Descriptive Epidemiology of Diabetes
Medha N. Munshi, Lewis A. Lipsitz in Geriatric Diabetes, 2007
Several trends have intersected to influence current diabetes management. First, there is an imperative for better control of vascular disease risks associated with diabetes that is generated by increasing obesity, decreasing activity levels, and high prevalences of prediabetes syndromes and diabetes. Second, we have a relatively good understanding of the causal relationship of diabetes to atherosclerotic and microvascular complications, poor quality of life, and increased costs of care. Third, although less discussed, clinicians and researchers are beginning to realize that diabetes is related to additional, distal, negative health outcomes, illustrated in Figure 1, which also demean quality of life and increase health-care and personal care costs. Finally, high-quality randomized controlled trials (RCTs) have proven that some diabetes management interventions (blood pressure and cholesterol control) decrease macrovascular diabetes complications (in some populations and under some conditions) and some interventions (glycemic control, blood pressure control, eye and foot exams, urine protein monitoring, angiotensin converting enzyme inhibitor/angiotensin receptor blocker) can prevent or decrease microvascular complications (8,30). All these factors have led to the current interest codifying high-quality diabetes management by developing and using diabetes clinical quality indicators to measure the quality of primary care delivery to patients with diabetes (31–33).
Physical Examination of the Hand
J. Terrence Jose Jerome in Clinical Examination of the Hand, 2022
Clinical examination of the patient is not complete without vascular examination. Physical examination is the clinical and primary method to evaluate patients with vascular diseases. It is vital to look for radial pulse in both upper extremities. The radial artery lies more superficial in the forearm running under the anterior aspect of the brachioradialis. It crosses the supinator to enter the anterior and radial aspect of the forearm. We can palpate the radial pulse between the brachioradialis and flexor carpi radialis at the wrist. In 10% of individuals, a persistent median artery is felt along the course of the median nerve. The persistent median artery contributes to form the superficial arch and passes deep to the transverse carpal ligament.
Therapeutic Implications
Thomas F. Lüscher, Paul M. Vanhoutte in The Endothelium: Modulator of Cardiovascular Function, 2020
In most blood vessels serotonin evokes contractions by activating 5HT2-serotonergic receptors on vascular smooth muscle, while the receptors on the endothelium linked to the release of EDRF are of a 5HT,-subtype (Figure 17; see Chapter 6). Thus, 5HT2-serotonergic blockers (e.g., ketanserin, naftidrofuryl) prevent the vasoconstrictor effect of platelet-released serotonin, and often unmask endothelium-dependent relaxations to the monoamine or to aggregating platelets. These effects may be relevant to the treatment of vascular disease.981 In addition, naftidrofuryl causes the release of EDRF at least in the femoral artery of the dog (Figure 19).1341,1435
Targeting VCAM-1: a therapeutic opportunity for vascular damage
Published in Expert Opinion on Therapeutic Targets, 2023
Mayarling F Troncoso, Magda C Díaz-Vesga, Fernanda Sanhueza-Olivares, Jaime A Riquelme, Marioly Müller, Luis Garrido, Luigi Gabrielli, Mario Chiong, Ramon Corbalan, Pablo F Castro, Sergio Lavandero
Cardiovascular diseases are the leading cause of death in the world and represent 32% of worldwide deaths in 2019, highlighting the urgency of treatment and early detection. The mortality associated with COVID-19 was markedly high in 2020, and the estimated risk of death from the virus increased by 2.25-fold in people with cardiovascular diseases. Nearly 19 million people died from cardiovascular diseases that year [1]. Cardiovascular diseases include blood vessel diseases, such as atherosclerosis, coronary heart disease, cerebrovascular disease, peripheral arterial disease, deep vein thrombosis, and pulmonary embolism [2]. Together, vascular diseases are highly relevant in cardiovascular diseases and require the development of novel and effective therapeutic strategies to limit their morbidity and mortality.
The Myocardium is a Cardiac Structure
Published in Structural Heart, 2021
Anthony N. DeMaria
Due to its predominant prevalence, atherosclerosis and coronary artery disease has usually received the bulk of the attention of the medical community. Moreover, the treatment of vascular disease involved medical, interventional, and surgical approaches, whereas disorders of non-vascular structures generally required surgical therapy, or were not amenable to therapy at all. Interventional cardiology meetings were almost entirely devoted to coronary artery disease and its complications. That all changed, of course, with the advent of Transcatheter Aortic Valve Replacement (TAVR) and the birth of the field of structural heart disease. However, just as primary myocardial disorders were not usually considered in the spectrum of vascular disease, they somehow have not been perceived as an integral part of structural heart disease either.
Clinical safety of low-dose anticoagulation with fondaparinux in patients undergoing peripheral endovascular treatment due to critical limb-threatening ischaemia – a pilot study
Published in Acta Cardiologica, 2021
Sorin Giusca, Michael Lichtenberg, Christoph Eisenbach, Grigorios Korosoglou
Traditional risk factors for vascular disease, including (1) arterial hypertension, (2) hyperlipidaemia, (3) current or prior smoking, (4) diabetes mellitus and (5) family history of coronary artery disease (CAD) were recorded. The total number of atherogenic risk factors (range 0–5) was calculated. History of CAD and laboratory markers, such as haemoglobin, the estimated glomerular filtration rate (GFR), Hba1c in patients with diabetes mellitus and highly sensitive troponin (hsTnT) were also recorded at the time of the initial endovascular treatment. In addition, the HAS-BLED score including uncontrolled arterial hypertension, renal failure with creatinine >2.26 mg/dL, liver disease, history f stroke, prior major bleeding, labile INR measures, age >65 years and medication with aspirin or clopidogrel and alcohol use, was recorded in all patients [8].