scholarly journals Clinical pearls for the monitoring and treatment of antipsychotic induced metabolic syndrome

2021 ◽  
Vol 11 (6) ◽  
pp. 311-319
Author(s):  
Beth M. DeJongh
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Weight Gain ◽  
Adverse Effects ◽  
Improve Patient Care ◽  
Premature Death ◽  
Atherosclerotic Cardiovascular Disease ◽  
Antipsychotic Medications ◽  
Improve Patient

Abstract Antipsychotic medications increase the risk of metabolic syndrome, which then increases the risk of atherosclerotic cardiovascular disease and premature death. Routinely monitoring for signs of metabolic syndrome in patients taking antipsychotics allows for early detection and intervention. Psychiatric pharmacists can improve patient care through metabolic syndrome monitoring and recommendation of appropriate interventions. Monitoring for the metabolic adverse effects of antipsychotics, management of weight gain, and management of lipids and blood pressure are explored through 2 patient cases.

Components Analysis of Metabolic Syndrome in Acute Myocardial Infarction Patients

2018 ◽  
Vol 29 (2) ◽  
pp. 6-10
Author(s):  
Khan MMR ◽  
Sana NK ◽  
PM Basak ◽  
BC Sarker ◽  
M Akhtarul Islam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Acute Myocardial Infarction ◽  
High Blood Pressure ◽  
Abdominal Obesity ◽  
Premature Death ◽  
Medical College ◽  
The Metabolic Syndrome ◽  
Low Hdl

Background: Metabolic syndrome confers the risk of developing acute myocardial infarction which is the most common form of coronary heart disease and the single most important cause of premature death worldwide. The frequency and association of different components of metabolic syndrome on AMI are not well understood and has not been well evaluated.Objective: The aim of this study was to assess the components of the metabolic syndrome and its association with AMI patients. This study will help in awareness building in reducing AMI by early detection of components of metabolic syndrome.Patients and methods: This was a prospective observational study consisted of 325 AMI patients who were aged >20 years. Patients with first time AMI arriving in CCU of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview, clinical examination, and laboratory tests within 24 hrs of AMI. Five components of metabolic syndrome were defined according to criteria set by modified NCEP ATP III (according to ethnic variation).Results: In AMI patients (n=325), no metabolic components were in 24 (7.4%) patients, one in 53 (16.3%), 2 components in 91(28.0%), 3 components were in 61(18.8%), 4 in 67(20.6%) and all 5 components were in 29 (8.9%) patients. In this study, there was no component in 7.4% of AMI patients, at least 1 component was 92.6%, at least 2 components were 76.3%, at least 3 components were 48.3%, at least 4 components were 29.5% and at least 5 components were 8.9%. The Metabolic syndrome was 48.3% (n=157). Among metabolic syndrome (≥3 components) in AMI (n=157, 48.3%) 4 components (20.6%) were more, next was 3 components (18.8%) and than 5 components (8.9%). Overall frequencies of components in acute myocardial infarction (n=325) were in order of abdominal obesity (54.8%) > high blood pressure (54.5%) > high FPG (54.2%) > Triglyceride (46.2%) and low HDL-C (46.2%) in acute myocardial infarction. Highest percentage was observed in abdominal obesity (54.8%) followed by high blood pressure (54.5%) and FPG (54.2%).TAJ 2016; 29(2): 6-10

Cardiovascular Prognosis in Drug-Resistant Hypertension Stratified by 24-Hour Ambulatory Blood Pressure: The JAMP Study

Hypertension ◽  
2021 ◽  
Author(s):  
Kazuomi Kario ◽  
Satoshi Hoshide ◽  
Keisuke Narita ◽  
Yukie Okawara ◽  
Hiroshi Kanegae ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Ambulatory Blood Pressure ◽  
Resistant Hypertension ◽  
Cardiovascular Events ◽  
Atherosclerotic Cardiovascular Disease ◽  
Artery Disease

Resistant hypertension is an important cardiovascular risk factor. This analysis of the JAMP study (Japan Ambulatory Blood Pressure Monitoring Prospective) data investigated the effects of uncontrolled resistant hypertension diagnosed using ambulatory blood pressure (BP) monitoring on the risk of heart failure (HF) and overall cardiovascular events. The JAMP study patients with hypertension and no HF history were included. They had true resistant hypertension (24-hour BP ≥130/80 mm Hg), pseudoresistant hypertension (24-hour BP <130/80 mm Hg), well-controlled nonresistant hypertension (24-hour BP <130/80 mm Hg), or uncontrolled nonresistant hypertension (24-hour BP ≥130/80 mm Hg). The primary end point was total cardiovascular events, including atherosclerotic cardiovascular disease (fatal/nonfatal stroke and fatal/nonfatal coronary artery disease), and HF. During 4.5±2.4 years of follow-up the overall incidence per 1000 person-years was 10.1 for total cardiovascular disease, 4.1 for stroke, 3.5 for coronary artery disease, and 2.6 for HF. The adjusted risk of total cardiovascular and HF events was significantly increased in patients with true resistant versus controlled nonresistant hypertension (hazard ratio, 1.66 [95% CI, 1.12–2.48]; P =0.012 and 2.24 [95% CI, 1.17–4.30]; P =0.015, respectively) and versus uncontrolled nonresistant hypertension (1.51 [1.03–2.20]; P =0.034 and 3.03 [1.58–5.83]; P <0.001, respectively). The findings were robust in a sensitivity analysis using a slightly different definition of resistant hypertension. True resistant hypertension diagnosed using ambulatory BP monitoring is a significant independent risk factor for cardiovascular disease events, especially for HF. This highlights the importance of diagnosing and effectively treating resistant hypertension. Registration: URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000020377.

Abstract 5276: Sumoylation Of Klf5 Is A Molecular Switch Regulating Ppar-δ-containing Transcriptional Programs Of Lipid Metabolism

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Yumiko Oishi ◽  
Ichiro Manabe ◽  
Kazuyuki Tobe ◽  
Takashi Kadowaki ◽  
Ryozo Nagai
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Lipid Metabolism ◽  
Cardiovascular Diseases ◽  
Transcriptional Control ◽  
Uncoupling Protein ◽  
Molecular Switch ◽  
Atherosclerotic Cardiovascular Disease ◽  
Transcriptional Regulatory ◽  
Reporter Assays

Metabolic syndrome is increasingly recognized as a major risk factor for cardiovascular disease. We have previously shown that a zinc finger transcription factor, Krüppel-like factor 5 (KLF5), plays an important role in cardiovascular diseases, such as atherosclerosis and cardiac hypertrophy. Interestingly, KLF5 is also expressed in metabolic tissues, such as adipose tissue, skeletal muscle and pancreatic β-cells. Moreover, we found that KLF5 is crucial for adipocyte differentiation. Therefore, it is very likely that KLF5 plays multiple roles in development and progression of metabolic syndrome and its cardiovascular and metabolic consequences including atherosclerotic cardiovascular disease. Indeed, KLF5 heterozygous knockout ( KLF5 +/− ) mice were resistant to high-fat-induced obesity and metabolic syndrome, despite consuming more food than wild-type mice. This appears to in part reflect their enhanced energy expenditure. Expression of the genes involved in lipid oxidation and energy uncoupling, including uncoupling protein (UCP) and carnitine-palmitoyl transferase 1b (CPT1b) was upregulated in the soleus muscles of KLF5 +/− mice. KLF5 could be reversibly modified by small ubiquitin-like modifier 1 (SUMO1), after which SUMOylated KLF5 strongly inhibited CPT1b , UCP3 and UCP2 promoter activity. Results of chromatin immunoprecipitation, two-hybrid, and reporter assays showed that under basal conditions SUMOylated KLF5 associated with transcriptionally repressive regulatory complexes containing unliganded PPARδ and corepressors. However, upon agonist stimulation of PPARδ, the deSUMOylating enzyme was recruited and KLF5 was deSUMOylated. The unSUMOylated KLF5 now formed transactivating complexes with liganded PPARδ and CBP. Thus, SUMOylation appears to be a molecular switch affecting function of KLF5 and the transcriptional regulatory programs governing lipid metabolism. Moreover, KLF5 is essential for the PPARδ agonist-dependent transcriptional control. Results of the present study have established KLF5 as a novel key molecule in lipid metabolism and suggest that the posttranscriptional modification of KLF5 is an attractive novel therapeutic target for both metabolic and cardiovascular diseases.

scholarly journals Patterns of Circadian Variation in 24-Hour Ambulatory Blood Pressure, Heart Rate, and Sympathetic Tone Correlate with Cardiovascular Disease Risk: A Cluster Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Myung Han Hyun ◽  
Jun Hyuk Kang ◽  
Sunghwan Kim ◽  
Jin Oh. Na ◽  
Cheol Ung Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Time Series ◽  
Circadian Variation ◽  
Sympathetic Tone ◽  
Atherosclerotic Cardiovascular Disease ◽  
Metabolic Factors ◽  
Multiple Variables ◽  
Ascvd Risk

To investigate whether specific time series patterns for blood pressure (BP), heart rate (HR), and sympathetic tone are associated with metabolic factors and the 10-year risk of atherosclerotic cardiovascular disease (ASCVD). A total of 989 patients who underwent simultaneous 24-hour ambulatory BP and Holter electrocardiogram monitoring were enrolled. The patients were categorized into sixteen groups according to their circadian patterns using the consensus clustering analysis method. Metabolic factors, including cholesterol profiles and apolipoprotein, were compared. The 10-year ASCVD risk was estimated based on the Framingham risk model. Overall, 16 significant associations were found between the clinical variables and cluster groups. Age was commonly associated with all clusters in systolic BP (SBP), diastolic BP (DBP), HR, and sympathetic tone. Metabolic indicators, including diabetes, body mass index, total cholesterol, high-density lipoprotein, and apolipoprotein, were associated with the four sympathetic tone clusters. In the crude analysis, the ASCVD risk increased incrementally from clusters 1 to 4 across SBP, DBP, HR, and sympathetic tone. After adjustment for multiple variables, however, only sympathetic tone clusters 3 and 4 showed a significantly high proportion of patients at high risk (≥7.5%) of 10-year ASCVD (odds ratio OR=5.90, 95% confidential interval CI=1.27–27.46, and P value = 0.024 and OR=15.28, 95% CI=3.59–65.11, and P value < 0.001, respectively). Time series patterns of BP, HR, and sympathetic tone can serve as an indicator of aging. Circadian variations in sympathetic tone can provide prognostic information about patient metabolic profiles and indicate future ASCVD risk.

scholarly journals Utilizing Animal Models of Infantile Spasms

2018 ◽  
Vol 18 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Chris G. Dulla
Keyword(s):  
Animal Models ◽  
Adverse Effects ◽  
Early Life ◽  
Improve Patient Care ◽  
Epileptic Encephalopathy ◽  
Infantile Spasms ◽  
Critical Component ◽  
Improve Patient ◽  
Review Current ◽  
New Strategies

Infantile spasms are a devastating epileptic encephalopathy characterized by early life spasms and later seizures. Clinical outcomes of infantile spasms are poor and therapeutic options are limited with significant adverse effects. Therefore, new strategies to treat infantile spasms are of the utmost importance. Animals models of infantile spasms are a critical component of developing new therapies. Here, we review current chronic animal models of infantile spasms and consider future advances that may help improve patient care, as well as our scientific understanding of this debilitating disease.

scholarly journals Metabolic syndrome in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a post hoc analyses of the EMPA-REG OUTCOME trial

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
João Pedro Ferreira ◽  
Subodh Verma ◽  
David Fitchett ◽  
Anne Pernille Ofstad ◽  
Sabine Lauer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Trial Registration ◽  
World Health ◽  
Atherosclerotic Cardiovascular Disease ◽  
Renal Outcomes ◽  
Outcome Trial

Abstract Background Patients with type 2 diabetes (T2D) and metabolic syndrome (MetS) are at greater cardiovascular risk than those with T2D without MetS. In the current report we aim to study the characteristics, cardio-renal outcomes and the effect of empagliflozin in patients with MetS enrolled in the EMPA-REG OUTCOME trial. Methods A total of 7020 patients with T2D and atherosclerotic cardiovascular disease were treated with empagliflozin (10 mg or 25 mg) or placebo for a median of 3.1 years. The World Health Organization MetS criteria could be determined for 6985 (99.5%) patients. We assessed the association between baseline MetS and multiple cardio-renal endpoints using Cox regression models, and we studied the change in the individual component over time of the MetS using mixed effect models. Results MetS at baseline was present in 5740 (82%) patients; these were more often white and had more often albuminuria and heart failure, had lower eGFR and HDL-cholesterol, and higher blood pressure, body mass index, waist circumference, and triglycerides. In the placebo group, patients with MetS had a higher risk of all outcomes including cardiovascular death: HR = 1.73 (95% CI 1.01–2.98), heart failure hospitalization: HR = 2.64 (95% CI 1.22, 5.72), and new or worsening nephropathy: HR = 3.11 (95% CI 2.17–4.46). The beneficial effect of empagliflozin was consistent on all cardio-renal outcomes regardless of presence of MetS. Conclusions A large proportion of the EMPA-REG OUTCOME population fulfills the criteria for MetS. Those with MetS had increased risk of adverse cardio-renal outcomes. Compared with placebo, empagliflozin improved cardio-renal outcomes in patients with and without MetS. Trial registration Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT 01131676

scholarly journals Relevance of a Hypersaline Sodium-Rich Naturally Sparkling Mineral Water to the Protection against Metabolic Syndrome Induction in Fructose-Fed Sprague-Dawley Rats: A Biochemical, Metabolic, and Redox Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-17 ◽  
Author(s):  
Cidália Dionísio Pereira ◽  
Milton Severo ◽  
João Ricardo Araújo ◽  
João Tiago Guimarães ◽  
Diogo Pestana ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Mineral Water ◽  
Tap Water ◽  
Magnesium Content ◽  
Atherosclerotic Cardiovascular Disease ◽  
Sprague Dawley ◽  
The Metabolic Syndrome ◽  
Sprague Dawley Rats ◽  
Calcium And Magnesium

The Metabolic Syndrome increases the risk for atherosclerotic cardiovascular disease and type 2 Diabetes Mellitus. Increased fructose consumption and/or mineral deficiency have been associated with Metabolic Syndrome development. This study aimed to investigate the effects of 8 weeks consumption of a hypersaline sodium-rich naturally sparkling mineral water on 10% fructose-fed Sprague-Dawley rats (Metabolic Syndrome animal model). The ingestion of the mineral water (rich in sodium bicarbonate and with higher potassium, calcium, and magnesium content than the tap water used as control) reduced/prevented not only the fructose-induced increase of heart rate, plasma triacylglycerols, insulin and leptin levels, hepatic catalase activity, and organ weight to body weight ratios (for liver and both kidneys) but also the decrease of hepatic glutathione peroxidase activity and oxidized glutathione content. This mineral-rich water seems to have potential to prevent Metabolic Syndrome induction by fructose. We hypothesize that its regular intake in the context of modern diets, which have a general acidic character interfering with mineral homeostasis and are poor in micronutrients, namely potassium, calcium, and magnesium, could add surplus value and attenuate imbalances, thus contributing to metabolic and redox health and, consequently, decreasing the risk for atherosclerotic cardiovascular disease.

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