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Serum lipoprotein(a) and risk of hemorrhagic stroke among incident peritoneal dialysis patients: a large study from a single center in China.
Conclusions: Among patients with incident PD, a higher serum Lp(a) level may predict a lower risk of hemorrhagic stroke. PMID: 31498021 [PubMed - in process]
Source: Renal Failure - September 10, 2019 Category: Urology & Nephrology Tags: Ren Fail Source Type: research

Stroke Risk in Atrial Fibrillation: Beyond the CHA 2 DS 2 -VASc Score
AbstractPurpose of ReviewStroke prevention is the cornerstone of atrial fibrillation (AF) management and the anticoagulation decision is currently based on CHA2DS2-VASc risk score. We discuss several novel risk factors besides those included in CHA2DS2-VASc score and alternative models for stroke prediction.Recent FindingsSeveral clinical markers including obstructive sleep apnea and renal failure, laboratory markers like brain natriuretic peptide, imaging criteria including left atrial appendage morphology, spontaneous echo contrast, and coronary artery calcium score may predict stroke in AF patients. Addition of African ...
Source: Current Cardiology Reports - July 26, 2019 Category: Cardiology Source Type: research

Correlation Between Intracranial Arterial Calcification and Imaging of Cerebral Small Vessel Disease
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension.
CONCLUSIONS: All-cause death is similar for first-line RAS inhibitors and first-line CCBs, thiazides and beta-blockers. There are, however, differences for some morbidity outcomes. First-line thiazides caused less HF and stroke than first-line RAS inhibitors. First-line CCBs increased HF but decreased stroke compared to first-line RAS inhibitors. The magnitude of the increase in HF exceeded the decrease in stroke. Low-quality evidence suggests that first-line RAS inhibitors reduced stroke and total CV events compared to first-line beta-blockers. The small differences in effect on blood pressure between the different classe...
Source: Cochrane Database of Systematic Reviews - November 14, 2018 Category: General Medicine Authors: Chen YJ, Li LJ, Tang WL, Song JY, Qiu R, Li Q, Xue H, Wright JM Tags: Cochrane Database Syst Rev Source Type: research

Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis
Publication date: Available online 24 December 2015 Source:The Lancet Author(s): Dena Ettehad, Connor A Emdin, Amit Kiran, Simon G Anderson, Thomas Callender, Jonathan Emberson, John Chalmers, Anthony Rodgers, Kazem Rahimi Background The benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established. However, the extent to which these effects differ by baseline blood pressure, presence of comorbidities, or drug class is less clear. We therefore performed a systematic review and meta-analysis to clarify these differences. Method For this systematic review and meta-ana...
Source: The Lancet - December 25, 2015 Category: Journals (General) Source Type: research

Long-Term Exposure to Ambient Fine Particulate Matter and Renal Function in Older Men: The Veterans Administration Normative Aging Study
Conclusions: In this longitudinal sample of older men, the findings supported the hypothesis that long-term PM2.5 exposure negatively affects renal function and increases renal function decline. Citation: Mehta AJ, Zanobetti A, Bind MC, Kloog I, Koutrakis P, Sparrow D, Vokonas PS, Schwartz JD. 2016. Long-term exposure to ambient fine particulate matter and renal function in older men: the VA Normative Aging Study. Environ Health Perspect 124:1353–1360; http://dx.doi.org/10.1289/ehp.1510269 Address correspondence to A.J. Mehta, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Landmark Ce...
Source: EHP Research - September 1, 2016 Category: Environmental Health Authors: Web Admin Tags: Research Article September 2016 Source Type: research

No-touch ’ heart bypass surgery reduces strokes
Four surgical methods of coronary artery bypass grafting with increasing degrees of aortic manipulation. Percentages pictured represent the relative decrease in risk of perioperative stroke using anOPCABG compared to the other techniques. [Image from the researchers]]A recent study from the University of Sydney and Sydney Heart and Lung Surgeons has shown that a new “no-touch” beating heart bypass surgery technique has reduced post-operative stroke by 78%. The procedure, known as an OPCABG, also reduced post-operative mortality by 50% compared to traditional coronary artery bypass grafting. It reduced renal failure by ...
Source: Mass Device - May 17, 2017 Category: Medical Devices Authors: Danielle Kirsh Tags: Cardiovascular CABG MedTech Sydney Heart and Lung Surgeons University of Sydney Source Type: news

U Wave Variability in the Surface ECG
A 72‐year‐old man with heart failure, left ventricular dysfunction (ejection fraction 20%), prior ischemic stroke, COPD, and exacerbation of chronic renal failure was admitted in our unit. Serum potassium was 6.1 mmol/L, calcium concentration was at the lower normal range 2.15 mmol/L, and NT‐pro‐BNP was 28,900 pg/mL. The surface 12‐lead electrocardiogram (ECG) showed sinus rhythm at 60 bpm, PR interval 160 ms, QRS duration 115 ms, QT interval 460 ms, and left ventricular hypertrophy criteria. Negative T waves in leads I, II, aVL, and V4–V6 were also seen. In leads V4–V6, negative U waves were observed in conc...
Source: Annals of Noninvasive Electrocardiology - April 21, 2014 Category: Cardiology Authors: Piotr Kukla, Adrian Baranchuk, Marek Jastrzębski, Leszek Bryniarski Tags: CASE REPORT Source Type: research

Blood pressure control and cardiovascular outcomes in normal-weight, overweight, and obese hypertensive patients treated with three different antihypertensives in ALLHAT
Objective:Epidemiologically, there is a strong relationship between BMI and blood pressure (BP) levels. We prospectively examined randomization to first-step chlorthalidone, a thiazide-type diuretic; amlodipine, a calcium-channel blocker; and lisinopril, an angiotensin-converting enzyme inhibitor, on BP control and cardiovascular outcomes in a hypertensive cohort stratified by baseline BMI [kg/m2; normal weight (BMI 30)]. Methods:In a randomized, double-blind, practice-based Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, 33 357 hypertensive participants, aged at least 55 years, were followed...
Source: Journal of Hypertension - June 6, 2014 Category: Cardiology Tags: ORIGINAL PAPERS: Obesity Source Type: research

Drug Therapy of Apparent Treatment-Resistant Hypertension: Focus on Mineralocorticoid Receptor Antagonists
Abstract Apparent treatment-resistant hypertension (aTRH) is defined as blood pressure (BP) >140/90 mmHg despite three different antihypertensive drugs including a diuretic. aTRH is associated with an increased risk of cardiovascular events, including stroke, chronic renal failure, myocardial infarction, congestive heart failure, aortic aneurysm, atrial fibrillation, and sudden death. Preliminary studies of renal nerve ablation as a therapy to control aTRH were encouraging. However, these results were not confirmed by the Symplicity 3 trial. Therefore, attention has refocused on drug therapy. Secondary forms o...
Source: Drugs - March 19, 2015 Category: Drugs & Pharmacology Source Type: research

Microsomal Prostaglandin E Synthase-1-Derived PGE2 Inhibits Vascular Smooth Muscle Cell Calcification.
CONCLUSIONS: Our data revealed the pivotal role of COX-2-mPGES-1-PGE2 axis in vascular calcification. The selective inhibition of COX-2 or mPGES-1 may increase the risk of calcification and subsequent adverse cardiovascular events during chronic renal failure. PMID: 26543101 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - November 5, 2015 Category: Cardiology Authors: Gao C, Fu Y, Li Y, Zhang X, Zhang L, Yu F, Xu SS, Xu Q, Zhu Y, Guan Y, Wang X, Kong W Tags: Arterioscler Thromb Vasc Biol Source Type: research

New therapies for arterial hypertension.
Authors: Pagliaro B, Santolamazza C, Rubattu S, Volpe M Abstract Arterial hypertension is the most common chronic disease in developed countries and it is the leading risk factor for stroke, ischemic heart disease, congestive heart failure, chronic renal failure and peripheral artery disease. Its prevalence appears to be about 30-45% of the general population. Recent European guidelines estimate that up to 15-20% of the hypertensive patients are not controlled on a dual antihypertensive combination and they require three or more different antihypertensive drug classes to achieve adequate blood pressure control. The...
Source: Panminerva Medica - January 18, 2016 Category: Journals (General) Tags: Panminerva Med Source Type: research

An unusual combination of neurological manifestations and sudden vision loss in a child with familial hyperphosphatemic tumoral calcinosis
We report a child with hyperphosphatemia who presented with multiple episodes of neurologic dysfunction involving lower motor neuron facial nerve palsy along with sequential visual loss. He also had an episode of stroke. There was an extensive metastatic calcification of soft tissue and vasculature. Hyperphosphatemia with normal serum alkaline phosphatase, calcium, parathyroid hormone, and renal function was noted. He was managed with hemodialysis and sevelamer (3 months) without much success in reducing serum phosphate level, requiring continuous ambulatory peritoneal dialysis (3 years). Intact fibroblast growth factor 23...
Source: Annals of Indian Academy of Neurology - June 30, 2019 Category: Neurology Authors: Lokesh Lingappa Shoji Ichikawa Amie K Gray Dena Acton Michael J Evans Rajsekara Chakravarthi Madarasu Ramesh Kekunnaya Sirisharani Siddaiahagari Source Type: research

Polyuria, Polydipsia and Possible Diabetes Insipidus?
Discussion The body is smart. It has mechanisms for maintaining balances within the body in a closely controlled manner but allows for a variety of states. This is very true for fluid balance in the body which is highly controlled between almost all of the major body organ systems. When fluid is low, the sensor sends signals for us to drink, and conserves fluid until we can. When the fluid is high, the kidneys excrete the excess and sends signals not to drink. Usually it works very well. While there are many pathological states that can cause polyuria and/or polydipsia, the most common reason is excessive fluid intake beca...
Source: PediatricEducation.org - March 7, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Influence of Renin-Angiotensin System Inhibitors on Postoperative Delirium in Patients With Pulmonary Arterial Hypertension: A Secondary Analysis of a Retrospective Cohort Study
ConclusionPreoperative use of ACEIs/ARBs in patients with PAH reduces the risk of POD. ACEIs/ARBs may be more recommended for patients with PAH in the future.
Source: Frontiers in Psychiatry - April 8, 2022 Category: Psychiatry Source Type: research