Abstract:
:Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespective of sex, or ethnicity, but it is worse with the advancement of age. Effective control of systolic blood pressure (SBP), is associated with significant reduction in the incidence of these complications. Currently, there is a debate about the optimal SBP control in view of the Systolic Blood Pressure Intervention Trial (SPRINT) showing beneficial cardiovascular (CV) effects of intensive SBP of < 120 mmHg in older patients. Also, the recently released blood pressure (BP) guidelines by the American College of Cardiology, the American Heart Association and the American Society of Hypertension (ACC/AHA/ASH) recommend a SBP reduction of < 130 mmHg. These SBP treatment recommendations are in contrast with the current (JNC VIII) committee of BP treatment guidelines, which recommend a SBP reduction < 150 mmHg for the same age of patients. All these different recommendations have created a debate regarding the optimal treatment targets for the systolic hypertension of the elderly patients. To gain more information a focused Medline search was conducted from 2010 to 2017 using the terms, systolic blood pressure, aggressive control, older subjects, treatment guidelines, and 37 pertinent papers were retrieved. The findings from these studies suggest a SBP reduction of < 140 mm Hg for persons aged ≥ 60 years, with an attempt for SBP reduction to ≤130 mm Hg in healthier subjects and hose with CVD, DM, and CKD. Care should be taken not to further reduce the SBP in older subjects if their DBP is ≤60 mmHg for the fear of J-curve effect.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Chrysant SGdoi
10.1080/00325481.2018.1433434subject
Has Abstractpub_date
2018-03-01 00:00:00pages
159-165issue
2eissn
0032-5481issn
1941-9260journal_volume
130pub_type
杂志文章,评审abstract::Joint and soft-tissue aspiration and injection procedures are relatively easy to master once the physician has acquired an understanding of the techniques and subtleties of performing these procedures at certain sites. These techniques can be used to diagnose and treat many painful joint and soft-tissue conditions and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2001.03.879
更新日期:2001-03-01 00:00:00
abstract::Asthma and chronic obstructive pulmonary disease (COPD) are disorders that affect millions of people in the United States and other countries in the world. Asthma is a chronic inflammatory disease of the airways that has cellular and molecular pathways. Affected patients have recurrent episodes of wheezing, dyspnea, c...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.12.2005.suppl44.232
更新日期:2005-12-01 00:00:00
abstract::A concerted national effort has reduced cardiovascular mortality rates in the general US population. Unfortunately, not all ethnic groups have benefited equally from these improvements in our national health. The author presents insights into social and clinical factors that affect cardiovascular disease among Hispani...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701252
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVES:The clinical significance of hyperplastic polyp-like histologic changes in random biopsy samples ('serrated epithelial change' or SEC) from patients with inflammatory bowel disease (IBD) remains uncertain, with some studies suggesting an increased risk of dysplasia and even carcinoma. Controlled studies are ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1802138
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVES:We aimed to determine the prevalence of chronic diseases and unhealthy lifestyle behaviors of Turkish doctors as compared with the general population and the frequency of compliance with preventive clinical practices among doctors. METHODS:This was an observational, prospective cohort study that enrolled gr...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2017.1272399
更新日期:2017-04-01 00:00:00
abstract::Preview Congestive heart failure (CHF) is a common and serious problem, and its diagnosis and treatment should not be the exclusive province of the cardiologist. Primary care physicians can very adequately manage most cases in a cost-effective manner. In this article, Dr Seager gives guidelines for a standard approach...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946074
更新日期:1995-11-01 00:00:00
abstract::Some patients with severe and chronic pain fail to obtain adequate pain relief with standard pharmacologic treatment agents, including low to moderate dosages of opioids. Understandably, physicians might not believe patients who claim that a standard opioid dosage is an ineffective treatment. These patients may be sev...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2014.996110
更新日期:2015-01-01 00:00:00
abstract::The cutaneous manifestations of systemic diseases are diverse. In some cases, they are the first signs of an underlying disorder, such as Cowden's disease, dermatomyositis, and Lyme disease. Sister Mary Joseph's nodule (metastatic involvement of the umbilicus) is an ominous sign of internal malignant disease. Drug-ind...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-12-01 00:00:00
abstract::Two distinct subpopulations in the pediatric age-group are particularly at risk for poisoning, and the substances likely to be ingested by each group differ. The method of critical care given here incorporates consideration of specific types of poisoning into an overall plan of general diagnostic and therapeutic measu...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716152
更新日期:1982-08-01 00:00:00
abstract::The clinical history and physical examination remain the most important factors in determining the presence, anatomic location, and physiologic extent of arterial occlusive disease and the need for operation. The physician should refrain from ordering arteriography to confirm the diagnosis of arterial disease unless o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714271
更新日期:1976-02-01 00:00:00
abstract::Preview Although heartburn is the most common symptom of gastroesophageal reflux, many patients with reflux have other, more obscure manifestations. Recognition of all potential signs and symptoms of reflux is important for expeditious management. This article focuses on these atypical presentations and discusses how ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946110
更新日期:1996-04-01 00:00:00
abstract::Evaluation of a patient presenting with dizziness begins with and largely depends on the patient's history. The diagnosis often can be accurately determined in a primary care setting when a stepwise algorithmic approach is used. The first step is getting a detailed account of precisely what the patient means by "dizzi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::Acute intermittent porphyria is an unusual syndrome that may be very difficult to differentiate from acute intraabdominal processes. Diagnosis requires the documentation of increased urinary porphobilinogen. Failure to perform appropriate tests early in the attack may necessitate diagnostic laparotomy to rule out intr...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704454
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:To identify attitudes and practices of endocrinologists (ENDOs), family practitioners (FPs), internists (IMs), primary care nurse practitioners (NPs), physician assistants (PAs), certified diabetes educators (CDEs), retail pharmacists (R-PHs), and hospital pharmacists (H-PHs) with respect to type 2 diabetes m...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.05.2764
更新日期:2014-05-01 00:00:00
abstract::The hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors of statin action are very effective and safe drugs, and they are widely used for the treatment of hyperlipidemia and the prevention of primary and secondary cardiovascular diseases (CVDs). However, recent meta-analyses of previous studies done with...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2017.1292107
更新日期:2017-05-01 00:00:00
abstract::Preview Practical assessment of the functional and support factors affecting quality of life in older patients should be an integral part of medical management. This approach allows physicians to focus on remediable problems that compromise patients' daily functioning and may hinder them from living independently. In ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946120
更新日期:1996-05-01 00:00:00
abstract::With prostate cancer being diagnosed and treated in more than 300,000 men each year, the pool of long-term survivors is dramatically increasing. Because these patients are usually elderly, they are often receiving follow-up care for unrelated problems in a primary care setting. This offers the physician an excellent o...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.09.73
更新日期:1996-09-01 00:00:00
abstract::Good personal hygiene is one of the most important measures for control of hepatitis infection. Hepatitis is transmitted by close contact with an infected person or nonhuman primate, exposure to infected food or water, transfusion of infected blood, dialysis, or contact with hepatitis-containing laboratory specimens. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715590
更新日期:1980-11-01 00:00:00
abstract::When confronted with a patient with an alteration in mental status following surgery, the physician must consider both organic and psychosocial causes and their synergistic interactions. A careful medical assessment will rule out metabolic disorders, sepsis, cardiopulmonary complications, and adverse drug effects. A m...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1980.11715409
更新日期:1980-03-01 00:00:00
abstract::By being aware of which patients are at high risk for ingestion or insertion of foreign bodies, physicians can be on the lookout for objects in the gastrointestinal tract and ready to institute initial care. Esophageal foreign bodies and other objects that increase the chance of perforation or obstruction may require ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1992.11701481
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVES:There is evidence that increasing severity of hypertriglyceridemia increases the risk of acute pancreatitis. There is a debate about superiority of treatment methods and previous works have specifically called for direct comparison between IV insulin and apheresis techniques. Identify patient characteristics...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2018.1470439
更新日期:2018-06-01 00:00:00
abstract::Management of the acutely poisoned patient should start with decontamination of the skin and irrigation of the eyes, if necessary, and assessment of cardiorespiratory status, neurologic status, and pupils and eye movement. If a definable toxic syndrome is present, the specific "antidote" should be given. If no such sy...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716063
更新日期:1982-05-01 00:00:00
abstract::Autonomic neural impulses that accompany discharges during a seizure can cause a variety of cardiac manifestations, including cardiac arrhythmias, sudden death, anginal chest pain, neurogenic pulmonary edema, and symptoms of pheochromocytoma. Either generalized or focal seizures may generate such signs and symptoms. A...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11716430
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Symptoms of irritable bowel syndrome (IBS) can have a profound impact on emotional health and quality of life, and current treatments are sometimes unsatisfactory for patients facing this lifelong disease. Probiotics, which can normalize gastrointestinal microflora, may alleviate symptoms of IBS. OBJECTIVE:...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2009.03.1984
更新日期:2009-03-01 00:00:00
abstract::Severe gastroesophageal reflux disease is usually a chronic problem with periods of relapse, but effective medical and surgical therapies are available. Two recently introduced agents, omeprazole (Prilosec) and cisapride (Propulsid), represent advances in medical therapy; the safety of long-term, continuous omeprazole...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::To our knowledge, this is the first reported case of primary Pseudomonas maltophilia pneumonia. Presenting symptoms were fever and chills of two days' duration and a density in the right upper lobe. Sputum culture showed normal flora, and multiple blood cultures were negative. Antibiotic therapy initially with penicil...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715067
更新日期:1979-02-01 00:00:00
abstract::Chronic otitis media was the cause of septicemia in two hospitalized men. The organisms involved, K pneumoniae and B fragilis, are not usually associated with primary infections of the middle ear and would not have been traced to this site had proper cultures not been performed. In adults, the true incidence of bacter...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Metformin is a first-line pharmacological treatment for patients with type 2 diabetes mellitus because of its favorable overall profile, including its glucose-lowering ability, weight-neutral effects, and low risk of hypoglycemia; however, gastrointestinal (GI) intolerance may limit use in some patients. Extended-rele...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.01.2241
更新日期:2011-01-01 00:00:00
abstract::Contrary to popular belief, hypoglycemia is an infrequently encountered condition and its presence is questionable until confirmed by appropriate tests. In ambulatory patients, blood glucose levels obtained during intake of a normal diet are more reliable than those obtained during a glucose tolerance test. If the blo...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11700028
更新日期:1987-11-01 00:00:00
abstract::On the basis of currently available information, the following recommendations can be made for treating osteoporosis. Women with no contraindications should maintain a total calcium intake of 1,000 mg daily before menopause and 1,500 mg daily after menopause. Calcium supplementation should be considered adjunct treatm...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704612
更新日期:1990-03-01 00:00:00