Although rates of coronary heart disease (CHD) mortality have declined substantially over the last three decades, the exact reasons for this are not yet clear. Identifying the factors associated with this improvement is vital for setting future healthcare policy. Diet, lifestyle, risk factors and treatment uptake are all important, but these change rapidly and have […]
Category: General cardiology
BP on ICU admission for chest pain inversely correlated to mortality
Although mortality and morbidity rates from acute coronary syndromes have been declining considerably, a high risk for death remains after discharge from the intensive care unit (ICU). In this study the authors studied long-term mortality in relation to supine blood pressure in patients admitted to the medical intensive care unit for acute chest pain. The […]
Systolic blood pressure variability is strong predictor of stroke
The mechanisms by which raised blood pressure causes stroke and other vascular events are poorly understood. Although substantial variability in clinical blood pressure is often noted, episodic hypertension tends not to be treated. The prognostic value of visit-to-visit variability and episodic hypertension in the same setting has not been established. Therefore in this study the risk […]
Novel blood pressure agent shows promise
Natriuretic peptides have a number of beneficial vascular effects: vasodilator and natriuretic properties, reduced sympathetic drive, antiproliferative effects, and inhibition of the renin-angiotensin-aldosterone (RAAS) system. Inhibition of neprilysin (neutral endopeptidase 24.11) leads to an increase in natriuretic peptide levels, however on its own this mechanism does not lead to a clinically significant decrease in blood […]
Aortic valve reoperative outcomes improve dramatically
With an increasingly elderly population and improvements in surgical and medical management, patients are living longer after cardiac surgery. Consequently, a higher percentage of patients with aortic valve disease are likely to undergo reoperative aortic valve replacement (AVR) in the foreseeable future. Previously, reoperative AVR was considered a high-risk operation with quoted mortality figures up […]
Informed patients have lower levels of coronary risk
Does informing patients about their coronary heart disease (CHD) risk lead to an improvement in that risk? And how many times do they need to be told? Current AHA prevention guidelines advise that patients over forty are informed of their global CHD risk in the hope that this will help to motivate adherence to risk-reducing […]
ABPI cannot be used to determine primary prevention benefit from aspirin
A low ankle brachial index (ABI) indicates the presence of atherosclerotic arterial disease, and therefore an increased risk of cardiovascular and cerebrovascular events. Screening for a low ABI may therefore identify a group of asymptomatic individuals who may benefit from preventive treatments. The Aspirin for Asymptomatic Atherosclerosis (AAA) trial was therefore established to investigate the […]
Anticholinergics and Cardiovascular Safety
Increasingly, the cardiovascular safety of commonly prescribed drugs has been brought into question with the notable recent examples of the COX-2 inhibitors and the thiazolidinediones. Among the most frequently prescribed inhaled medications for COPD, a common condition in patients with coronary disease due to the shared aetiology of cigarette smoking, are anticholinergic agents such as […]
Moderate emphysema impairs diastolic function
Severe chronic obstructive pulmonary disease leads to cor pulmonale , characterised by elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output. However, whether similar changes occur in more moderate emphysematous disease is unknown. In order to investigate this question the authors of this papar studied 2816 people between […]
FAIR-HF shows benefits of treating iron depletion in heart failure
Patients with heart failure may be prone to the development of iron deficiency either as a consequence of depletion of iron stores, defective iron absorption, or the reduced availability of iron recycled in the reticuloendothelial system. Iron plays a key role in oxygen uptake, transport, and storage, and oxidative metabolism in the skeletal muscle, as […]