keyword
https://read.qxmd.com/read/38089047/verapamil-chronicles-advances-from-cardiovascular-to-pancreatic-%C3%AE-cell-protection
#21
REVIEW
Hossein Arefanian, Lubaina Koti, Sardar Sindhu, Rasheed Ahmad, Ashraf Al Madhoun, Fahd Al-Mulla
Verapamil is a well-known drug used for treating angina and hypertension. Emerging data from current clinical trials suggest that this calcium channel blocker has a potential benefit for pancreatic β-cells through the elevation and sustenance of C-peptide levels in patients with diabetes mellitus (DM). This is intriguing, given the fact that the current therapeutic options for DM are still limited to using insulin and incretins which, in fact, fail to address the underlying pathology of β-cell destruction and loss...
2023: Frontiers in Pharmacology
https://read.qxmd.com/read/38087668/the-diagnostic-approach-and-management-of-hypertension-in-the-emergency-department
#22
REVIEW
A J Manolis, M S Kallistratos, M Koutsaki, M Doumas, L E Poulimenos, J Parissis, E Polyzogopoulou, A Pittaras, M L Muiesan, G Mancia
Hypertension urgency and emergency represents a challenging condition in which clinicians should determine the assessment and/or treatment of these patients. Whether the elevation of blood pressure (BP) levels is temporary, in need of treatment, or reflects a chronic hypertensive state is not always easy to unravel. Unfortunately, current guidelines provide few recommendations concerning the diagnostic approach and treatment of emergency department patients presenting with severe hypertension. Target organ damage determines: the timeframe in which BP should be lowered, target BP levels as well as the drug of choice to use...
December 11, 2023: European Journal of Internal Medicine
https://read.qxmd.com/read/38074796/incidental-detection-of-pheochromocytoma-during-workup-for-symptomatic-aortic-stenosis-a-case-report-and-management-discussion
#23
Grant Dorman, Benjamin Rosenfeld, Chittoor B Sai Sudhakar, Heiko Schmitt, Rabi K Panigrahi, Beatriz R Tendler, Benjamin T Ristau
Pheochromocytoma patients with high levels of circulating catecholamines are at risk of cardiovascular complications related to hypertensive emergencies and subsequent organ damage. A patient with concomitant aortic stenosis and pheochromocytoma has compounded risk of cardiovascular complications, especially during surgery, which complicates medical decision-making. We report a patient with Turner syndrome and congenital heart defects (CHDs) who was incidentally discovered to have a pheochromocytoma during workup of symptomatic severe bioprosthetic aortic stenosis...
November 2023: Urology Case Reports
https://read.qxmd.com/read/38045865/fahr-syndrome-secondary-to-pseudohypoparathyroidism
#24
Sharon W Shu, Sakshi Sharma, Qasim Z Iqbal, Karina G Romo
Fahr syndrome is a rare neurologic disorder, usually affecting young and middle-aged adults, that can present with symptoms ranging from extrapyramidal to neuropsychiatric abnormalities. Pseudohypoparathyroidism (PHP), characterized by parathyroid hormone (PTH)-resistance or PTH-unresponsiveness at target organs, is associated with Fahr syndrome and typically presents with hypocalcemia. The following case presents a 39-year-old-woman with PHP complicated by symptomatic hypocalcemia, hypokalemia, and movement disturbances, who had computed tomography imaging showing basal ganglia calcifications consistent with Fahr syndrome...
November 2023: JCEM Case Rep
https://read.qxmd.com/read/38027841/the-impact-of-antiplatelet-drugs-on-recurrent-stroke-in-patients-with-intracerebral-hemorrhage
#25
JOURNAL ARTICLE
Yi-Sin Wong, Ching-Fang Tsai, Cheung-Ter Ong
BACKGROUND: The influence of antiplatelet drugs on the risk of hemorrhagic stroke and the reduction of ischemic stroke in patients with intracerebral hemorrhage (ICH) remains unclear. This study aimed to elucidate the impact of antiplatelet therapy on the risk of recurrent stroke in ICH patients. METHODS: The study encompassed ICH survivors discharged from a central Taiwanese teaching hospital between January 1, 2013, and December 31, 2019. Patient hospitalization and treatment data were retrieved from electronic medical records...
November 2023: Heliyon
https://read.qxmd.com/read/38021907/management-of-hypertensive-emergency-in-the-setting-of-primary-aldosteronism-complicated-by-heart-failure-with-reduced-ejection-fraction
#26
Tauseef Sarguroh, Aliziya Punjwani
We present a case of a 49-year-old man with a past medical history of uncontrolled hypertension and alcohol use disorder presently in sustained remission who presented to the ED with shortness of breath. He was admitted for the management of hypertensive emergency and hypokalemia and was later found to have primary aldosteronism complicated by heart failure with reduced ejection fraction. The patient's treatment-resistant hypertension as well as hypokalemia, which was refractory to repletion, resolved with mineralocorticoid-receptor-antagonist pharmacotherapy...
October 2023: Curēus
https://read.qxmd.com/read/38021534/the-importance-of-interdisciplinary-care-in-the-management-of-postpartum-hypertensive-crisis
#27
Niyati S Upadhyay, Nika Vafadari, Rebecca K Zhang, Joseph Salami, Martin Castaneda
Postpartum hypertension can significantly increase maternal morbidity and mortality, and hence it requires prompt interdisciplinary evaluation and interventions. We present a case of a gravid patient with significant comorbidities who required multiple treatments and care from several specialists following a complicated vaginal delivery. The outcome of this case depended on a focused differential diagnosis and interdisciplinary consultation with the several teams involved. This case report illustrates the importance of effective communication and an interdisciplinary approach in the management of postpartum hypertensive emergencies...
October 2023: Curēus
https://read.qxmd.com/read/37987967/slow-on-the-draw-ed-management-of-elevated-bp-in-older-adults
#28
REVIEW
Kianna Eurick-Bering, Brett Todd, Lauren Cameron-Comasco
PURPOSE OF REVIEW: The purpose of this study is to review data surrounding the emergency department management of elevated blood pressure in older adults, including the management of hypertensive crisis and outpatient management of markedly elevated blood pressure. RECENT FINDINGS: Acute lowering of blood pressure in older adults with markedly elevated blood pressure may lead to serious complications without improvements in hospital length of stay, return visits, or mortality...
November 21, 2023: Current Hypertension Reports
https://read.qxmd.com/read/37975974/evaluation-and-management-of-elevated-bp-in-children-in-the-ed
#29
REVIEW
Lilian Awad, Usha Sethuraman
PURPOSE OF REVIEW: Pediatric hypertension has been on the rise over the past four decades. While most cases are evaluated and managed in the primary healthcare setting, some children may be referred to the emergency department (ED) for an expedited workup of elevated blood pressure or for management of hypertensive crisis. RECENT FINDINGS: Acute severe hypertension without end-organ damage and hypertensive emergency are life-threatening conditions that healthcare providers must be prepared to accurately recognize and treat as pediatric hypertension increases in prevalence...
November 17, 2023: Current Hypertension Reports
https://read.qxmd.com/read/37975973/hypertensive-emergency-parenteral-antihypertensives-and-population-data
#30
REVIEW
T Michael Farley
PURPOSE OF REVIEW: Review parenteral therapeutic choices in treatment of hypertensive crises by mechanism of action and summarize recent literature on the management of hypertensive crises. RECENT FINDINGS: Recent data have documented the safety and efficacy of labetalol and nicardipine in treatment of hypertensive crises as well as characterized the hypertensive emergency population to a much greater extent. Based on recent data, hypertensive emergencies are seen in 0...
December 2023: Current Hypertension Reports
https://read.qxmd.com/read/37957866/clinical-profile-of-patients-with-hypertensive-emergency-referred-to-a-tertiary-hospital-in-the-western-cape-province-of-south-africa
#31
JOURNAL ARTICLE
Mohammed Talle, Anton Doubell, Pieter-Paul Robbertse, Sa'ad Lahri, Philip Herbst
BACKGROUND: Despite advances in managing hypertension, hypertensive emergencies remain a common indication for emergency room visits. Our study aimed to determine the clinical profile of patients referred with hypertensive emergencies. METHODS: We conducted an observational study involving patients aged ≥18 years referred with hypertensive crisis. A diagnosis of hypertensive emergencies was based on a systolic blood pressure (BP) ≥180 mmHg and/or a diastolic BP ≥110 mmHg, with acute hypertension-mediated organ damage (aHMOD)...
November 8, 2023: Current Hypertension Reviews
https://read.qxmd.com/read/37943375/blasting-off-persistent-hypertension-in-a-child-with-neuroblastoma
#32
JOURNAL ARTICLE
Elizabeth Elliott, Sarah Rogal, Boh Song, Aadil Kakajiwala
Hypertension in children with neuroblastoma is uncommon and can be difficult to control due to the potential for multiple underlying causes. We present the case of a pediatric patient with high-grade neuroblastoma which was complicated by hypertensive emergency. The patient had imaging suggestive of renal artery compression, as well as significantly elevated normetaphrine levels. Multiple anti-hypertensive agents, including an angiotensin converting enzyme inhibitor, α- and β-adrenergic receptor blockers, and a tyrosine hydroxylase inhibitor, were initiated prior to tumor excision...
November 9, 2023: Pediatric Nephrology
https://read.qxmd.com/read/37908262/pancreatic-acth-hypersecretion-and-pituitary-macroadenoma
#33
Chiara M Bettale, Jason W Allen, Zaid K Mahdi, Adriana G Ioachimescu
A 55-year-old woman admitted for hypertensive emergency and myocardial infarction reported weight gain, muscle weakness, easy bruising, and recent-onset diabetes in the past 3 to 12 months. Urinary and salivary cortisol and adrenocorticotropin hormone (ACTH) levels were elevated. Pituitary imaging detected a macroadenoma. ACTH and cortisol did not increase after corticotropin-releasing hormone administration. Imaging revealed a large pancreatic mass. Pathology indicated a well-differentiated World Health Organization (WHO) grade 2 distal pancreatic neuroendocrine neoplasm which stained for ACTH by immunohistochemistry...
January 2023: JCEM Case Rep
https://read.qxmd.com/read/37897111/hypertension-in-the-emergency-department-a-missed-opportunity-to-screen-for-primary-aldosteronism
#34
JOURNAL ARTICLE
Rachel D Graven, Ignatius Lee, Jing Ren, Jun Yang, Diana Egerton-Warburton
OBJECTIVES: Primary aldosteronism (PA) is a common but under-diagnosed secondary cause of hypertension. Emergency departments (EDs) often assess patients with severe hypertension or its sequelae, some of whom have underlying PA. We aimed to determine the proportion of patients presenting to the ED with hypertension who meet the Endocrine Society criteria for PA testing, and the proportion who were screened. METHODS: We performed a structured retrospective chart review of adults who presented to three EDs in an Australian tertiary health network between August 2019 and February 2020, with a coded presenting complaint of hypertension...
October 28, 2023: Academic Emergency Medicine
https://read.qxmd.com/read/37889602/persistently-elevated-sflt-1-and-recovery-of-reduced-adamts13-activity-in-malignant-hypertension
#35
JOURNAL ARTICLE
Hongkun Ma, Chongjian Wang, Mengdi Jiang, Kexin Jin, Tingting Xu, Zhiyu Wang, Jing Xu, Liyan Ni, Hao Shi, Pingyan Shen, Yongxi Chen, Xiaobei Feng, Wen Zhang
BACKGROUND AND OBJECTIVES: Malignant hypertension (MHT) characterized by acute hypertension with retinopathy or multiorgan damage, is a severe form of hypertensive emergency and associated with target organ involvement and poor kidney outcome. However, the underlying mechanisms are unclear. METHODS: Eighty-four patients with acute severe hypertension from the Nephrology Department and Emergency Department in a single center during January 2016 and December 2017 were prospectively enrolled and divided into MHT (n = 48) and non-MHT (n = 36) subgroups according to target organ evaluation...
October 23, 2023: Journal of Hypertension
https://read.qxmd.com/read/37877060/type-a-aortic-dissection-and-non-contrast-computed-tomography
#36
JOURNAL ARTICLE
Amelie Spangenberg, Shiavax J Rao, John Mackrell, Sarah Rimm, Christopher J Haas
Non-contrast enhanced chest computed tomography (CT) carries a low sensitivity for acute aortic dissection; CT Angiography remains the gold standard. We highlight the potential utility of non-contrast CT for detection of aortic dissection in a case of a young, immunocompromised man presenting with acute abdominal pain and renal injury. Given elevated creatinine, an initial non-contrast chest CT demonstrated subtle findings suggestive of aortic dissection (aneurysmal dilation of the proximal ascending aorta as well as displaced calcified intimal flap/intraluminal high linear density in the thoracic descending and distal abdominal aorta)...
2023: Journal of Community Hospital Internal Medicine Perspectives
https://read.qxmd.com/read/37872037/one-year-outcomes-following-a-hypertensive-urgency-or-emergency
#37
JOURNAL ARTICLE
Christos Fragoulis, Dimitrios Polyzos, Andreas Mavroudis, Panagiotis-Anastasios Tsioufis, Alexandros Kasiakogias, Ioannis Leontsinis, Emmanouil Mantzouranis, Theodoros Kalos, Athanasios Sakalidis, John Ntalakouras, Ioannis Andrikou, Kyriakos Dimitriadis, Dimitris Konstantinidis, Costas Thomopoulos, Konstantinos Tsioufis
There are scarce data on the comparative prognosis between patients with hypertensive emergencies (HE), urgencies (HU), and those without HU or HE (HP). Our study aimed to compare cardiovascular (CV) outcomes of HE, HU, and HP during a 12-month follow-up period. The population consisted of 353 consecutive patients presenting with HE or HU in a third-care emergency department and subsequently referred to our hypertension center for follow-up. After both groups completed scheduled follow-up visits, patients with HU were matched one-to-one by age, sex, and hypertension history with HP who attended our hypertension center during the same period...
October 21, 2023: European Journal of Internal Medicine
https://read.qxmd.com/read/37868671/a-critical-care-standpoint-in-the-diagnosis-of-scleroderma-renal-crisis
#38
Ariana Tagliaferri, Brooke Kania, Abraam Rezkalla, Ruth Lamm
Typical or atypical presentations of rare diseases may be confounded by co-morbidities in critically-ill patients. It is imperative to diagnose and treat appropriately, despite this difficulty. Scleroderma renal crisis mimics many other conditions, and can be potentially fatal if not caught early enough. Particularly, in critically-ill patients with multiple pathologies, it can be difficult to distinguish scleroderma renal crisis from other diseases, such as thrombotic thrombocytopenic purpura (TTP), hypertensive emergency, posterior reversible encephalopathy syndrome (PRES), or atypical hemolytic uremic syndrome (HUS)...
2023: Journal of Community Hospital Internal Medicine Perspectives
https://read.qxmd.com/read/37819695/renin-inhibition-and-the-long-term-renal-function-in-patients-with-hypertensive-emergency-a-retrospective-cohort-study
#39
JOURNAL ARTICLE
Masaki Ueno, Wataru Fujii, Wataru Ono, Hiroshi Murata, Yoshihide Fujigaki, Shigeru Shibata
BACKGROUND: The rehospitalization rate in hypertensive emergency is high, indicating the necessity for optimizing its long-term management. The role of the renin-angiotensin system (RAS) blockade in this disorder remains uncertain. METHODS: We conducted a retrospective analysis involving 20 admitted patients who received aliskiren, a direct renin inhibitor (DRI), for the management of hypertensive emergency associated with elevated plasma renin activity (PRA). We analyzed the changes in blood pressure (BP), kidney function, and RAS activity in the subacute and chronic phases...
October 11, 2023: American Journal of Hypertension
https://read.qxmd.com/read/37819392/rosuvastatin-but-not-atorvastatin-enhances-the-antihypertensive-effect-of-cilostazol-in-an-acute-model-of-hypertension
#40
JOURNAL ARTICLE
Ahmed Hamdy, Hany M El-Bassossy, Shimaa M Elshazly, Shaimaa S El-Sayed
PURPOSE: Hypertensive emergency, a sudden and severe increase in blood pressure, necessitates immediate intervention to avoid end-organ damage. Cilostazol, a selective phosphodiesterase-III inhibitor, has vasodilator effect. Here, we investigated the effect of two commonly used statins, atorvastatin or rosuvastatin, on cilostazol antihypertensive activity in acute model of hypertension. METHODS: Hypertensive emergency was induced via angiotensin II intravenous infusion (120 ng...
October 11, 2023: Naunyn-Schmiedeberg's Archives of Pharmacology
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