Publications by authors named "Pc Manoria"

Adverse cardiovascular (CV) events have declined in Western countries due at least in part to aggressive risk factor control, including dyslipidemia management. The American and European (Western) dyslipidemia treatment guidelines have contributed significantly to the reduction in atherosclerotic cardiovascular disease (ASCVD) incidence in the respective populations. However, their direct extrapolation to Indian patients does not seem appropriate for the reasons described below.

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Article Synopsis
  • The Lipid Association of India updated its cardiovascular risk assessment algorithm to address the unique challenges of atherosclerotic cardiovascular disease (ASCVD) in Indians, focusing on early intervention.
  • A series of expert meetings were held to review current evidence and refine treatment guidelines, emphasizing the need for aggressive preventive measures due to the young age of onset for ASCVD in the Indian population.
  • The updated recommendations aim to enhance LDL-C-lowering therapy and improve risk management strategies for individuals at high risk of ASCVD, ultimately striving to reduce its prevalence in India and beyond.
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In 2021 an estimated 74 million individuals had diabetes in India, almost all type 2 diabetes. More than half of patients with diabetes are estimated to be undiagnosed and more 90% have dyslipidemia that is associated with accelerated development of atherosclerotic cardiovascular disease (ASCVD). Patients of Indian descent with diabetes have multiple features that distinguish them from patients with diabetes in Western populations.

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Lipid-lowering therapy plays a crucial role in reducing adverse cardiovascular (CV) events in patients with established atherosclerotic cardiovascular disease (ASCVD) and familial hypercholesterolemia. Lifestyle interventions along with high-intensity statin therapy are the first-line management strategy followed by ezetimibe. Only about 20-30% of patients who are on maximally tolerated statins reach recommended low-density lipoprotein cholesterol (LDL-C) goals.

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Article Synopsis
  • The Lipid Association of India recommends specific LDL cholesterol targets for stroke patients, with high-intensity statins as the first-line treatment and the possibility of adding nonstatin therapies if necessary.
  • Continuing statins is crucial for patients with acute ischemic stroke; those who have their statins stopped usually experience worse outcomes, while statins should not be initiated in acute intracerebral hemorrhage cases but continued if already prescribed.
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Worldwide, coronary heart disease (CHD), have assumed epidemic proportions. Increasing use of interventional therapy and a higher adherence to medical therapy have led to a 33% reduction in cardiac deaths at 5 years after hospital discharge. Angina pectoris is a common symptom of ischemic heart disease.

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Diabetes mellitus (DM) is a pandemic disease and an important cardiovascular (CV) risk factor. The atherogenic dyslipidemia in diabetes (ADD) is characterized by high serum triglycerides, high small dense LDL levels, low HDL levels and postprandial lipemia. Insulin resistance is a primary cause for ADD.

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Blockade of the renin-angiotensin system by angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers has been shown to be effective in treating hypertension and heart failure. There are currently seven angiotensin II receptor blockers in clinical practice, olmesartan medoxomil being the newest agent in the class. This article reviews the pharmacokinetics, pharmacodynamics, safety, efficacy, clinical use, dosing and cost of olmesartan medoxomil.

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Congestive cardiac failure (CCF) is a common problem through out the globe and is associated with high morbidity and mortality. The rapid progression of the disease due to neurohormonal activation can be blunted by use of angiotensin-converting enzyme inhibitor (ACEI) and beta blockers (BB) with a major impact on morbidity and mortality. Besides CCF, they are also useful in asymptomatic left ventricular dysfunction (LVD) and in prevention of heart failure in high risk patients without LVD.

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Hypertensive heart disease.

J Indian Med Assoc

March 1999

Hypertensive heart disease (HHD) is a common problem in clinical practice. Left ventricular hypertrophy (LVH) is pathognomonic of HHD. Echo-Doppler study is the modality of choice to document cardiac involvement in hypertension.

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