W H Frishman

..This article outlines the appropriate medical management of ischemic disorders of the intestine, with an emphasis on the drug treatments presently used in clinical practice and those being studied in the laboratory...

..Hyperkalemia remains a potential problem with all aldosterone antagonists...

..Various approaches under investigation include the use of partial nicotine agonists (eg, varenicline), inhibitors of the hepatic P-450 enzyme (eg, methoxsalen), cannaboid-1 receptor antagonists (eg, rimonabant), and nicotine vaccines...

..The drug will be marketed under the trade name of Revatio, not Viagra, the name used for the ED indication. The approved dose for primary pulmonary hypertension is 20 mg 3 times daily...

..Despite differences in the risk profiles of previously studied patients and INVEST patients, the antihypertensive effects of Ve+Tr were similar...

..A discussion of how atrial fibrillation has affected the Presidents is also included...

..Despite the large number of antiarrhythmic drugs having different electrophysiologic actions, as described in this article, only the β-blockers have been shown to be effective in reducing mortality and to lack proarrhythmic actions...

..Many drugs are also transferred into human milk with potential adverse effects on the nursing infant. This article summarizes some of the literature concerning the risks and benefits of using cardiovascular drugs during pregnancy...

..Intensive efforts over the past 45 years to develop important pharmacologic treatments have reduced CV risk dramatically. Described in this article are over 150 drugs being developed to prevent and treat CV disease...

..This review will discuss the impact of adherence to prescribed therapies for CVD, outline common barriers to adherence, and demonstrate the value of once-daily dosing regimens for improved patient adherence...

..In animal models, these newer agents also have been shown to prevent the progression of hypertensive microvascular damage. Their neuroprotective effects offer possible unique advantages in the management of hypertension...

..This review presents an overview of the clinical and pharmacologic carvedilol controlled-release data...

..g. mecamylamine) and glucose tablets. Various approaches under investigation include inhibitors of the hepatic P450 enzyme (e.g. methoxsalen), cannabinoid-1 receptor antagonists (e.g. rimonabant), and nicotine vaccines...

..Treatment for recurrent vasovagal syncope includes increased salt and water intake and various drug treatments, most of which are still under investigation...

..This article outlines the appropriate pharmacologic management of ischemic disorders of the intestine, with an emphasis on the pharmacologic treatments presently being used in clinical practice and those being studied in the laboratory...

..Amlodipine/atorvastatin retains the safety and efficacy of its parent compounds whilst simplifying the management of these comorbid conditions, in what may be considered the first version of a polypill...

..A novel approach to treatment using the cannabinoid-1 receptor antagonist rimonabant is also under investigation...

..Treatment for recurrent vasovagal syncope includes increased salt intake, and various drug treatments, most of which are still under investigation...

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..Indeed, the beta-adrenergic blockers have provided us with a great clinical legacy for now and in years to come...

..ACE inhibitors restore endothelial cell balance to improve arterial compliance, thus they can provide benefits beyond lowering blood pressure...

..Careful consideration of the lipid lowering efficacy and also the risk profile for drug-drug interactions should be taken before initiating patients on statin therapy, or switching patients between different drugs of the statin class...

..Nicotine replacement and nonnicotine modalities have been used alone and in combination to help in smoking cessation. These treatment modalities appear to be safe in patients with known stable coronary artery disease...

..Prolongation of the ECG QT interval with 5-HT2 serotonergic receptor blockers may pose a potential risk with these treatments in some patients...

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..The combination of clinical efficacy and tolerability should render ARBs as a major treatment alternative for hypertension...

..This article also discusses the adverse effects of cardiovascular drugs in the elderly, medications best to avoid in the elderly, and the prudent use of medications in the elderly...

..Torsades de Pointes is more common in women related to a longer QT-interval. Lower dose OCPs decrease the risk of MI, stroke and thrombosis. HRTs are not effective for CAD prevention...

..The systemic toxicity of these agents is reviewed, along with the possible drug interactions. Brief mention is also made of other antiglaucoma medications used alone and in combination with topical beta-blockers...

..beta-Blockers and dihydropyridine calcium channel blockers are effective as monotherapy in hypertensive patients and have complementary mechanisms for lowering BP...

..Despite differences in the risk profiles of previously studied patients and INVEST patients, the antihypertensive effects of Ve+Tr were similar...

..Patients at risk for hypertension should be monitored for changes in blood pressure during NSAID treatment...

..Additionally, better means need to be established for distinguishing between viral and noninfectious autoimmune forms of the disease, so that appropriate treatment can be instituted...

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..Representatives of both classes are now available in fixed-dose combinations containing an ACE inhibitor, the benefits of which include effective 24-hour BP control, a reduced incidence of adverse effects, and improved adherence...

..The role of testosterone in male cardiovascular health is not completely understood, and additional studies are needed to explain its effect on atherosclerosis and its complications...

..Eplerenone has already been approved for the treatment of systemic hypertension, and several clinical trials are currently underway to identify other therapeutic uses for this agent in cardiovascular disease management...

..Little is known about the long-term effectiveness of recent efforts to improve end-of-life care education at U.S. medical schools...

..Use of diuretics and NSAID by functioning elderly individuals is not necessarily associated with worsening azotemia...

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..The best laboratory procedure to screen for possible clopidogrel variability of response remains to be determined...

..This article reviews the current experience with exercise and congestive heart failure and discusses strategies used to implement an exercise program for patients...

..This review discusses the cardioprotective properties of flavanols, and the mechanisms underlying these beneficial actions...

..The overall data also suggest that reduction of stroke in persons with hypertension is related more to a reduction in blood pressure than to the type of antihypertensive drugs used...

..Various strategies to improve outcomes include the use of tight blood glucose control, and various coronary interventions are currently under clinical study...

..The endothelin antagonists have great potential as agents for use in the treatment of a wide spectrum of disease entities and as biologic probes for understanding the actions of endothelin in human beings...

..The patient responded successfully to plasmapheresis. The authors are reporting this case to emphasize the unpredictable nature of the association between the drug and the disease, which necessitates careful hematologic monitoring...

..In this article, the pathogenesis of free radical production and cell injury are discussed, and therapeutic approaches for disease prevention are presented...

..In addition, apoptosis in the region bordering the infarct can influence the development of ischemic cardiomyopathy and ventricular dilation...

..Based on the promising results from animal studies, active research and drug development programs are under way to investigate the clinical potential of endothelin antagonism for treatment of cardiovascular disease...

..Other strategies that have been evaluated are dietary glutamine supplementation and the use of the antioxidant probucol...

..Use of CRT, statins, and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers reduced mortality and hypertension, diabetes, and older age increased mortality...

..05), use of digoxin (risk ratio = 4.2), systemic hypertension (risk ratio = 14.2), diabetes (risk ratio = 4.3), and left ventricular ejection fraction (risk ratio = 1.1)...

..In conclusion, patients with implantable cardioverter-defibrillators should be treated with beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statins to reduce mortality...

..Patients will require close monitoring and slower refeedings to minimize the risk of these complications...

..Since neuropsychiatric symptoms are seen in patients with cardiovascular disease, clinicians should be aware of the possible relationship between these symptoms and concurrent cardiovascular drug therapy...

..The growing use of these new agents, such as acetylcysteine, endothelin blockers, and most recently fenoldopam, has increased the options available for the prevention of CaN...

..The data reported to date have been promising, but definitive studies are not possible because sauna treatment would be difficult to evaluate in a double-blind, placebo-controlled study...

..Despite the pharmacokinetic differences among beta-blockers, these drugs should always be titrated to achieve the desired individual patient response...

..Additional studies need to be done with TMR to assess whether it is a useful treatment or an addition to the list of placebo therapies initially thought to have been of benefit in the therapy for angina pectoris...

..Mention is made of other antiglaucoma medications used alone and in combination with topical beta-blockers. Identification of genetic loci-a bold new step toward glaucoma treatment-is mentioned briefly at the end of the article...

..Other benefits include improvement in New York Heart Association functional class status and improvement in dyspnea...

..Those individuals at high risk for aspirin resistance might best be treated with an additional oral antiplatelet drug (eg, clopidogrel) to achieve maximal protection against arterial thrombotic events...

..e., theophylline) for bradyasystolic rhythms. More innovative approaches include the use of thyroid hormone and endothelin...

..At present there is no evidence suggesting a favorable treatment outcome using thyroid hormone supplementation for any systemic condition except in those patients with documented hypothyroidism...

..Data from 13 placebo-controlled trials suggest that on average one stroke is prevented for every 143 patients treated with statins over a 4-year period...

..In addition, adrenomedullin has actions in the brain, lungs, and kidneys to regulate regional hemodynamics. With these activities defined, recent studies have suggested a potential therapeutic role for adrenomedullin...

..The last group reviewed includes echocardiographic contrast agents that, in this investigative setting, are employed to enhance detection of segmental wall motion when used with agents from groups 2 and 3...

..As our understanding of this receptor and its modulators deepens, the possibility of clinical application draws near...

..In conclusion, patients having implantable cardioverter-defibrillators should also be treated with beta-adrenergic blockers to reduce the frequency of appropriate shocks...

..In high-risk patients, the results of these most recent studies have not revealed any benefit of treatment...

..High baseline plasma levels of ADMA in patients with DM have been shown to predict diabetes related complications. However, there are limited data on the prognostic significance of baseline ADMA levels in patients with established DM...

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..In combination with other cholesterol-lowering drugs, such as statins, psyllium provides an added benefit on cholesterol lowering, and is well tolerated and cost-effective...

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..The results of clinical trials with growth factor infusions and gene therapy techniques to enhance growth factor production have shown some promise, but therapeutic angiogenesis remains at an early stage of development...

..In this article, treatment recommendations are included for those patients undergoing endoscopy who are receiving anticoagulation and for those who are at risk for bacterial endocarditis...

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..Table 2 summarizes the recommendations regarding the use of cardiovascular drugs during pregnancy and lactation...

..Bioavailability was similar for both formulations of propranolol. Propranolol CR exhibited appropriate pharmacokinetics for a chronotherapeutic approach to the treatment of hypertension...

..Most patients respond to drug therapy, but problems may arise related to a rapid normalization of blood pressure...

..Innovative therapies are now available for the treatment of migraine and vascular dementia. Primary prevention of stroke remains the optimal therapeutic strategy and includes treatment of systemic hypertension and hypercholesterolemia...

..Pharmacologic strategies that serve to inhibit chymase function may prove to be useful in the setting of vascular injury...

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..For example, cardiovascular drugs can induce a vast array of adverse dermatologic responses. This article reviews the various cutaneous reaction patterns that can occur as a result of treatment with Class I and II antiarrhythmic agents...

..This review article focuses on the pharmacology as well as clinical studies of the sirolimus-eluting stent...

..In particular, genetic polymorphisms of cardiovascular candidate genes and drug metabolism are described. The pharmacodynamic and pharmacokinetic variations among genders and ethnicities are summarized...