scholarly journals Three calcium antagonists: a place of everyone in treatment arterial hypertension (ALTERNATIVE study)

2009 ◽  
Vol 6 (4) ◽  
pp. 26-28
Author(s):  
Irina Evgen'evna Chazova ◽  
Lyudmila Gennadievna Ratova
Keyword(s):  
Risk Factors ◽  
Quality Of Care ◽  
Arterial Hypertension ◽  
Calcium Antagonists ◽  
Russian Society ◽  
Scientific Society ◽  
Russian Scientific ◽  
The Russian Federation ◽  
Regions Of Russia

In some regions of Russia, the prescription of different calcium antagonists by physicians was analyzed. This made it possible to assess their experience and knowledge and to direct ways to further improvements of the quality of care to patients with arterial hypertension. The present-day medical treatment of arterial hypertension in the Russian Federation is mainly determined by the recommendations made by the Russian Society of Hypertension and Russian Scientific Society of Cardiology 2008; however, the choice of a drug should be primarily based on a comprehensive assessment of risk factors available in a patient.

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

Clinical Presentation, Quality of Care, Risk Factors and Outcomes in Women with Acute ST-Elevation Myocardial Infarction (STEMI): An Observational Report from Six Middle Eastern Countries

2019 ◽  
Vol 17 (4) ◽  
pp. 388-395 ◽  
Author(s):  
Abdulla Shehab ◽  
Khalid F. AlHabib ◽  
Akshaya S. Bhagavathula ◽  
Ahmad Hersi ◽  
Hussam Alfaleh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Quality Of Care ◽  
Middle East ◽  
Clinical Presentation ◽  
Middle Eastern ◽  
High Morbidity ◽  
Inhospital Mortality ◽  
Acute Stemi

Background: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. Aims: To examine the clinical presentation, patient management, quality of care, risk factors and inhospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. Methods: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries. The study included 2928 patients; 296 women (10.1%) and 2632 men (89.9%). Clinical presentations, management and in-hospital outcomes were compared between the 2 groups. Results: Women were 10 years older and more likely to have diabetes mellitus, hypertension, and hyperlipidemia compared with men who were more likely to be smokers (all p<0.001). Women had longer median symptom-onset to emergency department (ED) arrival times (230 vs. 170 min, p<0.001) and ED to diagnostic ECG (8 vs. 6 min., p<0.001). When primary percutaneous coronary intervention (PPCI) was performed, women had longer door-to-balloon time (DBT) (86 vs. 73 min., p=0.009). When thrombolytic therapy was not administered, women were less likely to receive PPCI (69.7 vs. 76.7%, p=0.036). The mean duration of hospital stay was longer in women (6.03 ± 22.51 vs. 3.41 ± 19.45 days, p=0.032) and the crude in-hospital mortality rate was higher in women (10.4 vs. 5.2%, p<0.001). However, after adjustments, multivariate analysis revealed a statistically non-significant trend of higher inhospital mortality among women than men (6.4 vs. 4.6%), (p=0.145). Conclusion: Our study demonstrates that women in our region have almost double the mortality from STEMI compared with men. Although this can partially be explained by older age and higher risk profiles in women, however, correction of identified gaps in quality of care should be attempted to reduce the high morbidity and mortality of STEMI in our women.

scholarly journals Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
High Cardiovascular Risk ◽  
Very High

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.

scholarly journals Delirium and Antipsychotic Medications at Hospital Intake: Screening to Decrease Likelihood of Aggression in Inpatient Settings Among Unknown Patients With Dementia

2018 ◽  
Vol 34 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Tracy Wharton ◽  
Daniel Paulson ◽  
Kimberly Burcher ◽  
Heather Lesch
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Antipsychotic Medication ◽  
Care Providers ◽  
Antipsychotic Medications ◽  
Inpatient Settings ◽  
Logistic Regressions

For individuals with dementia, disorientation and both external and internal stimuli may trigger behaviors that are difficult to manage or dangerous to health-care providers. Identification of correlational risk factors to aggressive behavior in patients who are unknown to the hospital can allow providers to adapt patient care quickly. Records for patients aged 60+ who spent at least 24 hours at the hospital other than in the psychiatric unit were used (N = 14 080). The first 4000 records and every 10th person who met criteria (N = 5008) were searched for documentation of dementia (n = 505). Logistic regressions and χ2 tests were used to examine relationships between variables. Recognition of delirium ( P = .014, Exp(B) = 2.53), coupled with an existing prescription for antipsychotic medication at intake ( P < .001, Exp(B) < 4.37), may be a reliable means of screening for risk and intervening at the earliest possible contact, improving quality of care and safety in acute care for individuals with dementia.

scholarly journals Patterns of care of subjects with type 1 and type 2 diabetes according to their cardiovascular risk

2021 ◽  
Vol 24 (1) ◽  
pp. 30
Author(s):  
Pintaudi, B.
Keyword(s):  
Risk Factors ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Quality Indicators ◽  
High Cardiovascular Risk ◽  
Very High

AIM OF THE STUDY To explore the distribution by cardiovascular risk groups according to the classification promoted by the ESC (European Society of Cardiology) of subjects with type 1 (T1D) and type 2 (T2D) diabetes cared for by Italian diabetologists and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. DESIGN AND METHODS The study is based on data extracted from electronic medical records of patients treated at the 258 diabetes centers participating in the Annals AMD initiative and active in the year 2018. Patients with T1D or T2D were stratified by cardiovascular risk, in accordance with the recent ESC guidelines. General descriptive indicators and measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. RESULTS Overall, 29,368 adults with T1D and 473,740 subjects with T2D were evaluated. Among subjects with T1D: 64.7% were at very high cardiovascular risk, 28.5% at high risk and the remaining 6.8% at moderate risk. Among subjects with T1D at very high-risk: 54.7% had retinopathy, 29.0% had albuminuria, 7.3% had a history of major cardiovascular event, 47.3% had organ damage, 48.9% had three or more risk factors, and 70.6% had a diabetes duration of over 20 years. Among subjects with T2D: 78.5% were at very high cardiovascular risk, 20.9% at high risk and the remaining 0.6% at moderate risk. Among those with T2D at very high risk: 39.0% had organ damage, 89.1% had three or more risk factors, 18.7% had a previous major cardiovascular event, 26,4% had retinopathy, 39.5% had albuminuria. With regard to the glucose-lowering drugs: the use of DPPIV-i increased markedly as cardiovascular risk increased; the use of secretagogues also increased and, although within low percentages, also the use of GLP1-RA tended to increase. The use of SGLT2-i is also still limited, and only slightly higher in subjects with very high cardiovascular risk. In both types of diabetes, the overall quality of care, as summarized by the Q score values, tended to be lower as the level of cardiovascular riskincreased. CONCLUSIONS The analysis of a large population such as that of the AMD Annals database allowed to highlight the characteristics and quality indicators of care of subjects with T1D and T2D in relation to cardiovascular risk classes. A large proportion of subjects appear to be at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to the potential advantages in terms of reduction of cardiovascular risk of some drug categories (GLP1-RA and SGLT2-i) and, conversely, with respect to the potential risks related to the use of other pharmacological classes (sulfonylureas). Several actions are necessary to optimize care and improve the quality of care for both subjects with T1D and T2D. KEY WORDS type 1 diabetes; type 2 diabetes; cardiovascular risk; quality indicators of care.

scholarly journals Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines

2021 ◽  
Vol 26 (7) ◽  
pp. 4600
Author(s):  
D. S. Lebedev ◽  
E. N. Mikhailov ◽  
N. M. Neminuschiy ◽  
E. Z. Golukhova ◽  
V. E. Babokin ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Cardiac Pacing ◽  
Holter Monitoring ◽  
Russian Society ◽  
Clinical Electrophysiology ◽  
Scientific Society ◽  
Russian Scientific ◽  
Ventricular Tachycardias ◽  
Russian Association

Russian Society of Cardiology (RSC).With the participation of Russian Scientific Society of Clinical Electrophysiology, Arrhythmology and Cardiac Pacing, Russian Association of Pediatric Cardiologists, Society for Holter Monitoring and Noninvasive Electrocardiology.Approved by the Scientific and Practical Council of the Russian Ministry of Health.

Abstract 13776: The Impact of Race on In-hospital Quality of Care Among Young Adults With Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Diana Benea ◽  
Valeria Raparelli ◽  
hassan behlouli ◽  
Louise Pilote ◽  
Rachel Dryer
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Quality Of Care ◽  
Clinical Characteristics ◽  
Hospital Quality ◽  
P Value ◽  
White Race

Introduction: The extent to which race influences in-hospital quality of care among young adults with acute myocardial infarction (AMI) is unknown. We examined racial differences in in-hospital quality of AMI care in young adults and described the patient and/or clinical characteristics associated with potential disparities in care. Methods: Data from the GENESIS-PRAXY (Canada) and the VIRGO (U.S.) prospective cohorts of young adults with AMI were analyzed. Among a total of 4,048 adults with AMI (≤55 years) (median=49 years [IQR 44-52], 22% non-white, 58% women), we calculated an in-hospital quality of care score (QCS) for AMI (quality indicators divided by total, with higher scores indicating better care) based on AHA quality of care standards, reporting data disaggregated by race. We categorized race as white versus non-white, which included Black, Asian and North American Indigenous populations. Results: This cohort was comprised of 906 non-white individuals and 3142 white individuals. Non-white adults exhibited a clustering of adverse cardiac risk factors, psychosocial risk factors and comorbidities versus whites; they had higher rates of hypertension, diabetes, alcohol abuse and prior AMI and lower rates of physical activity. They were more likely to have a low SES and receive low social support, and were less likely to be employed, a primary earner, or married/living with a partner. Non-white individuals were also more likely to experience a NSTEMI and less likely to receive cardiac rehabilitation, smoking cessation counseling as well as dual antiplatelet therapy at discharge. Furthermore, non-white individuals had a lower crude QCS than whites (QCS=69.99 vs 73.29, P-value<0.0001). In the multivariable model adjusted for clinical and psychosocial factors, non-white race (LS Mean Difference=-1.49 95%CI -2.87, -0.11, P-value=0.0344) was independently associated with a lower in-hospital QCS. Conclusion: Non-white individuals with AMI exhibited higher rates of adverse psychosocial and clinical characteristics than white individuals yet non-white race was independently associated with lower in-hospital quality of care. Interventions are needed to improve quality of AMI care in non-white young adults.

scholarly journals Quality of sleep and risk factors for arterial hypertension between university members / Qualidade do sono e fatores de risco para hipertensão arterial entre universitários / Calidad del sono y factores de riesgo para hipertensión arterial..

2019 ◽  
Vol 8 (3) ◽  
pp. 55
Author(s):  
Karolaine Rodrigues da Silva ◽  
José Junior da Costa ◽  
Raul Rodrigues Cipriano de Sousa ◽  
Brenda Rodrigues de Sousa ◽  
Andressa Suelly Saturnino de Oliveira
Keyword(s):  
Risk Factors ◽  
Arterial Hypertension ◽  
Quality Of Sleep ◽  
Factores De Riesgo

Objetivo: analisar a relação entre a qualidade do sono e a presença fatores de risco para o desenvolvimento de hipertensão entre universitários. Metodologia: Estudo descritivo, quantitativo, desenvolvido entre fevereiro e dezembro de 2018 em uma Instituição de ensino superior, localizada em Picos – Piauí. A coleta de dados ocorreu através da aplicação do questionário de avaliação da qualidade do sono de Pittsburg e de formulário para avaliar a presença de fatores de risco para hipertensão e medidas antropométricas. Os dados foram analisados a partir do programa IBM SPSS Statistics versão 20.0, calculando-se as frequências absolutas e relativas, médias e desvios-padrão. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Piauí. Resultados: Participaram da pesquisa 68 acadêmicos, sendo 41 ingressantes e 27 concludentes, destes 85,3% eram do sexo feminino. A faixa etária média foi de 19,05 anos para os ingressantes e 23,33 anos para os concludentes. Apenas 32,4% praticar atividade física, 51,5% afirmara fazer uso de álcool e 73,5% obtiveram resultado da qualidade do sono como ruim. Conclusão: Os estudantes estão sob alto risco de desenvolver sobrepeso, devido à inatividade física, consumo de álcool e qualidade do sono, e consequentemente suscetíveis ao desenvolvimento de hipertensão arterial futuramente.Descritores: Fatores de risco. Universitários. Qualidade do sono. Hipertensão.

scholarly journals Arterial hypertension at the workplace: risk factors and the population value

2018 ◽  
Vol 90 (9) ◽  
pp. 138-143
Author(s):  
L A Strizhakov ◽  
S A Babanov ◽  
M V Lebedeva ◽  
S V Moiseev ◽  
V V Fomin
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Arterial Hypertension ◽  
Psychosocial Stress ◽  
Production Factors ◽  
Physical Chemical ◽  
Target Organs ◽  
The Russian Federation ◽  
The Relationship

The article presents data of domestic and foreign authors on the relationship between occupational factors and arterial hypertension. The role of latent arterial hypertension, its frequency in the population, the lesion of the target organs and the prognosis in comparison with normotensive individuals, arterial hypertension of the "white coat" and stable arterial hypertension have been analyzed. Arterial hypertension in the workplace is a form of latent arterial hypertension. The authors review the influence of harmful production factors (physical, chemical), as well as psychosocial stress on the risk of developing arterial hypertension.The risk of developing hypertension in specified groups of workers has been analyzed separately. The place of production-related diseases in modern occupational pathology in the Russian Federation. A wider implementation of measures aimed at early diagnosis and prevention of arterial hypertension in workers is proposed.

scholarly journals Influence of allure polymorphism distribution of arterial hypertensions gene-candidates jointly with cardiovascular risk factors on change of thickness of intima-media complex among patients with higher arterial pressure living in Mountain Shoriya

2018 ◽  
Vol 15 (3) ◽  
pp. 27-31
Author(s):  
T A Mulerova ◽  
S A Maksimov ◽  
A N Chigisova ◽  
M Yu Ogarkov
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Cardiovascular Risk Factors ◽  
Genetic Markers ◽  
Carotid Arteries ◽  
Subclinical Atherosclerosis ◽  
Medical Society ◽  
Control Group ◽  
Russian Society

Objective - to evaluate the association of genetic markers and cardiovascular risk factors with thickening of the intima-media complex among patients with arterial hypertension in the indigenous and non-indigenous population of Mountain Shoriya. Material and methods. The population of Mountain Shoriya in the number of 1409 people was surveyed by a single method (901 people are of indigenous nationality, Shorians, 508 people are non-indigenous 90% of them are Caucasians). Shors are a small Turkic-speaking people. Lipid blood spectrum, fasting plasma glucose, Quetelet index, waist circumference, genetic markers [ACE (I/D, rs4340), AGT (c.803T>C, rs699), AGTR1 (A1166C, rs5186), ADRB1 (p.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c.677C>T, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a)]. Carotid ultrasound was performed. Hypertension was diagnosed according to the National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010). The study included 226 Shorians and 124 non-indigenous people with arterial hypertension and an increased thickness of the intima-media complex. The control group consisted of individuals with high blood pressure without atherosclerosis of carotid arteries (81 and 66 people, respectively). Results. It was revealed that such risk factors as gender and age are significantly associated with the thickness of the intima-media complex in the shorthand cohort (OR 1.93; 95% CI 1.03-3.62 and OR 20.01; 95% CI 4.79-83.65) and age - in the cohort of representatives of non-indigenous nationality (OR 3.20; 95% CI 1.39-7.36). An important role in the formation of atherosclerosis of carotid arteries in patients with arterial hypertension has a duration of the course of the disease in both ethnic groups, respectively - OR 2.78; 95% CI (1.45-5.33) and OR 4.22; 95% CI (1.97-9.01). A significantly smaller contribution is made by the genetic component: the rs699 polymorphism of the AGT gene, as in the Shorts (OR 3.51; 95% CI 1.10-11.25), and in non-indigenous residents (OR 4.90; 95% CI 1.15-20.92) and polymorphism rs1801133 of the MTHFR gene only in persons of indigenous nationality (OR 10.80; 95% CI 2.35-49.70). Conclusion. Timely establishment of risk factors for subclinical atherosclerosis in hypertension and their correction depending on the national trait will help prevent the progression of the process, reverse it, and reduce the risk of complications, premature disability and mortality.

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