Tag Archives: Spironolactone

Presenters included cardiologists, Professors Michael Boehm (University of the Saarland, Homburg, Saarland, Germany) and Stefan Anker (University Medical Center Göttingen, Göttingen, Germany) and nephrologist, Matthew Weir (University of Maryland Medical Centre, Baltimore, Maryland, USA). Their presentations are summarised below. The addition of mineralocorticoid receptor antagonists (MRAs) to angiotensin converting enzyme (ACE) inhibition or receptor blockade (ARB) has been shown in randomised-controlled trials to improve morbidity and mortality in patients with heart failure.1,2 In the EMPHASIS-HF study, the addition of eplerenone in pat

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ENGAGE AF-TIMI 48: success for edoxaban in AF The new factor Xa inhibitor, edoxaban (Daiichi-Sankyo), was as effective in preventing strokes and safer than warfarin in patients with atrial fibrillation (AF) in the ENGAGE AF-TIMI 48 trial. The ENGAGE AF-TIMI 48 (Effective AnticoaGulation with Factor XA Next Generation in Atrial Fibrillation – Thrombolysis In Myocardial Infarction 48) trial included more than 21,000 AF patients from 46 countries who were randomised to edoxaban at one of two doses (60 mg or 30 mg per day) or warfarin. Results (table 1) showed that both edoxaban doses were associated with significantly less major bleeding than

Introduction Therapeutic interventions in chronic heart failure (CHF) can lead to renal dysfunction. Combination of the aldosterone antagonist (AA) spironolactone with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), reduced mortality and hospitalisation rates and improved the New York Heart Association (NYHA) functional class in patients recruited into the Randomised Aldactone Evaluation Study (RALES).1 That study showed no statistically significant difference in the incidence of hyperkalaemia between those on AA and those on placebo.1 However, when the results of the trial were implemented int

1. Check that the measurement is correct Ensure that they really are poorly controlled by resting the patient for 10 minutes, with the cuff in place to discourage them from standing, before taking at least two measurements, one to two minutes apart. Feel the radial pulse because in arrhythmias such as atrial fibrillation automatic sphygmomanometers are inaccurate and therefore traditional devices such as mercury sphygmomanometers must be used. People aged over 80 years and some diabetics may have postural hypotension. This is where the systolic blood pressure drops 20 mmHg on standing or they may have postural symptoms.2 Having made that diag

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