Abstract:
:Initial pharmacologic therapy for hypertension is low-dose thiazide diuretics, beta-blockers, and ACE inhibitors. Increasing data have confirmed that ACE inhibitors have specific benefit in patients with diabetes, atherosclerosis, left ventricular dysfunction, and renal insufficiency. CCBs are alternative agents for ISH in the elderly and appear to decrease stroke with perhaps less protection against progression of renal insufficiency and proteinuria, CAD mortality and new onset heart failure versus other initial agents, especially ACE inhibitors. ARBs are well tolerated and effective blood pressure lowering agents but have not been confirmed as effective as ACE inhibitors for reducing renal progression, clinical events, or mortality from heart failure. Effective pharmacologic antihypertensive therapy may avoid disabling and undetected cerebrovascular disease, cognitive dysfunction, and disturbing symptoms of elevated blood pressure. Vasopeptidase inhibitor, such as omapatrilat, and endothelin-1 antagonist, such as bosentan, may become future agents approved for the reduction of morbidity and mortality with hypertension. The ALLHAT trial continues to examine the potential benefits and harms of amlodipine versus chlorthalidone and lisinopril in a diverse high-risk population. Based on ALLHAT data, however, doxazosin is no longer an acceptable initial pharmacological agent. Intensive pharmacologic treatment with blood pressure lowering to less than 130/85 mm Hg is recommended with diabetes, renal insufficiency, and heart failure with additional goal of less than 125/75 mm Hg with renal failure and proteinuria greater than 1 g/24 h, based on multiple outcome studies.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Ferdinand KCdoi
10.1016/s0733-8651(05)70213-7subject
Has Abstractpub_date
2001-05-01 00:00:00pages
279-94, vissue
2eissn
0733-8651issn
1558-2264pii
S0733-8651(05)70213-7journal_volume
19pub_type
杂志文章,评审abstract::The medical management of patients with CHF and ventricular arrhythmias is one of the most challenging clinical situations frequently encountered by physicians on a daily basis. Reviewed and examined in this article are available data regarding the clinical relevance and prevalence of ventricular arrhythmias, their pr...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Initially, transcatheter aortic valve replacement (TAVR) was only used in patients with severe symptomatic aortic stenosis and prohibitive risk for surgical aortic valve replacement. Subsequently, TAVR was extended to patients with high and intermediate surgical risk. Recently, the results of randomized trials in low-...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.09.007
更新日期:2020-02-01 00:00:00
abstract::Heart-kidney interactions have been increasingly recognized by clinicians and researchers who study and treat heart failure and kidney disease. A classification system has been developed to categorize the different manifestations of cardiac and renal dysfunction. Work has highlighted the significant negative prognosti...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2010.04.004
更新日期:2010-08-01 00:00:00
abstract::Atrial fibrillation (AF) is the most prevalent heart rhythm disorder. AF accounts for a great proportion of deaths because it independently increases all-cause mortality and cardiovascular mortality risks. Ischemic stroke is the most common cardiovascular adverse event in AF patients. Oral anticoagulation (OAC) therap...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2015.12.006
更新日期:2016-05-01 00:00:00
abstract::Although it is convenient to think of hypertension in its renal, epidemiologic, and vascular eras, a new perspective is rapidly coming to the forefront. As we become more critical in evaluating the performance of our health care systems, it is obvious that the major problems in hypertension do not lie entirely with un...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract::Several studies have indicated that women sustaining a myocardial infarction have a higher unadjusted short-term (i.e., in-hospital or 30-day) mortality than men. The advanced age of women at the time of presentation appears to be the major factor contributing to their worse prognosis relative to men. Controlling for ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70383-0
更新日期:1998-02-01 00:00:00
abstract::Ebstein anomaly is a congenital malformation involving primarily the tricuspid valve, with failure of delamination from the underlying myocardium and right ventricular myopathy. Echocardiography is diagnostic in most patients and demonstrates apical displacement of the septal leaflet and variable tethering of leaflet ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2020.04.004
更新日期:2020-08-01 00:00:00
abstract::This article presents an approach to real-time three-dimensional imaging of the tricuspid valve from three different views. This is followed by some representative cases that illustrate these views and some unique tricuspid valve abnormalities, including one case of corrected transposition. ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2007.06.001
更新日期:2007-05-01 00:00:00
abstract::Venous thromboembolism (VTE) is a potentially fatal condition and includes deep vein thrombosis and pulmonary embolism. The novel oral anticoagulants, which include the direct thrombin and factor Xa inhibitors, have been shown to be safe and effective for the treatment of VTE. Additional interventions include thrombol...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.09.007
更新日期:2015-02-01 00:00:00
abstract::Although direct angioplasty may have been undervalued in the past, its utility in the treatment of acute coronary occlusion is now firmly established, and it unquestionably will remain an integral component of myocardial reperfusion therapy. As refinements in angioplasty equipment, cardiovascular support techniques, a...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 00:00:00
abstract::Right ventricular (RV) failure is an increasingly common clinical problem that may require mechanical support. In contrast to severe left ventricular failure, RV failure is typically more reversible. Therefore, application of shorter-term percutaneous support devices is potentially attractive. Current innovations prom...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.03.007
更新日期:2012-05-01 00:00:00
abstract::One of the major drivers of change in the practice of cardiology is population change. This article discusses the current debate about epidemiologic transition paired with other ongoing transitions with direct relevance to cardiovascular conditions. Challenges specific to patterns of risk factors over time; readiness ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2016.08.004
更新日期:2017-02-01 00:00:00
abstract::Evaluation of mitral regurgitation (MR) severity remains complex and challenging. An integrative approach to grading MR is recommended. The use of multiple Doppler methods should be used to help discriminate between grades of severity. Importantly, MR severity should always be considered in the context of clinical dat...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2013.04.002
更新日期:2013-05-01 00:00:00
abstract::The pericardium consists of a visceral mesothelial monolayer (epicardium) that reflects over the great vessels and joins an outer, relatively inelastic fibrous parietal layer of organized collagen and elastin fibers, between which is a potential space that normally contains up to 50 mL of plasma filtrate. Although not...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.07.002
更新日期:2017-11-01 00:00:00
abstract::Abnormal systolic ventricular function and persistent ischemia are sensitive indicators of poor prognosis following myocardial infarction. The use of exercise improves the utility of both radionuclide ventriculography and myocardial perfusion scintigraphy in the identification of postinfarction patients at high risk o...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1984-08-01 00:00:00
abstract::The Swan-Ganz catheter was developed 35 to 40 years ago for intensive and cardiac care units to allow bedside placement and continuous monitoring and recording of right-sided heart, pulmonary artery, and wedge pressures and reasonably accurate determinations of cardiac output. Considerations for the clinical applicati...
journal_title:Cardiology clinics
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.ccl.2007.08.005
更新日期:2007-11-01 00:00:00
abstract::Once considered dangerous and potentially life threatening, cardiac catheterization of the patient with pulmonary hypertension can be performed safely and provides essential information in the diagnosis and management of pulmonary hypertension. This article summarizes the modern techniques used for right-heart cathete...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2004.04.011
更新日期:2004-08-01 00:00:00
abstract::Diabetes and the metabolic syndrome, including insulin resistance, that underlies it are hyper-coagulable states. Increased platelet reactivity,augmented activity of the coagulation system,and impaired fibrinolysis are characteristic and understood to a remarkable extent. In aggregate,these derangements contribute to ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2004.06.009
更新日期:2004-11-01 00:00:00
abstract::This article discusses exercise testing in valvular heart disease, hypertension, and the evaluation of patients for surgery. It also provides information on the effects of drugs on the exercise test and the clinical significance of block patterns and arrhythmias encountered during exercise. ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Cardiac arrest in pregnancy is not only uncommon but also catastrophic. Early aggressive resuscitation by well-trained health care providers improves the chances of successful outcomes for both the patient and her fetus. Significant physiologic changes that occur normally in pregnancy require several modifications to ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.04.006
更新日期:2012-08-01 00:00:00
abstract::Medical management of PAD is a considerable challenge. Although patients typically present with IC, there is a substantial pool of subclinical PAD patients. PAD, whether symptomatic or not, confers a marked cardiovascular risk; with affected patients dying of heart attack or stroke, identification of index patients an...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(02)00089-9
更新日期:2002-11-01 00:00:00
abstract::Coronary thrombosis is now recognized as the most common proximate cause of acute myocardial infarction, and thrombolysis is evolving as an accepted therapeutic approach to patients presenting in the early stages of myocardial infarction. The ascent of thrombolysis in treatment hierarchies reflects multiple factors, i...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-02-01 00:00:00
abstract::Subaortic stenosis can be a complex disease of multiple anatomic etiologies. At the core is either an elongated and narrow outflow tract as compared to normal or a fully muscle-rimmed VSD used as an intraventricular routing pathway. An array of treatment modalities is needed for an effective management strategy. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(02)00013-9
更新日期:2002-08-01 00:00:00
abstract::Cardiac transplantation is now an accepted therapeutic procedure in the management of patients suffering from end-stage congestive heart failure. The advances in myocardial preservation, long-distance procurement, immunosuppression, improvement in the treatment of infectious diseases, and utilization of endomyocardial...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-02-01 00:00:00
abstract::Dilated cardiomyopathy is a heterogeneous disease, both clinically and genetically. Two genes responsible for X-linked DCM have been identified. Five genetic loci responsible for X-linked DCM have been identified. Five genetic loci responsible for autosomal dominant DCM have also been mapped but no genes identified so...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70037-0
更新日期:1998-11-01 00:00:00
abstract::Targeted ultrasound imaging uses acoustically active contrast agents bearing a ligand on the surface that binds to a function-specific molecule. These ultrasound contrast agents are typically gas-filled microbubbles, nongaseous liposomes, or lipid-encapsulated perfluorocarbon emulsions. Binding of the contrast agent t...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2004.02.008
更新日期:2004-05-01 00:00:00
abstract::The number of supporters of complete arch replacement in the surgery of acute type A aortic dissection has been steadily increasing as a result of cerebral perfusion techniques that enable the extension of safe circulatory arrest time. However, there is no agreement in the surgical community on an optimal surgical app...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2010.01.007
更新日期:2010-05-01 00:00:00
abstract::The ideal aortic valve substitute remains elusive. Bioprosthetic valves are the replacement option of choice in elderly patients undergoing aortic valve replacement (AVR). When implanted in young and middle-aged adults, both bioprosthetic and mechanical valves are associated with excess mortality compared with the age...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.09.012
更新日期:2020-02-01 00:00:00
abstract::In the 1960s, when LVADs and TAHs were introduced into clinical use, researchers estimated that, with this technology, the problem of heart failure could be solved within 20 years. Unfortunately, the evolution of these devices has taken much longer than anticipated. Nevertheless, significant advances have been achieve...
journal_title:Cardiology clinics
pub_type: 历史文章,杂志文章
doi:10.1016/s0733-8651(02)00133-9
更新日期:2003-02-01 00:00:00
abstract::Percutaneous left atrial appendage (LAA) closure is being increasingly used as a treatment strategy to prevent stroke in patients with atrial fibrillation (AF) who have contraindications to anticoagulants. Several approaches and devices have been developed in the last few years, each with their own unique set of advan...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.07.006
更新日期:2014-11-01 00:00:00