scholarly journals Population level risk stratification of hypertensive patients by predictive modeling

2021 ◽  
Author(s):  
Sricharan Bandhakavi ◽  
Zhipeng Liu ◽  
Sunil Karigowda ◽  
Jasmine McCammon ◽  
Farbod Rahmanian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Risk Stratification ◽  
Predictive Modeling ◽  
Early Identification ◽  
Beta Blockers ◽  
Treatment Options ◽  
Population Level ◽  
Treatment Patterns ◽  
Channel Blockers

Objective We recently reported that hypertension (HTN) patients having at least three rounds of distinct treatment options (atl_three_roto) in a 12-month window have elevated risk of next-year complications. However, early identification of these challenge to treat patients is non-trivial and drivers of complications in these vs remaining HTN patients are not fully defined. To address these challenges/gaps, we present predictive models for preceding outcomes, delineate their drivers, and highlight value of their integration for population level risk stratification/management of HTN patients. Materials and Methods 2.47 million HTN patients enrolled through 2015-2016 were selected from a nation-wide commercial claims database. Features associated with their treatment patterns, comedications, and comorbidities were extracted for 2015 and used to model/predict 2016 outcomes of atl_three_roto status and/or HTN complications. Logistic regression-derived odds-ratios were used to delineate drivers of each outcome. Results Prior year treatment patterns, specific hypertension drugs (anti-hypertensives, calcium channel blockers, beta blockers), and congestive heart failure most increased future odds of atl_three_roto status. Regardless of prior year atl_three_roto status, specific comorbidities (renal disease, congestive heart failure, myocardial infarction, vascular disease, diabetes with chronic complications) and comedications (beta blockers, cardiac agents, anti-lipidemics) most increased future odds of HTN complications. Proof-of-concept analysis with an independent dataset demonstrated that integrating these model predictions/drivers thereof can be leveraged for risk stratification/management of HTN patients. Discussion Integrating predictions and their drivers from above models supports early identification and targeted management of at-risk HTN patients. Conclusion We have developed a predictive modeling based approach for risk stratification and management of HTN patients.

Use of beta-blockers in congestive heart failure

2003 ◽  
Vol 35 (4) ◽  
pp. 259-266 ◽  
Author(s):  
John A Sallach ◽  
Sidney Goldstein
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Beta Blockers

scholarly journals Drug-Induced Heart Failure (Part 2: Mechanisms of Development, Clinical Signs, Differential Diagnosis, Risk Factors, Treatment and Prevention)

2020 ◽  
Vol 8 (2) ◽  
pp. 57-65
Author(s):  
O. D. Ostroumova ◽  
I. V. Goloborodova
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Channel Blockers ◽  
Drug Induced ◽  
Treatment And Prevention ◽  
Developing Heart

Heart failure is a complex clinical syndrome caused by an impaired pumping function of the heart muscle, etiologically associated with cardiovascular disease and, in the vast majority of cases, requiring complex therapeutic regimens and simultaneous prescription of several drugs. To date, we know several classes of drugs (including those used for heart failure) which can induce development/progression of heart failure in both patients with left ventricular dysfunction, and in patients who do not have cardiovascular diseases. The aim of the study was to analyse and systematize data on development mechanisms, as well as methods of prevention and treatment of drug-induced heart failure when using diff erent groups of drugs. It has been established that drug-induced heart failure is most often associated with the use of calcium channel blockers (verapamil, diltiazem, nifedipine), beta-blockers, antiarrhythmic drugs (disopyramide, fl ecainide, propafenone, amiodarone, ibutilide, dofetilide, dronedarone), anthracyclines (doxorubicin) and other antitumor drugs (trastuzumab, bevacizumab, infl iximab), hypoglycemic drugs (thiazolidinediones, saxagliptin, alogliptin), and nonsteroidal anti-infl ammatory drugs, including selective cyclooxygenase-2 inhibitors. The study revealed various mechanisms of heart failure development following drug treatment. In some patients, heart failure development is associated with the cardiotoxic eff ect of a particular drug, in others with adverse eff ects on hemodynamics. Much depends on risks of developing heart failure, including specifi c risks attributable to groups of drugs and individual drugs. The identifi cation of drugs that can contribute to the development/ progression of heart failure, and possible clinical manifestations of drug-induced heart failure, as well as provision of timely information to physicians, and engagement of clinical pharmacologists with the aim of optimizing treatment of patients can facilitate timely diagnosis, treatment and prevention of drug-induced heart failure. 

Ivabradine for Uncontrolled Sinus Tachycardia in Thyrotoxic Cardiomyopathy – Case Report

2021 ◽  
Vol 21 ◽  
Author(s):  
Amit Frenkel ◽  
Yoav Bichovsky ◽  
Natan Arotsker ◽  
Limor Besser ◽  
Ben-Zion Joshua ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Congestive Heart Failure ◽  
Sinus Tachycardia ◽  
Beta Blockers ◽  
Selective Inhibitor ◽  
Thyroid Storm ◽  
Case Presentation ◽  
Control Heart ◽  
Control Heart Rate

Background: Beta blockers, mainly propranalol, are usually administered to control heart rate in patients with thyrotoxicosis, especially when congestive heart failure presents. However, when thyrotoxicosis is not controlled, heart rate may be difficult to control even with maximal doses of propranolol. This presentation alerts physicians to the possibility of using ivabradine, a selective inhibitor of the sinoatrial pacemaker, for the control of heart rate. Case presentation: We present a 37-year-old woman with thyrotoxicosis and congestive heart failure whose heart rate was not controlled with a maximal dose of beta blockers during a thyroid storm. The addition of ivabradine, a selective inhibitor of the sinoatrial pacemaker, controlled her heart rate within 48 hours. Conclusion: Ivabradine should be considered in patients with thyrotoxicosis, including those with heart failure, in whom beta blockers are insufficient to control heart rate

Pulmonary Edema I: Cardiogenic Pulmonary Edema

2017 ◽  
Author(s):  
Annette Esper ◽  
Greg S Martin ◽  
Gerald W. Staton Jr
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pulmonary Edema ◽  
Clinical Characteristics ◽  
Distress Syndrome ◽  
Capillary Permeability ◽  
Treatment Options ◽  
Experimental Models ◽  
Lung Mechanics ◽  
Cardiogenic Pulmonary Edema

There are two categories of pulmonary edema: edema caused by increased capillary pressure (hydrostatic or cardiogenic edema) and edema caused by increased capillary permeability (noncardiogenic pulmonary edema, or acute respiratory distress syndrome). This review focuses on cardiogenic pulmonary edema and describes the general approach to patients with suspected cardiogenic pulmonary edema. The pathogenesis, diagnosis, treatment, and outcome of cardiogenic pulmonary edema are reviewed. Figures include chest scans showing pulmonary edema and noncardiogenic pulmonary edema, an illustration of the differences between cardiogenic and noncardiogenic edema, and a chart comparing lung mechanics and other variables in experimental models of cardiogenic pulmonary edema and noncardiogenic edema. Tables show clinical characteristics of patients with cardiogenic pulmonary edema and treatment options. This review contains 3 figures, 4 tables, and 24 references. Key words: cardiogenic pulmonary edema, congestive heart failure, pulmonary edema, Starling’s law

Management of Hepatic Hemangioendotheliomas of Infancy by Transarterial Embolization: A Report of Two Cases

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 546-549
Author(s):  
D. H. JOHNSON ◽  
A. M. VINSON ◽  
F. H. WIRTH ◽  
H. J. PRESBERG ◽  
G. HARKINS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Vascular Malformations ◽  
Transarterial Embolization ◽  
Treatment Options ◽  
Surgical Excision ◽  
Vascular Tumors ◽  
Artery Ligation ◽  
Abdominal Ultrasonography ◽  
Abdominal Masses

Hepatic hemangioendotheliomas are uncommon vascular tumors which present as abdominal masses, unexplained jaundice, bleeding disorders, or congestive heart failure.1-3 Death often results from congestive heart failure despite appropriate treatment with digoxin and diuretics.4 Verification of hepatic vascular malformations rests on selective angiography,5 hepatic scintigraphy,6 computed tomography,7 and abdominal ultrasonography.8 Successful treatment of heart failure depends on elimination of the malformation's left-to-right shunt and its adverse cardiac effects. Present theapeutic recommendations for symptomatic patients remain divided. Treatment options include surgical excision of localized lesions,9 hepatic artery ligation,10 radiation,11 and glucocorticoid therapy12,13, often combinations of these programs are used.

Beta-blockers reduce deaths from congestive heart failure

1998 ◽  
Vol 16 (5) ◽  
pp. 340
Author(s):  
P A Heidenreich ◽  
T T Lee ◽  
B M Massie
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Beta Blockers
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