Myocardial infarction antihypertensives

A third study (85) enrolled 7825 hypertensive patients (55% males and 45% females) having diastoHc blood pressures (DBP) of 99—104 mm Hg (13—14 Pa) there were no placebo controls. Forty-six percent of the patients were assigned to SC antihypertensive dmg therapy, ie, step 1, chlorthaUdone step 2, reserpine [50-55-5] or methyldopa [555-30-6], and step 3, hydralazine [86-54-4]. Fifty-four percent of the patients were assigned to the usual care (UC) sources in the community. Significant reductions in DBP and in cardiovascular and noncardiovascular deaths were noted in both groups. In the SC group, deaths from ischemic heart disease increased 9%, and deaths from coronary heart disease (CHD) and acute myocardial infarctions were reduced 20 and 46%, respectively. 

Hypertension is the most common cardiovascular disease in fact, nearly 25% of adults in the U.S. are considered hypertensive. Hypertension is defined as a consistent elevation in blood pressure such that systolic/diastolic pressures are >140/90 mmHg. Over time, chronic hypertension can cause pathological changes in the vasculature and in the heart. As a result, hypertensive patients are at increased risk for atherosclerosis, aneurysm, stroke, myocardial infarction, heart failure, and kidney failure. There are several categories of antihypertensive agents ... 

Many studies have shown that ginseng has a protective effect on the development of atherosclerosis that may lead to myocardial infarction and other cardiovascular diseases. The preventive effects on cardiovascular diseases of ginseng include its potential antihypertensive and antiatherosclerotic effects. Ginsenosides are likely to be responsible for some of these effects as they have been shown to have inhibitory effects on platelet aggregation and to suppress thrombin formation as well as an effect on blood vessel contraction. 

Reactive Loss (adverse life events). Physical illness (myocardial infarct, cancer). Drugs (antihypertensives, alcohol, hormones). Other psychiatric disorders (senility). More than 60% of all depressions. Core depressive syndrome depression, anxiety, bodily complaints, tension, guilt. May respond spontaneously or to a variety of ministrations. 

In addition to its antihypertensive effects, the ARB losartan demonstrated cardiovascular benefits beyond lowering blood pressure in the Losartan Intervention for Endpoint (LIFE) Reduction in Hypertension Study [8]. Similarly, results from the Valsartan in Acute Myocardial Infarction Trial showed that valsartan improves survival after acute MI in high-risk patients [15]. Due to a lack of clinical studies involving populations with the same cardiovascular risk profile, it is not possible to extrapolate these findings to all ARBs, particularly since the dose of ARB used appears critically important [7]. Several ARBs carry additional indications, including treatment of hypertension with LVH, stroke prevention, CHF, and nephropathy in typ. 2 diabetes mellitus. 

Gil-Nunez AC, Vivancos-Mora J (2005). Blood pressure as a risk factor for stroke and the impact of antihypertensive treatment. Cerebrovascular Diseases 20 40-52 GISSI-Prevenzione Investigators (1999). Dietary supplementation with -3 polyunsaturated fatty acids and vitamin E after myocardial infarction results of the GISSI-Prevenzione trial. Lancet 354 447-455 Glader CA, Stegmayr B, Boman J et al. (1999). Chlamydia pneumoniae antibodies and high lipoprotein (a) levels do not predict ischemic cerebral infarctions results from a nested case-control study in northern Sweden. Stroke 30 2013-2018... 

There has been some concern that the shorter-acting calcium channel blockers may adversely affect the risk of myocardial infarction and cardiac death. The evidence is based on case-control studies which cannot escape the possibility that sicker patients, i.e. with worse hypertension or angina, received calcium charmel blockade. The safety and efficacy of the class has been strengthened by the recent findings of two prospective comparisons with other antihypertensives. ... 

Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS, Rosendaal FR, Lemaitre RN, Smith NL, Wahl PW, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA 1995 274(8) 620-5. 

There is no vahd evidence that diuretics contribute to myocardial infarction, sudden death, or a failure of antihypertensive treatment or other risk factor interventions to prevent coronary deaths (50). An association between diuretics and sudden death has been suggested only in selected subset analyses, which allow no vahd conclusions. Even in subjects with electrocardiographic abnormalities before treatment, there is no sound or consistent evidence to support the suggestion that diuretics predispose to sudden death. 

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