Background: Spironolactone is the main addition for triple therapy for resistant hypertension, which has been proven by previous studies about how effective the drug is on reducing blood pressure. Renal denervation (RDN) is a catheter-based ablation procedure designed to treat resistant hypertension (RH). Both of these interventions are considered the main choices on treating resistant hypertension, however the use of spironolactone and renal denervation to decrease blood pressure in individuals with resistant hypertension has not before been compared in a systematic study. Methods: We performed the present systematic review according to preferred items in the 2020 PRISMA. A systematic search was conducted through Pubmed, Sciencedirect, Scopus, and Web of Science selecting randomized control study until July 2022 Results and Discussion: Our search yielded 987 studies of which we included 6 studies for the final analysis. A total of 224 patients were treated with spironolactone and 211 patients treated with RDN, however 1 study performed RDN combined with PVI. From the 6 studies included in this review, it has been found that spironolactone has a better lowering effect on both 24-hour and office blood pressure. Conclusion: Spironolactone is more effective than renal denervation in reducing blood pressure in patients with resistant hypertension.

Stroke has high mortality and high recurrence rate. Telemedicine usage is rapidly growing as a strategy to optimize stroke secondary prevention by managing stroke risk factors. In order to comprehensively assess the impact of telemedicine intervention, an updated review of more outcomes is required. This systematic review and meta-analysis of randomized controlled trials (RCTs) aim to assess the telemedicine effects on systolic blood pressure, diastolic blood pressure, stroke recurrence, and mortality in post-stroke patients. A literature search of RCTs related to telemedicine intervention from PubMed, Science Direct, Scopus, Web of Science, and ProQuest from 2018 to 2022 was included in this study. The quality of the study was evaluated using the Cochrane RoB 2 tool. We presented the pooling analysis of our result in the form of mean difference (MD) and odd ratio (OR) with 95% CI using RevMan 5.4 software. Six trials involving 3,942 patients met the eligibility criteria to conduct the meta-analysis. Telemedicine intervention had a significant effect on the change of systolic (MD -6.05; 95% CI -6.23, -5.87; p < 0.00001; I 2 =84%) and diastolic (MD -2.76; 95% CI -4.13, -1.39; p < 0.0001; I 2 =89%) blood pressure control. Telemedicine intervention was also associated with lower stroke recurrence (OR 0.82; 95% CI 0.42, 1.59; p=0.55; I 2 = 70%) and mortality rate (OR 0.87; 95% CI 0.68, 1.12; p=0.28; I 2 =0%). Therefore, telemedicine applications may be a promising strategy to optimize the implementation of stroke secondary prevention. More up-to-date trials with higher quality are needed to confirm our findings and assess the other outcomes of telemedicine intervention, such as cost-effectiveness, medical adherence, and quality of life outcomes.

Beta cell failure is central to the development and progression of type 2 diabetes (T2D). This article examines the mechanism of beta cell death in T2D. Chronic hyperglycemia and hyperlipidemia are toxic to beta cells and progressively lead to apoptosis. It is triggered by metabolic alterations such as glucotoxicity, lipotoxicity, inflammation, endoplasmic reticulum (ER) stress, mitochondrial dysfunction and oxidative stress. Our review focuses on the apoptosis of beta cell induced by hyperglycemia, hyperlipidemia, beta cell fatigue, and inflammation. This review may suggest areas for future research on the therapeutic options for protecting beta cell function/mass by targeting various underlying factors and mechanisms with a role in disease progression.