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Drug Safety
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Щаницын И. Н., Раздорская В. В., Колоколов О. et al.
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The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular
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disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with
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cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Global Hear, March 2014, Vol. 9 no.1
Quality of the Indian clinical practice guidelines for the management of cardiovascular conditions
Dhurjati, R.; Sagar, V.; Kanukula, R. et al.
Journal of the Royal Society of Medicine Open
(2022)
CC
To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from incep
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tion until August 2020, to identify Indian CPGs for the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures. Quality of the each included CPG was assessed using the AGREE II tool by four reviewers in duplicate, independently. Each AGREE II domain score and overall quality score was considered low (≤40%), moderate (40.1%-59.9%), and high (≥60%). Of the 23 CPGs included, six (26%) were reported to be adapted from other CPGs. Fourteen (61%) CPGs were produced by medical associations, six (26%) by individual authors and three (13%) by government agencies. Based on the AGREE II overall quality score, two (9%) CPGs were of high quality, four (17%) and seventeen (74%) CPGs were of moderate and low quality, respectively. Except for scope and purpose, and clarity of presentation all other domains were rated low. The quality of most Indian CPGs for managing CVD conditions assessed using the AGREE II tool was moderate-to-low. Combined efforts from different stakeholders are needed to develop, disseminate and implement high-quality CPGs while identifying and addressing barriers to their uptake to optimize patient care and improve outcomes.
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Type 1 diabetes in adults
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2023)
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The document provides quality standards for managing Type 1 diabetes in adults, emphasizing areas like structured education, continuous glucose monitoring (CGM), cardiovascular risk management, and diabetic foot assessment. It aims to improve care p
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rocesses, reduce complications, and enhance patient outcomes through evidence-based and patient-centered approaches. The guidelines also focus on supporting inpatient self-management and ensuring equality and accessibility in diabetes care.
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2021 World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas
Campbell, N.R.C.; Burnens, M.P.; Whelton, P.K. et al.
The Lancet Regional Health - Americas
(2022)
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Cardiovascular disease (CVD) is the leading cause of death in the Americas and raised blood pressure accounts for over 50% of CVD. In the Americas over a quarter of adult women and four in ten adult
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men have hypertension and the diagnosis, treatment and control are suboptimal. In 2021, the World Health Organization (WHO) released an updated guideline for the pharmacological treatment of hypertension in adults. This policy paper highlights the facilitating role of the WHO Global HEARTS initiative and the HEARTS in the Americas initiative to catalyze the implementation of this guideline, provides specific policy advice for implementation, and emphasizes that an overarching strategic approach for hypertension control is needed. The authors urge health advocates and policymakers to prioritize the prevention and control of hypertension to improve the health and wellbeing of their populations and to reduce CVD health disparities within and between populations of the Americas.
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Contents Summary Glycemic Index Individual foods Mixed meal or diet Glycemic Load Disease Prevention Type 2 diabetes mellitus Cardiovascular disease
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Cancer Gallbladder disease
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Cardiovascular disease, heart disease, and coronary heart disease may sound similar but they are
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not one in the same. This fact sheet will help you understand how these conditions differ.
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Technical package for cardiovascular disease management in primary health care.
Long-term exposure of humans to air pollution enhances the risk of cardiovascular and respiratory diseases. A novel Global Exposure Mortality Model (GEMM) has been derived from many cohort studies, providing much-improved coverage of the exposure to
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fine particulate matter (PM2.5). We applied the GEMM to assess excess mortality attributable to ambient air pollution on a global scale and compare to other risk factors.
Methods and results
We used a data-informed atmospheric model to calculate worldwide exposure to PM2.5 and ozone pollution, which was combined with the GEMM to estimate disease-specific excess mortality and loss of life expectancy (LLE) in 2015. Using this model, we investigated the effects of different pollution sources, distinguishing between natural (wildfires, aeolian dust) and anthropogenic emissions, including fossil fuel use. Global excess mortality from all ambient air pollution is estimated at 8.8 (7.11–10.41) million/year, with an LLE of 2.9 (2.3–3.5) years, being a factor of two higher than earlier estimates, and exceeding that of tobacco smoking. The global mean mortality rate of about 120 per 100 000 people/year is much exceeded in East Asia (196 per 100 000/year) and Europe (133 per 100 000/year). Without fossil fuel emissions, the global mean life expectancy would increase by 1.1 (0.9–1.2) years and 1.7 (1.4–2.0) years by removing all potentially controllable anthropogenic emissions. Because aeolian dust and wildfire emission control is impracticable, significant LLE is unavoidable.
Conclusion
Ambient air pollution is one of the main global health risks, causing significant excess mortality and LLE, especially through cardiovascular diseases. It causes an LLE that rivals that of tobacco smoking. The global mean LLE from air pollution strongly exceeds that by violence (all forms together), i.e. by an order of magnitude (LLE being 2.9 and 0.3 years, respectively).
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Non-communicable diseases (NCDs) account for 72% of all deaths globally and this proportion is growing. Greatest increases in NCD mortality are seen in low-income and middle-income countries (LMICs). Places that only a generation ago knew famine are
today experiencing epidemics of obesity, diabetes
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, cardiovascular disease, and cancer. These epidemics reduce human capital in developing countries and their economic costs are so great that they threaten to slow and even undercut trajectories of economic and social development.
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Heart & Circulatory Diseases (Cardiovascular Disease; CVD)
Heart and circulatory diseases is an umbrella term for all diseases of the heart and circulation. It includes everything from conditions t
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hat are inherited or that a person is born with, to those that develop later, such as coronary heart disease, atrial fibrillation, heart failure, stroke and vascular dementia.
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Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – along with mental health, cause nearly
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three quarters of deaths in the world. Their drivers are social, environmental, commercial and genetic, and their presence is global. Every year 17 million people under the age of 70 die of NCDs, and 86% of them live in low- and middle-income countries (LMICs).
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A cardiac risk calculator is a screening tool to assess your future risk of cardiovascular disease. It uses personal health information to evaluate heart health.
One of the first steps in developing a multisectoral action plan (MSAP) is to use a situation analysis to provide a comprehensive assessment of the health needs, prevailing risks and the context of the area to which the plan will apply. This will help countries, regions, provinces or cities intendi
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ng to create a multisectoral action plan to align with the global commitments on targeting the four major NCDs: cardiovascular disease, diabetes, cancer and chronic respiratory diseases.
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Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease caused by a newly discovered coronavirus (SARS-CoV-2).
Most people infected with the COVID-19 virus experience mild t
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o moderate respiratory illness and recover without requiring special treatment, the disease presentation is more likely to be severe in older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, etc.
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Guidelines for Therapy and Management of Hypertension in Cardiovascular Disease in Indonesia
Cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancers, and other non-communicable diseases are among the leading causes
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of morbidity and mortality in low-income, middle-income, and high-income countries, and The Lancet Taskforce recently made the case for investing in non-communicable disease prevention. Now, in The Lancet Planetary Health, Benjamin Bowe and colleagues report that exposure to PM2·5 air pollution is indeed a risk factor for diabetes.
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Diet
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2024)
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The webpage from the Institute for Health Metrics and Evaluation (IHME) discusses the global impact of diet on health, highlighting poor dietary habits as a major contributor to deaths worldwide, primarily through cardiovascular diseases. It emphasi
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zes the health risks of high sodium intake and insufficient consumption of fruits, vegetables, and whole grains while advocating for dietary improvements to reduce disease burden and improve overall health.
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Hypertension is the main risk factor for developing cardiovascular disease. Each year 1.6 million deaths befall from cardiovascular
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disease in the region of the Americas, of which about half a million occur in people under age 70, which is considered premature and preventable death. Hypertension affects between 20-40% of the adult population of the region, meaning that in the Americas around 250 million people suffer from high blood pressure. Hypertension is preventable or can be postponed by a set of preventive interventions, among which include the reduction of salt intake, a diet rich in fruits and vegetables, exercise and maintaining a healthy body weight. PAHO promotes policies and projects to impact on public health the prevention of hypertension through policies to reduce salt intake, to promote healthy eating, physical activity and to prevent obesity. Promotes and supports projects that facilitate access to essential medicines for the treatment of hypertension and promotes the development of human resources in health.
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