Vasodilators For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In summary, vasodilators play a pivotal role in managing cardiovascular conditions, including hypertension, which is rapidly becoming a global health concern. By expanding the body’s blood vessels, these unique medications can improve blood flow and decrease the pressure exerted by the heart, thereby providing relief to numerous patients worldwide. Their applications are diverse, extending beyond hypertension to conditions like angina, heart failure, and even erectile dysfunction. However, these medications should be taken carefully and always under the supervision of a doctor due to the potent...
Source: The EMT Spot - July 27, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Angiotensin II Receptor Blockers (ARBs) For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion Cardiovascular disease (CVD) has become a leading cause of death globally, necessitating the adoption of preventive measures, early detection, and effective management strategies. Hypertension, a significant risk factor for CVD, requires active management to mitigate associated risks. Angiotensin II Receptor Blockers (ARBs) have emerged as a favored choice among healthcare professionals due to their effectiveness and unique benefits. ARBs offer several advantages compared to other blood pressure medications. They effectively control blood pressure, protect vital organs such as the heart and kidneys, ...
Source: The EMT Spot - July 11, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

What are BNP and NT-proBNP tests? Cardiology Basics
BNP and NT-proBNP tests are used for detection of heart failure. When the heart fails, there is stretching of the ventricles which leads to release of BNP from the myocardium. Pro BNP is the precursor of BNP, which is cleaved by enzymes to NT-proBNP and BNP. BNP stands for brain natriuretic peptide or B-type natriuretic peptide.  BNP is biologically active while NT-proBNP is not. NT stands for amino terminal of the protein. NT-proBNP has a longer plasma half life than BNP. Hence levels of NT-proBNP are more stable. Thus, it can reflect the stretching of the left ventricle, over the previous 12 hours. This is the reas...
Source: Cardiophile MD - October 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Important blood tests in relation to the heart – Cardiology Basics
Important blood tests in relation to the heart – Cardiology Basics Here are some important blood tests in relation to the heart. Normal ranges of some of these tests may vary between labs. Cholesterol is a type of fat found in the blood and has a role in the development of atherosclerosis in the coronary arteries as well as other arteries. Desirable value of total cholesterol in blood is less than 200 milligrams per decilitre. Triglycerides is another type of fat found in the blood. Desirable value is less than 150 milligrams per decilitre. Very high levels of triglycerides carry a risk of pancreatitis. Calorie restr...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Cardiomyopathy in muscular dystrophies
Important muscular dystrophies due to mutations in structural cytoskeletal dystrophin gene are known as dystrophinopathies. They include Duchenne muscular dystrophy, Becker muscular dystrophy and X-linked dilated cardiomyopathy. Primary presentation of most dystrophinopathies is skeletal muscle weakness. Duchenne muscular dystrophy is caused by mutations leading to absence of functional dystrophin. Becker muscular dystrophy is due to mutations resulting in reduced amounts of shortened dystrophin protein. Cardiac muscle being a striated muscle, is affected in many types of muscular dystrophies. Cardiomyopathy would contrib...
Source: Cardiophile MD - August 30, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Cardiology MCQs
Which of the following is NOT a drug used for metabolic modulation in heart failure? Trimetazidine Ranolazine Perhexiline Sacubitril-valsartan Correct answer: 4. Sacubitril-valsartan Sacubitril-valsartan is an angiotensin receptor-neprilysin inhibitor (ARNI). Trimetazidine is a 3-ketoacyl coenzyme A thiolase inhibitor, while ranolazine inhibits the late sodium current. Perhexiline inhibits carnitine palmitoyl transferase. Latter three are metabolic modulators while sacubitril-valsartan is a hemodynamic modulator in heart failure [Ashrafian H, Neubauer S. Metabolic modulation in heart failure: high time for a definitive ...
Source: Cardiophile MD - July 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

GALACTIC-HF Trial: Omecamtiv mecarbil
GALACTIC-HF trial evaluated omecamtiv mecarbil, a cardiac myosin activator in heart failure with reduced ejection fraction [1]. The study had 8256 patients which included inpatients and outpatients with symptomatic heart failure with an ejection fraction of 35% or less. It was a placebo controlled trial of omecamtiv mecarbil in addition to standard heart failure therapy. Primary outcome was a composite of first heart failure event or death from cardiovascular causes. Heart failure event was defined as hospitalization or urgent hospital visit for heart failure. Over a median follow up of 21.8 months, primary outcome event ...
Source: Cardiophile MD - June 8, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Left ventricular remodeling
Left ventricular remodeling occurs in response to left ventricular stress and injury. It is progressive and occurs after large myocardial infarctions and dilated cardiomyopathy. Left ventricular volume increases and the normal elliptical shape becomes globular. Left ventricular remodeling is associated with changes at microscopic level which include myocyte hypertrophy, apoptosis and increased interstitial collagen deposition [1]. Left ventricular remodeling is a central pathophysiological mechanism in advancing heart failure. Reversal of remodeling with treatment is an important goal in the management of heart failure. ...
Source: Cardiophile MD - April 2, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Ranitidine (Zantac) recall expanded, many questions remain
Update: On April 1, 2020, the FDA requested manufacturers to withdraw all prescription and over-the-counter (OTC) ranitidine drugs (Zantac, others) from the market immediately, due to the presence of a contaminant known as N-Nitrosodimethylamine (NDMA). Although the FDA did not observe unacceptable levels of NDMA in many of the samples they tested, they have determined that the impurity in some ranitidine products increases over time and when stored at higher than room temperatures. As a result of this recall, ranitidine products will no longer be available for prescription or OTC use in the US. The FDA is also advising co...
Source: Harvard Health Blog - April 2, 2020 Category: Consumer Health News Authors: Joshua Gagne, PharmD, ScD Tags: Digestive Disorders Drugs and Supplements Source Type: blogs

Ranitidine (Zantac) recall expanded, many questions remain
As anticipated, recall of the popular heartburn medicine ranitidine (Zantac) has expanded. But we still have more questions than answers. As I mentioned in my original blog post on this topic, the online pharmacy Valisure, which originally alerted the FDA to the issue, found what they called “extremely high levels” of the probable cancer-causing substance N-nitrosodimethylamine (NDMA) in ranitidine products. The FDA has indicated that its own preliminary testing has detected low levels of NDMA in ranitidine. Testing methods may have influenced NMDA results The FDA has clarified that the testing method that found the ...
Source: Harvard Health Blog - October 10, 2019 Category: Consumer Health News Authors: Joshua Gagne, PharmD, ScD Tags: Digestive Disorders Drugs and Supplements Source Type: blogs

Fight Aging! Newsletter, September 2nd 2019
In conclusion, in the absence of obesity, visceral adipose tissue possesses a pronounced anti-inflammatory phenotype during aging which is further enhanced by exercise. Methods of Inducing Cellular Damage are Rarely Relevant to Aging, and the Details Matter https://www.fightaging.org/archives/2019/08/methods-of-inducing-cellular-damage-are-rarely-relevant-to-aging-and-the-details-matter/ One of the major challenges in aging research is determining whether or not models of cellular or organismal damage and its consequences are in any way relevant to the natural processes of aging. One can hit a brick wit...
Source: Fight Aging! - September 1, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

A Large Polypill Clinical Trial Shows a Third Reduction in Cardiovascular Events
The research and medical communities are slow to undertake work on combination therapies. Regulation makes it exceedingly expensive to assess multiple combinations, and there are numerous other perverse incentives to challenge any effort to build combination therapies with components developed and manufactured by different groups. Short of working around the existing system of regulation, and methods of doing this at scale are lacking at the present time, this is a challenging problem to solve. People follow incentives. Given this, it it is entirely plausible that there are many largely unexplored instances in which existi...
Source: Fight Aging! - August 30, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

What should you do if your blood pressure medication has been recalled?
Over the past several months, you may have heard that the FDA has recalled certain lots of angiotensin II receptor blocker (ARB) medications due to the presence of impurities. These contaminants — nitrosamine impurities — may occur as a byproduct of the manufacturing process. They include N-Nitrosodiethylamine (NDEA) and N-Nitrosodimethylamine (NDMA), which can potentially cause cancer. These substances are found in the environment as well in meats, dairy products, and water, but their presence in medications is not acceptable. Therefore, the FDA sets acceptable safety limits on the presence of these impurities in drug...
Source: Harvard Health Blog - August 5, 2019 Category: Consumer Health News Authors: James Yeh, MD, MPH Tags: Drugs and Supplements Health Hypertension and Stroke Source Type: blogs

Live the Wheat Belly lifestyle, get off prescription medications
Take a look at the list of medications people have been able to stop by following the Wheat Belly lifestyle. These represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, joint pain, high blood pressure, leg edema and other abnormal effects caused by wheat and grains. The list includes anti-inflammatory and pain medication, acid reflux drugs, injectable and oral drugs for diabetes, numerous anti-hypertensive agents, asthma i...
Source: Wheat Belly Blog - October 27, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates autoimmune blood sugar bowel flora cholesterol Gliadin gluten-free grain-free grains Inflammation undoctored Weight Loss wheat belly Source Type: blogs

Will you estimate BNP or NT-proBNP while on ARNI?
Will you estimate BNP or NT-proBNP (N-terminal pro-B-type natriuretic peptide) while on ARNI? BNP (B-type natriuretic peptide) and NT-proBNP are commonly estimated biomarkers for heart failure. They have importance in diagnosis as well as prognosis [1]. Valsartan/sacubitril is an Angiotensin II Receptor Blocker Neprilysin Inhibitor (ARNI), an important new medication in our therapeutic armamentarium for management of heart failure. But which one will you estimate if the person is on ARNI and why? Please post your answer as a comment below. Do follow the comments as we expect an active discussion! Reference Yancy CW, Jess...
Source: Cardiophile MD - June 5, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs