ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The hemodynamics of hypertension and antihypertensive therapy have generally been approached in terms of the steady-flow load on the heart. Recent evidence, however, suggests that the pulsatile component of hemodynamic load may play a fundamental role in both the development and progression of hypertensive cardiovascular disease and its clinical sequelae. Pulse pressure, a correlate of conduit vessel stiffness, has been shown to be an important independent predictor of clinical events in hypertensive patients and in the general population. Unrecognized effects on pulsatile hemodynamics may account for the differential effects of various agents on left ventricular mass and events. A better understanding of abnormalities in pulsatile load in hypertension will facilitate risk stratification in and treatment of patients with hypertension.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Syndrome X and microvascular angina are a heterogenous group of diseases. Several medications, including angiotensin-converting enzyme inhibitors, β-blockers, and calcium-channel blockers, have been reported to be successful in the treatment of microvascular angina. Control of hypertension and regression of left ventricular hypertrophy are important in controlling symptoms associated with this intriguing problem. The role of nitric oxide and the effects of L-arginine in the pathogenesis and treatment of hypertension and microvascular angina need to be elucidated. Optimal treatment will depend on the appropriate classification and diagnosis of chest pain in patients with hypertension and normal coronary angiograms.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Despite the many outstanding favorable results achieved in the treatment of hypertension, several unmet goals of antihypertensive therapy remain, such as better blood pressure control, greater protection against the organ damage associated with hypertension, better tolerability, and ultimately a more effective prevention of cardiovascular disease. These unmet goals are the reasons why new antihypertensive drugs are synthesized and tested in the clinical practice.This paper briefly mentions the goals of new antihypertensive agents and examines the main pharmacological and clinical features of new classes of antihypertensive drugs, such as angiotensin II receptor blockers, central agents, vasopeptidase inhibitors, and endothelin antagonists. The results of experimental and clinical studies with these new drugs are reviewed, emphasizing some advantages and potential disadvantages of these drugs compared with traditional antihypertensive drugs.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Over the past year, significant new advances have been made in preventive cardiology. New trials of lipid lowering, estrogen therapy, and hypertension control have added to our understanding of the pathophysiology and prevention of coronary atherosclerosis. This review highlights these new trials and provides insight into their applications in the practice of cardiology.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Long-term follow-up of placebo-controlled thrombolysis trials has proven that the survival benefit from thrombolysis in acute myocardial infarction (AMI) is maintained for up to 10 years. Ongoing research is being conducted with the aim to further improve early restoration of blood flow in the infarct vessel and, thus, reperfusion of the infarcted myocardium in patients with AMI, with the ultimate goal to improve survival. In two recent mega-trials, two new single-bolus fibrinolytics (lanoteplase and TNK-tissue plasminogen activator) were shown to be equivalent to front-loaded alteplase in reducing infarct mortality. The ease of application of these agents might help reduce the time from symptom onset to start of therapy. More potent thrombin inhibitors such as hirudin and hirulog seem to speed up thrombolysis with streptokinase and reduce the rate of reinfarctions. Very promising results are derived from angiographic trials combining reduced doses of thrombolytics with glycoprotein IIb/IIIa inhibitors. Advances in mechanical revascularization can be achieved with the use of stents and better conjunctive therapies. All of these developments are expected to further improve clinical outcome of patients with AMI in the near future.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Acute coronary occlusion is a serious manifestation of coronary artery disease leading to significant short-and long-term morbidity and mortality. Traditionally classified as Q-wave myocardial infarction, non–Q-wave myocardial infarction, and unstable angina, these events are more appropriately termedacute coronary syndromeswith and without ST-segment elevation, reflecting the diagnostic criteria used by clinicians to guide initial treatment strategies. Standard therapy with aspirin and heparin has been expanded with the low molecular weight heparin enoxaparin and the intravenous glycoprotein IIb/IIIa inhibitors eptifibatide and tirofiban. Debate continues as to whether a strategy of early intervention or initial conservative management is most appropriate. Continued clinical trials will help define optimal treatment strategies in this high-risk group of patients.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Several well-designed, randomized trials and registries have recently been completed in patients undergoing percutaneous coronary intervention (PCI) for the treatment of symptomatic coronary artery disease. These studies have further clarified the value of newer pharmacologic and mechanical approaches to patients with atherosclerotic disease and have resulted in improved clinical outcomes in patients undergoing PCI. As a result, many of the older paradigms of lesion-specific device selection have been revised to include the intricate balance of devices and drugs, tailored to the specific clinical presentation and lesion morphology in patients undergoing PCI. This article reviews several recent clinical trials and discusses their impact on early and late outcomes in patients undergoing PCI for symptomatic coronary artery disease.

ISSN:0268-4705    

出版商:OVID    

年代:1999

数据来源: OVID