Carvedilol in hypertension treatment

Although β-blockers have been previously shown to effectively reduce blood pressure (BP) and have been used for hypertension treatment for over 40 years, their effect on cardiovascular morbidity and mortality in hypertensive patients remains controversial and its use in uncomplicated hypertension is currently under debate. However, data on the above field derive mainly from studies which were conducted with older agents, such as atenolol and metoprolol, while considerable pharamacokinetic and pharmacodynamic heterogeneity is present within the class of β-blockers. Carvedilol, a vasodilating non-cardioselective β-blocker, is a compound that seems to give the opportunity to the clinician to use a cardioprotective agent without the concerning hemodynamic and metabolic actions of traditional β-blocker therapy. In contrast with conventional β-blockers, carvedilol maintains cardiac output, has a less extended effect on heart rate and reduces BP by decreasing vascular resistance. Further, several studies has shown that carvedilol has a beneficial or at least neutral effect on metabolic parameters, such as glycemic control, insulin sensitivity, and lipid metabolism, suggesting that they could be used in subjects with the metabolic syndrome or diabetes without negative consequences. This article summarizes the distinct pharmacologic, hemodynamic, and metabolic properties of carvedilol in relation to conventional β-blockers, attempting to examine the potential use of this agent for hypertension treatment

Telemonitoring in Chronic Heart Failure: A Systematic Review

Heart failure (HF) is a growing epidemic with the annual number of hospitalizations constantly increasing over the last decades for HF as a primary or secondary diagnosis. Despite the emergence of novel therapeutic approached that can prolong life and shorten hospital stay, HF patients will be needing rehospitalization and will often have a poor prognosis. Telemonitoring is a novel diagnostic modality that has been suggested to be beneficial for HF patients. Telemonitoring is viewed as a means of recording physiological data, such as body weight, heart rate, arterial blood pressure, and electrocardiogram recordings, by portable devices and transmitting these data remotely (via a telephone line, a mobile phone or a computer) to a server where they can be stored, reviewed and analyzed by the research team. In this systematic review of all randomized clinical trials evaluating telemonitoring in chronic HF, we aim to assess whether telemonitoring provides any substantial benefit in this patient population

Quality of life measurement in patients with hypertension in Cyprus

Cardiovascular diseases and hypertension may have a significant impact on the quality of life of those who suffer from these conditions. The aim of the present study was to measure health-related quality of life among Cypriot patients suffering from hypertension and/or dyslipidaemia, as well as to investigate any temporal changes in their quality of life at 3 and 6 months from the initial visit. Methods: A stratified random sampling method was used in this follow-up multi-centre study to select a representative sample of physicians who treat patients with hypertension in both public and private sector outpatient hospital clinics and physician offices. The participants were diagnosed by the physician according to the 2007 European guidelines for the management of arterial hypertension. The EQ-5D questionnaire was employed to measure self-assessed quality of life among these patients. Six hundred and fifty-four patients were recruited by physicians and agreed to participate, while 528 of them successfully completed EQ-5D at baseline and two subsequent phases (at 3 and 6 months), representing a response rate of 80.7%. Results: A total of 39.6% of the respondents reported problems in one or more of the EQ-5D dimensions. This was more apparent in the case of anxiety and depression. There appeared to be statistically significant improvements with regard to mobility, usual activities, pain/discomfort and anxiety/depression dimensions between the initial visit and on first follow up, as well as subsequently. Median (interquartile range) EQ-5D index scores were 0.97 (0.19), 0.97 (0.19) and 0.97 (0.17) at first visit, first follow-up and second follow-up respectively (p<0.001). Also, median EQ-5D VAS scores were 80 (20), 85 (10) and 90 (15) at the initial, first follow-up and second follow-up visit respectively (p<0.001). Median EQ-5D VAS scores increased over time amongst all socio-demographic and risk groups of participants. Conclusion: Hypertension had little association with mobility and physical activities, indicating that performing physical activities was not limited by hypertension. However, hypertension seems to be more strongly related to anxiety and depression