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Jc M, Chopra A, Js H, Mahajan A, Nair T, Ray S, Tr M, Pandey A, Srivastava S, Kumar YS, Navasundi G, Das DR, Abhyankar MV, Revankar S, Mate P. Experts' Consensus on Use of Long-Acting Nitroglycerine in the Management of Angina and Chronic Coronary Syndrome in India. J Assoc Physicians India 2022; 70:11-12. [PMID: 35438293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM To address the existing gaps in knowledge about long-acting nitroglycerine (LA-NTG) and provide recommendations to address these issues. METHODOLOGY Approved LA-NTG questionnaire that included 17 questions related to the role of LA-NTG in the management of angina and chronic coronary syndrome (CCS) was shared with 150 expert cardiologists from different regions from India. Results of these survey questionnaires were further discussed in 12 regional level meetings. The opinions and suggestions from all the meetings were compiled and analyzed. Further, recommendations were made with the help of attending national cardiology experts and a consensus statement was derived. RESULTS This is the first consensus on LA-NTG, summarizing the clinical evidence from India and suggesting recommendations based on these data. The experts recommended early use of LA-NTG as a first-line antianginal therapy in combination with beta-blocker since it improves exercise tolerance in patients with CCS. A strong consensus was observed for using LA-NTG in patients with co-morbid hypertension, diabetes, chronic kidney disease and post-percutaneous coronary intervention angina. As a part of cardiac rehabilitation, LA-NTG allows patients with angina to exercise to a greater functional capacity. CONCLUSIONS A national consensus was observed for several aspects of LA-NTG in the management of angina and CCS. The clinical experience of the experts confirmed an extremely satisfied patient perception about the efficacy of LA-NTG.
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Affiliation(s)
- Mohan Jc
- Consultant, Jaipur Golden Hospital, Delhi
| | - Arun Chopra
- Consultant, Fortis Escorts Hospital, Amritsar, Punjab
| | - Hiremath Js
- Consultant, Ruby Hall Clinic, Pune, Maharashtra
| | - Ajay Mahajan
- Consultant, Cardiocare Heart Clinic, Mumbai, Maharashtra
| | - Tiny Nair
- Consultant; PRS Hospital, Trivandrum, Kerala
| | - Saumitra Ray
- Consultant, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Muralitharan Tr
- Consultant, Sri Ramachandra University Medical Centre, Chennai, Tamil Nadu
| | - Ajay Pandey
- Consultant; Galaxy Hospital, Varanasi, Uttar Pradesh
| | | | - Y Shiva Kumar
- Consultant, Mahavir Cardiovascular Centre, Hyderabad, Telangana
| | | | | | - Mahesh V Abhyankar
- Vice President, Scientific Services, USV Private Limited, Mumbai, Maharashtra
| | - Santosh Revankar
- Deputy General Manager, Scientific Services, USV Private Limited, Mumbai, Maharashtra
| | - Pradip Mate
- Deputy General Manager, Scientific Services, USV Private Limited, Mumbai, Maharashtra
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Saboo B, Agarwal S, Gupta S, Makkar B, Panneerselvam A, Sahoo AK, Ramchandani GD, Das S, Erande S, Kadam Y, Abhyankar MV, Revankar S. REAL-world evidence of risk factors and comorbidities in YOUNG Indian adults with type 2 diabetes mellitus: A REAL YOUNG (diabetes) study. J Family Med Prim Care 2021; 10:3444-3452. [PMID: 34760771 PMCID: PMC8565132 DOI: 10.4103/jfmpc.jfmpc_2010_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/01/2021] [Indexed: 11/04/2022] Open
Abstract
Objective To assess the clinical characteristics, risk factors, and comorbidities associated with type 2 diabetes mellitus (T2DM) in young adult patients. Methods This is a retrospective, multicentric real-world study that included young adults (18-45 years) with T2DM. Primary information including demographics, medical and family history, biochemical measures (pre-and post-prandial blood glucose levels, glycosylated hemoglobin [HbA1c] and blood pressure, and lipid parameters) smoking and drinking habits were collected retrospectively from the medical records of the respective hospitals/clinics. Data were analyzed using descriptive and appropriate comparative statistics. Results A total of 22,921 patients from 623 sites were included. The median age was 37.0 years and the majority were men (61.6%). The proportion of patients from the age group >35-≤45 years was 62.7%. Among all patients, 46.9% had only T2DM; however, 53.1% of patients had T2DM with other comorbidities (T2DM with hypertension, dyslipidemia, and both). The majority of patients had elevated body mass index (BMI) (overweight, 46.6%; and obese, 22.9%). Family history of T2DM (68.1%) was most common in overall population. Sedentary lifestyle (63.1%), alcohol consumption (38.9%), and regular smoking (23.1%) were the most common associations in patients with T2DM with dyslipidemia and hypertension. Uncontrolled HbA1c level (≥7%) were observed in 79.2% of patients. The level of HbA1c was significantly increased with the duration of T2DM and sedentary lifestyle (p < 0.001). Conclusion Higher BMI, family history of T2DM, sedentary lifestyle, alcohol consumption, and smoking were the most common risk facors, while hypertension and dyslipidemia were the most prevalent comorbidities associated with T2DM in young Indian adults.
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Affiliation(s)
- Banshi Saboo
- Department of Diabetology, Diabetes Care and Hormone Clinic, Ambawadi, Ahmedabad, Gujarat, India
| | - Sanjay Agarwal
- Department of Internal Medicine, Dr. Sanjay Agarwal's Aegle Clinic, City, Pune, Maharashtra, India
| | - Sunil Gupta
- Department of Diabetology, Sunil's Diabetes Care Research Centre, Nagpur, Maharashtra, India
| | - Brij Makkar
- Department of Diabetology, Dr. Makkar's Diabetes and Obesity Centre, Delhi, India
| | - A Panneerselvam
- Department of Diabetology, Aruna Diabetes Centre, Chennai, Tamil Nadu, India
| | - Abhay Kumar Sahoo
- Department of Endocrinology, IMS and SUM Hospital, Bhubaneshwar, Odisha, India
| | - G D Ramchandani
- Ramachandani Diabetes Care and Research Centre, Kota, Rajasthan, India
| | - Sambit Das
- Department of Endocrinology, Endeavour Clinics, Bhubaneswar, Odisha, India
| | - Suhas Erande
- Department of Diabetology, Akshay Hospital and Diabetic Speciality Centre and Insulin Pump Centre, Pune, Maharashtra, India
| | - Yogesh Kadam
- Department of Diabetology, Poona Diabetes Centre, Pune, Maharashtra, India
| | - Mahesh V Abhyankar
- Department of Scientific Services, Scientific Services, USV Private Limited, Mumbai, Maharashtra, India
| | - Santosh Revankar
- Department of Scientific Services, Scientific Services, USV Private Limited, Mumbai, Maharashtra, India
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Desai N, Unni G, Agarwala R, Salagre S, Godbole S, Dengra A, Abhyankar MV, Revankar S. Risk Factors and Comorbidities in Young Indian Patients with Hypertension: REAL YOUNG (Hypertension) Study. Integr Blood Press Control 2021; 14:31-41. [PMID: 33664586 PMCID: PMC7924245 DOI: 10.2147/ibpc.s272548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To analyze the risk factors and comorbidities among the young Indian adults with hypertension. Patients and Methods This was a retrospective, multicentric real-world study which included patients diagnosed with and receiving treatment for hypertension. Data were collected from the medical records of clinics/hospitals across 623 study sites in India. Patients of either sex and aged 18–45 years were included. Demographic details (age, sex, anthropometric measurement), medical and family history, sedentary lifestyle, smoking status and alcohol consumption data were extracted. Descriptive and comparative analysis (Mann–Whitney U and chi-squared test) was done. Results Out of 15,006 young patients diagnosed with hypertension (men=63.6%), 65.7% belonged to the age group of >35–45 years. The median body mass index was 27.0 kg/m2. Patients diagnosed with only hypertension were 29.1% while other predominant comorbidities with hypertension were diabetes mellitus (42.4%) and dyslipidemia (7.8%). Hypertension with diabetes mellitus were prevalent in the age group of >35–45 years (43.8%). More than half of the patients with hypertension (n=7656) had a sedentary lifestyle. Overall, 35.6%, 47.3%, and 56.7% of the patients were alcoholic, smokers (present and former), and had a family history of hypertension, respectively. Conclusion The results showed that among the young population, hypertension was common in the age group of >35–45 years and diabetes mellitus and dyslipidemia were common comorbidities. Family history, sedentary lifestyle, smoking, alcohol consumption, and body mass index may also contribute to hypertension.
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Affiliation(s)
| | - Govindan Unni
- Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | | | | | | | - Ashish Dengra
- Mahi Diabetes Thyroid Care and Research Center, Jabalpur, Madhya Pradesh, India
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Iyengar SS, Narasingan SN, Gandhi P, Jaipuriar N, Mahilmaran A, Patil S, Abhyankar MV, Revankar S. Risk factors, comorbiditiEs and Atherogenic dysLipidaemia in Indian YOUNG patients with dyslipidaemia attending hospital/clinic: REAL YOUNG (dyslipidaemia) study. J Family Med Prim Care 2020; 9:4156-4164. [PMID: 33110825 PMCID: PMC7586548 DOI: 10.4103/jfmpc.jfmpc_546_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 11/06/2022] Open
Abstract
Objective: To evaluate the pattern of dyslipidaemia, risk factors, and comorbidities in young Indian adults with dyslipidaemia. Methods: A retrospective, multi-centric real-world study included individuals with dyslipidaemia, aged 18 - 45 years, attending to 623 hospitals/clinics across India. Data were collected retrospectively from medical records to note demographics, risk factors (smoking, alcohol consumption, sedentary lifestyle, family history of dyslipidaemia, diabetes mellitus, and hypertension), and clinical details (height, weight, waist circumference, body mass index (BMI), blood pressure, blood sugar, glycated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL-C), and high-density lipoprotein (HDL-C)).A descriptive analysis and comparative analysis (Mann-Whitney U test and Chi-square test) were done. Results: Of the total 8135 patients, the majority were men (65.0%). Overall, 87.1% of population had one or multiple comorbidities which included the presence of dyslipidaemia alone (12.9%), dyslipidaemia with diabetes and hypertension (39.1%), dyslipidaemia with diabetes (33.6%), and dyslipidaemia with hypertension (14.4%). Sedentary lifestyle was prevalent observation in >50% of the population. Youngest age (18 - 25) group had higher prevalence of hypertriglyceridemia (63.2%), high LDL-C levels (56.8%), and low HDL-C levels (64.6%), while patients from the age group >25 to ≤35 years had the highest incidence of hypercholesterolemia (66.6%). Atherogenic dyslipidaemia was observed in 41.9%, 25.5%, and 23.2% of patients from age groups of ≥18 to ≤25, >25 to ≤35, and >35 to ≤45 years, respectively. Patients with HbA1c ≥6.5% had significantly higher levels of TG, TC, LDL-C, and lower HDL-C compared to those with HbA1c <6.5%. Conclusion: Hypertriglyceridemia, high LDL-C, low HDL-C, and atherogenic dyslipidaemia were prevalent in the young Indian cohort and sedentary lifestyle, and HbA1c ≥ 6.5% were the predominant risk factors of dyslipidaemia.
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Affiliation(s)
- S S Iyengar
- Department of Cardiology, Manipal Hospital, Bengaluru, Karnataka, India
| | - S N Narasingan
- Former Adjunct Prof. The Tamil Nadu Dr. MGR Medical University Chennai, and Managing Director SNN Specialities Clinic and SNN Diagnostic Centre, Chennai, Tamil Nadu, India
| | - Pramod Gandhi
- Gandhi Research Institute, Nagpur, Maharashtra, India
| | | | | | - Sachin Patil
- Sachin Superspecilality Clinic, Kolhapur, Maharashtra, India
| | - Mahesh V Abhyankar
- Vice President, Scientific Services, USV Pvt Ltd, Mumbai, Maharashtra, India
| | - Santosh Revankar
- Deputy General Manager, Scientific Services, USV Pvt Ltd, Mumbai, Maharashtra, India
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