therapy – ABC CARDIOL

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Original Article

Does a Role Exist for Tilting-Guided Therapy in the Management of Neurocardiogenic Syncope?

Denise Hachul et al. Mauricio Scanavacca Eduardo Sosa

PURPOSE: Upright tilt-table testing (UTT) is an useful method for identifying patients with neurocardiogenic syncope, but its role in the evaluation of therapeutic efficacy is controversial. The aim of this study was to determine the correlation between negative UTT after therapy introduction (acute efficacy) and symptom recurrence during follow-up (chronic efficacy). METHODS: We studied 56 severely symptomatic patients (age 27±19 years) with recurrent (7±12 episodes) neurocardiogenic syncope (positive UTT). Once empirical pharmacological therapy was initiated, all patients underwent another UTT (therapeutic evaluation test – TET). Therapy was not modified after TET results. The probability of symptom recurrence was analyzed with the Kaplan-Meier method and compared by log-rank test in patients with negative and positive TET. RESULTS: Negative UTT after therapy was related to a significantly lower probability of recurrence during follow-up (4.9 versus 52.4% in 12 months, P<0.0001). CONCLUSION: A good correlation exists between acute and long-term efficacy of pharmacological therapy for neurocardiogenic syncope, so that serial UTT may be considered a good method for identifying an effective therapeutic strategy.

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Artigo Original

Antihypertensive treatment. Prescription and cost of drugs. Survey in a tertiary care hospital

Daniela Akashi et al. Flávia K. Issa Alexandre C. Pereira Anna C. Tannuri … Daniele Q. Fucciolo Maurício L. Lobato Tatiana G. Galvão Isabela M. Benseñor Paulo A. Lotufo

PURPOSE: To study the most prescribed anti-hypertensive drugs, evaluating their agreement with established guidelines and drug cost. METHODS: One hundred and forty one (101 women, mean age = 53.3 years) hypertensive patients who searched spontaneous attention were interviewed in a tertiary-care hospital. The inclusion criteria were previous diagnosis of hypertension and non cardiovascular complaints. RESULTS: The majority of the 107 (75.9%) patients were on medical treatment. In those receiving monotherapy, thiazides were the most utilized drugs, followed by methyldopa, ACE inhibitors, calcium channel-blockers, and beta-blockers. The association with thiazides (26.3%) followed the same preference. The second most prescribed drug, methyldopa, was the more expensive. Fifty percent of the patients purchased the drugs at their own expense. CONCLUSION: A preference for prescription of expensive drugs for hypertension was detected in this sample in Brazil. This does not agree with major guidelines, mainly the V-JNC, which suggest thiazides and betablockers as first choice drugs for hypertensives with no complications or associated comorbidity.

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Does a Role Exist for Tilting-Guided Therapy in the Management of Neurocardiogenic Syncope?

Antihypertensive treatment. Prescription and cost of drugs. Survey in a tertiary care hospital

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)