Pub Date : 2020-04-13DOI: 10.33552/ojcr.2020.03.000573
Ilan A Yaeger
Current single-artery FFR-oriented coronary stenosis severity assessment methods (resting P d /P a , wave-free iFR and hyperemic FFR) are used successfully in single vessel disease (SVD) cases. In such cases the stenotic artery is in an independent stand-alone position with a proximal intracoronary aortic driving pressure. The treatment decision criteria of each method (FFR threshold value and FFR ‘grey range’) apply to FFR of the artery (denoted FFR true ) which is the remnant fraction left in the stenotic artery of the calculated virtual blood flow of the very same artery prior to the onset of stenosis. As FFR true can be expressed in terms of the total stenotic resistance R s of the artery and the microvascular resistance Rmv associated with the artery, FFR true can be also justifiably regarded as an ad-hoc intrinsic property of the stenotic artery. It doesn’t change unless the artery undergoes revascularization, turning its FFR true to nearly 1.00. The general scenario however encountered in the PCI practice is one in which a stenotic artery interconnects with other stenotic arteries and it is no longer in an independent stand-alone position since inter-arterial stenosis-stenosis interactions take place. Due to this substantial change of circumstances, treatment decision criteria no longer apply to FFR true of an artery, rather to its actual FFR (denoted FFR real ). The multi-artery FFR method is not intended to constitute a substitute for any of the current FFR-oriented methods. As single-artery FFR-oriented methods cannot resolve complex scenarios of interacting stenotic coronary arteries, in this article the novel multi-artery FFR method extends these methods to the multi-artery domain with no need to alter their associated experimental techniques nor their treatment decision criteria. Reduction of the mathematics to minimal number of simple formulas in this article enables the PCI practitioner to apply the formulas to measured intracoronary pressures in real time.
目前以单动脉FFR为导向的冠状动脉狭窄严重程度评估方法(静息P d /P a、无波iFR和充血性FFR)已成功用于单血管疾病(SVD)病例。在这种情况下，狭窄动脉处于独立的独立位置，近端冠状动脉内驱动压力。每种方法的治疗决策标准(FFR阈值和FFR“灰色范围”)适用于该动脉的FFR(记为FFR true)，即同一动脉在狭窄发生前计算出的虚拟血流量在狭窄动脉中留下的残余分数。由于FFR true可以用动脉总狭窄阻力R s和与动脉相关的微血管阻力Rmv来表示，因此FFR true也可以被合理地视为狭窄动脉的一种特殊的内在属性。除非动脉经历血运重建，否则它不会改变，使其FFR真实值接近1.00。然而，在PCI实践中遇到的一般情况是狭窄动脉与其他狭窄动脉相互连接，由于动脉间狭窄-狭窄相互作用，它不再处于独立的独立位置。由于这种情况的重大变化，治疗决策标准不再适用于动脉的真实FFR，而是适用于其实际FFR(记为真实FFR)。多动脉FFR方法并不打算取代任何当前的FFR导向方法。由于以单动脉FFR为导向的方法不能解决复杂的冠状动脉狭窄相互作用的情况，在本文中，新的多动脉FFR方法将这些方法扩展到多动脉领域，而不需要改变其相关的实验技术和治疗决策标准。本文将数学简化为简单公式的最小数量，使PCI从业者能够将公式应用于实时测量的冠状动脉内压力。
{"title":"The Multi-Artery Fractional Flow Reserve (FFR) Method in The Percutaneous Coronary Intervention (PCI) Practice","authors":"Ilan A Yaeger","doi":"10.33552/ojcr.2020.03.000573","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000573","url":null,"abstract":"Current single-artery FFR-oriented coronary stenosis severity assessment methods (resting P d /P a , wave-free iFR and hyperemic FFR) are used successfully in single vessel disease (SVD) cases. In such cases the stenotic artery is in an independent stand-alone position with a proximal intracoronary aortic driving pressure. The treatment decision criteria of each method (FFR threshold value and FFR ‘grey range’) apply to FFR of the artery (denoted FFR true ) which is the remnant fraction left in the stenotic artery of the calculated virtual blood flow of the very same artery prior to the onset of stenosis. As FFR true can be expressed in terms of the total stenotic resistance R s of the artery and the microvascular resistance Rmv associated with the artery, FFR true can be also justifiably regarded as an ad-hoc intrinsic property of the stenotic artery. It doesn’t change unless the artery undergoes revascularization, turning its FFR true to nearly 1.00. The general scenario however encountered in the PCI practice is one in which a stenotic artery interconnects with other stenotic arteries and it is no longer in an independent stand-alone position since inter-arterial stenosis-stenosis interactions take place. Due to this substantial change of circumstances, treatment decision criteria no longer apply to FFR true of an artery, rather to its actual FFR (denoted FFR real ). The multi-artery FFR method is not intended to constitute a substitute for any of the current FFR-oriented methods. As single-artery FFR-oriented methods cannot resolve complex scenarios of interacting stenotic coronary arteries, in this article the novel multi-artery FFR method extends these methods to the multi-artery domain with no need to alter their associated experimental techniques nor their treatment decision criteria. Reduction of the mathematics to minimal number of simple formulas in this article enables the PCI practitioner to apply the formulas to measured intracoronary pressures in real time.","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"209 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131655954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-07DOI: 10.33552/ojcr.2020.03.000572
E. V. Gomes
Pericarditis is an inflammatory process that affects the layers of the pericardium. It is characterized by chest pain and electrocardiogram changes and may be followed by pericardial effusion and rub. Here, we aimed to identify the main clinical diagnosis criteria and therapeutic management approaches of pericarditis, its variants, and related complications.
{"title":"Pericarditis: A Clinical and Therapeutic Update","authors":"E. V. Gomes","doi":"10.33552/ojcr.2020.03.000572","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000572","url":null,"abstract":"Pericarditis is an inflammatory process that affects the layers of the pericardium. It is characterized by chest pain and electrocardiogram changes and may be followed by pericardial effusion and rub. Here, we aimed to identify the main clinical diagnosis criteria and therapeutic management approaches of pericarditis, its variants, and related complications.","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125753251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.33552/ojcr.2020.03.000571
T. Martinez
Although EUROSCORE II is a strong predictor of mortality, it is not completely exact. The literature presents several examples in which this parameter collaborates, but does not provide conclusive predictability. From a database of 950 adult patients and of both sexes from an Intensive Care Unit of a large tertiary hospital, smokers were selected, classified according to exposure levels, in a number of 81 in total. A regression was then performed using a linear model of least squares. Controlled variables: gender, age, diabetes, hypertension, body mass index and primary or secondary prevention. Formula EUROSCORE II in smoking patients presented associations with cholesterol and hypertension levels, which, according to statistical analysis, were not confounding factors.
{"title":"Can Hypercholesterolemia Alter Euroscore II Predictivity in Smokers?","authors":"T. Martinez","doi":"10.33552/ojcr.2020.03.000571","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000571","url":null,"abstract":"Although EUROSCORE II is a strong predictor of mortality, it is not completely exact. The literature presents several examples in which this parameter collaborates, but does not provide conclusive predictability. From a database of 950 adult patients and of both sexes from an Intensive Care Unit of a large tertiary hospital, smokers were selected, classified according to exposure levels, in a number of 81 in total. A regression was then performed using a linear model of least squares. Controlled variables: gender, age, diabetes, hypertension, body mass index and primary or secondary prevention. Formula EUROSCORE II in smoking patients presented associations with cholesterol and hypertension levels, which, according to statistical analysis, were not confounding factors.","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117051861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-31DOI: 10.33552/ojcr.2020.03.000570
Seriki Sa
Medicinal values of several plants have over time provided alternatives to conventional medicines in the treatment
随着时间的推移，几种植物的药用价值为治疗提供了传统药物的替代品
{"title":"Hypotensive Potential of Desmodium Adscendens on Cardiovascular Functions","authors":"Seriki Sa","doi":"10.33552/ojcr.2020.03.000570","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000570","url":null,"abstract":"Medicinal values of several plants have over time provided\u0000alternatives to conventional medicines in the treatment","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129440624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-12DOI: 10.33552/ojcr.2020.03.000568
Phillip J Camp
Background: It is well known that obstructive sleep apnea (OSA) prevalence increases as body mass index (BMI) increases. Patients with OSA experience nocturnal apnea episodes which can result in hypoxemia, transient elevation of right atrial pressures, and a possible increase in right to left shunting. As such, OSA diagnosis and therapy may be tailored to address right-to-left shunting in these patients. Whether the prevalence of PFO in OSA
{"title":"Prevalence and Impact of Patent Foramen Ovale in Patients with Obstructive Sleep Apnea","authors":"Phillip J Camp","doi":"10.33552/ojcr.2020.03.000568","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000568","url":null,"abstract":"Background: It is well known that obstructive sleep apnea (OSA) prevalence increases as body mass index (BMI) increases. Patients with OSA experience nocturnal apnea episodes which can result in hypoxemia, transient elevation of right atrial pressures, and a possible increase in right to left shunting. As such, OSA diagnosis and therapy may be tailored to address right-to-left shunting in these patients. Whether the prevalence of PFO in OSA","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121752770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-11DOI: 10.33552/ojcr.2020.03.000567
T. R. Martinez
Simultaneity of hypertension and hyperlipidemia as added risk factors for renal and cardiovascular disease cannot be approached without considering concomitant effect of some antihypertensive agents causing secondary hypercholesterolemia or hypertriglyceridemia. Hypertension and atherosclerosis are two important and related risk factors associated with the morbidity and mortality of patients with chronic renal failure. Increased prevalence of hypertensive nephropathy as a major cause of end stage renal disease has been reported. Among these patients, the cardiovascular morbidity is estimated around 10 to 20 times that observed in the general population and may be present in half of patients under dyalisis. Hypertension accelerates the development of atherosclerosis. On the other hand, dyslipidemias are associated to a higher dammage of hypertensive renal disease, aswell as to myocardial hypertrophy and to the incidence of cardiovascular events in hypertensive patients. Treatment of hypertension can modify the lipid profile and atherosclerosis induced by hyperlipidemia.
{"title":"Hyperlipidemia Associations with Hypertension Medications","authors":"T. R. Martinez","doi":"10.33552/ojcr.2020.03.000567","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000567","url":null,"abstract":"Simultaneity of hypertension and hyperlipidemia as added risk factors for renal and cardiovascular disease cannot be approached without considering concomitant effect of some antihypertensive agents causing secondary hypercholesterolemia or hypertriglyceridemia. Hypertension and atherosclerosis are two important and related risk factors associated with the morbidity and mortality of patients with chronic renal failure. Increased prevalence of hypertensive nephropathy as a major cause of end stage renal disease has been reported. Among these patients, the cardiovascular morbidity is estimated around 10 to 20 times that observed in the general population and may be present in half of patients under dyalisis. Hypertension accelerates the development of atherosclerosis. On the other hand, dyslipidemias are associated to a higher dammage of hypertensive renal disease, aswell as to myocardial hypertrophy and to the incidence of cardiovascular events in hypertensive patients. Treatment of hypertension can modify the lipid profile and atherosclerosis induced by hyperlipidemia.","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130406282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-18DOI: 10.33552/ojcr.2020.03.000566
F. Çınar
The aim of this study was to investigate the mobility levels of the patients who had open heart surgery and ınfluencing factors the postoperative period. Method: This is a descriptive cross-sectional study. The study sample consisted of 118 patients who had open heart surgery in a cardiovascular surgery clinic of a cardiovascular surgery training hospital. The study was conducted between October and December 2018 in a 3-month period. The mobility difficulties experienced by the patients and their activity levels during the postoperative period were evaluated using the Patient Mobility Scale and the Observer Mobility Scale. The data were analyzed using SPSS 25.0 software. Results: 41.7% of patients returned to the other side of the bed, 36.3% had to sit on the edge of the bed and 32.8% had oral warning and physical help while walking in the room, while 27.4% stand up independently with verbal warning on the edge of the bed. they were able to get up. The results showed that the patients were unable to turn independently from one side of the bed to the other. Conclusion: The findings of this study are significant in order to show that the patients who have undergone open heart surgery to increase the level of movement in early postoperative period will have a positive effect on the overall recovery process of the patients.
{"title":"The Investigation of Mobility Levels of Postoperative Patients Open Heart Surgery and Influencing Factors","authors":"F. Çınar","doi":"10.33552/ojcr.2020.03.000566","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000566","url":null,"abstract":"The aim of this study was to investigate the mobility levels of the patients who had open heart surgery and ınfluencing factors the postoperative period. Method: This is a descriptive cross-sectional study. The study sample consisted of 118 patients who had open heart surgery in a cardiovascular surgery clinic of a cardiovascular surgery training hospital. The study was conducted between October and December 2018 in a 3-month period. The mobility difficulties experienced by the patients and their activity levels during the postoperative period were evaluated using the Patient Mobility Scale and the Observer Mobility Scale. The data were analyzed using SPSS 25.0 software. Results: 41.7% of patients returned to the other side of the bed, 36.3% had to sit on the edge of the bed and 32.8% had oral warning and physical help while walking in the room, while 27.4% stand up independently with verbal warning on the edge of the bed. they were able to get up. The results showed that the patients were unable to turn independently from one side of the bed to the other. Conclusion: The findings of this study are significant in order to show that the patients who have undergone open heart surgery to increase the level of movement in early postoperative period will have a positive effect on the overall recovery process of the patients.","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126346246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-09DOI: 10.33552/ojcr.2020.03.000563
N. Oguanobi
Nelson I Oguanobi1*, Charles U Odenigbo2, Ogonna C Oguejiofor2, Ezechukwu Aniekwensi3, Uchenna C Okonkwo4, Ukamaka M Odenigbo5 and Tobenna Agogbua1 1Department of Internal Medicine, University of Nigeria Teaching Hospital Enugu, Nigeria 2Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria 3Department of Medicine, Federal Medical Centre Asaba, Nigeria 4Department of Medicine, University College Hospital Calabar, Nigeria 5Department of Dietetics, Federal University of Agriculture Umudike, Nigeria
Nelson I Oguanobi1*， Charles U Odenigbo2, Ogonna C Oguejiofor2, Ezechukwu Aniekwensi3, Uchenna C Okonkwo4, Ukamaka M Odenigbo5和Tobenna agogbu1 1尼日利亚大学埃努古教学医院内科2尼日利亚Nnamdi Azikiwe大学Nnewi教学医院内科3尼日利亚阿萨巴联邦医疗中心医学部4尼日利亚卡拉巴尔大学附属医院医学部5营养学系，乌穆代克联邦农业大学，尼日利亚
{"title":"Age-Related Electrocardiographic Changes in Apparently Healthy Adult Nigerians!","authors":"N. Oguanobi","doi":"10.33552/ojcr.2020.03.000563","DOIUrl":"https://doi.org/10.33552/ojcr.2020.03.000563","url":null,"abstract":"Nelson I Oguanobi1*, Charles U Odenigbo2, Ogonna C Oguejiofor2, Ezechukwu Aniekwensi3, Uchenna C Okonkwo4, Ukamaka M Odenigbo5 and Tobenna Agogbua1 1Department of Internal Medicine, University of Nigeria Teaching Hospital Enugu, Nigeria 2Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria 3Department of Medicine, Federal Medical Centre Asaba, Nigeria 4Department of Medicine, University College Hospital Calabar, Nigeria 5Department of Dietetics, Federal University of Agriculture Umudike, Nigeria","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"236 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132650365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-03DOI: 10.33552/ojcr.2019.03.000562
Rita Nascimento
In the present study we performed a literature review, aiming to understand the practical applicability of this new guidelines in the older people, and especially in frail elderly. We searched on the online database “Pubmed” the MESH terms “Hypertension” and “Frail Elderly” and we selected 32 out of 76 papers published in the last 10 years; from this 32 we selected the ones that approached the treatment targets for blood pressure. This research was complemented with the inclusion of other international guidelines and papers that were found relevant. From the papers selected to perform this review, we found guidelines, reviews and observational studies, some with conflicting results and others that are unable to define a blood pressure target in frail and institutionalized elderly. Hypertension is a well stablished cardiovascular (CV) risk factor in adults, active independent older people and even in frail elderly; nevertheless in the group of frail elderly there is evidence that they might lack a benefit in the aggressive treatment of high blood pressure. The randomized controlled trials from Beckett N, et al. [1] and Briasoulis A, et al. [2] showed that the hypertension treatment in older patients (age ≥65 years) and very old patients (≥80 years) significantly reduced CV morbidity and CV and all-cause mortality. In this studies treatment of hypertension was found to be well tolerated. The 2018 ESC/ESH guidelines recommend systolic blood pressure (SBP) target at 130-139 mmHg and diastolic blood pressure (DBP) under 80 mmHg for elderly above 65 years. The American guidelines (2017) recommend SBP under 130 mmHg for community dwelling older people above 65 years, but also recommend wariness in the risk-benefit relation, presence of comorbidities and limited life span. The Canadian guidelines (2018) refer to a lack of evidence to make a recommendation in blood pressure targets in institutionalized elderly [3]. The Australian guidelines (2016) recommend a target of SPB under 120 mmHg and the British (2017) omit a recommendation referring to targets in this population.
在目前的研究中，我们进行了文献综述，旨在了解这一新指南在老年人，特别是在体弱老年人中的实际适用性。我们在网络数据库Pubmed中检索MESH术语“Hypertension”和“虚弱的老年人”，从近10年发表的76篇论文中选择32篇;从这32种药物中，我们选择了接近血压治疗目标的药物。这项研究还纳入了其他被认为相关的国际准则和论文。从进行本综述的论文中，我们找到了指南、综述和观察性研究，其中一些结果相互矛盾，另一些则无法确定体弱和机构老年人的血压目标。高血压是成年人、活跃的独立老年人甚至体弱老年人中公认的心血管(CV)危险因素;然而，在体弱多病的老年人群体中，有证据表明他们在积极治疗高血压方面可能缺乏益处。Beckett N, et al.[1]和Briasoulis A, et al.[2]的随机对照试验表明，老年患者(≥65岁)和高龄患者(≥80岁)的高血压治疗可显著降低CV发病率、CV和全因死亡率。在这项研究中，发现高血压的治疗耐受性良好。2018年ESC/ESH指南建议65岁以上老年人收缩压(SBP)目标为130-139 mmHg，舒张压(DBP)低于80 mmHg。美国指南(2017)建议65岁以上社区居民的收缩压低于130 mmHg，但也建议注意风险-收益关系、合并症的存在和有限的寿命。加拿大指南(2018)指出，缺乏证据建议机构老年人的血压目标[3]。澳大利亚指南(2016年)建议将SPB目标控制在120毫米汞柱以下，英国指南(2017年)省略了针对这一人群的目标的建议。
{"title":"What are the Tensional Goals in the Frail Elderly?","authors":"Rita Nascimento","doi":"10.33552/ojcr.2019.03.000562","DOIUrl":"https://doi.org/10.33552/ojcr.2019.03.000562","url":null,"abstract":"In the present study we performed a literature review, aiming to understand the practical applicability of this new guidelines in the older people, and especially in frail elderly. We searched on the online database “Pubmed” the MESH terms “Hypertension” and “Frail Elderly” and we selected 32 out of 76 papers published in the last 10 years; from this 32 we selected the ones that approached the treatment targets for blood pressure. This research was complemented with the inclusion of other international guidelines and papers that were found relevant. From the papers selected to perform this review, we found guidelines, reviews and observational studies, some with conflicting results and others that are unable to define a blood pressure target in frail and institutionalized elderly. Hypertension is a well stablished cardiovascular (CV) risk factor in adults, active independent older people and even in frail elderly; nevertheless in the group of frail elderly there is evidence that they might lack a benefit in the aggressive treatment of high blood pressure. The randomized controlled trials from Beckett N, et al. [1] and Briasoulis A, et al. [2] showed that the hypertension treatment in older patients (age ≥65 years) and very old patients (≥80 years) significantly reduced CV morbidity and CV and all-cause mortality. In this studies treatment of hypertension was found to be well tolerated. The 2018 ESC/ESH guidelines recommend systolic blood pressure (SBP) target at 130-139 mmHg and diastolic blood pressure (DBP) under 80 mmHg for elderly above 65 years. The American guidelines (2017) recommend SBP under 130 mmHg for community dwelling older people above 65 years, but also recommend wariness in the risk-benefit relation, presence of comorbidities and limited life span. The Canadian guidelines (2018) refer to a lack of evidence to make a recommendation in blood pressure targets in institutionalized elderly [3]. The Australian guidelines (2016) recommend a target of SPB under 120 mmHg and the British (2017) omit a recommendation referring to targets in this population.","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133243341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-09DOI: 10.33552/ojcr.2019.03.000561
L. Albuquerque, D. Napierkowski, Thomas Greey
World health organization has recognized Cardiac rehabilitation (CR) as a standard of care for prevention of cardiovascular disease such as cardiovascular mortality, cardiac death, stroke and non-fatal myocardial infarction. CR includes supervised training and self-care management recommended by the American Heart Association (AHA) and American College of Cardiology. Endurance type of exercise helps in improving the peak aerobic capacity (Peak VO2).
{"title":"Cardiac Rehabilitation and Endurance Exercise Improves Heart Health Behaviors and Health Status: Do Patients Adhere?","authors":"L. Albuquerque, D. Napierkowski, Thomas Greey","doi":"10.33552/ojcr.2019.03.000561","DOIUrl":"https://doi.org/10.33552/ojcr.2019.03.000561","url":null,"abstract":"World health organization has recognized Cardiac rehabilitation (CR) as a standard of care for prevention of cardiovascular disease such as cardiovascular mortality, cardiac death, stroke and non-fatal myocardial infarction. CR includes supervised training and self-care management recommended by the American Heart Association (AHA) and American College of Cardiology. Endurance type of exercise helps in improving the peak aerobic capacity (Peak VO2).","PeriodicalId":289086,"journal":{"name":"Online Journal of Cardiovascular Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115359007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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