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- Małyszko, Jolanta, et al.
(författare)
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Do we know more about hypertension in Poland after the May Measurement Month 2017? - Europe
- 2019
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815. ; 21, s. 97-100
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Forskningsöversikt (refereegranskat)abstract
- Elevated blood pressure (BP) is a worldwide burden, leading to over 10 million deaths yearly. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for BP screening. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the globally approved MMM17 Study Protocol. In Poland 5834 (98.9%, Caucasian) individuals were screened. After multiple imputation, 2601 (35.3%) had hypertension. Of individuals not receiving anti-hypertensive medication, 976 (20.6%) were hypertensive. Of individuals receiving anti-hypertensive medication, 532 (49.1%) had uncontrolled BP. In the crude screened group, 81.4% declared to not receive any anti-hypertensive treatment, while the remaining 18.6% were on such medications. In overweight and obese patients both systolic and diastolic BP were significantly higher than in normal weight and underweight subjects. In addition, BP measured on Sundays was significantly lower than on Mondays. MMM17 was one of the largest recent BP screening campaigns in Poland. We found that over 1/3 of participants were hypertensive. Almost half of the treated subjects had uncontrolled BP. These results suggest that opportunistic screening can identify substantial numbers with raised BP.
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- Nieminen, Markku S., et al.
(författare)
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The potential of the inodilator levosimendan in maintaining quality of life in advanced heart failure
- 2017
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Ingår i: European Heart Journal, Supplement. - : OXFORD UNIV PRESS. - 1520-765X .- 1554-2815. ; 19:C, s. C15-C21
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Tidskriftsartikel (refereegranskat)abstract
- Maintaining adequate quality of life (QoL) is an important therapeutic objective for patients with advanced heart failure and, for some patients, may take precedence over prolonging life. Achieving good QoL in this context may involve aspects of patient care that lie outside the familiar limits of heart failure treatment. The inodilator levosimendan may be advantageous in this setting, not least because of its sustained duration of action, ascribed to a long-acting metabolite designated OR-1896. The possibility of using this drug in an outpatient setting is a notable practical advantage that avoids the need for patients to attend a clinic appointment. Intermittent therapy can be integrated into a wider system of outreach and patient monitoring. Practical considerations in the use of levosimendan as part of a palliative or end-of-life regimen focused on preserving QoL include the importance of starting therapy at low doses and avoiding bolus administration unless immediate effects are required and patients have adequate baseline arterial blood pressure.
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- Ricci, Fabrizio, et al.
(författare)
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Detection of inflammatory biomarkers associated with postural orthostatic tachycardia syndrome: insights from the SYSTEMA cohort
- 2018
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Ingår i: European Heart Journal, Supplement. - 1520-765X. ; 39:1, s. 889-889
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Konferensbidrag (refereegranskat)abstract
- Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a cardiovascular dysautonomic condition affecting predominantly young women. POTS is defined as the presence of chronic symptoms of orthostatic intolerance associated with an increased heart rate ≥30 bpm, or heart rate exceeding 120 bpm, within 10 minutes of standing or head-up tilt in the absence of orthostatic hypotension. The etiology is still unknown though autoimmunity has been hypothesized to play an important role. Purpose: To investigate whether an inflammatory biomarker signature is associated with POTS. Methods: We performed a cross-sectional study enrolling 475 patients aged between 15 and 55 years with unexplained syncope or symptoms of orthostatic intolerance. Of these 118 have been diagnosed with POTS and 357 controls demonstrated normal hemodynamic response during passive phase of HUT i.e. no orthostatic hypotension or POTS. A total of 318 patients provided supine blood plasma samples that were analyzed through the antibody-based Proximity Extension Assay technique, simultaneously measuring 53 inflammatory and cancer-related human protein biomarkers. After excluding 5 biomarkers with low call rate <65% (VEstatin, LITAF, MYD88, MICA, CEA) and 9 patients with missing data, the final study sample consisted of 309 patients (POTS, n=78; no POTS n=231). The discovery algorithm was a sequential two-step process of biomarker signature identification by multivariate principal component analysis (PCA), and verification by univariate ANOVA with Bonferroni correction. Results: POTS patients were younger (28 vs. 35 years; p<0.001) compared with controls. PCA and Bonferroni-adjusted ANOVA identified furin and FADD as the most robust targeted biomarker signature for POTS. The plasma concentration of furin was significantly lower (6.39 (0.5) vs 6.64 (0.4), p<0.001), whereas FADD levels were significantly higher (2.37 (0.72) vs 2.14 (0.69), p=0.01) in POTS patients compared with controls. In multivariable regression analysis, adjusting for age and sex, the results remained significant. Conclusion: Targeted protein profiling in POTS revealed a biomarker signature associated with immunoregulatory functions. Circulating levels of furin were downregulated, whereas circulating levels of FADD were elevated in POTS, suggesting the presence of a characteristic inflammatory signature in this unexplained condition.
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