Cardiovascular disease treatments

Risk for development of cardiovascular disease Treatment of patients with CKD includes the following ... 

Lime and Lime-Soda Processes. The first softening plant in the early 1900s used the lime softening process with fill and draw units. Later, continuous-treatment units, which greatiy increased the amount of water that could be treated in a faciUty of given size, were developed. More than 1000 municipahties soften water. Most are in the Midwest and in Florida. However, concern for the adverse effect of soft water on cardiovascular disease (CVD) may limit the number of plants that introduce softening. 

In a study with 3427 male and female patients having DBP of 95—109 mm Hg (12—15 Pa), and no clinical evidence of cardiovascular diseases, half of the patients were placebo-treated and half were SC antihypertensive dmg-treated, ie, step 1, chlorothiazide step 2, methyldopa, propranolol [525-66-6], or pindolol [13523-86-9], and step 3, hydralazine, or clonidine [4205-90-7] (86). Overall, when the DBP was reduced below 100 mm Hg (13 Pa), there were more deaths in the dmg-treated group than in the placebo group. The data suggest reduction of blood pressure by antihypertensive dmg treatment that includes a diuretic is accompanied by increased cardiovascular risks. 

When adrninistered long-term for the treatment of hypertension, diuretics fulfill the goals of preventing cardiovascular disease and increasing longevity. However, diuretic therapy may produce both side and toxic effects that are significant in certain patient subgroups, eg, diabetics and cardiac patients. 

As endothelins mediate potent vasoconstrictor effects, ECE inhibitors and endothelin receptor antagonists were developed for the treatment of cardiovascular diseases, such as acute and chronic heart failure, pulmonary hypertension and subarachnoid haemorrhage. As ETa recqrtors have potent mitogenic responses and may promote progression of ovarian and prostate cancer and bone metastases ETA receptors are also considered as a potential targets for anti-tumour activity. 

A number of chimerized, humanized, and one human mAb have now been approved for therapeutic use in humans in the treatment of autoimmunity, malignancy, infection and cardiovascular disease (Table 1). Some of the currently licensed mAb will be discussed here. A much larger number of mAb are currently being evaluated in Phase I, II and III trials. In general, chimeric, humanized and human mAb are very well tolerated with few side effects. Chimeric or humanized mAb still have the potential to evoke host immune response to the variable domains or CDRs of the antibody so-called HACA (human anti-chimeric antibody) or HAHA (human anti-human antibody) responses, although these responses are uncommon. Short-lived and occasionally severe infusion-related acute hypersensitivity reactions such as fever, skin itching, shivering, respiratory compromise and low blood pressure sometimes occur-. Such effects may... 

Low levels of vitamin E have been associated with increased incidence of coronary artery disease. Observational studies have therefore suggested that supplemental a-tocopherol might have value in the treatment of cardiovascular disease. Clinical studies demonstrated contradicting results regarding the benefits of vitamin E in the prevention of cardiovascular disease. Four... 

In most individuals, the systolic pressure increases sharply with age, whereas the diastolic pressure increases until about age 55 years and then declines. Older individuals with an elevated systolic pressure have a condition known as isolated systolic hypertension (ISH). When the systolic pressure is high, blood vessels become less flexible and stiffen, leading to cardiovascular disease and kidney damage. Research indicates that treating ISH saves lives and reduces illness. The treatment is the same for ISH as for other forms of hypertension. 

Relative contraindications to the use of anticholinesterase treatment include a history of cardiovascular disease, asthma, glaucoma, and gastrointestinal or genitourinary obstruction. Symptomatic treatment of tachyarrhythmias with propranolol may be considered P blockers, however, are less effective than physostigmine. 

Contraindications are the same as for immunotherapy for inhalant allergy, but are relative in nature because of the life-saving potential of venom immunotherapy. Elderly patients, especially with preexisting cardiovascular disease, are at a high risk to develop severe or even fatal anaphylaxis [26]. Therefore, venom immunotherapy is often recommended in patients over 50-60 years of age. Since (3-blocker treatment is associated with a significantly increased survival rate in patients with coronary heart... 

The a-tocopherol, P-carotene (ATBC) Cancer Prevention study was a randomised-controlled trial that tested the effects of daily doses of either 50 mg (50 lU) vitamin E (all-racemic a-tocopherol acetate), or 20 mg of P-carotene, or both with that of a placebo, in a population of more than 29,000 male smokers for 5-8 years. No reduction in lung cancer or major coronary events was observed with any of the treatments. What was more startling was the unexpected increases in risk of death from lung cancer and ischemic heart disease with P-carotene supplementation (ATBC Cancer Prevention Study Group, 1994). Increases in the risk of both lung cancer and cardiovascular disease mortality were also observed in the P-carotene and Retinol Efficacy Trial (CARET), which tested the effects of combined treatment with 30 mg/d P-carotene and retinyl pahnitate (25,000 lU/d) in 18,000 men and women with a history of cigarette smoking or occupational exposure to asbestos (Hennekens et al, 1996). 

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. There are a number of established risk factors including serum cholesterol levels, smoking and family history, which are responsible for between 50 and 75% of the CVD cases, with the remainder due to factors that cause atherosclerosis. Estrogen treatment such as hormone replacement therapy is known to protect against CVD by decreasing the levels of low-density... 

Hyperlipidemia plays a role in the development of cardiovascular disease (CVD) in patients with CKD. The primary goal of treatment of dyslipidemras is to decrease the risk of atherosclerotic cardiovascular disease. A secondary goal in patients with CKD is to reduce proteinuria and decline in kidney function. Treatment of hyperlipidemia in patients with CKD has been demonstrated to slow the decline in GFRby 1.9 mL/minute per year of treatment with antihyper Epidemic agents.21... 

HRT should not be prescribed to women with a history of or active thromboembolic disease, breast cancer or estrogen-dependent neoplasm, pregnancy, liver disease, or undiagnosed vaginal bleeding. It also should not be used for the prevention or treatment of cardiovascular disease, cerebrovascular disease, or dementia.11... 

A common form of EDTA used as a preservative is calcium disodium EDTA (CaNa2EDTA). What metals will this form of the sequestrant scavenge effectively The dissolution of the solid will yield calcium ions, sodium ions, and the EDTA anion. Any metal more effectively complexed than calcium will be readily scavenged, including all ions listed in Table 9.1 except silver (Ag+) and magnesium (Mg2+). (In the absence of the calcium counterion, as in the case of the acid form of EDTA, chelation of calcium in the body can occur. In fact, EDTA administered orally is an FDA-approved treatment for calcium deposits in the bloodstream that lead to cardiovascular disease.) Citric acid (Fig. 9.3.3) is another sequestrant of metal ions in foodstuffs. 

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