Description of Medical Condition A sensation of functionally impairing muscle fatigue, cramps and/or pain of the lower extremities brought on by exertion and relieved with rest. Less than 10% of patients with known lower extremity atherosclerosis develop claudication. Approximately 90% of all patients with claudication are cigarette smokers. System(s) affected: Cardiovascular, Musculoskeletal Genetics: Geni loci unidentified Incidence/Prevalence in USA: • Biennial incidence (Framingham study): 0.07% in men aged 35-44 …
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Fast dose titration leads to controlled blood pressure. Rapid dose titration is said to lower blood pressure better than using the traditional method of adjusting dosage over several months. The dosage adjustment is made at a hypertension clinic where the patient is seen for 3–4 days. Home BP measurement is an important part of the treatment plan.
[ Continue Reading... ]Application of Project ImPACT in the Pharmacy Time Management: Many community pharmacists are now saying: “Sounds wonderful, but who has the time?” Not surprisingly, two critical, time-saving components in this study of care in the pharmacy were scheduling patient appointments and staffing. The average time spent with patients on their initial visit was 45 minutes (range 30–60 minutes), and that on follow-up visits was 22 minutes (range 10–30 minutes). No doubt pharmacists found ways to streamline these visits as they gained experience. Furthermore, these visits were often arranged by appointment, during mid-afternoons, early evenings and other slow times in the pharmacy. Additionally, pharmacists learned to organize the time they had available …
[ Continue Reading... ]Project ImPACT: Hyperlipidemia Project ImPACT: Hyperlipidemia is a recently completed community pharmacy-based demonstration project. ImPACT is an acronym for Improve Persistence And Compliance with Therapy. The study began in March 1996 and concluded October 1999. There were four core objectives: 1) improve patient persistence and compliance with lipid-lowering therapy; 2) increase communication and the flow of clinical information among patients, pharmacists, and physicians; 3) improve the cholesterol levels of individual patients over time; and 4) increase the population of patients who reach and maintain their NCEP lipid goals. A total of 26 pharmacy practice sites in 12 states participated in the study. These sites were chosen based on criteria that addressed …
[ Continue Reading... ]There was a time when heart disease was considered a “man’s disease.” However, we now know that women are just as likely to be afflicted, especially after reaching the age of menopause. Coronary artery disease (CAD) is the number one killer of American women and men. Another way to interpret this startling statistic is that about every 29 seconds an American will suffer a coronary event, and about every minute someone will die from one. CAD is also the leading cause of premature, permanent disability in the United States labor force. The direct and indirect cost of coronary artery disease for the year 2000 was estimated at $118 billion. Risk Factors …
[ Continue Reading... ]Patient Counseling Pharmacists can take on a variety of roles in the management of lipid disorders. Several reports have described pharmacists’ involvement in the management of dyslipidemias. Particularly in the community setting, pharmacists are uniquely positioned to assist with screening, managing, and educating patients with lipid disorders. Typically, pharmacists’ activities include interviewing patients to assess medical histories, ascertaining risk factors and other pertinent information, assessing lipid profiles, tressing the treatment, and providing patient education and follow-up. Hypertension and Diabetes Risk Factors in the African American Population The high prevalence of hypertension and diabetes in African Americans increases their risk for CHD. The presence of cholesterol abnormalities (i.e., increased LDL, triglycerides, and …
[ Continue Reading... ]Heart disease is the leading cause of death among adults in the United States. Specifically, coronary heart disease (CHD) is the single largest killer of American males and females. Seven million Americans suffer from CHD, and about a half million people die each year from heart attacks caused by CHD. One out of two men, and one out of three women will develop heart disease sometime in their life. CHD is also the leading cause of death among African Americans, affecting this population disproportionately when compared to whites. In 1996 CHD death rates were 120.2 per 100,000 for white males, 125.4 for black males, 58.9 for white females, and 80.0 for …
[ Continue Reading... ]Suspicious? Resentful? Cynical? If those three words describe your personality, you may have more of a problem than just the lack of friends. Researchers at Arizona State University in Tempe have proven that people with hostile dispositions also have greater increases in diastolic blood pressure (the second number in a blood pressure reading). A higher diastolic pressure means that the vessels in the body are under increased pressure even when the heart is between beats, a situation than can contribute to heart disease and stroke. At the beginning of the study, the researchers designated 80 males and females as either high or low in hostility after taking a test measuring their …
[ Continue Reading... ]Systolic blood pressure should be considered “the major criterion for diagnosis, staging, and therapeutic management of hypertension, especially in middle-aged and older Americans”, according to a clinical advisory issued by Coordinating Committee of the National High Blood Pressure Education Program (NHBPEP). “We’ve been focusing on diastolic through the years, but we now know that systolic blood pressure is a better predictor of future cardiovascular events such as heart attacks, strokes, and heart failure, and that treating it reduces those risks,” says Dr. Edward Roccella, NHBPEP coordinator. “As people age, there’s a tendency for systolic blood pressure to rise, while diastolic pressure declines [after age 55]“, he explains. This is related to …
[ Continue Reading... ]Researchers may have discovered one of the secrets of the Mediterranean diet: olive oil! The scientific community agrees that olive oil, high in monounsaturated fatty acids (MUFA) and antioxidants, helps reduce levels of total and LDL cholesterol thereby reducing risk of cardiovascular disease. And a new study shows that a diet high in MUFA from olive oil can also help reduce blood pressure levels. Diet and blood pressure Researchers have known for some time that the characteristics of a Mediterranean-type diet are important in controlling blood pressure levels. These characteristics include: – high fiber intake, – high …
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