DOCSLIB.ORG

Cardiovascular Disease: Hypertension , Congestive Heart Failure and Angina

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cardiovascular Disease: Hypertension , Congestive Heart Failure and Angina Cardiovascular Disease: Hypertension , Congestive Heart Failure and Angina Toni Benton MD ---------------------------------------------------------- High Blood Pressure (Hypertension) Definition Blood pressure is a measurement of the pressure your blood exerts against the artery walls. Introduction High blood pressure occurs when the pressure of your blood against the artery walls is higher than normal. As your heart pumps out oxygen rich blood, the pressure in your arteries rises. Between heartbeats, the pressure drops back down. The pressure when the heart contracts is called the systolic pressure; this is the first number in the blood pressure reading. The pressure between beats, when the heart relaxes, is called the diastolic pressure. This is the second number in the blood pressure reading. If your blood pressure is consistently 140/90 or higher, you have high blood pressure. Most people with high blood pressure have no symptoms. Despite what a lot of people think, high blood pressure does not make you dizzy, nervous, or tense. Untreated high blood pressure can lead to stroke, heart disease or heart attack, or kidney failure. High blood pressure is very common; more than half of all older people have high blood pressure. Other persons who may be at increased risk include people who smoke, African Americans, those who are overweight, and people with a family history of high blood pressure. Diagnosis The blood pressure is measured by putting a blood pressure cuff around the arm, inflating the cuff, and listening for the flow of blood as the cuff is deflated. The normal blood pressure readings are 135/ 85 or lower. If the blood pressure is over 140/90, the diagnosis of high blood pressure, or hypertension can be made. The healthcare provider usually will make the diagnosis of high blood pressure when the blood pressure readings are consistently over 140/90; usually the criteria are high readings on three separate occasions. Your doctor may do lab tests to rule out treatable causes of high blood pressure. Essential hypertension (or primary hypertension) refers to high blood pressure in which the physician is unable to identify a specific cause. This is the most common type of high blood pressure, occurring in up to 95% of patients. Secondary hypertension has a recognizable cause-usually treatable or reversible, but these are rare causes, and your doctor will consider these in appropriate circumstances. These causes include kidney disease, thyroid problems, pregnancy, Cushing’s syndrome(a rare problem in which the body has too much of a hormone called cortisol), coarctation of the aorta( a narrowing of the large blood vessel that carries blood out of the heart to the body), cirrhosis (liver disease), sleep apnea (Link to sleep apnea), and pheochromocytoma (a rare type of tumor the produces a chemical similar to adrenaline, causing high blood pressure). Certain medications, including birth control pills, decongestants and nonsteroidal anti-inflammatory pain medications can cause or contribute to hypertension. Continuum of Care 2350 Alamo Avenue SE, Suite 155 Albuquerque, NM 87106 505.925.2350 Fax 505.925.2389 hsc.unm.edu/som/coc Treatment Many types of medicines are available to treat high blood pressure; these are called antihypertensive medications. The ideal situation is to lower the blood pressure to less than 135/85 with medicine that is easy to take and with as few side effects as possible. There are other things you can do to help lower your blood pressure besides medicines. Don’t smoke; nicotine constricts the arteries and raises the blood pressure. Avoid cocaine and other drugs that can affect your heart. If you are overweight, losing weight will help lower your blood pressure; regular exercise is a good way to bring down the blood pressure, and exercise is beneficial in helping to lower the blood pressure on its own. Limit your alcohol consumption to no more than 1-2 drinks per day. In some people, alcohol can raise blood pressure; these people should avoid alcohol altogether. Not everyone is affected by sodium (salt), but sodium can increase blood pressure in some people. Most people who have high blood pressure should limit the sodium they eat each day to less than 2,300 mg. Don't add salt to your food. Check food labels for sodium. If your blood pressure can only be controlled with medicine, you'll most likely need to take the medicine for the rest of your life. Don't stop taking the medicine without talking with your family doctor. If you do, you raise your risk of having a stroke or heart attack. Types of antihypertensive drugs: - Diuretics- help your body to get rid of extra sodium and fluid so your blood vessels don’t have to hold so much fluid. - Vasodilators-expand the blood vessels. - Beta blockers- these drugs block the effects of adrenaline, which eases the force of the heart’s pumping action, slows the pulse (heart) rate and decreases the tension in the arterial walls. - Alpha blockers-relax the blood vessels to help them stay open. - Calcium channel blockers-prevent the blood vessels from constricting by blocking calcium from entering your cells. - ACE inhibitors-decrease the production of angiotensin II, a chemical produced in the body that causes the blood vessels to constrict. - Angiotensin receptor blockers-These drugs prevent the action of angiotensin II by blocking the angiotensin II from entering the cells. Emergency Situations – What can go wrong? Hypertensive Crisis High blood pressure becomes an emergency when it is causing damage to the affected organs of the body. (i.e., brain, heart, kidneys). A person who has a severely elevated blood pressure (more than 200/120) whether they have signs of organ damage or not, requires urgent treatment of their high blood pressure, but not usually admission to the hospital. The decision to admit a patient to the hospital is not always based on the blood pressure reading, but the body’s response to the elevated blood pressure. A person who has a sudden increase in blood pressure may not tolerate the rise, whereas a person with chronically high blood pressure may be able to tolerate a very high blood pressure. Symptoms of hypertensive crisis can include headache, dizziness, blurred vision, chest pain, heart palpitations (a feeling of fluttering or rapid heart beat), or shortness of breath. The health care provider will evaluate a patient with very high blood pressure reading or symptoms of hypertensive crisis for any signs of damage to the brain, heart or kidneys. Continuum of Care 2350 Alamo Avenue SE, Suite 155 Albuquerque, NM 87106 505.925.2350 Fax 505.925.2389 hsc.unm.edu/som/coc Emergencies Caused by the Long Term Effects of High Blood Pressure Aneurysm/ stroke If hypertension is not detected and treated, life- threatening complications can develop over a course of years. High pressure, over time can make the arteries more vulnerable to build up of fatty deposits, and cause a condition called atherosclerosis. This condition in an artery in the brain can cause a stroke. Weakened portions of an artery wall can balloon out, and form an aneurysm. If an aneurysm ruptures, internal bleeding will occur. If this happens to an artery in the brain, stroke can occur. (link to stroke) Aneurysms and atherosclerosis can affect other parts of the body as well. Aortic Aneurysm An aneurysm that develops in the large artery that carries blood out of the heart, the aorta, can rupture, or pop, causing severe internal bleeding, and death. Symptoms of aortic aneurysm rupture depend on the part of the aorta that is bleeding. Excruciating pain in the front part of the chest if the upper part of the aorta is bleeding, or pain in the abdomen that migrates to the back if the lower part of the aorta is bleeding. If the top portion of the aorta is affected, pain can be in the neck, jaw or teeth. Sometimes the pain is described as much worse with each heartbeat. Heart Failure The heart has to work harder to pump against high pressure, causing the heart to become enlarged. An enlarged heart is not very good at pumping blood around the body, and this can lead to heart failure. Conclusion High blood pressure is a serious disease, usually with no symptoms. It is called the silent killer. If high blood pressure is not detected and treated, long-term damage can result, leading to deadly complications. High blood pressure can cause heart disease, eye disease, aneurysms, stroke, and kidney failure. With proper treatment, these complications can be prevented. Congestive Heart Failure Definition Blood pressure is a measurement of the pressure your blood exerts against the artery walls. Introduction Congestive Heart Failure does not mean that the heart has completely failed, but that the heart is not able to pump as strongly as it needs to, in order to keep up with the body’s need for oxygen and nutrients. When the heart has been damaged by heart disease, long standing high blood pressure, complications of diabetes, disease of the heart valves or heart attack, it no longer pumps effectively. The reduction in the ability to pump blood to the body has a predictable effect on the body. There are three types of heart failure, depending on which side of the heart is weak: left-sided heart failure, right –sided heart failure, and biventricular failure (both left and right sides are weak.) The left side of the heart pumps blood containing oxygen taken from the lungs to the cells of the body. When the body has used the oxygen in the blood, it returns to the heart. The right side of the heart then pumps the oxygen poor blood to the lungs to get a fresh load of oxygen.
Load more

Recommended publications
  • J Wave and Cardiac Death in Inferior Wall Myocardial Infarction
    ORIGINAL ARTICLES Arrhythmia 2015;16(2):67-77 J Wave and Cardiac Death in Inferior Wall Myocardial Infarction Myung-Jin Cha, MD; Seil Oh, MD, ABSTRACT PhD, FHRS Background and Objectives: The clinical significance of J wave Department of Internal Medicine, Seoul National University presentation in acute myocardial infarction (AMI) patients remains Hospital, Seoul, Korea unclear. We hypothesized that J wave appearance in the inferior leads and/or reversed-J (rJ) wave in leads V1-V3 is associated with poor prognosis in inferior-wall AMI patients. Subject and Methods: We enrolled 302 consecutive patients with inferior-wall AMI who were treated with percutaneous coronary in- tervention (PCI). Patients were categorized into 2 groups based on electrocardiograms before and after PCI: the J group (J waves in in- ferior leads and/or rJ waves in leads V1-V3) and the non-J group (no J wave in any of the 12 leads). We compared patients with high am- plitude (>2 mV) J or rJ waves (big-J group) with the non-J group. The cardiac and all-cause mortality at 6 months and post-PCI ventricular arrhythmic events ≤48 hours after PCI were analyzed. Results: A total of 29 patients (including 19 cardiac death) had died. Although all-cause mortality was significantly higher in the post-PCI J group than in the non-J group (p=0.001, HR=5.38), there was no difference between the groups in cardiac mortality. When compar- ing the post-PCI big-J group with the non-J group, a significant dif- ference was found in all-cause mortality (n=29, p=0.032, HR=5.4) and cardiac mortality (n=19, p=0.011, HR=32.7).
    [Show full text]
  • The Pulmonary Manifestations of Left Heart Failure*
    The Pulmonary Manifestations of Left Heart Failure* Brian K. Gehlbach, MD; and Eugene Geppert, MD Determining whether a patient’s symptoms are the result of heart or lung disease requires an understanding of the influence of pulmonary venous hypertension on lung function. Herein, we describe the effects of acute and chronic elevations of pulmonary venous pressure on the mechanical and gas-exchanging properties of the lung. The mechanisms responsible for various symptoms of congestive heart failure are described, and the significance of sleep-disordered breathing in patients with heart disease is considered. While the initial clinical evaluation of patients with dyspnea is imprecise, measurement of B-type natriuretic peptide levels may prove useful in this setting. (CHEST 2004; 125:669–682) Key words: Cheyne-Stokes respiration; congestive heart failure; differential diagnosis; dyspnea; pulmonary edema; respiratory function tests; sleep apnea syndromes Abbreviations: CHF ϭ congestive heart failure; CSR-CSA ϭ Cheyne-Stokes respiration with central sleep apnea; CPAP ϭ continuous positive airway pressure; Dlco ϭ diffusing capacity of the lung for carbon monoxide; DM ϭ membrane conductance; FRC ϭ functional residual capacity; OSA ϭ obstructive sleep apnea; TLC ϭ total lung ϭ ˙ ˙ ϭ capacity; VC capillary volume; Ve/Vco2 ventilatory equivalent for carbon dioxide early 5 million Americans have congestive heart For a detailed review of the pathophysiology of N failure (CHF), with 400,000 new cases diag- high-pressure pulmonary edema, the reader is re- nosed each year.1 Unfortunately, despite the consid- ferred to several excellent recent reviews.2–4 erable progress that has been made in understanding the pathophysiology of pulmonary edema, the pul- monary complications of this condition continue to The Pathophysiology of Pulmonary challenge the bedside clinician.
    [Show full text]
  • J Wave Syndromes
    Review Article http://dx.doi.org/10.4070/kcj.2016.46.5.601 Print ISSN 1738-5520 • On-line ISSN 1738-5555 Korean Circulation Journal J Wave Syndromes: History and Current Controversies Tong Liu, MD1, Jifeng Zheng, MD2, and Gan-Xin Yan, MD3,4 1Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, 2Department of cardiology, The Second Hospital of Jiaxing, Jiaxing, China, 3Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, Pennsylvania, USA, 4The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China The concept of J wave syndromes was first proposed in 2004 by Yan et al for a spectrum of electrocardiographic (ECG) manifestations of prominent J waves that are associated with a potential to predispose affected individuals to ventricular fibrillation (VF). Although the concept of J wave syndromes is widely used and accepted, there has been tremendous debate over the definition of J wave, its ionic and cellular basis and arrhythmogenic mechanism. In this review article, we attempted to discuss the history from which the concept of J wave syndromes (JWS) is evolved and current controversies in JWS. (Korean Circ J 2016;46(5):601-609) KEY WORDS: Brugada syndrome; Sudden cardiac death; Ventricular fibrillation. Introduction History of J wave and J wave syndromes The concept of J wave syndromes was first proposed in 2004 The J wave is a positive deflection seen at the end of the QRS by Yan et al.1) for a spectrum of electrocardiographic (ECG) complex; it may stand as a distinct “delta” wave following the QRS, manifestations of prominent J waves that are associated with a or be partially buried inside the QRS as QRS notching or slurring.
    [Show full text]
  • Unstable Angina with Tachycardia: Clinical and Therapeutic Implications
    Unstable angina with tachycardia: Clinical and therapeutic implications We prospectively evaluated 19 patients with prolonged chest pain not evolving to myocardiai infarction and accompanied with reversible ST-T changes and tachycardia (heart rate >lOO beats/min) in order to correlate heart rate reduction with ischemic electrocardiographic (ECG) changes. Fourteen patients (74%) received previous long-term combined treatment with nifedipine and nitrates. Continuous ECG monitoring was carried out until heart rate reduction and at least one of the following occurred: (1) relief of pain or (2) resolution of ischemic ECG changes. The study protocol consisted of carotid massage in three patients (IS%), intravenous propranolol in seven patients (37%), slow intravenous amiodarone infusion in two patients (lo%), and intravenous verapamil in four patients (21%) with atrial fibrillation. In three patients (16%) we observed a spontaneous heart rate reduction on admission. Patients responded with heart rate reduction from a mean of 126 + 10.4 beats/min to 64 k 7.5 beats/min (p < 0.005) and an ST segment shift of 4.3 k 2.13 mm to 0.89 k 0.74 mm (p < 0.005) within a mean interval of 13.2 + 12.7 minutes. Fifteen (79%) had complete response and the other four (21%) had partial relief of pain. A significant direct correlation was observed for heart rate reduction and ST segment deviation (depression or elevation) (f = 0.7527 and 0.8739, respectively). These patients represent a unique subgroup of unstable angina, in which the mechanism responsible for ischemia is excessive increase in heart rate. Conventional vasodilator therapy may be deleterious, and heart rate reduction Is mandatory.
    [Show full text]
  • Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults the U.S
    Understanding Task Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The U.S. Preventive Services Task Force (Task The Task Force reviewed the use of ABI to screen for Force) has issued a final recommendation statement PAD and to predict a person’s risk of heart attacks on Screening for Peripheral Artery Disease (PAD) and stroke. The final recommendation statement and Cardiovascular Disease (CVD) Risk Assessment summarizes what the Task Force learned about with Ankle Brachial Index (ABI) in Adults. the potential benefits and harms of this screening: There is not enough evidence to judge the benefits This final recommendation statement applies to and harms of using ABI for this purpose. adults who do not have signs or symptoms of PAD and who have not been diagnosed with PAD, CVD, This fact sheet explains the recommendation and severe chronic kidney disease, or diabetes. what it might mean for you. PAD is a disease in which fatty deposits called plaque build up in What is peripheral the arteries, especially those in the legs. Over time, the plaque can block the flow of blood to the legs often artery disease? leading to pain with walking. What is Cardiovascular disease affects the heart and blood vessels. It is caused by a build up of plaque in arteries that supply the heart, brain, and cardiovascular other parts of the body. When the build up is in the legs it is called disease? PAD. Heart attacks and strokes are other common types of CVD. Facts About CVD and PAD Cardiovascular disease is the leading killer of both men and women in the United States.
    [Show full text]
  • Cardiovascular Disease and Rehab
    EXERCISE AND CARDIOVASCULAR ! CARDIOVASCULAR DISEASE Exercise plays a significant role in the prevention and rehabilitation of cardiovascular diseases. High blood pressure, high cholesterol, diabetes and obesity can all be positively affected by an appropriate and regular exercise program which in turn benefits cardiovascular health. Cardiovascular disease can come in many forms including: Acute coronary syndromes (coronary artery disease), myocardial ischemia, myocardial infarction (MI), Peripheral artery disease and more. Exercise can improve cardiovascular endurance and can improve overall quality of life. If you have had a cardiac event and are ready to start an appropriate exercise plan, Cardiac Rehabilitation may be the best option for you. Please call 317-745-3580 (Danville Hospital campus), 317-718-2454 (YMCA Avon campus) or 317-456-9058 (Brownsburg Hospital campus) for more information. SAFETY PRECAUTIONS • Ask your healthcare team which activities are most appropriate for you. • If prescribed nitroglycerine, always carry it with you especially during exercise and take all other medications as prescribed. • Start slow and gradually progress. If active before event, fitness levels may be significantly lower – listen to your body. A longer cool down may reduce complications. • Stop exercising immediately if you experience chest pain, fatigue, or labored breathing. • Avoid exercising in extreme weather conditions. • Drink plenty of water before, during, and after exercise. • Wear a medical identification bracelet, necklace, or ID tag in case of emergency. • Wear proper fitting shoes and socks, and check feet after exercise. STANDARD GUIDELINES F – 3-5 days a week. Include low weight resistance training 2 days/week I – 40-80% of exercise capacity using the heart rate reserve (HRR) (220-age=HRmax; HRmax-HRrest = HRR) T – 20-60mins/session, may start with sessions of 5-15 mins if necessary T – Large rhythmic muscle group activities that are low impact (walking, swimming, biking) Get wellness tips to keep YOU healthy at HENDRICKS.ORG/SOCIAL..
    [Show full text]
  • The J Wave of the ECG. Concepts Compiled by Dr
    The J wave of the ECG. Concepts Compiled by Dr. Andrés R. Pérez Riera The J wave is a positive deflection in the ECG normal (present in 2%–14% of healthy individuals and is more prevalent in young males, particularly if athletic and African descent. Additionally, ERP is a common finding in young teen athletes (the prevalence in the athletic population rises to 20-90%.).1 In this population ERP in both inferior and lateral leads is more common (18.2%) than isolated inferior (9.1%) or lateral (8.2%) ERP. Young age might be a contributing factor in causing a more diffuse repolarization abnormality. 2 or pathological that occurs approximately (There is an overlap of ≈10 msec. 3) after the junction between the end of the QRS complex and the beginning of the ST segment, also known as the J point (junction point), QRS end, J-junction, ST0 [zero millisecond] or ST beginning to occur after the notch/slur or J wave 4. It is described as J deflection as slurring/lambda 5 or notching of the terminal portion of QRS complex. Currently, J waves, is defined as an elevation of the QRS-ST junction ≥1 mm either as QRS slurring or notching in at least 2 contiguous leads. Additionally, when it becomes more accentuated, it may appear as a small, R wave (R′) or ST segment elevation. The term J deflection or J-wave has been used to designate the formation of the wave produced when there is a large, prominent deviation of the J point from the baseline with two shapes: notching/spike-and- slurring/lambda 5 or dome 6 variety.
    [Show full text]
  • Percutaneous Mitral Valve Therapies: State of the Art in 2020 LA ACP Annual Meeting
    Percutaneous Mitral Valve Therapies: State of the Art in 2020 LA ACP Annual Meeting Steven R Bailey MD MSCAI, FACC, FAHA,FACP Professor and Chair, Department of Medicine Malcolm Feist Chair of Interventional Cardiology LSU Health Shreveport Professor Emeritus, UH Health San Antonio [email protected] SRB March 2020 Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the organization(s) listed below. Affiliation/Financial Relationship Company • Grant/Research Support • None • Consulting Fees/Honoraria • BSCI, Abbot DSMB • Intellectual Property Rights • UTHSCSA • Other Financial Benefit • CCI Editor In Chief SRB March 2020 The 30,000 Ft View Maria SRB March 2020 SRB March 2020 Mitral Stenosis • The most common etiology of MS is rheumatic fever, with a latency of approximately 10 to 20 years after the initial streptococcal infection. Symptoms usually appear in adulthood • Other etiologies are rare but include: congenital MS radiation exposure atrial myxoma mucopolysaccharidoses • MS secondary to calcific annular disease is increasingly seen in elderly patients, and in patients with advanced chronic kidney disease. SRB March 2020 Mitral Stenosis • Mitral stenosis most commonly results from rheumatic heart disease fusion of the valve leaflet cusps at the commissures thickening and shortening of the chordae calcium deposition within the valve leaflets • Characteristic “fish-mouth” or “hockey stick” appearance on the echocardiogram (depending on view) SRB March 2020 Mitral Stenosis: Natural History • The severity of symptoms depends primarily on the degree of stenosis. • Symptoms often go unrecognized by patient and physician until significant shortness of breath, hemoptysis, or atrial fibrillation develops.
    [Show full text]
  • Hypertension: Putting the Pressure on the Silent Killer
    HYPERTENSION: PUTTING THE PRESSURE ON THE SILENT KILLER MAY 2016 TABLEHypertension: putting OF the CONTENTS pressure on the silent killer Table of contents UNDERSTANDING HYPERTENSION AND THE LINK TO CARDIOVASCULAR DISEASE 2 Understanding hypertension and the link to cardiovascular disease THEThe social SOCIAL and economic AND impact ECONOMIC of hypertension IMPACT OF HYPERTENSION 3 Diagnosing and treating hypertension – what is out there? DIAGNOSINGChallenges to tackling hypertension AND TREATING HYPERTENSION – WHAT IS OUT THERE? 6 Opportunities and focus areas for policymakers CHALLENGES TO TACKLING HYPERTENSION 9 OPPORTUNITIES AND FOCUS AREAS FOR POLICYMAKERS 15 HYPERTENSION: PUTTING THE PRESSURE ON THE SILENT KILLER UNDERSTANDING HYPERTENSION AND THE LINK TO CARDIOVASCULAR DISEASE Cardiovascular disease (CVD), or heart disease, is the number one cause of death in the world. 80% of deaths due to CVD occur in countries and poor communities where health systems are weak, and CVD accounts for nearly half of the estimated US$500 billion annual lost economic output associated with noncommunicable diseases (NCDs) in low-income and middle-income countries. In 2012, CVD killed 17.5 million people – the equivalent of every 3 in 10 deaths.1 Of these 17 million deaths a year, over half – 9.4 million - are caused by complications in hypertension, also commonly referred to as raised or high blood pressure2. Hypertension is a risk factor for coronary heart disease and the single most important risk factor for stroke - it is responsible for at least 45% of deaths due to heart disease, and at least 51% of deaths due to stroke. High blood pressure is defined as a systolic blood pressure at or above 140 mmHg and/or a diastolic blood pressure at or above 90 mmHg.
    [Show full text]
  • Hypertension and Coronary Heart Disease
    Journal of Human Hypertension (2002) 16 (Suppl 1), S61–S63 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh Hypertension and coronary heart disease E Escobar University of Chile, Santiago, Chile The association of hypertension and coronary heart atherosclerosis, damage of arterial territories other than disease is a frequent one. There are several patho- the coronary one, and of the extension and severity of physiologic mechanisms which link both diseases. coronary artery involvement. It is important to empha- Hypertension induces endothelial dysfunction, exacer- sise that complications and mortality of patients suffer- bates the atherosclerotic process and it contributes to ing a myocardial infarction are greater in hypertensive make the atherosclerotic plaque more unstable. Left patients. Treatment should be aimed to achieve optimal ventricular hypertrophy, which is the usual complication values of blood pressure, and all the strategies to treat of hypertension, promotes a decrease of ‘coronary coronary heart disease should be considered on an indi- reserve’ and increases myocardial oxygen demand, vidual basis. both mechanisms contributing to myocardial ischaemia. Journal of Human Hypertension (2002) 16 (Suppl 1), S61– From a clinical point of view hypertensive patients S63. DOI: 10.1038/sj/jhh/1001345 should have a complete evaluation of risk factors for Keywords: hypertension; hypertrophy; coronary heart disease There is a strong and frequent association between arterial hypertension.8 Hypertension is frequently arterial hypertension and coronary heart disease associated to metabolic disorders, such as insulin (CHD). In the PROCAM study, in men between 40 resistance with hyperinsulinaemia and dyslipidae- and 66 years of age, the prevalence of hypertension mia, which are additional risk factors of atheroscler- in patients who had a myocardial infarction was osis.9 14/1000 men in a follow-up of 4 years.
    [Show full text]
  • Currentstateofknowledgeonaetiol
    European Heart Journal (2013) 34, 2636–2648 ESC REPORT doi:10.1093/eurheartj/eht210 Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases Downloaded from Alida L. P. Caforio1†*, Sabine Pankuweit2†, Eloisa Arbustini3, Cristina Basso4, Juan Gimeno-Blanes5,StephanB.Felix6,MichaelFu7,TiinaHelio¨ 8, Stephane Heymans9, http://eurheartj.oxfordjournals.org/ Roland Jahns10,KarinKlingel11, Ales Linhart12, Bernhard Maisch2, William McKenna13, Jens Mogensen14, Yigal M. Pinto15,ArsenRistic16, Heinz-Peter Schultheiss17, Hubert Seggewiss18, Luigi Tavazzi19,GaetanoThiene4,AliYilmaz20, Philippe Charron21,andPerryM.Elliott13 1Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences, University of Padua, Padova, Italy; 2Universita¨tsklinikum Gießen und Marburg GmbH, Standort Marburg, Klinik fu¨r Kardiologie, Marburg, Germany; 3Academic Hospital IRCCS Foundation Policlinico, San Matteo, Pavia, Italy; 4Cardiovascular Pathology, Department of Cardiological Thoracic and Vascular Sciences, University of Padua, Padova, Italy; 5Servicio de Cardiologia, Hospital U. Virgen de Arrixaca Ctra. Murcia-Cartagena s/n, El Palmar, Spain; 6Medizinische Klinik B, University of Greifswald, Greifswald, Germany; 7Department of Medicine, Heart Failure Unit, Sahlgrenska Hospital, University of Go¨teborg, Go¨teborg, Sweden; 8Division of Cardiology, Helsinki University Central Hospital, Heart & Lung Centre,
    [Show full text]
  • Hypertension, Cholesterol, and Aspirin with Cost Info
    Diabetes & Your Health High Blood Pressure & Diabetes Aspirin & Did you know as many as two out of three adults with Heart Health diabetes have high blood pressure? High blood pressure Studies have shown is a serious problem. It can raise your chances of stroke, that taking a low- heart attack, eye problems, and kidney disease. dose aspirin every Many people do not know they have high blood pressure day can lower the because they do not have any symptoms. That is why it risk for heart attack is often called “the silent killer.” and stroke. The only way to know if you have high blood pressure is Aspirin can help to have it checked. If you have diabetes, you should those who are at high have your blood pressure checked every time you see risk of heart attack, the doctor. People with diabetes should try to keep their such as people who blood pressure lower than 130 over 80. have diabetes or high blood pressure. Cholesterol & Diabetes Aspirin can also help Keeping your cholesterol and other blood fats, called lipids, under control can people with diabetes help you prevent diabetes problems. Cholesterol and blood lipids that are too who have already high can lead to heart attack and stroke. Many people with diabetes have had a heart attack or problems with their cholesterol and other lipid levels. a stroke, or who have heart disease. You will not know that your cholesterol and blood lipids are at dangerous levels unless you have a blood test to have them checked. Everyone with diabetes Taking an aspirin a should have cholesterol and other lipid levels checked at least once per year.
    [Show full text]