Relacion entre HVI y niveles de potasio serico

The relationship of electrocardiographic left ventricular hypertrophy to decreased serum potassium; Okin PM, Kjeldsen SE, Lindholm LH, Dahlöf B, Devereux RB; Blood Pressure (Jan 2012) Tags: atenolol hydrochlorothiazide losartan Read/Add Comments | Email This | Print This | PubMed Background. Low serum potassium (K) is associated with increased blood pressure, impaired cardiac function and renal dysfunction. Although lower serum K is associated with cardiac hypertrophy in animal models, the relationship of low serum K to the presence and severity of electrocardiographic left ventricular hypertrophy (LVH) is unclear. Methods. Baseline and yearly Cornell product LVH levels were examined in relation to low serum K (serum K ≤ 3.90 mEq/l, the lowest quartile of baseline K levels) in 8586 patients with baseline K levels. Patients were randomized to losartan-vs atenolol-based treatment and additional hydrochlorothiazide (HCTZ) therapy as needed. Results. After adjusting for age, sex, race, prior antihypertensive treatment, losartan vs atenolol therapy, HCTZ use, baseline diastolic and systolic pressure, body mass index, serum creatinine and urine albumin/creatinine ratio, baseline serum K ≤ 3.90 was associated with significantly higher mean baseline Cornell product LVH (2898 vs 2801 mm•ms, p = 0.001) and a 24% higher risk of Cornell product LVH>2440 mm•ms at baseline (OR 1.24, 95% CI 1.11-1.38, p<0.001). After also adjusting for baseline Cornell product and changes in diastolic and systolic pressure between baseline and each year of measurement, in-treatment serum K ≤ 3.90 determined yearly was associated with significantly higher mean Cornell product LVH at years 1-3 and with statistically significant 16-32% increased risks of LVH by Cornell product at years 1-4. Conclusions. A low serum K is independently associated with a greater likelihood and severity of Cornell product LVH during antihypertensive therapy.

Estatinas y nuevo inicio de diabetes

Source: Drugs Aging | Posted 6 days ago The long-term effect of statins on the risk of new-onset diabetes mellitus in elderly Taiwanese patients with hypertension and dyslipidaemia: a retrospective longitudinal cohort study; Ma T, Chang MH, Tien L, Liou YS, Jong GP; Drugs & Aging 29 (1), 45-51 (Jan 2012) Background: HMG-CoA reductase inhibitors (statins) have been linked to new-onset diabetes (NOD). Individual statins may differ in the extent to which they increase the risk for NOD; however, the effect of statins on the development of NOD in elderly hypertensive and dyslipidaemic patients has not been well studied. Objective: The aim of this study was to investigate the relative risk for NOD among elderly (age ≥65 years) hypertensive and dyslipidaemic Taiwanese patients who received different statins. Methods: This was a retrospective cohort study performed using data from claim forms provided to the central regional branch of the Bureau of National Health Insurance in Taiwan from July 2004 to December 2009. Prescriptions for statins before the index date were retrieved from a prescription database. We estimated the hazard ratios (HRs) of NOD associated with statin use. Non-diabetic subjects served as the reference group. Results: A total of 2735 NOD cases were identified among 15 637 elderly hypertensive and dyslipidaemic patients during the study period. The risk of NOD after adjusting for sex, age, concomitant medication and mean dose of prescription was lower among users of atorvastatin (HR 0.77; 95% CI 0.71, 0.83) and rosuvastatin (HR 0.65; 95% CI 0.51, 0.82) than among non-users. Patients who took lovastatin (HR 1.38; 95% CI 1.26, 1.50) or simvastatin (HR 1.30; 95% CI 1.14, 1.48) were at higher risk of developing NOD than non-users. Pravastatin and fluvastatin were not associated with increased risk of NOD. Conclusions: The results of this study suggest that elderly hypertensive and dyslipidaemic patients who take atorvastatin or rosuvastatin are at lower risk of NOD. Lovastatin and simvastatin were associated with a significant increase in the risk of NOD.

First Detailed Data Show Risk of Using Aliskiren With ACE Inhibitors or ARBs TORONTO -- January 12, 2012 -- Researchers at have published the first detailed figures showing the risk of using aliskiren (Rasilez) in combination with certain other blood pressure-lowering medications. Findings were fast-tracked into publication this week in the British Medical Journal. It provided the first specific data of the risks of taking the drug combinations The pharmaceutical company Novartis terminated a large, international clinical trial of the drug last month after finding an increased incidence of non-fatal stroke, renal complications, hyperkalemia, and low blood pressure after 18 to 24 months. As a result, Health Canada said on December 22, 2011 that it would review the safety of aliskiren. Even before Novartis halted its clinical trial, Ziv Harel, MD, St. Michael’s Hospital, Toronto, Ontario, and colleagues were examining the interaction between aliskiren and angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARB) drugs. After reviewing 10 large randomised clinical trials on the combination of these drugs, they found that patients taking aliskiren as well as an ACE inhibitor or ARB, had about a 50% greater risk of developing hyperkalemia than those taking only an ACE inhibitor or ARB. In addition, patients taking a combination of aliskiren plus an ACE inhibitor or ARB had a 70% greater risk of developing hyperkalemia than those taking aliskiren alone. Previous research in 2008 found an increased risk of hyperkalemia and acute kidney failure in people taking a combination of ACE inhibitors and ARBs. So when aliskiren entered the market, clinicians were keen to replace one of those drugs in the combination. Dr. Harel was surprised to find no increased risk of kidney failure in patients taking aliskiren and an ACE inhibitor or ARB over those taking just 1 of the drugs. He said that might be because the short-term clinical trials they reviewed used a conservative definition of kidney failure or the patients were being monitored so closely that any sign of kidney damage would have been detected and treated quickly. Dr. Harel said he believes that clinicians should offer alternatives to prescribing combinations of medications with a strong potential for life-threatening adverse events. SOURCE: St. Michael’s Hospital

Seguridad y eficacia de bajar la presion sanguinea en diabeticos comparando con no diabeticos Ontarget

Safety and Efficacy of Low Blood Pressures Among Patients With Diabetes Subgroup Analyses From the ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) | DocGuide

We sought to determine whether the blood pressure (BP) levels at which cardiovascular (CV) protection is achieved differ between diabetic and nondiabetic patients from the ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial). BACKGROUNDGreater absolute benefits of BP reductions have been claimed for diabetic as compared with nondiabetic patients

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Acido urico hipertension y embarazo

Hypertension
At the time of presentation, subjects with preeclampsia frequently have significantly elevated serum uric acid levels, and some studies suggest that the degree of elevation correlates with the severity of the maternal syndrome and fetal morbidity, including small-for-gestational-age infants and fetal death

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Salt consumption and cardiovascular, renal, and hypertensive diseases: clinical and mechanistic aspects

Salt consumption and cardiovascular, renal, and hypertensive diseases: clinical and mechanistic aspects Current Opinion in Lipidology Susic D et al. – It is now generally accepted that there is a direct positive correlation between dietary salt and arterial pressure. Thus, the beneficial effects of dietary salt reduction are, at least in part, due to a decrease in arterial pressure. Furthermore, the beneficial, pressure–independent effects of sodium restriction on the heart, blood vessels, and kidneys are being increasingly recognized, but not generally appreciated. Several new reports clearly demonstrate the role of high dietary salt in mediating cardiovascular and renal morbidity and mortality including stroke, myocardial infarction, arterial stiffening, heart failure, and renal insufficiency. A number of recent studies also indicate that in addition to increased sodium intake, simultaneous decrease in potassium intake may aggravate adverse cardiovascular and renal manifestations. http://www.mdlinx.com/cardiology/news-article.cfm/3903602/hypertension#ixzz1jZnN0KX3

Vitamin D status and cardiovascular disease

vitamin D status and cardiovascular disease Current Opinion in Lipidology Van der Schueren BJ et al. – Currently, robust clinical data are lacking to support raising intake requirements and target vitamin D plasma levels based on a role for vitamin D in preventing cardiometabolic diseases. Nonetheless, the high prevalence of vitamin D deficiency in the general population remains alarming and requires implementation of clear supplementation guidelines. There is an abundance of plausible mechanisms by which vitamin D might have a favorable effect on the cardiovascular risk profile in the general population. Epidemiological data strongly support such beneficial effects of vitamin D, but initial enthusiasm is giving way to skepticism as larger, well conducted, longitudinal observational trials fail to show an association between serum vitamin D levels and mortality from cardiovascular events. Moreover, the few existing prospective randomized controlled trials with vitamin D supplementation that report the incidence of cardiovascular events show no effect. Fortunately, larger and better designed prospective trials are underway. Nonetheless, one should also acknowledge that true vitamin D deficiency [<25nmol/l (10ng/ml)] remains prevalent in the general population and is convincingly associated with overall adverse outcomes. http://www.mdlinx.com/cardiology/news-article.cfm/3903603/cardiovascular-disease#ixzz1jZjTFJW1

Hormona podria mejorar tratamiento de diabeticos y obesos Harvard

Irisina, la hormona de la actividad física
Irisina, la hormona de la actividad física Científicos de Harvard descubren una sustancia clave en los efectos saludables del deporte y buscan un fármaco que imite su actividad | Empleada como fármaco, podría mejorar el tratamiento de la diabetes y la obesidad

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About nicturia

CCJM : Cleveland Clinic Journal of Medicine

Do you get up a lot at night to go to the bathroom?

FROM THE OFFICE OF DR. If you get up more than once every night to empty your bladder, you should tell your doctor. He or she may be able to do something about it. Many people get this problem as they get older. It even has a medical name: nocturia (noct = night, uria = urination). However, it is not something you just have to put up with. Read text

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Nocturia en el anciano

CCJM : Cleveland Clinic Journal of Medicine
Nocturia is multifactorial and is caused by factors that increase urine production and others that decrease the bladder’s ability to hold urine. The first priority in treating nocturia is to identify and treat concomitant conditions that may be contributing to it, such as diabetes mellitus, diabetes insipidus, urinary tract infections, hypercalcemia, and hypokalemia. Nonpharmacologic measures can help, but by themselves usually do not solve the problem. Drug therapies for nocturia include desmopressin (DDAVP), antimuscarinic agents, alpha-blockers, and 5-alpha reductase inhibitors. Read text

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Venas varicosas

Surgeons Offer Advice on Avoiding Varicose Veins - Drugs.com MedNews

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Depresion y riesgo de stroke

Stroke

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