study. Heartwire (Source: Medscape Today Headlines)

Phase I Clinical Trial of the CYP17 Inhibitor Abiraterone Acetate Demonstrating Clinical Activity in Patients With Castration-Resistant Prostate Cancer Who Received Prior Ketoconazole Therapy [Genitourinary Cancer]

Journal of Clinical Oncology — Thu, 18 Mar 2010 22:01:36 +0100

Conclusion Abiraterone acetate was well tolerated and demonstrated activity in CRPC, including in patients previously treated with ketoconazole. Continued clinical study is warranted. (Source: Journal of Clinical Oncology)

Phase II Multicenter Study of Abiraterone Acetate Plus Prednisone Therapy in Patients With Docetaxel-Treated Castration-Resistant Prostate Cancer [Genitourinary Cancer]

Journal of Clinical Oncology — Thu, 18 Mar 2010 22:01:36 +0100

Conclusion AA plus prednisone was well tolerated, with encouraging antitumor activity in heavily pretreated CRPC patients. The incidence of mineralocorticoid-related toxicities (hypertension or hypokalemia) was reduced by adding low-dose prednisone. The combination of AA plus prednisone is recommended for phase III investigations. (Source: Journal of Clinical Oncology)

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New omapatrilatlike drug impressive in hypertension

theHeart.org — Thu, 18 Mar 2010 20:00:01 +0100

A new BP-lowering drug that acts in a similar way to omapatrilat—an agent that never quite made it to the market—has shown promise in a preliminary trial. Crucially, this dual inhibiting... For complete story visit theheart.org. (Source: theHeart.org)

New drug, similar to omapatrilat, impressive in hypertension

theHeart.org — Thu, 18 Mar 2010 20:00:01 +0100

Hypertension Highlights: Does It All Begin and End With ALLHAT?

Medscape Today Headlines — Thu, 18 Mar 2010 19:43:25 +0100

Seven years after the first presentation of ALLHAT, we report results of the largest-ever hypertension study and discuss the possible future of antihypertensive therapy. And then -- champagne for all? Medscape Cardiology (Source: Medscape Today Headlines)

Colforsin-induced vasodilation in chronic hypoxic pulmonary hypertension in rats

Journal of Anesthesia — Thu, 18 Mar 2010 19:29:44 +0100

Conclusions cAMP-mediated vasodilatory responses without β-adrenergic receptor activation are impaired in structurally remodeled pulmonary arteries from PH rats. In these arteries, endothelial cells presumably play a compensatory role against the impaired cAMP-mediated vasodilatory response by releasing NO (and thereby attenuating the impairment). The results suggest that colforsin could be effective in the treatment of PH. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0912-7Authors Ayumu Yokochi, University of Mie Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine 2-174 Edobashi Tsu Mie 514-8507 JapanHiroo Itoh, Nabari City Hospital Department of Internal Medicine 178 Yurigaoka-Nishi-1ban-cho Nabari Mie 518-...

Taking blood pressure pills cuts risk of dying

Reuters: Health — Thu, 18 Mar 2010 19:14:27 +0100

NEW YORK (Reuters Health) - People with high blood pressure who want to reduce their risk of having a stroke or dying prematurely should get their prescriptions filled and see their doctor regularly. (Source: Reuters: Health)

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Taking Blood Pressure Pills Cuts Risk of Dying

MedlinePlus Health News — Thu, 18 Mar 2010 18:14:27 +0100

People with high blood pressure who want to reduce their risk of having a stroke or dying prematurely should get their prescriptions filled and see their doctor regularly.Source: Reuters Health Related MedlinePlus Pages: Blood Pressure Medicines, High Blood Pressure (Source: MedlinePlus Health News)

Impotence 'a sign of heart problems'

NHS News Feed — Thu, 18 Mar 2010 15:49:00 +0100

Conclusion This was a well-conducted study that confirms previous observational studies on erectile dysfunction and heart disease. There are some points to consider when interpreting the results. Participants in the two trials that originally provided data for this study were randomly assigned to treatment groups (randomised), but those in the substudy were not. They were instead grouped according to their history of impotence, making this an observational study rather than a randomised trial. This means that it is prone to the biases that occur in observational studies, although the researchers have correctly taken these into account in their reporting and analysis. At the start of the study, there were differences between the two groups in terms of the numbers of men with diabetes...

Comparison of the DNA methylation profiles of human peripheral blood cells and transformed B-lymphocytes

Human Genetics — Thu, 18 Mar 2010 15:24:46 +0100

Abstract Epidemiological studies of DNA methylation (DNAm) profiles may hold substantial promise for identifying mechanisms through which genetic and environmental factors jointly contribute to disease risk. Different cell types are likely to have different DNAm patterns. We investigate the DNAm differences between two types of biospecimens available in many genetic epidemiology studies. We compared DNAm patterns in two different DNA samples from each of 34 participants in the Genetic Epidemiology Network of Arteriopathy study (20 Caucasians and 14 African-Americans). One was extracted from peripheral blood cells (PBC) and the other from transformed B-lymphocytes (TBL). The genome-wide DNAm profiles were compared at over 27,000 genome-wide methylation sites. We found that ...

Unravelling the pathogenesis of lupus nephritis: novel genetic study confirms decisive contribution of circulating colony-stimulating factor-1 (CSF-1)

International Urology and Nephrology — Thu, 18 Mar 2010 14:17:00 +0100

Content Type Journal ArticleCategory Nephrology – Translational SectionDOI 10.1007/s11255-010-9726-7Authors Thomas Rauen, RWTH University of Aachen Department of Nephrology and Clinical Immunology Pauwelsstrasse 30 52057 Aachen GermanyPeter R. Mertens, Otto-von-Guericke-University Magdeburg Department of Nephrology and Hypertension Leipziger Strasse 40 39120 Magdeburg Germany Journal International Urology and NephrologyOnline ISSN 1573-2584Print ISSN 0301-1623 (Source: International Urology and Nephrology)

Inhaled Nitric Oxide Prevents 3-Nitrotyrosine Formation in the Lungs of Neonatal Mice Exposed to >95% Oxygen

Lung — Thu, 18 Mar 2010 14:13:48 +0100

Abstract Inhaled nitric oxide is being evaluated as a preventative therapy for patients at risk for bronchopulmonary dysplasia (BPD). Nitric oxide (NO), in the presence of superoxide, forms peroxynitrite, which reacts with tyrosine residues on proteins to form 3-nitrotyrosine (3-NT). However, NO can also act as an antioxidant and was recently found to improve the oxidative balance in preterm infants. Thus, we tested the hypothesis that the addition of a therapeutically relevant concentration (10 ppm) of NO to a hyperoxic exposure would lead to decreased 3-NT formation in the lung. FVB mouse pups were exposed to either room air (21% O2) or >95% O2 with or without 10 ppm NO within 24 h of birth. In the first set of studies, body weights and survival were mon...

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Effects of preserved spontaneous breathing activity during mechanical ventilation in experimental intra-abdominal hypertension

Intensive Care Medicine — Thu, 18 Mar 2010 14:12:03 +0100

Conclusions In the presence of severe intra-abdominal hypertension, the addition of unsupported spontaneous breaths to BIPAP did not improve hemodynamic and respiratory function and caused greater histopathologic damage to the lungs. Content Type Journal ArticleCategory ExperimentalDOI 10.1007/s00134-010-1827-3Authors Dietrich Henzler, University Hospital, RWTH Aachen Department of Anesthesiology Aachen GermanyNadine Hochhausen, University Hospital, RWTH Aachen Department of Anesthesiology Aachen GermanyRalf Bensberg, University Hospital, RWTH Aachen Department of Anesthesiology Aachen GermanyAlexander Schachtrupp, University Hospital, RWTH Aachen Department of Surgery Aachen GermanySonja Biechele, University Hospital, RWTH Aachen Department of Anesthesiology Aachen ...

Ethnicity-related differences in left ventricular function, structure and geometry: a population study of UK Indian Asian and European white subjects

Heart — Thu, 18 Mar 2010 12:24:40 +0100

Conclusion Compared to European white people, Indian Asians had attenuated longitudinal LV function, higher LV filling pressure and demonstrated a greater degree of concentric remodelling independent of other demographic and clinical parameters. (Source: Heart)

Prevention of cardiovascular disease in asymptomatic people

Heart — Thu, 18 Mar 2010 12:24:40 +0100

(Source: Heart)

Speckle myocardial imaging modalities for early detection of myocardial impairment in isolated left ventricular non-compaction

Heart — Thu, 18 Mar 2010 12:24:39 +0100

Conclusions LV SMI values are reduced in patients with iLVNC, even those with normal EF and PWTDI. The most accurate SMI modalities to discriminate between patients and controls are longitudinal sS mean of the six apical segments, LV apical rotation or LV torsion rate. (Source: Heart)

Glenmark gets USFDA nod for anti-hypertension tablets

The Economic Times Healthcare and Biotech News — Thu, 18 Mar 2010 12:24:07 +0100

Glenmark Pharmaceuticals today said its American subsidiary has received the final approval from the US Food and Drug Administration (FDA) for Moexipril Hydrochloride tablets used for treating hypertension. (Source: The Economic Times Healthcare and Biotech News)

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Glenmark gets USFDA nod for anti-hypertension tablets

The Economic Times Healthcare and Biotech News — Thu, 18 Mar 2010 12:24:07 +0100

Effects of Atenolol or Losartan on Fibrinolysis and von Willebrand Factor in Hypertensive Patients With Left Ventricular Hypertrophy

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:34 +0100

Conclusion: Losartan treatment was associated with preserved fibrinolytic balance compared to a more prothrombotic fibrinolytic and hemostatic state in the atenolol group. These findings suggest different fibrinolytic and hemostatic responses to treatment in hypertensive patients with LVH. (Source: Clinical and Applied Thrombosis/Hemostasis)

Periodontal Disease and Sjogren Syndrome: A Possible Correlation?

Angiology — Thu, 18 Mar 2010 11:46:14 +0100

Conclusion: This study shows that capillary alterations to patients with SS occur in gingival microcirculation. (Source: Angiology)

Pertinence of Myocardial Perfusion Imaging in Octogenarians

Angiology — Thu, 18 Mar 2010 11:46:14 +0100

Conclusion: Myocardial perfusion imaging in octogenarians is as accurate in diagnosing CAD as it is in younger people. (Source: Angiology)

Feeling Lonely Increases Blood Pressure For People 50 And Older

Hypertension News From Medical News Today — Thu, 18 Mar 2010 10:00:00 +0100

Chronic feelings of loneliness take a toll on blood pressure over time, causing a marked increase after four years, according to a new study at the University of Chicago... (Source: Hypertension News From Medical News Today)

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Feeling Lonely Increases Blood Pressure For People 50 And Older

Health News from Medical News Today — Thu, 18 Mar 2010 10:00:00 +0100

Chronic feelings of loneliness take a toll on blood pressure over time, causing a marked increase after four years, according to a new study at the University of Chicago. A new study shows, for the first time, a direct relation between loneliness and larger increases in blood pressure four years later-a link that is independent of age and other factors that could cause blood pressure to rise, including body-mass index, smoking, alcohol use and demographic differences such as race and income... (Source: Health News from Medical News Today)

Could Lowering Blood Pressure Help Stop Dementia?

MedicineNet High Blood Pressure General — Thu, 18 Mar 2010 07:00:00 +0100

Title: Could Lowering Blood Pressure Help Stop Dementia?Category: Health NewsCreated: 3/17/2010 10:10:00 AMLast Editorial Review: 3/18/2010 (Source: MedicineNet High Blood Pressure General)

Renal failure

BMJ Online First — Thu, 18 Mar 2010 00:05:36 +0100

(Source: BMJ Online First)

Haemodynamic, metabolic and neuro-humoral abnormalities in young normotensive women at high familial risk for hypertension

Journal of Human Hypertension — Thu, 18 Mar 2010 00:00:00 +0100

Authors: E G Ciolac, E A Bocchi, L A Bortolotto, V O Carvalho, J M D Greve & G V Guimarães (Source: Journal of Human Hypertension)

Nocturnal blood pressure but not insulin resistance influences endothelial function in treated hypertensive patients

Journal of Human Hypertension — Thu, 18 Mar 2010 00:00:00 +0100

Authors: T Konrad, S Franke, F Schneider, F Bär, G Vetter & K Winkler (Source: Journal of Human Hypertension)

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Endothelial dysfunction is associated with left ventricular mass (assessed using MRI) in an adult population (MESA)

Journal of Human Hypertension — Thu, 18 Mar 2010 00:00:00 +0100

Authors: J Yeboah, J R Crouse, D A Bluemke, J A C Lima, J F Polak, G L Burke & D M Herrington (Source: Journal of Human Hypertension)

A new oscillometric method for pulse wave analysis: comparison with a common tonometric method

Journal of Human Hypertension — Thu, 18 Mar 2010 00:00:00 +0100

Authors: S Wassertheurer, J Kropf, T Weber, M van der Giet, J Baulmann, M Ammer, B Hametner, C C Mayer, B Eber & D Magometschnigg (Source: Journal of Human Hypertension)

Blood pressure control has distinct effects on executive function, attention, memory and markers of cerebrovascular damage

Journal of Human Hypertension — Thu, 18 Mar 2010 00:00:00 +0100

Authors: A Semplicini, G Inverso, A Realdi, L Macchini, M Maraffon, M Puato, M Zanardo, C Tirrito, P Amodio, S Schiff, D Mapelli & R Manara (Source: Journal of Human Hypertension)

Central blood pressure and pulse wave velocity: relationship to target organ damage and cardiovascular morbidity-mortality in diabetic patients or metabolic syndrome. An observational prospective study. LOD-DIABETES study protocol

BMC Public Health - Latest articles — Thu, 18 Mar 2010 00:00:00 +0100

The objectives of this study are the following: to evaluate the prognostic value of central arterial pressure and pulse wave velocity in relation to the incidence and outcome of target organ damage and the appearance of cardiovascular episodes (cardiovascular mortality, myocardial infarction, chest pain and stroke) in patients with type 2 diabetes mellitus or metabolic syndrome. Methods: This is an observational prospective study with 5 years duration, of which the first year corresponds to patient inclusion and initial evaluation, and the remaining four years to follow-up.Setting: The study will be carried out in the urban primary care setting.Study population: Consecutive sampling will be used to include patients diagnosed with type 2 diabetes between 20-80 years of age. A total of 110 p...

Plasma selenium and risk of dysglycemia in an elderly French population: Results from the prospective Epidemiology of Vascular Ageing Study

Nutrition & Metabolism — Thu, 18 Mar 2010 00:00:00 +0100

Conclusions: This prospective study suggests a sex-specific protective effect of higher selenium status at baseline on later occurrence of dysglycemia. (Source: Nutrition & Metabolism)

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Part II, Provider perspectives: should patients be activated to request evidence-based medicine? : a qualitative study of the VA Project to Implement Diuretics (VAPID)

Implementation Science — Thu, 18 Mar 2010 00:00:00 +0100

Conclusions: Patient activation was acceptable to providers as a guideline implementation strategy, with considerable value placed on the activation process itself. By 'aligning' patients' objectives with those of their providers, this process also facilitated part of the effectiveness of the intervention. Patient activation shows promise for wider use as an implementation strategy, and should be tested in other areas of evidence-based medicine.Trial registrationNational Clinical Trial Registry number NCT00265538 (Source: Implementation Science)

Part I, Patient perspective: activating patients to engage their providers in the use of evidence-based medicine: a qualitative evaluation of the VA Project to Implement Diuretics (VAPID)

Implementation Science — Thu, 18 Mar 2010 00:00:00 +0100

Conclusion: Patients' perceptions of the intervention indicated it was effective via the encouragement of dialogue between themselves and their provider regarding evidence-based treatment options for hypertension. Additionally, patients' experiences with thiazide prescribing discussions shed light on the facilitators and barriers to implementing clinical practice guidelines regarding thiazides as first-line therapy for hypertension.Trial registrationNational Clinical Trial Registry number NCT00265538 (Source: Implementation Science)

Dietary meat fats and burden of cardiovascular disease risk factors, in the elderly; a report from the MEDIS study

Lipids in Health and Disease — Thu, 18 Mar 2010 00:00:00 +0100

Dietary fats have long been associated with human health, and especially cardiovascular disease (CVD). Some observational studies have shown that reduction in dietary fats, and particularly cholesterol is associated with lower cardiovascular risk; however, other prospective studies or randomized controlled trials of dietary fat reduction or modification have shown varying results on CVD morbidity and mortality. In this work we evaluated the relationships between dietary fats and a cluster of CVD risk factors (i.e., diabetes, obesity, hypercholesterolemia, hypertension), among elderly individuals without known CVD. In particular, dietary and clinical data from 1486 elderly (aged 65 to 100 years) men and women living in Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Syros, Naxos, C...

Endothelial dysfunction in diabetes: multiple targets for treatment.

Pflugers Archiv : European Journal of Physiology — Thu, 18 Mar 2010 00:00:00 +0100

Authors: Ding H, Triggle CR Robert Furchgott's discovery of the obligatory role that the endothelium plays in the regulation of vascular tone has proved to be a major advance in terms of our understanding of the cellular basis of diabetic vascular disease. Endothelial dysfunction, as defined by a reduction in the vasodilatation response to an endothelium-dependent vasodilator (such as acetylcholine) or to flow-mediated vasodilatation, is an early indicator for the development of the micro- and macroangipathy that is associated with diabetes. In diabetes, hyperglycaemia plays a key role in the initiation and development of endothelial dysfunction; however, the cellular mechanisms involved as well as the importance of dyslipidaemia and co-morbidities such as hypertension and obesity rema...

Review: Toxic effects (collateral damage) of targeted antiangiogenic therapies in ovarian cancer

NeLM - News — Thu, 18 Mar 2010 00:00:00 +0100

Source: Lancet Oncology Area: News This review discusses the following main toxic effects encountered and anticipated in clinical investigation and practice with antiangiogenic agents in patients with ovarian cancer, with particular focus on potential management strategies: . Hypertension . Proteinuria . Cardiac toxicity . Vascular thromboembolism . Haemorrhage . Gastrointestinal toxicity . Dermatological toxicity . Endocrine toxicities (Source: NeLM - News)

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A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey.

Chest — Thu, 18 Mar 2010 00:00:00 +0100

CONCLUSIONS: This simple, novel bleeding risk score (acronym HAS-BLED) provides a practical tool to assess the individual bleeding risk of 'real world' AF patients, potentially supporting clinical decision-making regarding antithrombotic therapy in AF patients. PMID: 20299623 [PubMed - as supplied by publisher] (Source: Chest)

Associations of Diet with Albuminuria and Kidney Function Decline.

Clinical Journal of the American Society of Nephrology : CJASN — Thu, 18 Mar 2010 00:00:00 +0100

CONCLUSIONS: Higher dietary intake of animal fat and two or more servings per week of red meat may increase risk for microalbuminuria. Lower sodium and higher beta-carotene intake may reduce risk for eGFR decline. PMID: 20299364 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

Bupropion Induced Serotonin Syndrome: A Case Report.

Journal of Medical Toxicology — Thu, 18 Mar 2010 00:00:00 +0100

Authors: Thorpe EL, Pizon AF, Lynch MJ, Boyer J Although there are no documented cases of serotonin syndrome (SS) following bupropion ingestion alone in the literature, the ability of bupropion to potentiate serotonin levels and lead to SS is known. A 15-year-old boy was found at home hallucinating. He then developed tonic-clonic activity. Upon arrival in the emergency department, he was confused and restless. On exam, he had tachycardia, hypertension, dilated pupils and dry oral mucosa, normal tone and reflexes in his arms, but rigidity and +4 reflexes in his legs with sustained clonus at his ankles. He was admitted and treated with intravenous fluids and lorazepam for his agitation. A urine drug screen (via gas chromatography/mass spectrometry) was positive only for naproxen and bupr...

A primary care pragmatic cluster randomized trial of the use of home blood pressure monitoring on blood pressure levels in hypertensive patients with above target blood pressure

Family Practice — Wed, 17 Mar 2010 21:41:56 +0100

Conclusion. Home BP monitoring may improve BP control in men with hypertension. (Source: Family Practice)

Rheumatoid arthritis tied to pregnancy complications

Reuters: Health — Wed, 17 Mar 2010 19:13:34 +0100

NEW YORK (Reuters Health) - Pregnant women with rheumatoid arthritis may have increased risks of high blood pressure, having an underweight baby or needing a cesarean section, a new study suggests. (Source: Reuters: Health)

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Chile: MSF help the population overcome fear

MSF News — Wed, 17 Mar 2010 18:25:00 +0100

The numerous tremors and after-shocks that followed the February 27 earthquake in Chile have added new levels of stress to an already shaken population. Médecins Sans Frontières (MSF) has therefore made mental health care a priority in its response to the disaster. Simultaneously, as the nights grow colder and the chance of rainfall increases, MSF is speeding up its distribution of plastic sheeting and blankets for people whose homes were damaged and who are now often camping outdoors. The MSF psychological team is providing direct counselling and psychosocial workshops for various groups, and debriefings for medical staff. It is also lending support to local authorities by training volunteers who will be deployed to provide mental health care in the affected areas. Photo: © MSF I...

The Treatment of Preeclampsia in a Rat Model Employing DigibindÂ®

American Journal of Perinatology — Wed, 17 Mar 2010 16:35:54 +0100

This study investigated the effects of Digibind in a rat model of PE. We induced a syndrome in rats, which includes many of the phenotypic characteristics of human PE. Digibind, in escalating doses, was given on days 10 to 20 of pregnancy. Digibind produced significant lowering of the blood pressure and reduced proteinuria in our rat model of PE. However, it also did not avert IUGR. In view of these findings, in our experimental model of human PE, further studies in the quest for effective treatment of PE need to focus on pharmaceuticals that can remedy the syndrome without compromising the fetus.[...]Â© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: American Journal of Perinatology)

Haplotypes of the adrenergic system predict the blood pressure response to β-blockers in women with essential hypertension

Future Medicine: Pharmacogenomics — Wed, 17 Mar 2010 15:07:48 +0100

Pharmacogenomics , March 2010, Vol. 11, No. 3, Pages 319-325. (Source: Future Medicine: Pharmacogenomics)

'Treat to target': moving targets from hypertension, hyperlipidaemia and diabetes to rheumatoid arthritis

Annals of the Rheumatic Diseases — Wed, 17 Mar 2010 14:45:57 +0100

(Source: Annals of the Rheumatic Diseases)

Treating rheumatoid arthritis to target: recommendations of an international task force

Annals of the Rheumatic Diseases — Wed, 17 Mar 2010 14:45:57 +0100

Conclusion The 10 recommendations are supposed to inform patients, rheumatologists and other stakeholders about strategies to reach optimal outcomes of RA based on evidence and expert opinion. (Source: Annals of the Rheumatic Diseases)

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Phosphodiesterase Type 5 Inhibitors for High-Altitude Pulmonary Hypertension: A Meta-Analysis

Clinical Drug Investigation — Wed, 17 Mar 2010 14:14:51 +0100

(Source: Clinical Drug Investigation)

Total Synthesis of “Aliskiren”: The First Renin Inhibitor in Clinical Practice for Hypertension

Organic Letters — Wed, 17 Mar 2010 13:22:22 +0100

Organic Letters, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Organic Letters)

Could Lowering Blood Pressure Help Stop Dementia?

MedlinePlus Health News — Wed, 17 Mar 2010 13:00:00 +0100

Major U.S. trial will enroll thousands to examine links between hypertension, Alzheimer's Source: HealthDay Related MedlinePlus Pages: Dementia, High Blood Pressure (Source: MedlinePlus Health News)

Search For New Diabetes And Heart Disease Treatments Unresolved

Hypertension News From Medical News Today — Wed, 17 Mar 2010 10:00:00 +0100

Treatment with the anti-hypertensive drug valsartan (Diovan) led to a modest reduction in the development of type 2 diabetes but did not significantly reduce cardiovascular events in patients with impaired glucose tolerance, according to researchers at Duke University Medical Center and the University of Oxford... (Source: Hypertension News From Medical News Today)

Health Care Delivery Fixes Somewhat Helpful In Heart Disease

Health News from Medical News Today — Wed, 17 Mar 2010 10:00:00 +0100

Research has shown that heart disease patients who make lifestyle improvements, take recommended medications and control risk factors such as high cholesterol and high blood pressure can prevent heart disease from worsening. A new review of studies looked at whether such patients would be more likely to reduce their risks if health care providers also made changes in appointment planning, patient education and monitoring of heart disease risk factors and medication use. "Well-organized care certainly does work," said lead author Brian Buckley, Ph.D... (Source: Health News from Medical News Today)

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Minorities At Greater Risk For Kidney Disease

Health News from Medical News Today — Wed, 17 Mar 2010 08:00:00 +0100

Certain ethnic minorities, including African Americans and Hispanics, are at a higher risk than the general population for developing potentially life-threatening chronic kidney disease (CKD) , which has been linked to higher rates of diabetes and high blood pressure, according to the National Kidney Foundation (NKF)... (Source: Health News from Medical News Today)

Minorities At Greater Risk For Kidney Disease

Urology / Nephrology News From Medical News Today — Wed, 17 Mar 2010 08:00:00 +0100

Dual Action Drug Fights High Blood Pressure, Heart Disease

Medical Headlines From Ivanhoe.com — Wed, 17 Mar 2010 05:00:00 +0100

(Ivanhoe Newswire) -- A new dual-action drug, called LCZ696, is well tolerated and provides significantly greater reductions in blood pressure than the established angiotensin receptor blocker (ARB) valsartan. (Source: Medical Headlines From Ivanhoe.com)

Journal Scan: Improved Survival Among Patients With Eisenmenger Syndrome Receiving Advanced Therapy for Pulmonary Arterial Hypertension (Circulation 2010;121:20-25.)

Cardiosource — Wed, 17 Mar 2010 00:00:00 +0100

A retrospective review was performed over a 10-year period at a single center. Survival rates were compared between patients on and off AT with use of a modified version of the Cox model, treating AT as a time-varying covariate. (Source: Cardiosource)

Drug in development: LCZ696 for hypertension

NeLM - News — Wed, 17 Mar 2010 00:00:00 +0100

Source: Lancet Area: News LCZ696, a new drug in development with a novel mechanism of action, had additive antihypertensive effects with valsartan in a controlled trial. LCZ696 inhibits neprilysin, resulting in increased circulating levels of natriuretic peptides that have vasodilatory and natriuretic effects, and also inhibits the angiotensin-II receptor. This proof-of-concept trial involved patients with mild to moderate hypertension who were randomised to LCZ696 100mg, 200mg, or 400mg, or valsartan 80mg, 160mg, or 320mg, or AHU377 (a pure neprilysin inhibitor), or placebo. Treatment was for 8 weeks, and the primary outcome was sitting diastolic blood pressure difference for LCZ696 vs. valsartan across the three dose levels. There were 1,328 patients randomis...

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Maternal and neonatal outcomes in the Torres Strait Islands with a sixfold increase in type 2 diabetes in pregnancy over six years

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 17 Mar 2010 00:00:00 +0100

Conclusion: A massive increase in DIP was seen. The neonatal outcomes improved slightly. There is need for improvement in follow-up of gestational diabetes. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Beta-Blocker Prescription Among Japanese Cardiologists and Its Effect on Various Outcomes.

Circulation Journal — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: Despite the low prescription rate of beta-blockers for CAD patients among Japanese physicians, the continuation rate was relatively high. Lipophilic beta-blockers may be a better choice than hydrophilic beta-blockers in terms of mortality risk, although a randomized control study would need to be conducted to verify this assertion. PMID: 20234099 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Is There Value in Routine Screening for Cushing's Syndrome in Patients with Diabetes?

The Journal of Clinical Endocrinology and Metabolism — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: The 1-3% detection rates of three recently published series have not been realized at our center where we studied a group using criteria making patients more likely to have hypercortisolism. Our results do not support the validity of screening patients without clinical features of Cushing's syndrome in the diabetes clinic. PMID: 20237165 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

PPAR/RXR Regulation of Fatty Acid Metabolism and Fatty Acid ω-Hydroxylase (CYP4) Isozymes: Implications for Prevention of Lipotoxicity in Fatty Liver Disease

PPAR Research — Tue, 16 Mar 2010 17:42:35 +0100

Fatty liver disease is a common lipid metabolism disorder influenced by the combination of individual genetic makeup, drug exposure, and life-style choices that are frequently associated with metabolic syndrome, which encompasses obesity, dyslipidemia, hypertension, hypertriglyceridemia, and insulin resistant diabetes. Common to obesity related dyslipidemia is the excessive storage of hepatic fatty acids (steatosis), due to a decrease in mitochondria β-oxidation with an increase in both peroxisomal β-oxidation, and microsomal ω-oxidation of fatty acids through peroxisome proliferator activated receptors (PPARs). How steatosis increases PPARα activated gene expression of fatty acid transport proteins, peroxisomal and mitochondrial fatty acid β-oxidation an...

Researcher Urges Early Treatment of Pediatric Hypertension

Medscape Today Headlines — Tue, 16 Mar 2010 17:25:34 +0100

Early detection and treatment are critical for managing children with essential hypertension. Medscape Medical News (Source: Medscape Today Headlines)

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Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort

Human Reproduction — Tue, 16 Mar 2010 17:05:41 +0100

CONCLUSIONS Between 24 and 27 weeks of gestation, risks of mortality and severe cranial haemorrhaging were higher for twins than singletons if they were from same sex pairs with discordant birthweights. (Source: Human Reproduction)

Early Treatment of Ocular Hypertension May Reduce Risk for Glaucoma

Medscape Today Headlines — Tue, 16 Mar 2010 16:36:57 +0100

A study shows that early treatment of ocular hypertension appears to lower the risk for the development of glaucoma, especially in individuals at highest risk. Medscape Medical News (Source: Medscape Today Headlines)

Does obesity affect the vaginal hysterectomy outcomes?

Archives of Gynecology and Obstetrics — Tue, 16 Mar 2010 14:49:09 +0100

Conclusion Obesity does not affect the perioperative outcomes and surgical complications of vaginal hysterectomy. Content Type Journal ArticleCategory General GynecologyDOI 10.1007/s00404-010-1422-4Authors Ozgur H. Harmanli, Baystate Medical Center Department of Obstetrics and Gynecology 759 Chestnut Street Springfield MA 01199 USAVani Dandolu, Temple University School of Medicine Department of Obstetrics, Gynecology, and Reproductive Sciences Philadelphia PA USAEbru F. Isik, Temple University School of Medicine Department of Obstetrics, Gynecology, and Reproductive Sciences Philadelphia PA USAUma R. Panganamamula, Temple University School of Medicine Department of Obstetrics, Gynecology, and Reproductive Sciences Philadelphia PA USAJeffrey Lidicker, Temple University C...

Valsartan delays progression to type 2 diabetes

Pharmacy Europe — Tue, 16 Mar 2010 14:42:57 +0100

Results from a landmark study involving more than 9,000 people showed that the high blood pressure medicine valsartan delayed progression to type 2 diabetes in patients with cardiovascular disease or risk factors and impaired glucose tolerance (IGT). (Source: Pharmacy Europe)

ACC: Dual Action Antihypertensive Outperforms ARB Alone (CME/CE)

MedPage Today Geriatrics — Tue, 16 Mar 2010 14:30:00 +0100

ATLANTA (MedPage Today) -- A novel agent that counteracts vasoconstriction as both an angiotensin receptor blocker (ARB) and neprilysin inhibitor appears to fight hypertension better than an ARB alone, researchers found. (Source: MedPage Today Geriatrics)

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Computation Error in: Population Attributable Risk of Incident Hypertension in Women [Correction]

JAMA — Tue, 16 Mar 2010 13:50:41 +0100

(Source: JAMA)

Generex Oral-lyn(TM) Presentation at CODHy Congress

Medical News (via PRIMEZONE) — Tue, 16 Mar 2010 13:30:00 +0100

WORCESTER, Mass., March 16, 2010 (GLOBE NEWSWIRE) -- Generex Biotechnology Corporation (Nasdaq:GNBT) (www.generex.com), the leader in drug delivery for metabolic diseases through the inner lining of the mouth, today announced that Philip Raskin, MD, of The University of Texas Southwestern Medical Center in Dallas, Texas, made a presentation in respect of Generex Oral-lyn(tm), the Company's proprietary buccal insulin spray product, at The Latin America Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension (CODHy) held in Buenos Aires, Argentina, March 11-14, 2010 (www.comtecmed.com/Codhy/argentina). (Source: Medical News (via PRIMEZONE))

Female Sex Chromosomes, Not Just Hormones, Help Regulate Blood Pressure

Health News from Medical News Today — Tue, 16 Mar 2010 12:00:00 +0100

Researchers at Georgetown University Medical Center (GUMC) have determined that something in female sex chromosomes appears to trigger a rise in blood pressure after the onset of menopause. This finding challenges the current belief that sex hormones are largely responsible for regulating blood pressure. Their work, reported online Monday in Hypertension, is the first of its kind and involves male mice engineered to have female (XX) sex chromosomes, and female mice with male (XY) chromosomes. The findings suggest that sex chromosomes regulate blood pressure in and of themselves... (Source: Health News from Medical News Today)

Female Sex Chromosomes, Not Just Hormones, Help Regulate Blood Pressure

Genetics News From Medical News Today — Tue, 16 Mar 2010 12:00:00 +0100

Physical Activity and Albuminuria

Medscape Today Headlines — Tue, 16 Mar 2010 11:04:24 +0100

This study explores the association between physical activity and albuminuria, which can be a predictor of future cardiovascular disease, hypertension, and chronic kidney disease. American Journal of Epidemiology (Source: Medscape Today Headlines)

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Occasional high blood pressure 'a risk for stroke'

Pulse Today Clinical Updates — Tue, 16 Mar 2010 09:40:00 +0100

Hypertension guidance is set to change after ‘revolutionary’ new research suggested patients with only occasional high blood pressure readings – who are not currently diagnosed as hypertensive - are at increased risk of stroke and should... (Source: Pulse Today Clinical Updates)

Occasional high blood pressure 'a risk for stroke'

Pulse Today Clinical Updates — Tue, 16 Mar 2010 09:40:00 +0100

It may sound daft but some doctors believe meditation really can lower blood pressure

the Mail online | Health — Tue, 16 Mar 2010 08:36:03 +0100

Claudia Zeff signed up to a pioneering programme where meditation and chanting are used to combat high blood pressure. Now she is not only medication-free, but her damaged heart has repaired itself. (Source: the Mail online | Health)

Women's Chromosomes May Affect Blood Pressure

MedicineNet High Blood Pressure General — Tue, 16 Mar 2010 07:00:00 +0100

Title: Women's Chromosomes May Affect Blood PressureCategory: Health NewsCreated: 3/15/2010 4:10:00 PMLast Editorial Review: 3/16/2010 (Source: MedicineNet High Blood Pressure General)

Boosting Vitamin D Can Do a Heart Good

MedicineNet High Blood Pressure General — Tue, 16 Mar 2010 07:00:00 +0100

Title: Boosting Vitamin D Can Do a Heart GoodCategory: Health NewsCreated: 3/15/2010 4:10:00 PMLast Editorial Review: 3/16/2010 (Source: MedicineNet High Blood Pressure General)

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New Combo Drug May Cut Blood Pressure

WebMD Health — Tue, 16 Mar 2010 05:00:00 +0100

By itself, Novartis's new blood pressure drug doesn't do a lot. But combined with the older drug Diovan, it boosts hypertension control better than either drug alone. (Source: WebMD Health)

Doctor prescribes sunshine to patients

Scotsman.com News - Health — Tue, 16 Mar 2010 00:00:00 +0100

Sunshine could reduce the risk of heart attack and high blood pressure, according to the latest research. (Source: Scotsman.com News - Health)

Advances in understanding the pathogenesis of chronic thromboembolic pulmonary hypertension

British Journal of Haematology — Tue, 16 Mar 2010 00:00:00 +0100

Chronic thromboembolic pulmonary hypertension (CTEPH) comprises organizing thrombotic obstructions in the pulmonary arteries. While roughly 40% of CTEPH cases are not preceded by a venous thromboembolic event, 0·1[ndash]5·1% of acute pulmonary thromboemboli evolve into organized obstructions of the pulmonary artery. In patients with predominantly proximal disease, surgical pulmonary endarterectomy provides a potential cure of the disease. For years, the scientific debate of CTEPH was mainly focused around its thromboembolic nature because of striking dissimilarities to classical venous thromboembolism, for example, the lack of risk factors for venous thrombosis, the lack of clinically apparent pulmonary embolism in many patients, the difficulty to reproduce the disease in animal models o...

The challenge of managing difficult-to-control hypertension

Prescriber — Tue, 16 Mar 2010 00:00:00 +0100

Our new series on Prescribing challenges focuses on areas of therapeutics that can present a particular challenge in general practice. Here, the authors address the familiar problem of hypertension that remains above target despite treatment with three anti-hypertensives. Copyright © 2010 Wiley Interface Ltd (Source: Prescriber)

ACC: Dual Action Antihypertensive Outperforms ARB Alone (CME)

Modern Medicine — Tue, 16 Mar 2010 00:00:00 +0100

A novel agent that counteracts vasoconstriction as both an angiotensin receptor blocker (ARB) and neprilysin inhibitor appears to fight hypertension better than an ARB alone, researchers found. (Source: Modern Medicine)

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Indications and Outcomes of Surgical Closure of Ventricular Septal Defect in Adults

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions Associated heart defects and AR were common indications for VSD closure in adults, which was performed with low mortality and morbidity. Patch closure and use of intraoperative transesophageal echocardiography improve surgical outcomes. Important residua emphasize the need for life-long informed follow-up. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

Imaging Lung Disease in Systemic Sclerosis

Current Rheumatology Reports — Mon, 15 Mar 2010 18:00:26 +0100

Abstract Interstitial lung disease and pulmonary hypertension (PH) are the most common cardiopulmonary findings in patients with systemic sclerosis (SSc). About two thirds of patients suffering from SSc develop scleroderma interstitial lung disease. PH is present in about 20% of SSc patients and is typically associated with severe lung disease, although it may be an isolated manifestation of SSc. High-resolution CT scanning is a key method for evaluating chest involvement. There are four roles of imaging in scleroderma interstitial lung disease: 1) detection of lung involvement, 2) identification of patients likely to respond to treatment, 3) assessment of treatment efficacy, and 4) exclusion of other significant diseases to include PH and cardiac and esophageal abnormalit...

Absence of aquaporin-4 antibodies in patients with idiopathic intracranial hypertension

Journal of Neurology — Mon, 15 Mar 2010 17:54:57 +0100

Content Type Journal ArticleCategory Letter to the EditorsDOI 10.1007/s00415-010-5499-2Authors Samish Dhungana, Sheffield Teaching Hospitals NHS Trust, University of Sheffield Department of Neurology Sheffield UKPatrick Waters, Weatherall Institute of Molecular Medicine, University of Oxford Oxford UKAzza Ismail, Sheffield Teaching Hospitals NHS Trust, University of Sheffield Department of Neurology Sheffield UKNicola Woodroofe, Biomedical Research Centre, Sheffield Hallam University Sheffield UKAngela Vincent, Weatherall Institute of Molecular Medicine, University of Oxford Oxford UKBasil Sharrack, Sheffield Teaching Hospitals NHS Trust, University of Sheffield Department of Neurology Sheffield UK Journal Journal of NeurologyOnline ISSN 1432-1459Print ISSN 0340-5354 (Source: Jo...

Riociguat for pulmonary hypertension

Future Cardiology — Mon, 15 Mar 2010 16:49:29 +0100

Future Cardiology , March 2010, Vol. 6, No. 2, Pages 155-166. (Source: Future Cardiology)

Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

Conclusion Normal weight obesity, defined as the combination of normal BMI and high BF content, is associated with a high prevalence of cardiometabolic dysregulation, metabolic syndrome, and CV risk factors. In women, NWO is independently associated with increased risk for CV mortality. (Source: European Heart Journal)

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Tissue Doppler E/E' ratio is a powerful predictor of primary cardiac events in a hypertensive population: an ASCOT substudy

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

Conclusion Tissue Doppler E/E', a non-invasive estimate of left atrial filling pressure, independently predicts primary cardiac events in a hypertensive population and out-performed traditional echocardiographic measures in this moderately sized, well-treated hypertensive population. E/E' represents a simple, effective tool for assessing cardiac risk in a hypertensive population. (Source: European Heart Journal)

Comparison of health-related measures of two groups of adolescents in a rural southeastern county in the United States

Health Education Journal — Mon, 15 Mar 2010 16:33:20 +0100

Conclusion Thus, this research shows differences between similar populations in the same county and these differences must be explored further. (Source: Health Education Journal)

Cardiovascular disease in pregnancy

Obstetrics, Gynaecology and Reproductive Medicine — Mon, 15 Mar 2010 15:07:39 +0100

Abstract: Cardiac disease continues to be an important cause of maternal morbidity and mortality and is now the leading cause of maternal deaths in the United Kingdom. This is largely because of extensive haemodynamic changes which occur during pregnancy, namely the increase in blood volume, fluctuations in cardiac output, fall in systemic vascular resistance and hypercoagulable state. High risk periods include the end of the second trimester, during labour and the immediate postpartum period. Prognosis depends on the specific cardiac condition, the patient's functional class, presence of cyanosis, prior history of cardiac events or arrhythmia and the degree of systolic dysfunction. Conditions where pregnancy should be include Eisenmenger's syndrome, pulmonary hypertension, complex cyanoti...

Do quick workouts beat long ones?

NHS News Feed — Mon, 15 Mar 2010 14:42:00 +0100

Conclusion This small observational study has demonstrated an improvement in muscle health following low-volume, high-intensity training in seven healthy men. There are a number of points to keep in mind when considering the results of this research, including: The small sample size. The study included only seven men with an average age of 21. The researchers report that they were healthy and “recreationally active two or three times a week”, but that “none were engaged in a structured exercise training programme”. The results of the study cannot therefore be taken to represent the wider population, particularly older people. This study lacked a comparator group. While newspapers have reported that short bursts of high-intensity exercise are as effective as longer-term traini...

ACCORD BP: Intensive BP control does not benefit diabetic patients at high CV risk

MedWire News - Hypertension — Mon, 15 Mar 2010 13:58:07 +0100

Intensive blood pressure control does not reduce the rate of cardiovascular events in patients with Type 2 diabetes and high CV risk, reveals research presented at the 59th Annual Scientific Sessions of the American College of Cardiology in Atlanta, Georgia, USA. (Source: MedWire News - Hypertension)

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The BILAG multi-centre open randomized controlled trial comparing ciclosporin vs azathioprine in patients with severe SLE

Rheumatology — Mon, 15 Mar 2010 13:35:46 +0100

Conclusions. Both drugs were effective corticosteroid-sparing agents. Ciclosporin was not a more effective corticosteroid-sparing agent. Ciclosporin may be considered in patients who are unable to tolerate AZA. Patients on ciclosporin require close monitoring of blood pressure and creatinine. Trial registration. Current Controlled Trials, http://www.controlled-trials.com/, ISRCTN35919612. (Source: Rheumatology)

Remifentanil for endotracheal intubation in neonates: a randomised controlled trial

Archives of Disease in Childhood - Fetal and Neonatal Edition — Mon, 15 Mar 2010 11:33:26 +0100

Conclusions Although remifentanil is comparable to fentanyl and succinylcholine in attenuating adverse physiologic responses during neonatal intubation, muscle rigidity is a concern at doses of 3 µg/kg. Further trials are required to evaluate ideal dosing regimens and combinations of agents for use with remifentanil in neonates. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube

Archives of Disease in Childhood - Fetal and Neonatal Edition — Mon, 15 Mar 2010 11:33:26 +0100

Conclusions SIL pharmacokinetics are highly variable in post-ECMO neonates and infants. In a median patient, the current dose regimen of 0.5–2.0 mg/kg four times a day leads to an exposure comparable to the recommended adult dose of 20 mg four times a day. Careful dose titration, based on efficacy and the occurrence of hypotension, remains necessary. Follow-up research should include appropriate pharmacodynamic endpoints, with a population pharmacokinetic/pharmacodynamic analysis to assign a suitable exposure window or target concentration. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)

Intensive BP, Combined Lipid Therapies Do Not Help Adults With Diabetes

Hypertension News From Medical News Today — Mon, 15 Mar 2010 09:00:00 +0100

Lowering blood pressure to normal levels - below currently recommended levels - did not significantly reduce the combined risk of fatal or nonfatal cardiovascular disease events in adults with type 2 diabetes who were at especially high risk for cardiovascular disease events, according to new results from the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial... (Source: Hypertension News From Medical News Today)

Marathoners Face Greater Risk of Artery Problems

MedicineNet High Blood Pressure General — Mon, 15 Mar 2010 07:00:00 +0100

Title: Marathoners Face Greater Risk of Artery ProblemsCategory: Health NewsCreated: 3/13/2010 2:10:00 PMLast Editorial Review: 3/15/2010 (Source: MedicineNet High Blood Pressure General)

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More Evidence That Swings in Blood Pressure Raise Stroke Risk

MedicineNet High Blood Pressure General — Mon, 15 Mar 2010 07:00:00 +0100

Title: More Evidence That Swings in Blood Pressure Raise Stroke RiskCategory: Health NewsCreated: 3/14/2010 6:10:00 PMLast Editorial Review: 3/15/2010 (Source: MedicineNet High Blood Pressure General)

Does Cholesterol Really Matter?

NaturalNews.com — Mon, 15 Mar 2010 07:00:00 +0100

(NaturalNews) I'd like to shine the spotlight on one of medicine's sacred cows- the belief that lowering cholesterol with drugs protects against heart attacks and premature death. Our obsession with cholesterol began in the 1950s when studies linked high consumption of animal fat with high rates of heart disease. This opened the door for clinical trials that laid the foundation of a new paradigm: the cholesterol theory of cardiovascular disease.This theory has had profound ramifications. It changed the way we eat (fats bad, carbohydrates good) and contributed to our problems with obesity and diabetes. It wormed its way into "clinical practice guidelines"- cholesterol management has become a "standard of care" that doctors are expected to follow. It spawned the invasive heart surgery indust...

Pathophysiology of heart failure

Clinical Research in Cardiology Supplements — Mon, 15 Mar 2010 05:33:01 +0100

Abstract Heart failure is a complex syndrome in which the patient typically has shortness of breath at rest or during exercise and/or fatigue. Heart failure begins after an “index event” that produces a decline in pumping capacity, which as a consequence activates compensatory mechanisms. This initial event may be myocardial infarction in patients with coronary heart disease, long-standing arterial hypertension, diseases of the valves, heart muscle disease itself, and more rarely other disorders, such as myocarditis. To overcome the detrimental effects of this initial event, the compensatory mechanisms (e.g., the adrenergic nervous system, the renin–angiotensin–aldosterone system, the cytokine system) are activated, which in the short term stabilize myocardial func...

Variation in blood pressure is associated with white matter microstructure but not cognition in African Americans.

Neuropsychology — Mon, 15 Mar 2010 05:00:00 +0100

Although hypertension is a major risk factor for cerebrovascular disease (CVD) and is highly prevalent in African Americans, little is known about how blood pressure (BP) affects brain–behavior relationships in this population. In predominantly Caucasian populations, high BP is associated with alterations in frontal–subcortical white matter and in executive functioning aspects of cognition. We investigated associations among BP, brain structure, and neuropsychological functioning in 52 middle–older-age African Americans without diagnosed history of CVD. All participants underwent diffusion tensor imaging for examination of white matter integrity, indexed by fractional anisotropy (FA). Three regions of interest were derived in the anterior (genu) and posterior (splenium) corpus callos...

Naturalistic monitoring of the affect-heart rate relationship: A day reconstruction study.

Health Psychology — Mon, 15 Mar 2010 05:00:00 +0100

Conclusion: Negative affect in everyday life is a reliable predictor of HR. Combining day reconstruction with psychophysiological and environmental monitoring is a minimally invasive method with promising interdisciplinary relevance. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (Source: Health Psychology)

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ACC: ACCORD Vindicates Patient-Centered Cardiac Care in Diabetes

MedPage Today Cardiovascular — Mon, 15 Mar 2010 01:10:52 +0100

ATLANTA (MedPage Today) -- Individualized care is again the message in the wake of lipid and hypertension results from the ACCORD trial presented here at the American College of Cardiology meeting, leading cardiologists suggest in this exclusive InFocus™ report. (Source: MedPage Today Cardiovascular)

INVEST analysis challenges diabetic BP targets

MedWire News - Hypertension — Mon, 15 Mar 2010 00:00:00 +0100

Tight control of systolic blood pressure to a target of less than 130 mmHg in diabetics with coronary artery disease does not significantly reduce the incidence of cardiovascular events compared with usual control, and is associated with increased all-cause mortality, shows an analysis of INVEST. (Source: MedWire News - Hypertension)

Lumigan 0.01% eye drops (bimatoprost) - New formulation

NeLM - SPC Changes — Mon, 15 Mar 2010 00:00:00 +0100

Source: Manufacturer notification Area: Other Library Updates > SPC Changes Allergan announced on 9th March that the European Medicines Agency (EMEA) has granted Marketing Authorisation for a new formulation of Lumigan (bimatoprost ophthalmic solution) 0.01%. Lumigan 0.01% is approved as first-line therapy for the reduction of elevated intraocular pressure (IOP) in adults with chronic open-angle glaucoma and ocular hypertension and is now available in the UK. Lumigan 0.01% is a once-daily prescription eye drop that delivers effective IOP-lowering results equivalent to those seen with Lumigan 0.03% with significantly improved tolerability. Lumigan 0.01% can be used as monotherapy or as an adjunctive therapy with beta-blockers. (Source: NeLM - SPC Changes)

Ischemia as a possible effect of increased intra-abdominal pressure on central nervous system cytokines, lactate and perfusion pressures

Critical Care — Mon, 15 Mar 2010 00:00:00 +0100

IntroductionThe aims of our study were to evaluate the impact of increased intra-abdominal pressure (IAP) on central nervous system (CNS) cytokines (interleukin 6 and tumor necrosis factor), lactate and perfusion pressures, testing the hypothesis that intra-abdominal hypertension (IAH) may possibly lead to CNS ischemia. Methods: Fifteen pigs were studied. Helium pneumoperitoneum was established and IAP was increased initially at 20mmHg and subsequently at 45mmHg, which was finally followed by abdominal desufflation. Interleukin 6 (IL-6), tumor necrosis factor alpha (TNFa) and lactate were measured in the cerebrospinal fluid (CSF) and intracranial (ICP), intraspinal (ISP), cerebral perfusion (CPP) and spinal perfusion (SPP) pressures recorded. Results: Increased IAP (20mmHg) was followed by...

Study shows marathon runners at risk

OrlandoSentinel: Medical Research — Mon, 15 Mar 2010 00:00:00 +0100

Marathon runners may be doing more harm to their heart than good. Researchers found that marathon runners are at risk for high blood pressure and stiffness in the aorta, as endurance training can stress the cardiovascular system. Experts say while... (Source: OrlandoSentinel: Medical Research)

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Right Atrial Appendage Function in Different Etiologies of Permanent Atrial Fibrillation: A Transesophageal Echocardiography and Tissue Doppler Imaging Study

Echocardiography — Mon, 15 Mar 2010 00:00:00 +0100

Conclusion: In patients with permanent AF, impairment of RAA function and development of right atrial SEC-thrombus are closely related to the underlying etiology. These results suggested that evaluation of RAA functions may have an incremental value over the assessment of the LAA for determining thromboembolic risk. (Echocardiography ****;**:1-10) (Source: Echocardiography)

Intensive BP control in type 2 diabetes doesn't seem to improve outcomes

NeLM - News — Mon, 15 Mar 2010 00:00:00 +0100

Source: NEJM Area: News Managing patients with hypertension and type 2 diabetes to a target systolic blood pressure (BP) of less than 120mmHg did not reduce cardiovascular events compared to a target of 140mmHg in a major randomised controlled trial. While it is accepted that people with type 2 diabetes are at increased cardiovascular risk compared to those without, and that management of all aspects of cardiovascular risk is important in such people, there is still debate over how best to do this. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial investigated two areas of cardiovascular risk management - intensive BP control and combination lipid lowering, as well as intensive vs. standard glycaemic control. All participants in the trial were randomised to o...

Nursing assessment of obstructive sleep apnea in hospitalised adults: A review of risk factors and screening tools

Contemporary Nurse — Mon, 15 Mar 2010 00:00:00 +0100

Contemporary Nurse 34(1): 19-33 Abstract Obstructive sleep apnea (OSA) affects approximately 2-4% of the general population and may be more prevalent in obese adults. However, sleep apnea remains consistently under-diagnosed in the general population as well as in hospital wards. Nurse awareness of OSA during routine monitoring could allow specific observations of hospitalised adults to identify those at high risk and ensure appropriate referral. This integrative literature review analysed major risk factors for OSA and identified screening tools that nurses could utilise in hospital wards. The most important risk factors relevant to nursing practice in hospital settings were obesity, hypertension and sleep position. The most suitable screening tool was the Berlin Questionnaire, while ther...

Bipolar Disorder, Meds and Blood Sugar

About.com Bipolar Disorder — Mon, 15 Mar 2010 00:00:00 +0100

I gained 80 pounds on various psychiatric meds, and I know hundreds of our community members are in the same boat. And along with the weight gain came the usual problems - high blood pressure and high cholesterol, not to mention the misery of being fat for the first time in my life. And now there's another problem related to that weight gain: high blood sugar, or hyperglycemia. As we reported last year, there are many lawsuits claiming that Seroquel causes diabetes, but the courts haven't bought the argument yet. And although I'm now borderline diabetic, I can't claim that, either, since I have a strong family history of diabetes. Still, the fact remains that my blood sugar is now high enough that I have to take medication for it. And bipolar disorder itself has a possible connection to ...