cardiovascular-agents and Hypercalcemia

Osteoporosis and cardiovascular diseases are epidemiologically associated. Calcification phenomena of atherosclerotic plaque involve cytokines and growth factors also involved in bone remodeling. Drugs given for either of these two conditions could act on these mechanisms. Can osteoporosis drugs have an influence on the occurrence of cardiovascular events? Conversely, can the treatment of hypertension alter the course of osteoporosis? It is possible that administration of high doses of calcium (1g/day) in patients who already have important dietary intake can increase the risk of myocardial infarction. Epidemiological studies show links between low serum vitamin D levels and cardiovascular disease but interventional studies show that vitamin D administration in moderately deficient subjects vitamin D does not prevent the occurrence of cardiovascular events. Cohort studies show a beneficial effect of beta-blockers and thiazides administered to hypertensive patients: they reduce by 20% risk of fracture of the proximal femur. Should we focus on these anti-hypertensive treatments for our patients with osteoporosis?

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Bone Density Conservation Agents; Calcium; Calcium, Dietary; Cardiovascular Agents; Cardiovascular Diseases; Denosumab; Diphosphonates; Drug Interactions; Humans; Hypercalcemia; Hypertension; Myocardial Infarction; Osteoporosis; Sodium Chloride Symporter Inhibitors; Teriparatide; Vitamin D; Vitamin D Deficiency

Topics: Acetanilides; Adrenergic beta-Antagonists; Angina Pectoris; Atrial Fibrillation; Benzazepines; Calcium; Calcium Channel Blockers; Cardiovascular Agents; Coronary Artery Disease; Electrocardiography; Endothelium, Vascular; Heart Failure, Diastolic; Humans; Hypercalcemia; Ivabradine; Myocardial Ischemia; Nitrates; Piperazines; Ranolazine; Sodium; Sodium Channels; Sodium-Calcium Exchanger

The common rhythm disturbances related to electrolyte imbalance are due predominantly to abnormalities of potassium. An understanding of the mechanism underlying these abnormalities is facilitated by a brief review of normal electrical activity during impulse propagation in cardiac tissue. Also discussed are the actions of all cardioactive and antiarrhythmic drugs on membrane permeability to ions. Lastly, the nonspecific arrhythmias associated with endocrine disturbances are outlined.

Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Cardiovascular Agents; Cimetidine; Digitalis Glycosides; Electrocardiography; Endocrine System Diseases; Humans; Hypercalcemia; Hyperkalemia; Hypocalcemia; Hypokalemia; Magnesium; Psychotropic Drugs; Water-Electrolyte Balance; Water-Electrolyte Imbalance

This retrospective study concerned 18 female and 23 male patients with cardiac sarcoidosis (CS). The average age at CS diagnosis was 38 years. CS was observed in white (73% of cases) and in black or Caribbean patients (27% of cases). All patients had extracardiac histologic proof of sarcoid tissue. In 63% of cases, the CS arose during the follow-up of systemic sarcoidosis. Systemic sarcoidosis was not specific except for a high frequency of neurosarcoidosis. Revealing cardiac signs were clinical in 63% of cases and electrical in 22%. In most patients these signs were associated with an abnormal echocardiography (77%) and/or a defect on thallium-201 or sestamibi imaging (75%). Thirty-nine patients received steroid therapy (initial dose mostly equal to 1 mg/kg per day), associated in 13 cases with another immunosuppressive treatment. In 26% of cases the immunosuppressive treatment was associated with a specific cardiac treatment. In the long-term follow-up (average follow-up, 58 mo), 87% of the cases showed an improvement, and 54% were cured from a clinical and laboratory point of view (electrocardiogram, 24-hour monitoring, echocardiography, radionuclide imaging). There was no sudden death. Two patients worsened, which can be explained in 1 case by very late treatment and in the other case by lack of treatment, except for a pacemaker. Our experience leads us to treat CS with corticosteroids as soon as possible and to use another immunosuppressive treatment where there is an insufficient therapeutic response or where there are contraindications to corticosteroids.

Topics: Adolescent; Adult; Aged; Alkaline Phosphatase; Biopsy; Black People; Blood Cell Count; Blood Sedimentation; Cardiomyopathies; Cardiovascular Agents; Echocardiography; Electrocardiography; Female; Humans; Hypercalcemia; Immunosuppressive Agents; Male; Middle Aged; Peptidyl-Dipeptidase A; Retrospective Studies; Sarcoidosis; Treatment Outcome; White People

Topics: Adrenal Cortex Hormones; Calcium; Cardiovascular Agents; Cortisone; Glucocorticoids; Humans; Hypercalcemia; Hyperthyroidism; Prednisone; Thyrotoxicosis