Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations)

Anderson, Jeffrey L.; Halperin, Jonathan L.; Albert, Nancy M.; Bozkurt, Biykem; Brindis, Ralph G.; Curtis, Lesley H.; DeMets, David L.; Guyton, Robert A.; Hochman, Judith S.; Kovacs, Richard J.; Ohman, E. Magnus; Pressler, Susan J.; Sellke, Frank W.; Shen, Win‐Kuang

doi:10.1161/cir.0b013e31828b82aa

Cited by 372 publications

(166 citation statements)

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“…The advanced lesions of atherosclerosis compromise the lumen diameter, reducing the blood flow in arteries and thus limiting kidney oxygenation. [44][45][46][49][50][51][52] In the early stages of atherosclerotic renal artery stenosis progressive decreases in blood flow are accompanied by compensatory changes in arteriovenous shunting, and decreases in glomerular filtration rate and tubular reabsorption of sodium, that either increase oxygen availability or reduce its consumption. Within the whole kidney these adaptive mechanisms appear to maintain appropriate oxygenation.…”

Section: Air Pollutionmentioning

confidence: 99%

“…A goal reinforced by the practice guidelines of the American Heart Association and the American College of Cardiology Foundation that state the preferred treatment for hemodynamically significant renal artery stenosis is improved kidney oxygenation. 49 …”

Section: Air Pollutionmentioning

confidence: 99%

“…81,83,87,[110][111][112]377,378 Artery narrowing is already routinely counteracted by renal angioplasty with or without stenting and the administration of vasoconstriction inhibitors that target the renin-angiotensin-aldosterone system. 49,[379][380][381] The targeting of vasoconstriction pathways controlled through vasopressin, endothelin, and voltage dependent calcium channels are in their infancy, as is the use of vasodilators such as arginine and kallikrein. 155,250,268,298,379,382,383 Beyond systemic hypooxygenation and vasoconstriction, the hypoxia-dependent processes of microvascular rarefaction, oxidative stress, leukocyte recruitment, and fibrosis all contribute to the development of CKD.…”

Section: A New Hypoxia Paradigmmentioning

confidence: 99%

“…This in turn is driven by a constellation of interlinked risk factors. Primary amongst these factors are anemia, [6][7][8][9] diabetic hyperglycemia, [10][11][12] hypertension, [13][14][15][16][17] hypercholesterolemia, [18][19][20] cigarette smoking, [21][22][23][24][25][26][27] air pollution, [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] atherosclerosis, [43][44][45][46][47][48][49][50][51][52] repeated episodes of acute kidney injury, [53][54][55][56]…”

mentioning

confidence: 99%

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Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

120

108

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In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure. Numerous studies have demonstrated that one of the most potent means by which hypoxic conditions within the kidney produce CKD is by inducing a sustained inflammatory attack by infiltrating leukocytes. Indispensable to this attack is the acquisition by leukocytes of an adhesive phenotype. It was thought that this process resulted exclusively from leukocytes responding to cytokines released from ischemic renal endothelium. However, recently it has been demonstrated that leukocytes also become activated independent of the hypoxic response of endothelial cells. It was found that this endothelium-independent mechanism involves leukocytes directly sensing hypoxia and responding by transcriptional induction of the genes that encode the β2-integrin family of adhesion molecules. This induction likely maintains the long-term inflammation by which hypoxia drives the pathogenesis of CKD. Consequently, targeting these transcriptional mechanisms would appear to represent a promising new therapeutic strategy.

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Section: Air Pollutionmentioning

confidence: 99%

Section: Air Pollutionmentioning

confidence: 99%

Section: A New Hypoxia Paradigmmentioning

confidence: 99%

mentioning

confidence: 99%

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Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

120

108

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“…Currently, the clinic evaluates for and treats lipid disorders, Hypertension (HTN), Diabetes Mellitus (DM), Peripheral Arterial Disease (PAD), Screening Abnormal Calcium Score, Tobacco dependence, and provides weight loss management and dedicated exercise program for weight loss and claudication treatment. Screening and treatment is based on the most recent evidenced-based guidelines published and updated annually, [2][3][4][5] and written up into strict standard operating procedures for all mid-providers within the clinic to follow. The clinic is part of the patient centered home model with a multi-disciplinary approach.…”

Section: Commentarymentioning

confidence: 99%

A Comprehensive Cardiovascular Preventive Clinic: Is it a Concept that is Possible to Implement in the Military System?

McConnell¹,

Suarez²,

Holuby³

et al. 2014

Heart Res Open J

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Cardiovascular disease has a huge impact on our society and the individuals affected. According to the most recent data published by American Heart Association (2014 Update), Coronary heart disease alone caused about 1 in 6 deaths in the United States in 2010. In 2010, the senior author attempted to explore the concept of truly comprehensive cardiovascular preventive clinics with goal driven protocols and operated by mid-level providers with different backgrounds from clinical pharmacy to advanced nurse practitioners. The concept, design and implementation of the Preventive Cardiology Clinic at Brooke Army Medical Center using a multi-disciplinary approach with evidence based protocols and standard operating procedures in a patient-centered design enhanced patient participation and optimized success in preventive care in a high-risk population. The Preventive Cardiology Clinic resulted in improved identification and screening of cardiovascular patients at risk, improved implementation of preventive therapies and achievement of target goals, significantly affected tobacco cessation success rates that surpasses nationally reported success rates, and improved quality of life. We feel this concept could be easily replicated using existing resources in most military and other medical treatment facilities KEYWORDS: Cardiovascular prevention; Lipid disorders; Smoking cessation; Peripheral arterial disease. COMMENTARYCardiovascular disease has a huge impact on our society and the individuals affected. According to the most recent data published by American Heart Association (2014 Update), Coronary heart disease alone caused about 1 in 6 deaths in the United States in 2010. Each year about 620,000 Americans have a new coronary attack and about 295,000 have a recurrent attack. The total direct and indirect cost of CVD and stroke in the United States for 2010 is estimated to be $315.4 billion. 1 As the national focus continues to be on health care utilization, care and quality it becomes increasingly important that we try to address the multiple modifiable risk factors that have been shown to improve cardiovascular outcomes. Very little has been published regarding comprehensive prevention in a combined approach utilizing a cardiovascular prevention clinic.In 2010, the senior author attempted to explore the concept of truly comprehensive cardiovascular preventive clinics with goal driven protocols and operated by mid-level providers with different backgrounds from clinical pharmacy to advanced nurse practitioners. The vision of the clinic was to streamline cardiovascular screening, medical management, and prevention programs in order to provide more efficient and higher quality care for the service members with ultimate goal

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Non‐atherosclerotic Peripheral Artery Disease

Weinberg

2017

Peripheral Artery Disease

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Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations)

Cited by 372 publications

References 0 publications

Hypoxia: The Force that Drives Chronic Kidney Disease

Hypoxia: The Force that Drives Chronic Kidney Disease

A Comprehensive Cardiovascular Preventive Clinic: Is it a Concept that is Possible to Implement in the Military System?

Non‐atherosclerotic Peripheral Artery Disease

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