nach oben

Rheumatology International

Erschienen in:

02.08.2019 | Comorbidities

Stiffening of aorta is more preferentially associated with rheumatoid arthritis than peripheral arteries

verfasst von: Yong Yang, Zhen Wang, Zihao Fu, Runrun Yang, Jia Wang, Lijun Yuan, Feng Gao, Yunyou Duan

Erschienen in: Rheumatology International | Ausgabe 10/2019

Einloggen, um Zugang zu erhalten

Abstract

The objective of this study is to investigate the relative impact of rheumatoid arthritis (RA) and other factors on arterial stiffness of different regions assessed by regional pulse wave velocity (PWV). Seventy-two patients with RA and 55 strictly matched healthy controls were included. Doppler ultrasound was used to measure the PWV of heart–carotid (hcPWV), heart–femoral (hfPWV), brachial–radial (brPWV), femoral–ankle (faPWV) and carotid–femoral segments (cfPWV) in all subjects. The reproducibility of regional PWV measurement was evaluated in 30 random RA patients. In RA patients, the hfPWV and cfPWV were significantly higher than that in controls (P = 0.0006, P = 0.0001, respectively), and the hcPWV, brPWV and faPWV only showed an increase trend without significance. The mean increase magnitude of hfPWV (17.5%) and cfPWV (18.5%) were greater than brPWV (7.2%) and faPWV (1.7%) in RA patients. The association between RA and both hfPWV, cfPWV remained significant after adjustments for other confounders (P < 0.001). However, the association between RA and brPWV (P = 0.199), faPWV (P = 0.599) was not significant. In addition, age and systolic blood pressure were also significant independent factors associated with hfPWV and cfPWV. The reproducibility analysis showed that hfPWV and cfPWV measurements had lower coefficient of variation than others. The stiffness of different arterial regions is not equally affected by RA. The stiffening of aorta is more preferentially associated with RA than that of the peripheral arteries in extremities. The discrepant stiffening between aorta and peripheral arteries may provide a new insight into the pathogenesis of cardiovascular and microvascular dysfunction frequently occurred in RA.

Nur mit Berechtigung zugänglich

Prasad M, Hermann J, Gabriel SE, Weyand CM, Mulvagh S, Mankad R, Oh JK, Matteson EL, Lerman A (2015) Cardiorheumatology: cardiac involvement in systemic rheumatic disease. Nat Rev Cardiol 12(3):168–176. https://doi.org/10.1038/nrcardio.2014.206 CrossRefPubMed

Fent GJ, Greenwood JP, Plein S, Buch MH (2016) The role of non-invasive cardiovascular imaging in the assessment of cardiovascular risk in rheumatoid arthritis: where we are and where we need to be. Ann Rheum Dis 0(0):1–7. https://doi.org/10.1136/annrheumdis-2016-209744 CrossRef

van den Oever IAM, Heslinga M, Griep EN, Griep-Wentink HRM, Schotsman R, Cambach W, Dijkmans BAC, Smulders YM, Lems WF, Boers M, Voskuyl AE, Peters MJL, van Schaardenburg D, Nurmohamed MT (2017) Cardiovascular risk management in rheumatoid arthritis patients still suboptimal: the implementation of cardiovascular risk management in rheumatoid arthritis project. Rheumatology (Oxford) 56(9):1472–1478. https://doi.org/10.1093/rheumatology/kew497 CrossRef

Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH (2011) Aortic stiffness: current understanding and future directions. J Am Coll Cardiol 57(14):1511–1522. https://doi.org/10.1016/j.jacc.2010.12.017 CrossRefPubMed

Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H, European Network for Non-invasive Investigation of Large A (2006) Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 27(21):2588–2605. https://doi.org/10.1093/eurheartj/ehl254 CrossRefPubMed

Vlachopoulos C, Aznaouridis K, Stefanadis C (2010) Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 55(13):1318–1327. https://doi.org/10.1016/j.jacc.2009.10.061 CrossRefPubMed

Maki-Petaja KM, Hall FC, Booth AD, Wallace SM, Yasmin Bearcroft PW, Harish S, Furlong A, McEniery CM, Brown J, Wilkinson IB (2006) Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation 114(11):1185–1192. https://doi.org/10.1161/CIRCULATIONAHA.105.601641 CrossRefPubMed

Kocabay G, Hasdemir H, Yildiz M (2012) Evaluation of pulse wave velocity in systemic lupus erythematosus, rheumatoid arthritis and Behcet’s disease. J Cardiol 59(1):72–77. https://doi.org/10.1016/j.jjcc.2011.09.004 CrossRefPubMed

Provan SA, Semb AG, Hisdal J, Stranden E, Agewall S, Dagfinrud H, Angel K, Atar D, Kvien TK (2011) Remission is the goal for cardiovascular risk management in patients with rheumatoid arthritis: a cross-sectional comparative study. Ann Rheum Dis 70(5):812–817. https://doi.org/10.1136/ard.2010.141523 CrossRefPubMed

10.

Inaba M, Tanaka K, Goto H, Sakai S, Yamada S, Naka H, Imanishi Y, Nishizawa Y (2007) Independent association of increased trunk fat with increased arterial stiffening in postmenopausal patients with rheumatoid arthritis. J Rheumatol 34(2):290–295PubMed

11.

Fan F, Galvin A, Fang L, White DA, Moore XL, Sparrow M, Cicuttini F, Dart AM (2014) Comparison of inflammation, arterial stiffness and traditional cardiovascular risk factors between rheumatoid arthritis and inflammatory bowel disease. J Inflamm (Lond) 11(1):29. https://doi.org/10.1186/s12950-014-0029-0 CrossRef

12.

del Rincon I, Haas RW, Pogosian S, Escalante A (2005) Lower limb arterial incompressibility and obstruction in rheumatoid arthritis. Ann Rheum Dis 64(3):425–432. https://doi.org/10.1136/ard.2003.018671 CrossRefPubMed

13.

Ambrosino P, Tasso M, Lupoli R, Di Minno A, Baldassarre D, Tremoli E, Di Minno MN (2015) Non-invasive assessment of arterial stiffness in patients with rheumatoid arthritis: a systematic review and meta-analysis of literature studies. Ann Med 47(6):457–467. https://doi.org/10.3109/07853890.2015.1068950 CrossRefPubMed

14.

Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Menard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovsky J, Wolfe F, Hawker G (2010) 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 69(9):1580–1588. https://doi.org/10.1136/ard.2010.138461 CrossRefPubMed

15.

Styczynski G, Rdzanek A, Pietrasik A, Kochman J, Huczek Z, Sobieraj P, Gaciong Z, Szmigielski C (2016) Echocardiographic assessment of aortic pulse-wave velocity: validation against invasive pressure measurements. J Am Soc Echocardiogr 29(11):1109–1116. https://doi.org/10.1016/j.echo.2016.07.013 CrossRefPubMed

16.

Yang Y, Wang Z, Yuan LJ, Cao TS, Liu J, Ren R, Duan YY (2017) Aortic stiffness evaluated by echocardiography in female patients with Takayasu’s arteritis. Clin Exp Rheumatol 35(1 Suppl 103):134–138 (PMID: 28466805) PubMed

17.

Hermeling E, Reesink KD, Reneman RS, Hoeks AP (2007) Measurement of local pulse wave velocity: effects of signal processing on precision. Ultrasound Med Biol 33(5):774–781. https://doi.org/10.1016/j.ultrasmedbio.2006.11.018 CrossRefPubMed

18.

Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, Filipovsky J, Huybrechts S, Mattace-Raso FU, Protogerou AD, Schillaci G, Segers P, Vermeersch S, Weber T, Artery S, European Society of Hypertension Working Group on Vascular S, Function, European Network for Noninvasive Investigation of Large A (2012) Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 30(3):445–448. https://doi.org/10.1097/hjh.0b013e32834fa8b0 CrossRefPubMed

19.

Triantafyllias K, De Blasi M, Hoffmann I, Thomaidis T, Drees P, Schwarting A (2016) The count of tender rather than swollen joints correlates with aortic stiffness in patients with rheumatoid arthritis. Springerplus 5:428. https://doi.org/10.1186/s40064-016-2066-z CrossRefPubMedPubMedCentral

20.

Botta E, Merono T, Saucedo C, Martin M, Tetzlaff W, Sorroche P, Boero L, Malah V, Menafra M, Gomez Rosso L, Chapman JM, Kontush A, Soriano E, Brites F (2016) Associations between disease activity, markers of HDL functionality and arterial stiffness in patients with rheumatoid arthritis. Atherosclerosis 251:438–444. https://doi.org/10.1016/j.atherosclerosis.2016.06.009 CrossRefPubMed

21.

Holmes MV, Jiang B, McNeill K, Wong M, Oakley SP, Kirkham B, Chowienczyk PJ (2010) Paradoxical association of C-reactive protein with endothelial function in rheumatoid arthritis. PLoS One 5(4):e10242. https://doi.org/10.1371/journal.pone.0010242 CrossRefPubMedPubMedCentral

22.

Anyfanti P, Triantafyllou A, Gkaliagkousi E, Koletsos N, Aslanidis S, Douma S (2018) Association of non-invasive hemodynamics with arterial stiffness in rheumatoid arthritis. Scand Cardiovasc J 52(4):171–176. https://doi.org/10.1080/14017431.2018.1453943 CrossRefPubMed

23.

Turkyilmaz AK, Devrimsel G, Kirbas A, Cicek Y, Karkucak M, Capkin E, Gokmen F (2013) Relationship between pulse wave velocity and serum Ykl-40 level in patients with early rheumatoid arthritis. Ann Rheum Dis 72:835–836

24.

Pieringer H, Stuby U, Pohanka E, Biesenbach G (2010) Arterial stiffness in a muscular artery in women with longstanding rheumatoid arthritis compared with healthy controls and patients with traditional cardiovascular risk factors. Rheumatol Int 30(10):1335–1339. https://doi.org/10.1007/s00296-009-1155-5 CrossRefPubMed

25.

Cypiene A, Dadoniene J, Rugiene R, Ryliskyte L, Kovaite M, Petrulioniene Z, Venalis A, Laucevicius A (2010) The influence of mean blood pressure on arterial stiffening and endothelial dysfunction in women with rheumatoid arthritis and systemic lupus erythematosus. Medicina (Kaunas) 46(8):522–530. https://doi.org/10.3390/medicina46080075 CrossRef

26.

Li P, Han CX, Ma CL, Guo JL, Liu B, Du J, Bi LQ (2013) Determinants of brachial–ankle pulse wave velocity in Chinese patients with rheumatoid arthritis. Clin Dev Immunol 2013:342869. https://doi.org/10.1155/2013/342869 CrossRefPubMedPubMedCentral

27.

Turesson C, Jacobsson L, Ryden Ahlgren A, Sturfelt G, Wollmer P, Lanne T (2005) Increased stiffness of the abdominal aorta in women with rheumatoid arthritis. Rheumatology (Oxford) 44(7):896–901. https://doi.org/10.1093/rheumatology/keh607 CrossRef

28.

Nichols WORM, Vlachopoulos C (2011) McDonald’s blood flow in arteries: theoretical, experimental and clinical principles, 6th edn. CRC Press, Boca Raton

29.

Safar ME, Asmar R, Benetos A, Blacher J, Boutouyrie P, Lacolley P, Laurent S, London G, Pannier B, Protogerou A, Regnault V, Arterial FSG (2018) Interaction between hypertension and arterial stiffness: an expert reappraisal. Hypertension 72(4):796–805. https://doi.org/10.1161/Hypertensionaha.118.11212 CrossRefPubMed

30.

Hollan I, Meroni PL, Ahearn JM, Cohen Tervaert JW, Curran S, Goodyear CS, Hestad KA, Kahaleh B, Riggio M, Shields K, Wasko MC (2013) Cardiovascular disease in autoimmune rheumatic diseases. Autoimmun Rev 12(10):1004–1015. https://doi.org/10.1016/j.autrev.2013.03.013 CrossRefPubMed

31.

Faccini A, Kaski JC, Camici PG (2016) Coronary microvascular dysfunction in chronic inflammatory rheumatoid diseases. Eur Heart J 37(23):1799–1806. https://doi.org/10.1093/eurheartj/ehw018 CrossRefPubMed

32.

Amigues I, Russo C, Giles JT, Tugcu A, Weinberg R, Bokhari S, Bathon JM (2019) Myocardial microvascular dysfunction in rheumatoid arthritis quantitation by (13)N-ammonia positron emission tomography/computed tomography. Circ Cardiovasc Imaging 12(1):e007495. https://doi.org/10.1161/CIRCIMAGING.117.007495 CrossRefPubMed

33.

Bordy R, Totoson P, Prati C, Marie C, Wendling D, Demougeot C (2018) Microvascular endothelial dysfunction in rheumatoid arthritis. Nat Rev Rheumatol 14(7):404–420. https://doi.org/10.1038/s41584-018-0022-8 CrossRefPubMed

34.

Gerli R, Sherer Y, Bocci EB, Vaudo G, Moscatelli S, Shoenfeld Y (2007) Precocious atherosclerosis in rheumatoid arthritis: role of traditional and disease-related cardiovascular risk factors. Ann N Y Acad Sci 1108:372–381CrossRef

35.

Soltesz P, Der H, Kerekes G, Szodoray P, Szucs G, Danko K, Shoenfeld Y, Szegedi G, Szekanecz Z (2009) A comparative study of arterial stiffness, flow-mediated vasodilation of the brachial artery, and the thickness of the carotid artery intima-media in patients with systemic autoimmune diseases. Clin Rheumatol 28(6):655–662. https://doi.org/10.1007/s10067-009-1118-y CrossRefPubMed

36.

Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, Boutouyrie P, Cameron J, Chen CH, Cruickshank JK, Hwang SJ, Lakatta EG, Laurent S, Maldonado J, Mitchell GF, Najjar SS, Newman AB, Ohishi M, Pannier B, Pereira T, Vasan RS, Shokawa T, Sutton-Tyrell K, Verbeke F, Wang KL, Webb DJ, Willum Hansen T, Zoungas S, McEniery CM, Cockcroft JR, Wilkinson IB (2014) Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 63(7):636–646. https://doi.org/10.1016/j.jacc.2013.09.063 CrossRefPubMed

37.

Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37(5):1236–1241CrossRef

38.

Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM (2001) Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 103(7):987–992. https://doi.org/10.1161/01.cir.103.7.987 CrossRefPubMed

39.

Wang KL, Cheng HM, Sung SH, Chuang SY, Li CH, Spurgeon HA, Ting CT, Najjar SS, Lakatta EG, Yin FC, Chou P, Chen CH (2010) Wave reflection and arterial stiffness in the prediction of 15-year all-cause and cardiovascular mortalities: a community-based study. Hypertension 55(3):799–805. https://doi.org/10.1161/HYPERTENSIONAHA.109.139964 CrossRefPubMedPubMedCentral

40.

Balta S, Demir M, Kucuk U, Ozturk C, Yildirim AO, Celik T (2016) Arterial stiffness: good predictor for hypertensive patients. J Clin Hypertens (Greenwich) 18(6):596. https://doi.org/10.1111/jch.12740 CrossRef

41.

Zhang X, Low S, Sum CF, Tavintharan S, Yeoh LY, Liu J, Li N, Ang K, Lee SB, Tang WE, Lim SC (2017) Arterial stiffness is an independent predictor for albuminuria progression among Asians with type 2 diabetes—a prospective cohort study. J Diabetes Complicat 31(6):933–938. https://doi.org/10.1016/j.jdiacomp.2017.02.004 CrossRefPubMed

42.

Fountoulakis N, Thakrar C, Patel K, Viberti G, Gnudi L, Karalliedde J (2017) Increased arterial stiffness is an independent predictor of renal function decline in patients with type 2 diabetes mellitus younger than 60 years. J Am Heart Assoc. https://doi.org/10.1161/jaha.116.004934 CrossRefPubMedPubMedCentral

43.

Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, Jeppesen J (2006) Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 113(5):664–670. https://doi.org/10.1161/CIRCULATIONAHA.105.579342 CrossRefPubMed

44.

Szekanecz Z, Kerekes G, Soltesz P (2009) Vascular effects of biologic agents in RA and spondyloarthropathies. Nat Rev Rheumatol 5(12):677–684. https://doi.org/10.1038/nrrheum.2009.219 CrossRefPubMed

45.

Kerekes G, Soltesz P, Der H, Veres K, Szabo Z, Vegvari A, Shoenfeld Y, Szekanecz Z (2009) Effects of biologics on vascular function and atherosclerosis associated with rheumatoid arthritis. Ann N Y Acad Sci 1173:814–821. https://doi.org/10.1111/j.1749-6632.2009.04645.x CrossRefPubMed

46.

Kerekes G, Soltesz P, Szucs G, Szamosi S, Der H, Szabo Z, Csathy L, Vancsa A, Szodoray P, Szegedi G, Szekanecz Z (2011) Effects of adalimumab treatment on vascular disease associated with early rheumatoid arthritis. Isr Med Assoc J 13(3):147–152 PMID: 21608334 PubMed

47.

Ikdahl E, Rollefstad S, Wibetoe G, Olsen IC, Berg IJ, Hisdal J, Uhlig T, Haugeberg G, Kvien TK, Provan SA, Semb AG (2016) Predictive value of arterial stiffness and subclinical carotid atherosclerosis for cardiovascular disease in patients with rheumatoid arthritis. J Rheumatol 43(9):1622–1630. https://doi.org/10.3899/jrheum.160053 CrossRefPubMed

48.

Maki-Petaja KM, Booth AD, Hall FC, Wallace SM, Brown J, McEniery CM, Wilkinson IB (2007) Ezetimibe and simvastatin reduce inflammation, disease activity, and aortic stiffness and improve endothelial function in rheumatoid arthritis. J Am Coll Cardiol 50(9):852–858. https://doi.org/10.1016/j.jacc.2007.04.076 CrossRefPubMed

49.

Kume K, Amano K, Yamada S, Hatta K, Ohta H, Kuwaba N (2011) Tocilizumab monotherapy reduces arterial stiffness as effectively as etanercept or adalimumab monotherapy in rheumatoid arthritis: an open-label randomized controlled trial. J Rheumatol 38(10):2169–2171. https://doi.org/10.3899/jrheum.110340 CrossRefPubMed

50.

Cypiene A, Laucevicius A, Venalis A, Ryliskyte L, Dadoniene J, Petrulioniene Z, Kovaite M, Laskova V, Gintautas J (2007) Non-invasive assessment of arterial stiffness indices by applanation tonometry and pulse wave analysis in patients with rheumatoid arthritis treated with TNF-alpha blocker remicade (infliximab). Proc West Pharmacol Soc 50:119–122PubMed

51.

Simon A, Chironi G, Levenson J (2007) Comparative performance of subclinical atherosclerosis tests in predicting coronary heart disease in asymptomatic individuals. Eur Heart J 28(24):2967–2971. https://doi.org/10.1093/eurheartj/ehm487 CrossRefPubMed

52.

Inaba Y, Chen JA, Bergmann SR (2010) Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis. Int J Cardiovasc Imaging 26(6):631–640. https://doi.org/10.1007/s10554-010-9616-1 CrossRefPubMed

53.

Charakida M, Masi S, Luscher TF, Kastelein JJ, Deanfield JE (2010) Assessment of atherosclerosis: the role of flow-mediated dilatation. Eur Heart J 31(23):2854–2861. https://doi.org/10.1093/eurheartj/ehq340 CrossRefPubMed

54.

Yeboah J, Crouse JR, Hsu FC, Burke GL, Herrington DM (2007) Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: the cardiovascular health study. Circulation 115(18):2390–2397. https://doi.org/10.1161/CIRCULATIONAHA.106.678276 CrossRefPubMed

55.

Kerekes G, Soltesz P, Nurmohamed MT, Gonzalez-Gay MA, Turiel M, Vegh E, Shoenfeld Y, McInnes I, Szekanecz Z (2012) Validated methods for assessment of subclinical atherosclerosis in rheumatology. Nat Rev Rheumatol 8(4):224–234. https://doi.org/10.1038/nrrheum.2012.16 CrossRefPubMed

56.

Crowson CS, Matteson EL, Roger VL, Therneau TM, Gabriel SE (2012) Usefulness of risk scores to estimate the risk of cardiovascular disease in patients with rheumatoid arthritis. Am J Cardiol 110(3):420–424. https://doi.org/10.1016/j.amjcard.2012.03.044 CrossRefPubMedPubMedCentral

57.

Mankad R (2015) Atherosclerotic vascular disease in the autoimmune rheumatologic patient. Curr Atheroscler Rep 17(4):497. https://doi.org/10.1007/s11883-015-0497-6 CrossRefPubMed

58.

Van Bortel LM (2006) Is arterial stiffness ready for daily clinical practice? J Hypertens 24(2):281–283. https://doi.org/10.1097/01.hjh.0000199805.03058.78 CrossRefPubMed

Titel: Stiffening of aorta is more preferentially associated with rheumatoid arthritis than peripheral arteries
verfasst von: Yong Yang
Zhen Wang
Zihao Fu
Runrun Yang
Jia Wang
Lijun Yuan
Feng Gao
Yunyou Duan
Publikationsdatum: 02.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Rheumatology International / Ausgabe 10/2019
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-019-04405-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2019

Incidence of cancer in a cohort of patients with primary Sjögren syndrome in Argentina

Prevalence of other connective tissue diseases in idiopathic inflammatory myopathies

Kawasaki disease and immunodeficiencies in children: case reports and literature review

Clinical characteristics and prognosis of polymyositis and dermatomyositis associated with malignancy: a 25-year retrospective study

Gait as predictor of physical function in axial spondyloarthritis: the prospective longitudinal FOLOMI (Function, Locomotion, Measurement, Inflammation) study protocol