cardiovascular-agents and Arthralgia

We previously reported that the fixed-dose combination of isosorbide dinitrate and hydralazine hydrochloride (FDC I/H) significantly decreased the risk of all-cause death and first hospitalization for heart failure (HF) and improved quality of life in patients with New York Heart Association class III or IV heart failure in the African-American Heart Failure Trial (A-HeFT). The current analyses further define the effect of FDC I/H on the timing of event-free survival (mortality or first hospitalization for HF) and time to first hospitalization for HF, as well as effects by subgroups and effects on cause-specific mortality.. Kaplan-Meier analyses of the 1050 A-HeFT patients on standard neurohormonal blockade demonstrated that FDC I/H produced a 37% improvement in event-free survival (P<0.001) and a 39% reduction in the risk for first hospitalization for HF (P<0.001). These benefits appeared to emerge early (at approximately 50 days of treatment) and were sustained through the duration of the trial. Subgroup analyses of treatment effect by age, sex, baseline blood pressure, history of chronic renal insufficiency, presence of diabetes mellitus, cause of HF, and baseline medication usage demonstrated consistent beneficial effect of FDC I/H on the primary composite score and event-free survival across all subgroups. Mortality from pump failure was reduced by 75% (P=0.012).. FDC I/H treatment of black patients with moderate to severe HF who were taking neurohormonal blockers produced early and sustained significant improvement in event-free survival and hospitalization for HF in the A-HeFT cohort, with significant reduction in mortality from cardiovascular and pump failure deaths. The treatment effects on the primary composite end point and event-free survival were consistent across subgroups.

Topics: Adult; Aged; Arthralgia; Biomarkers; Black or African American; Cardiovascular Agents; Cause of Death; Disease-Free Survival; Dizziness; Double-Blind Method; Drug Combinations; Heart Failure; Heart Transplantation; Hospitalization; Humans; Hydralazine; Hypotension; Isosorbide Dinitrate; Kaplan-Meier Estimate; Middle Aged; Mortality; Natriuretic Peptide, Brain; Nitric Oxide Donors; Proportional Hazards Models; Quality of Life; Surveys and Questionnaires; Treatment Outcome; Vasodilator Agents

Demographic changes in Japan have resulted in an increased number of elderly living alone.. The aim of this study was to identify if there is an association between frailty and living alone.. We conducted a cross-sectional study of 1602 Japanese men and women living in isolated islands. Information obtained included height, body weight, handgrip strength, and family structure; antihypertensive, hypoglycaemic, and lipid-lowering medication use; history of stroke or ischaemic heart disease, smoking history, alcohol intake, joint pain or swelling. Relevant laboratory test results were obtained from recent health check-ups. The Frailty Index for Japanese elderly, a 15-item self-report questionnaire was completed by participants and the Kessler Psychological Distress Scale (K6) was administered.. After individuals aged below 60 years old or those with missing data were excluded, data from 1224 participants were analysed. Living alone (single household family structure) was significantly associated with frailty in men (odds ratio [OR] 3.85; 95% confidence interval [CI] 1.94-7.65), but not in women (OR 1.08; 95% CI 0.72-1.63). This association in men remained statistically significant after adjustment for known risk factors for frailty.. In the elderly population in rural Nagasaki, men living alone have a high risk of frailty. Screening and intervention to prevent frailty in this population is urgently needed.

Topics: Age Factors; Aged; Aged, 80 and over; Alcohol Drinking; Arthralgia; Body Weights and Measures; Cardiovascular Agents; Cardiovascular Diseases; Cross-Sectional Studies; Family Characteristics; Female; Frail Elderly; Hand Strength; Humans; Hypoglycemic Agents; Islands; Japan; Male; Middle Aged; Odds Ratio; Risk Factors; Sex Factors; Smoking; Social Isolation