Hypertension

In the changing landscape of hospital medicine one of the largest areas of focus has been on readmission rates, this is also true for patients who are discharged from one hospital and then readmitted into another location for further treatment.

From cardiologists to physical therapists to nurses there is a team approach needed to provide cardiac patients the care they need for treatment. Keeping that care going even after a cardiac event has passed has been a growing focus of the field in recent years.

Even in hospital settings patients can suffer fatal cardiac events if they are not properly monitored. This is especially true at night when staffing numbers drop and families are not with their loved ones until morning.

After much criticism on the price of 2 new cholesterol-lowering drugs, Praluent and Repatha, Express Scripts said this week it will now include both drugs in its National Preferred Formulary.

Heart disease is a growing problem in the country and work has been done to improve the overall public health through a number of steps including cardiac imaging. That work is also focused on the proper blood pressure for patients of all ages.

There could be a new first-line treatment for hypertension in patients needing diuretic therapy, according to research presented at the European Society of Cardiology (ESC) Congress conference in London, UK.

With a rallying cry of "Hands off Our Legs" protestors are due to picket the US Department of Health and Human Services over a proposed Medicare rule change that would affect amputees.

Anterior ischemic optic neuropathy (AION) was first described in 1974. It results from non-perfusion of the posterior ciliary blood supply to the optic nerve head.

A recent study looked at whether metabolic syndrome confers a greater cancer risk than the sum of its individual components and component associations, and whether it is a useful predictor for future cancer risk.

A drug normally used to treat hypertension reduced the symptoms of multiple sclerosis in mice models of the disease.

Obesity rates have climbed nearly 50 percent since 1997, with as much as 30 percent of the population classified as obese. There is strong belief within the health care industry that obesity should be treated as a primary medical condition, with physicians playing a major role. Evidence suggests that patients are more likely to lose weight when they are advised by their primary care physicians to do so.

The results of the largest study of its kind to date indicate that new antipsychotic medications-including quetiapine, olanzapine, and risperidone-do not appear to put women at additional risk of developing gestational diabetes, hypertensive disorders, or major blood clots that obstruct circulation, all conditions that often develop during pregnancy or with the use of older antipsychotic medications.

Hypertension needs to be managed quickly and carefully for patients to avoid health problems

More than 13,000 physicians and cardiovascular team members attended the ACC 2015 meeting in San Diego on March 14-16, 2015. In this issue of Cardiology Review, we focus on 6 important studies presented at ACC 2015: LEGACY, OSLER, PEGASUS, EMBRACE-STEMI, MATRIX, and CoreValve.

In a multicenter observational study reported April 29 at the Asian Pacific Society of Cardiology Congress 2015, held in Abu Dhabi, researchers examined the relationship between the severity and presence of coronary artery disease in male patients and the number of wives they have. The more wives, the more heart disease.

Lack of sleep and chronic kidney disease (CKD) independently lead to hypertension, diabetes mellitus, lower quality of life, and shorter life expectancy. Severity of CKD and sleep disturbances may also worsen diabetes and hypertension synergistically.

It is well established that among patients with the clinical syndrome of heart failure, approximately half have preserved systolic function, known commonly as heart failure with preserved ejection fraction (HFpEF). Although originally considered to be a syndrome that pathophysiologically involves diastolic dysfunction, ongoing investigation suggests that although diastolic abnormalities may be present in many patients, other aspects of pathophysiology likely also contribute to symptoms. This study examined the association of beta-blockers with mortality in patients with HFpEF.

Elderly and frail patients whose blood pressure is also being treated need to be carefully treated, suggest findings published in JAMA Internal Medicine.

The US Food and Drug Administration (FDA) has approved a polypill for hypertension, a combination of perindopril arginine and amlodipine (Prestalia/ Symplmed Pharma-Servier).

This 27-year old female medical student with recently diagnosed hypertension is seen following a chest x-ray in work up of a positive PPD. Upon questioning, the patient notes what she described as "gray-out spells" when tired and leg numbness with exercise after periods of sitting.