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Journal Scan 6 – Fractional flow reserve, Hypertension and Exercise in Diabeties

De Bruyne B, Pijls N, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med 2012; DOI: 10.1056/NEJMoa1205361. Available at:http://www.nejm.org.

The FAME-2 trial compared angioplasty guided by just the angiogram with angioplasty guided by the angiogram and a special pressure sensor wire Known as FFR) to see if outcomes could be improved in stable angina patients. If the narrowing turned out not to be significant after FFR, the risk if future events was low. If a stent was placed in a significant lesion then again the event rate was low. However, if the significant narrowing was left alone, there was a higher risk of needing urgent angioplasty later, although not dear or heart attack. The days of just relying in the angiogram are fast disappearing. If you have stable angina and may need angioplasty, as your doctor if he is aware of the FAME-2 results and and uses FFR routinely. The answer has to be yes to both to receive the best care.

 

Fischer D, Mahfoud F, Lenski M, et al. Anxiety, depression, quality of life and stress in patients with resistant hypertension before and after renal sympathetic denervation. European Society of Cardiology 2012 Congress; August 26, 2012; Munich, Germany.Abstract 1168.

In this study looking at renal denervation therapy in severe hypertension, impressive improvement in anxiety, depression and quality of life scores occurred after therapy. This seems to suggest that the effects of therapy goes beyond the blood pressure, or perhaps the blood pressure was causing these subtle symptoms. If you have severe hypertension, get in touch. Dr Malik can discuss renal denervation therapy with you.

The PURE results presented at the European Society of Cardiology this year showed that high blood pressure is present in up to 50% of the western population and that control is inadequate. The study aimed to assess the prevalence, awareness, and control of hypertension worldwide by measuring blood pressure in 153 000 patients. This can lead to long term risk of stroke and heart failure. Blood pressure control is best assessed with either home monitoring or 25 hour BP monitors. To arrange a review of your blood pressure please get in touch with us.

 

Sluik D, Buijsse B, Muckelbauer R, et al. Physical activity and mortality in individuals with diabetes mellitus. Arch Intern Med 2012; DOI:10.1001/archinternmed.2012.3130. Available at:http://archinte.jamanetwork.com/journal.aspx.

Exercise reduces death rate whether you are diabetic or non diabetic. Although not as easy taking a pill, exercise works. In this study it seemed produce a remarkable 1/3 reduction in the risk of dying. To find out if you are safe to increase your exercise levels, feel free to consult us.

Posted on 17 September 2012
Author: LCC
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