1,720,982 research outputs found
Neue amerikanische Leitlinien zur Hypertonie: neue Konsequenzen für uns?
No full textAbstractFollowing the publication of the new US guidelines, especially the new classifications of hypertension and the general reduction in treatment targets were discussed worldwide. Applying the US guidelines to a recent German cohort study would in practice lead to a significant increase in the diagnosis of “hypertension” in untreated patients. The number of under-adjusted patients would also increase sharply, increasing more than those predicted in the US Guidelines. Affected by an intensified antihypertensive therapy would be particularly elderly patients, in which adverse drug reactions but also occur more frequently. It seems doubtful whether the massive increase in the diagnosis “hypertension” can improve the supply situation: the opposite effect of avoiding therapists and patients could occur. Determining the individual risk with suitable, evaluated instruments certainly makes sense to treat more targeted patients. More important than new blood pressure limits is a more accurate classification of blood pressure. Repeated self-measurements and ambulatory blood pressure measurement lead to a better selection of patients benefiting from a therapy.</jats:p
Einfluss der Corona-Pandemie auf kardiovaskuläre Risikofaktoren – Daten von 1775 Teilnehmern der ELITE Studie vor und während der Corona Pandemie
No full textZusammenfassung Hintergrund Die COVID-19-Pandemie und deren Maßnahmen haben zu einem Defizit der medizinischen Versorgung und zu Änderungen in der Lebensführung der Menschen geführt, was in der Konsequenz auch die kardio- und zerebrovaskuläre Primär- und Sekundärprävention verändert hat. Die vorhandenen Daten beruhen im Wesentlichen auf Umfragen. Neben der Problematik der Korrektheit von Selbsteinschätzungen können die Pandemie per se und die massive öffentliche Berichterstattung die Daten verzerrt haben. Nur wenige Publikationen haben vor der Pandemie erhobene Daten mit den Ergebnissen im Verlauf der Pandemie verglichen. In der ELITE-Studie werden seit Jahren bei über 5000 Teilnehmern regelmäßige Kontrollen von Risikofaktoren (RF) und psychosozialen Parametern (Stress, Depressionen, Wohlbefinden, Ernährung, Hirnleistung, Bewegung) vorgenommen. Aus dieser Studie wurden die Daten von 1775 Personen ausgewertet, die vor Beginn und erneut während der Pandemie (06.05.2020–25.01.2022) erhoben wurden. Damit waren die Ausgangswerte unbeeinflusst von der Pandemie. Ergebnisse Erwartungsgemäß fanden sich sowohl Verbesserungen als auch Verschlechterungen der erhobenen Parameter. Blutdruck und depressive Symptome verschlechterten sich signifikant häufiger, wobei Frauen häufiger betroffen waren. Auch das Gewicht und die Stressbelastung stiegen häufiger an, als dass sie sich verbesserten. Nur die körperliche Aktivität zeigte eine geringgradige Zunahme. 24,1 % wiesen ausschließlich Verschlechterungen und keine Verbesserungen dieser Parameter auf. Demgegenüber zeigten 19,6 % ausschließlich Verbesserungen. In der Gruppe mit ausschließlich Verschlechterungen fand sich ein signifikanter Anstieg von Personen mit den Risikofaktoren (RF) Hypertonie, Adipositas, erhöhtes LDL-Cholesterin, Nikotin und Diabetes mellitus. Dies führte zu einer Zunahme von Personen mit 2 und mehr RF. Dagegen reduzierte sich die Zahl von Personen mit 2 und mehr RF in der Gruppe, die nur Verbesserungen aufwies. Auffällig war, dass sich Personen mit Risikofaktoren häufiger verbesserten. Folgerung Bei einem nicht unerheblichen Teil der Bevölkerung kam es in der Pandemie zu deutlichen Verschlechterungen der RF. Dies betraf besonders den Blutdruck und depressive Symptome – und dabei häufiger Frauen
Long-term effects of baroreflex activation therapy: 2-year follow-up data of the BAT Neo system
No full textHyperuricemia as an Early Indicator of Cardiovascular Risk in the General Population
No full textBackground: This prospective cohort study examines the association between hyperuricemia (HU) and cardiovascular diseases. The aim of the current study was to assess whether there might be a correlation between hyperuricemia and cardiovascular risk and future cardiovascular events. Methods: We analyzed data from 4082 participants, dividing them into two groups based on serum uric acid levels. Results: Our findings reveal that participants with elevated serum uric acid or xanthine oxidase inhibitor (XOI) therapy had a significantly higher incidence of cardiovascular events such as coronary artery disease (8.4% vs. 3.3%), stroke (2.6% vs. 1.2%), heart failure (3.4% vs. 0.9%), and chronic kidney insufficiency (4.5% vs. 1.9%) compared to those with normal uric acid levels. Moreover, group 2, which had higher serum uric acid levels, also exhibited a higher burden of established cardiovascular risk factors, including hypertension, obesity, and diabetes. These results support the hypothesis that HU is not only a marker for metabolic dysfunction but may also serve as an independent risk factor for cardiovascular morbidity and mortality. Conclusions: We propose that routine measurement of uric acid levels could be a valuable tool for early identification of high-risk cardiovascular patients, particularly in individuals with multiple metabolic risk factors. Further prospective studies are needed to explore the potential benefits of early XOI therapy in reducing cardiovascular events
ELITE-Studie – Ernährung, Lebensstil und individuelle Information zur Verhinderung von Schlaganfall, Demenz und Herzinfarkt – Studiendesign und kardiovaskuläre Aufnahmedate
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Effects of SGLT2 inhibitors on parameters of renal venous congestion in intrarenal Doppler ultrasonography
No full textABSTRACT Background Cardiorenal syndrome is a common condition in clinical practice in which renal venous congestion (VC) plays an important role. Intrarenal Doppler ultrasound (IRD) is a non-invasive method to assess and quantify renal VC. The current study aims to investigate the effects of SGLT2 inhibitor (SGLT2i) therapy on IRD parameters of renal VC. Methods This prospective observational study included patients with chronic kidney disease (CKD) with or without type 2 diabetes mellitus and/or heart failure (HF) with reduced and preserved ejection fraction who had an indication for standard of care SGLT2i therapy. IRD, assessing venous impedance index (VII), and intrarenal venous flow pattern (IRVF) analysis were performed within the interlobar vessels of the right kidney before and 6 months after initiation of SGLT2i therapy. Results A number of 64 patients with CKD and a cardiorenal risk profile were included (mean eGFR 42.9 ml/min/1.73 m2; 56% with HF, and 38% with type 2 diabetes mellitus). 17 patients exhibited signs of VC in the IRD. VII was significantly correlated with levels of NT-proBNP, female gender, NYHA class, and was significantly negative correlated with body mass index. After 6 months, a notable decrease in the mean VII of the right interlobar veins by 0.13 (P < .01) was observed. Stratification according to IRVF pattern showed a significant shift towards reduced renal VC pattern after 6 months (P = .03). Conclusions In this study, SGLT2i therapy resulted in a reduction in renal VC as assessed by IRD. These findings underscore the potential haemodynamic benefits of SGLT2 inhibitors in cardiorenal syndrome and warrant further investigation into their clinical implications.Open-Access-Publikationsfonds 202
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Relationship between Lipoprotein(a) and cardiovascular risk factors—data from 4602 participants of the ELITE study
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