Betabloqueadores e hipertension arterial
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This document contains references to several medical studies on hypertension and antihypertensive treatments that were published between 2005-2012. It includes citations from The Lancet, Circulation, Hypertension, and Archives of Internal Medicine. It also contains figures from some of these studies showing results on the risk of new-onset diabetes with different treatments and ankle-brachial indexes between treatment groups over time.
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Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts
Know more on http://www.emergency-live.com
Total and Cause-Specific Mortality of U.S.
Nurses Working Rotating Night Shifts
Fangyi Gu, MD, ScD, Jiali Han, PhD, Francine Laden, ScD, An Pan, PhD, Neil E. Caporaso, MD,
Meir J. Stampfer, MD, DrPH, Ichiro Kawachi, MD, PhD, Kathryn M. Rexrode, MD, MPH,
Walter C. Willett,MD, DrPH, Susan E. Hankinson, ScD, Frank E. Speizer,MD, Eva S. Schernhammer,MD, DrPH
Background: Rotating night shift work imposes circadian strain and is linked to the risk of several
chronic diseases.
Purpose: To examine associations between rotating night shift work and all-cause; cardiovascular
disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses
from the Nurses’ Health Study.
Methods: Lifetime rotating night shift work (defined as Z3 nights/month) information was
collected in 1988. During 22 years (1988–2010) of follow-up, 14,181 deaths were documented,
including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated
multivariable-adjusted hazard ratios (HRs) and 95% CIs.
Results: All-cause and CVD mortality were significantly increased among women withZ5 years of
rotating night shift work, compared to women who never worked night shifts. Specifically, for
women with 6–14 and Z15 years of rotating night shift work, the HRs were 1.11 (95% CI¼1.06,
1.17) and 1.11 (95% CI¼1.05, 1.18) for all-cause mortality and 1.19 (95% CI¼1.07, 1.33) and 1.23
(95% CI¼1.09, 1.38) for CVD mortality. There was no significant association between rotating night
shift work and all-cancer mortality (HRZ15years¼1.08, 95% CI¼0.98, 1.19) or mortality of any
individual cancer, with the exception of lung cancer (HRZ15years¼1.25, 95% CI¼1.04, 1.51).
Conclusions: Women working rotating night shifts for Z5 years have a modest increase in allcause
and CVD mortality; those working Z15 years of rotating night shift work have a modest
increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental
effect of rotating night shift work on health and longevity.
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Antihipertensivos
AntihipertensivosLaboratorio de Histología Facultad de Ciencias Médicas y Biológicas "Dr. Ignacio Chávez" UMSNH
1) El documento describe los diferentes tipos de antihipertensivos, incluyendo bloqueadores beta, vasodilatadores como la nitroglicerina y el nitroprusiato.
2) Explica las características farmacológicas, mecanismos de acción, efectos y aplicaciones de estos medicamentos en el control de la hipertensión arterial aguda y crónica.
3) Incluye recomendaciones de las guías JNC 7 y JNC 8 sobre el tratamiento de la hipertensión arterial de acuerdo a la edad y condiciones delBeta blockers in cardiology practice
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2) Studies have shown that lowering blood pressure, including through the use of beta blockers, reduces complications from diabetes such as heart attacks, strokes, and heart failure.
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1. A retrospective study found that male veterans with low testosterone who received testosterone therapy had a higher risk of heart attack, stroke, or death compared to those not receiving therapy, even after adjusting for potential confounding factors.
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1) The expected survival of patients with pulmonary arterial hypertension (PAH) varies based on the underlying cause, with idiopathic PAH having a median survival of 2.8 years based on historical studies.
2) Medical therapies like epoprostenol have improved survival rates, with studies showing 1, 2, and 3 year survival rates with epoprostenol between 63-87%, compared to 27-52% historically.
3) The prognosis is worse for PAH associated with scleroderma or collagen vascular diseases, with median survival around 1-2 years, while PAH associated with congenital heart disease has a better prognosis, with reported 3 year survival of 77%.
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This study examined the risk of recurrent stroke or death among older patients treated with clopidogrel after a stroke, and whether concurrent use of a proton pump inhibitor (PPI) increased this risk. The study used healthcare databases in Ontario, Canada to identify patients aged 66 and older who were newly prescribed clopidogrel within 30 days of hospital discharge after a stroke between 2002-2008. The study identified 118 patients who were readmitted for stroke and 472 control patients. After adjusting for potential confounding factors, current use of a PPI within 60 days was not found to be associated with a significantly increased risk of recurrent stroke or death among these older patients treated with clopidogrel after a stroke.
Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts
Know more on http://www.emergency-live.com
Total and Cause-Specific Mortality of U.S.
Nurses Working Rotating Night Shifts
Fangyi Gu, MD, ScD, Jiali Han, PhD, Francine Laden, ScD, An Pan, PhD, Neil E. Caporaso, MD,
Meir J. Stampfer, MD, DrPH, Ichiro Kawachi, MD, PhD, Kathryn M. Rexrode, MD, MPH,
Walter C. Willett,MD, DrPH, Susan E. Hankinson, ScD, Frank E. Speizer,MD, Eva S. Schernhammer,MD, DrPH
Background: Rotating night shift work imposes circadian strain and is linked to the risk of several
chronic diseases.
Purpose: To examine associations between rotating night shift work and all-cause; cardiovascular
disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses
from the Nurses’ Health Study.
Methods: Lifetime rotating night shift work (defined as Z3 nights/month) information was
collected in 1988. During 22 years (1988–2010) of follow-up, 14,181 deaths were documented,
including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated
multivariable-adjusted hazard ratios (HRs) and 95% CIs.
Results: All-cause and CVD mortality were significantly increased among women withZ5 years of
rotating night shift work, compared to women who never worked night shifts. Specifically, for
women with 6–14 and Z15 years of rotating night shift work, the HRs were 1.11 (95% CI¼1.06,
1.17) and 1.11 (95% CI¼1.05, 1.18) for all-cause mortality and 1.19 (95% CI¼1.07, 1.33) and 1.23
(95% CI¼1.09, 1.38) for CVD mortality. There was no significant association between rotating night
shift work and all-cancer mortality (HRZ15years¼1.08, 95% CI¼0.98, 1.19) or mortality of any
individual cancer, with the exception of lung cancer (HRZ15years¼1.25, 95% CI¼1.04, 1.51).
Conclusions: Women working rotating night shifts for Z5 years have a modest increase in allcause
and CVD mortality; those working Z15 years of rotating night shift work have a modest
increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental
effect of rotating night shift work on health and longevity.
(Am J Prev Med 2015;](]):]]]–]]]) & 2015 American Journal of Preventive Medicine. All rights reserved.
Digoxina metaanalisis
This systematic review and meta-analysis analyzed 19 studies comprising over 326,000 patients to investigate the effect of digoxin use on mortality in patients with atrial fibrillation (AF) or congestive heart failure (CHF). The analysis found that digoxin use was associated with an increased relative risk of all-cause mortality, with a 29% higher mortality risk seen in AF patients and a 14% higher risk in CHF patients. The results suggest that digoxin therapy may increase mortality risk, particularly in patients with AF. However, significant heterogeneity was seen between the individual studies.
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Herbal medicines in cardiac patients
This document summarizes research on potential adverse effects of herbal medicine use in cardiac patients taking prescription medications. It reviews 5 studies that explored interactions between common herbal medicines (e.g. cranberry, garlic) and cardiac drugs (e.g. warfarin). The studies found that certain herbal medicines can increase or decrease the effects of drugs like warfarin when taken together, potentially causing issues like abnormal bleeding or clotting in patients. However, many of the studies had limitations like small sample sizes. Overall, more research is still needed but the document suggests herbal medicine use should be carefully monitored in cardiac patients on multiple medications.
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This document summarizes a clinical trial that evaluated the safety and efficacy of patiromer for treating hyperkalemia in patients with chronic kidney disease receiving RAAS inhibitors. The trial had two phases - an initial 4-week treatment phase followed by an 8-week randomized withdrawal phase. Results showed that patiromer significantly reduced serum potassium levels and maintained normokalemia compared to placebo. The most common side effects were constipation and diarrhea. The authors concluded that patiromer was effective for treating hyperkalemia and allowing continued use of RAAS inhibitors in patients with chronic kidney disease.
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This study analyzed the prescription patterns of antihypertensive drugs prescribed to 137 patients in India to determine adherence to JNC 7 guidelines. The most frequently prescribed classes of drugs were diuretics, followed by calcium channel blockers, beta blockers, ACE inhibitors, and ARBs. Combination drug therapy was prescribed to 72% of patients, most commonly a combination of a calcium channel blocker and beta blocker. The prescription patterns were found to adhere to JNC 7 guidelines, which recommend diuretics as first-line treatment and combination therapy including a diuretic for stage 2 hypertension.
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Association between depression and mortality in patients receiving long term ...
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1) El documento describe los diferentes tipos de antihipertensivos, incluyendo bloqueadores beta, vasodilatadores como la nitroglicerina y el nitroprusiato.
2) Explica las características farmacológicas, mecanismos de acción, efectos y aplicaciones de estos medicamentos en el control de la hipertensión arterial aguda y crónica.
3) Incluye recomendaciones de las guías JNC 7 y JNC 8 sobre el tratamiento de la hipertensión arterial de acuerdo a la edad y condiciones delBeta blockers in cardiology practice
1) Beta blockers are recommended in current cardiovascular guidelines for the treatment of hypertension and heart failure.
2) Studies have shown that lowering blood pressure, including through the use of beta blockers, reduces complications from diabetes such as heart attacks, strokes, and heart failure.
3) Different beta blockers have varying selectivity for beta-1 receptors in the heart versus beta-2 receptors elsewhere. Some beta blockers also have additional alpha-blocking or vasodilating properties.
Betabloqueadores
Sir James Black desarrolló dos fármacos importantes, incluyendo el propanolol, un betabloqueador. Los betabloqueadores bloquean los receptores beta adrenérgicos para tratar varias afecciones cardiovasculares como la hipertensión, la insuficiencia cardíaca y el infarto de miocardio. Se clasifican como lipofílicos o hidrofílicos y tienen propiedades farmacocinéticas y efectos clínicos diferentes. Son tratamientos esenciales para muchas enfermedades del corazón pero también pueden caus
Guia jnc 8
Este documento resume las recomendaciones de la Guía JNC-8 para el tratamiento de la hipertensión arterial. La guía se centra en responder tres preguntas clave sobre el manejo de la presión arterial elevada y ofrece recomendaciones sobre los umbrales y metas de tratamiento para diferentes grupos de pacientes, los agentes antihipertensivos iniciales y el manejo cuando no se alcanzan las metas.
Beta adrenergic blockers
This presentation deals with the beta blockers commonly used in day-to-day practice alongwith some interesting mnemonics to remember their names & site of action
ADRENERGIC BLOCKERS
This presentation contains drugs which blocks the adrenergic system e.g receptor blockers like alpha and beta receptor antagonists, adrenergic neuron blocking agents in details.various animated pictures are also included to make the presentation interesting as well as i have used various diagrams and tables to have better understanding of the topic. Thank you.
Beta blockers
Beta blockers act on beta 1 and/or beta 2 receptors. They are classified as non-selective, selective, and mixed blockers. Non-selective blockers like propranolol block both beta 1 and beta 2 receptors. They are used for cardiovascular conditions like hypertension, angina, heart failure, and arrhythmias. Adverse effects include bronchospasm, bradycardia, hypoglycemia, and heart failure. Cardioselective blockers mainly block beta 1 receptors. Newer blockers have improved safety profiles.
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This document discusses different types of iatrogenic (medically induced) diabetes, including:
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Initial combination therapy is superior to sequential mono-therapy for treating hypertension. Combination therapy controls blood pressure faster by acting on multiple mechanisms, reducing complications by 40-54%. Combinations have greater efficacy, improve adherence, and have protective effects beyond blood pressure lowering like anti-inflammatory and metabolic benefits. Clinical trials show combination therapy achieves better blood pressure control rates and lowers cardiovascular events compared to mono-therapy. Therefore, guidelines recommend starting treatment for hypertension with initial combination therapy.
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The patient, B.J., has stage C heart failure with a functional limitation of stage II based on her symptoms of shortness of breath after physical activity that is relieved by rest. Her pertinent medical history and examination findings support stage C heart failure. She is prescribed lisinopril, spironolactone, metoprolol, atorvastatin, aspirin, and an increased dose of sertraline to treat her heart failure, hypertension, hyperlipidemia, history of myocardial infarction, and depression respectively based on ACC/AHA guidelines.
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Predicting Trends in Preventive Care Service Utilization Impacting Cardiovasc...
National reports point towards disparities in the utilization of preventive care services but sparse literature exists regarding predicting utilization pattern of preventive care services.
METHODS: The 2007 Medical Expenditure Panel Survey (MEPS), a national probability sample survey of the ambulatory civilian US population, was analyzed to determine demographic patterns of utilization. Recommendations by JNC-VII and NCEP were used to determine guideline adherence to blood pressure and cholesterol checkup respectively. Utilization of blood pressure screening and cholesterol checkup services were used as the dependent variable while age, gender, race, ethnicity, insurance status, perceived health status were used as independent variables. Since guidelines differ for people with elevated blood pressure, respondents with elevated blood pressure were identified in the MEPS database by self-reported diagnosis. Descriptive statistics were used to describe the population, chi-square analysis was used to determine the group differences for the categorical variables. Multivariate logistic regression model was built to predict odds of utilizing appropriate preventive se!
rvices. All analysis was carried out using SAS v9.1.
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249 ) preventive services. Males had much lower odds of getting blood pressure (OR=0.350, CI=0.318-0.384) and cholesterol (OR=0.597, CI=0.516-0.692) checks done compared to females. Odds of utilization were nearly similar for all races. Uninsured had lower odds for blood pressure (OR=0.282, CI=0.253-0.315) and cholesterol (OR=0.314, CI=0.262-0.376) use compared to privately insured people.
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Strive Teleconf Presentation Apr11 2007
The COURAGE trial found that adding PCI to optimal medical therapy did not reduce the risk of death or heart attack compared to medical therapy alone in stable coronary artery disease patients over a median 4.6 years. PCI did provide better relief of angina. The MERLIN TIMI-36 trial found that adding ranolazine to standard therapy reduced recurrent ischemia in NSTE-ACS patients compared to placebo with no increase in safety issues. A Danish registry study reported higher rates of late stent thrombosis over 1 year with drug-eluting stents compared to bare-metal stents based on ARC definitions.
Strive Teleconf Presentation Apr11 2007
The COURAGE trial found that adding PCI to optimal medical therapy did not reduce the risk of death or heart attack compared to medical therapy alone in stable coronary artery disease patients over a median 4.6 years. PCI did provide better relief of angina. The MERLIN TIMI-36 trial found that adding ranolazine to standard therapy reduced recurrent ischemia in NSTE-ACS patients compared to placebo with no increase in safety issues. A Danish registry study reported higher rates of late stent thrombosis over 1 year with drug-eluting stents compared to bare-metal stents based on ARC definitions.
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This expert consensus document from the World Heart Federation provides recommendations for antiplatelet therapy in East Asian patients with acute coronary syndrome or undergoing percutaneous coronary intervention. While current guidelines are based primarily on large Western clinical trials, few East Asian patients were included. Additionally, East Asians have differing risk profiles and responses to antiplatelet drugs compared to white patients. This consensus aims to determine the most appropriate antiplatelet strategies for East Asians based on available evidence.
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- 29. Figure 6. Risk of new-onset diabetes mellitus with antihypertensive treatment. Messerli F et al. Circulation 2008;117:2706-2715 Copyright © American Heart Association
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- 56. Ankle-brachial index in the 2 treatment groups at baseline and after the 48 week treatment period. Espinola-Klein C et al. Hypertension 2011;58:148-154 Copyright © American Heart Association