Orthotopic renal autotransplantation for young-onset and medical treatment-requiring complex renovascular hypertension

Objective: In this article, we aim to prove the safety and effectiveness of orthotopic renal autotransplantation using ex vivo repair for the treatment of complex renovascular hypertension (RVH). Methods: We retrospectively reviewed five consecutive patients (three women, two men) with young-onset RVH from January 2009 to August 2014. Orthotopic renal autotransplantation using ex vivo repair was performed and perioperative data were collected for statistical analysis. Results: The median age at diagnosis was 20 years (range, 11 to 27 years). Technique success was achieved in all the patients with no in-hospital or late deaths. During a median follow-up of 3.4 years (range, 1.5 to 6 years), the postoperative blood pressure was decreased compared with preoperative level (204 ± 8/133 ± 8 mm Hg vs 129 ± 3/78 ± 5 mm Hg; p < 0.0001). The postoperative anti-hypertensive medications number was reduced (3.4 ± 0.4 vs 0.2 ± 0.2; p < 0.0001). Early and late renal functions were both well preserved as measured by no changes in serum creatinine level ( p > 0.05). The primary patent rate was 100% (5/5) at one-year follow-up. Conclusion: In our small series, orthotopic renal autotransplantation using ex vivo repair was safe and effective for the resolution of complex young-onset RVH.

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Feasibility of hybrid telerehabilitation as component of a novel comprehensive care program after acute myocardial infarction in a one-year follow-up preliminary experience of a single center

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.338 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

E Piotrowicz ◽

P Orzechowski ◽

I Kowalik ◽

R Piotrowicz

Keyword(s):

Myocardial Infarction ◽

Blood Pressure ◽

Acute Myocardial Infarction ◽

Heart Rate ◽

Functional Capacity ◽

Care Program ◽

Comprehensive Care ◽

Monitoring Center ◽

One Year

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Health Fund Background. A novel comprehensive care program after acute myocardial infarction (AMI) „KOS-zawał" was implemented in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid telerehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of this program. The purpose of the pilot study was to evaluate a feasibility, safety and patients’ acceptance of HTR as component of a novel care program after AMI and to assess mortality in a one-year follow-up. Methods The study included 55 patients (LVEF 55.6 ± 6.8%; aged 57.5 ± 10.5 years). Patients underwent a 5-week HTR based on Nordic walking, consisting of an initial stage (1 week) conducted within an outpatient center and a basic stage (4-week) home-based telerehabilitation five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise training. The influence on physical capacity was assessed by comparing changes in functional capacity (METs) from the beginning and the end of HTR. Patients filled in a questionnaire in order to assess their acceptance of HTR at the end of telerehabilitation. Results HTR resulted in a significant improvement in functional capacity and workload duration in exercise test (Table). Safety: there were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the monitoring center. Prognosis all patients survived in a one-year follow-up. Conclusions Hybrid telerehabilitation is a feasible, safe form of rehabilitation, well accepted by patients. There were no deaths in a one-year follow-up. Outcomes before and after HTR Before telerehabilitation After telerehabilitation P Exercise time [s] 381.5 ± 92.0 513.7 ± 120.2 <0.001 Maximal workload [MET] 7.9 ± 1.8 10.1 ± 2.3 <0.001 Heart rate rest [bpm] 68.6 ± 12.0 66.6 ± 10.9 0.123 Heart rate max effort [bpm] 119.7 ± 15.9 131.0 ± 20.1 <0.001 SBP rest [mmHg] 115.6 ± 14.8 117.7 ± 13.8 0.295 DBP rest [mmHg] 74.3 ± 9.2 76.2 ± 7.3 0.079 SBP max effort [mm Hg] 159.5 ± 25.7 170.7 ± 25.5 0.003 DBP max effort [mm Hg] 84.5 ± 9.2 87.2 ± 9.3 0.043 SBP systolic blood pressure, DBP diastolic blood pressure.

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Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

Scientific Reports ◽

10.1038/s41598-021-94121-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

M. A. Salinero-Fort ◽

F. J. San Andrés-Rebollo ◽

J. Cárdenas-Valladolid ◽

M. Méndez-Bailón ◽

R. M. Chico-Moraleja ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Antihypertensive Drugs ◽

Hdl Cholesterol ◽

First Year ◽

Backward Elimination ◽

One Year ◽

Time Varying Covariates

AbstractWe aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

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Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: a multi-institutional cohort study and meta-analysis

10.21203/rs.3.rs-48852/v2 ◽

2020 ◽

Author(s):

Kai-Cheng Chang ◽

Shih-Chieh Shao ◽

Shihchen Kuo ◽

Chen-Yi Yang ◽

Hui-Yu Chen ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Cohort Study ◽

Real World ◽

Comparative Effectiveness ◽

Blood Pressure Reduction ◽

Renal Functions ◽

Diabetes Patients

Abstract Background Head-to-head comparison of clinical effectiveness between dulaglutide and liraglutide in Asia is limited. This study was aimed to assess the real-world comparative effectiveness of dulaglutide versus liraglutide. Methods We conducted a retrospective cohort study by utilizing multi-institutional electronic medical records to identify real-world type 2 diabetes patients treated with dulaglutide or liraglutide during 2016-2018 in Taiwan and followed up until 2019. Effectiveness outcomes were assessed at every three months in the one-year follow-up. Propensity score techniques were applied to enhance between-group comparability. Significant differences in changes of effectiveness outcomes between treatment groups during the follow-up were examined and further analyzed using mixed-model repeated-measures approaches. Results A total of 1,512 subjects receiving dulaglutide and 1,513 subjects receiving liraglutide were identified. At 12 months, significant HbA1c changes from baseline were found in both treatments (dulaglutide: -1.06%, p<0.001; liraglutide: -0.83%, p<0.001), with a significant between-group difference (-0.23%, 95% confidence interval: -0.38 to -0.08%, p<0.01). Both treatments yielded significant declines in weight, alanine aminotransferase level, and estimated glomerular filtration rate from baseline (dulaglutide: -1.14 kg, -3.08 U/L and -2.08 ml/min/1.73 m2, p<0.01; liraglutide: -1.64 kg, -3.65 U/L and -2.33 ml/min/1.73 m2, p<0.001), whereas only dulaglutide yielded a significant systolic blood pressure reduction (-2.47 mmHg, p<0.001). Between-group differences in changes of weight, blood pressure, and liver and renal functions at 12 months were not statistically significant. Conclusions In real-world T2D patients, dulaglutide versus liraglutide was associated with better glycemic control and comparable effects on changes of weight, blood pressure, and liver and renal functions.

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Left ventricular end-diastolic dimensions measured at the P wave and Q wave during a randomized, double-blind one-year follow-up study comparing the effect of atenolol vs. hydrochlorothiazide + amiloride on blood pressure in men with mild to moderate hypertension

Scandinavian Journal of Clinical and Laboratory Investigation ◽

10.3109/00365519309088402 ◽

1993 ◽

Vol 53 (2) ◽

pp. 155-162

Author(s):

J. E. Otterstad ◽

G. Froeland ◽

J. Erikssen

Keyword(s):

Blood Pressure ◽

Moderate Hypertension ◽

Left Ventricular ◽

P Wave ◽

Double Blind ◽

Follow Up Study ◽

One Year ◽

Q Wave

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One-year follow-up study of blood pressure and dietary patterns in dietary approaches to stop hypertension (DASH)?sodium participants

American Journal of Hypertension ◽

10.1016/j.amjhyper.2004.07.005 ◽

2004 ◽

Vol 17 (12) ◽

pp. 1156-1162 ◽

Cited By ~ 31

Author(s):

J ARD ◽

C COFFMAN ◽

P LIN ◽

L SVETKEY

Keyword(s):

Blood Pressure ◽

Dietary Patterns ◽

Follow Up Study ◽

One Year

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One-year follow-up changes in weight are associated with changes in blood pressure in young Mexican adults

Public Health ◽

10.1016/j.puhe.2012.02.005 ◽

2012 ◽

Vol 126 (6) ◽

pp. 535-540 ◽

Cited By ~ 8

Author(s):

F.C.D. Andrade ◽

I. Vazquez-Vidal ◽

T. Flood ◽

C. Aradillas-Garcia ◽

J.M. Vargas-Morales ◽

...

Keyword(s):

Blood Pressure ◽

Mexican Adults ◽

One Year

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Hypertension and Cerebrovascular Diseases: A Large Long Term Followed Up Cohort Hypertension Patients

10.21203/rs.3.rs-135851/v1 ◽

2021 ◽

Author(s):

An le li ◽

shuai zhu ◽

zhi hao hu ◽

qian peng ◽

fang xiang ◽

...

Keyword(s):

Blood Pressure ◽

Cerebrovascular Disease ◽

Cumulative Incidence ◽

Cerebrovascular Diseases ◽

Seasonal Characteristics ◽

Four Seasons ◽

Younger Age ◽

One Year

Abstract Background: Cerebrovascular disease (CVD) is the first cause of death in Chinese residents [1]. Hypertension (HP) has been shown to be the single most important modifiable risk factor among multiple etiologies. The incidence of stroke has increased gradually and has begun occurring at a younger age in recent years [1-2]. There were few related studies on CVD of HP cohort. Objective: To explore CVD distribution and epidemic characteristics in followed-up hypertension patients.Methods: Using the Hypertension Follow-up Management System database in Jiading district in Shanghai. We designed a retrospective cohort study that included all followed-up hypertension patients between 2002 and 2020. The endpoint was the occurrence of CVD confirmed by the hospital; otherwise, the patients were tracked until September 30, 2020. Record information of every patient has been collected in the registration card and each followed-up record.Results: Among 166688 followed-up HP patients, the total cumulative incidence of CVD was 6.68% (male 7.02%, female 6.37%) during follow-up period, cumulative incidence of ischemic CVD, hemorrhagic CVD and unclassified stroke was respectively 4.76%, 0.40% and 1.53%. Cumulative incidence of CVD increased with age, the group under 30 was 0, and the group over 70 was the highest (9.24%). The higher blood pressure was, the higher prevalence of CVD was. The prevalence of CVD increased with duration of HP, 3.76% within one year and 11.34% after 10 years. The proportion of CVD cases in HP patients from April to June was the largest in the four seasons; the proportion of patients from October to December was the minimum.Conclusion: Hypertension patient was prone to falling cerebrovascular disease; the main type of disease was cerebral infarction. Male incidence was higher than female incidence. The cumulative incidence of CVD increased with age, blood pressure and duration of HP patients. It had seasonal characteristics, which was relatively high from April to June within year.

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Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: a multi-institutional cohort study and meta-analysis

Cardiovascular Diabetology ◽

10.1186/s12933-020-01148-8 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Kai-Cheng Chang ◽

Shih-Chieh Shao ◽

Shihchen Kuo ◽

Chen-Yi Yang ◽

Hui-Yu Chen ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Cohort Study ◽

Real World ◽

Comparative Effectiveness ◽

Blood Pressure Reduction ◽

Renal Functions ◽

Diabetes Patients

Abstract Background Head-to-head comparison of clinical effectiveness between dulaglutide and liraglutide in Asia is limited. This study was aimed to assess the real-world comparative effectiveness of dulaglutide versus liraglutide. Methods We conducted a retrospective cohort study by utilizing multi-institutional electronic medical records to identify real-world type 2 diabetes patients treated with dulaglutide or liraglutide during 2016–2018 in Taiwan and followed up until 2019. Effectiveness outcomes were assessed at every 3 months in the 1-year follow-up. Propensity score techniques were applied to enhance between-group comparability. Significant differences in changes of effectiveness outcomes between treatment groups during the follow-up were examined and further analyzed using mixed-model repeated-measures approaches. Results A total of 1512 subjects receiving dulaglutide and 1513 subjects receiving liraglutide were identified. At 12 months, significant HbA1c changes from baseline were found in both treatments (dulaglutide: − 1.06%, p < 0.001; liraglutide: − 0.83%, p < 0.001), with a significant between-group difference (− 0.23%, 95% confidence interval − 0.38 to − 0.08%, p < 0.01). Both treatments yielded significant declines in weight, alanine aminotransferase level, and estimated glomerular filtration rate from baseline (dulaglutide: − 1.14 kg, − 3.08 U/L and − 2.08 mL/min/1.73 m2, p < 0.01; liraglutide: − 1.64 kg, − 3.65 U/L and − 2.33 mL/min/1.73 m2, p < 0.001), whereas only dulaglutide yielded a significant systolic blood pressure reduction (− 2.47 mmHg, p < 0.001). Between-group differences in changes of weight, blood pressure, and liver and renal functions at 12 months were not statistically significant. Conclusions In real-world T2D patients, dulaglutide versus liraglutide was associated with better glycemic control and comparable effects on changes of weight, blood pressure, and liver and renal functions.

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Abstract WP323: Bridging The Gap Between Acute Care and Public Health

Stroke ◽

10.1161/str.47.suppl_1.wp323 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Kari D Moore ◽

Bonita Bobo ◽

Peter Rock ◽

Elizabeth Wise

Keyword(s):

Public Health ◽

Blood Pressure ◽

Medication Adherence ◽

Hospital Readmission ◽

Community Resources ◽

Post Discharge ◽

Readmission Rates ◽

National Quality ◽

One Year

Background: The WHO estimates that only 50% of patients with chronic illness adhere to treatment recommendations. The Affordable Care Act targets hospital readmission rates as cost savings opportunities. Readmission rates reported in the literature range from 6-33%. Transitional care programs have been shown to improve patient outcomes. Purpose: To reduce readmission and recurrent stroke, the Stroke Patient Education and Navigation (SPEN) Project sought to enhance the continuum of care post discharge by forming collaboration between the University of Louisville Stroke Center (UL), Taylor Regional Hospital (TRH) and the Department for Public Health. Primary outcomes of this three-year project were hospital readmission, medication adherence, utilization of community resources, and National Quality Forum (NQF) 18: blood pressure less than 140/90. Methods: Stroke patients transferred from TRH to UL discharged home from October 2013 to January 2015 were invited to participate. After discharge nurses made 3 home visits at 2 weeks, 3 months, and 6 months to assess outcomes, biometrics, and blood pressure self-management. A follow up phone call was made at one year. Results: 44 patients participated (mean age 70, 28 male, 16 female). 32/44 (73%) completed all 3 visits. 36/44 (82%) with medication adherence. 2/44 (5%) readmitted within 30 days (1 with TIA and 1 with pneumonia). 2/24 (8%) participated in a community resource (smoking cessation program and diabetes classes). Reasons for not using community resources were lack of transportation and “not needed”. Results of NQF 18 goals achieved: 29/44 (66%) at visit 1 and 12/28 (43%) for all 3 visits. At one-year post discharge 10 patients had been readmitted, 3 for vascular events (1 TIA, 1 MI, 1 HTN). Cost of project per patient was $306.62. Conclusions: the SPEN project achieved low 30-day readmission rate and positive medication compliance, but did not achieve utilization of community resources or satisfactory NQF 18 results. Future projects should consider methods to improve resource utilization and cost effective methods of follow-up, such as multiple telephone or telehealth interactions.

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