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Future Research Needs For Angiotensin Converting Enzyme Inhibitors Or Angiotensin Ii Receptor Blockers Added To Standard Medical Therapy For Treating Stable Ischemic Heart Disease
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Author :U.S. Department of Health and Human Services Publisher :CreateSpace ISBN 13 :9781502907035 Total Pages :100 pages Book Rating :4.9/5 (7 download)
Book Synopsis Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by : U.S. Department of Health and Human Services
Download or read book Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by U.S. Department of Health and Human Services and published by CreateSpace. This book was released on 2014-10-31 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Agency for Healthcare Research and Quality (AHRQ) conducts the Effective Health Care Program as part of its mission to organize knowledge and make it available to inform decisions about health care. As part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Congress directed AHRQ to conduct and support research on the comparative outcomes, clinical effectiveness, and appropriateness of pharmaceuticals, devices, and health care services to meet the needs of Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).
Book Synopsis Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by :
Download or read book Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: A comparative effectiveness review (CER) published by the University of Connecticut Evidence-based Practice Center (EPC) in 2009 found strong evidence that ACE inhibitors reduced total mortality and nonfatal myocardial infarction (MI) in comparison to placebo among adults with stable IHD and preserved ventricular function, but increased the risk for syncope and cough. There was low to moderate evidence that ARBs reduced a composite of cardiovascular endpoints compared to placebo, and these agents were well-tolerated. The one available study directly comparing the impact of ACE inhibitors and ARBs on cardiovascular outcomes in patients with IHD revealed no significant difference between the classes in the rate of cardiovascular outcomes, but demonstrated higher rates of cough and angioedema among patients treated with ACE inhibitors, and higher rates of hypotensive symptoms among patients treated with ARBs. A list of research gaps is a common component of CERs and is an important step in outlining a future research agenda; however, such lists do not always clearly suggest how future research should be prioritized, or which projects are in fact feasible. In this pilot project, we sought to expand on the work done by the University of Connecticut EPC to identify and prioritize gaps in the evidence supporting the comparative effectiveness of ACE inhibitor and ARB therapy in patients with IHD. The prioritization process we used combined a review of recently published and ongoing studies, engagement of nine stakeholders, and participation of these stakeholders in both qualitative and quantitative exercises of research needs prioritization.
Book Synopsis Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease: Identification of F by :
Download or read book Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease: Identification of F written by and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by :
Download or read book Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This is an evidence report prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center (EPC) concerning the benefits and harms associated with using angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), either alone or in combination, in people with stable ischemic heart disease or ischemic heart disease risk equivalents and intact left ventricular systolic function. While the role of ACE inhibitors and ARBs in patients with post-myocardial infarction left ventricular dysfunction or chronic heart failure is well established, the role for these modalities in patients with stable ischemic heart disease or ischemic heart disease risk equivalents and preserved left ventricular systolic function is not as clear. The aim of this report is to acquire, assess, and summarize the current evidence about the benefits and harms associated with the use of ACE inhibitors and ARBs, either alone or in combination, in this patient population. The information is intended to inform clinicians, payors, and the public, while helping to define avenues for future research.
Author :U. S. Department of Health and Human Services Publisher :Createspace Independent Pub ISBN 13 :9781484828083 Total Pages :328 pages Book Rating :4.8/5 (28 download)
Book Synopsis Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by : U. S. Department of Health and Human Services
Download or read book Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-04-27 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nearly 2,400 Americans die of cardiovascular disease each day. Cardiovascular disease claims more lives each year than cancer, chronic lower respiratory diseases, accidents, and diabetes mellitus combined. American College of Cardiology and American Heart Association guidelines support the use of angiotensin converting enzyme (ACE) inhibitors in patients who have chronic heart failure or those with myocardial infarction and left ventricular dysfunction, while angiotensin receptor blockers (ARBs) are reserved for those who cannot tolerate ACE inhibitors. Combined ACE inhibitor and ARB therapy has been shown to provide additional benefits over therapy with an ACE inhibitor alone among patients with heart failure. However, the combined use of an ACE inhibitor and ARB in post-myocardial-infarction patients with left ventricular dysfunction or heart failure was no better than the use of captopril alone and carried an increased risk of harms. This report summarizes the available evidence comparing the efficacy and safety of using ACE inhibitors, ARBs, or their combination vs. standard medical therapy in a population with stable ischemic heart disease, or an ischemic heart disease risk equivalent, and preserved left ventricular function. This report addresses the following questions: KQ1. What is the comparative effectiveness of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, the composite endpoint of the latter three items, and atrial fibrillation? What is the evidence of benefit on other outcomes such as symptom reporting, hospitalization, revascularization, and quality of life measures? KQ2. In patients who are receiving standard medical therapy, what is the comparative effectiveness of combining ACE inhibitors and ARBs vs. either an ACE inhibitor or ARB alone in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, the composite endpoint of the latter three items, and atrial fibrillation? What is the evidence of benefit on other outcomes such as symptom reporting, hospitalization, revascularization, and quality of life measures? KQ3. In patients who had to have recently undergone, or are set to undergo, a coronary revascularization procedure, what is the comparative effectiveness of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, the composite endpoint of the latter three items, and atrial fibrillation? What is the evidence of benefit on other outcomes such as symptom reporting, hospitalization, revascularization, and quality of life measures? KQ4. What are the comparative harms of adding ACE inhibitors or ARBs to standard medical therapy when compared to standard medical therapy alone? KQ5. In patients receiving standard medical therapy, what is the evidence of comparative harms of combination ACE inhibitor and ARB therapy vs. use with either an ACE inhibitor or ARB alone? KQ6. In patients who had to have recently undergone, or are set to undergo, a coronary revascularization procedure, what are the comparative harms of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone? KQ7. What is the evidence that benefits or harms differ by subpopulations, including: demographics, clinical course, dose of the ACE inhibitor or ARB used, comorbidities, and other medications?
Book Synopsis Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by :
Download or read book Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Cardiovascular Disability by : Institute of Medicine
Download or read book Cardiovascular Disability written by Institute of Medicine and published by National Academies Press. This book was released on 2010-12-04 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
Author :U. S. Department Human Services Publisher :Createspace Independent Publishing Platform ISBN 13 :9781484974186 Total Pages :0 pages Book Rating :4.9/5 (741 download)
Book Synopsis Future Research Needs for Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension by : U. S. Department Human Services
Download or read book Future Research Needs for Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension written by U. S. Department Human Services and published by Createspace Independent Publishing Platform. This book was released on 2013-05-14 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is the most common reason older adults visit the doctor and advances in antihypertensive therapy have dramatically reduced the associated cardiovascular, cerebrovascular, and renal events. Inhibitors of the renin-angiotensin system (RAS) are the most frequently used medications for blood pressure control and are highly efficacious for reducing hypertension-related outcomes. In 2007, a comparative effectiveness review (CER) sponsored by the Agency for Healthcare Research and Quality (AHRQ) evaluated the long-term benefits and harms of the two most common classes of RAS inhibitors for treating essential hypertension in adults: angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers/antagonists (ARBs). This 2007 CER was updated in 2011 to incorporate the significant additional direct comparison research published in the interval, and to include the direct renin inhibitors (DRIs), which are the newest class of RAS inhibitors. The 2011 CER addressed the three following Key Questions: KQ 1. For adult patients with essential hypertension, how do ACEIs, ARBs, and DRIs differ in blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life, and other outcomes? KQ 2. For adult patients with essential hypertension, how do ACEIs, ARBs, and DRIs differ in safety, adverse events, tolerability, persistence with drug therapy, and treatment adherence? KQ 3. Are there subgroups of patients-based on demographic and other characteristics (i.e., age, race, ethnicity, sex, comorbidities, concurrent use of other medications)-for whom ACEIs, ARBs, or DRIs are more effective, are associated with fewer adverse events, or are better tolerated? The results of the CER included 97 studies (36 new since 2007) directly comparing ACEIs versus ARBs and 3 studies directly comparing DRIs to ACEIs or ARBs. The strength of evidence remained high for equivalence between ACEIs and ARBs for blood pressure lowering, and for superiority of ARBs over ACEIs for short-term adverse events (primarily cough). The new evidence did not strengthen the conclusions regarding long-term cardiovascular outcomes, quality of life, progression of renal disease, medication adherence or persistence, rates of angioedema, or differences in key patient subgroups; the strength of evidence for these outcomes remained low to moderate. Evidence on the comparative effectiveness of DRIs versus either ACEIs or ARBs was limited to 3 studies with 2,049 patients and did not allow definitive conclusions on any of the included outcomes. Few studies involved a representative patient sample treated in a typical clinical setting over a long duration; treatment protocols had marked heterogeneity; and significant amounts of data about important outcomes and patient subgroups were missing. Our approach to identifying evidence gaps, prioritizing future research, and developing recommendations for stakeholders is outlined in the following steps. Further detail is provided below. 1. Develop an analytic framework from the original CER in order to understand the clinical and policy context of the review and its initial list of future research needs. 2. Create an initial list of evidence gaps based on the CER organized according to the population, interventions, comparators, and outcomes (PICO) framework. 3. Form a stakeholder group representing appropriate clinician, policymakers, and patient perspectives. 4. Expand the list of evidence gaps based on stakeholder input. 5. Perform an updated review of published literature since the last CER (search last updated in December 2010) and a horizon scan for recently published and ongoing studies that may address the evidence gaps, but which are not included in the current CER. 6. Solicit stakeholder prioritization of the identified research gaps based on the updated literature review. 7. Determine the most appropriate study designs for the highest priority research areas.
Book Synopsis Future Research Needs for Angiotensin-converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension by :
Download or read book Future Research Needs for Angiotensin-converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension written by and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Almost 75 million American adults have hypertension. Advances in antihypertensive therapy have dramatically reduced cardiovascular, cerebrovascular, and renal events. Among the effective pharmacotherapies are inhibitors of the renin-angiotensin-aldosterone system (RAS). In 2007, the Agency for Healthcare Research and Quality (AHRQ) sponsored a comparative effectiveness review (CER) of the two most common renin system inhibitors, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), to answer the following three Key Questions for adults with essential hypertension: do ACEIs and ARBs differ in their (1) blood pressure control, cardiovascular events, quality of life, and other outcomes; (2) safety, tolerability, persistence with therapy, or treatment adherence; and (3) effects within important subgroups of patients? This 2007 CER was updated in 2011 to incorporate the significant additional direct comparison research published in the interval and to include direct renin inhibitors (DRIs), which are the newest class of RAS inhibitors. The results of the updated CER included 97 studies (36 new since 2007) directly comparing ACEIs versus ARBs and 3 studies directly comparing DRIs to ACEIs or ARBs. The strength of evidence remained high for equivalence between ACEIs and ARBs for blood pressure lowering, and for superiority of ARBs over ACEIs for short-term adverse events (primarily cough). The new evidence did not strengthen the conclusions regarding long-term cardiovascular outcomes, quality of life, progression of renal disease, medication adherence or persistence, rates of angioedema, or differences in key patient subgroups; the strength of evidence for these outcomes remained low to moderate. Evidence on the comparative effectiveness of DRIs versus either ACEIs or ARBs was limited to 3 studies with 2,049 patients and did not allow definitive conclusions on any of the included outcomes. Few studies involved a representative patient sample treated in a typical clinical setting over a long duration; treatment protocols had marked heterogeneity; and significant amounts of data about important outcomes and patient subgroups were missing. Given the clinical and economic importance of these medications, the ongoing investment in research, and the remaining areas of uncertainty, we sought to create a prioritized research agenda representing the interests of diverse stakeholders in order to address the remaining areas of uncertainty.
Book Synopsis Clinical Guide to Cardiology by : Christian Fielder Camm
Download or read book Clinical Guide to Cardiology written by Christian Fielder Camm and published by John Wiley & Sons. This book was released on 2016-03-07 with total page 440 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical Guide to Cardiology is a quick-reference resource, packed full of bullet points, diagrams, tables and algorithms for the key concepts and facts for important presentations and conditions within cardiology. It provides practical, evidence-based information on interventions, investigations, and the management of clinical cardiology. Key features include: A clear evidence-base providing key guidelines and clinical trials in each chapter Coverage of examination techniques, common conditions, imaging modalities (including ECGs, chest X-rays, MRI and CT), interventional therapies, and pharmacology A companion website at www.wiley.com/go/camm/cardiology featuring audio clips, developed for differing levels of knowledge, that explain key concepts or an area in greater detail, as well as numerous additional clinical case studies, audio scripts, and self-assessment material
Book Synopsis Coronary Microvascular Dysfunction by : Filippo Crea
Download or read book Coronary Microvascular Dysfunction written by Filippo Crea and published by Springer Science & Business Media. This book was released on 2013-08-15 with total page 263 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.
Book Synopsis The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction by : Muhammad Wali
Download or read book The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction written by Muhammad Wali and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Background. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are essential to the treatment of heart failure with reduced ejection fraction (HFrEF). However, little data are available to determine whether their efficacy in reducing hospitalizations and mortality may differ between men and women with HFrEF.Purpose. To explore whether differences exist in the efficacy of ACEi/ARBs in HFrEF by sex.Methods. We conducted a pooled analysis of individual data from 4 randomized clinical trials: The Study of Left Ventricular Dysfunction (SOLVD) Treatment, SOLVD Prevention, Candesartan in Heart Failure: Assessment of Morbidity and Mortality (CHARM) Alternative and Added trials. The primary outcome was a composite of death or hospitalization for heart failure. Multivariable analyses were conducted using Cox proportional hazards models, adjusting for confounders, to obtain sex specific hazard ratios (HRs) and the interaction was tested by a sex-by-randomized treatment term. Results. Among the 11,373 participants (19% women; mean age 61.5), women were older, with a higher prevalence of type 2 diabetes and hypertension, and a lower prevalence of ischemic heart disease than men regardless of treatment group. The ACEi/ARBs group had a lower incidence of the primary outcome compared to placebo [13.3 vs 16.6 per 100 person-year], with a similar efficacy in both men and women [adjusted-HR men 0.76 vs women 0.88, p¬-sex-by-drug interaction=0.12]. However, women were more likely than men to be hospitalized for HF despite treatment [adjusted-HR men 0.65 95%CI 0.54-0.79 vs women 0.82 95%CI 0.74-0.90, p-sex-by-drug interaction =0.09].Conclusions. The association between ACEi/ARB and the primary outcome of death or HF hospitalization did not differ between men and women. However, women were more likely than men to have HF hospitalizations despite ACEi/ARB treatment. Future trials should include a larger enough sample size of women and men to enable sex-specific recommendations about HF drug efficacy"--
Book Synopsis Evidence-Based Cardiology by : Salim Yusuf
Download or read book Evidence-Based Cardiology written by Salim Yusuf and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 1024 pages. Available in PDF, EPUB and Kindle. Book excerpt: This second editionis a ground-breaking clinical text with a strong emphasis on rigorous evidence. Leaders in the field discuss best practice in the light of systematic reviews and randomised control trials, and how best to treat where the information is less clear. Case histories provide intriguing discussions on how to apply the evidence in real life situations. Evidence-based Cardiology also includes free access to the latest evidence, which is automatically posted on a companion website.
Book Synopsis The ESC Textbook of Preventive Cardiology by : Stephan Gielen
Download or read book The ESC Textbook of Preventive Cardiology written by Stephan Gielen and published by European Society of Cardiology. This book was released on 2015 with total page 369 pages. Available in PDF, EPUB and Kindle. Book excerpt: "EACPR, European Association for Cardiovascular Prevention and Rehabilitation -- European Society of Cardiology."
Book Synopsis Acute Heart Failure by : Alexandre Mebazaa
Download or read book Acute Heart Failure written by Alexandre Mebazaa and published by Springer Science & Business Media. This book was released on 2009-12-24 with total page 922 pages. Available in PDF, EPUB and Kindle. Book excerpt: For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.
Book Synopsis PanVascular Medicine by : Peter Lanzer
Download or read book PanVascular Medicine written by Peter Lanzer and published by Springer. This book was released on 2015-03-30 with total page 5004 pages. Available in PDF, EPUB and Kindle. Book excerpt: Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established. Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.
Book Synopsis Nitro-glycerine as a Remedy for Angina Pectoris by : William Murrell
Download or read book Nitro-glycerine as a Remedy for Angina Pectoris written by William Murrell and published by . This book was released on 1882 with total page 118 pages. Available in PDF, EPUB and Kindle. Book excerpt:
