1,721,216 research outputs found
Antihypertensive Efficacy of lcz696 in Hypertension
No full textEssential hypertension is a complex clinical condition, characterized by sustained elevation of systolic and/or diastolic blood pressure (BP) levels and an increased risk of developing major cardiovascular (CV) outcomes, mostly including coronary artery disease, stroke, and death. Several studies have also reported that high BP levels are significantly related to AC higher risk of new- onset congestive heart failure than normotension and that hypertensive disease (i.e., left ventricular diastolic dysfunction with or without left ventricular remodeling or hypertrophy) may be responsible of the progression from hypertension toward left ventricular systolic dys- function and clinically evident heart failure, indepen- dently of the presence of concomitant conditions and co- morbiditie
Integrated cardiovascular risk management for the future: lessons learned from the ASCOT trial.
No full textCardiovascular disease is the leading cause of morbidity and mortality in Western countries, and hypertension-related cardiovascular events affect about 37 million people per year worldwide. In this perspective, treatment of hypertension is a reference illustrating strategies of cardiovascular prevention. Hypertensive patients are at increased risk of undergoing a cardiovascular event throughout their lives, and treatment of high blood pressure is one of the most effective strategies to reduce global cardiovascular risk. However, due to its multifactorial pathophysiology and frequent association with other important risk factors and clinical conditions such as dyslipidemia, diabetes, left ventricular dysfunction, and renal impairment, treatment of hypertension requires an integrated approach, including life-style measures, antihypertensive drugs and other therapies (statins, ASA, etc.). Nonetheless, worldwide, general practitioners continue to focus on managing a single risk factor, e.g. blood pressure, rather than on overall cardiovascular risk profiles. Another debated issue is whether it matters how blood pressure is lowered in hypertensive patients at high risk. In other words, are the latest antihypertensive drugs more effective than older blood pressure strategies in terms of reduction of cardiovascular events? The recent results of the ASCOT Study address these controversial issues and throw new light on the management of cardiovascular risk in hypertension
Use of fixed combination therapies to improve blood pressure control in the clinical management of hypertension: a key opportunity
Full text linkExploring New Options for Cardiovascular Disease Prevention May Improve Patients' Quality of Life and Outcomes
No full textComment on
Pet Ownership and the Risk of Dying from Cardiovascular Disease Among Adults Without Major Chronic Medical Conditions
High resolution signal averaged electrocardiography may improve diagnosis of atrial fibrillation and reduce stroke
No full textPathophysiology of Atrial Fibrillation (AF) is multifactorial, by linking elec- trical alterations with neurohormonal factors and structural changes of the left atrium (LA). Also pulmonary veins have a central role in the pathophysiology of AF, through re- entry circuits that, spreading to the atria, may generate a “chaotic” electrical activation. Structural alterations, such as LA enlargement, fibrosis and adipose tissue deposition, may further promote a disorganized electrical conduction, by creating anatomical conduction blocks, which generate and sustain the development of AF
Olmesartan in the treatment of hypertension in elderly patients: a review of the primary evidence.
No full textHypertension, particularly systolic hypertension, is prevalent in the elderly and increases with advancing age, in part because of age-related endothelial dysfunction and increased arterial stiffness. There is strong evidence from randomized clinical trials that supports the use of antihypertensive treatment for effective and sustained blood pressure (BP) control in older patients to reduce the risk of vascular-related morbidity and mortality, particularly cerebrovascular accidents, including stroke. Furthermore, current evidence and guidelines suggest that all major classes of antihypertensive agents are equally effective in controlling BP and preventing cardiovascular events in older patients. Diuretics are commonly used in elderly patients, but recent outcomes data have raised doubt about their long-term benefits. Renin-angiotensin system inhibitors have a better tolerability profile than diuretics. Extensive clinical evidence has demonstrated the excellent efficacy and tolerability profile of olmesartan medoxomil (OM)--an angiotensin II receptor blocker AT1 receptor antagonist--including in elderly patients. Randomized and observational studies have shown that OM provides effective BP control across the 24 h dosing interval in the elderly. It also has a good tolerability profile, a pharmacokinetic profile unaffected by age and a low propensity for drug interactions. An additional factor is that OM once-daily regimens are simple and straightforward, which can be an important factor in maintaining adherence to therapy in elderly patients. This article provides an overview of the main recent clinical evidence supporting the use of OM-based therapy in elderly patients with hypertension
Reducing therapeutic inertia to improve blood pressure control: the Spanish lesson
No full text[No abstract available
Antihypertensive therapy and cerebrovascular protection
No full textPURPOSE OF REVIEW: Stroke represents the most devastating cardiovascular disease in the Western world, accounting for approximately 700,000 cases each year, including 500,000 first attacks and 200,000 recurrent episodes. High blood pressure is the most relevant modifiable risk factor for developing stroke. RECENT FINDINGS: In hypertensive patients, especially those with additional cardiovascular risk factors or clinical settings such as diabetes, target organ damage or associated clinical conditions, even small decreases in blood pressure levels are associated with large reductions in the incidence of cerebrovascular events. The benefits of blood pressure reductions, however, are not strictly proportional to stroke incidence, and it has been recently postulated that the different classes of antihypertensive drugs may have specific properties for organ protection and cerebrovascular accident prevention. SUMMARY: In particular, the hypothesis of a higher cerebrovascular protection provided by newer antihypertensive agents with respect to the conventional antihypertensive therapy is an attractive perspective that deserves further investigatio
Managing hypertension in cardiology practice according to risk profile.
Full text linkCardiologists play a central role in managing hypertensive patients, although recent surveys reveal a marked discrepancy between cardiologists' appreciation of their patients' risk status and the measures taken to reduce that risk. The diagnosis and the management of hypertension, in fact, must be viewed today not in isolation, but as part of a patients' global cardiovascular (CV) risk, resulting from the concomitant presence of a variety of risk factors, organ damage (left ventricular hypertrophy, carotid or peripheral atherosclerosis, microalbuminuria or impaired glomerular filtration rate), and hypertension-related clinical conditions. The choice of timing and the intensity of antihypertensive treatment should be based on blood pressure (BP)-lowering efficacy and the propensity to favourably impact patient's individual absolute CV disease risk profile. As part of this paradigm shift in CV disease prevention strategy, cardiologists can take several key steps to help improve standards of hypertension control: (i) increase the awareness of total risk management; (ii) initiate an integrated management strategy tailored to the individual patient's global CV risk (e.g. hypertension, hypercholesterolaemia, diabetes, age, smoking and gender); (iii) use any elevation in BP as a gateway to begin total risk management and (iv) utilise combination therapies (particularly fixed-dose combinations) to achieve more rapid and persistent BP control and improve patient compliance/persistence with therapy. To help improve standards of hypertension control in the cardiology setting, this review examines the concept of treating hypertension using a global risk assessment approach and proposes effective hypertensive therapy as part of global risk management in patients typically seen in cardiology practice
- …
