Most cited article: Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date

Author(s):Isabella Barreto S. Machado, Matheus Rampinelli Tofanelli, Ariadna A. Saldanha da Silva and Ana Cristina Simões e Silva*

Background: Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted.

Objective: The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors.

Methods: This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus.

Results: The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms.

Conclusion: The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.

Read what our Authors have to say about publishing in our Journals | Dr. Rina Das

 

By Dr. Rina Das

Journal Name: Current Drug Targets

Contributed Article: Considering Circadian Pattern of Blood Pressure in the Treatment of Hypertension via Chronotherapy: A Conducive or Maladroit Approach

Press Release | Dose-dependent effects of esmolol-epinephrine combination therapy in myocardial ischemia

 

The article by Dr. Tobias Eckle et al. is published in Current Pharmaceutical Design, Volume 25, 2019. The complete paper is published in Current Pharmaceutical Design. Please visit the following link to access the paper: http://www.eurekaselect.com/node/172732/article/dose-dependent-effects-of-esmolol-epinephrine-combination-therapy-in-myocardial-ischemia-and-reperfusion-injury

 

 

Epinephrine has been included in resuscitation guidelines worldwide since the 1960s. It is believed that epinephrine increases the chance of restoring a person’s heartbeat and improves long-term neurological outcome through increasing coronary and cerebral perfusion pressure. However, recent studies have raised doubts about the benefit of epinephrine regarding neurological outcomes in cardiac arrest. Moreover, epinephrine use in the stabilization of a cardiogenic shock in post-myocardial infarction patients has been found to increase the incidence of refractory shock. In fact, beta-adrenergic receptor stimulation has been suggested to have deleterious effects as stimulation of this pathway increases oxygen consumption and reduces sub-endocardial perfusion. In contrast, esmolol, a cardio-selective β1-blocker, has been shown to provide cardioprotection after myocardial ischemia in animal and human studies. Therefore, esmolol co-administration with epinephrine may help to reduce epinephrine-reperfusion injury but maintain esmolol-cardioprotection and epinephrine mediated increases in chronotropy and inotropy. Indeed, recent studies in animals have uncovered beneficial effects of epinephrine and esmolol co-administration in a cardiac arrest model. Based on these findings, Dr. Tobias Eckle and his team at the University of Colorado School of Medicine, University of Colorado have investigated esmolol-epinephrine combination therapy in a mouse model of myocardial ischemia and reperfusion injury.

Comparing different esmolol doses in combination with epinephrine in a mouse model of myocardial infarction, Eckle’s team demonstrated that at a specific esmolol-epinephrine ratio (15:1), esmolol-cardioprotection and epinephrine β1 mediated hemodynamic activity can both simultaneously exist during myocardial ischemia and reperfusion injury. “These findings might have implications for current clinical practice in the treatment of patients with cardiogenic shock or cardiac arrest”, says Eckle. “In fact, a cardiogenic shock after myocardial ischemia disallows the use of esmolol due to hemodynamic instability.” Interestingly, a definite recommendation for a specific catecholamine regimen in cardiogenic shock is lacking.

Combination therapy of epinephrine with esmolol seems less intuitive in cardiogenic shock after myocardial ischemia according to the research; higher esmolol doses could compromise epinephrine mediated increases of cardiac output via β1 adrenergic receptor inotropic and chronotropic effects, or higher epinephrine doses could compromise esmolol mediated cardioprotection via β1 adrenergic receptor blockade. Surprisingly, by increasing the esmolol dose, the study team was able to restore esmolol-cardioprotection while heart rate and some blood pressures in the early reperfusion phase were significantly increased compared to an esmolol treatment alone. “This finding is novel and highlights that esmolol cardioprotection is not fully understood,” says Eckle. Having increased heart rates, which is β1 mediated, and at the same time seeing cardioprotection via esmolol β1 blockade, indicates that only a part or short-term blockade of β1 receptors is necessary for the salutary effects of esmolol in myocardial ischemia and reperfusion injury.

While some clinicians occasionally use esmolol in patients on epinephrine infusion due to cardiogenic shock going off cardiac bypass to treat epinephrine-induced arrhythmias, no study to date has evaluated potential cardioprotective effects of esmolol-epinephrine co-administration during cardiac bypass surgery or a cardiogenic shock. As this is the first animal study on epinephrine-esmolol co-administration during myocardial ischemia and reperfusion injury, further studies in larger animals using multiple dosing protocols are suggested. Read full press release to find out more at: https://www.eurekalert.org/pub_releases/2019-07/bsp-deo070219.php

ARTICLE BY DISEASE – The Prevalence of the Classical and Non-Classical Cardiovascular Risk Factors in Multiple Sclerosis Patients

 

ARTICLE BY DISEASE ON “ACOUSTIC NEUROMA”

 

Background: Inflammation is known to play a role in cererovascular risk. Multiple sclerosis (MS) is a neurodegenerative disease that is initially characterized by inflammatory changes in the brain. We hypothesized that due to chronic inflammation, MS patients would present with a higher levels of cardiovascular (CV) risk factors than non-MS patients.

Methods: We performed a retrospective chart review on 206 MS patients and 142 control patients suffering from meningiomas and acoustic neuromas, non inflammatory, non autoimmune diseases of the brain. The obtained data included fasting lipid profiles, plasma glucose, systolic and diastolic blood pressure (BP), serum levels of homocysteine and uric acid, data on iron status, smoking habit, and list of medications. In addition, data on indicators of MS disease severity was obtained for MS patients.

Results: MS patients had significantly higher total plasma cholesterol, p = 0.01, and plasma high density lipoprotein, P <0.001, but lower plasma glucose, P <0.001, and systolic BP, P = 0.001, than non-MS patients. In addition, MS patients had lower erythrocyte sedimentation rate and serum vitamin B12, but higher serum folic acid and vitamin D3 than non-MS patients. A positive correlation was observed between plasma glucose and the extended disability status scale (EDSS), P = 0.008, and between plasma glucose and the rate of clinical relapse, P = 0.001.

Conclusion: The MS pathophysiology may be among factors for the lower CV risk factors in MS patients. Future studies should examine whether the chronic use of many pharmacological agents influence CV risk factors in MS patients.

 

For more details, please visit: http://www.eurekaselect.com/node/107982/article

ARTICLES BY DISEASE – The Prevalence of the Classical and Non-Classical Cardiovascular Risk Factors in Multiple Sclerosis Patients

ARTICLE BY DISEASE ON “ACOUSTIC NEUROMA”

 

Abstract:

Background: Inflammation is known to play a role in cererovascular risk. Multiple sclerosis (MS) is a neurodegenerative disease that is initially characterized by inflammatory changes in the brain. We hypothesized that due to chronic inflammation, MS patients would present with a higher levels of cardiovascular (CV) risk factors than non-MS patients.

Methods: We performed a retrospective chart review on 206 MS patients and 142 control patients suffering from meningiomas and acoustic neuromas, non inflammatory, non autoimmune diseases of the brain. The obtained data included fasting lipid profiles, plasma glucose, systolic and diastolic blood pressure (BP), serum levels of homocysteine and uric acid, data on iron status, smoking habit, and list of medications. In addition, data on indicators of MS disease severity was obtained for MS patients.

Results: MS patients had significantly higher total plasma cholesterol, p = 0.01, and plasma high density lipoprotein, P <0.001, but lower plasma glucose, P <0.001, and systolic BP, P = 0.001, than non-MS patients. In addition, MS patients had lower erythrocyte sedimentation rate and serum vitamin B12, but higher serum folic acid and vitamin D3 than non-MS patients. A positive correlation was observed between plasma glucose and the extended disability status scale (EDSS), P = 0.008, and between plasma glucose and the rate of clinical relapse, P = 0.001.

Conclusion: The MS pathophysiology may be among factors for the lower CV risk factors in MS patients. Future studies should examine whether the chronic use of many pharmacological agents influence CV risk factors in MS patients

For more details, please visit: http://www.eurekaselect.com/node/107982/article

Treat Blood Pressure With Exercise

Blood pressure is among the most common problems that people suffer with. This is a more frequently occurring phenomena as we age. There are several reasons including increased body weight, weaker heart, hardening blood vessels and such. Usually people are left with no option but to take regular medicines to keep the pressure in control.

Research, however, has proven that there can be another resort, which is to include regular exercise in our life. Exercise does not only mean weight training; it can be any physical work where we exert energy and keep ourselves moving. Mowing the lawn, normal morning and evening walks, jogging and other routines that we spend time on every day, can do the trick. When we exercise, our heart muscles gradually become stronger. Stronger heart can pump blood more easily without putting extra pressure. As the pumping improves the blood flow to vessels also improves. This means that our heart does not have to pressurize the vessels by pounding blood through them.

Similarly our breathing improves with exercise. We tend to get more oxygen into our blood with better breathing. The exercises that enhance breathing are also called aerobics. The Department of Health and Human Services, USA, has proposed that we should have at least 150 minutes of moderate aerobics, or 75 minutes of intense aerobics every week to keep the blood pressure in check. There are various routines – simple to very complex – that can be followed depending on our capacity. But the key to exercising is consistency. If you start it one day, do it every day and see your blood pressure well under control.

Health Benefits of Deep Breathing

When we are stressed, angry or anxious, we might experience rapid, shallow breathing, tightened muscles, and other negative symptoms. Not only do these unpleasant symptoms feel bad, they may also lead to heart problems, sleeplessness, increased blood pressure, infections and autoimmune diseases in the long run, if experienced repeatedly.

Luckily, deep breathing can help you avoid these unpleasant symptoms and diseases. But what exactly does deep breathing do for you? Here’s a list:

1. It relaxes your muscles

It is hard to maintain physical tension when breathing deeply.

2. It improves oxygen delivery

When you are relaxed and breathing deeply, fresh oxygen is supplied to every cell in your body. This leads to better functionality of body organs, as well as enhanced mental focus and physical strength.

3. It lowers blood pressure

As your muscles release tension as a result of deep breathing, your blood vessels expand and your blood pressure is normalized.

4. It causes endorphins’ release

Deep breathing causes the release of endorphins, thus increasing the sensations of comfort and relieving pain.

5. It detoxifies

Taking long and deep breaths helps improve lymphatic system function which boosts dangerous toxin release, thus cleansing the body and allowing it to focus its energy to more fruitful tasks.

So, breathe deeply and live more joyfully!

Open Access Article – Control of Risk Factors for Cardiovascular Disease among Multinational Patient Population in the Arabian Gulf – Current Vascular Pharmacology

Journal: Current Vascular Pharmacology

Author(s): Ibrahim Al-Zakwani, Wael Al-Mahmeed, Mohamed Arafah, Ali T. Al-Hinai, Abdullah Shehab, Omer Al-Tamimi, Mahmoud Al-Awadhi,Shorook Al-Herz, Faisal Al-Anazi, Khalid Al-Nemer, Othman Metwally, Akram Al-Khadra, Mohammed Fakhry, Hossam Elghetany, Abdel R. Medani,Afzal H. Yusufali, Obaid Al-Jassim, Omar Al-Hallaq, Fahad O.A.S. Baslaib, Haitham Amin, Raul D. Santos, Khalid Al-Waili, Khamis Al-Hashmi,Khalid Al-Rasadi.

Abstract:

We evaluated the control of cardiovascular disease (CVD) risk factors among patients with atherosclerotic cardiovascular disease (ASCVD) in the Centralized Pan-Middle East Survey on the undertreatment of hypercholesterolaemia (CEPHEUS) in the Arabian Gulf. Of the 4398 enrolled patients, overall mean age was 57 ± 11 years, 60% were males, 13% were smokers, 76% had diabetes, 71% had metabolic syndrome and 78% had very high ASCVD risk status. The proportion of subjects with body mass index <25 kg/m², HbA1c <7% (in diabetics), low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L (100 mg/dL) and <1.8 mmol/L (70 mg/dL) for high and very high ASCVD risk cohorts, respectively and controlled blood pressure (<140/90 mmHg) was 14, 26, 31% and 60%, respectively. Only 1.4% of the participants had all of their CVD risk factors controlled with significant differences among the countries (P < .001). CVD risk goal attainment rates were significantly lower in those with very high ASCVD risk compared with those with high ASCVD risk status (P < .001). Females were also, generally, less likely to attain goals when compared with males (P < .001).

Read more here: http://www.eurekaselect.com/136029

What We Know of Migraine

Migraine is among the most prevalent problems, and is very hard to deal with. Doctors and researchers have been perplexed for decades what exactly causes it and how can it be fought off. Migraine is signified by chronic headaches that recur either in days or weeks. The pain can be mild or intensified, varying from case to case. But no one is yet sure about the reason for this problem.

Suspecting that it is caused by high or low blood pressure, trauma, high level of stress, some deficiency or any such issue, people try to resolve it through medicines, exercise and change in diet etc. The pain may disappear for the time being but it returns with the same strength. This goes to show that there is some other reason, and the researchers believe that migraine is genetic disorder. Researchers, psychologists and doctors consider it illusive in nature as migraine cannot be diagnosed through X-rays, MRI, other means of brain imaging or any other physical symptoms. The only means of diagnosis is through the accounts of the patents about how often they face it, and how they feel in it.

The psychologists are now developing integrated solutions to attempt to treat migraine sufferers. They suggest lifestyle changes, diet alterations, pills as well as exercises to harness, if not eliminate, this widespread disorder. But the greatest developments are antimigraine drugs that can get patients rid of it.

Here are some important articles on migraine, published by Bentham Science Publishers:

http://www.eurekaselect.com/149377

http://www.eurekaselect.com/127406

 

Highlighted Article – Ginseng for Treating Hypertension – Current Vascular Pharmacology

To access this article, please visit: http://www.eurekaselect.com/154179/article