F H Messerli

..In conclusion, most likely, the pheochromocytoma was the underlying cause of this erratic blood pressure pattern and may have worsened the course of the president's ischemic cardiomyopathy...

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..Here, the authors consider the extended debate on this topic and discuss the mechanisms of action for traditional and newer b-blockers and their role in hypertension management...

..Newer calcium antagonists demonstrate antihypertensive efficacy similar to that of their predecessors but appear to have a reduced propensity to cause edema...

..Whether measured in office or clinical trials, BP is an important clinical tool that should be treasured by practitioners and clinical investigators alike...

..However, these concerns should not deter physicians from pursuing a more aggressive control of hypertension, because currently blood pressure is brought to recommended target levels in only approximately one-third of patients...

..Thus, low-dose combination therapy (of a dihydropyridine calcium antagonist with either an ACE inhibitor or an ARB) may be preferred over high-dose monotherapy...

..No. Dual renin-angiotensin system blockade has never been shown to reduce the rates of morbidity or death from any cause...

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..Concomitant administration of amlodipine and atorvastatin is an effective and well tolerated treatment for coexisting hypertension and dyslipidemia...

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..Despite the availability of effective and safe antihypertensive drugs, hypertension and its concomitant risk factors remain uncontrolled in most patients...

..The long-term safety of antihypertensive therapy is documented poorly because most trials only last 4 to 6 years. Despite these drawbacks and concerns, the benefits of antihypertensive therapy clearly outweigh its potential risk...

..51, p=0.22). In conclusion, statin therapy effectively decreases CV morbidity and mortality to the same extent in hypertensive and nonhypertensive patients...

..These micro- and macrovascular features make lercanidipine an attractive new member in the arsenal of the powerful dihydropyridine calcium antagonists...

..To analyze the available data to assess the benefits of antihypertensive therapy in hypertensive patients with diabetes mellitus...

..To assess antihypertensive efficacy of beta-blockers and their effects on cardiovascular morbidity and mortality and all-cause morbidity compared with diuretics in elderly patients with hypertension...

..Because coronary perfusion occurs mainly during diastole, patients with coronary artery disease (CAD) could be at increased risk for coronary events if diastolic pressure falls below critical levels...

..To analyse effects of a heart rate-lowering calcium antagonist in hypertensive post-myocardial infarction patients...

..Therefore, until ironclad safety data are provided, doxazosin, and probably all alpha-blockers, should no longer be used as first-line antihypertensive therapy...

..With regard to other antihypertensive drug classes, we suggest continuing the management of hypertension according to current treatment guidelines with little fear of any substantial cancer risk...

..This large practice-based clinical trial assessed the efficacy and tolerability of fixed-dose combination therapy with amlodipine/benazepril, compared with amlodipine monotherapy, in patients with mild-to-moderate hypertension...

..Combination of more than one drug is frequently required to control BP and may be more beneficial than monotherapy...

..The purpose of the study was to compare a beta-blocker-based strategy with a heart rate-lowering calcium antagonists-based strategy in patients with prior MI...

..The combination of a heart rate lowering calcium antagonist, particularly verapamil, with an ACE inhibitor offers some potential to either prevent or reverse target organ disease associated with hypertension and diabetes...

..To determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin]...

..However, their use together in left ventricular hypertrophy and in patients with coronary heart disease, although promising, must be proved through carefully designed, prospective, randomized trials...

..However, whether this phenomenon exists in patients with hypertension and coronary artery disease is not known...

..Sweeping recommendations for the use of beta-blockers and diuretics as preferred therapeutic strategies are inappropriate and a more sophisticated drug therapy regimen is often needed...

..These effects may be explained by celiprolol's cardiac beta-1 receptor inhibitory and peripheral beta-2 receptor agonistic effects...

..This risk was greater in patients with higher baseline body mass indexes and higher baseline fasting glucose levels and in studies in which beta blockers were less efficacious antihypertensive agents compared with other treatments...

..This article reviews the data on risk reduction involving the beta-blockers and calcium antagonists, as well as other antihypertensive classes that have been shown to reduce the risk of cerebrovascular and cardiovascular disease...

..Unless data emerge to the contrary, dual RAS blockade should no longer be used in clinical practice...

..Prehypertension is considered a precursor of stage 1 hypertension and a predictor of excessive cardiovascular risk. We investigated whether pharmacologic treatment of prehypertension prevents or postpones stage 1 hypertension...

..However the data on comparison of fixed-dose combination with free-drug regimen to improve patient's medication compliance is limited...

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..Thus, recent evidence argues against universal cardioprotective properties of beta-blockers but attest to their usefulness for specific cardiovascular indications...

..Moreover, the incidence of stroke is significantly related to baseline BP, which may be an important factor to consider when deciding on treatment strategies in high-risk patients with CAD...

..These findings suggest that systemic and renal hemodynamic effects may be drug specific and not uniform for all ACE inhibitors...

..Fixed-dose combinations should be used routinely for the management of hypertension and should also be considered when initiating therapy for patients with newly diagnosed hypertension...

..The purpose of this study was to evaluate the role of heart rate reduction with beta-blockers on the risk of cardiovascular events in patients with hypertension...

..Thus, combination therapy should primarily be used for lowering arterial pressure and only secondarily to possibly improve concomitant pathophysiologic conditions associated with hypertensive heart disease...

..As we enter the new millennium, it is critical to examine the efforts that have led to our ability to treat this once incurable disease...

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..The cardiac adaptation to cyclosporine-induced hypertension has more severe concentric left ventricular hypertrophy and impaired left ventricular systolic performance.(ABSTRACT TRUNCATED AT 250 WORDS)..

..Combination therapy with angiotensin receptor blockers and hydrochlorothiazide was additive, without any significant effect on the safety profile...

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..This article reviews the data available from clinical trials and argues that beta-blockers are less efficacious than other currently available antihypertensive agents for patients with uncomplicated hypertension...

..Newer beta-blockers have additional properties which may be beneficial. Although, whether these additional benefits will help in primary prevention is not clear...

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..Finally, the pathway provides a step by step recommendation for the management of in hospital HTN and of hypertensive emergencies...

..This study sought to evaluate the efficacy of beta-blockers (BBs) for primary prevention of heart failure (HF) in patients with hypertension...

..However, beta-blockers remain very efficacious agents for the treatment of heart failure, certain types of arrhythmia, hypertropic obstructive cardiomyopathy, and in patients with prior myocardial infarction...

..We aimed to critically review the evidence to assess the use of perioperative beta blockers in patients having non-cardiac surgery...

..7 vs. 20.3; P = .1139). Our study demonstrates that pulse pressure, a well-established marker of vascular health, is a significant independent predictor of the severity of CAD as assessed by coronary angiography in South Asians...

..However, this is applicable for hypertension and beta-blockers continue to be efficacious for other indications...

..Normalization of CR is associated with better survival, whereas transition to LV hypertrophy increases mortality...

..Short-acting CCBs have an unfavorable hemodynamic profile. The role of long-acting CCBs in patients with coronary artery disease is unknown...

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..Stroke is the most devastating consequence of hypertensive cardiovascular disease, and our hypothesis of cerebroprotection by AT2 receptor activation should be tested by a head-to-head comparison of an ARB with an ACE inhibitor...

..Thus, a verapamil SR-based antihypertensive treatment strategy is an alternative to a beta-blocker-based strategy in adults with CAD and diabetes...

..We analyzed the available data to assess the effects of calcium antagonists in hypertensive patients with diabetes mellitus...

..Also participating were Philip B. Gorelick, MD, MPH, Director, Center for Stroke Research, University of Illinois College of Medicine, Chicago, IL, and Franz H. Messerli, MD, St Luke's-Roosevelt Hospital Center, New York, NY...

..CONCLUSION: The verapamil-trandolapril-based strategy was as clinically effective as the atenolol-hydrochlorothiazide-based strategy in hypertensive CAD patients...

..CONCLUSIONS: Antihypertensive drug classes have different effects on left ventricular mass reduction. Whether a greater reduction of left ventricular mass results in better clinical outcomes remains to be determined...

..Decreased beta-adrenergic responsiveness with age and comorbid conditions makes beta-blockers unattractive. Thus, they should not be considered appropriate for first-line therapy of uncomplicated hypertension in the geriatric population...

..Thus, calcium antagonists may be safely used in the management of hypertension and angina pectoris...

..CODAS verapamil was found to be efficacious and well tolerated among elderly hypertensive patients in this community trial...

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..Despite the concern that has been raised regarding the long-term safety of some antihypertensive agents, it is clear that lowering BP is safe and beneficial...

..We reviewed the randomized controlled trials that evaluated the effects of an antihypertensive drug versus placebo or another antihypertensive agent of a different class on carotid intima-media thickness...

..The perspective of a renewal of therapeutical strategies to optimise the prevention of target organ damage and perhaps even some of the diseases of ageing, such as loss of cognitive function is emphasised...

..The use of carvedilol compared with metoprolol did not effect glycemic control...

..This is particularly true for black and Hispanic patients who have been underrepresented in randomized CAD trials...

..The effects of the 2 beta-blockers on clinical outcomes need to be compared in long-term clinical trials...

..Accordingly, factors predicting stroke risk in hypertensive, clinically stable coronary artery disease patients were determined with data from the INternational VErapamil SR-trandolapril STudy (INVEST)...