Current Opinion in Cardiology最新文献_第5页

Hypertension management in patients with advanced chronic kidney disease with and without dialysis. 晚期慢性肾病伴和不伴透析患者的高血压管理。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-03 DOI: 10.1097/HCO.0000000000001221

Maria L Gonzalez Suarez, Jose Arriola-Montenegro, Leticia Rolón

{"title":"Hypertension management in patients with advanced chronic kidney disease with and without dialysis.","authors":"Maria L Gonzalez Suarez, Jose Arriola-Montenegro, Leticia Rolón","doi":"10.1097/HCO.0000000000001221","DOIUrl":"10.1097/HCO.0000000000001221","url":null,"abstract":"Purpose of review: Hypertension is a common comorbidity in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) on dialysis, contributing significantly to cardiovascular disease and increased mortality. Managing hypertension in this population is complex due to the frequent occurrence of resistant hypertension. This review highlights the recent updates in hypertension management for these patients, especially considering new guidelines and therapeutic options.Recent findings: Recent literature emphasizes updated KDIGO guidelines, which have lowered blood pressure targets to decrease cardiovascular risks in patients with advanced CKD and ESKD. First-line therapies include diuretics, angiotensin converting enzyme inhibitors, and angiotensin II receptor blockers. New pharmacological treatments, such as sodium-glucose cotransporter-2 (SGLT2) inhibitors, endothelin receptor antagonists, RNA interference therapeutics, and aldosterone synthase inhibitors, offer promising options for resistant hypertension. Additionally, lifestyle modifications, including a low-salt diet and aerobic exercise, and volume control through ultrafiltration in dialysis patients, are crucial for blood pressure management.Summary: The findings suggest that individualized treatment strategies, incorporating both pharmacologic and nonpharmacologic approaches, are essential for optimizing blood pressure control in patients with advanced CKD and ESKD. These strategies can improve cardiovascular outcomes and enhance patient quality of life, with important implications for clinical practice.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"199-205"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of glucagon-like peptide-1 receptor agonists on hypertension management: a narrative review. 胰高血糖素样肽-1受体激动剂对高血压治疗的影响：叙述性综述。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-11 DOI: 10.1097/HCO.0000000000001225

Diana De Oliveira-Gomes, Adhvithi Pingili, Sara Inglis, Stacy A Mandras, Juan F Loro-Ferrer, Adrian daSilva-deAbreu

{"title":"Impact of glucagon-like peptide-1 receptor agonists on hypertension management: a narrative review.","authors":"Diana De Oliveira-Gomes, Adhvithi Pingili, Sara Inglis, Stacy A Mandras, Juan F Loro-Ferrer, Adrian daSilva-deAbreu","doi":"10.1097/HCO.0000000000001225","DOIUrl":"10.1097/HCO.0000000000001225","url":null,"abstract":"Purpose of review: The increasing prevalence of hypertension, alongside the growing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for conditions beyond type 2 diabetes, underscores the need for understanding if there is a role for these medications in blood pressure management. This review addresses the timely opportunity to assess how GLP-1 RAs could influence blood pressure control, potentially broadening therapeutic strategies for cardiovascular risk management.Recent findings: Emerging literature indicates that GLP-1 RAs influence blood pressure through various mechanisms, such as sympathetic nervous modulation, vasodilation, and diuretic effects. Clinical trials demonstrate modest yet statistically significant reductions in systolic blood pressure (SBP), with less consistent effects on diastolic blood pressure (DBP). The advent of dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists presents enhanced possibilities for managing hypertension.Summary: The implications of these findings suggest that GLP-1 RAs have potential as adjunctive therapies for hypertension, especially in patients already receiving these agents for other cardiometabolic conditions. The blood pressure-lowering effects, often independent of weight loss or glucose control, warrant further investigation to determine their precise role within hypertension treatment algorithms and encourage integration into clinical practice.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"185-192"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension in atherosclerotic cardiovascular disease: insights into epidemiology, management strategies, and outcomes. 动脉粥样硬化性心血管疾病中的高血压：流行病学、管理策略和结果的见解

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-04-23 DOI: 10.1097/HCO.0000000000001226

Prerna Gupta, Julia A Bast, Alexander C Razavi, Mario Enrico Canonico, Anum Shahzad, Muhammad Naeem, Marc P Bonaca, Laurence S Sperling, Raymundo A Quintana

{"title":"Hypertension in atherosclerotic cardiovascular disease: insights into epidemiology, management strategies, and outcomes.","authors":"Prerna Gupta, Julia A Bast, Alexander C Razavi, Mario Enrico Canonico, Anum Shahzad, Muhammad Naeem, Marc P Bonaca, Laurence S Sperling, Raymundo A Quintana","doi":"10.1097/HCO.0000000000001226","DOIUrl":"10.1097/HCO.0000000000001226","url":null,"abstract":"Purpose of review: To provide a comprehensive review of hypertension among patients with atherosclerotic vascular disease. Although there is significant alignment in treatment goals and strategies, blood pressure targets and therapies differ among atherosclerosis in varying vascular territories. Hypertension is a prominent risk factor for the development and amplification of atherosclerosis, as well as the cause of significant downstream morbidity and mortality.Recent findings: Hypertension is the greatest contributor to population attributable cardiovascular risk. Hypertension accelerates the development of atherosclerotic cardiovascular disease (ASCVD), and treatment of hypertension is a central tenet to managing ASCVD. Patients with ASCVD often merit a multidisciplinary approach, require multiple specialists and medications, and may suffer from additional consequences of therapy due to multimorbidity. Significant arterial stenoses may lead to unintended consequences of antihypertensive therapy. Further, there have been recent advances in the interventional management of hypertension, including techniques like renal denervation.Summary: In recent years, there have been significant changes in management guidelines of hypertension and peripheral arterial disease, new evidence in coronary artery disease, and simultaneously there's been an evolution in interventional management of hypertension, such as renal denervation. We provide an update on hypertension treatment in atherosclerotic disease among different vascular beds.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"206-212"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anabolic-androgenic steroids among recreational athletes and cardiovascular risk. 休闲运动员中的合成代谢雄激素类固醇与心血管风险。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-07-01 Epub Date: 2025-05-14 DOI: 10.1097/HCO.0000000000001235

Sean Meagher, Michael S Irwig, Prashant Rao

{"title":"Anabolic-androgenic steroids among recreational athletes and cardiovascular risk.","authors":"Sean Meagher, Michael S Irwig, Prashant Rao","doi":"10.1097/HCO.0000000000001235","DOIUrl":"10.1097/HCO.0000000000001235","url":null,"abstract":"Purpose of review: The use of androgenic anabolic steroids (AAS) is rising, particularly among recreational athletes. This review addresses growing concerns about the underrecognized cardiovascular and multiorgan consequences of chronic AAS exposure with a focus on noncompetitive populations.Recent findings: It is well documented that AAS use enhances muscle mass and strength, but at the cost of multisystem toxicity including endocrine disruption, hepatotoxicity, and mood disorders. Emerging evidence highlights the profound cardiovascular impact of AAS use, including elevated blood pressure, adverse lipid profiles, accelerated atherosclerosis, subclinical cardiomyopathy, and increased risk of myocardial infarction and sudden cardiac death. Structural and functional cardiac abnormalities such as left ventricular hypertrophy, ventricular dysfunction, and arterial stiffness have been reported, with some changes persisting after cessation.Summary: AAS use carries multisystem risks with evidence for adverse cardiovascular remodeling and atherogenesis. Clinicians caring for athletes using AAS should recognize patterns of AAS use and provide risk stratification, monitoring, and tapering strategies. Future research should prioritize long-term outcomes, sex-specific effects, and multidisciplinary approaches to care.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"221-229"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension in chronic kidney disease and future heart failure. 高血压在慢性肾脏疾病和未来的心力衰竭。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-10 DOI: 10.1097/HCO.0000000000001206

Michel Burnier

{"title":"Hypertension in chronic kidney disease and future heart failure.","authors":"Michel Burnier","doi":"10.1097/HCO.0000000000001206","DOIUrl":"10.1097/HCO.0000000000001206","url":null,"abstract":"Purpose of review: Hypertension and chronic kidney diseases (CKDs) are known risk factors for the development or worsening of heart failure. In last years, several new therapeutic approaches for the management of people with diabetic and nondiabetic CKD and hypertension have been investigated. In this brief review, the most recent findings regarding the ability of SGLT-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (nsMRA) and GLP-1 receptor agonists to prevent heart failure in patients with hypertension and CKD will be discussed.Recent findings: In the last 3 years, several large clinical trials involving very large numbers of CKD patients have been published showing that these new therapeutic approaches significantly reduce the risk of heart failure events and hospitalizations in patients with diabetic and nondiabetic nephropathies and hypertension as well as in patients with heart failure without nephropathy. Moreover, these drugs retard the progression of CKD towards end-stage kidney disease.Summary: These observations already have a major impact on the management of people with hypertension and CKD. SGLT-2 inhibitors are now recommended as first-line therapy in people with diabetes, CKD and heart failure. The use of nsMRA is increasing and could replace spironolactone over time in heart failure as well as in early CKD stages.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"158-163"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac phenotypes in LMNA mutations. LMNA突变中的心脏表型。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1097/HCO.0000000000001209

Leila Rouhi

{"title":"Cardiac phenotypes in LMNA mutations.","authors":"Leila Rouhi","doi":"10.1097/HCO.0000000000001209","DOIUrl":"10.1097/HCO.0000000000001209","url":null,"abstract":"Purpose of review: This review highlights the diverse cardiac manifestations of LMNA mutations, focusing on their underlying molecular mechanisms and clinical implications. As LMNA mutations are implicated in cardiomyopathies, such as dilated cardiomyopathy (DCM), arrhythmogenic cardiomyopathy (ARVC), and conduction system diseases, understanding these phenotypes is critical for advancing diagnosis and management strategies.Recent findings: Recent studies reveal that LMNA mutations disrupt nuclear envelope stability, activating the DNA damage response (DDR) and compromising chromatin organization and mechanotransduction. Mouse models have elucidated pathways linking LMNA dysfunction to fibrosis, arrhythmias, and myocardial remodeling. Emerging evidence demonstrates that fibroblasts play a crucial role in cardiac phenotypes. Advances in genetic screening have also underscored the importance of early identification and risk stratification, particularly for arrhythmias and sudden cardiac death.Summary: The diverse spectrum of LMNA-related cardiac phenotypes, from isolated conduction defects to severe DCM and ARVC, underscores the necessity of personalized care strategies. Bridging insights from molecular studies and clinical research paves the way for targeted therapies to slow disease progression and improve patient outcomes. Future efforts should prioritize translational research on molecular mechanisms with potential in mouse models, alongside a deeper exploration of genotype-phenotype correlations, to refine and implement effective therapeutic interventions.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"131-138"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mitigating heart failure risk in patients with diabetes and chronic kidney disease. 减轻糖尿病和慢性肾脏疾病患者心力衰竭的风险。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI: 10.1097/HCO.0000000000001208

Nicholas S Kowalczyk, Megan Prochaska

{"title":"Mitigating heart failure risk in patients with diabetes and chronic kidney disease.","authors":"Nicholas S Kowalczyk, Megan Prochaska","doi":"10.1097/HCO.0000000000001208","DOIUrl":"10.1097/HCO.0000000000001208","url":null,"abstract":"Purpose of review: Patients with chronic kidney disease and diabetes are at high risk of cardiovascular disease, including heart failure. Risk mitigation requires a comprehensive approach with lifestyle modifications, blood pressure management, renin-angiotensin blockade, and sodium-glucose cotransporter 2 inhibitors. Recent trials have shown that nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) should also be components of this approach. This review will discuss the comprehensive approach to mitigating risk in these high-risk patients and highlight the recent trials of ns-MRAs and GLP-1 RA.Recent findings: In recent years, large, randomized controlled trials of ns-MRA and GLP-1 RA have shown benefit in kidney and cardiovascular outcomes for patients with chronic kidney disease and diabetes.Summary: The substantial benefits and overall favorable safety profiles for ns-MRA and GLP-1 RA in patients with chronic kidney disease and diabetes demonstrate that these medications should be considered as a part of a comprehensive approach to cardiovascular risk reduction in this high-risk population. Future studies should consider different combination therapies and guide how and when to initiate these therapies.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"178-183"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetics, manifestations, and management of catecholaminergic polymorphic ventricular tachycardia. 儿茶酚胺能多形性室性心动过速的遗传学、表现和管理。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-01-20 DOI: 10.1097/HCO.0000000000001202

Shubh Desai, Oliver M Moore, Xander H T Wehrens

{"title":"Genetics, manifestations, and management of catecholaminergic polymorphic ventricular tachycardia.","authors":"Shubh Desai, Oliver M Moore, Xander H T Wehrens","doi":"10.1097/HCO.0000000000001202","DOIUrl":"10.1097/HCO.0000000000001202","url":null,"abstract":"Purpose of review: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating heritable channelopathy that can lead to sudden cardiac death in children and young adults. This review aims to explore genetics, the cardiac and extracardiac manifestations of mutations associated with CPVT, and the challenges involved with managing phenotypically variable variants.Recent findings: The understanding of the genetics and mechanisms of CPVT continues to grow with recent discoveries including alternative splicing of cardiac TRDN and calmodulin gene variants. Additionally, there is an increasing recognition of the extra-cardiac manifestations such as epilepsy, neurodevelopmental delay, and glucose homeostasis abnormalities in RyR2 variant carriers. Advances in precision medicine, including the development of iPSC-derived cardiomyocytes, are valuable models for developing targeted therapeutics.Summary: CPVT remains a complex disorder with cardiac and neurological manifestations impacting management. Early genetic testing and personalized treatment, including beta-blockers, flecainide, and ICDs, is important in improving outcomes. Ongoing research into the mechanism of each mutation will help in developing more effective, personalized therapeutics.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"150-157"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI: 10.1097/HCO.0000000000001213

引用次数: 0

RNA therapeutics in cardiovascular medicine. RNA在心血管医学中的应用。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-18 DOI: 10.1097/HCO.0000000000001210

Tulsi Ram Damase, John P Cooke

{"title":"RNA therapeutics in cardiovascular medicine.","authors":"Tulsi Ram Damase, John P Cooke","doi":"10.1097/HCO.0000000000001210","DOIUrl":"10.1097/HCO.0000000000001210","url":null,"abstract":"Purpose of review: RNA therapeutics came to global attention when mRNA-based vaccines provided an answer to the SARS-CoV-2 pandemic. The immense significance of this development notwithstanding, it is important to note that almost a decade prior to the pandemic, RNA drugs had made important inroads toward the amelioration of disease. The first class of RNA therapies to be introduced into clinical use were the antisense oligomers and siRNA drugs which generally induce a therapeutic effect by acting to brake or to modulate mRNA expression. RNA therapeutics is quickly becoming the fourth pillar of pharmacotherapy, and will have broad applications, including for the treatment of cardiovascular disease.Recent findings: The United States (US) Food and Drug Administration (FDA) has approved several antisense oligomers (ASOs) and siRNA-based drugs to treat disorders associated with cardiovascular disease. In addition, multiple RNA-based drugs are in clinical trials to assess their safety and efficacy in patients with cardiovascular disorders, such as Zodasiran, a siRNA therapy that targets angiopoietin-like protein 3 (ANGPTL3) to reduce LDL cholesterol.Summary: Because of limitless sequence choice; speed of design; and relative ease of synthesis, RNA drugs will be rapidly developed, will have broad applications, and will be generated at lower cost than other drug types. This review aims to highlight RNA therapies for cardiovascular diseases that are approved, and those that are under clinical evaluation.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"139-149"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0