Cardiology

Lege Artis Medicinae

FEBRUARY 20, 2024

[Reno- and cardioprotective effects of sodium-glucose cotransporter 2 inhibitors beyond treating diabetes mellitus ]

AMBRUS Csaba, BENCZÚR Béla

[SGLT2-inhibitors, originally used as anti­dia­­betics, improved unexpectedly the outcome of cardiac diseases (mainly heart failure) and nearly halved the risk of renal events of diabetic patients. More recently, administering these drugs decreased significantly the morbidity and mortality in primary renal endpoint studies and among patients with heart failure – in diabetic and non-diabetic patients respectively. Con­cer­ning these recent outcomes and according to international and domestic guidelines, SGLT-2 inhibitors are considered as first line medications in both chronic kidney dis­ease and the whole spectrum of chronic heart failure, and they should be initiated as early as possible in these conditions. Since the beginning of 2024, these drugs which changed significantly the outcome of these diseases can be prescribed with greater support of Hungarian public financing not only for type 2 diabetic patients but non-diabetics too with chronic kidney diseases and heart failure with reduced ejection fraction. ]

HUN 2024;34(1-2)

Lege Artis Medicinae

FEBRUARY 20, 2024

[The place of rosuvastatin/acetylsalicylic acid fixed combination in the daily practice ]

SIMONYI Gábor

[In Hungary, cardiovascular diseases are the leading cause of death; however, they have also a large share among preventable and treatable conditions. Statins and acetylsalicylic acid (ASA) play a prominent role in the secondary prevention of cardiovascular diseases. Their areas of application are wide, but at the same time, they are recommended for secondary prevention of many common cardiovascular diseases. Among acetylsalicylic acid and statin combinations, the ASA/rosuvastatin combination – if compared to other statins – reduced most significantly the risk of cardiovascular diseases. Other studies have highlighted the benefits of fixed drug combinations in cardiovascular risk reduction.
A new domestic fixed combination, containing that of ASA/rosuvastatin can claim a prominent position in the secondary prevention of cardiovascular diseases.]

HUN 2024;34(1-2)

Hypertension and nephrology

DECEMBER 18, 2023

[Chronic kidney disease and obesity]

FREISINGER Lilla, NÉMETHY Orsolya, LELOVICS Zsuzsanna, SZLOVÁK Edina, DOLGOS Szilveszter

[Nowadays, the epidemic spread of obesity is mainly linked to changing environmental factors and is a serious public health problem. Obesity alone can be associated with increased mortality, but obesity is also an independent risk factor for several chronic diseases such as diabetes, hypertension and chronic kidney disease which have a major public health burden.]

HUN 2023;27(06)

Hypertension and nephrology

DECEMBER 18, 2023

[Elderly, obes and stressed hypertension patients]

SIMONYI Gábor

[Increased sympathetic nervous system activity can be found in all forms of hypertension, but the degree of this may differ depending on the individual accompanying diseases.]

HUN 2023;27(06)

Hypertension and nephrology

DECEMBER 18, 2023

[Methodology and clinical relevance of measuring blood pressure variability based on the consensus paper of the European Society of Hypertension]

JÁRAI Zoltán

[Blood pressure is an ever-changing vital parameter. Its observed variability over time is blood pressure variability, which is influenced by both regulatory mechanisms within the body and environmental factors affecting the body.]

HUN 2023;27(06)

Lege Artis Medicinae

DECEMBER 19, 2023

[Hypothyroidism of the elderly – To treat or not to treat? ]

VALKUSZ Zsuzsanna

[Hypothyroidism is common in the elderly. Frequent causes of hypothyroidism include autoimmune disease of the thyroid gland, previous thyroid surgery and radioiodine therapy. Symptoms may be atypical, and the level of serum thyroid-stimulating hormone (TSH) must be measured as a part of the biochemical workup. Elevated serum TSH levels have to be confirmed with a repeated tests, which must be completed by measuring the serum thyroxine level too. The recommended and relevant replacement therapy for hypothyroidism is levothyroxine sodium administration. Le­vo­thyroxine sodium is orally only partially absorbed since it is affected by food, minerals, drugs and the composition of the tablet. The initial hormone replacement dose should be low if any heart disease is suspected. The main risk of levothyroxine sodium therapy is its over supplementation, the side effects of which may include anxiety, muscle atrophy, osteoporosis, and atrial fibrillation. Subclinical hypothyroidism with elevated serum TSH level but with a T4 level in its reference range may be considered as a mild form of hypothyroidism. Studies published so far did not prove the positive effect of substitution therapy for non-goitrous subclinical hypothyroidism, especially in elderly patients.]

HUN 2023;33(12)