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A clinical perspective on renal function in acute myocardial infarction reviews pathophysiology, prognostic markers, and management implications, including contrast nephropathy prevention and hemodynamic support.
Introduction Hypertension is a major cardiovascular risk factor. There is a strong relationship between blood pressure (BP) elevation and stroke, myocardial infarction, heart failure and mortality due to kidney disease. It is known that the loss of the dipping pattern in hypertension is associated with increased target organ damage. In our study, we aimed to investigate the prevalence of dipper hypertension (DHT) and nondipper hypertension (NDHT) and related factors in patients with stage 1 and 2 chronic kidney disease (CKD). Materials and Methods A total of 158 patients diagnosed with stage 1 or stage 2 CKD were included in the study. Demographic characteristics, anthropometric measurements, physical examination findings and laboratory results of the patients were recorded. Ambulatory BP monitoring was performed in all patients. Results Of the 158 patients (female n: 98), 78 (49%) were in the stage 1 CKD group and 80 (51%) were in the stage 2 CKD group. No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The rate of NDHT was 59.5% (94/158 patients). Female patients had more DHT in the general population and in the stage 1 group than male patients (p=0.05, p=0.01, respectively). Conclusion No significant difference was observed in the prevalence of DHT or NDHT between hypertensive patients in the stage 1 and 2 CKD groups. The prevalence of DHT in female patients was significantly higher in both groups than in men in both groups, but especially in the stage 1 CKD group.
In deaths and diseases attributed to tobacco smoke cardiovascular events exceed cancer and respiratory diseases. Second hand smoke promotes the development of arteriosclerosis and can trigger acute changes of endothelial function and blood coagulability. Indoor smoking bans reduced coronary syndrome and myocardial infarction 10-20% within one year and were followed by sustainable decreases of stroke and diabetes. With a smoke-free hospitality industry people recognized tobacco smoke as an air pollutant, smoking in public was denormalized and social acceptance of smoking in front of children and pregnant women decreased also in homes and cars. Combined effects with ambient air pollution are proven for active smoking and suspected for SHS. Contamination with third hand smoke (THS) persists for months in homes and cars, creating secondary pollutants that in some cases are more toxic (e.g. nitrosamines). Remnants found in air, dust, and on surfaces (carpets, wallpapers, upholstery, soft toys) were associated with their metabolites in saliva of children and in urine of nonsmokers residing in homes previously occupied by smokers. In animal experiments effects of THS were found on thrombogenesis, insulin resistance through oxidative stress, on the developing immune system, lipid metabolism and alterations in liver, lung, skin and behavior. Much less is known about health effects for bystanders from the aerosols exhaled during “vaping” of e-cigarettes, but nicotine and other toxins from e-cigarettes are certainly a hazard, which should be prevented by the use of dermal and oral nicotine products, which are safer for nicotine replacement and without risk for bystanders.
Background Hypertension is one of the most prevalent risk factors for myocardial infarction, strokes, congestive cardiac failure and chronic kidney disease (CKD)and its prevalence is significantly higher inthe elderly population. Objectives To assess the demography, various presentations and the prevalence of risk factors among elderly hypertensive patients followed up in a tertiary care hospital in Sri Lanka. Materials and Methods This was a cross sectional descriptive study involving 250 patients whoseage was 60 years or above onantihypertensives for at least 6 months. Results Approximately 65.2% of the study population was female. The mean age was 70.17.Dizziness and chest pain were the most prevalent symptoms.The mean age at first detection was 58.17 years.Mean SBP and DBP were 128.5mmHg and 81.14mmHg respectively. The prevalence of alcohol consumption and smoking among men were 70.1% and 72.4% respectively. Approximately 54.7% were either overweight or obese.Approximately 81.6% females and 41.4% males had a waist circumference ofmore than therisk level with p-value<0.05. Approximately 36% had diabetes mellitus and 27.6% of the patients had at least one parent and 36.8% had at least one sibling diagnosed with hypertension. Approximately 61.3% of the patients hadadequate levels of physical activity while 31.8% had IHD,11.5% had stroke and 3.8% had CKD. Conclusion Dizziness and chest pain were the most disturbing symptoms while abdominal obesity among females,and alcohol consumption and smoking among males were the major risk factors in elderly hypertensive patients
Background: Disorders of lipid metabolism are manifested by elevation of the plasma concentration of the various lipid and lipoprotein fractions and the result, predominantly cardiovascular diseases. Lipid research clinic’s coronary primary prevention trial has provided useful information on the reduction of plasma cholesterol level in hyperlipidemic subjects by diet and drug therapy and thus the reduction in risk of myocardial infarction and death. Conventional lipid lowering drugs are used for lowering lipid level. But in the last few years’ herbal drugs are gaining popularity in the management of hyperlipidemia. In this study we compare the hypolipidemic effect of MomordicaCharantia (MC) with atorvastatin, a commonly used hypolipidemic drug. Methods: The present experimental study was done in the pharmacology department of Dhaka Medical College during the period of July, 2011 to June, 2012. For this study a total number of 30 Norwegian rats of either sex were selected. They were divided into 5 groups each comprises of 6 rats. In the experiment group A was given normal diet with high fatty diet (1.5 ml olive oil plus 1% cholesterol) which was control group and other experimental groups (B,C,D,) were allowed to feed a high fatty diet along with fresh juice of MomordicaCharantia (in different doses) for 10 days. Another experimental group, E was given high fatty diet along with atorvastatin (0.14mg/kg/day) for 10 days. Rats were sacrificed on 11th day and blood was collected by cardiac puncture for estimation of serum lipid profile. Results: After administration of fatty diet in group A for 10 days, there was significant increased total cholesterol (TCL), low density lipoprotein (LDL) and triglyceride (TG) levels. Concomitant administration of fatty diet and fresh juice of MC (in different doses) daily for 10 days in group B,C,D reduced serum TCL, LDL and TG levels which was more significant in higher doses in comparison to atorvastatin given group E. Conclusion: The present study provides a rationale for use a new herbal medicine much needed for the reduction of serum lipid levels.MomordicaCharantia could be useful in hyperlipidemic conditions. They are as effective as a standard lipid lowering agent- atorvastatin.