1,721,430 research outputs found

    Ipertensione arteriosa e fibrillazione atriale

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    L’ipertensione arteriosa rappresenta una condizione assai diffusa, con una prevalenza compresa fra il 30% e il 40% nella popolazione generale, seppur con significative variazioni geografiche1,2. Le aritmie, sia ventricolari che sopraventricolari, costituiscono una comorbilità comune nei pazienti ipertesi. La fibrillazione atriale (FA) costituisce la forma più comune di aritmia cardiaca, con un progressivo aumento della prevalenza e dell’incidenza nel tempo; negli ultimi anni, in considerazione del rilevante impatto sulla morbilità e mortalità cardiovascolare, è stata rivolta sempre maggiore attenzione a questa condizione clinica

    Dronedarone: an emerging therapy for atrial fibrillation.

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    Atrial fibrillation (AF) is a common arrhythmia, with a prevalence ranging from 0.1% to 9.0% at different ages, and is associated with increased cardiovascular events and mortality. A significant increase in the prevalence of the disease is expected to occur in the coming years as a consequence of the aging of the population and advances in the management of coronary artery disease and heart failure. Effective rhythm control may be difficult to obtain in a significant proportion of patients with AF. The limited efficacy and the possible adverse effects of antiarrhythmic drugs has led researchers to focus their attention on new molecules, in a search of compounds with antiarrhythmic efficacy and a more favourable safety profile. Among several new drugs developed for the management of AF, dronedarone, a benzofuran derivative that shares many of the antiarrhythmic properties of amiodarone, but with a more favourable safety profile, seems particularly promising. The drug is noniodinated, has less lipophilicity, reaches therapeutic concentrations over a shorter period of time and has lower tissue accumulation. Dronedarone, similarly to amiodarone, exhibits electrophysiologic characteristics of all 4 Vaughan Williams classes. Clinical studies have shown that dronedarone effectively reduces ventricular rate, may prevent or delay the recurrence of AF, and may reduce cardiovascular morbidity and mortality in patients with AF or atrial flutter. The drug has an overall good safety profile, in particular with low pulmonary and thyroid toxicity. An important exception is represented by patients with unstable haemodynamic conditions, in which the use of dronedarone has been found to be associated with an increase in mortality. Dronedarone has been recently approved for clinical use by the Food and Drug Administration and by the European Medicines Agency. Further results from trials and clinical use will better define the efficacy and safety profile of dronedarone in AF compared with other antiarrhythmic drugs and its role in the management of patients with AF

    Paziente con ipertensione arteriosa sistolica isolata: caso clinico

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    Riscontrabile in tutte le fasce di età, l’ipertensione arteriosa sistolica isolata è in realtà una condizione clinica più frequente nell’anziano. Attualmente sono disponibili solide evidenze che dimostrano un significativo beneficio associato al suo trattamento, dove l’approccio più razionale è bene che preveda associazioni di antipertensivi: una combinazione Ace-inibitore e calcioantagonista comporta un effetto additivo ed è ben tollerat
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