Tag Archives: heart failure

Endocrine Society experts call for expanded screening for primary aldosteronism

Posted on by MaryO

Washington, DC–The Endocrine Society today issued a Clinical Practice Guideline calling on physicians to ramp up screening for primary aldosteronism, a common cause of high blood pressure.

People with primary aldosteronism face a higher risk of developing cardiovascular disease and dying from it than other people with high blood pressure. As many as one in ten people with high blood pressure may have primary aldosteronism. Uncontrolled high blood pressure can put these individuals at risk for stroke, heart attack, heart failure or kidney failure.

The guideline, entitled “The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline,” was published online and will appear in the May 2016 print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society. The guideline updates recommendations from the Society’s 2008 guideline on primary aldosteronism.

“In the past eight years, we have come to recognize that primary aldosteronism, despite being quite common, frequently goes undiagnosed and untreated,” said John W. Funder, MD, PhD, of the Hudson Institute of Medical Research in Clayton, Australia, and chair of the task force that authored the guideline. “This is a major public health issue. Many people with primary aldosteronism are never screened due to the associated costs. Better screening processes are needed to ensure no person suffering from primary aldosteronism and the resulting risks of uncontrolled high blood pressure goes untreated.”

Primary aldosteronism occurs when the adrenal glands — the small glands located on the top of each kidney – produce too much of the hormone aldosterone. This causes aldosterone, which helps balance levels of sodium and potassium, to build up in the body. The resulting excess sodium can lead to a rise in blood pressure.

The Endocrine Society recommends primary aldosterone screening for people who meet one of the following criteria:

  • Those who have sustained blood pressure above 150/100 in three separate measurements taken on different days;
  • People who have hypertension resistant to three conventional antihypertensive drugs;
  • People whose hypertension is controlled with four or more medications;
  • People with hypertension and low levels of potassium in the blood;
  • Those who have hypertension and a mass on the adrenal gland called an adrenal incidentaloma;
  • People with both hypertension and sleep apnea;
  • People with hypertension and a family history of early-onset hypertension or stroke before age 40; and
  • All hypertensive first-degree relatives of patients with primary aldosteronism.

Other recommendations from the guideline include:

  • The plasma aldosterone-to-renin ratio (ARR) test should be used to screen for primary aldosteronism.
  • All patients diagnosed with primary aldosteronism should undergo a CT scan of the adrenal glands to screen for a rare cancer called adrenocortical carcinoma.
  • When patients choose to treat the condition by having one adrenal gland surgically removed, an experienced radiologist should take blood samples from each adrenal vein and have them analyzed. This procedure, called adrenal vein sampling, is the gold standard for determining whether one or both adrenal glands is producing excess aldosterone.
  • For people with primary aldosteronism caused by overactivity in one adrenal gland, the recommended course of treatment is minimally invasive surgery to remove that adrenal gland.
  • For patients who are unable or unwilling to have surgery, medical treatment including a mineralocorticoid receptor (MR) agonist is the preferred treatment option.

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The Hormone Health Network offers resources on primary aldosteronism athttp://www.hormone.org/questions-and-answers/2012/primary-aldosteronism.

Other members of the Endocrine Society task force that developed this guideline include: Robert M. Carey, of the University of Virginia Health System in Charlottesville, VA; Franco Mantero of the University of Padova in Padua, Italy; M. Hassan Murad of the Mayo Clinic in Rochester, MN; Martin Reincke of the Klinikum of the Ludwig-Maximilians-University of Munich in München, Bavaria, Germany; Hirotaka Shibata of Oita University in Oita, Japan; Michael Stowasser of the University of Queensland in Brisbane, Australia; and William F. Young, Jr. of the Mayo Clinic in Rochester, MN.

The Society established the Clinical Practice Guideline Program to provide endocrinologists and other clinicians with evidence-based recommendations in the diagnosis and treatment of endocrine-related conditions. Each guideline is created by a task force of topic-related experts in the field. Task forces rely on evidence-based reviews of the literature in the development of guideline recommendations. The Endocrine Society does not solicit or accept corporate support for its guidelines. All Clinical Practice Guidelines are supported entirely by Society funds.

The Clinical Practice Guideline was co-sponsored by the American Heart Association, the American Association of Endocrine Surgeons, the European Society of Endocrinology, the European Society of Hypertension, the International Association of Endocrine Surgeons, the International Society of Hypertension, the Japan Endocrine Society and The Japanese Society of Hypertension.

The guideline was published online at http://press.endocrine.org/doi/10.1210/jc.2015-4061, ahead of print.

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society, which is celebrating its centennial in 2016, has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

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From http://www.eurekalert.org/pub_releases/2016-04/tes-ese042616.php

8 Energy Boosters to Beat Menopause Fatigue

Posted on by MaryO

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Menopause got you dragging? Here are a few simple ways to fight menopause energy drain and regain your oomph.

If you’re like many women, you’ll probably experience bothersome symptoms during menopause — one of which may be fatigue. Fatigue is a common menopause complaint, especially in the early stages of menopause, as your body adjusts to its new chemistry.

But low energy can be also caused by number of other medical conditions, including anemia, coronary artery disease, diabetes, heart failure, hypothyroidism, hyperthyroidism, and kidney or liver disease. If you are fatigued, “you should talk to your doctor just to be sure it’s a menopause symptom,” says Wendy Klein, MD, associate professor emeritus of internal medicine, obstetrics, and gynecology and chair of the Women’s Health Conference at the Virgina Commonwealth University School of Medicine.

“Most women don’t need treatment for their menopause symptoms,” Klein says. “The majority of women will have symptoms that are transient. They last two or three years and abate by themselves.” But there are lifestyle changes you can make to help relieve symptoms you may experience.

If you’re dealing with fatigue as you go through menopause, try these eight simple tricks to boost low energy:

1. Exercise daily. You should aim for at least 30 — and preferably 60 — minutes of exercise most days of the week. Exercising may be the last thing you want to do when you’re feeling weak or tired, but exercise actually boosts your energy, says Staness Jonekos, who co-authored The Menopause Makeover with Dr. Klein. “Exercise is your fountain of youth,” Jonekos says. “It produces those feel-good hormones and gives you the energy you’re looking for when you’re not feeling good.” Some people find it helps to exercise earlier in the day rather than close to bedtime.

2. Cap caffeine and alcohol consumption. Caffeine and alcohol can both affect energy levels and interfere with getting a good night’s sleep if you indulge in the evening. They may give you an immediate rush, but when they wear off, they can leave you feeling more drained than before. Nicotine can also have this effect, so if you smoke, quit. You’ll find you have more energy without artificial stimulants.

3. Limit food portions. Being overweight during menopause can cause you to feel sluggish. The best diet is one that is rich in fruits, vegetables, and whole grains and that includes lean sources of protein (poultry, lean meats, and fish) and low- or no-fat dairy products. Limit the amount of fats and sweets you eat. Eating smaller meals more frequently can provide energy throughout the day, Jonekos says. But if you eat more often, be sure you’re not overeating — watch your total calories.

4. Embrace relaxation. How do you unwind? Whether you like to read, take long walks, or meditate, take the time to indulge in your favorite activities. “You’re entitled to pamper yourself and take time for yourself,” Jonekos says. “As a result, you will be more energetic.” Stress and anxiety could be causing your fatigue, and relaxation techniques can be very helpful in learning to overcome them. A study published in Menopause: The Journal of the North American Menopause Society shows that stress-reduction therapy may also help with menopause symptoms, decreasing the degree to which women were bothered by hot flashes by 22 percent.

5. Get your Zzz’s. Another menopause symptom is hot flashes or night sweats, which can keep you up at night. Restful sleep is important during menopause so you’re not overly tired during the day. This may require keeping your bedroom cooler than you usually do. Use a ceiling fan and wear lighter bed clothes. Make sure the room is dark and set your body clock by going to bed and waking up around the same time every day — even on weekends.

6. Stay hydrated. “You need to nourish your body with healthy food and water,” Jonekos says. Thirst is your body’s way of telling you that you need more fluid. When you’re dehydrated, your body has to work harder to perform, which can lead to fatigue. Dehydration also can cause nausea and difficulty concentrating. Keep a water bottle handy so you can drink when you’re thirsty. Choose water or caffeine-free tea or coffee — not calorie-laden drinks, as weight gain can make you sluggish.

7. Don’t overbook. You may be fatigued because you’re trying to do too much. Learn to say no. Know your limits and what you can and can’t accomplish in a day. Also, if you set reasonable limits, you’ll be less stressed, Jonekos says.

8. Try herbal remedies. Two herbal remedies that may help reduce menopause symptoms that can cause fatigue and anxiety are black cohosh and valerian. Talk to your doctor before taking herbs as teas or supplements as they can interfere with some medications.

“No one recipe fits everyone,” Jonekos says. “But if you’re suffering from fatigue during menopause, you need to take control, and you can do that by adopting a healthy lifestyle.” Eat right, exercise, get adequate sleep, and learn to relax — you will find you have more energy to enjoy your life.

From http://www.everydayhealth.com/hs/guide-to-managing-menopause/8-energy-boosters-for-menopause-fatigue/

Heart failure symptoms easy to miss for unsuspecting patients – Chicago Tribune

Posted on by MaryO

“I have hardly been sick a day in my life. I take vitamins, try homeopathic remedies and have a great immune system,” says Kilian, 53.However, little did she know while treating her flu/bronchitis symptoms at home in November 2013, that she would end up in the hospital for nearly three weeks.”

Over the winter, I just wasn’t getting better,” says Kilian. “I was having trouble breathing and was starting to feel like I was gaining weight from eating healthy foods to keep my strength up. But, in reality, I was retaining fluid from heart failure.”

Kilian said that her water retention started out slowly, but it became more rapid as her symptoms progressed. Eventually, her brother, who lives in Naperville, brought her to the Elmhurst Memorial Hospital Emergency Department.”

The doctors were shocked at the amount of fluid that I had around my heart. I ended up with a pacemaker in the process,” says Kilian.

Read the entire article at Heart failure symptoms easy to miss for unsuspecting patients – Chicago Tribune.

Big Step in regenerating the heart muscle

Posted on by MaryO

A remarkable discovery in heart research was made by scientists at the Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB in Stuttgart: they found the surface markers of cardiovascular functional living progenitor cells CPCs. This discovery is extremely important for heart research because it demonstrates that the cardiovascular progenitor cells CPCs can be derived from induced pluripotent stem cells, iPS cells. Investigation results were recently published in the journal PLoS ONE.

Progenitor cells are cells that are normally found only in the fetus and have the ability to develop into all cell types of the heart: cardiomyocytes, etc. The goal of the study led by Prof. Dr. Katja Schenke-by Layland from the Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB in Stuttgart, was to produce functional cardiomyocytes from progenitor cells. Cardiomyocytes are heart muscle cells that play an essential role in contraction. Myocardial infarction leads to loss of functional cardiomyocytes. As a result of a blockage of a coronary artery, myocardium served by that artery will not be supplied with oxygen anymore, thus it will die. A frequent consequence of patients who suffer a heart attack is heart failure, which means decreased ability of the heart contraction.

Read more at Big Step in regenerating the heart muscle.