MedWorm: Beta-Blockers

  Effects of Atenolol or Losartan on Fibrinolysis and von Willebrand Factor in Hypertensive Patients With Left Ventricular Hypertrophy

Conclusion: Losartan treatment was associated with preserved fibrinolytic balance compared to a more prothrombotic fibrinolytic and hemostatic state in the atenolol group. These findings suggest different fibrinolytic and hemostatic responses to treatment in hypertensive patients with LVH. (Source: Clinical and Applied Thrombosis/Hemostasis)

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  Review: Risks and benefits associated with beta-blocker prophylaxis in non-cardiac surgery

Source: Am J Health-Syst Pharm Area: News It is estimated that 4-6% of patients with cardiac disease or cardiac risk factors who undergo non-cardiac surgery (NCS) experience an MI, 0.5-1.0% have a stroke, and 2-3% die of cardiovascular or other causes. An exaggerated sympathetic response after NCS has been linked to an increased risk of myocardial ischemia and MI. Perioperative use of a beta-blocker has been shown to reduce myocardial ischemia in NCS patients and has been recommended by the American College of Cardiology and the American Heart Association. Trials including the PeriOperative Ischemic Evaluation (POISE) trial, the largest and most recent, suggest a trade-off between benefits and risks   In this article, the authors critique the key NCS trials and the two most recen...

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  Effective Reduction of Brown Fat FDG Uptake by Controlling Environmental Temperature Prior to PET Scan: an Expanded Case Series

Conclusion  In this larger series, CET effectively reduced the false-positive 18FDG uptake in BF on PET scans without the use of drugs. Content Type Journal ArticleCategory Research ArticleDOI 10.1007/s11307-010-0298-9Authors Carlos Garcia, Washington Hospital Center Division of Nuclear Medicine, Department of Medicine 110 Irving St, NW Washington DC 20010 USAVaralakshmi Bandaru, Washington Hospital Center Division of Nuclear Medicine, Department of Medicine 110 Irving St, NW Washington DC 20010 USADouglas Van Nostrand, Washington Hospital Center Division of Nuclear Medicine, Department of Medicine 110 Irving St, NW Washington DC 20010 USAShyam Chennupati, Washington Hospital Center Division of Nuclear Medicine, Department of Medicine 110 Irving St, NW Washington DC 20...

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  Lumigan 0.01% eye drops (bimatoprost) - New formulation

Source: Manufacturer notification Area: Other Library Updates > SPC Changes Allergan announced on 9th March that the European Medicines Agency (EMEA) has granted Marketing Authorisation for a new formulation of Lumigan (bimatoprost ophthalmic solution) 0.01%. Lumigan 0.01% is approved as first-line therapy for the reduction of elevated intraocular pressure (IOP) in adults with chronic open-angle glaucoma and ocular hypertension and is now available in the UK. Lumigan 0.01% is a once-daily prescription eye drop that delivers effective IOP-lowering results equivalent to those seen with Lumigan 0.03% with significantly improved tolerability. Lumigan 0.01% can be used as monotherapy or as an adjunctive therapy with beta-blockers. (Source: NeLM - SPC Changes)

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  [Severe circulatory insufficiency in a patient with neonatal hyperthyroidism.]

Authors: Szalóczi B, Harmath A, Pete B, Kovács E, Rigó J, Hajdú J Authors describe a case of a premature infant whose mother had a history of thyroidectomy due to Graves' disease and her hormonal status was not controlled during pregnancy. She did not receive prenatal care and on 33rd week the premature infant was delivered by emergency cesarean section because of fetal tachycardia and imminent intrauterine asphyxia. The infant with a weight of 1350 gram (percentile <10) was dysmature and had a large struma. The newborn received both conventional and high frequency ventilation for respiratory insufficiency and was treated with beta-blocker, digoxin and dobutamine for severe tachycardia (>180/min) and cardiac decompensation. Further examinations proved cardiome...

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  The effect of evidence-based medication use on long-term survival in patients hospitalised for heart failure in Western Australia.

CONCLUSION: ACE inhibitors/ARBs and beta-blockers, prescribed during initial hospitalisation for HF, are associated with improved long-term survival. Therapy became more evidence based over the study period, but echocardiography, an important predictor of evidence-based therapy, was underutilised. PMID: 20230346 [PubMed - in process] (Source: Med J Aust)

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  Blood pressure changes before stroke

Conclusion Professor Rothwell has presented a compelling argument in support of his theory that fluctuations in blood pressure may help to predict the risk of vascular events such as stroke. As mentioned in an accompanying editorial, it is important to point out that Professor Rothwell is not questioning the validity of using average blood pressure to predict risk, but is advocating also using variable blood pressure as a supplementary indicator of increased risk. As with all narrative reviews the research methods that the author used to identify evidence to support his theories are not definitively laid out. It is therefore not possible to carry out a full appraisal of this evidence. However, the systematic appraisal of data on blood pressure and stroke is a robust and standardised way of...

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  Adaptations of the Autonomous Nervous System Controlling Heart Rate Are Impaired by a Mutant Thyroid Hormone Receptor-{alpha}1.

Authors: Mittag J, Davis B, Vujovic M, Arner A, Vennström B Thyroid hormone has profound direct effects on cardiac function, but the hormonal interactions with the autonomic control of heart rate are unclear. Because thyroid hormone receptor (TR)-alpha1 has been implicated in the autonomic control of brown adipose energy metabolism, it might also play an important role in the central autonomic control of heart rate. Thus, we aimed to analyze the role of TRalpha1 signaling in the autonomic control of heart rate using an implantable radio telemetry system. We identified that mice expressing the mutant TRalpha1R384C (TRalpha1+m mice) displayed a mild bradycardia, which becomes more pronounced during night activity or on stress and is accompanied by a reduced expression of nucleotide-...

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  Changing patterns of secondary preventive medication among newly diagnosed coronary heart disease patients with diabetes in Finland: A register-based study.

CONCLUSIONS: beta-blocker use was constant and ACE inhibitor and angiotensin II antagonist use increased. Lipid-lowering medication use increased considerably after a health insurance reform in 2000, in which elevated reimbursement of drug costs (75%) was extended to include all CHD patients with hyperlipidaemia.Socioeconomic differences in medication use disappeared after the reform. However, lipid-lowering medication use remained at a lower level among men with diabetes, suggesting that their treatment did not follow guidelines. PMID: 20228159 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Public Health)

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  Beta blockers seen as underused before referral for ICD, clashing with guidelines

Perhaps a third of patients with systolic heart failure don't take any beta blockers, and many more don't take enough, in the three months before they receive a primary-prevention defibrillator,... For complete story visit theheart.org. (Source: theHeart.org)

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  Long-Term Survival of Routine Implantable Cardioverter/Defibrillator Recipients Appears to be Significantly Impaired with Concomitant Diuretics and Improved with Aldosterone Antagonists

Evidence-based treatment for heart failure (HF) comprises beta-blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone receptor antagonists (ARA). Diuretics (DR) are prescribed in acute and chronic HF, but their impact on survival and ventricular tachyarrhythmias (VT/VF) is unclear. The present observational study aims to examine the influence of DR and ARA on survival and appropriate cardioverter/defibrillator (ICD) treatment episodes in routine ICD patients. In 352 consecutive ICD patients (291 men, 60 ± 12 years, LVEF 34 ± 15%, follow-up 37 ± 19 months) overall survival and the time to a first appropriate VT/VF episode were assessed. Electrograms were validated. Potassium and creatinine serum levels and the medical treatment regimen for hear...

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  Chronic Heart Rate Reduction Facilitates Cardiomyocyte Survival After Myocardial Infarction.

In this study, we tested the hypothesis that cell survival within the infarct region was enhanced by these two pharmacological agents. Four weeks after ligating the left anterior descending coronary artery, the percentage of the LV that contained the infarct was similar in the untreated (MI) rats and those chronically treated with ivabradine (MI + IVA) or atenolol (MI + ATEN). However, the mean thickness (mm) of the ventricular wall containing the scar was significantly greater in the MI + IVA, 1.54 (P </= 0.01) and the MI + ATEN 1.32, compared to 1.1 in the MI group, due to a 2-fold greater area of surviving cardiomyocytes (P </= 0.01) in the treated rats compared to the untreated group. Regions of cell survival were usually in the subepicardium, with cardiomyocytes surrounding vein...

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  Risk factors for subject withdrawals in clinical trials evaluating glaucoma medications

Conclusions  Subject withdrawals from clinical trials for total administrative errors or AEs potentially might be reduced by choosing sites with lower historical rates of protocol violations or medication dispensing errors. Drug class choice also may influence subject withdrawals for AEs and poor IOP control. Content Type Journal ArticleCategory GlaucomaDOI 10.1007/s00417-010-1339-4Authors William C. Stewart, PRN Pharmaceutical Research Network, LLC Charleston SC USAChristina M. Demos, Charleston Research Company, LLC Charleston SC USAMeredith K. Turner, Charleston Research Company, LLC Charleston SC USAJeanette A. Stewart, PRN Pharmaceutical Research Network, LLC Charleston SC USA Journal Graefe's Archive for Clinical and Experimental OphthalmologyOnline ISSN...

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  Cocaine and beta-blockers: The paradigm.

This article explores the role of beta-blockers in the management of cocaine toxicity. PMID: 20206876 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

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  Propranolol therapy for infantile haemangiomas: Review of the literature

Conclusion: There is the obtain that propranolol will detach steroids in the therapy for infantile haemangiomas. (Source: International Journal of Pediatric Otorhinolaryngology)

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  Heart Failure: Beta Blockers Underused

(Ivanhoe Newswire) -- Heart failure patients may be putting their health at a disadvantage by not taking meds that could potentially take them off the surgery list. (Source: Medical Headlines From Ivanhoe.com)

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  Predictors of Early Mortality in Patients Age 80 and Older Receiving Implantable Defibrillators

Conclusion: In general, patients [ge] 80 years of age who meet current indications for ICD implantation live sufficiently long to warrant device implantation based on anticipated survival alone. However, those with an EF [le] 20% have a markedly elevated 1-year mortality with no observed increase in appropriate ICD therapy, thus reducing the benefit of device implantation in this population. (PACE 2010; 1[ndash]7) (Source: Pacing and Clinical Electrophysiology : PACE)

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  Cardiac Gap Junction Channels Are Upregulated by Metoprolol: An Unexpected Effect of Beta-Blockers

Pharmacology 2010;85:203–210 (DOI:10.1159/000276982) (Source: Karger Publishers)

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  Methylphenidate-induced impulsivity: pharmacological antagonism by {beta}-adrenoreceptor blockade

This article examined the relative roles of noradrenaline and dopamine in the modulation of methylphenidate-induced impulsive responding in rats performing the 5-choice serial reaction time task. Experiment 1 examined the systemic antagonism of methylphenidate-induced impulsivity with either propranolol, a β-adrenoreceptor blocker, or prazosin, an 1-adrenoreceptor antagonist, which antagonises the locomotor activating effects of amphetamine. Propranolol completely abolished methylphenidate-induced impulsivity. This effect was centrally rather than peripherally mediated, as nadolol, a peripheral β-blocker failed to affect methylphenidate-induced premature responding. Prazosin partially attenuated the methylphenidate-mediated increase in premature responding. A second experiment ex...

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  Propranolol transiently inhibits reinstatement of nicotine-seeking behaviour in rats

Noradrenergic transmission has been implicated in the affective component of relapse to tobacco smoking. Evidence in human and laboratory animals showed that smoking or nicotine administration may cause changes of the noradrenergic system resulting in hyperactivity in this system after cessation. It has been hypothesised that the anti-adrenergic β-blocker propranolol may decrease affective activation and arousal observed during drug withdrawal or cue-induced relapse. The aim of the present work was to test the effects of propranolol pre-treatment in a rat model of nicotine cue-induced relapse to nicotine seeking. We also tested the effects of propranolol on food cue-induced reinstatement of food seeking in rats trained on food self-administration. Propranolol transiently inhibited nic...

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  Beta Blocker Therapy Underused In Heart Failure Patients

New Saint Louis University research has found that beta blockers, a class of drugs used to prevent the progression of heart failure and manage arrhythmias (irregular heart beat) and hypertension (high blood pressure), are underused in heart failure patients who receive implantable cardiac devices. Failure to take beta blockers prior to implanting a cardiac device can affect the patient's overall outcome and survival rate, says Paul Hauptman, M.D., SLUCare cardiologist and professor of internal medicine at Saint Louis University School of Medicine and lead author of the study... (Source: Health News from Medical News Today)

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  Beta Blocker Therapy Underused In Heart Failure Patients

New Saint Louis University research has found that beta blockers, a class of drugs used to prevent the progression of heart failure and manage arrhythmias (irregular heart beat) and hypertension (high blood pressure), are underused in heart failure patients who receive implantable cardiac devices... (Source: Cardiovascular / Cardiology News From Medical News Today)

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  Vulnerability to anemia may underlie beta-blocker peri-operative risk

The putative excess risk for certain peri-operative complications in patients given beta blockers may be caused by the drugs increasing patients’ vulnerability to the effects of anemia, research suggests. (Source: MedWire News - Anesthesiology)

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  Beta-Blocker Efficacy in High-Risk Patients with the Congenital Long-QT Syndrome Types 1 and 2: Implications for Patient Management

Conclusions: The present findings suggest that beta-blocker therapy should be routinely administered to all high-risk LQT1 and LQT2 patients without contraindications as a first line measure, whereas primary defibrillator therapy should be recommended for those who experience syncope during medical therapy. (J Cardiovasc Electrophysiol, Vol. pp. 1[ndash]9) (Source: Journal of Cardiovascular Electrophysiology)

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  Efficacy of Ivabradine in a Case of Inappropriate Sinus Tachycardia and Ventricular Dysfunction

We present a case of a 49-year-old man with inappropriate sinus tachycardia and ventricular dysfunction. The conventional treatment (ace-inhibitor and beta-blockers) was not well tolerated by the patient, so Ivabradine, a specific inhibitor of If current in the sinus node, was started. After 3 months of using this medication, we observed an improvement of ejection fraction and quality of life. (J Cardiovasc Electrophysiol, Vol. pp. 1[ndash]3) (Source: Journal of Cardiovascular Electrophysiology)

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  Beta blockers ‘underused’ before and after device implantation in HF patients

Beta blockers are underused before and after cardiac device procedures in patients with heart failure, a US study shows. (Source: MedWire News - Cardiology)

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  The quantal secretion of catecholamines is impaired by the accumulation of β-adrenoceptor antagonists into chromaffin cell vesicles

Conclusions and implications: We propose that [beta]-blockers are progressively concentrated into sympathetic secretory vesicles, and interfere with the storage of catecholamines and are co-released with the natural transmitters, resulting in a decrease in the sympathetic tone. This could explain the delayed onset of the hypotensive effects of [beta]-blockers. (Source: British Journal of Pharmacology)

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  Beta blockers ‘underused’ before and after device implantation in HF patients

Beta blockers are underused before and after cardiac device procedures in patients with heart failure, a US study shows. (Source: MedWire News - Heart Failure)

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  Beta Blocker Therapy Underused in Heart Failure Patients

New Saint Louis U research suggests reliance on technology rather than drug therapy ST. LOUIS, March 4, 2010 – New Saint Louis University research has found that beta blockers, a class of drugs used to prevent the progression of heart failure... (Source: Drugs.com - Clinical Trials)

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  [Infantile hemangioma.]

Authors: Léauté-Labrèze C, Sans-Martin V Infantile hemangioma is the most common tumor in children, but its pathophysiology is still not well understood. Infantile hemangioma develops during the first weeks of life, usually builds up over 3 to 6 months, and then regresses very slowly over a period of 3 to 7 years. Three quarters of these hemangiomas are lobular and are not associated with malformations. On the other hand, the hemangiomas referred to as segmental may be associated with developmental abnormalities (PHACES and PELVIS/SACRAL syndromes). Because of their spontaneous involution, most infantile hemangiomas do not require therapeutic intervention. In 10 to 15 % of cases, treatment is necessary because of complications when life or physiological functioning is th...

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  The Relationship Between Mental and Physical Health

People with depression often have worse physical health, as well as worse self-perceived health, than those without depression. Depression and other physical health conditions have separate but additive effects on well-being. For example, the combination of heart disease and depression can cause twice the reduction in social interaction than either condition alone. Patients with both depression and physical health problems are at particular risk: The physical problem can complicate depression’s assessment and treatment by masking or mimicking its symptoms. It can work the other way as well. People with any chronic physical disease tend to feel more psychological distress than do healthy people. Poor physical health brings an increased risk of depression, as do the social and relati...

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  Beta blocker therapy underused in heart failure patients

(Saint Louis University) New Saint Louis University research has found that beta blockers, a class of drugs used to prevent the progression of heart failure and manage arrhythmias (irregular heart beat) and hypertension (high blood pressure), are underused in heart failure patients who receive implantable cardiac devices. Failure to take beta blockers prior to implanting a cardiac device can affect the patient's overall outcome and survival rate. (Source: EurekAlert! - Medicine and Health)

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  Holistic visualisation of the multimodal transport and fate of twelve pharmaceuticals in biosolid enriched topsoils.

This study focuses on the transfer of a selection of pharmaceutical residues from municipal sewage sludge to agricultural topsoils and their fate therein after an accelerated 6-month rainfall event. Twelve pharmaceuticals encompassing antibiotics, analgesics, anti-inflammatories, beta-blockers, hyperlipidaemics and stimulants were invesigated by employing a combination of extraction techniques and liquid chromatography-tandem mass spectrometry. Both liquid- and solid-phase pharmaceutical contents were analysed and pharmaceutical and personal care products quantified at defined timepoints to elucidate transport behaviour and transformation potential. Results show the distribution and separation of pharmaceuticals over a 100-mm soil depth following typical biosolid enrichment. Using experime...

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  Aerobic capacity in patients with chronic liver disease: Very modest effect of liver transplantation.

DISCUSSION: Our study provides evidence of a very modest and inconsistent increase in aerobic capacity in liver transplant candidates after liver transplantation alone. This persistent impairment of exercise tolerance was principally of peripheral origin but anemia and beta-blocker treatment should be considered as major aggravating factors. Rehabilitation programs before and after transplantation may increase its benefits to these deconditioned liver transplant recipients in their daily lives. PMID: 20202784 [PubMed - as supplied by publisher] (Source: Presse Medicale)

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  Predictors and in-hospital outcomes of cardiogenic shock on admission in patients with acute coronary syndromes admitted to hospitals without on-site invasive facilities.

Conclusions: CS on admission is an important determinant of treatment strategy selection and is associated with unfavorable prognosis of ACS patients admitted to hospitals without on-site invasive facilities. PMID: 20201656 [PubMed - in process] (Source: Acute Cardiac Care)

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  Detailed insight into failing heart cells gained using new nano technique

Researchers have been able to see how heart failure affects the surface of an individual heart muscle cell in minute detail, using a new nanoscale scanning technique. The findings may lead to better design of beta-blockers, the drugs that can slow the development of heart failure, and to improvements in current therapeutic approaches to treating heart failure and abnormal heart rhythms. (Source: ScienceDaily Headlines)

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  Drug-Induced QTc-Interval Prolongation in the Intensive Care Unit: Incidence and Predictors

In conclusion, increased risk of proarrhythmia, as assessed by QTc prolongation, occurs in the majority of ICU patients when prescribed medications with electrophysiologic properties. Increased vigilance is warranted. The possible protective effect of beta-blockers requires confirmation. (Source: Journal of Pharmacy Practice)

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  Researchers Gain Detailed Insight Into Failing Heart Cells Using New Nano Technique

Researchers have been able to see how heart failure affects the surface of an individual heart muscle cell in minute detail, using a new nanoscale scanning technique developed at Imperial College London. The findings may lead to better design of beta-blockers, the drugs that can slow the development of heart failure, and to improvements in current therapeutic approaches to treating heart failure and abnormal heart rhythms. Heart failure is a progressive and serious condition in which the heart is unable to supply adequate blood flow to meet the body's needs... (Source: Health News from Medical News Today)

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  Group CBT has sustained benefits for back pain

Group CBT is a low-cost therapy for low-back pain with year-long benefitsRelated items from OnMedicaFalls prevention services are not evidence-basedWomen with small babies can safely wait for labourPay more heed to parent concern over sick childrenPreventative role of aspirin questionedGPs not prescribing enough beta blockers (Source: OnMedica Latest News)

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  Nebivolol Dilates Human Penile Arteries and Reverses Erectile Dysfunction in Diabetic Rats through Enhancement of Nitric Oxide Signaling

Conclusions. Nebivolol in vivo activated the NO/cGMP pathway, enhanced erectile response and reversed ED in diabetic rats. Moreover, nebivolol in vitro potentiated NO/cGMP-mediated relaxation of human erectile tissues. These effects may account for the low incidence of ED in nebivolol-treated hypertensive patients. Nebivolol therefore may have utility in the treatment of ED, particularly ED associated with diabetes. Angulo J, Wright HM, Cuevas P, González-Corrochano R, Fernández A, Cuevas B, La Fuente JM, Gupta S, and de Tejada IS. Nebivolol dilates human penile arteries and reverses erectile dysfunction in diabetic rats through enhancement of nitric oxide signaling. J Sex Med **;**:**[ndash]**. (Source: The Journal of Sexual Medicine)

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  Heart failure

New evidence; conclusions changed for: Angiotensin II receptor blockers for diastolic heart failure One RCT added comparing irbesartan versus placebo found no significant difference between irbesartan and placebo in all-cause mortality or in hospital admission for cardiovascular causes at a mean follow-up of 49.5 months. Evidence for effect of irbesartan on hospital admission for cardiovascular disease differs from evidence previously reported for candesartan for this outcome. Effects of angiotensin II receptor blockers as a class in treatment of diastolic heart failure is unclear. Categorisation changed from Likely to be beneficial to Unknown effectiveness. New evidence; conclusion confirmed for: Multidisciplinary intervent...

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  Triage After Hospitalization With Advanced Heart Failure: The ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) Risk Model and Discharge Score

Conclusions: The ESCAPE study discharge risk model and score refine risk assessment after in-hospital therapy for advanced decompensated systolic HF, allowing clinicians to focus surveillance and triage for early life-saving interventions in this high-risk population. (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness [ESCAPE]; NCT00000619) (Source: Journal of the American College of Cardiology)

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  Thoracic Aortic Aneurysm: Clinically Pertinent Controversies and Uncertainties

This paper addresses clinical controversies and uncertainties regarding thoracic aortic aneurysm and its treatment. 1) Estimating true aortic size is confounded by obliquity, asymmetry, and noncorresponding sites: both echocardiography and computed tomography/magnetic resonance imaging are necessary for complete assessment. 2) Epidemiology of thoracic aortic aneurysm. There has been a bona fide increase in incidence of aortic aneurysm making aneurysm disease the 18th most common cause of death. 3) Aortic growth rate. Although a virulent disease, thoracic aortic aneurysm is an indolent process. The thoracic aorta grows slowly—0.1 cm/year. 4) Evidence-based intervention criteria. It is imperative to extirpate the thoracic aorta before rupture or dissection occurs; surgery at 5.0- to 5.5-cm...

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  Appropriate Use of Early Beta-Blocker Therapy in Acute Coronary Syndrome

Cardiology 2010;115:209–210 (DOI:10.1159/000287234) (Source: Cardiology)

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  Pre-Angio Beta Blockade Contraindicated for Many

Beta blockade before computed tomographic coronary angiography (CTA) can improve image quality, but a substantial number of patients who require CTA have contraindications to beta blockers, new research shows. Reuters Health Information (Source: Medscape Medical News Headlines)

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  Should {beta} blockers be second line treatment?

(Source: BMJ Online First)

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  Studies unclear on role of pre-surgery beta blockers

It's not unusual for patients to suffer a cardiac event before surgery, and in theory, beta blockers will reduce the risk by relieving stress on the heart. But the one-size-fits-all approach can harm some patients, and heart specialists report that clinical studies have been unclear about who should get perioperative beta blockers and at what dosage. (Source: ScienceDaily Headlines)

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  Baseline Characteristics of the Nateglinide and Valsartan Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial Population: Comparison with Other Diabetes Prevention Trials

In conclusion, the NAVIGATOR study comprises prediabetic subjects who typically have concurrent BP and metabolic disturbances and an enhanced risk of CVD, and are thus at higher risk for cardiovascular events than subjects in previous DM prevention trials. (Source: Cardiovascular Therapeutics)

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  In Long QT Syndrome, Syncope During Beta-Blockade an Indication for ICD Therapy

An implantable cardioverter-defibrillator (ICD) should be considered when patients with long QT syndrome (LQTS) have syncope while on beta-blockers. Reuters Health Information (Source: Medscape Medical News Headlines)

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  Physician-Directed Patient Self-Management of Left Atrial Pressure in Advanced Chronic Heart Failure.

Conclusions-Physician-directed patient self-management of left atrial pressure has the potential to improve hemodynamics, symptoms, and outcomes in advanced heart failure. Clinical Trial Registration Information-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00547729. PMID: 20176990 [PubMed - as supplied by publisher] (Source: Circulation)

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  High prevalence of exercise-induced arrhythmias in catecholaminergic polymorphic ventricular tachycardia mutation-positive family members diagnosed by cascade genetic screening

Conclusion Exercise test revealed a high prevalence of arrhythmias in CPVT mutation carriers diagnosed by cascade genetic screening. β-Blocker therapy appeared to suppress the most severe exercise-induced arrhythmias, while less severe arrhythmias occurred at a lower heart rate. (Source: Europace)

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  Individuals at risk of beta-blocker discontinuation: a cohort study in 19,177 Chinese patients

Conclusions  Patients who were prescribed beta-blockers with these associated factors should be monitored more closely for antihypertensive drug adherence. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00392-010-0114-1Authors Martin C. S. Wong, Chinese University of Hong Kong School of Public Health and Primary Care, Faculty of Medicine New Territories Hong KongJohnny Y. Jiang, Chinese Academy of Medical Sciences and Peking Union Medical College DongDan SanTiao 9, DongCheng District Beijing 100730 ChinaXuefen Su, Chinese University of Hong Kong School of Public Health and Primary Care, Faculty of Medicine New Territories Hong KongHaoxiang Wang, Chinese University of Hong Kong School of Public Health and Primary Care, Faculty of Medicine New Territori...

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  Preoperative Evaluation in Aortic Endocarditis: Findings on Cardiac CT

CONCLUSION. Our study shows the feasibility of preoperative CT in aortic infective endocarditis for providing relevant data about the presence and relationships of aortic valvular pseudoaneurysms. A larger prospective study including a systematic comparison with transesophageal echocardiography should be performed to determine the respective value of each technique. (Source: American Journal of Roentgenology)

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  Primary prevention of CVD: treating hypertension

New evidence; conclusions changed for: Potassium supplementation One systematic review added found no significant difference at 8 to 16 weeks between potassium supplementation and placebo in improvement in systolic and diastolic blood pressure, although the difference between groups for both outcomes was large.The authors of the review also commented that follow-up of some of the RCTs included in the meta-analysis may have been too short to draw conclusions on the effectiveness of potassium supplementation. The findings and conclusion reached by the review differ from systematic review evidence previously presented. One review and one RCT added assessing the effects of combined mineral supplementation on blood pressure found no significant difference between place...

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  Risk of Fatal Arrhythmic Events in Long QT Syndrome Patients After Syncope

Conclusions: Patients with syncope during beta-blocker therapy are at high risk of life-threatening events, and implantable cardioverter-defibrillator therapy should be considered in these patients. The risk of beta-blocker failure is highest in young children and in women. (Source: Journal of the American College of Cardiology)

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  Serum-protein effects on the detection of the beta-blocker propranolol by ion-transfer voltammetry at a micro-ITIES array.

Authors: Collins CJ, Lyons C, Strutwolf J, Arrigan DW In this work, the effect of the serum protein, bovine serum albumin (BSA), on the detection of propranolol in artificial serum by ion-transfer voltammetry at an array of micro-interfaces between two immiscible electrolyte solutions (muITIES) is presented. Cyclic voltammetry (CV), differential pulse voltammetry (DPV), and differential pulse stripping voltammetry (DPSV) were examined for the detection of low concentrations of propranolol. Both CV and DPV had an interference effect from BSA, manifested as lower currents in the presence of the protein. DPSV proved to be the most effective technique, enabling the detection of 0.05muM propranolol in the presence of BSA. The DPSV method employed a preconditioning step as well as a preconce...

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  Reference Intervals for Aldosterone, Renin, and the Aldosterone-to-Renin Ratio in the Population-based Study of Health in Pomerania (SHIP-1)

Horm Metab ResDOI: 10.1055/s-0030-1247545AbstractThe renin-angiotensin-aldosterone system plays a key role in the regulation of human blood pressure. The aldosterone-to-renin ratio (ARR) is widely accepted for screening the primary hyperaldosteronism (PAL). Various cutoffs for positive PAL screening have been defined in patient cohorts from endocrinological referral centers and primary care. However, the distribution of the ARR in the general population is largely unknown. We aim to provide reference ranges for plasma aldosterone concentration (PAC), plasma renin concentration (PRC), and the ARR for the general population of north-east Germany. A cohort of 3 300 subjects participated in the first follow-up of the longitudinal, population-based Study of Health in Pomerania (SHIP). PAC...

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  Journal Scan: Perioperative Beta-Blockers for Cardiac Risk Reduction: Time for Clarity (JAMA 2010;303:551-552.)

(Source: Cardiosource)

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  Haemodynamic effects of acute intravenous metoprolol in apical ballooning syndrome with dynamic left ventricular outflow tract obstruction

We present a case of apical ballooning syndrome complicated by dynamic LVOTO, treated with metoprolol. (Source: European Journal of Heart Failure)

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  Prevalence and pharmacological treatment of left-ventricular dysfunction in patients undergoing vascular surgery

Conclusions This study demonstrates a high prevalence of LV dysfunction in vascular surgery patients and under-utilization of ESC recommended pharmacological treatment. Standard pre-operative evaluation of LV function could be argued based on our results to reduce this observed care gap. (Source: European Journal of Heart Failure)

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  Reducing Left Ventricular Mass -- It's Clear That Beta Blockers Are Inferior, but What Drug Is Best?

Henry Black, MD, comments on a meta-analysis comparing the effects of different blood-pressure lowering therapies on reducing left-ventricular hypertrophy. Do ACE inhibitors win? Medscape Cardiology (Source: Medscape Today Headlines)

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  [Hallucinations and vivid dreams by use of metoprolol.]

Authors: Ahmed AI, van Mierlo PJ, van Waarde JA, Jansen PA A 71-year-old man had had visual hallucinations and vivid dreams for two years after starting to take metoprolol. When metoprolol was replaced by atenolol the patient's symptoms disappeared within five days. Side-effects of beta-blockers on the central nervous system are relatively uncommon. The mechanisms underlying these side-effects are not fully understood. Lipophilic beta-blockers can cross the blood-brain barrier, whereas hydrophilic beta-blockers cannot. Doctors need to be alerted to the varying side-effects of specific beta-blockers. PMID: 20146183 [PubMed - as supplied by publisher] (Source: Tijdschrift voor Psychiatrie)

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  Influence of Gender on Long-term Prognosis of Patients With Chronic Heart Failure Seen in Heart Failure Clinics

Controversy exists concerning the influence of gender in the prognosis of patients with heart failure and no evidence is available from specific heart failure clinics.Women with ambulatory heart failure are managed differently than men, although their prognosis might be better than men.We analyzed the clinical characteristics, complementary test results, treatment, and prognosis in 4720 patients with chronic heart failure seen in 62 specialized clinics forming part of a multicenter registry during a mean follow-up of 40 months. The mean age was 65 ± 12 years and 71% were men. The men were younger than the women and more often had a history of hyperlipidemia and ischemic heart disease. The men had a more advanced heart failure New York Heart Association (NYHA) functional class (III-IV) tha...

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  Recommendations on perioperative {beta}-blockers: differing guidelines: so what should the clinician do?

(Source: British Journal of Anaesthesia)

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  Current beta-blocker advice 'may increase glaucoma'

NICE guidance on blood pressure treatment 'may have to be reviewed' after evidence showed prescribing beta-blockers may reduce a hypertensive patient’s risk of developing glaucoma, according to UK researchers. (Source: Pulse)

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  Current beta-blocker advice 'may increase glaucoma'

NICE guidance on blood pressure treatment 'may have to be reviewed' after evidence showed prescribing beta-blockers may reduce a hypertensive patient’s risk of developing glaucoma, according to UK researchers. (Source: Pulse)

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  Coping with Atypical Antipsychotic Side Effects

Atypical antipsychotics are widely believed to be better tolerated in adults than first-generation, or typical antipsychotics, and more likely to be taken long-term. They are less likely to cause tremors and other serious movement disorders that affect users of typical antipsychotics. In contrast to the earlier drugs, atypicals usually work on serotonin receptors in addition to dopamine receptors. Drugs in this group include olanzapine (Zyprexa), clozapine (Clozaril), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify) and paliperidone (Invega). The drugs are prescribed for conditions such as schizophrenia and bipolar disorders and may also be given for agitation, anxiety, psychotic episodes and obsessive behaviors. Their off-label use is increasin...

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  Novel Biomarker-Guided Strategy Hastens Optimal Dosing in Highest-Risk HF Patients

Once higher-risk patients are identified by natriuretic-peptide testing, the assays can be used to accelerate their beta-blocker uptitration and optimize dosing of other drugs, researchers say. Heartwire (Source: Medscape Today Headlines)

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  Novel biomarker-guided strategy hastens optimal dosing in highest-risk HF patients

Once higher-risk patients are identified by natriuretic-peptide testing, the assays can be used to accelerate their beta-blocker uptitration and optimize dosing of other drugs, researchers say. For complete story visit theheart.org. (Source: theHeart.org)

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  Comment: peri-operative beta-blockade for cardiac risk reduction

Source: JAMA Area: News Use of beta-blockers peri-operatively in patients at risk of coronary heart disease has theoretical attractions, however clinical trials have given conflicting results. Guidelines have therefore moved from recommending broad use to tight restrictions on use as trial results appeared. The authors of this Commentary discuss why the guidelines have changed and where the evidence currently stands.   They note that while there have been many trials in this field, there were fundamental differences between them. Inclusion criteria and risk stratification methods varied, such that a patient deemed high-risk in one might be considered moderate risk in another; additionally, the surgical procedures involved differed. As a result, the patient cohorts are not directl...

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  Perioperative {beta}-Blockers for Cardiac Risk Reduction: Time for Clarity [Commentary]

(Source: JAMA)

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  Studies unclear on role of pre-surgery beta blockers

(University of Michigan Health System) It's not unusual for patients to suffer a cardiac event before surgery, and in theory, beta blockers will reduce the risk by relieving stress on the heart. But the one-size-fits-all approach can harm some patients, and University of Michigan heart specialists write in this week's JAMA that clinical studies have been unclear about who should get perioperative beta blockers and at what dosage. (Source: EurekAlert! - Medicine and Health)

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  Incidence and prediction of major cardiovascular complications in head and neck surgery

Patients with head and neck squamous cell carcinoma (HNSCC) usually have a history of tobacco and alcohol abuse. These 2 intoxications not only are main oncologic risk factors but also show a strong causal relationship with certain comorbid conditions. Examples are coronary artery disease, stroke, renal dysfunction, and heart failure, which are all proven major risk factors for an adverse postoperative outcome after stressful noncardiac surgery. Preoperative identification of these conditions could lead to preventive measures in patients with HNSCC that undergo extensive surgery. Preventing morbidity and mortality is of medical and economical importance.All comorbidity of 135 consecutive patients with HNSCC that underwent extensive oncologic and reconstructive surgery as the first form of ...

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  Fixed Combination of Latanoprost and Timolol vs Individual Components for Primary Open-Angle Glaucoma or Ocular Hypertension: A Randomized, Double-Masked Study [Clinical Trial]

Conclusions  Fixed-combination latanoprost-timolol therapy is as safe and effective in lowering IOP in patients with either ocular hypertension or glaucoma as monotherapy with latanoprost or timolol. Combination therapy can be used to treat patients for whom monotherapy does not provide sufficient IOP reduction. Application to Clinical Practice  The simplicity, efficacy, and tolerability of FCLT contribute to its utility in clinical practice. Trial Registration  clinicaltrials.gov Identifier NCT00277498 (Source: Archives of Opthalmology)

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  Topical Treatment for Capillary Hemangioma of the Eyelid Using {beta}-Blocker Solution [Research Letters]

(Source: Archives of Opthalmology)

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  Diagnostic and Statistical Manual Changes Proposed For Addictions

Image (c) Ivan Petrov The long-awaited proposed criteria for the next edition of the Diagnostic and Statistical Manual (DSM), due to be published in 2013, have been revealed, and are available for public viewing and commentary online. Fundamental changes to the way that addictions are categorized are proposed, including: A shift in focus from "dependence," which is proposed to refer exclusively to physiological dependence as a normal process, to "addiction," which is proposed to refer to "compulsive, out-of-control" behaviors. A move towards including behavioral addictions, such as gambling and internet addictions. Re-naming the "Substance-Related Disorders" category "Addiction and Related Disorders," a move which reflects both of the above changes. These are very positive changes. In ad...

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  Potential physiological effects of pharmaceutical compounds in Atlantic salmon (Salmo salar) implied by transcriptomic analysis.

CONCLUSIONS: The continuously growing number of annotations of representative species relevant for environmental quality testing is facilitating pathway analysis processes for not completely annotated organisms. KEGG has shown to be a useful tool for the analysis of induced pathways from data generated by microarray techniques with the selected pharmaceutical contaminants acetaminophen, carbamazepine, and atenolol, but further studies have to be carried out in order to determine if a similar expression pattern in terms of fold change quantity and pathways is observed after long-term exposure. Together with the information obtained in this study, it will then be possible to evaluate the potential risk that the continuous release of these compounds may have on the environment and ecosystem f...

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  Review Article: Examining Treatment of ST-Elevation Myocardial Infarction: The Importance of Early Intervention

Early reperfusion in ST-segment elevation myocardial infarction (STEMI) is imperative. Acute reperfusion may be achieved with fibrinolytic agents and/or percutaneous coronary intervention (PCI); however, PCI is associated with lower rates of death and myocardial infarction compared with fibrinolysis. As treatment delays are associated with worse outcomes, current guidelines recommend minimizing time from symptom onset to treatment initiation. Regardless of the reperfusion strategy, patients with STEMI are at increased risk of early recurrent ischemic events and death. These risks can be significantly reduced by promptly initiating a combination of pharmacotherapies that includes antiplatelet and anticoagulant agents, β-blockers, and inhibitors of the renin-angiotensin-aldosterone syst...

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  Effects of Labetalol on Hemodynamic Parameters and Soluble Biomarkers of Inflammation in Acute Coronary Syndrome in Patients With Active Cocaine Use

In conclusion, labetalol appears to be safe in cocaine-associated ACS. Furthermore, labetalol provides a beneficial hemodynamic response and, in comparison to diltiazem, potentiates an anti-inflammatory vascular response in this setting. (Source: Journal of Cardiovascular Pharmacology and Therapeutics)

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  Health Tip: Beta Blockers May Have Side Effects

But most people have no adverse reactions Source: HealthDay (Source: MedlinePlus Health News)

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  β-Blocker in Post-Myocardial Infarct Survivors with Preserved Left Ventricular Systolic Function

Conclusion:[beta]-blocker use was associated with a decrease in overall mortality and cardiac death in post-MI patients with preserved LV function. (PACE 2010; 1[ndash]6) (Source: Pacing and Clinical Electrophysiology : PACE)

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  Driving While Medicated: 72 Percent of Older Drivers Have No Idea Their Meds Impair Driving

(NaturalNews) Even though the vast majority of elderly drivers use one or more medications, few of them area aware of the effects that their drugs can have on driving performance, according to a study conducted by researchers from the University of Alabama-Birmingham and released as a report by the nonprofit AAA Foundation for Traffic Safety."That's really scary," said Peter Kissinger of the AAA Foundation. "The risks are real."The researchers interviewed 630 drivers between the ages of 56 and 93, and found that 78 percent of them were taking one or more medications. Yet only 28 percent of the respondents knew of the potential risks from driving while medicated. Only 18 percent of those taking drugs especially known to impair driving ability -- including ACE inhibitors, beta blockers and s...

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  Takotsubo Cardiomyopathy, or Broken-Heart Syndrome (March).

CONCLUSIONS: Takotsubo cardiomyopathy causes a reversible left ventricle dysfunction which occurs most commonly in postmenopausal women with or without cardiovascular disease. Recognition is detected with coronary angiography. It is thought to primarily be due to an abnormally high sympathetic stimulation after emotional or psychological stress. Treatment consists of an angiotensin converting enzyme inhibitor and/or beta blocker if needed for left ventricular dysfunction and possibly an anxiolytic agent. PMID: 20124462 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  Endothelial dysfunction: a strategic target in the treatment of hypertension?

Authors: Tang EH, Vanhoutte PM Endothelial dysfunction is a common feature of hypertension, and it results from the imbalanced release of endothelium-derived relaxing factors (EDRFs; in particular, nitric oxide) and endothelium-derived contracting factors (EDCFs; angiotensin II, endothelins, uridine adenosine tetraphosphate, and cyclooxygenase-derived EDCFs). Thus, drugs that increase EDRFs (using direct nitric oxide releasing compounds, tetrahydrobiopterin, or L: -arginine supplementation) or decrease EDCF release or actions (using cyclooxygenase inhibitor or thromboxane A2/prostanoid receptor antagonists) would prevent the dysfunction. Many conventional antihypertensive drugs, including angiotensin-converting enzyme inhibitors, calcium channel blockers, and third-generation beta-bloc...

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  Beta-Blockers and Depression [Letters to the Editor]

(Source: Am J Psychiatry)

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  Timolol Activates the Enzyme Activities of Human Carbonic Anhydrase I and II.

Authors: Sugimoto A, Ikeda H, Tsukamoto H, Kihira K, Ishioka M, Hirose J, Hata T, Fujioka H, Ono Y Timolol, a beta-blocker, has been shown to be an effective ocular hypotensive agent when used alone or with carbonic anhydrase inhibitor on ocular hypertensive or open angle glaucoma patients. The effect of timolol hemihydrate on the CO(2) hydration activities of human carbonic anhydrase (HCA) I and II and their reaction mechanisms were investigated. Timolol activates the enzyme activities of HCA I and HCA II. In HCA I and II, the enzyme kinetic results clearly showed that timolol increases the value of V(max) but does not influence the value of K(m). The enzyme kinetic method showed that timolol noncompetitively activates HCA I and II activities through the formation of a ternary complex...

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  Beta-blockers and depression.

Authors: Xiong GL, Gagliardi JP, Jiang W PMID: 20123927 [PubMed - in process] (Source: The American Journal of Psychiatry)

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  Drug treatment for chronic systolic heart failure.

Authors: Mörike K, Sindermann JR Drug treatment of chronic systolic heart failure usually includes angiotensin-converting enzyme inhibitor, or an angiotensin II receptor blocker, and a beta blocker, as prognostic benefit of these agents has been demonstrated in a large body of clinical trials. Depending on the stage of the disease and concomitant factors, an aldosterone antagonist and/or a digitalis glycoside may provide additional benefit. Most patients also receive a diuretic for symptomatic relief. Conversely, some drugs may precipitate or aggravate chronic systolic heart failure. PMID: 20101534 [PubMed - in process] (Source: The Thoracic and Cardiovascular Surgeon)

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  Nebivolol Should Not Get Heart Failure Indication, Panel Says

SILVER SPRING, MD. — A Food and Drug Administration advisory panel has unanimously recommended against approval of the beta-blocker nebivolol as a treatment for heart failure, citing the lack of a robust effect in the clinical trial submitted for approval and the need for more corroborating evidence to support approval. (Source: Cardiology News)

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  Direct Myocardial Implantation of Human Fetal Stem Cells in Heart Failure Patients: Long-term Results.

Conclusion: Although these initial findings suggest direct myocardial implantation of HFDSCs is feasible and improves cardiac function in HF patients at 40 months, more clinical research is required to confirm these observations. PMID: 20150037 [PubMed - in process] (Source: The Heart Surgery Forum)

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  Management and comorbidities of atrial fibrillation in patients admitted in cardiology service in Kosovo-a single-center study.

CONCLUSIONS: Patients with atrial fibrillation were mainly with ischemic, hypertensive heart disease and congestive heart failure. Our study, suggests underuse of anticoagulation therapy. The independent predictors of under prescription of anticoagulants in patients with atrial fibrillation were elder age, non-enlarged left atrium, and good left ventricular ejection fraction. Medical treatment with other groups of drugs for atrial fibrillation and comorbidities seems to be according to current guidelines. PMID: 20150002 [PubMed - in process] (Source: Anadolu Kardiyol Der...)

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  [Epidemiological study of the cardiovascular risk factors and clinical medications in patients with cardiovascular diseases in Guangzhou hospitals.]

CONCLUSION: The cardiovascular risk factors and clinical medications underwent significant changes in Guangzhou hospitals in the period from 1995 to 2005, and the blood pressure, blood glucose, hypertriglyceridemia of the patients did not appear to be well controlled. The application rate of ACEI, ARB, beta-blockers, diuretics, aspirin, clopidogrel and statins increased rapidly for treatment of cardiovascular diseases, and these drugs have become the first-line drugs. PMID: 20159710 [PubMed - in process] (Source: Journal of Southern Medical University)

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  Propranolol in the treatment of periocular hemangiomas

This study reports the results of a series of patients who received propranolol treatment and proposes a new outpatient initiation regimen. (Source: Journal of AAPOS)

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  Beta-blockers and non-cardiac operations what will change after the POISE study?

We describe a typical case of apical ballooning syndrome in an octogenarian female patient with left ventricular wall motion abnormality on electrocardiography, whose ventricular function returned to normal. The patient has allergic rhinitis and had used nasal decongestant excessively a few hours prior to the episode of pain.Describimos un caso típico de síndrome de abombamiento apical en una paciente octogenaria con alteración electrocardiográfica, de contractilidad del ventrículo izquierdo, y que presentó recuperación de la función ventricular. La paciente es portadora de rinitis alérgica y hace uso excesivo de descongestionante nasal horas antes del episodio del dolor. (Source: Arquivos Brasileiros de Cardiologia)

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  Propranolol for infantile hemangiomas: Early experience at a tertiary vascular anomalies center

This study explores the impact of propranolol on both proliferative and involuting hemangiomas at a tertiary vascular anomalies center.Retrospective single institution review.We reviewed children treated with propranolol for problematic hemangiomas followed by a blinded prospective analysis of serial photographs taken during the course of their therapy. Parental questionnaires were obtained to evaluate perceived therapeutic response and complications to oral propranolol.Thirty-two children with complete photo documentation were treated with oral propranolol for infantile hemangiomas between September 2008 and June 2009. Twenty-seven patients began therapy during the proliferative phase of their lesions (mean age, 4.9 months), whereas five patients began during the involutional phase (mean ...

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  Beta Blockers: Less Effect on Pulse Pressure Than Diuretics

A new review of the use of beta blockers as second-line therapy for primary hypertension has shown that they appear to lower BP in a different way than thiazide diuretics, with less of an effect on pulse pressure. Heartwire (Source: Medscape Today Headlines)

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  Carvedilol may alleviate late cardiac remodelling following surgical ventricular restoration [Original articles]

Conclusions: High-dose carvedilol alleviated LV remodelling and diastolic dysfunction following SVR accompanying with reduction in myocardial fibrosis. Blockade of β-adrenergic receptor may be a promising adjuvant therapy in patients following SVR. (Source: European Journal of Cardio-Thoracic Surgery)

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  Beta blockers: Less effect on pulse pressure than diuretics

A new review of the use of beta blockers as second-line therapy for primary hypertension has shown that they appear to lower BP in a different way than thiazide diuretics, with less of an effect on... For complete story visit theheart.org. (Source: theHeart.org)

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  Teva UK Limited Launches Dorzolamide 2% Eye Drops Solution

CASTLEFORD, England, January 28 (HSMN NewsFeed) -- We are pleased to announce the launch of dorzolamide 2% eye drops solution available in a 5ml bottle. Dorzolamide solution is indicated as adjunctive therapy to beta-blockers, as monotherapy in patients ... Biopharmaceuticals, Generics, OphthalmologyTeva UK, Teva Pharmaceutical, dorzolamide, Trusopt (Source: HSMN NewsFeed)

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  [Catecholaminergic polymorphic ventricular tachycardia.]

Authors: Leren IS, Haugaa KH, Edvardsen T, Anfinsen OG, Kongsgård E, Berge KE, Leren TP, Amlie JP Background. CPVT (catecholaminergic polymorphic ventricular tachycardia) is a condition characterized by syncopes and cardiac arrest that was first described in 1975. CPVT has later been classified as a genetic disease with a great risk for life-threatening arrhythmias that are mainly caused by mutations in the ryanodine receptor 2 gene. Starting with a case report, we present an overview of CPVT. Material and methods. The literature reviewed was identified through a non-systematic search in PubMed. Results. Diagnosing CPVT may be difficult, as resting ECG is normal and the syncopes may be misdiagnosed as epilepsy. Information about syncopes related to physical or emotional stress and...

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  Blood pressure lowering efficacy of beta-blockers as second-line therapy for primary hypertension

Source: Cochrane Library Area: Evidence > Drug Class Focused Reviews Background Beta-blockers are one of the more commonly prescribed classes of anti-hypertensive drugs, both as first-line and second-line.   Objectives To quantify the effect on systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate and withdrawals due to adverse effects of beta-blocker therapy when given as a second-line drug in adult patients with primary hypertension.   Search strategy CENTRAL (The Cochrane Library 2009, Issue 2), MEDLINE (1966-Aug 2009), EMBASE (1988-Aug 2009) and bibliographic citations of articles and reviews were searched.   Selection criteria Double-blind, randomized controlled trials comparing a beta-blocker in combination with a drug from another clas...

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  Effects of {beta}-Blockers and Anxiety on Complication Rates after Acute Myocardial Infarction.

Conclusion Anxious patients had more complications and longer stays than did nonanxious patients. The administration of metoprolol did not eliminate this relationship, perhaps because patients did not receive a sufficient dose of metoprolol to counter the effect of anxiety. PMID: 20107234 [PubMed - as supplied by publisher] (Source: American Journal of Critical Care)

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  Drug Treatment for Chronic Systolic Heart Failure

Thorac cardiovasc Surg 2010; 58: S170-S172DOI: 10.1055/s-0029-1240711AbstractDrug treatment of chronic systolic heart failure usually includes angiotensin-converting enzyme inhibitor, or an angiotensin II receptor blocker, and a beta blocker, as prognostic benefit of these agents has been demonstrated in a large body of clinical trials. Depending on the stage of the disease and concomitant factors, an aldosterone antagonist and/or a digitalis glycoside may provide additional benefit. Most patients also receive a diuretic for symptomatic relief. Conversely, some drugs may precipitate or aggravate chronic systolic heart failure.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents  |  Abstract  |  Full text (Source: The Thoracic and Cardiovascular Surgeo...

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  Calcium-channel blocker plus diuretic less favourable in hypertension than other combinations?

Source: BMJ Area: News An epidemiological study suggests that people with hypertension taking a diuretic plus a calcium-channel blocker (CCB) may have a higher risk of myocardial infarction (MI) than those taking diuretics with beta-blockers or with ACE-inhibitors and angiotensin receptor blockers (ARB). Risk of stroke was similar.   Low dose diuretics are a mainstay of antihypertensive treatment and are recommended as the first-line therapy for many patients in both US and UK guidelines. There is no controlled trial evidence, however, on the optimum second-line drug. The authors of this reports therefore carried out a case-control study using data from a US Health Maintenance Organisation to compare clinical outcomes in patients with hypertension who were treated with low-dose d...

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  Hypertension: Beta-blockers effective in combination therapies

Using beta-blockers as a second-line therapy in combination with certain anti-hypertensive drugs significantly lowers blood pressure in patients with hypertension, according to a new review. This review also goes some way to explaining the differences in the way that patients respond to beta-blockers and other classes of blood pressure lowering drugs. (Source: ScienceDaily Headlines)

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  Successful management of a patient with Marfan syndrome complicated with acute aortic dissection using landiolol during Cesarean section

Abstract  Aortic dissection is a lethal complication in pregnant women with Marfan syndrome. To decrease arterial wall stress, beta-blockers have been used as standard treatment, although uterine contractions caused by beta-2-adrenergic receptor antagonism may result. Herein, we report a patient with Marfan syndrome who was given landiolol, a selective beta-1-adrenergic receptor antagonist with a short half-life, for management during a Cesarean section procedure following development of acute aortic dissection. A 30-year-old pregnant woman with Marfan syndrome in the 38th week of gestation was referred to our department for an emergency Cesarean section because of development of acute aortic dissection. Blood pressure (BP) decreased from 157/70 to 128/64 mmHg after gi...

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  The Optimal Heart Rate to Reduce Mortality after Traumatic Brain Injury

Background: Increasing data indicates treatment with beta blockers improves survival after traumatic brain injury (TBI). Although the optimal heart rate (HR) to reduce mortality for trauma patients assumes a lower heart rate is better, no study exists that demonstrates the optimal HR for mortality reduction after isolated moderate to severe TBI. Hypothesis: Mortality is reduced for a specific heart rate range in patients with isolated TBI. Patients and Methods: The Los Angeles County Trauma System Database, consisting of 5 Level I and 8 Level II trauma centers, was queried for all injured patients admitted between 1998 and 2005 (n=147,788). Moderate to severe isolated head injured patients (head AIS ≥3, all other ≤3) were then identified. Patients who were dead on arrival, with head AI...

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  Relationships of beta-blockers and anxiolytics intake and salivary secretion, masticatory performance and taste perception

Conclusions: Patients under beta-blockers therapy presented reduced non-stimulated salivary flow when compared to controls, without influencing the sense of taste or masticatory performance. The use of anxiolytics did not affect salivary flow and taste perception in the studied sample. (Source: Archives of Oral Biology)

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  Early Beta-Blockade for ACS Does Not Alter Short-Term Mortality

Giving beta-blockers within 8 hours of presentation with acute coronary syndrome (ACS) does not reduce in-hospital mortality, a meta-analysis has shown. Reuters Health Information (Source: Medscape Pharmacist Headlines)

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  What is the rationale and evidence for combining angiotensin converting enzyme inhibitors with angiotensin II receptor antagonists in heart failure?

Source: London Medicines Information Service Area: Evidence > Medicines Q & A Candesartan and valsartan are licensed to be used together with an ACE inhibitor for heart failure. Based on the results of the CHARM-Added study, the addition of candesartan to an ACE inhibitor leads to a further reduction in cardiovascular death.  Based on the results of the Val-HeFT study, valsartan in addition to an ACE inhibitor is no more effective in reducing mortality than an ACE inhibitor alone. The risk of adverse events, especially, renal dysfunction and hyperkalaemia may increase with combination therapy. The addition of ARB to an ACE inhibitor can be considered in heart failure patients if standard therapy has already been optimised. Evidence suggests, the addition of an A...

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  A comparison of clinical characteristics, medications, and outcome between acute stroke and acute myocardial infarction

Conclusion: AMI affects people at early life phases compared to AS. HTN and DM are among the common risk factors. Prescribing of medications for secondary prevention could be improved. Gender and age differences in outcome are seen in both AS and AMI patients. (Source: CVD Prevention and Control)

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  ARCA Announces Publication Of Bucindolol Data In Circulation: Heart Failure

ARCA biopharma, Inc. (Nasdaq: ABIO), a biopharmaceutical company developing genetically targeted therapies for heart failure and other cardiovascular disease, today announced that the paper "An alpha-2C-Adrenergic Receptor Polymorphism Alters the Norepinephrine Lowering Effects and Therapeutic Response of the Beta Blocker Bucindolol in Chronic Heart Failure" was published in the January 2010 edition of the peer-reviewed journal Circulation: Heart Failure (http://circheartfailure.ahajournals.org)... (Source: Health News from Medical News Today)

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  Natural History and Expansive Clinical Profile of Stress (Tako-Tsubo) Cardiomyopathy

Conclusions: In this large SC cohort, the clinical spectrum was heterogeneous with about one-third either male, ≤50 years of age, without a stress trigger, or with in-hospital death, nonfatal recurrence, embolic stroke, or delayed normalization of ejection fraction. Beta-blocking drugs were not absolutely protective and SC was a marker for increased noncardiac mortality. These data support expanded management and surveillance strategies including CMR imaging and consideration for anticoagulation. (Source: Journal of the American College of Cardiology)

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  Prevalence and Impact of Diabetes Mellitus in Patients With Acute Myocardial Infarction: A 10-year Experience

Conclusions: The prevalence of diabetes mellitus among patients with acute myocardial infarction in a geographically defined population in the developing world is high with a trend for poor outcomes. However, mortality was not significantly higher in diabetes mellitus than non-diabetes mellitus patients. (Source: Angiology)

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  Review: Systolic heart failure

Source: N Engl J Med Area: News The New England Journal of Medicine features a review of systolic heart failure beginning with a case vignette and followed by a discussion of:   . The clinical problem . Diagnosis . Pharmacological therapy (diuretics, ACE inhibitors, angiotensin-receptor blockers, beta-blockers, aldosterone antagonists, hydralazine and isosorbide dinitrate) . Organization of care . Lifestyle and exercise . Devices (implantable cardioverter-defibrillators and cardiac-resynchronisation therapy) . Surgery . Areas of uncertainty . Guidelines . Recommendations on the case (Source: NeLM - Cardiovascular Medicine)

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  Electrical storm induced by H1N1 A influenza infection

We report a case of electrical storm during H1N1 influenza A infection in a patient with congenital long-QT syndrome (LQTS) that was previously stable on β-blocker therapy. Possible causes for the association of A flu and LQTS recurrent ventricular arrhythmias are discussed. (Source: Europace)

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  Effect of Beta-Blocker Add-On Therapy Quantified (CME/CE)

Beta-blockers achieve statistically significant, dose-dependent decreases in blood pressure when added to a diuretic or calcium-channel blocker, a systematic review of published studies showed. (Source: MedPage Today Nephrology)

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  AF less frequent with ACE inhibitors, ARBs, beta blockers than with CCBs

Long-term monotherapy with ACE inhibitors, angiotensin receptor blockers, or beta blockers in patients with hypertension is associated with reduced risk for atrial fibrillation compared with long-term calcium channel blocker monotherapy, report researchers. (Source: MedWire News - Cardiology)

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  Beta-Blockers Effective In Combination Therapies For Hypertension

Using beta-blockers as a second-line therapy in combination with certain anti-hypertensive drugs significantly lowers blood pressure in patients with hypertension, according to a systematic review by Cochrane Researchers. This review also goes some way to explaining the differences in the way that patients respond to beta-blockers and other classes of blood pressure lowering drugs. Beta-blockers are commonly used in the treatment of hypertension (high blood pressure) to help reduce the risk of stroke and cardiovascular disease... (Source: Health News from Medical News Today)

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  Beta-Blockers Effective In Combination Therapies For Hypertension

Using beta-blockers as a second-line therapy in combination with certain anti-hypertensive drugs significantly lowers blood pressure in patients with hypertension, according to a systematic review by Cochrane Researchers. This review also goes some way to explaining the differences in the way that patients respond to beta-blockers and other classes of blood pressure lowering drugs... (Source: Hypertension News From Medical News Today)

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  Atrial fibrillation risk 'lower with some classes of antihypertensives'

Hypertensive patients receiving long-term treatment with ACE inhibitors, angiotensin-receptor blockers or beta-blockers have a reduced risk of atrial fibrillation compared with calcium-channel blockers, UK primary care data shows. (Source: Pulse)

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  Rest Premature Ventricular Contractions on Routine ECG and Prognosis in Heart Failure Patients

Conclusion: The presence of PVC on an ECG is a powerful predictor of CV mortality even after adjusting for confounding factors. Ann Noninvasive Electrocardiol 2010;15(1):56[ndash]62 (Source: Annals of Noninvasive Electrocardiology)

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  Long QT Syndrome in African-Americans

Conclusions: The clinical course of LQTS in African-Americans is similar to that of Caucasians with comparable risk factors and benefit from beta-blocker therapy in the two racial groups. Ann Noninvasive Electrocardiol 2010;15(1):73[ndash]76 (Source: Annals of Noninvasive Electrocardiology)

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  Journal Scan: ST Elevation on the Exercise ECG in Patients Presenting With Chest Pain and No Prior History of Myocardial Infarction (Heart 2009;95:1792-1797.)

Stress testing with ECG monitoring was undertaken in 19,189 patients over an 8-year period. EST was performed with a standard Bruce protocol, and beta-blockers were held prior to testing. There was evidence of prior MI in 4,248, leaving 14,941 EST for evaluation. Within this cohort, 116 (0.78%) pati. . . (Source: Cardiosource)

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  Study: Second-line double-dose beta blocker good for hypertension

Using beta blockers as a second-line drug therapy for hypertension patients can reduce blood pressure by 30 percent, if dosage is doubled, according to research published in the current issue of the Cochrane Library. (Source: Cardiovascular Business News)

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  ACE Inhibitors, ARBs, and Beta Blockers Reduce Risk of AF

Hypertensive patients receiving long-term monotherapy with ACE inhibitors, ARBs, or beta blockers were less likely to develop new-onset atrial fibrillation than those who received only calcium-channel antagonists, a new study finds. Heartwire (Source: Medscape Today Headlines)

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  Lower Afib Risk Seen with Some Antihypertensives More than Others (CME/CE)

Hypertensive patients treated with angiotensin-converting enzyme inhibitors, angiotensin II-receptor blockers, or beta-blockers have a lower risk for atrial fibrillation than those treated with calcium channel blockers, a nested case-control analysis found. (Source: MedPage Today Nephrology)

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  Beta-blockers and non-cardiac operations what will change after the POISE study?: ¿qué cambia después del estudio POISE?

We describe a typical case of apical ballooning syndrome in an octogenarian female patient with left ventricular wall motion abnormality on electrocardiography, whose ventricular function returned to normal. The patient has allergic rhinitis and had used nasal decongestant excessively a few hours prior to the episode of pain.Describimos un caso típico de síndrome de abombamiento apical en una paciente octogenaria con alteración electrocardiográfica, de contractilidad del ventrículo izquierdo, y que presentó recuperación de la función ventricular. La paciente es portadora de rinitis alérgica y hace uso excesivo de descongestionante nasal horas antes del episodio del dolor. (Source: Arquivos Brasileiros de Cardiologia)

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  Risk for atrial fibrillation varies with different antihypertensive drugs

This study used data from the UK GPRD, a well-validated database comprising approximately 5 million UK primary care patient records, to analyse risk of AF in patients receiving monotherapy (or monotherapy with low-dose diuretic) with several drug classes. For the study population, the authors extracted details of treated hypertensive patients who had received one or more prescriptions for an ACE-inhibitor, ARB, beta-blocker, CCB, or ... (Source: NeLM - News)

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  Antihypertensive Medication Prescribing Patterns in a University Teaching Hospital

J Clin Hypertens (Greenwich) Treatment of hypertension among hospitalized patients represents an opportunity to improve blood pressure recognition and treatment. To address this issue, the authors examined patterns of antihypertensive medication prescribing among 5668 hypertensive inpatients. Outcomes were treatment with any antihypertensive medication and treatment with first-line therapy, defined as angiotensin-converting enzyme inhibitors, [beta]-blockers, thiazide diuretics, or calcium channel blockers. Logistic regression models adjusting for age, sex, race, length of stay, service line, and comorbidity were used for all comparisons. The multivariate-adjusted odds ratios for treatment were higher for men (1.4, P (Source: The Journal of Clinical Hypertension)

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  Antihypertensive Therapy in African Americans: Findings From an Inner-City Ambulatory Clinic

J Clin Hypertens (Greenwich). African Americans bear a greater burden of hypertension. Understanding prevailing epidemiologic patterns can facilitate the implementation and successful outcome of community programs. The authors assessed practice patterns of antihypertensive drug utilization and blood pressure (BP) control in a predominantly African American population in Brooklyn, NY, from January 1 to January 31, 2008. A total of 416 (53.1%) had hypertension, with a mean age of 61 years, and 267 (64%) were women. In general, 212 (50.9%) were at goal BP and 59.9% of those at goal were taking at least 2 drugs. Patient age correlated with the number of drugs used (r=0.14; P=.004). Patients taking [beta]-blockers and calcium channel blockers were older: 63.6 vs 60.1 years (P=.01) and 62.7 vs 6...

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  Hypertensive Drugs Can Lower Risk of Atrial Fibrillation

Long-term use of angiotensin-converting enzyme inhibitors, angiotensin II-receptor blockers, or β-blockers reduces the risk of atrial fibrillation among patients with hypertension, according to a study in the Jan. 19 issue of the Annals of Internal Medicine. (Source: Modern Medicine)

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  Risk for incident atrial fibrillation in patients who receive antihypertensive drugs: a nested case-control study.

CONCLUSION: In hypertensive patients, long-term receipt of ACE inhibitors, ARBs, or beta-blockers reduces the risk for atrial fibrillation compared with receipt of calcium-channel blockers. PRIMARY FUNDING SOURCE: None. PMID: 20083826 [PubMed - in process] (Source: Annals of Internal Medicine)

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  AF less frequent with ACE inhibitors, ARBs, beta blockers than with CCBs

Long-term monotherapy with ACE inhibitors, angiotensin receptor blockers, or beta blockers in patients with hypertension is associated with reduced risk for atrial fibrillation compared with long-term calcium channel blocker monotherapy, report researchers. (Source: MedWire News - Hypertension)

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  ACE inhibitors, ARBs, and beta blockers reduce risk of AF

Hypertensive patients receiving long-term monotherapy with ACE inhibitors, ARBs, or beta blockers were less likely to develop new-onset atrial fibrillation than those who received only... For complete story visit theheart.org. (Source: theHeart.org)

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  Can Antihypertensive Treatment Reverse Large-Artery Stiffening?

Abstract  In some controlled therapeutic trials for hypertension, a selective reduction of systolic blood pressure has been obtained with long-term treatment. The greatest effects on cardiovascular outcomes stem from a decrease of central blood pressure through a significant reduction of arterial stiffness, wave reflections, or both. Until now, all protocols have used angiotensin II blockade, mainly through angiotensin-converting enzyme inhibition. Cardiovascular outcomes have been significantly improved when compared with controls, but most of them have been treated with beta blockers. Such “de-stiffening” therapies are important to consider and require additional trials. Content Type Journal ArticleDOI 10.1007/s11906-009-0085-7Authors Michel E. Safar, Centre de Di...

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  Clinical trials update from the American Heart Association meeting 2009: HEAAL, FAIR-HF, J-CHF, HeartMate II, PACE and a meta-analysis of dose-ranging studies of beta-blockers in heart failure

This article provides information and a commentary on trials relevant to the pathophysiology, prevention, and treatment of heart failure presented at the annual meeting of the American Heart Association held in Orlando, Florida in 2009. Unpublished reports should be considered as preliminary, as analyses may change in the final publication. Patients with heart failure randomized to high-dose losartan treatment (150 mg) in the HEAAL study had a reduced risk of death or heart failure hospitalization compared with patients in the low-dose (50 mg) group. In FAIR-HF, patients with heart failure and concomitant iron deficiency but without severe anaemia who received iron supplementation therapy demonstrated an improvement in symptoms at 24 weeks compared with placebo. The J-CHF study was too sma...

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  Red blood cell distribution width and 1-year mortality in acute heart failure

Conclusion Red blood cell distribution width is frequently elevated among patients with acute HF and does not appear to be associated with nutritional status, transfusion history, or inflammation. Red blood cell distribution width independently predicts 1-year mortality in acute HF. The value of RDW appears additive to other established prognostic variables such as NT-proBNP. (Source: European Journal of Heart Failure)

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  Rationale and design of the {beta}-blocker in heart failure with normal left ventricular ejection fraction ({beta}-PRESERVE) study

Conclusion This study will provide important evidence, for the first time to our knowledge, of the long-term efficacy of β-blocker therapy in the management of HFNEF. (Source: European Journal of Heart Failure)

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  Human cardiac tissue in a microperfusion chamber simulating extracorporeal circulation - ischemia and apoptosis studies

Conclusions: Our human cardiac preparation served as a reliable cellular model tool to study apoptosis in vitro. Decisively cardiac tissue from the right auricle can be easily obtained at nearly every cardiac operation avoiding biopsying of the myocardium or even experiments on animals.The apoptotic damage induced by the ischemia/reperfusion stimulus could be significantly reduced by the cold crystalloid cardioplegia. The additional treatment of cardiomyocytes with a non-selective beta-blocker, carvedilol had even a significantly higher reduction of apoptotis. (Source: BioMed Central)

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  Osborn waves and incessant ventricular fibrillation during therapeutic hypothermia

A 33-year-old man suddenly collapsed and presented with ventricular fibrillation (VF) when the emergency team arrived. Conversion to sinus rhythm and return of spontanous circulation was achieved with a single shock from a defibrillator. The patient was admitted to hospital comatose, mechanically ventilated but haemodynamically stable. Therapeutic hypothermia was initiated using the Arctic Sun (www.medivance.com) external cooling system. Initial ECG and echocardiography were quite normal. Coronary artery disease was excluded by angiography. Clinical and laboratory examination revealed no pathology. While the patient was hypothermic (33°C/91.4°F) progressive ECG changes appeared. The heart rate decreased to 35/min and the QRS complexes became wide with the appearance of a prominent J wave...

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  Diagnostic accuracy of dual-source CT coronary angiography in a population unselected for degree of coronary artery calcification and without heart rate modification

Aim: To assess the ability of coronary angiography performed using dual-source computed tomography (DSCT) to evaluate coronary artery disease (CAD) in a population with unselected heart rates and extensive coronary calcification.Materials and methods: Forty-four patients at intermediate to high risk for CAD underwent both DSCT coronary angiography and invasive coronary angiography (ICA) within 30 days. No beta blockers were administered prior to imaging. Image quality and quantitatively stenosis of all coronary segments with a diameter ≥1.5mm were accessed. Patients were stratified according to mean heart rate ( (Source: Clinical Radiology)

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  NICE consults on draft guideline (partial update) on chronic heart failure

Source: NICE Area: News NICE has issued for consultation from 14 January to 10 March 2010 a draft partially updated guideline on chronic heart failure. New updated recommendations have been added on signs and symptoms, echocardiography, specialist assessment and the measurement of serum natriuretic peptides in the diagnosis of heart failure, as well as pharmacological treatment with ACE inhibitors, beta-blockers, aldosterone antagonists, isosorbide/hydralazine and angiotensin II receptor antagonists, and disease monitoring with serum natriuretic peptides, and rehabilitation. (Source: NeLM - Cardiovascular Medicine)

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  Improving the management of non-ST elevation acute coronary syndromes: systematic evaluation of a quality improvement programme European QUality Improvement Programme for Acute Coronary Syndrome: The EQUIP-ACS project

DiscussionIf we can demonstrate important improvements in the quality of patient care as a result of a quality improvement programme, this could lead to a greater acceptance that such programmes should be incorporated into routine health training for health professionals and hospital managers.Trial registration: Clinicaltrials.gov NCT00716430 (Source: Trials)

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  Blood pressure drugs and dementia

Conclusion This large and well conducted study adds weight to the plausible theory that angiotensin receptor blockers can reduce the risk of Alzheimer’s disease and vascular dementia. However, it is too soon to start using these drugs in a targeted attempt at preventing or slowing dementia. Several cautions are raised by the researchers and in an editorial published in the BMJ: The people treated with ARBs were known to be different from those in the other groups in two important ways: their rates of diabetes and cardiovascular disease. As such, there may have been other differences between the groups, to the extent that the ARBs group were already less likely to develop dementia. For example the ARBs group may have had less severe vascular disease, or the other groups may have had m...

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  FDA panel votes down Bystolic as heart failure treatment

The use of nebivolol (Bystolic, Forest Laboratories), an oral beta blocker, to treat hypertension was unanimously vetoed for its use as a treatment for chronic heart failure by the FDA’s Cardiovascular and Renal Drugs Advisory Committee on Monday. (Source: Cardiovascular Business News)

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  A 12-week, randomized, double-masked study of fixed combination latanoprost/timolol versus latanoprost or timolol monotherapy.

Conclusions. Fixed combination latanoprost/timolol safely reduces IOP levels in patients with glaucoma or ocular hypertension, though only slightly more than does latanoprost monotherapy. PMID: 20099236 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

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  Losartan therapy in adults with Marfan syndrome: study protocol of the multi-center randomized controlled COMPARE trial

DiscussionThe COMPARE study will provide important evidence of effects of losartan treatment in adult Marfan patient population. We expect losartan to significantly reduce the occurrence and progression of aortic dilatation. This trial investigates a wide spectrum of clinical, genetic and biochemical effects of losartan aiming to provide further insight in the pathogenesis and treatment of Marfan syndrome.Trial registrationNetherlands Trial Register NTR1423. (Source: Trials)

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  Hormone and pharmaceutical regulation of ASP production in 3T3-L1 adipocytes

Several studies have demonstrated increases in acylation stimulating protein (ASP), and precursor protein C3 in obesity, diabetes and dyslipidemia, however the nature of the regulation is unknown. To evaluate chronic hormonal and pharmaceutical mediated changes in ASP and potential mechanisms, 3T3-L1 adipocytes were treated with physiological concentrations of relevant hormones and drugs currently used in treatment of metabolic diseases for 48 h. Medium ASP production and C3 secretion were evaluated in relation to changes in adipocyte lipid metabolism (cellular triglyceride (TG) mass, non-esterified fatty acid (NEFA) release and real-time FA uptake). Chylomicrons increased ASP production (up to 411 ± 133% P < 0.05), while leptin, triiodothyronine, and [beta]-blockers atenolol and proprano...

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  Simultaneous determination of atenolol, chlorthalidone and amiloride in pharmaceutical preparations by capillary zone electrophoresis with ultraviolet detection.

Authors: Al Azzam KM, Saad B, Aboul-Enein HY Capillary zone electrophoresis methods for the simultaneous determination of the beta-blocker drugs, atenolol, chlorthalidone and amiloride, in pharmaceutical formulations have been developed. The influences of several factors (buffer pH, concentration, applied voltage, capillary temperature and injection time) were studied. Using phenobarbital as internal standard, the analytes were all separated in less than 4 min. The separation was carried out in normal polarity mode at 25 degrees C, 25 kV and using hydrodynamic injection (10 s). The separation was effected in an uncoated fused-silica capillary (75 mum i.d. x 52 cm) and a background electrolyte of 25 mm H(3)PO(4) adjusted with 1 m NaOH solution (pH 9.0) and detection at 198 nm. The metho...

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