Postgraduate medicine
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Postgraduate medicine · Jun 2023
Perspectives of patients, care partners, and primary care physicians on management of mild cognitive impairment and mild Alzheimer's disease dementia.
Early diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia is crucial for effective disease management and optimizing patient outcomes. We sought to better understand the MCI and mild AD dementia medical journey from the perspective of patients, care partners, and physicians. ⋯ PCPs play a vital role in the timely diagnosis and treatment of MCI and mild AD dementia but often are not considered the care coordinator. For the majority of patients, the initial discussion with a PCP took place 15 months after symptom onset; therefore, it is important to educate patients/care partners and PCPs on MCI and AD risk factors, early symptom recognition, and the need for early diagnosis and treatment. PCPs could improve patient care and outcomes by building their understanding of the need for early AD diagnosis and treatment and improving the efficiency of the patient medical journey by serving as coordinators of care.
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Postgraduate medicine · Jun 2023
The relationship between visceral adipose index and resistant hypertension in people living with diabetes.
Resistant hypertension (RHT) is a more risky HT phenotype in terms of mortality and morbidity. It is more common in people living with diabetes. Studies have shown that visceral adipose index (VAI), a new obesity parameter, is associated with HT and diabetes mellitus (DM). The association of VIA with RHT has not been previously evaluated. The aim of this study is to analyze the relationship between VAI and RHT in people living with diabetes. ⋯ In our study, we have determined that increased VAI is an independent risk factor for RHT in people living with diabetes. VAI may have better ability to predict RHT than many other parameters.
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Postgraduate medicine · Jun 2023
ReviewPossible cardiovascular risks of white coat hypertension: updated.
White-coat hypertension (WCH) has been defined as an increased blood pressure (BP) in the doctor's office and a normal BP outside the office by 24 hr ambulatory BP monitoring (ABPM) or home BP measurement. It is generated by fear and anxiety of whether an abnormal value could be found and indicate the existence of hypertension. When first described, it was defined as a neuro-defense reaction related to the presence of the doctor in their office or clinic and associated with an increase in heart rate. ⋯ The prevalence of WCH varies by different studies from 15% to 40% and up to 50% in older subjects. Currently, the management of WCH if not associated with CV risk factors should be conservative with healthy lifestyle changes and exercise. Drug therapy should be considered if these measures do not work or in the presence of CV risk factors, HMOD, or preexisting cardiovascular disease.