1,721,010 research outputs found
Pregnancy 3 months after inclisiran injection: a unique case report including newborn baby monitoring
Full text linkBackground: Data on the safety of inclisiran, a lipid-lowering small interfering RNA (siRNA) inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9) secretion, during pregnancy are absent. Case summary: A 30-year-old woman suffering from heterozygous familial hypercholesterolaemia started treatment with inclisiran 25 weeks before the start of gestation and received a second administration 13 weeks before the start of gestation. As soon as we became aware of the unplanned pregnancy, given the absence of any data regarding the administration of inclisiran during this period, the treatment was discontinued and the pregnancy was closely monitored. After a normal and full-term gestation, birth occurred at 41 + 0 gestational weeks. The baby was female and healthy, with normal anthropometry for her gestational age; her growth and development in the first 8 months of life followed a normal course. Discussion: Potential harms to the foetus with systemic malformations have been highlighted with the genetically proxied LDL cholesterol lowering through PCSK9. To the best of our knowledge, this is the first case of pregnancy initiated few months after inclisiran administration, without reporting any adverse effect on the patient or the baby. More data are needed on the pharmacodynamics and safety of siRNAs in general, and of inclisiran in particular, to confirm that this drug could be safe even in this specific setting
Single-pill fixed-dose drug combinations to reduce blood pressure: the right pill for the right patient
Full text linkArterial hypertension is one of the major causes of cardiovascular morbidity and mortality worldwide. Effective and sustained reduction in blood pressure is essential to reduce individual cardiovascular risk. In daily clinical practice, single-pill fixed-dose combinations of different drug classes are important therapeutic resources that could improve both treatment adherence and cardiovascular risk management by targeting distinct pathophysiological mechanisms. The aim of this practical narrative review is to help physicians choosing the right single-pill fixed-dose combination for the right patient in the daily clinical practice, based on the individual clinical phenotype and cardiovascular risk profile
Reader Response: Statin Use and All-Cause Mortality in Nursing Home Residents With and Without Dementia: A Retrospective Cohort Study Using Claims Data
No full textOsteocrin/musclin and the natriuretic peptides system: A novel focus in metabolism and cardiovascular prevention
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Prevalence and Control of Dyslipidemia In Patients Referred For High Blood Pressure: The Disregarded “Double-Trouble” Lipid Profile In Overweight/Obese
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Associations Between Body Mass Index, Ambulatory Blood Pressure Findings, and Changes in Cardiac Structure: Relevance of Pulse and Nighttime Pressures
No full textAmbulatory blood pressure monitoring (ABPM) is central in the management of hypertension. Factors related to BP, such as body mass index (BMI), may differently affect particular aspects of 24-hour ABPM profiles. However, the relevance of BMI, the most used index of adiposity, has been underappreciated in the determination of specific aspects of 24-hour ABPM profiles in hypertension. The authors evaluated the association between BMI and aspects of ABPM together with their associations with cardiac remodeling in 1841 patients. A positive association of BMI with 24-hour, daytime, and nighttime pulse pressure in untreated normal weight and overweight/obese hypertensive patients and a positive association of BMI with nocturnal BP parameters in treated overweight/obese hypertensive patients was observed. The clinical relevance of these findings was supported by the positive significant correlations of BMI-related BPs with left ventricular mass and atrial diameter
Cardiovascular Risk Assessment and Control in Outpatients Evaluated by 24-hour Ambulatory Blood Pressure and Different LDL-C Equations
Full text linkIntroduction: Office blood pressure (OBP) and low-density lipoprotein cholesterol (LDL-C) calculated by the Friedewald formula (F) are the cornerstones of the cardiovascular risk (CVR) assessment and management based on the SCORE2/SCORE2-OP model proposed by the 2021 ESC Guidelines on Cardiovascular Disease Prevention. Aim: We compared the CVR stratification estimated by the old SCORE and the SCORE2/SCORE2-OP using OBP and ambulatory blood pressure measurement (ABPM), and we evaluated the prevalence of LDL-C control, after calculating it using three validated equations, in outpatients referred for arterial hypertension. Methods: A cross-sectional study on 1539 consecutive patients with valid ABPM. LDL-C was calculated using the Friedewald formula (F), its modification by Martin (M), and the Sampson (S) equation. SCORE and SCORE2/SCORE2-OP were estimated using OBP, mean daytime (+ 5 mmHg adjustment), and mean 24-hour systolic blood pressure (+ 10 mmHg adjustment). Individual CVR by 2021 ESC Guidelines (and SCORE2/SCORE2-OP) was compared to the 2019 ESC/EAS Guidelines (and SCORE). Differences in the prevalence of LDL-C control according to the three methods to calculate LDL-C were also analysed. Results: Mean age was 60 +/- 12 years, with male prevalence (54%). Mean LDL-C values were 118 +/- 38 mg/dL (F), 119 +/- 37 mg/dL (M), and 120 +/- 38 mg/dL (S), respectively. Within the same population, SCORE and SCORE2/SCORE2-OP significantly varied, but no differences emerged after comparing the average SCORE2/SCORE2-OP calculated with OBP (6% IQR 3-10), mean 24-hour systolic BP (7% IQR 4-11), and mean daytime systolic BP (7% IQR 4-11). SCORE2/SCORE2-OP and 2021 ESC Guidelines reclassified the CVR independently of the method used for BP measurement. The low-moderate risk group decreased by 32%, whereas the high and veryhighrisk groups increased by 18% and 12%, respectively. We found a significant reduction in reaching the LDL-C goals regardless of the equation used to calculate it, except for those > 65 years, in whom results were confirmed only by using the M. Conclusion: SCORE2/SCORE2-OP and 2021 ESC Guidelines recommendations led to a non-negligible CVR reclassification and subsequent lack of LDL-C goal, regardless of estimating SCORE2 using OBP or ABPM. Calculating the LDL-C with the M may be the best choice in specific settings
Hypertensive heart disease and obesity: a complex interaction between hemodynamic and non hemodynamic factors.
No full textThe worldwide prevalence of obesity has nearly doubled, with an increase in obesity-related cardiovascular disease and mortality. Several factors are involved in the genesis of hypertension and hypertensive heart disease (HHD) in overweight/obesity. This review is focused on bridging factors between excessive adiposity and HHD, presenting a unifying hypothesis of vascular-metabolic syndrome, where an "handicap" of the natriuretic peptide system has a central role both in adipocyte dysmetabolism as well as in increased blood pressure and HHD
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