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Peripartum Cardiomyopathy and Heart Failure in Pregnancy
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Anita Saraf, Fred H. Rodriguez
In hemodynamically stable pregnant women with volume overload, every effort should be made to continue pregnancy for as long as possible or until at least 37 weeks of gestation, when the baby reaches term. Diuretics are used judiciously to reduce symptoms of volume overload, such as shortness of breath and pedal edema, while avoiding dehydration. Beta-blockers (excluding atenolol) improve cardiovascular remodeling and minimize arrhythmias and are recommended for at least six months after myocardial recovery.48 Careful monitoring for fetal bradycardia is recommended during pregnancy when on a beta-blocker. While angiotensin-converting enzyme inhibitors (ACEis) and angiotensin-receptor blockers (ARBs) are standard medications in HF management and facilitate afterload reduction, these agents are contraindicated in pregnancy due to fetal toxicity. However, benazepril, captopril, and enalapril have been tested in nursing women and are safe for babies.49 Hydralazine and nitrates, however, can be used for afterload reduction in pregnant women. Spironolactone and other mineralocorticoid receptor antagonists are contraindicated in pregnancy. Digoxin has a good safety profile during pregnancy and can be used to improve LV contraction, as well as to reduce arrhythmias and tachycardia.
The Nephroprotective Effect of Antihypertensive Treatment
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Luis M. Ruilope, Jose R. Banegas
Even so, data from trials devoted to hypertension and to renal disease have come to clarify the positive role of calcium antagonists in renal protection when used either alone or in combination with drugs suppressing the RAAS (67). More recently, the Delapril and Manidipine for Nephroprotection in Diabetes (DEMAND) trial failed to slow GFR decline after 3.8 years of median follow-up, but safely ameliorated CVD, retinopathy and neuropathy in hypertensive type 2 diabetic patients receiving combined manidipine and delapril therapy (68). It has also been shown that patients with hypertension or established CVD and CKD seem to be particularly good responders to the suppression of the RAAS (69,70) and to the administration of a statin (71) and aspirin (72). The Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BLPA) showed a 15% reduction of development of renal impairment in high-risk hypertensive patients receiving a combination of amlodipine and perindopril (73). Moreover, the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial showed that patients with hypertension, chronic kidney disease, and minimal or no albuminuria who achieved blood pressure of 130/80 mmHg with an initial combination of benazepril plus amlodipine have lower rates of cardiovascular events and slower progression of chronic kidney disease than do patients treated with a combination of benazepril plus hydrochlorothiazide (74).
Selected Functional Foods That Combat the Effects of Hyperglycemia and Chronic Inflammation
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
Angiotensin-converting enzyme (ACE) inhibitors: Angiotensin-converting enzyme ACE inhibitors, such as benazepril (Lotensin), lisinopril (Prinivil and Zestril), and fosinopril (Monopril), are used primarily to treat high blood pressure. Taking potassium iodide with ACE inhibitors can increase the risk of hyperkalemia (elevated blood levels of potassium).
The relation between submaximal aerobic exercise improving vascular elasticity through loss of visceral fat and antihypertensive
Published in Clinical and Experimental Hypertension, 2021
Hong Fang, Chi Liu, Omer Cavdar
According to the cardiopulmonary exercise test, the exercise program of participants was designed. Individual exercise prescription and training for the patients based on the cardiopulmonary exercise. The treadmill exercise trial was performed and modified according to Nielsen as described. Briefly, before and after the training period the subjects performed a 60 min treadmill exercise bout at 65% of Pmax. The program was composed of a warm-up, main exercise, and cooldown. Exercise intensity was adjusted according to the principle of gradual overload. The exercise period for this study was 12 months and frequency was set to three times a week. The participants were instructed to maintain their habitual diets. Furthermore, the subjects were instructed not to eat 2 hours prior to the daily exercise sessions. To be safe, all observational objects still use antihypertensive drugs. For assuring the comparability, every participant was administered with benazepril (10 mg daily) and amlodipine (5 mg daily) during the experiment period (10, 11).
A case of immunotactoid glomerulopathy in a patient with monoclonal gammopathy of renal significance
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Victoria Campdesuner, Yeshanew Teklie, Natalia Lattanzio, Christian Lorenzo, Stephen Bell, Yorlenis Rodriguez, Ashok Sastry
A 78-year-old male presented to his nephrologist with acute kidney injury. His medical history included a transient ischemic attack, atrial fibrillation on anticoagulation with warfarin, bladder cancer status post Bacillus Calmette-Guerin treatment currently under surveillance, chronic obstructive uropathy and subsequent CKD stage III, human papillomavirus positive head and neck squamous cell carcinoma status post radiation 4 years prior to presentation, hyperlipidemia, hypertension, and gout. Creatinine had increased to 1.7 mg/dL from a baseline of 1.2 mg/dL. The patient denied any hematuria, foamy urine, or worsening edema. Blood pressure was well controlled at 128/82 mm Hg on benazepril 10 mg daily and amlodipine 5 mg daily. Examination revealed chronic, stable 1+ pitting edema of the lower extremities. Otherwise, physical examination was unremarkable. Repeat creatinine on initial visit was 1.55 mg/dL with a protein/creatinine ratio of 1821.6 mg/G (see Table 1). Antineutrophil antibody (ANA) titer was elevated at 1:320. Complement 3 (C3) and complement 4 (C4) levels were within normal limits.
Combination of leflunomide and benazepril reduces renal injury of diabetic nephropathy rats and inhibits high-glucose induced cell apoptosis through regulation of NF-κB, TGF-β and TRPC6
Published in Renal Failure, 2019
Huili Li, Yuanyuan Wang, Zhangqing Zhou, Fang Tian, Huanhuan Yang, Juzhen Yan
Application of benazepril in treatment of diabetes has been reported in many studies. Xue et al. showed benazepril hydrochloride could improve DN by decreasing ANGPTL-4 expression [11]. Niu et al. found benazepril could affect integrin-linked kinase and smooth muscle α-actin expression in diabetic rat glomerulus [20]. In an early research, it was found benazepril could also slow progression of renal dysfunction in patients with non-diabetic renal disease [21]. Besides, Jin et al. studied combination use of leflunomide and benazepril in STZ-induced DN rats and found leflunomide and benazepril showed synergistic effects [13]. In our research, it was also demonstrated benazepril could improve the renal function and reduce the renal injury of DN rats. Moreover, we demonstrated the effects of leflunomide and benazepril were through regulation of NF-κB, TGF-β and TRPC6, as well as inhibition of cell apoptosis.