2014年07月08日

Gordons Chemists Launch a new Cardiovascular Screening Clinic
23 May 2014 12:19:30

CardioHealth NI – Give your arteries an MOT!

Gordons Chemists are pleased to offer a new cardiovascular screening clinic.
Statistics indicate that around 60% of the time in heart attack cases, a standard cholesterol or blood pressure test won’t have revealed anything out of the ordinary. Guidelines (published in 2007) from the European Society of Hypertension recommend measuring arterial stiffness in patients with arterial hypertension (high blood pressure).
Gordons Chemists are pleased to offer across Northern Ireland a cardiovascular screening clinic, using a state-of-the-art arteriograph. CardioHealth NI is the first and only company in Northern Ireland that uses an arteriograph; a session with CardioHealth NI at one of our cardiovascular screening clinics is priced at only £50.
A cardiovascular screening using an arteriograph reveals much more than a typical blood pressure or cholesterol test will. By offering this cardiovascular screening clinic, we allow the patient to have a better understanding of the health of their arteries. As such they can make the decision to take control of their cardiovascular health – hopefully reducing the incidence or severity of heart attack, stroke or high blood pressure.
In addition to identifying underlying health problems, the screening includes recommendations on diet and natural health solutions. A detailed report allows the patient to consult with their GP or medical professional in order to seek further advice and treatment, based on the findings of the screening.
The cardiovascular screening clinic is suitable for anyone aged 16 years and over, or anyone with a family history of heart disease, kidney disease or diabetes. It’s also suitable for anyone who drinks alcohol or smokes, is overweight, or participates in (or is returning to) a sport.

About the Arteriograph
An arteriograph is a sophisticated instrument used for detecting changes to the artery walls. The arteriograph uses a cuff that contains special pressure sensors.
These pressure sensors are designed to detect the Pulse Wave (pressure wave) that leaves the heart as it contracts. When the pulse wave reaches the end of the arterial system, it is then reflected back towards the heart. Three key measurements are taken from this pulse wave.
An arteriograph reveals damage to the heart and arteries that a standard blood pressure or cholesterol test will not. It measures parameters that indicate if the patient might at risk of heart attack or stroke, including:
Central Systolic Blood Pressure
This in effect measures blood pressure, at the heart. Studies indicate that this is of greater value than measuring blood pressure on the arm.
Brachial Augmentation
This reveals early damage to, and clogging up of, your smaller arteries. When arterial clogging begins, it occurs firstly in the small arteries of the hands and feet. This can be measured and it indicates the degree of clogging and the damage to the inner lining of your smaller arteries.
Pulse Wave Velocity
The speed of the pressure wave described above is measured over a given distance. An increased speed indicates a clogging of the arteries. There is a direct correlation between this, and an increased risk of heart attack/stroke. The reading is often found to be abnormal in patients with kidney disease, diabetes, sufferers of rheumatoid arthritis, and smokers.
The Arteriograph is a new, easy-to-use, and time-effective method for assessing arterial stiffness. Prior to the arteriograph, there were (and still are) two invasive methods used within a hospital setting: the tonometric and piezo-electronic systems (SphygmoCor and Complior).
An arteriograph is not intended as a replacement for these. Instead, the device is intended for use as a quick, affordable and non-invasive means of diagnosing an underlying condition that the patient may not be aware of. Clinical trials (see below for details) reveal that an arteriograph gives accurate results (which are comparable to the two systems mentioned).
The main advantage of using an arteriograph is that it offers a quick and affordable assessment, using only the upper arm.
Other methods involve a detailed examination and take time to complete. Typically, these (due to the time and expense involved in completing a screening) aren’t readily available at the request of a patient.
CardioHealth NI’s cardiovascular screening clinics offer the patient the opportunity to have a detailed and accurate assessment of their cardiovascular system completed – at a relatively low price, in a location close to them, in just half an hour.
Upcoming clinic detail can be obtained by emailing: info@gordonsdirect.com

Clinical Evidence
Publications on the validation of the Arteriograph device:
• Baulmann, J. et al.
• "A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods"
• J Hypertens 2008, 26:523-528
• http://www.arteriograph.hu/downloads/pdf/Baulmann%20validation-J-Hypert%2708March-Cover.pdf

• Jatoi, N.A., et al.
• “Assessment of arterial stiffness in hypertension: comparison of oscillometric (Arteriograph), piezoelectronic (Complior) and tonometric (SphygmoCor) techniques”
• J Hypertens 2009, 27:2186–2191
• http://www.arteriograph.hu/downloads/pdf/Mahmud-Feely-Compl-Sphygm-Art-JHypert-Oct%2709.pdf

• Boutouyrie P, Revera M and Parati G.
• “Obtaining arterial stiffness indices from simple arm cuff measurements: the holy grail?”
• J Hypertension 2009; 27:2159-2161
• http://www.arteriograph.hu/downloads/pdf/Boutouyrie-Editorial-JHypert-Oct%2709.pdf

• Rajzer MW, Wojciechowska W, Klocek M, Palka I, Brzozowska-Kiszka M, Kawecka-Jaszcz K.
• “Comparison of aortic pulse wave velocity measured by three techniques: Complior, SphygmoCor and Arteriograph.”
• J Hypertens 2008; 26:2001-7
• http://www.arteriograph.hu/downloads/pdf/Marek%20Rajzer%20comp%20study%20with%20ARG.pdf

• Horvath, G.I. et al
• “Invasive validation of a new oscillometric device (Arteriograph) for measuring augmentation index, central blood pressure and aortic pulse wave velocity”
• J Hypertens 2010, 28:2068–2075
• http://www.arteriograph.hu/downloads/pdf/Invasive%20validation%20JoH%202010%2028.pdf

• Parati G, Buyzere de M
• “Evaluating aortic stiffness through an arm cuff oscillometric device: is validation against invasive measurements enough?"
• Journal of Hypertension 2010, 28:2003–2006
• http://www.arteriograph.hu/downloads/pdf/Parati%20Editorial%20Comment%20on%20invasive%20validation.pdf





ozpalm at 18:43 

2014年06月05日




































ozpalm at 04:54 
Labtech 心電図

個々の方の心電図を一生管理

心臓疾患患者のあらゆる心電図を管理

院外心電図、クリニック心電図、病院心電図、治療前、治療後、自宅、再入院、旅行中、















ozpalm at 04:51 
Arteriograph
































ozpalm at 04:38 




ozpalm at 04:35 






ozpalm at 04:34 
Labtech video

NetECG


Holter


PC based ECG



ozpalm at 04:33 

2014年06月02日



ozpalm at 14:07 
4. Laboratory investigations (WP4): fasting plasma glucose, lipids, serum creatinine, serum
liver enzymes, biomarkers (for inflammation, copeptin, etc., see Table 1), urinary spot sample
for microalbuminuria and albumin/creatinine ratio. In addition, faeces samples will be
obtained for determination of secreted factors as well as a genetic screening for evaluation of
the gut bacterial content and composition (microbiota). A biobank will be established in
technical collaboration between Lund University and other partners (Region Skane,
BBMRI.se). Assessment of leukocyte types and activation in whole blood will be performed
in representative subsets of subjects.
5. Metabolic investigation (WP5): including fasting blood sampling for plasma glucose and
serum lipids (total cholesterol: C, HDL-C, LDL-C and triglycerides, LpLA2, Lp(a), etc.), and
an oral glucose tolerance test (OGTT; 75 g glucose), with measurements at 0,30,(60) and 120
min of plasma glucose, incretins (GLP-1, GIP), insulin, C-peptide and glucagon.
6. Technical investigations (WP6): arterial stiffness (Sphygmocor R assessment of pulse wave
velocity, augmentation index, central blood pressure), arteria carotis morphology and
function (Sekoya R ultrasound device), 24-h ambulatory blood pressure recordings, and
central aortic pressure (24-h Arteriograph R Central BP). We will perform screening
spirometry and evaluation of endothelial function (by EndoPat R).Measurement of Advanced
Glycation End Products (AGE) will be conducted transdermally by use of an AGE-ReaderR.
In addition, other investigations are optional and depending on funding, such as brain
magnetic resonance imaging (MRI) as well as echocardiography, and retinal artery imaging


ozpalm at 13:59 
Diurnal variation in blood pressure and arterial stiffness in CKD – the role of endothelin-1
Neeraj Dhaun, Rebecca Moorhouse, Iain M MacIntyre, Vanessa Melville,
Robert A Kimmitt, Kayleigh E Brown, Euan Kennedy, Jane Goddard, David J Webb
BHF Centre of Research Excellence, University of Edinburgh

Introduction
Hypertension and arterial stiffness are important independent cardiovascular risk factors in CKD to which endothelin-1 (ET-1) contributes. Whereas loss of nocturnal blood pressure (BP) dipping in CKD is associated with disease progression there are no data on diurnal variations in arterial stiffness. We examined the diurnal variation of BP, arterial stiffness and the ET system in CKD and the effects on these of ETA receptor antagonism.

Methods
First, in a case-control study we compared 24h ambulatory BP and arterial stiffness using the TensioMed™ Arteriograph 24 ambulatory arterial stiffness monitor in 16 patients with CKD and 15 matched controls. Second, in an observational study we examined the diurnal variation in plasma and urinary ET-1 (midday and midnight) in 15 patients with CKD. Third, in a randomised double-blind, 3-way crossover study in 27 patients with CKD, we examined the effects of 6 weeks’ treatment with placebo, sitaxentan (an ETA receptor antagonist), and nifedipine on the diurnal variation of BP assessed at baseline and week 6 of each study period. This was in addition to the primary endpoints of proteinuria, BP and arterial stiffness.

Results
There were nocturnal dips in systolic and diastolic BP (SBP, DBP) and pulse wave velocity (PWV), our measure of arterial stiffness, in 15 controls (SBP -3.2 ± 4.8%, p < 0.05; DBP -6.4 ± 6.2%, p = 0.001; PWV -5.8 ± 5.2%, p < 0.01), but not in 16 CKD patients. In 15 CKD patients, plasma ET-1 increased from 4.8 ± 1.5 at midday to 5.1 ± 1.5pg/ml at midnight (p < 0.01). Urinary ET-1 did not change. 6 weeks’ treatment with placebo and nifedipine did not affect nocturnal dips in SBP or DBP between baseline and week 6 whereas dipping was increased following 6 weeks’ sitaxentan treatment (baseline vs. week 6, SBP: -7.0 ± 6.2 vs. -11.0 ± 7.8mmHg, p < 0.05; DBP: -6.0 ± 3.6 vs. -8.3 ± 5.1mmHg, p < 0.05). There was no nocturnal dip in pulse pressure at baseline in the 3 phases of the study, whereas sitaxentan was linked to the development of a nocturnal dip in pulse pressure.

Conclusion
In CKD, activation of the ET system appears to contribute not only to raised BP, but also the loss of BP dipping. The clinical significance of these findings should be explored in future clinical trials.



ozpalm at 13:58 
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