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Sildenafil should be avoided in valve disease with residual pulmonary hypertension, study suggests

"Valvular disease is considered the next cardiac epidemic because of its strong association with age and the rapid aging of the population worldwide," said principal investigator Dr Javier Bermejo, a cardiologist at Hospital General Universitario Gregorio Marañon, Madrid, Spain. "The only established treatment is repair or replacement of the valve surgically or percutaneously," he continued. "But symptoms often remain or reappear in the long-term. Residual pulmonary hypertension is the most important risk factor for death and disability after successful correction of the valvular lesion." Pulmonary hypertension refers to increased blood pressure in the pulmonary artery. In patients with long-standing valvular disease, the high pressure in the left side of the heart is transmitted backwards to the lung vessels which react by thickening. This process may not revert after valve treatment, resulting in persistent pulmonary hypertension. Sildenafil (cen...
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Young adults, especially men, fall behind in high blood pressure treatment and control

oung adults, particularly men, lag behind middle-aged and older adults in awareness and treatment of high blood pressure, putting this population at an increased risk for heart attack and stroke, according to new research in the American Heart Association's journal  Hypertension . High blood pressure is a leading risk factor for heart attack and stroke and is also a significant public health burden, costing the United States about $110 billion in direct and indirect costs in 2015, according to American Heart Association estimates. American Heart Association guidelines define blood pressure as normal at less than 120/80 and high blood pressure as 140/90 or above. "While hypertension awareness, treatment and control have improved overall since the early 2000s, all three remain worse in young adults -- those aged 18-39," said senior study author Andrew Moran, M.D., M.P.H., an assistant professor at Columbia University Medical Center in New York. The study, based on ...
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Preventing sudden death in hypertrophic cardiomyopathy

A large study conducted across North America, Europe, the Middle East and Asia has validated the ESC recommendations for predicting and preventing sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). The HCM-EVIDENCE study, presented at ESC Congress 20171, tested the ESC's recommendations in a diverse cohort of patients, said study investigator Constantinos O'Mahony, MRCP(UK). "Since 2014, the ESC has recommended using a special risk prediction tool called the HCM Risk-SCD to identify which patients are at highest risk for sudden death and would benefit most from having a prophylactic implantable cardioverter defibrillator," explained Dr O'Mahony, from St. Bartholomew's Centre for Inherited Cardiovascular Disease, St Bartholomew's Hospital, and the University College London Centre for Heart Muscle Disease, Institute of Cardiovascular Science, London. "But, whenever a risk model is created, there are concerns about ho...
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