Objective Risk factor modification is key to preventing subsequent cardiac events after a heart attack. This study was designed to investigate the disparity between preventive guidelines and clinical practice among sm...Objective Risk factor modification is key to preventing subsequent cardiac events after a heart attack. This study was designed to investigate the disparity between preventive guidelines and clinical practice among smoking patients. Methods The study was carried out in smokers admitted with myocardial infarction (MI). Atotal of 275 patients who had been regularly followed for over one year after MI were randomly selected and enrolled in this study.We investigated changes in smoking behavior and the adherence rate to ACC/AHA Guidelines for secondary prevention in patients with coronary artery disease at the time of, and one year after, the index event. Results The study population consisted of 275 patients (97.1% males) with a mean age of 57.0 ±11.2 years. Achievement of target goals at one year was as follows: smoking cessation, 52.3%; blood pressure, 83.9%; HbA1c, 32.7%; lipid profile, 65.5%; and body mass index (BMI), 50.6%. Over one year, 80% of the patients attempted to quit smoking; 27% of them re-started smoking within one month after discharge while 65% succeeded in cessation of smoking. At one year, only 52% of the patients overall had stopped smoking. From the multivariate logistic analysis including smoking patterns and clinical characteristics, the severity of coronary artery disease was the only independent predictor for smoking cessation (Relative risk (RR): 1.230; P = 0.022). Conclusions Only a small percentage of MI patients adhere to guidelines for secondary prevention and a sizable proportion fail to stop smoking. These findings underscore the need for an effective patient education system.展开更多
Background Central blood pressure （BP） is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease. Arterial stiffness is also a good predictor of cardiovascular morbidit...Background Central blood pressure （BP） is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease. Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality. The effects of benidipine, a unique dual L-IT-type calcium channel blocker, on central BP have not been reported. This study aimed to compare the effect of benidipine and Iosartan on the central BP and arterial stiffness in mild to moderate essential hypertensives. Methods This 24 weeks, multi-center, open label, randomized, active drug comparative, parallel group study was designed as a non-inferiority study. The eligible patients （n=200） were randomly assigned to receive benidipine （n=101） or Iosartan （n=99）. Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP, pulse wave velocity （PWV） and augmentation index （AIx）. We also measured the metabolic and inflammatory markers. Results After 24 weeks, the central BP decreased significantly from baseline by （16.8±14.0/10.5±9.2） mmHg （1 mmHg =0.133 kPa） （systolic/diastolic BP; P 〈0.001） in benidipine group and （18.9±14.7/12.1±10.2） mmHg （P 〈0.001） in Iosartan group respectively. Both benidipine and Iosartan groups significantly lowered peripheral BP （P 〈0.001） and AIx （P 〈0.05）, but there were no significant differences between the two groups. The mean aortic, brachial and femoral PWV did not change in both groups after 24-week treatment. There were no significant changes of the blood metabolic and inflammatory biomarkers in each group. Conclusion Benidipine is as effective as Iosartan in lowering the central and peripheral BP, and improving arterial stiffness.展开更多
文摘Objective Risk factor modification is key to preventing subsequent cardiac events after a heart attack. This study was designed to investigate the disparity between preventive guidelines and clinical practice among smoking patients. Methods The study was carried out in smokers admitted with myocardial infarction (MI). Atotal of 275 patients who had been regularly followed for over one year after MI were randomly selected and enrolled in this study.We investigated changes in smoking behavior and the adherence rate to ACC/AHA Guidelines for secondary prevention in patients with coronary artery disease at the time of, and one year after, the index event. Results The study population consisted of 275 patients (97.1% males) with a mean age of 57.0 ±11.2 years. Achievement of target goals at one year was as follows: smoking cessation, 52.3%; blood pressure, 83.9%; HbA1c, 32.7%; lipid profile, 65.5%; and body mass index (BMI), 50.6%. Over one year, 80% of the patients attempted to quit smoking; 27% of them re-started smoking within one month after discharge while 65% succeeded in cessation of smoking. At one year, only 52% of the patients overall had stopped smoking. From the multivariate logistic analysis including smoking patterns and clinical characteristics, the severity of coronary artery disease was the only independent predictor for smoking cessation (Relative risk (RR): 1.230; P = 0.022). Conclusions Only a small percentage of MI patients adhere to guidelines for secondary prevention and a sizable proportion fail to stop smoking. These findings underscore the need for an effective patient education system.
文摘Background Central blood pressure （BP） is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease. Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality. The effects of benidipine, a unique dual L-IT-type calcium channel blocker, on central BP have not been reported. This study aimed to compare the effect of benidipine and Iosartan on the central BP and arterial stiffness in mild to moderate essential hypertensives. Methods This 24 weeks, multi-center, open label, randomized, active drug comparative, parallel group study was designed as a non-inferiority study. The eligible patients （n=200） were randomly assigned to receive benidipine （n=101） or Iosartan （n=99）. Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP, pulse wave velocity （PWV） and augmentation index （AIx）. We also measured the metabolic and inflammatory markers. Results After 24 weeks, the central BP decreased significantly from baseline by （16.8±14.0/10.5±9.2） mmHg （1 mmHg =0.133 kPa） （systolic/diastolic BP; P 〈0.001） in benidipine group and （18.9±14.7/12.1±10.2） mmHg （P 〈0.001） in Iosartan group respectively. Both benidipine and Iosartan groups significantly lowered peripheral BP （P 〈0.001） and AIx （P 〈0.05）, but there were no significant differences between the two groups. The mean aortic, brachial and femoral PWV did not change in both groups after 24-week treatment. There were no significant changes of the blood metabolic and inflammatory biomarkers in each group. Conclusion Benidipine is as effective as Iosartan in lowering the central and peripheral BP, and improving arterial stiffness.
