Hypertension
- The role of multiple risk factors in cardiovascular morbidity and mortality
BACKGROUND Cardiovascular disease remains the leading cause of death in the United States.
OBJECTIVE To identify important modifiable cardiovascular risk factors and appropriate interventions.
DISCUSSION The three most important modifiable risk factors are hypertension, cigarette smoking, and dyslipidemia. Systolic hypertension poses a greater risk than diastolic, but the prognostic significance of diastolic blood pressure may have been underestimated. When a smoker quits, the cardiovascular risk soon approaches that of the nonsmoker. Cardiovascular risk increases progressively with elevations of the serum total cholesterol level above 200 mg/dL. Recently identified risk factors include hyperinsulinemia and left ventricular hypertrophy.
CONCLUSION Each patient deserves an evaluation of cardiovascular risk followed by education about and therapy for those risk factors that can be changed. When more than one risk factor is present, as is often the case, the increase in risk may be synergistic rather than additive.
- Current hypertension management: separating fact from fiction
Speculations that have led many physicians to abandon the use of diuretics have not proven to be of clinical relevance in most instances.
- Primary pulmonary hypertension, then and now: 28 years of experience
Patients with PPH are presenting at earlier stages of the disease, have fewer complications during cardiac catheterization, and probably survive longer after diagnosis than patients seen several decades ago.
- Adrenergic agents: clinical trials and experiences
Different beta blockers have different effects on cardiac output and heart rate, and some may diminish detrimental arterial changes induced by hypertension. A long-term preventive effect against coronary artery disease remains to be demonstrated.
- The hemodynamic effects of adrenergic blocking agents
Alpha-1 blockers may suit patients with active life-styles, peripheral vascular disorders, or high blood-cholesterol levels, while beta blockers are useful in tachycardia, palpitations, or angina pectoris. An overview of the pharmacologic qualities and numerous clinical applications of these agents.
- Treating hypertension to prevent coronary disease
Past successes and failures in treating hypertension suggest ways to provide better overall therapy and reduce the incidence of coronary heart disease.
- Alpha- and beta-blocking agents: pharmacology and properties
Continued investigations into the multiple effects of certain alpha and beta blockers may provide clues to more effective treatment of hypertension.
- Tailoring antihypertensive therapy in 1991
The trend is toward individualized treatment and away from rigid stepped care.
- The Telelab personal blood pressure transmitter: accurate and reliable home monitoring for hypertensive patients
A home blood pressure recording device that can transmit data by phone is accurate and convenient.
- The role of adrenergic drugs in antihypertensive therapy
The clinical effects of drugs in the adrenergic class can be predicted by the location of the alpha or beta receptors that the drug activates or inhibits.