Implementation of therapeutic recommendations in high cardiovascular-risk patients. The Polish population of EUROASPIRE V survey

The worldwide morbidity and mortality burden of cardiovascular disease (CVD) is overwhelming and caused by increasing life expectancy and an epidemic of risk factors, including hypertension. Therapeutic options targeting different areas of the renin–angiotensin–aldosterone system (RAAS) to disrupt pathophysiological processes along the cardiovascular continuum are available. Angiotensin-converting enzyme (ACE) inhibitors are first-line treatments for CVD and angiotensin receptor blockers (ARBs) are suitable alternatives. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Additionally, several studies have demonstrated that RAAS blockade can reduce cardiovascular risk beyond what might be expected from BP lowering alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. Recently, the Ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET) study showed that telmisartan reduces cardiovascular events in high cardiovascular risk patients similarly to the gold standard ACE inhibitor ramipril beyond BP lowering alone, but with a better tolerability. Based on the results of the ONTARGET and Telmisartan randomized assessment study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) studies, telmisartan is indicated for the reduction of cardiovascular morbidity. This article aims to review current guidelines for the management of CVD and consider key data from clinical trials and clinical practice evaluating the role of telmisartan in CVD.

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Use of Left Ventricular Strain to Predict Heart Failure and Mortality in High Cardiovascular Risk Patients

Heart Lung and Circulation ◽

10.1016/j.hlc.2018.06.538 ◽

2018 ◽

Vol 27 ◽

pp. S285-S286

Author(s):

K. Haji ◽

T. Marwick ◽

C. Neil ◽

S. Stewart ◽

M. Carington ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Risk ◽

Left Ventricular ◽

High Cardiovascular Risk ◽

Left Ventricular Strain ◽

Risk Patients

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Efficacy and safety of adding alirocumab to rosuvastatin versus adding ezetimibe or doubling the rosuvastatin dose in high cardiovascular-risk patients: The ODYSSEY OPTIONS II randomized trial

Atherosclerosis ◽

10.1016/j.atherosclerosis.2015.11.010 ◽

2016 ◽

Vol 244 ◽

pp. 138-146 ◽

Cited By ~ 120

Author(s):

Michel Farnier ◽

Peter Jones ◽

Randall Severance ◽

Maurizio Averna ◽

Elisabeth Steinhagen-Thiessen ◽

...

Keyword(s):

Cardiovascular Risk ◽

Randomized Trial ◽

Efficacy And Safety ◽

High Cardiovascular Risk ◽

Risk Patients

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Real-World Characteristics And Risk Of Cardiovascular Events In High Cardiovascular Risk Patients In France

Atherosclerosis ◽

10.1016/j.atherosclerosis.2019.06.546 ◽

2019 ◽

Vol 287 ◽

pp. e180

Author(s):

G. Désaméricq ◽

F. Fagnani ◽

C. Emery ◽

J. Gourmelen ◽

J.V. Chauny ◽

...

Keyword(s):

Cardiovascular Risk ◽

Real World ◽

Cardiovascular Events ◽

High Cardiovascular Risk ◽

Risk Patients

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Body mass index, cognitive deficit and depressive symptoms in high cardiovascular risk patients

Dementia & Neuropsychologia ◽

10.1590/s1980-57642010dn40400010 ◽

2010 ◽

Vol 4 (4) ◽

pp. 313-319 ◽

Cited By ~ 1

Author(s):

Amanda Lucas da Costa ◽

Juliana Santos Varela ◽

Matheus Roriz Cruz ◽

Andry Fitterman Costa ◽

Paulo Dornelles Picon ◽

...

Keyword(s):

Cognitive Impairment ◽

Depressive Symptoms ◽

Cardiovascular Risk ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Obese Patients ◽

High Cardiovascular Risk ◽

Point Increase ◽

Risk Patients ◽

Relationship Of

Abstract To evaluate the relationship of obesity, cognitive impairment and depressive symptoms in patients with high cardiovascular risk. Methods: A sample of 93 patients aged 50 years or older was selected from the Center of Dyslipidemia and High Cardiovascular Risk from Hospital de Clínicas de Porto Alegre (HCPA). Patients with stroke were excluded. For cognitive evaluation, the MMSE (Mini Mental State Examination) was used. A score of 24 or less was considered as cognitive impairment, and for those who had 4 years or less of education, the cutoff point was 17. The GDS-15 (Geriatric Depression Scale) was also used, with the cutoff of 6 for presence of depressive symptoms. Results: Obese patients showed lower mean MMSE scores compared to non-obese patients (p=0.0012). Additionally, for every one point increase in BMI above 30 there was a 27% increase in the chances of the patient having cognitive impairment. The obese patients presented 31% chance of having cognitive impairment compared with overweight subjects. Conclusions: Our findings corroborated the association between obesity and cognitive impairment in high cardiovascular risk patients. This association however, was not observed for depressive symptoms.

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