Abstract:
:The MAPHY Study was conducted to investigate whether metoprolol, a relatively beta 1-selective beta-blocker, given as initial antihypertensive treatment, would lower cardiovascular complications of high blood pressure to a greater extent than do thiazide diuretics as initial treatment at similar blood pressure control. In a controlled, randomized, stratified primary prevention study (n = 3234; 16,180 patient-years) in white men (40 to 64 years old) with mild to moderate uncomplicated hypertension, a treatment schedule starting antihypertensive treatment with metoprolol was compared with treatment starting with a thiazide diuretic. The two treatment groups were well matched in blood pressure and other major clinical characteristics at randomization, as well as at the last follow-up during treatment. Total mortality was significantly lower in patients randomized to metoprolol. At the median follow-up time (4.2 years) 28 deaths occurred in the metoprolol group and 54 in the diuretic group--a difference of 48% in total mortality (95% confidence limit, ranging from 68% to 17%), mainly because of a highly significant reduction in coronary heart disease at this point in time. The benefit demonstrated with metoprolol seems to have important implications for clinical practice and public health policy, since hypertension and coronary heart disease are major health problems worldwide.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Wikstrand Jdoi
10.1016/0002-8703(88)90112-3subject
Has Abstractpub_date
1988-07-01 00:00:00pages
338-47issue
1 Pt 2eissn
0002-8703issn
1097-6744pii
0002-8703(88)90112-3journal_volume
116pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND:Performing preoperative coronary angiography (CA) before surgical repair of a type A acute aortic dissection (TA-AAD) remains controversial. Although the information provided by CA may be useful in planning the surgical approach, the potential delay to surgery and complications of CA may confer added risk of...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.01.010
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to examine prospectively the incidence, predisposing cardiovascular conditions, and risk factors for sudden death in women compared with men. METHODS AND RESULT:The study design was a prospective general population examination of a cohort of 2873 women for development of sudd...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1998.v136.90226
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Myxomas, the most common cardiac tumor in adults, occur in the atria and are prone to embolization. Obstructive valvular tumors in infants occur in pulmonic and aortic valves and generally have a more benign course. METHODS:We conducted a review of our experience in infants with tumors obstructing the right...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2002.121736
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Among patients receiving thrombolytic therapy for myocardial infarction, the outcome for those with a history of infarction is dramatically worse than for those with their first event. Methods And Results We performed a post hoc analysis of patients with a history of myocardial infarction enrolled in the Glo...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2000.106166
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Anemia is now recognized as being a common finding in CHF and is associated with increased mortality and morbidity. However, it is uncertain whether the anemia is actually causing the worse prognosis or is merely a marker of more severe cardiac disease. Previous intervention studies with subcutaneous (s.c.) ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.08.005
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Complications of vascular access are one of the most common adverse events after coronary angiography and percutaneous coronary intervention (PCI) and are reported to occur in 1% to 9% of cases. There are conflicting reports of the association of vascular complications with the use of vascular closure device...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.12.014
更新日期:2007-04-01 00:00:00
abstract::Repetitive 10-hour ECG recordings of 289 patients obtained within a year after myocardial infarction were analyzed for the presence of ventricular runs, and their association with various types of ventricular ectopic activity (VEA), average rate of premature ventricular complexes (PVCs), and coupling interval of PVCs ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90690-7
更新日期:1983-09-01 00:00:00
abstract::The aim of this prospective study was to compare the short-term reproducibility of the signal-averaged ECG (SAECG) with three analysis techniques, conventional time-domain analysis, spectral-temporal mapping (STM), and spectral-turbulence analysis (STA), in a large series of normal subjects and patients with acute myo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90202-3
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The study aimed to compare the short-term costs and long-term cost-effectiveness of 2 antithrombotics, fondaparinux and enoxaparin, for non-ST-elevation acute coronary syndrome in the United States. METHODS:It was based on a large randomized trial of 20,078 patients Fifth Organization to Assess Strategies i...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2009.02.017
更新日期:2009-05-01 00:00:00
abstract::To determine whether a dose of 5 mg of nifedipine would be useful in the treatment of hypertensive emergencies, we compared the acute hypotensive effects of two different doses of nifedipine, 5 mg and 10 mg, in patients with severe hypertension. In this prospective, randomized, double-blind study, 30 consecutive black...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(92)90283-2
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:The prodrug clopidogrel requires activation by cytochrome P-450 (CYP) enzymes for its antiplatelet effect. The genes encoding enzymes for clopidogrel activation are polymorphic, leading to reduced or increased function, depending on the respective genotype. Reduced-function alleles have been associated with ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.06.039
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The follow-up of patients with mitral and tricuspid regurgitation is important for their clinical treatment. We aimed to evaluate the reproducibility of the flow convergence method in mitral and tricuspid regurgitation. METHODS:The proximal flow convergence region was imaged with color Doppler ultrasound sc...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2003.11.006
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:A common regimen for patients requiring dual-antiplatelet therapy who are at risk for gastrointestinal complications is the synchronous administration of enteric-coated (EC) aspirin, a proton pump inhibitor, and clopidogrel, although proton pump inhibitors have the potential for pharmacodynamic interaction w...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.07.032
更新日期:2013-02-01 00:00:00
abstract::To investigate the mechanisms of restenosis and detect useful interventions to prevent it, reliable quantitative measurements must be evaluated. Coronary arteries of domestic and minipigs (n = 18) were mechanically injured by balloon overstretching and killed at different intervals (2 to 25 weeks) after quantitative a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90531-d
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:The study evaluates whether Optison used during dobutamine stress echocardiography (DSE) will improve endocardial border definition and whether this will translate to an improvement in sensitivity and specificity of the test in patients with poor echocardiographic windows. DSE is extremely valuable in the wo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.117608
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:There is growing interest in assessing therapy for acute myocardial infarction. Because thrombolysis was not a study therapy in the GISSI-3 trial, the decision about thrombolysis was left to the responsible physicians. We evaluated the data on thrombolytic therapy among patients with acute myocardial infarct...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70320-5
更新日期:1998-03-01 00:00:00
abstract::The possibility of demonstrating noninvasively with C-11 palmitate and positron emission tomography (PET) changes in myocardial substrate metabolism in normal and diseased human myocardium in response to altered substrate availability in blood and disease-related abnormalities was examined in five normal volunteers an...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90006-2
更新日期:1986-06-01 00:00:00
abstract::An 84-year-old female who previously underwent repair of an atrial septal defect had evidence of increased reflectiveness of the posterior tricuspid anulus in the apical four-chamber view and the right ventricular two-chamber view. In addition, the inferior vena cava was dilated and during contrast echocardiography, c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(84)90839-1
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:The pulmonary venous flow signal measured by transesophageal echocardiography is generally recorded from the left upper pulmonary vein in the left lateral decubitus position, whereas that by transthoracic echocardiography is from the right upper pulmonary vein in the left semi-lateral decubitus position. The...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70486-2
更新日期:1999-03-01 00:00:00
abstract::Fifty adult men with mild to moderate hypertension were recruited to participate in a double-blind crossover study. Each subject received 14 days of drug treatment and 14 days of placebo treatment (random order). Half the subjects were assigned to a metoprolol (150 mg/day) vs placebo treatment regimen and half to an a...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(88)90106-8
更新日期:1988-07-01 00:00:00
abstract:INTRODUCTION:It has been demonstrated that skin tissue cholesterol (SkinTc) is associated with angiographic disease. Now, we further delineate the relative risk of multivessel disease (>50% stenosis in at least two vessels) in the conjoint presence of high SkinTc and high traditional risk burden. METHODS:Patients sche...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.04.027
更新日期:2006-10-01 00:00:00
abstract::The effects of amiodarone on delayed afterdepolarization (DAD) and triggered automaticity induced by low potassium (0.5 mEq/L) were evaluated on isolated rabbit right ventricular muscles, by means of standard microelectrode techniques. Triggered automaticity was induced in 6 of 10 muscles in the control group, in four...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90267-5
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:The timely and accurate identification of symptoms of acute coronary syndrome (ACS) is a challenge for patients and clinicians. It is unknown whether response times and clinical outcomes differ with specific symptoms. We sought to identify which ACS symptoms are related-symptom clusters-and to determine if s...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2010.01.003
更新日期:2010-03-01 00:00:00
abstract::A study of nonbacterial thrombotic endocarditis has been carried out in a series of 3,404 autopsies performed upon atomic bomb survivors in Hiroshima in the period 1953-1970. The prevalence of the lesion was 2.4 per cent, with a greater frequency among the elderly and among females, and with a significant relationship...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90119-2
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is associated with increased risk of death, thromboembolic complications, and a lowered quality of life. Despite this burden, pharmacologic agents for prevention of AF in patients who achieved normal sinus rhythm are of limited utility, mostly because of serious and frequent side eff...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2008.10.027
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Drug-eluting stents (DES) have largely replaced bare-metal stents (BMS) for percutaneous coronary intervention (PCI). It is uncertain, however, whether introduction of DES had a significant impact on the comparative effectiveness of PCI versus coronary artery bypass graft surgery (CABG) for death and myocard...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2014.10.004
更新日期:2015-01-01 00:00:00
abstract::It has been shown that brief episodes of myocardial ischemia can render the heart more resistant to a prolonged subsequent ischemic episode. This phenomenon, called "preconditioning," has been described in human beings during coronary angioplasty with the use of clinical, electrocardiographic (ECG), or metabolic param...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70200-x
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Clinical trials have helped clarify the efficacy of clopidogrel for the treatment and prevention of vascular disease. Costs for its use exceeded $5.9 billion in 2005, making it the second greatest source of drug expenditure in the world. However, little is known about the appropriateness of that use. Overuse...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.11.039
更新日期:2008-05-01 00:00:00
abstract::Functional, ambulatory, community-dwelling subjects (n = 423, aged 75 to 85 years) underwent baseline 24-hour ambulatory electrocardiography (ECG) examinations as part of the Bronx Aging Study, a 10-year prospective cohort study designed to identify risk factors and disease markers for cardiovascular, cerebrovascular,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90425-1
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Women with X-chromosome monosomy or Turner syndrome (TS) are at increased risk for aortic dilation and dissection. To better understand the pathology and develop tools to monitor the risk of aortic disease, we investigated N-terminal pro-brain natriuretic peptide (BNP) (NT-proBNP) levels in women with TS and...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.06.021
更新日期:2012-09-01 00:00:00