Cardio Debate
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Gender differences in cardiovascular disease - Prof Juan Tamargo
More must be done to address gender differences in cardiovascular drugs. Even in 2017, women are under-represented in randomised clinical trials.
Professor Juan Tamargo, Professor of Pharmacology, Universidad Compultense, Madrid, Spain talks about the need to educate cardiologists and physicians about sex-differences in heart disease, and how the guidelines must also reflect these differences.
For more in-depth analysis and conversations around novel and controversial issues in cardiology visit www.cardio-debate.com
TRANSCRIPT
Why is there a need for sex-specific labelling in CVD drugs?
I think the main point is that usually when we write a guideline or a position paper in the ESC, we just mention the compounds that are recommended with different levels of evidence. And all this evidence, in general, has been obtained from randomised clinical trials where mainly men were involved.
So we are extrapolating the data from these clinical trials to both genders and we can probably accept that it can be extrapolated. But in some cases it is not the case.
The reason why we cannot extrapolate the data is that even in 2017 women are under-represented in randomised clinical trials.
This is very important. First of all, we have the idea that women are protected during their active sexual life, but after menopause we know that things change quite dramatically. When we try to compare men and women of the same range of age, we miss the point that women live longer than men.
Sometimes, we as practitioners say ‘they are protected, this is not a problem for women,’ but it is a problem for women and we need all the information related to differences in drug response to be included in clinical guidelines.
If we have the evidence it should be mentioned in the clinical guidelines and position papers. And indeed this is what we are not doing.
What are the main sex-related differences in the pharmacokinetics of CVD drugs?
I would like to say not only pharmacokinetics. The main point is that when we put on a clinical trial we give the same dose of a certain drug to men and women, and we forget something. For instance, usually women’s weight is lower, and usually we forget that women have a different renal function which is slower than in men. So if we give the same dose to men and women, the problem is that the plasma levels usually are higher in women than in men, and this can explain simple things like the higher incidence of adverse effects in women.
When we try to compare men and women, the first thing we need to look at is the dose calculated based on body weight, and secondly it is calculated according to renal function - and in most cases this does not happen.
We must remember that women are different than men, just because of weight, dose and renal function.
And I would like to also look at pharmacodynamics, because the responses are different. If I gave torsemide, a diuretic, I know that the electrolyte disturbances are more frequent in women than in men. Adverse effects are more frequent in women than in men.
This is important because of pharmacokinetics, because of the different responses, incidences of adverse effects is greater in women. Women may stop treatment, they do not continue with the treatment, or they do not follow my indications as a general practitioner. As a result they are not protected against cardiovascular diseases. This is a real problem.
There is also the feeling - and this is funny- because men, medical doctors usually consider that women need the less strict treatment, we don’t give the same advice to men as we do to women and so on.
There are a lot of things that should be included in position papers and clinical guidelines, but this is not the case. We need to offer to the general practitioner and the cardiologist all this information, because there is misinformation.
What now needs to be done?
to continue reading the transcript please go to
www.cardio-debate.com/2017/10/15/gender-differences-in-cardiovascular-disease/
zhlédnutí: 417

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Komentáře

  • @markbodine9298
    @markbodine9298 Před 13 dny

    Lower your overall blood pressure; remove the glucose and insulin dump trucks in your bloodstream

  • @ijaztahirkheli9775
    @ijaztahirkheli9775 Před měsícem

    I am 88 years old male confirmed patient of Angina Pictoris nd using Ranexa 500 mg for nearly 12 years nd no more angina effect wonderful medicine

  • @LYJManchesterUnited
    @LYJManchesterUnited Před 2 měsíci

    I have this too when i did a ECG when i'm 20 wasn't told to me until I saw it myself in a recent ECG I'm almost 30 now

  • @sutenly1
    @sutenly1 Před 4 měsíci

    How treat it

  • @lifincolors8854
    @lifincolors8854 Před 4 měsíci

    I was started on ranolazine 375mgs twice a day I am diabetic trying to control by diet Although my cardiac symptoms are getting relieved I feel extremely thirsty and very fry mouth very tired no motivation too do work I am on Bisoprolol 1.25 mg I would like to know if these are side effects of ranolazine or Bisoprolol thank you

    • @parthk5513
      @parthk5513 Před 4 měsíci

      Fatigue and decreased motivation can be common adverse effects of Beta blockers like Bisoprolol.

  • @BrendaKing-zs9tb
    @BrendaKing-zs9tb Před 6 měsíci

    What about ckd2???

  • @gaylewills1294
    @gaylewills1294 Před 6 měsíci

    I have taken ranozaline for 14 yrs. Stopped the nonstop angina. Brought the intensity of angina pain down.

  • @jeffreyconnor9769
    @jeffreyconnor9769 Před rokem

    A tumor or mass on the Adrenal or pituitary gland will lump out Aldosterone and or Cortsol. A pituitary tumor may have the same effect. Most doctors don’t even think to check this. They usually find it in the autopsy. Are doctors willfully ignorant??? They hand out blood pressure pills like they’re candy and never bother to even look for the cause of the hypertension. Hypertension is NOT a disease. It is a symptom. Big Pharm System is destroying Lives chasing the almighty dollar.

  • @pachuco1815
    @pachuco1815 Před rokem

    my oldest brother died from a massive heartattack

  • @soulman7552
    @soulman7552 Před rokem

    My ECG just showed early repolarization, currently I'm experiencing left side chest pain that feels like sqeezing. How dangerous it is? I am around 29

  • @jakewoodisgood1
    @jakewoodisgood1 Před rokem

    are there any reasons to be concerned with taking adderall if you have this diagnosis? my psychologist has completely halted my prescription until i can get in to see a cardiologist which could take weeks or even months, time that i do not have to waste and am up against a bit of a deadline for the whole reason i even got back on Adderall. i have no symptoms and am very active in my early 30s. i know for a fact that i have had this for at least the last 7 years and have had no issues.

  • @jaym9846
    @jaym9846 Před rokem

    8:39 So how we protect the areas of arteries where there is turbulent (vs laminar) flow? How do we change flow near bifurcations, bends, etc? Walking? Sprinting? Unusual yoga positions?

  • @jaym9846
    @jaym9846 Před rokem

    31:10 Does higher LDL correlate with obesity, body fat, or visceral fat?

  • @ijaztahirkheli9775
    @ijaztahirkheli9775 Před rokem

    I am 87 years old living in north london was diagnosed suffering with angina pictoris nd have been using ranexa 500 mg for last 7 years nd enjoying life .

  • @Itspoppypoodle
    @Itspoppypoodle Před rokem

    Azad k8

  • @romaniamyland6191
    @romaniamyland6191 Před rokem

    Thank you. You have explained really well the differences

  • @pabloqueiroz7230
    @pabloqueiroz7230 Před rokem

    Lots of patients are dismissed as anxious people... Putative (and false) psychological diagnosis...

  • @luckssj
    @luckssj Před rokem

    He does not share his slides - why?

  • @abrahammatar1671
    @abrahammatar1671 Před rokem

    A legendary doctor!

  • @wendi2819
    @wendi2819 Před 2 lety

    I've battled with anemia and iron deficiency for 8-9 yrs. Early on I had a lot of tests like CTs, MRIs. Since American medicine is so compartmentalized the blood specialist only looked for cancer. I have had IV iron and transfusions for years. I had an echocardiogram about 5 yrs ago. It must've been ok. But finally it got bad enough I've been diagnosed with hypertrophic cardiomyopathy. Which came first here? had I been treated wholistically maybe I wouldn't have developed HCM? All I got for 8 years was treatment of a symptom. No one ever said to me what damage this was doing to my heart! Now I'm trying hard to lose 75 lbs and reduce my salt to help me live a longer life. (Frustrating indeed)!

  • @luckssj
    @luckssj Před 2 lety

    What they don't talk about is the Glycocalyx by destroying the Glycocalyx the Endothelial cells will be damaged and the mitochondria dies and cell dies.

  • @onuegbufavour978
    @onuegbufavour978 Před 2 lety

    Thank you dr Igudia on CZcams for all you do, just got my test result today and am now type 2 diabetes negative. I will keep letting the world know about your good work sir

  • @traceypoynter2582
    @traceypoynter2582 Před 2 lety

    I’m so much grateful to Dr Igudia on his CZcams channel who cured my type 2 Diabetes with his natural herbs medication and I’m also using this opportunity to recommend everyone who also suffers from Diabetes disease to contact him on his CZcams channel because his herbs are indeed very effective and cures diabetes completely.

  • @ruthzepeda5451
    @ruthzepeda5451 Před 2 lety

    Drs. Thank you for sharing how this drug work.

  • @ruthzepeda5451
    @ruthzepeda5451 Před 2 lety

    Person with chest pain when activity or without activity. This drug Chanel Blocker Ranolazin may is good for this problem due to Coronary disease 🦠 or general heart disease. What monitor when star , chest pain relief. How it feel , liver disease and hearts failure Side effects Headache Nausea Dizziness Gastrointestinal Constipation This medication need to avoid Antibiotics like Erythromycin and Fungus Laboratory check level of kidneys

  • @martinkral7222
    @martinkral7222 Před 2 lety

    I have been taking 1000mg ranolazine for the last 8 years. I fact, I started at 1000mg by a very aggressive cardiologist. Helps me with no side effects.

  • @martinkral7222
    @martinkral7222 Před 2 lety

    I have been taking 1000mg of ranolazine twice a day for the last 8 years with no side effects. I also take 60 mg of mononitrate isosorbide twice a day. However, I still use nitro-stat when I overexert any activity. I have had a decent life the last 11 years and celebrated my 74th birthday last February. Just thought I would offer a positive response.

    • @fredrickriffel5845
      @fredrickriffel5845 Před 2 lety

      Have ever through about doing a diet change like Dr Dean Ornish diet?

  • @916hayabusa
    @916hayabusa Před 2 lety

    Gota keep the lie protected, another blah, blah, blah video, not questioning the covid experimental injections.

    • @stevenroach1800
      @stevenroach1800 Před 2 lety

      This was 6 years ago…. Are all of you this stupid?

  • @karenblackerby8704
    @karenblackerby8704 Před 2 lety

    My Diabetes came to an end after using the natural herbs medication which I ordered from Dr IGUDIA on his CZcams channel. The herbs medication was indeed very effective and helpful and I encourage anyone who also suffers from Diabetes disease or any form of disease like Cancer, High blood pressure, Obesity, Herpes infection, Heart disease, COPD, Skin disease to contact the great doctor on his CZcams channel for help with the name Dr Igudia

  • @user-or9cj3vk6t
    @user-or9cj3vk6t Před 2 lety

    Was this news story back-dated or "created to look" older than it is in order to normalise heart problems so no one looks at the now evidentially harmful injections? I thought it was the con-vid injections pushed by World Health Organization & United Nation's "sustainable development" & Agenda 2030 & WEF's Great Reset & Internet of Bodies. What a silly sausage I am

  • @LINDAMSTCYR2367
    @LINDAMSTCYR2367 Před 2 lety

    Recently found out i have this after coronavirus

  • @sheeloopoonam
    @sheeloopoonam Před 2 lety

    ☺️

  • @gregpeterman1102
    @gregpeterman1102 Před 2 lety

    This stuff makes me feel weak and sick, and seems to cause heart pain 3 to 4 hours after a dose.

  • @gregbarratt4249
    @gregbarratt4249 Před 2 lety

    Smoke screen

    • @dede4004
      @dede4004 Před 2 lety

      Agreed. Smoke screen to cover the effects of the mandated item thry all had to take.

    • @stevenroach1800
      @stevenroach1800 Před 2 lety

      @@dede4004 but it was five years before the vaccine w existed….

    • @stevenroach1800
      @stevenroach1800 Před 2 lety

      Check the date bud. Smoke screen for what?

    • @deebois5541
      @deebois5541 Před rokem

      @@stevenroach1800 right, this been happening before covid, but with covid it was like perfect storm to increase these type of deaths.

    • @justinappropriate5353
      @justinappropriate5353 Před rokem

      Lol. This video was uploaded 6 years ago….get it together bud

  • @tajlee1
    @tajlee1 Před 2 lety

    Prescient. Thank you.

  • @isaacharrison5796
    @isaacharrison5796 Před 2 lety

    I thought having this disease was as a result of my old age, while I was diagnosed of heart disease Dec. 19 2020, I used series of medication but I was still having the severe pain, until I used an herbal mixture from Dr. Gbenga which I saw on CZcams and I was completely cured, I appreciate Dr. Gbenga for his help

  • @julietacarbajal4973
    @julietacarbajal4973 Před 3 lety

    My mom was admitted for chest pain. They place a temporary peacemaker and the next day they placed the Pacemaker, she died. The doctor said that after she died they studied her case and found out she had TAKOTSUBO. Does that mean she was misdiagnosed?

  • @pigravid6265
    @pigravid6265 Před 3 lety

    A 20-point decline in my blood pressure level was the result of the , Notovα Shocking Plan 2-week blood pressure level method which I looked in Go ogle. Still, workout for around THIRTY FIVE short minutes everyday is needed in order for this guide to be successful. The impression I have now is significantly happy for the reason that my blood pressure level is under the border line.

  • @rogermichelle7690
    @rogermichelle7690 Před 3 lety

    (GET YOURSELF CURED FROM ( HPV/HSV 1&2) WITH HERBAL MEDICINE).I want to thank the great doctor Osas who brought my boyfriend back to me. I had seen many hospitals, Dr Osas gave me medication and told me all the truth, and I trusted Dr Osas and had him do the spells for me. It took awhile because it was very very messy between us. I had to wait for each spell to do its work. but once the last spell finally was working and the other spells had worked, that is when he called. We met. then it took many more meetings. but now we are back together and I can only thank Dr Osas, he is the greatest Dr that cured my boyfriend from herpes virus. and he can cure ASSHOLE DISEASE JAUNDICE, CIRRHOSIS, HEPATITIS, CERVICAL CANCER, RECTAL PROLAPSE, HPV, HSV1&2, ALS, ADD/ADHD, GENITAL WARTS, SORE COLD, HIV/AIDS, SICKLE CELL ANEMIA, TYPHOLD, ULCER DISEASE, CUSHING, HEARTBURN DISEASE, SYNDROME, you should also contact him Email:osad2383@gmail.com or him via: WhatsApp/Call +2349154653305. I am a living testimony

  • @jekkogifi7206
    @jekkogifi7206 Před 3 lety

    A 20-point reduction in my blood pressure level was the result of the , Notovα Shocking Plan 2-week hypertension treatment which I looked in Go ogle. Nevertheless, you will need to exercise for around 35 minutes every single day. The idea I have now is overwhelmingly happy mainly because my high blood pressure is under the border line.

  • @pigravid6265
    @pigravid6265 Před 3 lety

    My buddy inquired my lookup , Notovα Shocking Plan, the blood pressure levels treatment on Go ogle. Just before, his blood pressure was at 158/120. Through the help of the program and ingesting nice and clean, it was able to reduce swiftly normal again. It has slowly and gradually decreased and 2 weeks later with far healthier eating his blood pressure is 128/84.

  • @katokacharlie7408
    @katokacharlie7408 Před 3 lety

    Thanks to a cousin who introduced me to Dr. Gbenga, using his herbal mixture got me cured of cardiovascular disease, after series of medication for 6 years, thanks Doctor.

  • @jannevainikainen4636
    @jannevainikainen4636 Před 3 lety

    Haluaisin tietää, oliko Christian Ericssonin entinen lääkäri bodaaja ja mahdollinen steroidien käyttäjä itsekin. Onko hänen tutkimuksensa tarkastettu tieteellisestä taholta? Antoiko hän jotain "myrkkyä" Ericssenille nyt tai aikaisemmin? Mihin hänen eliittihoitonsa oikeasti perustuvat? Onko hän valelääkäri?

    • @venus7617
      @venus7617 Před 3 lety

      Why are you asking this? What do you suspect?

  • @cotulla1gal
    @cotulla1gal Před 3 lety

    My spouse has resistant hbp. He is 67, African American and is now on two doses of Losartan one dose Metropolol Forgot the name of the stroke med at night . (he has not had a stroke yet) And after a fainting spell few weeks ago..he was in the hospital and during his stay lying in bed his bp was 209/100. His GP sucks, they are not helping him. With all new meds at home today like 3 pm his bp was 159/95. Mine is almost always 110/65. 117/65. All day. Hardly ever goes past that. I am on no meds. I cannot imagine what my spouse feels like. His limbs are cold to the touch like a cadaver. Someone help us. All they ever do is give him more doses. He sleeps alot these days.

  • @johnwake6432
    @johnwake6432 Před 3 lety

    If anyone is unfortunate enough to get this guy as your endocrinologist. Don't bother. He's a standard endo-illiterate shill who shrugs his shoulders and tells you readings in the bottom 0.01% of "normal" range are perfectly healthy.

  • @datoyap4148
    @datoyap4148 Před 3 lety

    Modern cardiovascular medicine has failed to reduce let alone stop CVD deaths as No 1 cause of death globally

  • @lilydev2808
    @lilydev2808 Před 3 lety

    Chronic endothelial dysfunction must precede hypertension

  • @pickledrick5158
    @pickledrick5158 Před 3 lety

    As a T1D diabetic patient I developed hypertension rather quickly at around 16 years old. It was followed by the growth spur having HbA1c of around 10%+ for nearly a year. For my case it seems Endothelial dysfunction does cause HT no person in my family has hypertension specially not at an early age. Elevated blood glucose appears to be a big driver for Endothelial dysfunction based on articles by the ADA.

  • @dennisabitria3983
    @dennisabitria3983 Před 3 lety

    Hi I just had an early polarization pattern and prior to that a year ago I had a myocardial infarction but my Doctor told me that there is no problem with early polarization. My blood pressure everyday is more or less 170/120.

    • @whatamove
      @whatamove Před 2 lety

      Dude, you need to see a doctor.

  • @ramsechavez
    @ramsechavez Před 3 lety

    Mom has been taking this I believe it's generic ranexa. Keeps throwing up and foods that help with the nausea?