Burning issues in the prevention of heart failure

Chronic heart failure is common, debilitating, and often the culmination of pervasive cardiovascular insults that systematically undermine the heart's circulatory capacity and invoke counterproductive neuro-hormonal compensatory changes. Prevention of chronic heart failure therefore requires minimising the impact of traditional cardiovascular risk factors with incisive treatment of hypertension and type II Diabetes Mellitus (T2DM) and prompt lifestyle interventions for smoking, lack of exercise, obesity and hypercholesterolemia. This review is narrative, with selected emphasis on major studies, rather than structured on a specific clinical question, and should be read as such

Burning issues in blood pressure control

Globally more than 1 billion people have hypertension and it is predicted that because of ageing populations and increasing sedentary lifestyles, this figure will rise to about 1.5 billion by 2025. Elevated blood pressure (BP) is the leading cause of premature death and morbidity due to stroke and ischemic heart disease. Hypertension is also a major risk factor for heart failure, atrial fibrillation, chronic kidney disease, peripheral arterial disease and cognitive decline. This article discusses the current evidencebased treatment guidelines and pressing temporal issues in optimal blood pressure control

From Bowditch to Beta-Blockers : Evolution of the Understanding of the Importance of Heart Rate and Myocardial Energetics in Cardiomyopathy

During the past three decades; every aspect of cardiomyopathy has undergone dramatic change. When examining the literature on the physiological aspects of the failing heart; one immediately recognises that South Africa has made a contribution : Brink; Bester and Lochner evaluated the possible therapeutic aspects of the Bowditch phenomenon and myocardial energetics in cardiomyopathy almost four decades ago; at a time when the condition even had another name; myocardiopathy

Management issues in hypertensive diabetics

This article discusses seven issues in the management of hypertension in diabetic patients; namely the importance of blood pressure control; optimal blood pressure control levels; the importance of blocking the renin-angiotensin system; the inevitability of combination anti-hypertensive therapy; drug choices; the diabetogenic effects of high dose thiazide diuretics and beta-blockers and the importance of treating other risk factors; like dyslipidaemia