Linked Life Data

7729325

Source:http://linkedlifedata.com/resource/pubmed/id/7729325

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1995-6-1
pubmed:abstractText
Antihypertensive therapy has been used for almost 40 years to reduce blood pressure and to prevent morbidity and mortality related to the hypertensive state. Cardiovascular events are related to the initial elevation of blood pressure; the benefits of treating malignant, severe or moderate hypertension are well established. Although large scale clinical trials have demonstrated a decrease in morbid events when mildly elevated blood pressures is treated, the benefits are neither universal or dramatic and treatment is certainly less cost effective than no treatment. Recently it has been emphasised that the absolute risk of cardiovascular events is determined only in part by blood pressure, and that it is also influenced by age, gender, race and the presence of other cardiovascular risk factors. For example, in older individuals where the absolute risk of vascular complications is greater than in younger individuals for any given level of blood pressure, the benefits of therapy will be greater. It has been suggested that in younger individuals with mild hypertension and a low absolute risk of developing cardiovascular morbid events it may be more appropriate to monitor the effects of drug therapy on measures of cardiac and vascular damage that are associated with the hypertensive state. Drug therapy has been shown to be extremely effective in reducing the incidence of stroke, congestive cardiac failure and renal failure associated with elevated blood pressure. Meta-analysis of randomised large scale clinical trials indicates that drug therapy may not reduce coronary events to the extent expected in patients with hypertension. One plausible explanation is that the trials have been of insufficient duration to detect the benefit of blood pressure lowering on coronary heart disease. It has also been suggested that certain adverse metabolic effects associated with the use of thiazide diuretics and beta-blockers employed in these trials may have partially offset the benefits of blood pressure reduction. However, the clinical significance of these drug-induced metabolic disturbances remains unclear. Experimental data suggesting differences in the ability of antihypertensive drugs to inhibit atherosclerosis in animal models are also of interest, but again the relation of the findings to the clinical situation is unknown. Thiazide diuretics, beta-blockers, calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors and alpha-blockers can produce regression of left ventricular hypertrophy (LVH). While LVH is clearly a strong and independent predictor for coronary disease, it remains to be shown that a lower risk for coronary morbid events exists in patients whose LVH has undergone regression over and above that attributable to blood pressure reduction.(ABSTRACT TRUNCATED AT 400 WORDS)
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0012-6667
pubmed:author
pubmed:issnType
Print
pubmed:volume
49
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
161-75
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:7729325-Adrenergic alpha-Antagonists, pubmed-meshheading:7729325-Adrenergic beta-Antagonists, pubmed-meshheading:7729325-Angiotensin-Converting Enzyme Inhibitors, pubmed-meshheading:7729325-Antihypertensive Agents, pubmed-meshheading:7729325-Benzothiadiazines, pubmed-meshheading:7729325-Blood Pressure, pubmed-meshheading:7729325-Calcium Channel Blockers, pubmed-meshheading:7729325-Cardiovascular Diseases, pubmed-meshheading:7729325-Clinical Trials as Topic, pubmed-meshheading:7729325-Cost-Benefit Analysis, pubmed-meshheading:7729325-Diuretics, pubmed-meshheading:7729325-Epidemiologic Methods, pubmed-meshheading:7729325-Guidelines as Topic, pubmed-meshheading:7729325-Humans, pubmed-meshheading:7729325-Hypertension, pubmed-meshheading:7729325-Sodium Chloride Symporter Inhibitors
pubmed:year
1995
pubmed:articleTitle
Goals of antihypertensive therapy.
pubmed:affiliation
Department of General and Preventive Medicine, University of Minnesota, Minneapolis, USA.
pubmed:publicationType
Journal Article, Review