Efficacy and safety of sacubitril/valsartan after six months in patients with heart failure with reduced ejection fraction and asymptomatic hypotension

BACKGROUND It is not clear whether sacubitril/valsartan is beneficial for patients with heart failure(HF)with reduced ejec-tion fraction(HFrEF)and low systolic blood pressure(SBP).This study aimed to investigate the efficacy and tolerability of sacu-bitril/valsartan in HFrEF patients with SBP<100 mmHg.METHODS&RESULTS An observational study was conducted on 117 patients,40.2%of whom had SBP<100 mmHg wit-hout symptomatic hypotension,and 59.8%of whom had SBP≥100 mmHg in an optimized HF follow-up management system.At the 6-month follow-up,52.4%of patients with SBP<100 mmHg and 70.0%of those with SBP≥100 mmHg successfully rea-ched the target dosages of sacubitril/valsartan.A reduction in the concentration of N-terminal pro-B-type natriuretic peptide was similar between patients with SBP<100 mmHg and SBP≥100 mmHg(1627.5 pg/mL and 1340.1 pg/mL,respectively;P=0.75).The effect of sacubitril/valsartan on left ventricular ejection fraction was observed in both SBP categories,with a 10.8%increase in patients with SBP<100 mmHg(P<0.001)and a 14.0%increase in patients with SBP≥100 mmHg(P<0.001).The effects of sac-ubitril/valsartan on SBP were statistically significant and inverse across both SBP categories(P=0.001),with an increase of 7.5 mmHg in patients with SBP<100 mmHg and a decrease of 11.5 mmHg in patients with SBP≥100 mmHg.No statistically signi-ficant differences were observed between the two groups in terms of the occurrence of symptomatic hypotension,deteriorating re-nal function,hyperkalemia,angioedema,or stroke.CONCLUSIONS Within an optimized HF follow-up management system,sacubitril/valsartan exhibited excellent tolerability and prompted left ventricular reverse remodeling in patients with HFrEF who presented asymptomatic hypotension.

Knowledge,attitude,practice and factors that influence the awareness of college students with regards to breast cancer

BACKGROUND Breast cancer has the highest incidence of all global cancers.Recent data show that breast cancer is becoming more prevalent in the younger population.Therefore,preventing breast cancer in young populations is a significant priority for public health.Relevant investigations of the incidence of breast cancer in young females have already been undertaken in China;however,none of these previous studies investigated the awareness of female college students with regards to breast cancer.AIM To investigate the knowledge,attitude,and practice(KAP)of female college students in Yunnan with regards to breast cancer and a series of influential factors.METHODS A random sample of 1387 female college students from two universities in Dali city were investigated by questionnaires.RESULTS The total KAP scores for breast cancer were 9.86±2.50,3.19±2.01 and 13.31±2.49,respectively.Multiple linear regression analysis showed that educational grade was the most significant influential factor underlying the level of knowledge female college students had with regards to the treatment of breast cancer(P<0.05).Registered residence and educational grade were the most significant factors that influenced attitude(P<0.05).Age,registered residence,grade and major,were the most significant factors that influenced behavior(P<0.05).The KAP of female college students in western Yunnan with regards to breast cancer were low.CONCLUSION There is an urgent need to provide standardized publicity and educational strategies in China to improve the knowledge,attitude,and practice,of college students with regards to breast cancer.