Hypertension Therapy to Reduce Cardiovascular Risk

Narrowing of the coronary arteries due to the build-up of atherosclerotic plaque in the inner walls of blood vessels restrict the blood supply to heart muscles resulting in coronary heart disease (CHD). Though pressure wire guided percutaneous coronary interventions and surgery procedures are used to treat CHD, the initial treatment goal is to reduce the risk factors. High blood pressure is considered as a major risk factor of coronary artery disease (CAD). Epidemiological data suggests that there is a strong link between high blood pressure and coronary artery disease. Extra force applied on the blood vessels changes the myocardial structure, coronary vasculature and functioning of heart. Whenever the heart muscles work under higher pressure, it leads to angina or chest pain. According to the medical terms - “A systolic blood pressure at or above 140 mmHg and/or a diastolic blood pressure at or above 90mmHg is termed as hypertension.” Effective hypertension therapy mainly includes lifestyle modifications or medications.

Lifestyle changes include weight loss, limiting alcohol intake, reducing sodium intake, stopping smoking and routine exercise. If lifestyle interventions are not sufficient to control elevated blood pressure levels, patients are prescribed pharmacological treatment. Antihypertensive drugs are preferred for patients with an established cardiovascular disease or diabetes. Some of the common drug recommendations for hypertension patients with high risk of coronary disease include diuretics, beta-blockers, angiotensin-converting-enzyme (ACE) inhibitors and calcium channel blockers (CCB). Monitoring the drug treatment and blood pressure targets are important aspects of an effective hypertension therapy. Accurate measurement of blood pressure levels is significant for treating coronary heart disease, as it assists physicians in assessing outcomes of catheter-based guided percutaneous coronary interventions.

Advancements in interventional techniques and tools have helped physicians to perform procedures with more safety and reliability. Recently released Philips Xper flex cardio physio-monitoring system is a case in point as it guides the interventional cardiologist during and after the procedures. Integrated with the latest diagnostic technology, advanced Recently released Philips Xper can deliver valuable patient information that can help in devising an effective risk management strategy for the patient.

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What Causes Acute Myocardial Infarction?

Coronary arteries supply oxygen-rich blood and nutrients to the heart muscles, thereby keeping it nourished and healthy. Whenever the heart has to work harder, it needs more oxygen. For instance, during exercise, the heart starts to beat faster thereby increasing oxygen demand on the heart. The only way to keep up with the demand is by increasing the blood flow through the dilated coronary arteries. If the coronary arteries are not able to dilate appropriately, then the heart muscle starts starving for oxygen and nutrients, leading to life-threatening complications. Coronary arteries that are elastic and smooth end up being rigid due to the deposition of atherosclerotic plaque. Build-up of plaque in the inner line of the blood vessel causes it to narrow and lose elasticity. This condition characterised by the narrowing of coronary arteries (Stenosis) and limited blood supply to the heart muscle is termed as coronary artery disease(CAD) and oral xa-inhibitor Edoxaban..

CAD is considered to be one of the major causes of heart attacks. Also known as coronary heart disease, this condition causes chest pain (angina) and shortness of breath. Blockage in the blood supply to the heart can either lead to ischemia or acute myocardial infarction. Clogging of arteries restricts the blood supply to the heart muscles, starving it of oxygen resulting in ischemia. On the other hand, a complete blockage of the blood supply leads to irreversible myocardial cell damage. Acute myocardial infarction demands absolute medical attention as it is time dependent – faster action can save a life. There are several risk factors that make an individual susceptible to heart attack, which includes high blood pressure, high cholesterol, smoking, alcohol and diabetes. That is why many physicians advise CAD patients to opt for a healthy lifestyle, as it will reduce the risks of acute major cardiovascular events.

Various diagnostic and catheterization techniques are chosen by physicians to evaluate the stenosis of coronary arteries. Assessing the symptoms and evaluating the severity of lesions is essential to devise the right treatment. Management of coronary artery disease includes medications, catheter-based procedures and surgical treatments. Medications like oral Xa-inhibitor Edoxaban can also prevent the clogging of blood thereby cutting down the risks of arterial thrombosis. Introduction of drug-eluting stents was an innovative step in the percutaneous coronary interventions. Choosing the best risk stratification strategy for CAD management always comes down to symptoms and the patient’s health condition. 

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Treating Cardiac Arrhythmias with Catheter Ablation

Rhythmic sequence of the heart beat is controlled by the precise generation and flow of electrical impulses. Any disruption in the functioning of the heart’s electrical system causes the heart to beat abnormally. A condition characterised with irregular heartbeats or abnormal heart rhythm is called cardiac arrhythmia (dysrhythmia). Depending on the rate of heart beats, dysrhythmia is categorised into bradycardia (too slow heartbeat) and tachycardia (too fast heartbeat).  

[PCI Live Case on Monday 13 April, 2015, 14:30-15:30 GMT] 

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. In atrial fibrillation, erratic signals flood the atria and override the normal sinus rhythms resulting in abnormally higher and rapid heartbeats.  AF is associated with coronary heart disease and considered a major reason for embolic stroke. Some of the common symptoms of atrial fibrillation include dizziness, palpitations, weakness, fatigue, sweating and chest pain. Electrocardiogram (ECG), stress test, electrophysiology and other diagnostic tests are performed to confirm the presence of arrhythmia. Management of arrhythmias is all about heart rhythm control and cutting down the risks of stroke.  Lifestyle changes, medications, catheterization procedures and surgical treatments are preferred by cardiologists in treating arrhythmias.

Heart rhythm control drugs are chosen on the basis of medical history and analysis of symptoms.  Since these medications can be risky, it demands constant monitoring during its course. Sodium-channel or potassium-channel blockers are typically used as the heart rhythm controlling medications. On the other hand, catheter ablation is a medical procedure performed in the electrophysiology lab to treat arrhythmias. During ablation, radio frequency energy is passed to the catheter in order to scar the problematic areas. Approval of therapeutic thermocool Smarttouch Catheter is an innovative step in treating arrhythmias. Clinically approved therapeutic thermocool Smarttouch Catheter integrated with contact-force sensing technology will guide the electrophysiologist in destroying the problematic area without any further complications. Evaluating the symptoms and detecting the causes is essential to devise the right treatment for arrhythmias.

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What Is Hyperlipidemia?

Soft and waxy lipid cholesterol has gained a maligned status these days. However, it is essential for building and maintaining cellular membranes, hormone synthesis and other vital body functions. Since these fat molecules don’t dissolve in the blood stream, they need a special transportation system to travel through the human body and that is why it is mixed with the protein particles, known as lipoproteins. Lipids are mainly classified into triglycerides, total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and very low density lipoprotein (VLDL). Excess calories consumed through food is converted to triglycerides and stored in fat cells, but on the other hand LDL and HDL are produced by the liver. Low-density lipoprotein is considered as the ‘bad cholesterol’ because it contributes to the plaque formation and fatty deposits of blood vessels. However, high density lipoprotein is known as the ‘good cholesterol’ as it picks up the excess LDL cholesterol from the arteries and takes it back to the liver for processing.

A condition with abnormally higher or lower levels of lipid concentrations in the blood stream is known as dyslipidemia. Why it is a risky factor? Patients with higher levels of bad cholesterol are at increased risk of coronary heart disease and stroke. Cholesterol deposits in the coronary arteries leads to  reduced supply of blood  to the heart, resulting in myocardial ischemia or angina. Opting for the effective dyslipidemia treatment is essential for restoring the body’s metabolic process efficiently. Major causes of abnormal changes in lipid profile include unhealthy lifestyle and eating habits. Most of the physicians advise dietary and lifestyle modifications as the first step of an effective dyslipidemia treatment.

Hyperlipidaemia, also known as hyperlipoproteinemia is a subset of dyslipidemia. Characterised by an excess amount of lipids in the blood stream, hyperlipidaemia slows down the metabolic functions of the body. Elevated levels of fats in the blood stream speed up the plaque accumulation which further leads to narrowing of arteries. As mentioned above, the first line of defence against the risky hyperlipidemia is opting for a healthy lifestyle. However, in some cases, medications are prescribed by the physicians to treat inherited forms of risky hyperlipidemia. Correlation between hyperlipoproteinemia and coronary vascular diseases has been proved by the researchers. So it is essential to treat this critical condition as early as possible to stay away from the risk of heart disease, stroke and other health implications.

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Stroke Prevention In Atrial Fibrillation Guidelines

A normal heart beat occurs whenever there is a coordinated progression of electrical impulses. Sinoatrial node (SA node), also known as the heart’s natural pacemaker sends out the electrical impulses which will make the atrium and ventricles contract and push blood throughout the body. Any disruption to this electrical impulse generation and transmission results in symptomatic heart valve disease treatment, abnormal heart rhythms and is termed asarrhythmia. In some cases, the erratic impulses are produced by any other heart muscle in the atria that overrides the functioning of the heart’s natural pacemaker. This leads to the fibrillation of atria, further resulting in excessively higher or abnormal heart rates and the condition is termed as atrial fibrillation (AF) or AFib. Evaluating the symptoms and seeking the right atrial fibrillation treatment is essential to reduce the risks of stroke and heart failure.

Erroneous electrical signals sent from the atria leads to the disorganized contractions of heart chambers.  Irregular contraction of atria and ventricles leads to an abnormally faster heartbeat thereby reducing the heart’s efficiency and performance. Moreover, the chaotic rhythm in the atria causes disturbances in the blood flow. This sometimes leads to blood clot formation, which can travel to the brain, resulting in stroke. People with AF are at a higher risk of having embolic stroke and heart failures. That is why it is always recommended to opt for the most helpful form of right atrial fibrillation treatment.  AFib patients with higher or moderate risk of developing a blood clot are prescribed with medications, catheter-based procedures or surgery. Stroke prevention in atrial fibrillation is possible only by cutting down the chances of blood clot formation.

Depending on the level of risk and assessment of your symptoms, anticoagulant medicines are prescribed by the physicians. Vitamin K antagonists have been used as the standard therapeutic option for stroke prevention in atrial fibrillation patients. Warfarin, dabigatram, rivaroxaban and apixaban are some of the commonly used blood thinning medicines. Preventing the abnormalities in heart rate is also important for the symptomatic heart valve disease treatment. Depending on the severity of Afib episodes, underlying cardiac issues and the symptoms, the physician will determine the best risk stratification strategy.

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