scholarly journals Hypercholesterolemia and cardiovascular disease: What to do before initiating pharmacological therapy

2020 ◽  
Vol 42 ◽  
pp. e25-e29
Author(s):  
Bernhard Föger ◽  
Catriona Jennings ◽  
Angela Pirillo ◽  
Lale Tokgözoğlu ◽  
Matteo Pirro ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Pharmacological Therapy

scholarly journals Pharmacological therapy and cardiovascular risk reduction for type 2 diabetes

2020 ◽  
Vol 66 (9) ◽  
pp. 1283-1288
Author(s):  
Eduardo Bello Martins ◽  
Eduardo Gomes Lima ◽  
Fábio Grunspun Pitta ◽  
Leticia Neves Solon Carvalho ◽  
Thiago Dias de Queiroz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Pharmacological Therapy ◽  
High Cardiovascular Risk ◽  
Cardiovascular Risk Reduction ◽  
Drug Classes ◽  
Clinical Benefits

SUMMARY The pharmacological therapy for type 2 diabetes mellitus has presented important advances in recent years, which has impacted the treatment of patients with established cardiovascular disease or with high cardiovascular risk. In this scenario, two drug classes have emerged and demonstrated clear clinical benefits: SGLT-2 inhibitors and GLP-1 agonists. The present review discusses the pharmacology, adverse effects, and clinical trials that have demonstrated the benefits of these medications in reducing cardiovascular risk.

Cardiovascular risk estimation at the individual level

ESC CardioMed ◽  
2018 ◽  
pp. 846-863
Author(s):  
Yvo M. Smulders ◽  
Marie-Therese Cooney ◽  
Ian Graham
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Estimation ◽  
Pharmacological Therapy ◽  
Cardiovascular Risks ◽  
Individual Level ◽  
The Individual ◽  
Very High ◽  
Cardiovascular Risk Estimation

The absolute benefit of any measure to prevent cardiovascular disease, be it lifestyle improvement or pharmacological therapy, depends on the baseline cardiovascular risk. This risk cannot be assessed exactly, but only be estimated because many known risk determinants cannot be accounted for in existing risk scoring systems, and because the application to an individual of risk estimates derived from populations is imprecise. Several cardiovascular risk estimation methods are available, and the European Society of Cardiology has favoured the European-based Systematic COronary Risk Evaluation (SCORE) system as a basis for their cardiovascular disease prevention guidelines. SCORE estimates absolute 10-year cardiovascular mortality risk. In specific circumstances, estimation of relative risk, risk age, or lifetime risk may be considered. High- and very-high-risk population are defined by SCORE risks greater than 5% and greater than 10%, respectively, or by clinical conditions conferring (very) high risk, such as existing cardiovascular disease or chronic kidney disease. The role of additional risk information on top of the information entered in SCORE is generally limited. In particular, markers of early cardiovascular damage should be collected and interpreted with caution. Absolute cardiovascular risks in young and elderly individuals are almost always low or very high, respectively, and the options for appropriate interpretation and management of these risks are discussed.

scholarly journals Follow-up of ischemic cardiopathy, an essential moment in the communication between in-patient and out-patient setting: problems and opportunities

2008 ◽  
Vol 2 (4) ◽  
pp. 169-179
Author(s):  
Italo Paolini
Keyword(s):  
Cardiovascular Disease ◽  
Patient Education ◽  
Nurse Practitioners ◽  
Critical Time ◽  
Physician Assistants ◽  
Outpatient Setting ◽  
Pharmacological Therapy ◽  
Appropriate Treatment ◽  
Errors In Treatment

It is known that the transition from the inpatient to the outpatient setting is a critical time. Evidence suggests that contact between patients and providers (i.e., physicians, nurse practitioners, and physician assistants) during this interval may be crucial for appropriate treatment modifications and recognition of errors in treatment. Ambulatory follow-up provides opportunities for clinical assessment, patient education, and medication review, which may in turn improve outcomes. However, little is known about the appropriate timing and type of follow-up that is necessary following hospitalization for AMI. In Italian System of Heath contact between general pratictioner and specialists, after dicharge, is critical moment for management of chronic pharmacological and non pharmacological therapy. If professional approaches are not integrated can reduce patients compliance and effectiveness of therapies themselves. Good management of chronic cardiovascular disease requires attention to stenghtening the continuity of information and management of patients.

scholarly journals Complementary and Alternative Therapy for Pain and Anxiety in Cardiovascular Disease: A Literature Review

2021 ◽  
Author(s):  
Indah Sri Wahyuningsih ◽  
Moses Glorino Rumambo Pandin
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Positive Impact ◽  
Conventional Medicine ◽  
Alternative Therapy ◽  
Complementary Therapy ◽  
Pharmacological Therapy ◽  
Psychological Problems ◽  
Complementary And Alternative Therapy ◽  
Complementary And Alternative

Cardiovascular disease is the first leading cause of death in the world. Patients with cardiovascular disease may experience various problems, including physiological and psychological problems. Apart from pharmacological therapy, complementary therapy is necessary as a support to conventional medicine. This review aims to describe complementary and alternative therapies for pain and anxiety in patients with cardiovascular disease. This review utilized data from ProQuest, ScienceDirect, and PubMed with search keywords of "Complementary" AND "Nursing" AND "Pain" AND "Anxiety" AND "Coronary artery disease". Ten articles that met the inclusion criteria were analyzed. The results show that nursing actions increasingly develop along with the patient needs. One form of holistic nursing action is complementary and alternative therapy (CAT) that consists of three categories: body-based methods, mind therapies, and sensory therapies. CAT has positive impacts on patients with heart disease. It can reduce anxiety and pain, lower blood pressure, and improve the quality of life. This review also shows that CAT has a positive impact on the recovery of patients with heart disease. Proper therapeutic management should be implemented to reduce the risks of physiological and psychological problems in patients.

Cardiovascular risk estimation at the individual level

ESC CardioMed ◽  
2018 ◽  
pp. 846-863
Author(s):  
Yvo M. Smulders ◽  
Marie-Therese Cooney ◽  
Ian Graham
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Estimation ◽  
Pharmacological Therapy ◽  
Cardiovascular Risks ◽  
Individual Level ◽  
The Individual ◽  
Very High ◽  
Cardiovascular Risk Estimation

The absolute benefit of any measure to prevent cardiovascular disease, be it lifestyle improvement or pharmacological therapy, depends on the baseline cardiovascular risk. This risk cannot be assessed exactly, but only be estimated because many known risk determinants cannot be accounted for in existing risk scoring systems, and because the occurrence of cardiovascular disease is likely to depend not just on pre-existing risk factors, but also on chance. Several cardiovascular risk estimation methods are available, and the European Society of Cardiology has favoured the European-based Systematic COronary Risk Evaluation (SCORE) system as a basis for their cardiovascular disease prevention guidelines. SCORE estimates absolute 10-year cardiovascular mortality risk. In specific circumstances, estimation of relative risk, risk age, or lifetime risk may be considered. High- and very-high-risk population are defined by SCORE risks greater than 5% and greater than 10%, respectively, or by clinical conditions conferring high risk, such as existing cardiovascular disease or chronic kidney disease. The role of additional risk information on top of the information entered in SCORE is generally limited. In particular, markers of early cardiovascular damage should be collected and interpreted with caution. Absolute cardiovascular risks in young and elderly individuals are almost always low or very high, respectively, and the options for appropriate interpretation of these risks are discussed.

scholarly journals MENINGKATKAN KOLESTEROL HDL Paradigma baru dalam pencegahan penyakit kardiovaskular

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Starry H. Rampengan
Keyword(s):  
Cardiovascular Disease ◽  
Heart Diseases ◽  
Hdl Cholesterol ◽  
Pharmacological Therapy ◽  
Morbidity And Mortality ◽  
Patient Treatment ◽  
Coronary Heart Diseases ◽  
Low Level ◽  
Cholesterol Levels ◽  
Close Relationship

Abstract: Studies of statin have proven that lower LDL-cholesterol levels will reduce morbidity and mortality of coronary heart diseases with succesfull rate only about 20-30%; therefore, it needs another attempt to decrease these morbidity and mortality rate. The other important risk factor is HDL-cholesterol which protects against atherosclerotic events. Several studies have shown that there is a close relationship between low levels of HDL-cholesterol and the increased incidence of cardiovascular diseases. The inverse relationship between HDL cholesterol and cardiovascular disease prevention applies to both males and females, as well as morbidity and mortality. The increase of HDL-cholesterol levels about 1 mg/dl can reduce the risk of coronary heart disease 2% in males and 3% in females. It needs to know the goal of patient treatment to achieve the higher HDL-cholesterol level. There are 4 groups of patients with low level of HDL-cholesterol, as follows: type 2 diabetes mellitus, metabolic syndrome/central obesity, elderly, and post-myocardial infarction. The management of patients with low level of HDL-cholesterol consists of non-pharmacological therapy such as diet, exercise, stop smoking, and alcohol restriction as well as pharmacological therapy by using drugs to increase the HDL-cholesterol levels such as fibrates and nicotinic acid. These drugs can be combined with others such as the statins.Keywords: HDL-Cholesterol, cardiovascular disease, managementAbstrak: Penelitian golongan statin membuktikan bahwa penurunan kadar kolesterol-LDL akan menurunkan angka kesakitan dan kematian akibat penyakit jantung koroner dengan angka keberhasilan hanya sebesar 20-30%, sehingga harus ada upaya lain dalam menurunkan angka kesakitan maupun kematian penyakit kardiovaskuler. Komponen lain yang penting yaitu kolesterol-HDL yang bersifat protektif terhadap kejadian aterosklerosis. Beberapa penelitian membuktikan bahwa terdapat hubungan erat antara rendahnya kadar kolesterol-HDL dengan meningkatnya kejadian penyakit kardiovaskular. Hubungan terbalik antara kolesterol-HDL tinggi dan pencegahan penyakit kardiovaskular berlaku baik bagi pria maupun wanita, serta morbiditas maupun mortalitas. Setiap kenaikan kadar kolesterol-HDL plasma sebesar 1 mg/dl dapat mengurangi risiko penyakit jantung koroner sebesar 2% pada pria dan 3% pada wanita. Untuk meningkatkan kadar kolesterol-HDL, perlu diketahui target pasien yang menjadi sasaran pengobatan. Terdapat 4 kelompok pasien yang memiliki kadar kolesterol-HDL rendah, yaitu: pasien dengan diabetes melitus tipe 2, sindroma metabolik/obesitas sentral, usia lanjut, dan pasca infark miokard. Penatalaksanaan pasien dengan kadar kolesterol-HDL rendah terdiri dari terapi non-farmakologis antara lain: diet, olahraga, berhenti merokok, dan restriksi konsumsi alkohol) serta penggunaan obat untuk meningkatkan kadar kolesterol-HDL, diantaranya ialah golongan fibrat dan asam nikotinik. Obat-obat ini dapat dikombinasikan dengan obat lain seperti golongan statin.Kata kunci: kolesterol-HDL, penyakit kardiovaskular, penatalaksanaan

scholarly journals Anticipating recurrent ischemic events after an acute coronary syndrome: validation and application of the SMART-REACH score

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Gomes ◽  
J Presume ◽  
F Albuquerque ◽  
P Lopes ◽  
M Sousa Paiva ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Acute Coronary Syndrome ◽  
Goodness Of Fit ◽  
Pharmacological Therapy ◽  
Major Adverse Cardiovascular Events ◽  
Prior History ◽  
P Value ◽  
Goodness Of Fit Test ◽  
Coronary Syndrome ◽  
Ischemic Events

Abstract Background The SMART-REACH score (SRS) was developed to predict the risk of major adverse cardiovascular events in ambulatory patients with established cardiovascular disease, although it has not been extensively validated. Patients at higher risk of recurrent ischemic events may benefit from novel, more intensive treatment options, and earlier identification of these patients can potentially improve outcomes. Purpose We aimed to validate the SRS and evaluate its performance in a population recently admitted with acute coronary syndrome. Methods In this single-centre retrospective cohort, we included 320 patients aged 45 to 80 years, who were discharged following admission for an acute coronary syndrome between 2016 and 2018. To calculate the SRS for each patient, we considered clinical data on admission (age, gender, smoking, diabetes, prior history of vascular disease, heart failure or atrial fibrillation), lipid values obtained within the first 24 hours of hospitalization, serum creatinine level at baseline and once the patient was deemed clinically stable, and discharge medication. The outcome of interest was defined as stroke, myocardial infarction or cardiovascular death (MACE) at two years of follow-up. SRS was assessed for discrimination and calibration. Results Mean age was 63±9 years, and 240 (75%) were male. There was high prevalence of cardiovascular risk factors: 71% had hypertension, 32% had diabetes mellitus, 42% were active smokers and 25% had previously established cardiovascular disease. The outcome of interest was observed in 38 patients (22 cardiovascular deaths, 6 strokes and 14 myocardial infarctions). SRS showed good discrimination of the estimated MACE risk with overall C-statistic of 0.646 (95% CI, 0.554–0.737, p=0.004) (picture 1) and calibration (p-value for the goodness-of-fit test of 0.544). The global estimated risk of MACE at 2-years was 4.8% (3.8%-6.8%). The expected/ observed ratio was 0.56 for the occurrence MACE (picture 2). Conclusions Over the first two years after discharge from an acute coronary syndrome, one of every 8 patients developed a potentially fatal recurrent ischemic event. The SRS performed reasonably well in discriminating those at highest risk of MACE, suggesting that this score may help select patients at discharge for ad initium more intensive pharmacological therapy. FUNDunding Acknowledgement Type of funding sources: None. ROC curve for the SMART-REACH score Expected versus observed MACE

scholarly journals Novel pharmacological therapy in type 2 diabetes mellitus with established cardiovascular disease: Current evidence

2019 ◽  
Vol 10 (5) ◽  
pp. 291-303 ◽  
Author(s):  
Leonardo Pozo ◽  
Fatimah Bello ◽  
Andres Suarez ◽  
Francisco E Ochoa-Martinez ◽  
Yamely Mendez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Pharmacological Therapy ◽  
Current Evidence

Metabolic syndrome and the menopause

2008 ◽  
Vol 14 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Risto J Kaaja
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Pharmacological Therapy ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Atherogenic Dyslipidaemia ◽  
Ovarian Syndrome

The metabolic syndrome consists of a combination of risk factors that include abdominal obesity, atherogenic dyslipidaemia, hypertension and insulin resistance. It increases the risk of cardiovascular disease and type 2 diabetes. The increased risk of cardiovascular disease is higher in women than in men. The first manifestation of metabolic syndrome may occur in pregnancy presenting as gestational diabetes or preeclampsia. Both conditions are associated with increased insulin resistance. Also metabolic syndrome is more common in polycystic ovarian syndrome. It has been suggested that there is a metabolic syndrome resulting from the menopause due to estrogen deficiency, as many of the risk factors are more prevalent in postmenopausal women. Also estrogen replacement improves insulin sensitivity and reduces the risk of diabetes. The key elements in managing the metabolic syndrome are weight reduction, increasing physical activity and diet modification. If blood pressure, lipid and glycaemic control are not achieved through these interventions then pharmacological therapy will be required.

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