Úvodník

Michal Vrablík

Vnitr Lek 2019, 65(12):739  

Hyperlipidemia management in Slovakia: observational study

Ľubomíra Fábryová, Alena Nemcová

Vnitr Lek 2019, 65(12):761-769 | DOI: 10.36290/vnl.2019.133  

Aim: A multicountry observational study was conducted to gain insight into the current management of elevated low density lipoprotein cholesterol (LDL-C) in high-risk (HR) and very high-risk (VHR) patients with hyperlipidaemia across central and eastern Europe and Israel. Here we present data from the Slovakian subpopulation. Methods: We enrolled adult patients who were receiving lipid-lowering therapy (LLT) and attending a specialist (cardiologist/diabetologist/internist) for a routine visit at 9 sites (including academic/specialist centers) across Slovakia. Data were collected retrospectively from patients' records for the 12 months...

Stanovisko výboru České společnosti pro aterosklerózu k doporučením ESC/EAS pro diagnostiku a léčbu dyslipidemií z roku 2019

Michal Vrablík, Jan Piťha, Vladimír Bláha, Renata Cífková, Tomáš Freiberger, David Karásek, Pavel Kraml, Hana Rosolová, Vladimír Soška, Tomáš Štulc, Zuzana Urbanová

Vnitr Lek 2019, 65(12):743-754 | DOI: 10.36290/vnl.2019.131  

Notes on the new "Recommendations for the treatment of dyslipidemia. Influencing of lipids to reduce cardiovascular risk"

Richard Češka

Vnitr Lek 2019, 65(12):755-760  

New guidelines on dyslipidemia (DLP) related problems appear earlier than planned. Primarily in view of the results of science and large clinical studies, but also with regard to the advent of biological therapy (PCSK9-i) in many European countries. Also, the "conventional" hypolipidemic therapy is generified and therefore cheaper, more affordable. The recommendations are based, as the preceding ones, on the principle of estimating the overall cardiovascular risk. The innovated SCORE tables are used for this, but more emphasis is placed on non-invasive diagnostics using imaging methods, be it carotid ultrasound or, in particular, non-contrast CT coronarography....

Vascular age

Ondřej Petrák, Richard Češka

Vnitr Lek 2019, 65(12):770-774 | DOI: 10.36290/vnl.2019.134  

Age can be evaluated according to many criteria. Of course the objective measure is the calendar age which may differ from the biological age. The biological age more or less correlates with the vascular age. The concept of vascular age is based on the statement that "An individual is as old as his blood vessels". The process of vascular aging already starts in childhood. Arterial aging may essentially be viewed from two standpoints. First, it involves stiffening of arteries and loss of their elasticity; second, degenerative changes and formation of atherosclerotic plaques occur, being the cause of ischemia, especially in case of the development of...

Atherosclerosis in patients with type 1 diabetes

David Karásek

Vnitr Lek 2019, 65(12):775-782 | DOI: 10.36290/vnl.2019.135  

Type 1 diabetes is often associated with the early manifestation of atherosclerosis, which represents the morphological basis for macrovascular complications of diabetics. Atherosclerosis in patients with type 1 diabetes shows certain specific features that result from different proportions of risk factors, the presence of diabetes and its complications. The paper deals with the possibilities of influencing and detecting the atherosclerotic process in these risk patients.

Hypertriglyceridemia and atherosclerosis risk

Rudolf Poledne, Jan Kovář

Vnitr Lek 2019, 65(12):783-787 | DOI: 10.36290/vnl.2019.136  

The history of studying hypertriglyceridemia as a risk factor for atherosclerosis has been going on for a half a century. The significance of this parameter as measured in fasting state is not entirely clear, since the statistical significance between triglyceride concentration and cardiovascular risk is lost after adjustment to HDL-cholesterol concentration. Remnant particles of chylomicrons and very low density lipoproteins measured postprandially appear to be responsible for the risk associated with hypertriglyceridemia. As the concentration of non-fasting triglycerides increases, the risk of myocardial infarction increases gradually up to five times.

Extermination of atherosclerosis not only in lower extremities

Jan Piťha, Věra Boháčová

Vnitr Lek 2019, 65(12):788-793 | DOI: 10.36290/vnl.2019.137  

Majority of patients with peripheral artery disease (PAD) are affected by coronary artery disease and other vascular complications, often fatal. PAD is, therefore, powerful indicator of a very high risk of death. The main risk factors are smoking and diabetes mellitus; both factors can be corrected very successfully, in theory. In most of patients suffering from PAD mixed dyslipidemia is found, which presents by moderately elevated LDL-cholesterol and triglyceride levels. However, since PAD patients are at a very high risk of cardiovascular death, even moderately elevated LDL-cholesterol levels are very dangerous and should be kept below 1.4 mmol/l....

Atherosclerosis and beta-blockade: A forgotten option?

Michal Vrablík, Eva Tůmová

Vnitr Lek 2019, 65(12):795-801 | DOI: 10.36290/vnl.2019.138  

Beta-blockers have been ranked fourth in management recommendations for arterial hypertension in the management of arterial hypertension. This "retreat" is justified by the results of studies comparing different antihypertensive strategies that documented a lesser benefit of the beta-blockers tested compared to control therapies. Obviously, even within the beta-adrenergic receptor blocking group, there are important differences between agents. Properties such as selectivity to receptors and their subtypes, hydrophilicity and resp. lipophilicity, control of blood pressure, influence of intermediate metabolism or directly influence on vascular reactivity...

Pharmacologically induced thyreopathy in patients with cardiovascular disease

Tomáš Brutvan, Jan Krátký, Jana Ježková

Vnitr Lek 2019, 65(12):802-808 | DOI: 10.36290/vnl.2019.139  

Thyroid gland function is mediated by thyreoideal hormones, in which iodine is very important structural part. High iodine intake, can initiate thyroid dysfunction. Amiodarone induced hypothyroidism is treated with levothyroxine and amiodarone taking is not interrupted. Amiodarone induced hyperthyroidism is divided into two subtypes, which differ by mechanism of origin and treatment strategy. In patients with cardiovascular disease is higher possibility of getting substances, with high content of iodine in diagnostic-therapeutic examination with contrast or treatment with amiodarone. In this group of patients is necessary to control thyroid function...

Importance of fixed-dose combinations in cardiovascular prevention: the possibility of treating two diagnoses with a single pill

Eva Tůmová, Michal Vrablík

Vnitr Lek 2019, 65(12):809-814 | DOI: 10.36290/vnl.2019.140  

In the care of a cardiovascular risk patient there is certainly a more frequent situation in which we try to influence several risk factors at the same time. Treatment of a single self-occurring risk factor is rather an exception. In most cases, we need to intervene with more risk factors, often involving combination therapy, which can achieve the desired goals more quickly and reliably. However, with the number of tablets taken by the patient, the patient's willingness to take long-term and correct use decreases, which has a significant impact on the effectiveness of therapy and the development of individual cardiovascular risk. In an effort to control...

Ľubomíra Fábryová, Pavol Holéczy a kolektív. Diabezita. Diabetes a obezita: nerozlučné dvojičky

Martin Haluzík

Vnitr Lek 2019, 65(12):814