Prevencia, diagnostika a liečba AH je stále významným globálnym zdravotníckym problémom. Existujú presvedčivé dôkazy, že srdcová frekvencia je dôležitý rizikový faktor kardiovaskulárnych ochorení. Odporúčania pre meranie kľudovej srdcovej frekvencie sú identické ako pre meranie hodnôt tlaku krvi a oba parametre by sa mali merať súčasne. V rôznych štádiách KV kontinua sú stanovené rizikové hodnoty srdcovej frekvencie. Vysoká srdcová frekvencia u pacientov s artériovou hypertenziou znamená vysoké reziduálne kardiovaskulárne riziko. Jednou z dôležitých príčin nedostatočnej kontroly tlaku krvi a súčasne kontroly srdcovej frekvencie je zlá adherencia pacientov k liečbe. Je potrebné individualizovať liečbu pacientov so zvýšenou srdcovou frekvenciou v celom kardiovaskulárnom kontinuu. Použitie fixnej kombinácie liekov znižuje riziko nonkompliancie a mala by sa zvážiť v liečbe chronických ochorení akými sú napríklad artériová hypertenzia. Zlepšenie kompliancie pacientov vedie k dosiahnutiu lepších klinických výsledkov.
Prevention, detection, and treatment of high blood pressure remain an important public health challenge. There is convincing evidence that heart rate is an important risk factor for cardiovascular disease. Recommendations for the resting heart rate measurement are roughly the same as those used for blood pressure measurement which is usually made during the same session. Across different parts of the cardiovascular disease continuum, different heart rate thresholds are identified. Elevated heart rate identifies patients with hypertension at high cardiovascular risk. One of the important causes of inadequate blood pressure control and at the same time heart rate control is the poor adherence of patients to treatment. It is necessary to individualize the treatment of patients with elevated heart rates throughout the cardiovascular continuum. Fixed-dose combination decreases the risk of medication non-compliance and should be considered in patients with chronic conditions like hypertension for improving medication compliance which can translate into better clinical outcomes.
- MeSH
- adherence k farmakoterapii MeSH
- fixní kombinace léků MeSH
- hypertenze * diagnóza farmakoterapie MeSH
- lidé MeSH
- srdeční frekvence MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Artériová hypertenzia (AH) je veľmi častým ochorením s narastajúcou incidenciou a prevalenciou. AH je hlavnou preventabilnou príčinou predčasných úmrtí celosvetovo. Preto je veľmi dôležité, aby bola artériová hypertenzia včasne diagnostikovaná a včasne liečená. Stále vysoká KV mortalita na Slovensku, v ktorej máme pozíciu až na chvoste v porovnaní s ostatnými európskymi krajinami, veľmi úzko súvisí s nedosahovaním cieľových hodnôt tlaku krvi (TK). AH sa iba zriedka vyskytuje izolovane, často sa vyskytuje v spojení s ostatnými rizikovými faktormi ako napríklad dyslipidémia a obezita. 2018 ESC/ESH odporúčania pre manažment artériovej hypertenzie priniesli niekoľko nových konceptov pre manažment artériovej hypertenzie. Dôležité je implementovať odporúčania Európskej kardiologickej spoločnosti do každodennej klinickej praxe v každej krajine.
Arterial hypertension (AH) is a very common disease with increasing incidence and prevalence. AH becomes worldwide the main preventable cause of the preventable deaths. Therefore, it is very important to obtain early diagnose and convenient treatment. Still high cardiovascular mortality in Slovakia, where we have a position at the tail compared to other European countries, very closely related to the failure to obtain treatment blood pressure (BP) target ranges. AH rarely occurs in isolation, and often clusters with other CV risk factors such as dyslipidemia and obesity. 2018 ESC/ESH Guidelines for the management of arterial hypertension has brought several new concepts how to manage arterial hypertension. However, it is important to implement the recommendations of the European Society of Cardiology to everyday clinical practice in each country.
Artériová hypertenzia patrí medzi najčastejšie podceňované ochorenia. Zároveň sú s ňou spájané rôzne mýty. Preťaženie množstvom dostupných klinických údajov a ich nesprávna analýza spôsobuje vytvorenie mylných predstáv, čo vedie k nesprávnemu výkladu skutočných dát a k pochybným riešeniam problémov. Uvedené mylné predstavy vedú k nedostatočnej kontrole hodnôt krvného tlaku. Prejdime si niekoľko bežných mýtov v našom článku, takže na základe faktov si môžete urobiť racionálne rozhodnutia v liečbe artériovej hypertenzie.
Arterial hypertension is one of the most commonly underestimated diseases. At the same time various myths are frequently associated with this illness. Likewise, the overload of available clinical data causes misconceptions, which then lead to the misinterpretation of real and also doubtful issues. Unfortunately, these misconceptions result in insufficient blood pressure control. Let's sort through some common myths in our article, so you can make health decisions in the management of hypertension based on the facts.
- MeSH
- amlodipin farmakologie terapeutické užití MeSH
- antihypertenziva farmakologie terapeutické užití MeSH
- fixní kombinace léků MeSH
- hypertenze * farmakoterapie MeSH
- indapamid farmakologie terapeutické užití MeSH
- lidé MeSH
- perindopril farmakologie terapeutické užití MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- Check Tag
- lidé MeSH
Fibrilácia predsiení (FP) a diabetes mellitus (DM) sú ochorenia s vysokou prevalenciou a závažným dopadom na zdravotný stav obyvateľstva. Pacienti s DM majú vyššie riziko vzniku cievnej mozgovej príhody pri súčasnej komorbidite fibrilácií predsiení. Súčasne diabetes mellitus je jedným z rizikových faktorov cievnej mozgovej príhody u pacientov s FP.
Atrial fibrillation and diabetes mellitus are both highly prevalent and global public health issues. Importantly patients with diabetes mellitus are at increased risk for stroke when atrial fibrillation is present, and diabetes is thus part of stroke risk prediction tools.
- MeSH
- antithrombiny terapeutické užití MeSH
- fibrilace síní * etiologie farmakoterapie komplikace MeSH
- inhibitory agregace trombocytů terapeutické užití MeSH
- inhibitory faktoru Xa terapeutické užití MeSH
- komplikace diabetu MeSH
- lidé MeSH
- rivaroxaban MeSH
- tranzitorní ischemická ataka etiologie farmakoterapie prevence a kontrola MeSH
- warfarin terapeutické užití MeSH
- Check Tag
- lidé MeSH
Celosvetovo sú kardiovaskulárne ochorenia hlavnou príčinou úmrtnosti u žien s prihliadnutím na vek, rasu, etnicitu, hoci ich prevalencia narastá najmä po menopauze. Na narastajúcom výskyte kardiovaskulárnych ochorení u žien sa podieľa mnoho faktorov, niektoré z nich sú ovplyvniteľné (nadváha, fajčenie, dyslipoproteinémia, artériová hypertenzia, porucha glukózovej tolerancie, diabetes mellitus). Niektoré rizikové faktory sú u žien podceňované. Ženy majú dlhšiu dĺžku života ako muži. Uvedený trend nárastu kardiovaskulárnych ochorení sa však bude zhoršovať i v dôsledku narastajúcej epidémie obezity, metabolického syndrómu a diabetes mellitus, všetko klinické jednotky, ktoré postihujú najmä ženy. Atypické symptómy, vyšší vek pri výskyte a vyššia prevalencia rizikových faktorov čiastočne vysvetľujú vyšší výskyt komplikácií a horšiu prognózu kardiovaskulárnych ochorení u žien. Preto by snahy lekárov a zdravotníckych pracovníkov mali viesť k dôslednému rozpoznávaniu a liečbe rizikových faktorov aterosklerózy a jej komplikácií.
Worldwide, cardiovascular disease is a major cause of mortality in women regarding to age, race, ethnicity, although the prevalence increases especially after menopause. Many factors contribute to the increased incidence of cardiovascular disease in women. Some of them are modifiable (obesity, smoking, dyslipoproteinaemia, hypertension, impaired glucose tolerance, diabetes mellitus). Some of them are underestimated. Women have a longer life expectancy than men. However, this trend of increased incidence of cardiovascular disease will deteriorate in consequence of growing epidemic of obesity, metabolic syndrome and diabetes, clinical states which mainly affect women. Atypical symptoms, old-age onset and higher prevalence of risk factors partly explain the higher incidence of complications and poorer prognosis of cardiovascular disease in women. Therefore, the efforts of doctors and healthcare professionals should lead to consistent recognition and treatment of risk factors of atherosclerosis and its complications.
- MeSH
- ateroskleróza etiologie MeSH
- diagnostické techniky kardiovaskulární * MeSH
- dospělí MeSH
- dyslipidemie patofyziologie MeSH
- hypertenze patofyziologie MeSH
- komplikace diabetu MeSH
- koronární nemoc * diagnóza farmakoterapie terapie MeSH
- lidé MeSH
- mortalita MeSH
- obezita patofyziologie MeSH
- populační skupiny MeSH
- prevalence MeSH
- rizikové faktory MeSH
- sekundární prevence MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sexuální faktory MeSH
- snížení rizika poškození MeSH
- stabilní angina pectoris * diagnóza farmakoterapie terapie MeSH
- věkové faktory MeSH
- zátěžový test MeSH
- životní styl MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví * MeSH
Polyunsaturated omega-3 fatty acids (omega-3 PUFA) are important components of cell membrane affecting its function and their deficiency is deleterious to health. We have previously shown that spontaneously hypertensive rats (SHR) are prone to life-threatening arrhythmias that are reduced by omega-3 PUFA intake. Purpose of this study was to explore plasma and red blood cells (RBC) profile of omega-3 and omega-6 PUFA as well as to determine omega-3 index, a risk factor for sudden cardiac death, in aged SHR and the effect of omega-3 PUFA intake. Male and female 12-month-old SHR and age-matched Wistar rats fed with omega-3 PUFA (200 mg/kg BW/day/2 month) were compared with untreated rats. Composition of omega-3 PUFA: alpha linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as omega-6 PUFA: linoleic acid and arachidonic acid was analyzed by gas chromatography. Results showed sex- and strain-related differences of basal omega-3 and omega-6 PUFA levels in plasma and RBC as well as in response to omega-3 PUFA intake. Comparing to Wistar rats omega-3 index, expressed as a percentage of EPA+DHA of total fatty acids, was lower in SHR and it increased due to consumption of omega-3 PUFA. Findings support our hypothesis that lower omega-3 index may be also a marker of increased propensity of the hypertensive rat heart to malignant arrhythmias.
- MeSH
- biologické markery krev MeSH
- dietní tuky nenasycené krev farmakokinetika MeSH
- hypertenze krev komplikace MeSH
- krevní tlak MeSH
- krysa rodu rattus MeSH
- kyseliny mastné omega-3 krev MeSH
- potkani inbrední SHR MeSH
- potkani Wistar MeSH
- prognóza MeSH
- reprodukovatelnost výsledků MeSH
- rizikové faktory MeSH
- senzitivita a specificita MeSH
- srdeční arytmie krev etiologie MeSH
- srdeční frekvence MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The aim of the study was study the prevalence of ED, TDS, and MS in patients with BMI over 30 or waist circumference over 94 cm. TDS significantly decreased quality of life and occurrence is 38.7% in men over 45 years. MS is defined by the presence of at least three of the following: “abdominal obesity“ (waist circumference over 94 cm), arterial hypertension, hypercholesterolemy, hypertriglyceridemy, diabetes mellitus or disorder of blood sugar tolerance. Metabolic syndrome increase risc of diabetes mellitus and heard disease. It is suspected that TDS can be next component of MS. This can be basis for treatment MS with testosteron. Material and methods: We have examined 79 patients over 50 years of age with body mass index (BMI) over 30 or with waist circumference over 94 cm. Hormonal evalutation as well as a complete urological evaluation (including PSA) and medical evaluation were carried out in every patient. To assess subjective symptoms related to TDS and 5 domains of sexaul health, the Androgen Deficiency Questionaire and Sexual Health Questionaire were utlized. In all patients, the presence of prostate cancer was ruled out. Normal ranges of testosterone are 10-28 nmol/l. When results were in range 10-14 we examined free testosterone. Results: Total serum testosterone values decreased in 55/79, 32 below 10 nmol/l and 23 betwen 10-14. Free testosterone was 22-51%. Symptoms of TDS have 48 (87%) patients. ED had 50 (91%) and MS had 46 (83.6%) patients. Discussion Tsai et al. shows that all this 3 factors: obesity, insulin resistency or hypogonadismus can be introduction which leads to MS. Conclusions: Conclusion Symptomatic complex caused by the lack of androgens mainly in men over 50 years, is gradually becoming the topic of interest for urologists, andrologist and general practitioners. In respect to longer life expectancy and prolonged survival, the diagnosis and treatment of ED, TDS and MS may significantly improve the quality of life of the affected men. In patients with abdominal obesity we find out increased number of patients with TDS, ED and MS.
Background: Due to limitations of the Friedewald formula, alternative methods for calculating low-density lipoprotein cholesterol (LDL-C) were suggested. We evaluated utility of these methods. Methods: Ninety three subjects free of coronary heart disease were considered. LDL-C was me asured by the homogeneous method, and calculated by the Friedewald formula LDL-C = TC - HDL - (TG/ 2.2) (LDL1) and alternative formulas LDL-C = 0.41 TC - 0.32 TG + 1.70 apoB - 0.27 (LDL2) and LDL-C = 0.94 TC - 0.94 HDL - 0.435 TG (LDL3). Results: All three formulas underestimated the me asured LDL-C, both in the whole group and in subgroups according to TG levels (TG < 1.7 and in a range of 1.7-4.5 mmol/ l, p < 0.001 for all). We found significantly higher bias for all three formulas in subjects with 1.7 <= TG < 4.5 mmol/ l levels. The Friedewald formula showed the lowest assay bias in all the groups investigated. The mean absolute bias for LDL1 was 7.6 %, 18.3 % for LDL2 and 13.6 % for LDL3, respectively. Linear regression analysis showed correlation of calculated LDL-C values with the direct method in the range of r = 0.82 - 0.90 (p < 0.0001 for all, except of LDL2 in 1.7 <= TG < 4.5 mmol/ l group where p = 0.0011). Conclusions: The Friedewald formula seems to be a better estimator of LDL-C in our study than the other two alternative formulas; however, it underestimated the LDL-C levels.
- MeSH
- financování organizované MeSH
- klinické laboratorní techniky metody MeSH
- lidé MeSH
- lipoproteiny LDL diagnostické užití fyziologie krev MeSH
- triglyceridy fyziologie krev MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- hodnotící studie MeSH
