Aldosterone Synthase Inhibitors for Resistant Hypertension: Pharmacological Insights - A Systematic Review.

Background: Resistant hypertension (RHT) is a challenging clinical condition characterized by persistently elevated blood pressure despite adherence to lifestyle modifications and the use of at least three antihypertensive agents, including a high-dose diuretic. RHT is a heterogeneous condition, influenced by multiple pathophysiological mechanisms such as sodium retention, sympathetic overactivity, and vascular dysfunction. Among these, hyperaldosteronism plays a pivotal role in a subset of patients.

Retrospective Evaluation of L-Acetyl Carnitine and Palmitoylethanolamide as Add-On Therapy in Patients with Fibromyalgia and Small Fiber Neuropathy.

Fibromyalgia is a complex disorder characterized by chronic widespread pain and a variety of related symptoms. Growing evidence suggests that the central and peripheral nervous systems are involved, with small fiber neuropathy playing a key role in its development. We retrospectively reviewed the medical records of 100 patients diagnosed with primary fibromyalgia.

Crystal clear - part I: The role of uric acid in cardiorenal disease.

This review opens a two-part series by exploring the evolutionary origins, vascular implications, renal pathophysiology, and prognosis related to serum uric acid (SUA). We begin by examining the ancestral loss of uricase in hominoids, which conferred elevated SUA-initially advantageous for sodium retention and antioxidant defense, yet maladaptive in today's purine- and fructose-abundant diet. UA thus re-emerges as a biologically active molecule, exhibiting both protective antioxidant effects and harmful pro-inflammatory actions.

Triglyceride-glucose index threshold for cardiovascular mortality in hypertensive individuals - URRAH project.

Aims: The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance (IR). Data regarding this topic is constantly increasing, however, few and heterogeneous data are available on the relationship between this index and cardiovascular mortality risk in hypertensive populations. In this context, we aimed to explore the relationship between TyG and cardiovascular mortality in a large sample of hypertensive individuals from the URRAH cohort.

Women HEalth and PREgnancy Complications (HER): a physician-based Survey on Hypertensive Disorders in Pregnancy of the Italian Society of Hypertension (SIIA).

Introduction: Management of hypertensive disorders in pregnancy (HDP) remains challenging, with various healthcare providers involved and no uniform approach with variability in medications, monitoring, and intervention timing reflecting gaps in research.

Aim: To investigate Italian physicians' knowledge on the topic and examine their clinical practices.

Methods: We collected multi-regional data from Italian experts on Hypertension and Gynecologists.

Managing glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors in clinical practice.

The obesity epidemic has significantly heightened the impact of cardiometabolic risk factors on the global burden of cardiovascular and kidney diseases. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is), originally developed for type 2 diabetes treatment, have demonstrated in randomised controlled trials their ability to reduce the risk of cardiovascular and kidney diseases. This has led to substantial improvements in patient outcomes.

Lorundrostat in Participants With Uncontrolled Hypertension and Treatment-Resistant Hypertension: The Launch-HTN Randomized Clinical Trial.

Importance: Uncontrolled hypertension remains a global health concern and dysregulated aldosterone production is a central mechanism. Lorundrostat, a novel aldosterone synthase inhibitor that reduces aldosterone production, demonstrated efficacy in participants with uncontrolled hypertension, including those with treatment-resistant hypertension.

Objective: To evaluate the efficacy and safety of lorundrostat for lowering blood pressure (BP) when added to a prescribed regimen of 2 to 5 antihypertensive medications in adults with uncontrolled hypertension and treatment-resistant hypertension.

New Insights into Uric Acid Metabolism in the Pathophysiology of Ischaemic Heart Disease.

The role of hyperuricaemia as an independent cardiovascular risk factor remains controversial and subject to debate. Nonetheless, multiple studies have highlighted the central role of uric acid (UA) in conditions such as hypertension, metabolic syndrome, heart failure and coronary artery disease. Various mechanisms have been proposed to explain UA's involvement in cardiovascular diseases, including through UA-induced oxidative stress, systemic inflammation, endothelial dysfunction and activation of the renin-angiotensin-aldosterone system (RAAS).

Psychological and Clinical Factors Mediate Post-COVID-19 Irritable Bowel Syndrome.

Background: Exposure to COVID-19 has been shown previously to be associated with a higher risk for irritable bowel syndrome (IBS). This study aimed to better explain this relationship using mediation analysis.

Methods: This post hoc analysis of a multicenter cohort study includes 623 patients with and without COVID-19 infection.

A Real-World Analysis of the Population with Hepatitis C Virus Infection Affected by Type 2 Diabetes in Italy: Patients' Characteristics, Comorbidity Profiles and Treatment Patterns.

: HCV infection represents a main risk factor for type 2 diabetes (T2D). This real-world analysis investigated the HCV-positive (HCV+) population with a T2D co-diagnosis in Italy. : From 2017 to 2021, HCV+ patients were identified from administrative databases and stratified into T2D-HCV+ and HCV+-only cohorts in the presence/absence of a T2D diagnosis.

In these cases, I treat hypertension with renal ablation.

Systemic arterial hypertension is one of the leading causes of mortality and morbidity worldwide. Despite therapeutic advancements, a significant proportion of hypertensive patients fail to achieve adequate blood pressure control. Renal denervation (RDN) is emerging as an innovative and minimally invasive procedure to treat hypertension by modulating the renal sympathetic nervous system.

Reliability of different formulas for estimating plasma Apolipoprotein B levels in a large cohort of South European individuals.

Background And Aims: Direct measurement of apolipoprotein B (ApoB) is not always standardized and is relatively expensive, making it unavailable in several low-income settings. To address this issue, several formulas have been developed to estimate ApoB levels. Therefore, our study aims to compare the reliability of 23 formulas for estimating ApoB levels in a large cohort of South-European individuals.

Establishing a Bioink Assessment Protocol: GelMA and Collagen in the Bioprinting of a Potential Intestinal Model.

Collagen and gelatin methacryloyl (GelMA) are widely studied biomaterials for extrusion-based bioprinting (EBB) due to their excellent biological properties and ability to mimic the extracellular matrix of native tissues. This study aims to establish a preliminary workflow for approaching EBB by assessing collagen and GelMA printability and biological performance. GelMA was selected for its cost-effectiveness and ease of synthesis, while our collagen formulation was specifically optimized for printability, which is a challenging aspect of bioprinting.

Long-Term Impact of COVID-19 on Disorders of Gut-Brain Interaction: Incidence, Symptom Burden, and Psychological Comorbidities.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has highlighted the potential exacerbation of gastrointestinal symptoms in patients with disorders of gut-brain interaction (DGBIs). However, the distinct symptom trajectories and psychological burden in patients with post-COVID-19 DGBIs compared with patients with pre-existing irritable bowel syndrome (IBS)/functional dyspepsia (FD) and non-DGBI controls remain poorly understood.

Objectives: To examine the long-term gastrointestinal symptom progression and psychological comorbidities in patients with post-COVID-19 DGBI, patients with pre-existing IBS/FD and non-DGBI controls.

Sudden cardiac arrest prediction via deep learning electrocardiogram analysis.

Aims: Sudden cardiac arrest (SCA) is a commonly fatal event that often occurs without prior indications. To improve outcomes and enable preventative strategies, the electrocardiogram (ECG) in conjunction with deep learning was explored as a potential screening tool.

Methods And Results: A publicly available data set containing 10 s of 12-lead ECGs from individuals who did and did not have an SCA, information about time from ECG to arrest, and age and sex was utilized for analysis to individually predict SCA or not using deep convolution neural network models.

Long-term event rates, risk factors, and treatment pattern in 1.4 million individuals qualifying for dual blood pressure lowering therapy.

Objectives: We assessed rates of cardiovascular events, all-cause death, baseline risk factors, and treatment patterns in a population qualifying for initiation of dual combination blood pressure (BP)-lowering therapy. We also evaluated the association between dual versus monotherapy during follow-up and incidence of cardiovascular events.

Methods: This study utilized integrated databases in England: Clinical Practice Research Datalink, Hospital Episode Statistics, and Office for National Statistics.

New pharmacological agents and novel cardiovascular pharmacotherapy strategies in 2024.

Despite substantial advances in cardiovascular pharmacotherapy and devices in recent years, prevention and treatment of many cardiovascular diseases (CVDs) remain limited, thus reflecting the need for more effective and safer pharmacological strategies. In this review, we summarize the most relevant studies in cardiovascular pharmacotherapy in 2024, including the approval of first-in-class drugs for the treatment of resistant hypertension and pulmonary arterial hypertension, label expansions for bempedoic acid and semaglutide, and the results of major randomized clinical trials (RCTs) that have met the pre-specified primary endpoints, thereby filling some gaps in knowledge and opening new perspectives in the management of CVD, and those RCTs whose results did not confirm the proposed research hypotheses. We also include a section on drug safety, where we describe the newest data on adverse reactions and drug-drug interactions that may complicate treatment and/or reduce drug adherence with the consequent decrease in drug effectiveness.

2024 consensus document of the Italian Society of Arterial Hypertension (SIIA) and the Italian Society of Cardiovascular Prevention (SIPREC): update on LDL cholesterol lowering in patients with arterial hypertension.

Hypertension and hypercholesterolemia often occur in the same individuals, increasing the risk of major cardiovascular (CV) outcomes, including myocardial infarction, stroke, CV death, as well as other CV complications. Concomitant management of these condition now represent a crucial step to reduce individual global CV risk and improve CV disease prevention in daily clinical practice. Given the high prevalence of hypertension and hypercholesterolemia in general population and their impact on health status, several pharmacological options are currently available to achieve the recommended therapeutic targets.

Assessment of cardiovascular, thromboembolic and cancer risk in patients eligible for treatment with Janus Kinase inhibitors: The JAK-ERA multidisciplinary consensus.

Introduction: JAK inhibitors (JAKi) have emerged as effective treatments for chronic inflammatory diseases, including gastrointestinal, dermatological, and rheumatological conditions. Despite their efficacy, concerns about their safety profile necessitate a comprehensive framework for their optimal use. This study aimed to establish an expert consensus (the JAK-ERA [Janus Kinase-inhibitors Evidence-based Risk Analysis] Multidisciplinary Expert Consensus) on the principles guiding JAKi therapy to maximize therapeutic benefits while mitigating risks.

Predictive value of TG/HDL-C and GFR-adjusted uric acid levels on cardiovascular mortality: the URRAH study.

Background: Insulin resistance (IR) and serum uric acid (SUA) are closely interconnected: SUA contributes to adversely affects the insulin signaling pathway and contributes to IR, while IR is a known predictor for the development of hyperuricemia. The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio has been proposed as an easily obtainable marker for IR. This research aimed to investigate the interaction between IR and glomerular filtration rate (GFR)-adjusted uricemia (SUA/GFR ratio) in determining CV risk in a large population cohort study.

Screening of primary aldosteronism and pheochromocytoma among patients with hypertension: an Italian nationwide survey.

Purpose: The delayed or missed diagnosis of secondary hypertension contributes to the poor blood pressure control worldwide. This study aimed to assess the diagnostic approach to primary aldosteronism (PA) and pheochromocytoma (PHEO) among Italian centers associated to European and Italian Societies of Hypertension.

Methods: Between July and December 2023, a 10-items questionnaire was administered to experts from 82 centers of 14 Italian regions and to cardiologists from the ARCA (Associazioni Regionali Cardiologi Ambulatoriali) Piemonte.

Updating Primary Antibiotic Resistance in Helicobacter pylori Strains Isolated in Italy.

Background And Aims: Bacterial resistance toward the most used antibiotics is increasing in Helicobacter pylori (H. pylori) strains worldwide. The emergence of multidrug resistance significantly affects the efficacy of standard therapy regimens.