: Peripheral arterial disease (PAD), being a manifestation of systemic atherosclerosis, carries a high risk of adverse cardiovascular events. Secondary medical prevention therapies of same magnitude as that for coronary artery disease (CAD) are recommended for PAD patients also. Available evidence indicates that this condition commonly remains underdiagnosed and undertreated. There is lack of any report about management of these patients in India. Objective: To characterize the atherosclerotic risk factor profile and pattern of drug prescription for patients of PAD at a tertiary care teaching hospital and to compare this management with standard guidelines. Material and methods: Data were collected from prescriptions of patients attending CTVS OPD with diagnosis of atherosclerotic PAD from July 2012 to Jun 2013. Results: One hundred twenty prescriptions were analysed. The mean age (± SD) of patients was 53 ± 7.18 years and 23.3% were females. History of smoking, either past or present, was present in 91.6% patients. History of ischemic heart disease was present in 25% while 26.7% patients were diabetic. Mean number of cardiovascular risk factors was 2.6. The percentage of eligible patients who were receiving a particular drug was 100 % for aspirin and statins, 48.3% for ACE inhibitors, 46.7% for beta blockers and 66.7% for cilostazol. Conclusion: The vascular surgeons of this centre are using antiplatelet agents and statins adequately for PAD. The prescription of ACE inhibitors, beta blockers and cilostazol is low. Exercise therapy and smoking cessation need more attention. Introduction Peripheral arterial disease (PAD) is a common disorder which affects large populations of adults worldwide. It most commonly... ... middle of paper ... ...entoxyphylline) was recorded. Prescription of drugs for other purposes (e.g. antacids, analgesics or antipyretics, multivitamins) was not recorded. Assessment of eligibility for drugs: Each prescription was analysed for eligibility for drugs for modification of atherosclerotic risk factors (aspirin, ACE inhibitors, beta blockers and lipid lowering drugs) and for drugs for intermittent claudication (cilostazol and pentoxyphylline). Eligibility was decided based on ACC/AHA and TASC-II guidelines for management of patients of PAD.[11, 12] All patients were considered to be eligible for aspirin, ACE inhibitors, lipid lowering drugs and cilostazol. In addition, patients with history of ischemic heart disease (IHD) were considered as eligible for beta blockers. Patients were considered eligible for pentoxiphylline only if cilostazol was contraindicated / not tolerated.
Ace Inhibitors are used to treat hypertension and congestive heart failure (CHF). Most of the drugs that are Ace Inhibitors have the common ending –pril. It inhibits an enzyme; that decreases the tension of blood vessels and the blood volume, thus lowering blood pressure. Lotensin (benzapril) comes in tablets and is used for oral administration. It is one of the ace inhibitors that are indicated for treating hypertension. There is warning while using Lotensin when pregnant, it indicates to stop using immediately when pregnancy is detected. Vasotec (enalpril) comes in tablets and injection. It is indicated for the treatment of hypertension and is effective alone or in combination with other Ace Inhibitors agents, especially thiazide-type diuretics. There is a warning for fetal toxicity; when pregnancy is detected; stop using.
Coronary artery disease is a heart disease characterized by narrow arteries and restricted blood flow in arteries and is the major cause of morbidity and mortality globally.[1] According to WHO estimation, 6.8% in men and 5.3% in women are affected globally.[2-4] Cardiovascular disease account for 29% of all deaths in Canada; of all the cardiovascular death, 54% and 23% was due to ischemic heart disease and heart attack, respectively. The total costs for heart disease and stroke were more than $20.9 billion every year. [5,6] With more than 1 artery impacted, multivessel coronary artery disease is more complex and more likely accompanied by other comorbidities including diabetes or high blood pressure; multivessel coronary artery disease usually is more difficult to deal with, has worse prognosis and cost more compared with single coronary artery disease. [7]
Ischemic Stroke is caused due to a blood clot in an area of the brain, leading to loss of neural function if last for more than 24 hours. In the United States, ischemic stroke affects 2.7% of men and 2.5% of women of age range 18 years and older. In addition, it has reported that annually about 610,000 and 185,000 of new strokes and recurrent strokes cases occur in US1. Moreover, it has reported that patients who have suffered from a stroke have more chances of recurrent stroke, Myocardial infarction, and death from vascular causes2. One of the risk factor of ischemic stroke is formation of plaque in the blood vessels causing blood clot3. Several randomized trials have also reported that antiplatelet medications are efficient in preventing recurrences of stroke in patients who had an incident of ischemic stroke. Antiplatelet medications for preventing recurrences of stroke are aspirin, combination of aspirin and extended-release dipyridamole, and clopidogrel alone4. It ha...
“Chronic diseases and illnesses are the leading causes of death and disability in the United States” (CDC.gov, 2014). These types of illnesses are the most common health problems that people in this country face today and they are also the most preventable (CDC.gov, 2014). Every year the cost to help care for and manage people with these types of illnesses increases and there is less being done about educating people about prevention. Venous Thromboembolism is one such chronic disease that is very deadly but also very preventable if the right precautions are taken. This paper will aim to educate about the disease, courses and costs of treatment, clinical microsystems that are involved and what barriers if any exist to achieving generative relationships among the various clinical microsystems involved.
Although atherosclerosis affects millions of people around the world, there are many ways to prevent and treat it once it has developed. Simple life style changes can greatly reduce the inflammation and damage to the endothelial wall of the artery. It is very important that people who have high blood pressure or diabetes get regular checkups; if atherosclerosis goes untreated, the adverse effects, such as stroke or myocardial infarction can be deadly.
Cardiovascular disease has become an increasingly significant issue in many countries as it is the leading cause of death for the whole human population. According to World Health Organization, ischemic heart disease had caused about 7 million people to lose their life in 2011. One of the most common cardiovascular illnesses is myocardial infarction. It is defined as the death of cardiac myocytes due to complete blockage of a coronary artery. t-PA is a thrombolytic drug that used to treat myocardial infarction by dissolving the thrombus that causes the occlusion.
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
After a thorough examination, J.P. was diagnosed with a deep vein thrombosis (DVT). “DVT develops most often in the legs but can occur also in the upper arms…” (Ignatavicius & Workman, 2013). Due t...
Peripheral artery disease is usually caused by atherosclerosis, which is when fatty deposits accumulate in the arteries of, most likely, limbs. This does affect all arteries throughout the body, then in turn, slowing the blood flow. PAD may also be due to inflammation of the blood vessels, injury to the extremities, or even exposure to radiation. “Peripheral arterial disease (PAD) affects approximately 10% of the American population” (Gurbir Dhaliwal; Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment; 2007). If not taken care of, PAD may lead to critical limb ischemia, open sores on the feet or legs that become infected by gangrene. The gangrene is then removed surgically, but doctors might have to amputate the extremity all together. Another issue that arises with PAD if it is not under control is the risk of stroke or heart attack. These can cause death to part of the heart or brain, or even death itself. The population more at risk would be smokers, diabetics, people who are obese, those with hypertension or hyperlipidemia, over the age of 50, have a family history of PAD, or those with a high level of homocysteine. If someone does fall into a few of these categories a physician can do a few tests to check for PAD. The doctor will more than likely start off with a physical exam, blood test, and possibly an ultrasound. From there the physician may try an ankle-brachial index, or ABI, which compares the blood pressure of the feet to the blood pressure of the arm. “An American survey of 2174 patients older than 40 years of age used the ankle-brachial index (ABI) as a screening tool, and showed a PAD prevalence of 0.9% between the ages of 40 and 49 years, 2.5% between the ages of 50 and 59 years, ...
... J. (2009). Heart disease and stroke statistics--2010 updated: a report from the American Heart Association. Journal of the American Heart Association. doi:10.1161/CIRCULATIONAHA.109.192667
Atherosclerosis or arteriosclerosis is the main cause of coronary artery disease. Atherosclerosis or arteriosclerosis is the gradual buildup of cholesterol inside the artery. When this happens in a coronary artery, the space inside the artery where blood flows becomes narrow, making it difficult for blood to flow freely. The result is less blood flow through the artery and less blood supply to heart tissue. Symptoms can include chest pain, shortness of breath, and fatigue that can be mild, or abrupt and severe, such as a heart attack. –http://www.heartpoint.com
In United States, according to American Heart Association, Cardiovascular disease also called Heart Disease is number one cause of death in United States. There are different types of heart disease and one of them is Coronary Heart disease or Coronary Artery Disease/CAD. Coronary Artery disease or CAD is the most common type of heart disease for both men and women. It is unannounced and can be a silent killer. CAD is mostly can be from damaged or diseased arteries. Some conditions, habits, or traits may increase the risk of CAD and the more problem shows, th...
The American Medical Women's Association. Guide to Cardiovascular Health, New York, NY: Dell Publishing, 2009.
Roger, Go, Lloyd-Jones, et al. states “Cardiovascular disease is the leading cause of death in the United States for men and women of all racial and ethnic groups.” (As cited in Hinkle & Cheever 2014, p. 729). There are different types cardiovascular diseases and they have a lot in common in terms of characteristics. This paper will focus on discussing acute coronary syndrome and myocardial infarction. To distinguish the two from each other, it is important to know the similarities and differences in etiology, clinical manifestations, medical management, collaborative care and nursing management for these two diseases.
The arteries supply blood rich in oxygen to the body, the veins direct deoxygenated blood from the capillaries back to the heart. These roles make up the circulatory function. Blood flow through these blood vessels can be disrupted resulting in peripheral vascular diseases. These diseases occur as a result of narrowing or blocking of the blood vessels. The risk factors of peripheral vascular diseases include diabetes, smoking, high level of cholesterol, overweight, high blood pressure etc. these risk factors result to aneurysms, Raynaud’s diseases, Buerger’s disease, renal artery disease etc. With this diseases, the peripheral vascular system should be assessed to enable nurses and other health personnel make good