1,721,142 research outputs found
Evaluation of intermediate endpoints: Clinical implications in the management of arterial hypertension
No full textArterial hypertension heavily contributes to the global cardiovascular burden of morbidity and mortality, as well as to increase individual absolute cardiovascular risk. In addition, the clustering of cardiovascular risk factors and target organ damage in hypertensive patients is indeed an extremely frequent observation in both the epidemiological studies and in the clinical practice. In this view, a systematic research of intermediate endpoints or disease markers may represent an useful strategy in order to evaluate the presence of target organ damage as well as to predict cardiovascular events in essential hypertension. In fact, when considering the long natural history of hypertension, it appears very useful to postulate that modifications in measurable intermediate endpoints may permit a better evaluation of the efficacy of a given treatment in preventing or modifying the course of target organ damage, rather than variation in the future risk for development of hard endpoints. This represents a valuable approach in the clinical practice and can be easily undertaken by physicians to evaluate the status of a patient the prognosis and the effectiveness of a treatment through a better stratification of absolute cardiovascular risk in individual patients, resulting in a more strict and cost-effective control of high blood pressure levels
Per Lino Marini storico dell'età moderna
No full textLino Marini appartenne a quella generazione di storici e di intellettuali usciti ancora giovanissimi dalla drammatica esperienza della Seconda guerra mondiale, ma anche nutriti di "lezioni" di grandi maestri che avevano variamente attraversato il Ventennio. Allievo dell'Istituto italiano di Studi storici, Marini si formò al magistero di Croce e soprattutto di Federico Chabod
Hypertensive crisis management in the emergency room. time to change?
No full textA rapid, marked and persistent rise in blood pressure (BP) levels above 180/120 mmHg is a clinical condition currently defined as hypertensive emergency or urgency in the presence or absence of acute signs of hypertension-mediated organ damage, respectively [1]. Beyond the magnitude of BP rise and absolute BP levels, early recognition of these conditions is crucial from both a prognostic and a therapeutic point of view. Indeed, current European guidelines recommend clinical observation with repeated BP measurements and gradual BP reductions throughout the administration of oral antihypertensive drug therapies in individuals with hypertensive urgencies [2]. On the other hand, patients with hypertensive emergencies should immediately receive pharmacological and non-pharmacological interventions for lowering BP levels, mostly through the administration of intravenous drugs, and undergo specific treatment protocols for the clinical management of associated clinical conditions, such as acute coronary syndromes, stroke, pulmonary oedema, eclampsia, and aortic dissection [2]. Similar recommendations have been issued by the United States guidelines on hypertension [3]
Are we really sure about the pycnogenol antihypertensive effect?
No full textDear Editor,
We carefully read the meta-analysis by Malekahmadi et al. recently accepted for publication in Pharmacological Research with a little criticism [1].
Our concerns regard the fact that not every included study meets the inclusion criteria of the meta-analysis. As a matter of fact, the authors considered 9 non-randomized clinical studies (non-RCTs) (references 26, 28, 33, 34, 36, 38, 41, 44, 45 in the paper), and a clinical trial (reference 24 in the paper) testing the effect of Oligopin® supplementation, which is characterized by a higher content in low molecular weight oligomeric procyanidins than Pycnogenol® (∼20 % vs. 5 %)
Xanthine oxidase inhibitors in elderly patients with heart failure. useful or useless?
No full textElevated serum uric acid levels have been progressively emerged as a powerful and independent risk factor for many cardiovascular diseases, including hypertension, coronary artery disease, stroke and congestive heart failure. It has been also reported strong, positive and independent correlations between high-serum levels of uric acid and metabolic abnormalities, including hypercholesterolemia, atherogenic dyslipidaemia, obesity, metabolic syndrome, and diabetes. Additionally, high serum uric acid levels are able to predict progression from end-stage renal and heart failure and they have been related to worsen prognosis and increased risk of cardiovascular death in many observational studies. On the other hand, several reports have demonstrated that reducing levels of serum uric acid levels with xanthine oxidase inhibitors was associated with better prognosis and improved event-free survival rate in different cardiovascular settings, including hypertension, coronary artery disease, and even congestive heart failure. On the basis of these consideration, high-serum levels of uric acid should never be neglected or ignored, independently by the clinical context or the clinical condi- tion in which they are observe
Excess of dyslipidemia in low income countries. The case of Colombia in the PURE study
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Proprotein Convertase Subtilisin-Kexin Type 9 (PCSK9) Inhibitors and Cardiovascular Risk: Does a Further Analysis of the Fourier Trial Suggest Changes in the Target of Lipid Lowering Therapy?
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How to Improve Patients' Adherence to Antihypertensive Therapy. A Simple Solution for a Big Trouble
No full textNo abstract availabl
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