The Paradise Renal Denervation System: An FDA-approved catheter-based treatment option for resistant hypertension.

Resistant hypertension is defined as office blood pressure >140/90 mm Hg with a mean 24-hour ambulatory blood pressure of >130/80 mm Hg in patients who are compliant with 3 or more antihypertensive medications. Those who persistently fail pharmaceutical therapy may benefit from interventional treatment, such as renal denervation. Sympathetic nervous activity in the kidney is a known contributor to increased blood pressure because it results in efferent and afferent arteriole vasoconstriction, reduced renal blood flow, increased sodium and water reabsorption, and the release of renin.

Sotatercept: A New Era in Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension (PAH) is a progressive disease characterized by proliferative remodeling and obliterative narrowing of the pulmonary vasculature. While outcomes have improved with existing treatments targeting 3 main pathways, there remains a critical need for novel therapies that address different and novel mechanisms of PAH. Sotatercept, recently Food and Drug Administration (FDA) approved, is a groundbreaking fusion protein that binds to activin and growth differentiation factors, rebalancing antiproliferative and pro-proliferative signals to reverse remodeling in both the pulmonary vasculature and the right ventricle.

Iloprost: Old and New Indications.

Iloprost is a synthetic long-acting prostacyclin-analog drug used to treat various vascular diseases. The Federal Drug Administration approved the drug in 2004 for pulmonary arterial hypertension, and it has since been shown to be helpful in other vascular conditions such as scleroderma and Raynaud phenomenon. The Federal Drug Administration has now approved the use of iloprost for severe frostbite.

Curbside Consult Optimizing Statin Therapy in the Elderly: A Personalized Approach to Cardiovascular Disease Prevention.

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) play a vital role in managing and preventing cardiovascular disease, particularly in elderly populations who face elevated risks for atherosclerosis and related conditions. This review delves into the mechanisms of statin action, emphasizing their impact on low-density lipoprotein cholesterol levels, anti-inflammatory properties, and potential genetic factors influencing efficacy and drug tolerability. Consideration is given to statin intolerance and management strategies, drug interactions, and guidelines for primary and secondary prevention of cardiovascular events.

The First Triple Agonist for Antiobesity: Retatrutide.

The prevalence of individuals with overweight and obesity has increased by 18% since 1990 and it is projected that by 2030, nearly 50% of US adults will have obesity. Lifestyle modifications, such as diet and exercise, typically lead to approximately 3-5% weight loss, whereas 5-15% weight loss is necessary to significantly impact obesity-associated comorbidities and improve overall health outcomes. In addition to lifestyle modifications, pharmacotherapy has been utilized as an adjunctive treatment to increase weight loss and improve health outcomes.

Beyond the Local Effect: An Examination of Cardiovascular and Other Systemic Complications of Ophthalmologic Drugs.

Ophthalmologic drugs may be delivered to the eye via a number of ways, including topical drops and gels, intraocular injections, and parenteral or oral administration. The inadvertent systemic absorption of these drugs may lead to a myriad of side effects, ranging from benign cosmetic changes to potentially fatal cardiovascular complications. Historically, glaucoma treatment, including β-blockers and α-agonists, have been particularly examined for such events.

Hypertension and Cognitive Disorders.

Systemic hypertension is possibly the most important modifiable risk factor for the development of cognitive decline, both for mild cognitive impairment (MCI) and dementia. For effective blood pressure (BP) control, it requires proper assessment, using brachial, central, and ambulatory measurements, and monitoring with a focus on different BP parameters. Different BP parameters like pulse pressure, mean arterial pressure, BP variability, and circadian parameters, like nondippers and early morning surge, should be considered in the evaluation for the risk of cognitive decline due to hypertension in middle age and older adults.

Oral GLP-1 Receptor Agonists for Weight Loss.

With the increasing prevalence of obesity and the advent of new and highly effective antiobesity medications, there is renewed interest in novel antiobesity pharmacotherapy. Currently, the most effective medications for obesity are injectable medicines. There is a need to develop equally efficacious oral drugs to increase availability to patients.

Cardiovascular Effect of Drugs Used to Treat Alzheimer's Disease.

This review examines the cardiovascular effects of the mainstay drugs used to treat Alzheimer's disease (AD), namely cholinesterase inhibitors (ChEIs) and memantine. ChEIs represent the current first-line treatment for AD. Memantine is typically reserved for moderate to severe AD.

The Effects of Metformin on Weight Loss, Cardiovascular Health, and Longevity.

Metformin, a biguanide derived from Galega officinalis, was first synthesized by Werner and Bell in 1922. Metformin was approved for the treatment of diabetes by the US Food and Drug Administration in 1994. It has since become the most widely used oral antidiabetic agent.

Leukocytosis as a Risk Factor for Coronary Artery Disease: Pathophysiology and Epidemiology.

Coronary artery disease (CAD) is a significant health concern characterized by reduced blood flow to the heart muscle, primarily due to the buildup of atherosclerotic plaques in the coronary arteries. This process begins with endothelial injury, leading to a cascade of biological responses contributing to plaque formation. Endothelial injury attracts the migration of monocytes which differentiate into macrophages upon uptake of oxidized low-density lipoproteins, changing into lipid-laden macrophage or "foam cells.

Implementing a Comprehensive CPR Education in New York State Public High Schools: Ideas, Drawbacks, & Future Directions.

Cardiopulmonary resuscitation (CPR) is a lifesaving skill that can be employed when people experience cardiac arrest. While the benefits of CPR on survival are well known, much of the American population remains uneducated on how to perform it. There are many reasons for this, ranging from the cost of CPR courses to fear of making mistakes in emergency situations.

Comprehensive Guide to Paravalvular Leak: Symptoms, Effects, and Treatments.

Paravalvular leak (PVL) represents a common complication often encountered following valve replacement surgeries, posing significant diagnostic and therapeutic challenges within the field of cardiology. The condition, characterized by an abnormal flow of blood around the edges of a prosthetic valve, can lead to a spectrum of clinical manifestations, from asymptomatic states to severe heart failure or hemolysis. Its relevance is underscored by its contribution to morbidity and mortality among affected individuals, necessitating a deeper understanding of its etiology, diagnosis, and management.

Scar-Related Ventricular Tachycardia: Pathophysiology, Diagnosis, and Management.

Scar-related ventricular tachycardia (VT) commonly results from scarring in the myocardium, principally produced by antecedent myocardial infarction, cardiomyopathy, or prior cardiac surgery. The resultant arrhythmogenic substrate from scarred tissue and the alteration of normal cardiac electrical conduction predispose patients to reentrant circuits, followed by VT. This literature review synthesizes current research on pathophysiology, diagnostic methods, and treatment modalities of scar-related VT.

Revolutionizing Cardiac Care: The Role of Gene Therapy in Treating Cardiomyopathy.

Gene therapy presents a method for addressing types of cardiomyopathies that play a substantial role in heart failure. This innovative approach, leveraging technologies such as clustered regularly interspaced short palindromic repeats/Cas9 for modifying genomes, holds promise for lasting treatments or potential cures that go beyond therapies. It is essential to grasp the workings of gene therapy, including gene silencing, clustered regularly interspaced short palindromic repeats genome editing, and enhancing sarcomere function to effectively apply it to treating cardiomyopathy.

Pulmonary Artery Denervation: An Emerging Treatment for Pulmonary Hypertension.

Pulmonary hypertension (PH) is a debilitating disease with a poor overall prognosis. Pulmonary artery denervation (PADN) has emerged as a promising new treatment which has been shown to improve hemodynamics, functionality, and REVEAL scores for patients with PH. This article reviews notable updates in the management of PH since the 6th World Symposium on PH, the pathophysiology of PH, how PADN may work given the pathophysiology of PH, and focuses on evidence from the eleven studies supporting the use of PADN from trials that include human participants.

Cardiac Manifestations of Lyme Disease.

Lyme disease (LD) is an inflammatory disorder caused by an infectious bacterial agent and is the most common tick-borne illness in the United States and Europe. About 1.5-10% of adults infected with LD develop cardiac complications.

Ultrasound Therapy as a Treatment for Valvular Aortic Stenosis: A Review.

Calcific aortic stenosis is the most common form of aortic stenosis, and offers a poor prognosis in affected patients. Current treatment methods for aortic stenosis, including open surgical aortic valve repair and transcatheter aortic valve replacement, are invasive, and require the patient to undergo open-heart surgery with cardiopulmonary bypass. Ultrasound therapy offers a potential solution for patients ineligible for traditional surgical treatment.

Curbside Consults Salt-Free Potassium-Enriched Substitute Versus Salt-Free Diet in Hypertension: Which Is Better?

This article examines the potential benefits of using potassium-enriched salt and following a salt-free diet to control hypertension, a prevalent global condition and a major risk factor for heart disease, stroke, and kidney disease. The article explores the impact of sodium on high blood pressure, explains what potassium-fortified salt is, and includes personal experiences. The article also examines the scientific proof backing potassium-fortified salt, evaluating its advantages and constraints.

Discontinuation of Cardiac Devices at or Near an Adult Patient's End of Life.

Advances in medical technology have begun to blur the lines between life and death as well as the lines between appropriate and inappropriate therapy. This review addresses the charged issue of the management of cardiac devices at or near the end of a patient's life, provides a summary of prior and current opinion with some historical context, and attempts to provide some modest guidance as to how to approach the various options to the patient's best advantage. Modalities to be addressed include indwelling electronic devices, the left ventricular assistance device, and extracorporeal mechanical oxygenation, and includes available outcome data as well as ethical analysis from a number of commentators.