(HealthDay News) -- For patients with prostate cancer, androgen deprivation therapy (ADT) has a lasting impact on physical function, according to a study published online in Cancer.

Shabbir M.H. Alibhai, M.D., from the University Health Network in Toronto, and colleagues examined the impact of ADT on physical function and quality of life over 36 months. They enrolled 87 men with nonmetastatic prostate cancer who were starting continuous ADT, and two control groups matched by age and education (86 prostate cancer patients without ADT and 86 healthy controls).

The researchers found that in both control groups there was an initial improvement in the 6-minute walk test which then stabilized, while there was no change for ADT users (P = 0.0030). In control groups, grip strength remained stable, but there was a sharp decline in the ADT group by 3 months, which then remained stable to 36 months (P = 0.0041). Over 36 months, Timed Up and Go scores declined gradually in the ADT group and did not change in control groups (P = 0.0001). In all groups, the aggregate mental quality of life was stable. Declines seen in the first year of ADT use were independent of age and generally persisted during 36 months.

"Previously noted physical side effects over the first 12 months of ADT persisted or continued to worsen over an additional 2 years with no evidence of recovery," the authors write. "Exercise interventions to counteract these declines may be warranted."

One author disclosed financial ties to the biopharmaceutical industry.

Source

1. Alibhai, S, et al. Published online by Cancer, March 24, 2015; doi: 10.1002/cncr.29355.

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(HealthDay News) -- Leading groups of heart experts have issued updated guidelines that set blood pressure goals for people with coronary artery disease. The updated guidelines, from the American Heart Association, the American College of Cardiology, and the American Society of Hypertension, were published online in Hypertension.

Specifically, the guidelines reinforce a target blood pressure of less than 140/90 mm Hg for those at risk for heart attack and stroke. The guidelines also set a goal of 130/80 mm Hg for those with heart disease who have already had a heart attack, stroke, or a transient ischemic attack, or who have had carotid artery disease, peripheral artery disease, or an abdominal aortic aneurysm.

However, the new guidelines are intended to be more flexible than ones crafted in 2007, Clive Rosendorff, M.D., Ph.D., chairman of the committee that wrote the updated guidelines, told HealthDay. Ultimately, the blood pressure goal any individual patient tries to achieve should be left to the discretion of the doctor and the patient. For example, the lower goal may not be appropriate for older, frail patients who might experience dizziness if their blood pressure drops too much.

According to Rosendorff, one change in the updated guidelines is a concise statement about which drugs should be used to lower blood pressure in patients with heart disease. "There are 3 drugs which have been shown to improve outcomes," he said. These include beta-blockers, angiotensin II receptor blockers, and angiotensin-converting-enzyme inhibitors.

Source

1. Clive Rosendorff, C, et al. Published online by Hypertension, March 30, 2015; doi: 10.1161/HYP.0000000000000018.

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Medtronic announced the launch of a clinical trial program that will assess the use of renal denervation in patients with uncontrolled hypertension, according to a press release.

The SPYRAL HTN global clinical trial program comprises two prospective, randomized, sham-controlled trials: SPYRAL HTN-OFF MED and SPYRAL HTN-ON MED. The trials will be conducted simultaneously. In both, participants will undergo renal denervation by experienced operators with the Symplicity Spyral catheter and Symplicity G3 radiofrequency generator (Medtronic).

SPYRAL HTN-OFF MED will evaluate the impact of renal denervation on BP reduction without the use of antihypertensive medications. SPYRAL HTN-ON MED will assess renal denervation in patients with uncontrolled hypertension despite treatment with three antihypertensive medications; these drugs are not required to be prescribed at maximum tolerated medication dosages, a factor which may have contributed to variability in patient adherence and the large number of medication changes during the SYMPLICITY HTN-3 trial, according to the release.

The trials will include approximately 100 patients with moderate- to high-risk hypertension, enrolled at 20 centers worldwide, according to the release.

“Studying patients both on and off medication in a less severe and more homogeneous population than we saw in the SYMPLICITY HTN-3 trial is critical to gaining clarity on the true effect of this therapy,” Raymond Townsend, MD, director of the hypertension program at the University of Pennsylvania and a principal investigator for the new studies, said in the release. “By specifying medication classes and not requiring maximum tolerated doses, we can expect medication variability to be reduced, which will allow for a more controlled assessment of the impact of renal denervation in the presence of medication.”

Depending on the results of these trials, Medtronic may conduct a pivotal study to support a premarket application to the FDA, according to the release.

Disclosure:The SPYRAL HTN global clinical trial program is sponsored by Medtronic. Townsend is a principal investigator for the trials.

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Until recently, many Nigerians who suffer kidney failure couldn't live for long because of difficulty in kidney transplant and more importantly is the inadequate government dialysis facilities which could help in regular cleaning up of the body wastes; function hitherto carried out by the kidney.

The involvement of the MTN Foundation in partnership with Adcem Pharmaceuticals Limited in providing the needed dialysis machines to members of the public has no doubt helped give some relief to many patients who now have access to regular dialysis.

Speaking on the success of the MTNF's kidney support project, Managing Director, Adcem Pharmaceuticals Limited, Adeyemi Adewole described the intervention as one of the best things to happen to healthcare delivery in the country.

Adeyemi who is a trained pharmacist from ahmadu Bello University, Zaria noted, that the organisation in 1992 chose to get involved in providing sevices for patients with kidney diseases because it found out that there was a shortfall in service provision.

According to him, "In 1992, whilst researching on dialysis and kidney disease I discovered that services were inadequate and so we decided to partner with Fresenius AG Germany which has both pharmaceutical and medical equipment divisions, mostly specializing in kidney diseases", said Adeyemi.

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