scholarly journals Neprilysin: A Potential Therapeutic Target of Arterial Hypertension?

2020 ◽  
Vol 16 (1) ◽  
pp. 25-35 ◽  
Author(s):  
Juan Salazar ◽  
Joselyn Rojas-Quintero ◽  
Clímaco Cano ◽  
José L. Pérez ◽  
Paola Ramírez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Hypertension ◽  
Adult Population ◽  
Significant Risk ◽  
Cardiovascular Pharmacology ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Clinical Syndrome ◽  
Major Health Problem ◽  
Neprilysin Inhibitor

Arterial hypertension is the most prevalent chronic disease in the adult population of developed countries and it constitutes a significant risk factor in the development of cardiovascular disease, contributing to the emergence of many comorbidities, among which heart failure excels, a clinical syndrome that nowadays represents a major health problem with uncountable hospitalizations and the indolent course of which progressively worsens until quality of life decreases and lastly death occurs prematurely. In the light of this growing menace, each day more efforts are invested in the field of cardiovascular pharmacology, searching for new therapeutic options that allow us to modulate the physiological systems that appear among these pathologies. Therefore, in the later years, the study of natriuretic peptides has become so relevant, which mediate beneficial effects at the cardiovascular level such as diuresis, natriuresis, and decreasing cardiac remodeling; their metabolism is mediated by neprilysin, a metalloproteinase, widely expressed in the human and capable of catalyzing many substrates. The modulation of these functions has been studied by decades, giving room to Sacubitril, the first neprilysin inhibitor, which in conjunction with an angiotensin receptor blocker has provided a high efficacy and tolerability among patients with heart failure, for whom it has already been approved and recommended. Nonetheless, in the matter of arterial hypertension, significant findings have arisen that demonstrate the potential role that it will play among the pharmacological alternatives in the upcoming years.

Chronic heart failure

2020 ◽  
pp. 217-240
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Mortality Rate ◽  
Adult Population ◽  
Age Groups ◽  
Severe Heart Failure ◽  
Signs And Symptoms ◽  
Developed Countries ◽  
Clinical Syndrome ◽  
The Uk

Heart failure is a complex clinical syndrome of signs and symptoms that suggest the ability of the heart to pump effectively has been impaired. It is distinguished by dyspnoea, effort intolerance, fluid retention, and poor survival. The prevalence of heart failure is around 1–2% in the adult population in developed countries, and 920 000 people in the UK have heart failure. The incidence of heart failure has decreased; however, the number of people newly diagnosed with heart failure has increased. This is thought to be largely due to an ageing population, improvement in the management and survival of people with ischaemic heart disease, and effective treatment of heart failure. The condition can occur in all age groups; however, the incidence and prevalence steeply increase with age. The average age at first diagnosis is typically 77yrs. Chronic heart failure (CHF) has a poor prognosis, the mortality rate for CHF being worse than for many cancers. It is estimated that 70% of those hospitalized for the first time with severe heart failure will die within 5yrs. However, this has been improving, with 6mth mortality rate ↓ from 26% in 1995, 15% in 2009, to 8.9% in 2016. This chapter will outline the aetiology, pathophysiology, and management of CHF, including considerations for palliative care.

Abstract P341: Juvenile Exposure To Doxorubicin Differentially Alters The Cardiac Response To Angiotensin II And Isoproterenol In Adult Mice

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Marianne K Grant ◽  
Beshay N Zordoky
Keyword(s):  
Heart Failure ◽  
Risk Factor ◽  
Angiotensin Ii ◽  
Cardiac Function ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Childhood Cancer Survivors ◽  
Cardiac Response

Hypertension is the most significant risk factor for heart failure in doxorubicin (DOX)-treated childhood cancer survivors. We previously developed a two-hit mouse model of juvenile DOX-induced latent cardiotoxicity that is exacerbated by adult-onset angiotensin II (ANGII)-induced hypertension. Nevertheless, it is still not known how juvenile exposure to DOX would predispose the heart to other cardiovascular pathologic stimuli that do not cause hypertension. The objective of this work was to compare the effects of ANGII to those of isoproterenol (ISO) in adult C57BL6/N mice pre-exposed to DOX as juveniles. Five-week-old male mice were administered a low dose of DOX (4 mg/kg/week) or saline for 3 weeks and then allowed to recover for 5 weeks. Thereafter, mice were either infused with ANGII (1.4 mg/kg/day) or injected with ISO (10 mg/kg/day) for 14 days. Juvenile exposure to DOX abrogated the hypertrophic response to both ANGII and ISO, while it failed to correct ANGII- and ISO-induced upregulation in the hypertrophic markers ANP and BNP. ANGII, but not ISO, worsened cardiac function in DOX-exposed mice as measured by echocardiography. Cardiac fibrosis was also exacerbated by ANGII, but not ISO, in DOX-exposed mice as evident by Masson’s trichrome staining and upregulation of the inflammatory and fibrotic markers, Cox-2, Col1a1, Col3a1 , and galectin-3 . In conclusion, the current work demonstrates that ANGII causes more severe deterioration in cardiac function and adverse cardiac remodeling in DOX-exposed mice when compared to ISO. The comparison between DOX/ANGII and DOX/ISO models is critical to understanding why hypertension is the most significant risk factor for heart failure in DOX-treated childhood cancer survivors and thereby devising effective therapeutic strategies against this significant clinical problem.

scholarly journals PREVALENCE OF SMOKING IN ADULT POPULATION OF IRKUTSK

2016 ◽  
Vol 1 (6) ◽  
pp. 153-156
Author(s):  
Максикова ◽  
Tatyana Maksikova ◽  
Бабанская ◽  
Evgeniya Babanskaya ◽  
Меньшикова ◽  
...  
Keyword(s):  
Risk Factor ◽  
Adult Population ◽  
Age Groups ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Noncommunicable Diseases ◽  
Age Difference ◽  
Age Group ◽  
Considerable Problem ◽  
The One

Smoking is a significant risk factor of chronic noncommunicable diseases. Smoking prevalence is variable in different populations. A study of the prevalence of this risk factor allows to estimate its contribution to the development of cardiovascular pathology, to plan the necessary amount of medical care for people using tobacco, and to determine the effectiveness of prevention activities in the region. As a result of the study, smoking frequency in population of the Irkutsk region older 18years of age or over was established as 29.5%. The number of smokers increased with age, reaching maximum value of 38.6% in the group 30–39 years. Male smokers made maximum in the age group 30–39 years, women – in the age group of 18–19 years. The average age of smokers was 34 years, the one of nonsmokers – 43 years. The age difference was 9 years, and it was lower in the group of men than in the group of women (5 and 11 years, respectively). The number of the smoking men were 3 times larger, than women: 50.2% and 13.5%, respectively. Among persons with arterial hypertension, 22.1% were smoking with the maximum frequency of smoking in age groups from 20 to 49 years. These figures point to a considerable problem of smoking in the region.

CLINICAL AND HEMODYNAMIC EFFICACY OF CHOLINE ALFOSCERATE IN ARTERIAL HYPERTENSION AND HYPERTENSIVE ENCEPHALOPATHY

2021 ◽  
Vol 2 (3) ◽  
pp. 23-27
Author(s):  
G.M. Tulaboeva ◽  
Keyword(s):  
Arterial Hypertension ◽  
Significant Risk ◽  
Cholinergic Neurons ◽  
Significant Risk Factor ◽  
Hypertensive Encephalopathy ◽  
Brain Lesions ◽  
Chronic Cerebral Ischemia ◽  
Cerebrovascular Accidents ◽  
Neuronal Membranes ◽  
The Brain

Arterial hypertension (AH)is currently considered the most significant risk factor for the development of not only acute cerebrovascular accidents and chronic cerebral ischemia, but also disorders of memory and other cognitive (cognitive) functions. Numerous studies have proven the connection between persistent increase in blood pressure (BP) and the risk of the onset and progression of cognitive impairment. The positive dynamics on the part of clinical and hemodynamicparameters is explained by the fact that gliatilin improves thetransmission of nerve impulses in cholinergic neurons; positively affects the plasticity of neuronal membranes and receptor function. Gliatilin improves cerebral blood flow, enhances metabolic processes in the brain, activates the structures of the reticular formation of the brain and restores consciousness in traumatic brain lesions.

scholarly journals Risk for Occurrence of Laryngeal Cancer Among Current Cigarette Smokers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 13s-13s ◽  
Author(s):  
I. Pavlovska ◽  
B. Taushanova ◽  
B. Zafirova
Keyword(s):  
Risk Factor ◽  
Cigarette Smoking ◽  
Laryngeal Cancer ◽  
Malignant Tumors ◽  
Smoking Habit ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Control Group

Background: Cancer is a leading cause of death worldwide. It is on the second place as a death cause in developed countries and among the three leading death causes in adults in developing countries. Every year, worldwide, approximately 10 million persons have been diagnosed with malignant tumors (in every locations), and more than 6 million of these people die. According to many studies, several risk factors are brought in connection with laryngeal cancer (LarC). The most significant and generally accepted is alcohol consumption and the habit of cigarette smoking. Cigarette smoking habit caused about 30% of all cancers, due to which it represents the most significant risk factor for occurrence of these disorders in humans. Aim: Aim of the study was to determine the existence of the eventual causal associations among the cigarette smoking and development and distribution of the laryngeal cancer. Methods: This study is an analytical type of case-control study. It elaborated 185 patients, suffering from laryngeal cancer and the same number of persons without malignant disease (control group-CG). Risk analyses were done using unconditional logistic regression, which provides results in the form of adjusted odds ratio. The odds ratios and their 95% confidence intervals (CI) were computed. Results: Among patients were 79% of current smokers (CS), 18.3% of former smokers (FS) and only 2.7% of never smokers (NS), compared with 40.5% of CS, 28.7% of FS and 30.8% of NS among controls. More than a half of the CS has been smoking 21-40 cigarettes per day (c/day) (54.8%), while in CG members this percent was 29.3%. Group of so called “heavy” smokers (> 40c/day), includes 13.7% of patients, and only 4% from CG. Majority of CS with LarC had smoking length, ranging from 31-45 years (56.2%). CS had 16.03 (95% CI, 6.25-41.12), times significantly higher risk to become ill from LarC, compared with NS. CS who were smoking < 20 c/day had 10.49 (95% CI, 3.87-28.45), while those who were smoking > 20 c/day, had 45.6 (95% CI, 16.55-125.67), times significantly higher risk to become ill, compared with NS. Univariate analysis in CS showed significantly higher risk for the persons to become ill, who were smoking > 40 years, compared with those who were smoking < 40 years (OR=3.73; 95% CI 2.03-6.84). The risk of occurring LarC has been four times (95% CI, 2.35-7.88), significantly higher in the CS who are smoking > 20 years, > 20 c/day, compared with those, who in the same time period, smoke < 20 c/day. Conclusion: Cigarette smoking is by far the most important risk factor for laryngeal cancer. Concerted control of smoking appears to be an urgent priority in LarC prevention, including efforts to prevent adolescents from starting to smoke.

scholarly journals Studying the antihyperlipidaemic basis of ayurvedic formulations –Avipattikara churna and triphala churna

2020 ◽  
Vol 11 (4) ◽  
pp. 5634-5642
Author(s):  
Dixit Praveen K ◽  
Nagarajan K ◽  
Kumar Sokindra
Keyword(s):  
Risk Factor ◽  
Medicinal Plants ◽  
Heart Diseases ◽  
Lipid Level ◽  
Significant Risk ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Blood Lipid Profile

Increased blood lipid profile (hyperlipidaemia) has been described as a significant risk factor, which is majorly responsible for making the coronary heart diseases more severe. Coronary heart disease, stroke, atherosclerosis and hyperlipidaemia are the primary cause of death. The increase in total cholesterol and total low-density lipoprotein (LDL) cholesterol is described for its main risk factor, which is responsible for cardiovascular disease. The anti-hyperlipidemic drugs are used frequently for its lipids lowering potential to protect disorders which are induced by a condition like atherosclerosis. Still, these hypolipidemic agents also have various sorts of adverse events. Many plants and their derivatives and have been tested successfully for their anti-hyperlipidemic role. Almost 70 medicinal plants and more than this have been successfully screened for their significant anti-hyperlipidemic role. The significant increase observed in the use of medicinal plants in metropolitan regions of developed countries in the last decades. There are so many medicinal plants play a crucial role in lowering the blood lipid level. The most important advantage and popularity of traditional medicine system are because of effectiveness, safety, affordability and acceptability. This review focus on the anti-hyperlipidemic role of Avipattikar Churna and Triphala Churna used for the treatment of hyperlipidaemia.

scholarly journals Non-Adherence to Anti-Hypertensive Treatment

2020 ◽  
Vol 32 (1) ◽  
pp. 126-129
Author(s):  
Shalini . ◽  
Manish Kumar Goel
Keyword(s):  
Side Effects ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
New Delhi ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional

Background: In developed countries, adherence among patients suffering from chronic diseases averages only 50%; in developing countries it is assumed to be much lower. Aims & objectives: To find out the prevalence of non-adherence to antihypertensive treatment among individuals seeking anti-hypertensive treatment from tertiary care hospital in New Delhi & to find out the factors related to non-adherence to the anti-hypertensive treatment among study subjects. Material and Methods: A cross-sectional hospital-based study was conducted from June to October 2018 among 150 diagnosed cases of hypertension. The drug adherence was assessed by using standard Brief Medication Questionnaire I (BMQ I) and to know the determinants of non-adherence a semi-structured (self-designed and pre tested) questionnaire was used. The association of different factors with adherence was analyzed by applying chi square (χ2) test. Results: Among total of 150 participants 44% were males and 56% were females. The magnitude of non-adherence to anti-hypertensive drugs was 35.3%. Side effects of anti-hypertensive drugs was significant risk factor for non-adherence to anti-hypertensive drugs and common reasons for non-adherence were unwanted side effects (64.2%) followed by worry about long term side effects (62.3%). Conclusion: Prevalence of non-adherence to anti-hypertensive drugs was quite high, most common reason for non-adherence to anti-hypertensive medication was unwanted side effects and worry about long term side effects.

scholarly journals Investigation of early signs of systolic and diastolic dysfunction among persons with type 1 diabetes

Open Heart ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. e001020
Author(s):  
Daniel Vestberg ◽  
Magnus Carl Johansson ◽  
Anette Letho ◽  
Aldina Pivodic ◽  
Sara Hallström ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Type 1 Diabetes ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Early Signs ◽  
Study Population

BackgroundPersons with type 1 diabetes have a higher risk to develop heart failure than the general population, and the mechanism behind the increased risk is unclear. In epidemiological studies with hospitalisation for heart failure as endpoint HbA1c, body mass index and decreased kidney function are significant risk factors, but it is unclear how these risk factors influence the development of heart failure.MethodsIn this study, we investigated early signs of systolic and diastolic dysfunction with transthoracic echocardiography. Statistical analysis on correlation of risk factors and early signs of diastolic and systolic dysfunction was made.ResultsIn this study population of 287 persons with type 1 diabetes, 160 were men and 127 were women with a mean age of 53.8 (SD 11.6) years and a mean diabetes duration of 36.2 (SD 13.5) years. There were 23 (8.2%) persons who fulfilled the definition of systolic dysfunction (ejection fraction <50% or regional wall motion abnormalities) and 24 persons (9%) the definition for diastolic dysfunction. When comparing the groups with either systolic or diastolic dysfunction to the rest of the population, the only significant risk factor was age in both groups and previous myocardial infarction in the systolic group.ConclusionIn our study population with type 1 diabetes, we found signs of diastolic dysfunction in 9% and systolic dysfunction in 8.2%. Compared with published data from the general population, this rate is somewhat higher in a younger population. Only age was a significant risk factor in the study.

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