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Adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

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International Journal of Clinical Medicine 2024年第3期15卷 145-154页

作者： Maria Maiello Francesca Amati Vincenzo Ezio Santobuono Andrea Igoren Guaricci Cinzia Forleo Marco Matteo Ciccone Pasquale Palmiero Department of Cardiology ASL BR SSN3 Brindisi Italy cardiovascular Diseases Section Interdisciplinary Department of Medicine (DIM) University of Bari “Aldo Moro” Bari Italy

Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

关键词： Adherence cardiovascular prevention Postmenopausal Women Hypertensive Metabolic Syndrome

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Effectiveness and safety of red yeast rice predominated by monacolin Kβ-hydroxy acid form for hyperlipidemia treatment and management

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Journal of Traditional Chinese Medicine 2022年第2期42卷 264-271页

作者： CHEN Benjian HUANG Xiaodan PENG Huiting LI Yishi CAO Yongtao WU Huanlin XU Danping Department of Medical Guangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China the Second Clinical College Guangzhou University of Chinese MedicineGuangzhou 510405China the First Clinical College Guangzhou University of Chinese MedicineGuangzhou 510405China Department of Mathematical&Computer Sciences Indiana University of PennsylvaniaIndiana 15705PAUSA Department of Cardiology Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 350122China Department of Traditional Chinese Medicine the Eighth Affiliated HospitalSunYat-Sen UniversityShenzhen 518033China

OBJECTIVE:To assess the lipid-lowering activity and safety of a dietary supplement containing monacolin Kβ-hydroxy acid form(MKA),Heye(Folium Nelumbinis),and Cangzhu(Rhizoma Atractylodis Lanceae),compared to lifestyle modifications.METHODS:Totally 117 subjects with moderate to severe dyslipidemia(according to Chinese guidelines)and low CV risk were randomly assigned into three treatment groups:lifestyle modification(LM),LM plus a low dosage of MKA,LM plus a high dosage of MKA,and treated for 60 d.The primary endpoint was the reduction of low density lipoprotein cholesterol(LDL-C)and total cholesterol(TC).Safeties along with Traditional Chinese Medicine Syndromes were assessed through the study.RESULTS:A low dosage of MKA along with lifestyle modifications caused a significant decrease in LDL-C by 15.6%on average(95%CI,9.6%to 21%)with,a decrease in TC by 15.3%on average(95%CI,9.26%to 21.4%),and a decrease in non-HDL-C by 35.4%(95%CI,25.76%to 41.34%).Weak evidence of a reduction of triglycerides but an increment of HDL-C was observed in patients with severe hyperlipidemia.No severe adverse events occurred during the study.CONCLUSION:Our results confirm the LDL-C and TC lowering properties of MKA is clinically meaningful.It also produces a significant reduction of non-HDL-C,and slightly effects on TG and HDL-C as well.

关键词： hydroxy acids lovastatin hyperlipidemias cholesterol cardiovascular prevention lifestyle modifications red yeast rice

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Estrogen rapid effects:a window of opportunity for the aging brain?

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Neural Regeneration Research 2022年第8期17卷 1629-1632页

作者： Ivanny Marchant Jana Stojanova Lilian Acevedo Pablo Olivero Laboratorio de Modelamiento en Medicina Escuela de MedicinaUniversidad de ValparaísoViña del MarChile Interdisciplinary Centre for Health Studies(CIESAL) Universidad de ValparaísoViña del MarChile Servicio de Neurología Hospital Carlos van Buren ValparaísoChile Laboratorio de Estructura y Función Celular Escuela de MedicinaFacultad de MedicinaUniversidad de ValparaísoValparaísoChile Centro Interoperativo en Ciencias Odontológicas y Médicas Universidad de ValparaísoValparaísoChile

Estrogen produces several beneficial effects in healthy neurological tissues and exhibits cardioprotective effects.Hormone therapy has been widely used to treat menopausal estrogen deficiency for more than 80 years.Despite high initial expectations of cardioprotective effects,there has been substantial distrust following important randomized clinical trials,such as the Women’s Health Initiative.Subsequently,the timing of treatment in relation to the onset of menopause came under consideration and led to the proposal of the timing hypothesis,that early initial treatment is important,and benefits are lost as the timing since menopause becomes prolonged.Subsequent analyses of the Women’s Health Initiative data,together with more recent data from randomized and observational trials,consistently show reductions in coronary heart disease and mortality in younger menopausal women.Regarding cognitive function,the timing hypothesis is consistent with observations from basic and animal studies.There is some clinical evidence to support the benefits of hormonal therapy in this context,though skepticism remains due to the paucity of clinical trials of substantial length in younger menopausal women.It is likely that the effects of estrogens on cognitive performance are due to rapid mechanisms,including mechanisms that influence Ca2+homeostasis dynamics,provide protection in a hostile environment and reduce inflammatory signals from neural tissues.In the future,inflammatory profiles accounting for early signs of pathological inflammation might help identify the‘window of opportunity’to use estrogen therapy for successful cognitive protection.

关键词： aging cardiovascular prevention cognitive function estrogen hormone treatment inflammaging rapid effects timing hypothesis TRPV1 window of opportunity

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cardiovascular rehabilitation in patients aged 70-year-old or older:benefits on functional capacity,physical activity and metabolic profile in younger vs.older patients

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Journal of Geriatric Cardiology 2020年第9期17卷 544-553页

作者： Marta Fontes-Oliveira Maria Trêpa Patrícia Rodrigues Preza Fernandes Sandra Magalhães Sofia Cabral Mário Santos Severo Torres Cardiology Department University Hospital Centre of PortoPortoPortugal Cardiac Rehabilitation Unit Cardiology DepartmentUniversity Hospital Centre of PortoPortoPortugal Pulmonary Vascular Disease Unit University Hospital Centre of PortoPortoPortugal

Background The benefits of exercise-based cardiac rehabilitation(EBCR)programs in post-acute myocardial infarction(AMI)patients have been demonstrated.Our aim was to assess the impact of EBCR in³70-years-old vs.younger post-AMI patients.Methods We retrospectively evaluated patients who underwent a supervised EBCR protocol,twice a week during 6-12 weeks.We evaluated changes in several outcomes based on pre-and post-CRP assessments.Results Of a total of 1607 patients,333(21%)were³70-years-old.After the EBCR,an overall improvement on functional capacity,daily physical activity,lipid profile,body mass index,glycated hemoglobin(HbA1c),N-terminal pro-brain natriuretic peptide(NT-pro-BNP)and C-reactive protein was observed in both younger and older patients(P<0.05).Older patients showed a smaller benefit on the increment of daily physical activity and lipid profile improvement,but a larger reduction in NT-pro-BNP.In the multivariate analysis,only improvements on daily physical activity and HbA1c were dependent on age.Conclusion As their younger counterparts,older patients,significantly improved functional capacity,metabolic parameters and level of daily physical activity after EBCR.

关键词： Aging cardiovascular prevention Exercise-based cardiac rehabilitation

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