High Heart Rate can Herald Cardiovascular Trouble
Large epidemiological studies have demonstrated that elevated heart rate is an independent risk factor for mortality and morbidity in healthy individuals with and without hypertension and in patients with coronary artery disease (CAD), myocardial infarction, and congestive heart failure.
Modern Medicine – Issue 3 2022
Neuro-modulation: A New Approach to HF
Heart failure (HF) is a complex clinical syndrome characterised by abnormalities in cardiac structure and function, dynamic remodelling, and perturbations of the neurohormonal axis. recently, the concept of neuro-modulation, rather than neuro-inhibition, has been successfully tested with the angiotensin receptor neprilysin inhibitor (arni) class representing a potential shift in the treatment of HF from partial neurohormonal system inhibition to an integrated composite neurohormonal system modulation.
Modern Medicine – Issue 6 2021
Controlling Triglycerides in Type 2 Diabetes Cuts CVD Risk
Hypertriglyceridaemia is a prevalent risk factor for cardiovascular disease (CVD) and increasingly important in the setting of current obesity and insulin resistance epidemics. Statins are the primary drug treatment option, however, trial data show substantial ‘residual risk’ in people with type 2 diabetes (T2D) who are on statin treatment. This indicates that preventative treatment with statins alone may not be enough in people with T2D and additional therapies, such as fibrates, may need to be considered.
Modern Medicine – Issue 6 2021
Low-dose Aspirin Reduces Pre-existing Vascular Disease
Aspirin reduces cardiovascular morbidity and mortality in patients with pre-existing vascular disease and is therefore widely prescribed for secondary prevention of cardiovascular events.
Modern Medicine – Issue 5 2021
ESC 2021 Heart Failure Guideline Update
The European Society of Cardiology recently released their 2021 updated guidelines for the diagnosis and treatment of acute and chronic heart failure. This article looks at the treatment of heart failure with reduced ejection fraction (HFrEF). The diagnosis of HFrEF requires the presence of symptoms and/or signs of heart failure (HF) and a reduced ejection fraction (LVEF ≤ 40%). Pharmacotherapy is the cornerstone of treatment for HFrEF and should be implemented before considering device therapy, and alongside non-pharmacological interventions.
Modern Medicine – Issue 5 2021
Fenofibrate is an Effective Tool in Dyslipidaemia
Increased risk of cardiovascular disease in type 2 diabetes is attributable in part to the high prevalence of associated risk factors including hypertension and diabetic dyslipidaemia, the latter characterised by elevated plasma triglyceride levels and low plasma levels of high-density lipoprotein cholesterol (HDL-C). Fibrates are used in patients with dyslipidaemia and high cardiovascular risk, where the greatest benefits of fenofibrate are seen among those with marked hypertriglyceridemia.
Modern Medicine – Issue 5 2021
Identifying Atrial Fibrillation Events Following Cryptogenic Stroke
In 20–40% of ischaemic strokes, a definitive cause is not identified, despite extensive evaluation1; this condition has been defined as ‘cryptogenic stroke.’ Atrial fibrillation (AF) is a well-known cause of ischaemic stroke and about 15% of strokes are attributable to a documented AF. Many strategies have been explored to improve detection of AF, ranging from in-hospital monitoring, serial electrocardiography and Holter monitoring and the use of external events (or loop recorders) or insertable cardiac monitors (ICM).
Modern Medicine – Issue 5 2021
Tackle LDL-C Targets to Cut CVD Risk
A wealth of evidence from both observational and large randomised controlled clinical trials (RCTs) supports the use of statins in a wide variety of patients with hypercholesterolaemia. The absolute benefit of treatment depends on the individual’s absolute risk of cardiovascular disease (CVD) and the absolute reduction of low-density lipoprotein cholesterol (LDL-C) achieved. Rosuvastatin, compared to atorvastatin, has demonstrated high efficacy for LDL-C lowering, enabling patients with hypercholesterolaemia to achieve their lipid goals.
Modern Medicine – Issue 4 2021
Fenofibrate Cuts Residual Risk in Statin Users
An elevated low-density lipoprotein cholesterol (LDL-C) level is a major risk factor for cardiovascular disease (CVD), and several randomised clinical trials have shown that lowering LDL-C levels with statins results in a substantial reduced CVD morbidity and mortality. However, a significant number of treated patients continue to experience events, despite targeting LDL-C levels according to current guidelines. Moreover, even upon high doses of statins, a substantial residual risk remains.
Modern Medicine – Issue 4 2021
Acute Stroke: Preventing stroke and managing complications
GPs are ideally placed to identify patients with modifiable risk factors for stroke and to institute prevention strategies, including lifestyle changes and antihypertensive and anticoagulation therapy when appropriate. GPs can also help reduce morbidity in stroke survivors through recognising and managing complications such as depression, sexual dysfunction and fatigue
Modern Medicine – Issue 4 2021
