Domenic A Sica

..In patients with stage 2 hypertension, treatment with the combination of AZL-M and CLD resulted in substantially greater SBP reduction compared with either agent alone...

..It is important to identify secondary causes of hypertension that are endocrine in nature because surgical intervention may result in correction or substantial improvement of the hypertension...

..In heart failure, diuretics should always be given in the lowest possible dose with careful attention to reducing dietary sodium intake...

..In its current form, this process has very limited application potential to states of abnormal renal function...

..As blood pressure is brought to goal in the patient with hypertension, ongoing attention should be directed to long-term adherence to therapy...

..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...

..It remains to be determined to what level blood pressure should be lowered in the patient with chronic kidney disease, however...

..The role of thiamine in heart failure, however, remains arguable...

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..Serum creatinine values can take several weeks to return to their baseline values following discontinuation of a fibrate...

..As a result of diuretic-related adverse events, clinicians must be resourceful in the dose amount and frequency of dosing...

..As such, steps should be taken to lessen the likelihood of it occurring if therapy is being contemplated with agents in this class...

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..These findings suggest that AZL-M could provide higher rates of hypertension control compared with other ARBs in the class...

..In the patient with diabetes and hypertension, tight blood pressure control, more so than using a specific drug class, is the most important aspect of therapy...

..This article will review the various classes of antihypertensive drugs used in the management of high BP in patients with CKD, with an emphasis on pitfalls that arise when kidney function is impaired...

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..A number of questions still remain unanswered in the pharmacotherapy of chronic kidney disease, including the optimal dose for these drugs as well as what represents the most favorable achieved blood pressure...

..Clinical trials designed to evaluate the efficacy and safety of this therapy in patients with treatment resistant hypertension, are now ongoing in both Europe and the United States...

..Additional clarifying studies are required to establish whether specific patient subsets exist that might benefit from such combination therapy...

..Guidelines for the monitoring of serum potassium levels in the setting of antihypertensive therapy are at best makeshift and often drawn from the know-how of the treating physician...

..Eplerenone has not been studied in ESRD in a therapeutic or safety capacity. Additional studies are needed with these compounds in the ESRD population before their use can be considered safe...

..As the mechanistic basis for the action(s) of angiotensin receptor blockers more completely unfolds, added credence may ultimately be lent to widely touted and often overstated intraclass differences...

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..Losartan, like other angiotensin-receptor antagonists, is devoid of significant adverse effects...

..The frequency of such scrutiny should be patient-specific and based on the constellation of risk factors for hyperkalemia...

..Despite the potential for side effects with CCBs, their potent blood pressure-lowering effect makes them a prerequisite for blood pressure control in many patients...

..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...

..Considering the safety of curcumin, these studies should facilitate future clinical trials in suppressing hypertrophy in patients with CRF...

..This review discusses the physiologic and non-physiologic basis for side effects with ACE inhibition...

..We conclude that carvedilol CR is a very effective antihypertensive agent with clear dose-related peak blood pressure reduction and continuous 24-hour control...

..It remains to be determined if this represents a class effect for all angiotensin-converting enzyme inhibitors...

..To characterize the pharmacokinetics and pharmacodynamics of the different calcium-channel blockers...

..Furthermore, AKT (activated via alpha1A receptors), as well as increased alpha1A receptors and their agonist NE, might contribute to the observed hypertrophy...

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..Additional clarifying studies are needed to establish whether specific patient subsets exist that might benefit from such combination therapy...

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..If made truly cost-competitive, it will gain an increasing share of the hypertensive market. If not, market forces will relegate it to a secondary role for hypertension treatment...

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..Additional outcomes trials, which are currently proceeding to their conclusion, may provide the necessary proof to support an expanded use of these 2 drug classes in combination...

..We sought to determine the effect of baroreflex activation therapy (BAT) on systolic blood pressure (SBP) in patients with resistant hypertension...

..Escalating doses of drugs in this class often give rise to salt and water retention, in which case diuretic therapy becomes a valuable adjunctive therapy...

..provides data from INVEST (INternational VErapamil-Trandolapril STudy), which shows the particular utility of a CCB and ACE inhibitor combination in bringing elderly hypertensive patients with CAD to goal BP when monotherapy..

..Here, the authors review current guidelines for the management of hypertension in patients with type 2 diabetes mellitus and explore ways in which nurse practitioners can improve care for these patients...

..As such, steps should be taken to lessen the likelihood of its occurring if therapy is being contemplated with agents in this class...

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..These attributes would favour the increased use of ARBs in this population...

..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...

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..Propranolol CR is an effective antihypertensive formulation that may reduce blood pressure during the morning period of maximum cardiovascular risk...

..Vasopressin receptor antagonists will redefine the treatment of heart failure-related hyponatremia and may possibly evolve as adjunct therapies to loop diuretics in diuretic-resistant patients...

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..To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss...

..This article is the first in a series describing important pharmacotherapeutic considerations of the individual drug classes used in the treatment of hypertension...

..However, the exact role of torsemide in the outpatient management of congestive heart failure remains to be determined...

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..Hyperkalemia should be considered as a possibility in any patient receiving these medications and as such is best addressed preemptively...

..Renal prognosis is very poor if collapsing FSGS develops. Thus, prevention or early detection rather than effective therapy should be the primary consideration...

..There is, however, a place for minoxidil in the treatment of resistant hypertension especially in patients with advanced renal disease...

..Clinical trials designed to evaluate the efficacy and safety of this therapy in patients with resistant hypertension are now underway in both Europe and the USA...

..The temptation should be avoided to simply reduce the doses of either metolazone or the loop diuretic as a means to controlling an active diuresis...

..A valued member of our therapeutic armamentarium need not be laid entirely to rest; rather, doxazosin should now be viewed as a secondary or tertiary antihypertensive therapy pending a more complete review of the ALLHAT data...

..An evidence-based therapeutic approach derived from these trials would argue for ARBs to be the foundation of therapy in the patient with type 2 diabetes and nephropathy...

..The results indicate that, for some subjects with mild to moderate hypertension, a daily dietary supplement of Chlorella reduced or kept stable their SiDBP...

..Understanding these issues is important to the effective use of these compounds...

..A reduction in hemoglobin concentration in a patient who is receiving treatment for hypertension and does not have an obvious source of blood loss should account for potential antihypertensive therapy involvement...

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..Like most matters in the clinical sector the approach to a disease in this case hypertension should remain highly individualised and cognisant of what can be significant cost considerations...

..Results from a series of outcomes trials increasingly support the use of drugs in this class as cardioprotective and renoprotective agents in patients with heart failure, diabetic nephropathy, and post-myocardial infarction...

..The results of this trial are both interesting and relevant to what is an expanding use of angiotensin-receptor blockers in the hypertensive population...

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

..Adverse events, including clinical chemistry values, were similar in the drug-treated and placebo groups. Carvedilol CR has a clinically meaningful defined dose-dependent antihypertensive effect that persists throughout a 24-hour period...

..The basis for this more favorable pattern of efficacy and side-effects with controlled-release isradipine, although mechanistically unresolved, may relate to a lesser degree of sympathetic nervous system activation...

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..When these strategies are employed, the adverse effects seen with diuretics can be minimized or negated, and in so doing cardiovascular benefits can be optimized...

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..Therapeutic agents for the treatment of hypertension may differ in their efficacy during the early-morning period, a time when both morbid and mortal cardiovascular events are increased compared with other times of the day...