H R Black

..Hypertensive patients are often given a calcium antagonist to reduce cardiovascular disease risk, but the benefit compared with other drug classes is controversial...

..Aggressive lowering of BP is critical to help reduce the risk of CVD and help prevent the development of HF...

..To examine regional differences in the Controlled ONset Verapamil INvestigation of Cardiovascular Endpoints (CONVINCE) trial...

..Larger and longer studies will be needed to document any long-term reduction in cardiovascular event rates associated with treating stage 1 systolic hypertension...

..We must also encourage the development of antihypertensive drugs that lower SBP more effectively than those that are currently available...

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..0%), the frequency of adverse events was similar for doxazosin GITS and placebo. Doxazosin GITS was effective as combination antihypertensive therapy with the major classes of antihypertensive agents...

..We assessed the effects of these drug combinations on progression of chronic kidney disease...

..These findings demonstrate that doxazosin add-on therapy is an effective, well-tolerated treatment strategy for patients with inadequately controlled hypertension...

..Setting appropriate blood pressure goals and working to meet them through aggressive antihypertensive treatment, with multiple agents if necessary, can reduce those risks...

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..The positive effects of doxazosin on serum lipids make combination therapy with doxazosin an attractive treatment option for patients who have concomitant hyperlipidemia or glucose intolerance...

..The hypothesis that reduced exercise capacity is associated with an increased risk of death was investigated in a cohort of 5721 asymptomatic women who underwent baseline examinations in 1992...

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..No older person should suffer a preventable, life-threatening event or become confined to a wheel chair if attention to lifestyle issues and a few pills a day could avoid that outcome...

..In this Review, we attempt to summarize the recently published data concerning the epidemiology, attendant risks and potential treatment options for this important and growing public-health problem...

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..This article reviews the role of the RAAS in the development of hypertension and discusses the rationale for the use of eplerenone with other medications affecting the RAAS to control blood pressure...

..Future cardiovascular risk may be related directly to the blood pressure attained, rather than to how it was attained...

..Otherwise, a multidrug regimen is constructed and additional agents added in logical fashion. A majority of patients with higher risk can attain control at the specified BP goal safely and effectively by using a combination of agents...

..Last, an updated algorithm is provided that incorporates many of the new findings and is suggested as a starting point to achieve blood pressure goals...

..This paper will review these possible reasons for the coronary artery disease paradox, concentrating on classification and problems with drug therapy...

..Although DBP control was easy to achieve, achieving SBP goal still remained difficult. Employing goal-oriented management can translate BP control results achieved in clinical trials into outpatient practice...

..The role of ST-segment changes and symptoms with stress testing in asymptomatic women does not provide additional prognostic information...

..Our objectives were to construct a nomogram to permit determination of predicted exercise capacity for age in women and to assess the predictive value of the nomogram with respect to survival...

..To change this alarming trend, physicians must become aggressive in using the available armamentarium of lifestyle modifications and drugs in treating hypertension and other risk factors that increase the burden of atherosclerosis...

..1% of self-reported hypertensives. Results from this study and national surveys indicate that hypertension detection and control remain major public health challenges in preventing cardiovascular disease in older women...

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..We need to be sure that future trials of chronic conditions such as hypertension are done with this trial paradigm, so that those who pay for care have the accurate knowledge needed to spend their money wisely...

..This article reviews the impact of antihypertensive treatment on cardiovascular disease and treatment endpoints...

..These actions should be pursued with vigour in accordance with current clinical guidelines, with the details of implementation adapted to the economic and cultural setting...

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..The results of this trial highlight the importance of ambulatory BP monitoring in the design of hypertension clinical studies...

..We investigated the association between HR response to exercise testing and age with prognosis in 5437 asymptomatic women...

..Women with clinical findings suggestive of ischemia but without findings of obstructive coronary artery disease (CAD) on angiography represent a frequent clinical problem; predicting prognosis is challenging...

..Goal-oriented strategy, especially in diabetic subjects, should be aggressively sought rather than relaxing goals to promote achievement...

..This prospective, single-center, cohort study characterized ambulatory blood pressure monitoring as an early pharmacodynamic biomarker of VEGF signaling pathway inhibition by sorafenib...

..Prehypertension is common and is associated with increased vascular mortality. The extent to which it increases risk of nonfatal myocardial infarction, stroke, and congestive heart failure is less clear...

..The most recently introduced drugs, the vasodilating beta-blockers carvedilol and nebivolol, are now being broadly evaluated as to their efficacy and tolerability in clinical practice...

..However, questions have been raised regarding the validity of the HF diagnosis...

..Optimal initial antihypertensive drug therapy in people with the metabolic syndrome is unknown...

..The purpose of this study was to determine the possible benefit of dual antiplatelet therapy in patients with prior myocardial infarction (MI), ischemic stroke, or symptomatic peripheral arterial disease (PAD)...

..The authors maintained full control of the discussion and the resulting content of this article; Novartis had no input in the choice of topic, speakers, or content...

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..The authors maintained full control of the discussion and the resulting content of this article...

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..01 (95% CI: 0.96 to 1.06.) In postmenopausal women, calcium plus vitamin D3 supplementation did not reduce either blood pressure or the risk of developing hypertension over 7 years of follow-up...

..One patient died following an angioedema episode. The occurrence of angioedema in the angiotensin-converting enzyme inhibitor arm corresponds with previously reported angioedema-angiotensin-converting enzyme inhibitor associations...

..In a trial conducted in actual clinical practices, the CODAS formulation of verapamil was shown to be safe and effective in African Americans, Caucasians, Hispanics and Asians...

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

..We compared the efficacy and safety of omapatrilat to a representative angiotensin-converting enzyme (ACE) inhibitor, enalapril...

..Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount...

..In this report, we provide the final results with regard to estrogen plus progestin and CHD from the Women's Health Initiative (WHI)...

..Empathy builds trust and is a potent motivator. Finally, in presenting these guidelines, the committee recognizes that the responsible physician's judgment remains paramount...

..The need to reduce renin-angiotensin aldosterone system activity in a heart failure patient would seem to justify the small risk of angioedema with ARB therapy in a patient having previously experienced ACE inhibitor-related angioedema...

..It is likely that the majority of people with hypertension could achieve a blood pressure <140/90 mm Hg with the antihypertensive medications available today...

..Upward titration of Verelan PM from 200 to 400 mg nearly doubled the DBP response rate (45.8% to 85.3%). This chronotherapeutic formulation of verapamil was well tolerated in this community trial...

..Such justification might include the presence of heart failure or proteinuric nephropathic states among other considerations...

..Additional analyses will be conducted in men and women, in diabetic patients, in different risk classes and according to prior evidence of vascular disease...

..We sought to characterize the risk factors and treatments of a diverse contemporary population of patients with atherothrombosis...

..We believe it would be preferable to classify all individuals as either normal or hypertensive, based on their cardiovascular evaluation, using the four categories of normal and stages 1, 2, and 3 hypertension...

..Dr. Henry R. Black of Rush University Medical Center, Chicago, IL; and Dr. Vito M. Campese of the University of Southern California, Los Angeles, CA...

..Some, but not all, of these differences may be explained by less effective blood pressure control in the lisinopril arm...

..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...

..Overall, clopidogrel plus aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, stroke, or death from cardiovascular causes. (ClinicalTrials.gov number, NCT00050817.)...

..The efficacy of calcium with vitamin D supplementation for preventing hip and other fractures in healthy postmenopausal women remains equivocal...

..Multiple epidemiologic studies and some trials have linked diet with cardiovascular disease (CVD) prevention, but long-term intervention data are needed...

..Observational studies and polyp recurrence trials are not conclusive regarding the effects of a low-fat dietary pattern on risk of colorectal cancer, necessitating a primary prevention trial...

..The hypothesis that a low-fat dietary pattern can reduce breast cancer risk has existed for decades but has never been tested in a controlled intervention trial...

..Their success will be followed yearly by the Program Director of the Clinical Research Curriculum Award ..

..e., evaluating proposals for safety, risk, and safeguards; improving the quality of the informed consent process; and educating investigators and research staff about the responsible conduct of research. ..

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