Newer targets and therapies for hypertension and dyslipidemia in diabetic patients
This article will discuss the studies supporting this optimal systolic blood pressure goal. The selection of antihypertensive drug therapy in patients with diabetes mellitus depends on associated medical conditions. The American Diabetes Society 2013 guidelines recommend that the drug regimen should include an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker unless the patient is pregnant. (Source: Cardiovascular Endocrinology)
Source: Cardiovascular Endocrinology - February 10, 2015 Category: Cardiology Tags: Review articles Source Type: research
Endocrine aspects of pre-eclampsia
Pre-eclampsia, defined as hypertension with proteinuria occurring after 20 weeks’ gestation, complicates up to 8% of pregnancies and is a major contributor to perinatal morbidity and mortality worldwide. It is now widely accepted that pre-eclampsia is also associated with the risk of maternal cardiovascular disease in later life. Although the pathogenesis of this complex condition remains incompletely understood, impaired placentation and subsequent endothelial dysfunction and inflammation are among the proposed hypotheses. In recent years, there has been a resurgence of interest in the pivotal role of aldosterone and vo...
Source: Cardiovascular Endocrinology - February 10, 2015 Category: Cardiology Tags: Review articles Source Type: research
Hitode heart: a report of two cases of midventricular takotsubo cardiomyopathy
Stress cardiomyopathy presents very similarly to acute coronary syndrome and its multiple inciting stressors make the decision to obtain angiography challenging. Here we describe two cases of stress cardiomyopathy presenting with a rare variant ECG pattern of a starfish. The first case presented after an emotional stressor with a history of diabetes and hypothyroidism. The second case presented after a traumatic brain injury with presumed underlying primary idiopathic hypercalciuria. We discuss the implications of calcium metabolic abnormalities on stress cardiomyopathy in classic presentations and morphologic variants. (S...
Source: Cardiovascular Endocrinology - December 1, 2014 Category: Cardiology Tags: Case report Source Type: research
Testosterone and cardiovascular disease: controversy or wake-up call?
In men with hypogonadism due to diseases of the hypothalamus, pituitary, or testis, testosterone therapy is generally safe and has been shown to induce beneficial effects. Conversely, in men with age-related low testosterone levels, the significance of this change and the effects of testosterone therapy are debatable. Studies have linked low testosterone levels with increased cardiovascular morbidity and mortality, with testosterone therapy being reported to improve cardiovascular risk profiles. However, two recent retrospective studies have fueled the controversy on testosterone therapy by reporting increased cardiovascul...
Source: Cardiovascular Endocrinology - December 1, 2014 Category: Cardiology Tags: Reviews Source Type: research
Hitode heart: a report of two cases of midventricular takotsubo cardiomyopathy
Stress cardiomyopathy presents very similarly to acute coronary syndrome and its multiple inciting stressors make the decision to obtain angiography challenging. Here we describe two cases of stress cardiomyopathy presenting with a rare variant ECG pattern of a starfish. The first case presented after an emotional stressor with a history of diabetes and hypothyroidism. The second case presented after a traumatic brain injury with presumed underlying primary idiopathic hypercalciuria. We discuss the implications of calcium metabolic abnormalities on stress cardiomyopathy in classic presentations and morphologic variants. (S...
Source: Cardiovascular Endocrinology - November 19, 2014 Category: Cardiology Tags: Case report Source Type: research
Sex-specific differences in the effects of local androgen metabolism in the heart as an indicator for the risk of myocardial infarction
ConclusionGenetic variation in SRD5A1 is associated with an increased risk of MI in western European women, possibly because of the sex-specific potential of local androgen conversion and effect. (Source: Cardiovascular Endocrinology)
Source: Cardiovascular Endocrinology - November 19, 2014 Category: Cardiology Tags: Original articles Source Type: research
Role of insulin resistance in essential hypertension
ConclusionEssential hypertension is significantly associated with higher mean fasting insulin levels and insulin resistance. Hyperinsulinemia has a possible role in the pathophysiology of essential hypertension with insulin resistance being the likely predominant mechanism. (Source: Cardiovascular Endocrinology)
Source: Cardiovascular Endocrinology - November 19, 2014 Category: Cardiology Tags: Original articles Source Type: research
Determinants of interleukin-12 in stable ischaemic heart disease
ConclusionThe results suggest that, contrary to the hypothesis, IL-12 was associated inversely with plasma levels of two known risk factors of coronary atherosclerosis (triglycerides, homocysteine) in stable, statin-medicated IHD patients. The lack of association of IL-12 with high-sensitivity C-reactive protein, erythrocyte sedimentation rate and the number of inflammatory cells in blood suggests that moderately elevated IL-12 did not imply ongoing systemic inflammation in these patients. Although increased IL-12 production is a sign of proinflammatory activity, it was associated directly with the plasma high-density lipo...
Source: Cardiovascular Endocrinology - November 19, 2014 Category: Cardiology Tags: Original articles Source Type: research
Testosterone and cardiovascular disease: controversy or wake-up call?
In men with hypogonadism due to diseases of the hypothalamus, pituitary, or testis, testosterone therapy is generally safe and has been shown to induce beneficial effects. Conversely, in men with age-related low testosterone levels, the significance of this change and the effects of testosterone therapy are debatable. Studies have linked low testosterone levels with increased cardiovascular morbidity and mortality, with testosterone therapy being reported to improve cardiovascular risk profiles. However, two recent retrospective studies have fueled the controversy on testosterone therapy by reporting increased cardiovascul...
Source: Cardiovascular Endocrinology - November 19, 2014 Category: Cardiology Tags: Reviews Source Type: research
Does dipeptidyl peptidase IV inhibitor increase the risk of heart failure? A cardiologist’s paradox
Diabetes patients have a higher burden of cardiovascular disease compared with the general population. In addition, type 2 diabetes portends a very high risk for major adverse cardiovascular events. The SAVOR trial showed that patients with documented type 2 diabetes and a previous history of, or risk factors for, cardiovascular disease had a 1-year cardiovascular event rate of 2–3%. Whereas in the EXAMINE trial, type 2 diabetes patients with acute coronary syndrome had a 1-year event rate between 6 and 7% after revascularization. Both of these prospective trials used new dipeptidyl peptidase IV (DPP-4) inhibitors as the...
Source: Cardiovascular Endocrinology - November 19, 2014 Category: Cardiology Tags: Reviews Source Type: research
Clarithromycin-induced QT prolongation in a patient with incidental parathyroidectomy
We report a case of QT prolongation in a patient with hypocalcemia secondary to hypoparathyroidism who received clarithromycin. The contributions of these factors to the prolonged QT interval are discussed. (Source: Cardiovascular Endocrinology)
Source: Cardiovascular Endocrinology - August 12, 2014 Category: Cardiology Tags: Case report Source Type: research
Acute cardiometabolic responses facilitating a state of chronic hyperglycemia and renal impairment: the SABPA study
BackgroundAugmented α-adrenergic response patterns are associated with vascular risk in Africans. Therefore, the aims of this study were (a) to assess ethnic differences related to glucose and cardiovascular responses during acute laboratory stress, and (b) to assess whether these responses are associated with chronic hyperglycemia (HbA1c≥5.7%) and albumin : creatinine ratio (ACR).
Materials and methodsAmbulatory blood pressure of 81 African and 100 Caucasian men was recorded. Beat-to-beat blood pressure was obtained during exposure to the Color Word Conflict (STROOP) and Cold Pressor Tests (CPT). Overnight 8 h fasting ...
Source: Cardiovascular Endocrinology - August 12, 2014 Category: Cardiology Tags: Original articles Source Type: research
Effect of atrial natriuretic peptide on lipolysis in the mouse heart
Overweight is associated with triglyceride accumulation in cardiomyocytes, which can cause cardiac dysfunction. It is also associated with reduced synthesis and plasma concentration of atrial natriuretic peptide (ANP). In adipocytes, ANP stimulates lipolysis through natriuretic peptide receptor-A (NPR-A), leading to cGMP-dependent phosphorylation of hormone-sensitive lipase. Cardiac myocytes express NPR-A and hormone-sensitive lipase. In the present study, we investigated whether ANP affects triglyceride stores in the heart. Subcutaneously implanted osmotic minipumps were used to administer ANP (125 or 500 ng/kg/min) or sa...
Source: Cardiovascular Endocrinology - August 12, 2014 Category: Cardiology Tags: Original articles Source Type: research
Hemoglobin A1c less than 6.5% on admission increases risk for in-hospital and 1-year mortality in patients with diabetes and chest pain
BackgroundAs the association between low hemoglobin A1c (HbA1c) and adverse clinical outcomes in patients with chest pain and myocardial infarction has not been extensively examined, a prospective cohort study was conducted to examine whether low HbA1c magnifies mortality risk.
Patients and methodsA total of 717 consecutive patients (284 with diabetes and 433 without known diabetes) admitted to a public hospital over a 6-month period with chest pain and troponin measurement were included. HbA1c was obtained upon admission. Mortality was confirmed by National Death Index search. Cox proportional hazards models were construc...
Source: Cardiovascular Endocrinology - August 12, 2014 Category: Cardiology Tags: Original articles Source Type: research
Glucose in the coronary care unit: some evidence, more questions
No abstract available (Source: Cardiovascular Endocrinology)
Source: Cardiovascular Endocrinology - August 12, 2014 Category: Cardiology Tags: Editorial Source Type: research
