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Obesity, hypertension and the metabolic syndrome

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Journal of Geriatric cardiology 2006年第1期3卷 59-60页

作者： Matthew J.Sorrentino Department of Medicine section of cardiology University of Chicago Pritzker School of Medicine ChicagoIllinois USA

　　The prevalence of obesity in both developed and developing countries has increased dramatically in recent years.1Many people who are obese develop metabolic changes that increase the risk of diabetes mellitus and adverse cardiovascular outcomes. Obesity leads to the development of insulin resistance, lipid abnormalities and increased blood pressure.……

关键词： hypertension and the metabolic syndrome Obesity

Reducing cholesterol to prevent coronary heart disease

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Journal of Geriatric cardiology 2005年第4期2卷 243-247页

作者： Matthew J.Sorrentino Medicine University of Chicago Pritzker School of Medicine Department of MedicineSection of Cardiology 5841 S.Maryland Ave.ChicagoIl 60637

Coronary heart disease (CHD) remains the number one killer of men and women in the United States of America despite major advances in interventional technologies for the treatment of coronary artery disease. CHD is rapidly becoming a major cause of morbidity and mortality in developing nations as well and is now recognized as the leading cause of death worldwide.

关键词： LDL HDL CHD Reducing cholesterol to prevent coronary heart disease

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

Changes of Plasma Renin Activity and Angiotensin II Level and Their Relations to Sodium in Heart Failure Patients

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Journal of Medical Colleges of PLA(China) 1989年第1期4卷 65-68页

作者：赵连友张宁仔 section of cardiology Department of Internal Medicine Tangdu Hospital Fourth Military Medical University Xi'an

The levels of plasma renin activity(PRA), (?) II(ATII), serum sodiurnand urinary sodium excretion within 24 h m heart failure (?) were (?), in onder to studythe effect of sodium on the PRA and ATII levels in heart (?) patients The (?) showed thatthe PRA and ATII levels were higher left heart falure patents than those in nonnal persons andright heart failure patients, but the serum sodium and urinary sodium excretion left heart failurepatients was lower than that of normal persons and right heart failure patients that patients withleft heart failure were of high renin activity type and patients with right heart failure were of low ornormal renin activity type and that in heart failure patients the PRA and ATII level and urinary so-dium excretion were inversely conelated We suggest that it may be useful in selecting drugs forheart failure (?) when the patients are divided into subgroups by PRA and sodium index.

关键词： congestive heart renin angiotensin Ⅱ sodium

Inflammation,infection and coronary heart disease

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老年心脏病学杂志：英文版 2007年第3期4卷 135-136页

作者： Matthew J. Sorrentino section of cardiology Department of MedicineUniversity of Chicago Pritzker School of Medicine. 5841 S. Mary-land AveMC 6080ChicagoIllinois 60637 USA

　　It has become clear that inflammation is an important component of coronary heart disease. Atherosclerotic disease usually begins with injury to endothelial cells.……

关键词： LDL

Associations of accelerometry-measured and self-reported physical activity and sedentary behavior with skeletal muscle energetics:The Study of Muscle,Mobility and Aging(SOMMA)

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Journal of Sport and Health Science 2024年第5期13卷 621-630页

作者： Yujia(Susanna)Qiao Terri L.Blackwell Peggy M.Cawthon Paul M.Coen Steven R.Cummings Giovanna Distefano Samaneh Farsijani Daniel E.Forman Bret H.Goodpaster Stephen B.Kritchevsky Theresa Mau Frederico G.S.Toledo Anne B.Newman Nancy W.Glynn Department of Epidemiology School of Public HealthUniversity of PittsburghPittsburghPA 15261USA San Francisco Coordinating Center California Pacific Medical Center Research InstituteSan FranciscoCA 94143USA Department of Epidemiology and Biostatistics University of CaliforniaSan FranciscoCA 94143USA Translational Research Institute AdventHealthOrlandoFL 32804USA Department of Medicine(Geriatrics and cardiology) University of Pittsburghand GeriatricsResearchEducationand Clinical Center(GRECC)VA Pittsburgh Healthcare SystemPittsburghPA 15261USA Department of Internal Medicine Section on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston-SalemNC 27109USA Division of Endocrinology and Metabolism Department of MedicineUniversity of PittsburghPittsburghPA 15261USA

Background:Skeletal muscle energetics decline with age,and physical activity(PA)has been shown to offset these declines in older adults.Yet,many studies reporting these effects were based on self-reported PA or structured exercise interventions.Therefore,we examined the associations of accelerometry-measured and self-reported PA and sedentary behavior(SB)with skeletal muscle energetics and explored the extent to which PA and sedentary behavior would attenuate the associations of age with muscle energetics.Methods:As part of the Study of Muscle,Mobility and Aging,enrolled older adults(n=879),810(age=76.4±5.0 years old,mean±SD;58%women)had maximal muscle oxidative capacity measured ex vivo via high-resolution re spirometry of permeabilized myofibers(maximal oxidative phosphorylation(maxOXPHOS))and in vivo by ^(31)phosphorus magnetic resonance spectroscopy(maximal adenosine triphosphate(ATP_(max))).Accelerometry-measured sedentary behavior,light activity,and moderate-to-vigorous PA(MVPA)were assessed using a wrist-worn ActiGraph GT9X over 7 days.Self-reported sedentary behavior,MVPA,and all PA were assessed with the Community Healthy Activities Model Program for Seniors(CHAMPS)questionnaire.Linear regression models with progressive covariate adjustments evaluated the associations of sedentary behavior and PA with muscle energetics,as well as the attenuation of the age/muscle energetics association by MVP A and sedentary behavior.As a sensitivity analysis,we also examined activPAL-measured daily step count and time spent in sedentary behavior and their associations with muscle energetics.Results:Every 30 min/day more of ActiGraph-measured MVPA was associated with 0.65 pmol/(s×mg)higher maxOXPHOS and 0.012 mM/s higher ATP_(max)after adjusting for age,site/technician,and sex(p<0.05).Light activity was not associated with maxOXPHOS or ATP_(max).Meanwhile,every 30 min/day spent in ActiGraph-measured sedentary behavior was associated with 0.39 pmol/s×mg lower maxOXPHOS and0.006 mM/s lower ATP_(max)(p<0.05).Only associatio

关键词： Aging Exercise Mitochondria

In-hospital outcomes and readmission in older adults treated with percutaneous coronary intervention for stable ischemic heart disease

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Journal of Geriatric cardiology 2022年第9期19卷 631-642页

作者： Dae Yong Park Jonathan M.Hanna Sumeet Kadian Mannat Kadian WSchuyler Jones Abdulla Al Damluji Ajar Kochar Jeptha P.Curtis Michael G.Nanna Department of Medicine Cook County HealthChicagoILUSA Department of Internal Medicine Yale School of MedicineNew HavenCTUSA University of Connecticut StorrsCTUSA East Lyme High School East LymeCTUSA section of Interventional cardiology Duke University Health SystemDurhamNCUSA section of Interventional cardiology Johns Hopkins UniversityBaltimoreMDUSA section of Interventional cardiology Brigham and Women’s HospitalBostonMAUSA section of Cardiovascular Medicine Yale School of MedicineNew HavenCTUSA

Background Percutaneous coronary intervention(PCI)for stable ischemic heart disease(SIHD)in older adults requires a metic-ulous assessment of procedural risks and benefits,but contemporary data on outcomes in this population is lacking.Therefore,we examined the risk of near-term readmission,bleeding,and mortality in high-risk cohort of older adults undergoing inpatient PCI for SIHD.METHODS We analyzed the National Readmissions Database from 2017 to 2018 to identify index hospitalizations in which PCI was performed for SIHD.Patients were stratified into those≥75 years old(older adults)and those<75 years old.The primary outcome was 90-day readmission.Secondary outcomes included in-hospital mortality,hospital length of stay(LOS),and total hospital charge.RESULTS A total of 74,516 patients underwent inpatient PCI for SIHD,of whom 24,075 were older adults.Older adult patients had higher odds of in-hospital mortality(OR=2.00,95%CI:1.68-2.38),intracranial hemorrhage(OR=2.03,95%CI:1.24-3.34),and gastrointestinal hemorrhage(OR=1.72,95%CI:1.43-2.07)during index hospitalization,with longer LOS and in-hospital charge.Older adults also experienced a higher hazard of 90-day readmission for any cause(HR=1.61,95%CI:1.57-1.66)and car-diovascular causes(HR=1.84,95%CI:1.77-1.91).CONCLUSION Older adults undergoing inpatient PCI for SIHD were at increased risk for in-hospital mortality,periprocedural morbidities,higher cost,and readmissions compared with younger adults.Understanding these differences may improve shared decision-making for patients with SIHD being considered for PCI.

关键词： mortality coronary younger

Heart failure with preserved ejection fraction in the elderly: pathophysiology, diagnostic and therapeutic approach

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Journal of Geriatric cardiology 2019年第5期16卷 421-428页

作者： Ernesto Ruiz Duque Alexandros Briasoulis Paulino A Alvarez Cardiomyopathy section Cardiology Division University of Iowa

Heart failure with preserved ejection fraction(HFpEF)is a clinical syndrome characterized by symptoms and sings of heart failure with elevated left ventricular filling pressures at rest or during exercise.It is the most common type of heart failure in the elderly and its prevalence increases with age and is higher in females at any given age.HFpEF is frequently accompanied of comorbid conditions such as diabetes mellitus,obesity,atrial fibrillation and renal dysfunction.The diagnosis relies in the integration of clinical information,laboratory data and interpretation of cardiac imaging and hemodynamic findings at rest and during exercise.Conditions that have a specific treatment such as coronary artery disease,valvular disease,cardiac amyloidosis and constrictive pericarditis should be considered and evaluated as appropriate.Aggressive management of comorbidities,optimization of blood pressure control and volume status using diuretics as needed are among the current treatment recommendations.There are no specific therapies that have shown to decrease mortality in HFpEF.In symptomatic patients with history of hospital admission for decompensated heart failure,the implantation of a wireless pulmonary artery pressure monitor should be considered.Finally,given the high mortality of this condition,goals of care discussion should be initiated early and involvement of palliative care medicine should be considered.

关键词： Echocardiography Ejection fraction Heart failure Pharmacology The elderly

Cryoballoon ablation on an elder paroxysmal atrial fibrillation patient implanted with double chamber pacemaker: a case report

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Journal of Geriatric cardiology 2019年第5期16卷 434-436页

作者： Yu XU Yan-Fang ZHAO section of cardiology Jinling Hospital

Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,increasing in prevalence with age.Catheter ablation is recommended to symptomatic paroxysmal AF refractory or intolerant to at least one Class I or III antiarrhythmic medication.[1]Main current catheter ablation of AF with radiofrequency can give priority to,other include freezing,ultrasonic and laser ablation etc.Recent studies provides substantial information regarding the efficacy and safety of novel cryoballoon technology in creating pulmonary vein(PV)isolation.[2,3]Processed in cyroballoon ablation,some AF patients implanted with double chamber pacemaker are difficult to puncture atrial septal,because of the atrial electrode.My case report was as follows.

关键词： Atrial fibrillation Cryoballoon Double chamber pacemaker