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Daiichi Sankyo, Inc.,
announced that data presented at the American Society of
Hypertension’s Twenty- Third Annual Scientific Meeting (ASH 2008) in New
Orleans demonstrated that the powerful combination drug AZOR(TM)
(amlodipine and olmesartan medoxomil) safely and effectively helped
patients across several major subpopulations lower their blood pressure
(BP). An analysis of patient subgroups from the pivotal registrational
trial demonstrated the efficacy of AZOR in several key difficult to treat
patient groups including people of African and Hispanic/Latino decent,
people with high body mass index (BMI) and those with diabetes.
The subgroup analyses were based on data from a pivotal, randomized,
double-blind, placebo-controlled factorial design study conducted in 1,940
pts with mild to severe hypertension (SeDBP) 95-120 mm Hg) to determine
if amlodipine (AML) 5-10mg/day plus olmesartan (OM) 10-40 mg/day for eight
weeks is more efficacious in reducing BP versus monotherapy components. The
groups were chosen because each population generally have either poor
control rates (Blacks and Hispanic/Latinos),(1)(2) are difficult to control
(people with high BMI)(3) or require lower blood pressure to achieve
control (those with diabetes).(4)
"As we know, hypertension affects many people from all walks of life,"
said Suzanne Oparil, M.D., Director, Vascular Biology & Hypertension
Program, University of Alabama at Birmingham, an investigator in the study
and President of ASH. "No two patients are alike, nor do any two people
present in the exact same way. This study has demonstrated that AZOR is an
important tool for physicians to consider when treating hypertensive
patients of different ethnicities and health characteristics, as well as
the more difficult to treat populations, such as people with diabetes."
Hypertension, also known as high blood pressure, affects approximately
72 million people in the United States and approximately one billion
worldwide.(5)(6) Called the "silent killer" because it often has no
specific symptoms, hypertension increases the risk of cardiovascular and
related diseases such as stroke, heart attack, heart failure and kidney
disease.(7) Of those diagnosed with high blood pressure, 64.9 percent do
not have the condition under control.(8)
ABOUT THE ANALYSES
RACE/ETHNICITY:
Blood pressure control in patients with hypertension remains
unsatisfactorily low in the US, particularly in Black and Hispanic/Latino
populations, with fewer than 30% of patients in these minority groups
treated to goal BP.(9)(10) Guidelines acknowledge that combination therapy
will be required for the majority of patients to attain BP goals, and
recommend that combination therapy utilizing agents from complimentary drug
classes should be considered when BP is difficult to control or there is
high cardiovascular risk, such as in minority patient
populations.(11)(12)(13)
Of the 1,940 patients who entered the eight week pivotal study, 1,459
were non-Black and 481 were Black. Further, ethnicity was asked separately
from race: 245 patients were Hispanic/Latino. All subgroups were matched
for baseline BP of 164/102 mm Hg. AZOR 10/40 mg demonstrated a 29/16 mm Hg
mean reduction in the Black cohort vs. 31/20 mm Hg in non-blacks. Further,
in the Hispanic/Latino study patient population, AZOR 10/40 mg demonstrated
a mean reduction of 29/21 mm Hg compared to 30/19 mm Hg in
non-Hispanic/non-Latino.
BMI:
A higher body mass index (BMI) often makes it more difficult for
patients with hypertension to achieve target BP.(14) The analysis of data
from the pivotal study demonstrated the ability of AZOR to produce
substantial reductions in BP compared to the monotherapy components,
regardless of BMI levels. For those patients with BMI greater than or equal
to 30 kg/m(2), AZOR 10/40 mg demonstrated mean reductions of 30/18 mm Hg
from an average baseline BP of 163/102 in the total cohort. Patients with
BMI of less than 30 kg/m(2) saw BP reductions of 31/21 mm Hg when treated
with Buy generic amoxil AZOR 10/40 mg from an average baseline BP of 165/101 in total cohort.
DIABETES:
Patients with hypertension and diabetes are at greater risk of
cardiovascular and renal disease and consequently have a more stringent
recommended target BP goal of Buy amoxil without prescription | Buy lexapro without prescription | Generic fosamax pills no prescription

For Health Professionals
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The post-university years can start out tough. The good news: it gets better.
A new University of Alberta study of almost 600 of its graduates (ages 20-29 years old) tracked mental health symptoms in participants for seven years post-graduation and looked at how key events like leaving home and becoming a parent were related to depression and anger. Graduates showed a significant decrease in depressive symptoms over the seven years. Expressed anger also declined over time after graduation, suggesting improved mental health.
The researchers also found that while home may be a haven for young people in the early years of adulthood, the longer they stay at home, or if they return home, the more likely they are to experience symptoms of depression. Previous research has found that more than half of students under 25 in four-year university programs lived with their parents.
In this study, it was shown that younger participants were more depressed at times when they lived on their own, while older participants were more depressed while they lived with their parents.
"Generic soma pills no prescription Some key events, such as leaving home, may throw emerging adults a little off kilter, depending on the timing of the transition," said Nancy Galambos, University of Alberta psychology professor. "Leaving home too soon can be challenging in ways that have the potential to affect mental health."
It was revealed that women were more depressed and angry at the start of the study than men. Also, anger increased when participants became parents.
"Although we generally welcome parenthood as a positive experience, we found that people who became parents became angrier, and this was especially pronounced for mothers," said Harvey Krahn, University of Alberta chair of sociology. "The transition to parenthood produces a new set of demands on the couple that may be difficult to cope with as parents have to negotiate a whole new set of family responsibilities."
—————————-
Article adapted by Medical News Today from original press release.
—————————-
The study was conducted by Nancy Galambos, University of Alberta psychology professor, and Harvey Krahn, University of Alberta chair of sociology. It appears in the Journal of Marriage and Family.
Source: Kris Connor
University of Alberta
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The negative effects of stress on cognitive functioning appear to be amplified by a genetic variation associated with Alzheimer’s disease, a new federally funded study has found. The genetic variation may, in effect, accelerate the development of age-related cognitive decline by as much as eight years.
Researchers from the Baltimore Memory Study report in The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association, that a high level of the stress hormone cortisol in study participants aged 50 to 70 years was associated with worsened cognitive abilities. The researchers also found that the effect was greater among those with a common form of the gene for apolipoprotein E (APOE), which has been shown to increase the risk for Alzheimer’s disease.
This gene-environment interaction is reported by Brian Lee, M.H.S., Brian Schwartz, M.D., and colleagues at Johns Hopkins University. The group’s findings will be presented online on July 1 under AJP in Advance .
The effect appears to increase as the number of copies of a specific APOE gene in the individual increases. Everyone inherits two versions of the APOE gene, known as alleles - one from each parent. The most common APOE alleles are epsilon-2, -3, and -4. Having at least one epsilon-4 allele increases an individual’s risk of late-onset Alzheimer’s disease. Individuals with two copies of the esiplon-4 version of the gene are particularly susceptible to the damaging effects of cortisol in the brain.
"Our findings indicate that the APOE epsilon-4 allele may increase vulnerability of the aging brain to elevated cortisol levels," said lead author Lee, a doctoral student in epidemiology at the Johns Hopkins Bloomberg School of Public Health. "While our results remain to be replicated, the observed cortisol-APOE interaction is intriguing since both cortisol and APOE have been implicated in cognitive decline associated with aging as well as in Alzheimer’s disease."
The effects on cognitive functioning extended to six of the seven areas that were studied: language, eye-hand coordination, executive functioning, verbal memory/learning, visual memory, and ability to copy a complex visual design.
Buy generic zithromax The deficits are similar in magnitude to those seen with advancing age. The authors estimated the equivalent years of increased age, represented by the poorer cognition of the study participants with high cortisol and the epsilon-4 form of the APOE gene. For language ability, the lower scores of people with high cortisol levels and one epsilon-4 copy were comparable to an age increase of eight years. For those with two epsilon-4 copies, the comparable age increase was even larger.
The study was supported by the National Institute on Aging and the National Institutes of Health Division of Research Resources.
Reference
Lee BK, Glass TA, Wand GS, McAtee MJ, Bandeen-Roche K, Bolla KI, Schwartz BS: Apolipoprotein E Genotype, Cortisol and Cognitive Function in Community-Dwelling Older Adults. Am J Psychiatry (published online July 1, 2008; doi: 10.1176/appi.ajp.2008.07091532)
About the American Journal of Psychiatry
The American Journal of Psychiatry is the official journal of the American Psychiatric Association. Statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association. AJP in Advance is a regular online feature where original research articles accepted for publication in The American Journal of Psychiatry are posted online in advance of their appearance in print.
About the American Psychiatric Association
The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at and
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Researchers from the Cleveland Clinic, Brown University, and Massachusetts General Hospital will present results of a long-term outcome study that builds on previous promising research, which has shown that deep brain stimulation (DBS) is a potentially effective treatment option for people with treatment resistant major depression.
The World Health Organization rates major depression as the top cause of disability worldwide. While many patients with major depression find relief through a combination of psychotherapy and medication, some people are left severely disabled. Patients who are most resistant to medications, psychotherapies, and electroconvulsive therapy (ECT) have little hope of recovery, and suffer a heightened risk of suicide and mortality. Sadly, statistics show that the suicide rate in people with major depression is as high as 15 percent.
DBS surgery involves the placement of tiny implantable electrodes into specific parts of the brain that are functioning abnormally. These electrodes emit tiny pulses of electrical stimulation to block the abnormal activity in the brain, which causes a variety of symptoms such as pain, tremors, movement problems; as well as obsessions, moods and anxieties associated with psychiatric disorders. The success of DBS is dependent on the surgical team’s ability to precisely pinpoint the specific brain area for stimulation. The advantage of DBS is that it is reversible, nondestructive, and can be modified by adjustment of the stimulator settings after implantation.
Ali R. Rezai, MD, director of Cleveland Clinic’s Center for Neurological Restoration, and a multi-center team of investigators were inspired by the success of DBS in treating the tremors associated with Parkinson’s and movement disorders like dystonia and essential tremor. "Starting in 2001, we began treating patients with obsessive compulsive disorder (OCD) with promising outcomes. These findings resulted in the initiation of a subsequent trial for patients with severe and medication intractable major depression, starting in 2003," stated Dr. Rezai.
"The preliminary results of research undertaken between 2003 and 2005 indicated that bilateral DBS of the anterior limb of the internal capsule holds promise for the treatment of intractable major depression, which led to the more extensive research results being presented today," added Dr. Rezai.
The results of the current study, Deep Brain Stimulation for the Treatment of Depression: Long-Term Outcomes from a Prospective Multi-Center Trial, will be presented by Dr. Rezai, from 10:30 to 10:44 a.m. on Tuesday, April 29, 2008, during the 76th Annual Meeting of the American Association of Neurological Surgeons in Chicago. Co-authors are Linda Carpenter, MD, Darin Dougherty, MD, Emad Eskandar, MD, Gerhard Friehs, MD, Cynthia Kubu, PhD, Andre Machado, MD, PhD, Paul Malloy, PhD, Donald Malone, MD, Lawrence H. Price, MD, Steven Rasmussen, MD, Scott Rauch, MD, Stephen Salloway, MD, and Audrey Tyrka, MD, PhD. This multidisciplinary group consists of close collaboration between neurosurgeons, psychiatrists and psychologists from these institutions.
Fifteen chronic and severely depressed patients were enrolled in this study. These patients had failed multiple medication trials, as well as psychotherapy and electroconvulsive therapy (ECT). These highly intractable and often suicidal patients underwent bilateral DBS implantation in the ventral internal capsule/ventral striatum (VC/VS) at the three institutions.
The Montgomery-Asberg Depression Rating Scale (MADRAS) was the primary outcome scale, among many scales, including those assessing overall quality of life, functioning and cognitive status. The outcome raters were blinded to the DBS status of the patient. Follow-up ranged from six to 48 months, with a duration of one year or longer in 11 of the 15 patients. Responder criteria was defined by this study as a 50 percent decrease in MADRAS scores. The following outcomes were noted:
– Responses were seen in seven (47 percent) of 15 patients at six months, five (45.5 percent) of 11 at 12 months, and eight (53.3 percent) of 15 at last follow-up.
– Long-term improvement in depression severity, functioning, and quality of life were all noted.
– Measures of short-term memory improved.
– There were no hemorrhages, infections or other neurological deficits.
"This research substantiates our earlier findings, which indicate that bilateral DBS of the anterior limb of the internal capsule holds promise and hope for select patients suffering from severe and treatment resistant major depression, stated Dr. Rezai. "While about half of this patient group responded to treatment, I feel that as we learn more about this rather new technology, efficacy will continue to improve. It is important to understand that this treatment is not for everyone with major depression and only for those that have tried various medications, psychotherapy and ECT. But, nevertheless, it is very promising news for the many suffering patients and their family members that have virtually given up hope."
Results of the OCD study, Deep Brain Stimulation of the Ventral Internal Capsule/Ventral Striatum for Obsessive-Compulsive Disorder (OCD): World-Wide Experience, will be presented by Dr. Rezai, one day prior to the depression study, 2:45 to 2:59 p.m., Monday, April 28. While OCD is not as prevalent as depression, it does affect 2 to 3 percent of the United States population, and at least 10 percent of patients have disabling cases that are resistant to treatment. The results reveal meaningful symptom reductions and functional improvement in about two-thirds of highly resistant patients after open treatment. Recent improvements in outcomes have been achieved through refinements in targeting areas. This is a worldwide cooperative prospective study involving the largest number of severe and intractable OCD patients with long-term follow-up with DBS.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 7,200 members worldwide. Buy generic soma The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves.
American Association of Neurological Surgeons (AANS)
5550 Meadowbrook Dr.
Rolling Meadows, IL 60008
United States

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