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Publication year: 2009
Source: The American Journal of Geriatric Pharmacotherapy, Volume 7, Issue 5, October 2009, Pages 233-249
Judy W.M., Cheng , Monica, Nayar

Background: In the United States, the incidence of heart failure (HF) in the elderly population (age, ≥65 years) approached 10 per 1000 population in 2006, and HF was a common reason for hospitalization. Many clinical features and the management of HF differ in elderly patients compared with their younger counterparts due to changes in physiology and the presence of comorbidities.Objective: The aim of this review was to explore the risks and benefits of different classes of HF pharmacotherapy for chronic HF management in the elderly population.Methods: Peer-reviewed articles were identified from MEDLINE and Current Contents database (both, 1966–May 21, 2009)…

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Publication year: 2009
Source: The American Journal of Geriatric Pharmacotherapy, Volume 7, Issue 5, October 2009, Pages 250-261
Kairav, Shah , Salah U., Qureshi , Michael, Johnson , Niraj, Parikh , Paul E., Schulz , …

Background: Hypertension appears to contribute to the development of dementia. Antihypertensive drugs may play an important role in altering the incidence or progression of dementia, particularly dementia of the vascular type; however, the neuroprotective effects of these agents in other types of dementia are not well characterized.Objectives: The main aims of this review were to examine the relationship between use of antihypertensive agents and the incidence and progression of Alzheimer’s dementia (AD), vascular dementia (VaD), and unspecified dementia, and to consider whether these agents may be neuroprotective.Methods: A search of the English-language literature (January 1996–August 2009) was conducted using PubMed,…

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Publication year: 2009
Source: The American Journal of Geriatric Pharmacotherapy, Volume 7, Issue 5, October 2009, Pages 262-270
Linda, Simoni-Wastila , Christopher M., Blanchette , Jingjing, Qian , Hui-wen Keri, Yang , Lirong, Zhao , …

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. COPD increases health care resource utilization and spending and adversely affects quality of life. Data from the clinical and economic outcomes in Medicare beneficiaries with COPD who reside in long-term care (LTC) facilities are limited.Objective: The purpose of this study was to investigate the clinical and economic outcomes associated with COPD in Medicare beneficiaries residing in LTC facilities.Methods: This retrospective cohort study analyzed data from MarketScan Medicaid, a large US administrative claims database containing data on Medicaid programs in 8 states. The study cohort comprised…

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Publication year: 2009
Source: The American Journal of Geriatric Pharmacotherapy, Volume 7, Issue 5, October 2009, Pages 271-280
Rollin M., Wright , Richard, Sloane , Carl F., Pieper , Christine, Ruby-Scelsi , Jack, Twersky , …

Background: Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood.Objectives: The aims of this work were to assess the prevalence of medication underuse and to determine whether polypharmacy or comorbidity was associated with medication underuse among physically frail older veterans transitioning from the hospital to the community.Methods: This was a cross-sectional analysis of patients who were discharged from 11 US veterans’ hospitals to outpatient care, based on data from the Geriatric Evaluation and Management Drug Study, a substudy of the Veterans Affairs Cooperative Study of geriatric evaluation…

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Publication year: 2009
Source: The American Journal of Geriatric Pharmacotherapy, Volume 7, Issue 5, October 2009, Pages 281-284
Joseph P. Vande, Griend , Sunny A., Linnebur , Jacquelyn L., Bainbridge

Background: Compared with traditional antiepileptic drugs, levetiracetam has a unique mechanism of action and unique properties, including predominant renal excretion and lack of drug-drug interactions. In the elderly, depression associated with levetiracetam has not been reported.Case summaries: A 73-year-old black man (height, 172.7 cm; weight, 92.7 kg; body mass index [BMI], 31 kg/m2) with stage 4 kidney disease was taking levetiracetam 500 mg BID for partial complex seizures. After 5 months of taking medication, new-onset depression, evidenced by depressed mood, weight loss, fatigue, and appearing withdrawn, was noted in this patient. Levetiracetam was discontinued by order of the patient’s primary…

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Publication year: 2009
Source: The American Journal of Geriatric Pharmacotherapy, Volume 7, Issue 5, October 2009, Pages 285-292
David R.P., Guay

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Publication year: 2009
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 26 November 2009
João Manoel Theotonio, Santos , Ingrid, Kowatsch , Jeane Mike, Tsutsui , Carlos Eduardo, Negrão , Nancy, Canavesi , …

Exercise training has been shown to be effective in improving exercise capacity and quality of life in patients with heart failure and left ventricular (LV) systolic dysfunction. Real-time myocardial contrast echocardiography (RTMCE) is a new technique that allows quantitative analysis of myocardial blood flow (MBF). The aim of this study was to determine the effects of exercise training on MBF in patients with LV dysfunction. We studied 23 patients with LV dysfunction who underwent RTMCE and cardiopulmonary exercise testing at baseline and 4 months after medical treatment (control group, n = 10) or medical treatment plus exercise training (trained group,…

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Publication year: 2009
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 26 November 2009
Steven C., Halbert , Benjamin, French , Ram Y., Gordon , John T., Farrar , Kathryn, Schmitz , …

Currently, no consensus has been reached regarding the management of hyperlipidemia in patients who develop statin-associated myalgia (SAM). Many statin-intolerant patients use alternative lipid-lowering therapies, including red yeast rice. The present trial evaluated the tolerability of red yeast rice versus pravastatin in patients unable to tolerate other statins because of myalgia. The study was conducted in a community-based setting in Philadelphia, Pennsylvania. A total of 43 adults with dyslipidemia and a history of statin discontinuation because of myalgia were randomly assigned to red yeast rice 2,400 mg twice daily or pravastatin 20 mg twice daily for 12 weeks. All subjects…

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Publication year: 2009
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 26 November 2009
Els, Moltzer , Francesco U.S. Mattace, Raso , Yusuf, Karamermer , Eric, Boersma , Gary D., Webb , …

Even after successful repair, hypertension is one of the main determinants of cardiovascular morbidity and mortality in patients with aortic coarctation (CoA). We compared the effect of candesartan (angiotensin II receptor blockade) and metoprolol (β-adrenergic receptor blockade) on blood pressure, large artery stiffness, and neurohormonal status in hypertensive patients after repair of CoA. In the present open-label, crossover study, hypertensive patients after CoA repair were first randomly assigned to treatment with candesartan 8 mg or metoprolol 100 mg once per day. After 8 weeks of treatment with one of the drugs, the other treatment was given for 8 weeks. The…

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Publication year: 2009
Source: The American Journal of Cardiology, In Press, Corrected Proof, Available online 26 November 2009
Fadi G., Hage , Raed, Aqel , Wael, Aljaroudi , Jaekyeong, Heo , Koteswara, Pothineni , …

Myocardial infarct (MI) size is a well-established prognostic marker but the association of serum markers with MI size, as measured by myocardial perfusion imaging (MPI), has not been well studied in patients with hypertrophic cardiomyopathy (HC) after alcohol septal ablation (ASA). Creatine kinase (CK), CK-MB, troponin I, and brain natriuretic peptide were measured before and at multiple points after ASA in patients with HC and were correlated with MI size measured by MPI. MPI at rest was performed in 54 patients with HC at a median of 2 days after ASA. CK, CK-MB, and troponin I increased after ASA to…

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