Read Books Online and Download eBooks, EPub, PDF, Mobi, Kindle, Text Full Free.
Comparative Effectiveness Of Angiotensin Converting Enzyme Inhibitors Aceis And Angiotensin Ii Receptor Antagonists Arbs For Treating Essential Hypertension
Download Comparative Effectiveness Of Angiotensin Converting Enzyme Inhibitors Aceis And Angiotensin Ii Receptor Antagonists Arbs For Treating Essential Hypertension full books in PDF, epub, and Kindle. Read online Comparative Effectiveness Of Angiotensin Converting Enzyme Inhibitors Aceis And Angiotensin Ii Receptor Antagonists Arbs For Treating Essential Hypertension ebook anywhere anytime directly on your device. Fast Download speed and no annoying ads. We cannot guarantee that every ebooks is available!
Book Synopsis Comparative Effectiveness of Angiotensin-converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension by : David B. Matchar
Download or read book Comparative Effectiveness of Angiotensin-converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension written by David B. Matchar and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: In this comparative effectiveness review, we examine the scientific literature on angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor antagonists (ARBs, or angiotensin receptor blockers) for individuals with hypertension regarding their relative benefits (blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life, and other outcomes), as well as relative risks (safety, adverse events, tolerability, persistence, and adherence). In addition, we will examine the clinical determinants of these outcomes with a focus on the long-term impact.
Book Synopsis Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension by :
Download or read book Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension written by and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :U. S. Department Human Services Publisher :Createspace Independent Publishing Platform ISBN 13 :9781484974186 Total Pages :0 pages Book Rating :4.9/5 (741 download)
Book Synopsis Future Research Needs for Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension by : U. S. Department Human Services
Download or read book Future Research Needs for Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension written by U. S. Department Human Services and published by Createspace Independent Publishing Platform. This book was released on 2013-05-14 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is the most common reason older adults visit the doctor and advances in antihypertensive therapy have dramatically reduced the associated cardiovascular, cerebrovascular, and renal events. Inhibitors of the renin-angiotensin system (RAS) are the most frequently used medications for blood pressure control and are highly efficacious for reducing hypertension-related outcomes. In 2007, a comparative effectiveness review (CER) sponsored by the Agency for Healthcare Research and Quality (AHRQ) evaluated the long-term benefits and harms of the two most common classes of RAS inhibitors for treating essential hypertension in adults: angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers/antagonists (ARBs). This 2007 CER was updated in 2011 to incorporate the significant additional direct comparison research published in the interval, and to include the direct renin inhibitors (DRIs), which are the newest class of RAS inhibitors. The 2011 CER addressed the three following Key Questions: KQ 1. For adult patients with essential hypertension, how do ACEIs, ARBs, and DRIs differ in blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life, and other outcomes? KQ 2. For adult patients with essential hypertension, how do ACEIs, ARBs, and DRIs differ in safety, adverse events, tolerability, persistence with drug therapy, and treatment adherence? KQ 3. Are there subgroups of patients-based on demographic and other characteristics (i.e., age, race, ethnicity, sex, comorbidities, concurrent use of other medications)-for whom ACEIs, ARBs, or DRIs are more effective, are associated with fewer adverse events, or are better tolerated? The results of the CER included 97 studies (36 new since 2007) directly comparing ACEIs versus ARBs and 3 studies directly comparing DRIs to ACEIs or ARBs. The strength of evidence remained high for equivalence between ACEIs and ARBs for blood pressure lowering, and for superiority of ARBs over ACEIs for short-term adverse events (primarily cough). The new evidence did not strengthen the conclusions regarding long-term cardiovascular outcomes, quality of life, progression of renal disease, medication adherence or persistence, rates of angioedema, or differences in key patient subgroups; the strength of evidence for these outcomes remained low to moderate. Evidence on the comparative effectiveness of DRIs versus either ACEIs or ARBs was limited to 3 studies with 2,049 patients and did not allow definitive conclusions on any of the included outcomes. Few studies involved a representative patient sample treated in a typical clinical setting over a long duration; treatment protocols had marked heterogeneity; and significant amounts of data about important outcomes and patient subgroups were missing. Our approach to identifying evidence gaps, prioritizing future research, and developing recommendations for stakeholders is outlined in the following steps. Further detail is provided below. 1. Develop an analytic framework from the original CER in order to understand the clinical and policy context of the review and its initial list of future research needs. 2. Create an initial list of evidence gaps based on the CER organized according to the population, interventions, comparators, and outcomes (PICO) framework. 3. Form a stakeholder group representing appropriate clinician, policymakers, and patient perspectives. 4. Expand the list of evidence gaps based on stakeholder input. 5. Perform an updated review of published literature since the last CER (search last updated in December 2010) and a horizon scan for recently published and ongoing studies that may address the evidence gaps, but which are not included in the current CER. 6. Solicit stakeholder prioritization of the identified research gaps based on the updated literature review. 7. Determine the most appropriate study designs for the highest priority research areas.
Book Synopsis Future Research Needs for Angiotensin-converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension by :
Download or read book Future Research Needs for Angiotensin-converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), Or Direct Renin Inhibitors (DRIs) for Treating Hypertension written by and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Almost 75 million American adults have hypertension. Advances in antihypertensive therapy have dramatically reduced cardiovascular, cerebrovascular, and renal events. Among the effective pharmacotherapies are inhibitors of the renin-angiotensin-aldosterone system (RAS). In 2007, the Agency for Healthcare Research and Quality (AHRQ) sponsored a comparative effectiveness review (CER) of the two most common renin system inhibitors, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), to answer the following three Key Questions for adults with essential hypertension: do ACEIs and ARBs differ in their (1) blood pressure control, cardiovascular events, quality of life, and other outcomes; (2) safety, tolerability, persistence with therapy, or treatment adherence; and (3) effects within important subgroups of patients? This 2007 CER was updated in 2011 to incorporate the significant additional direct comparison research published in the interval and to include direct renin inhibitors (DRIs), which are the newest class of RAS inhibitors. The results of the updated CER included 97 studies (36 new since 2007) directly comparing ACEIs versus ARBs and 3 studies directly comparing DRIs to ACEIs or ARBs. The strength of evidence remained high for equivalence between ACEIs and ARBs for blood pressure lowering, and for superiority of ARBs over ACEIs for short-term adverse events (primarily cough). The new evidence did not strengthen the conclusions regarding long-term cardiovascular outcomes, quality of life, progression of renal disease, medication adherence or persistence, rates of angioedema, or differences in key patient subgroups; the strength of evidence for these outcomes remained low to moderate. Evidence on the comparative effectiveness of DRIs versus either ACEIs or ARBs was limited to 3 studies with 2,049 patients and did not allow definitive conclusions on any of the included outcomes. Few studies involved a representative patient sample treated in a typical clinical setting over a long duration; treatment protocols had marked heterogeneity; and significant amounts of data about important outcomes and patient subgroups were missing. Given the clinical and economic importance of these medications, the ongoing investment in research, and the remaining areas of uncertainty, we sought to create a prioritized research agenda representing the interests of diverse stakeholders in order to address the remaining areas of uncertainty.
Book Synopsis Angiotensin-converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension by :
Download or read book Angiotensin-converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVES: A 2007 comparative effectiveness review (CER) evaluated the long-term benefits and harms of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin II receptor blockers/antagonists (ARBs) for treating essential hypertension in adults. Since then, significant additional research has been published comparing these agents, and direct renin inhibitors (DRIs) have been introduced to the market. We sought to update 2007 CER on ACEIs versus ARBs and expand this to include comparisons with DRIs. DATA SOURCES: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, a list of systematic reviews underway in the Cochrane Hypertension Review Group, and selected gray literature sources. REVIEW METHODS: We included studies that directly compared ACEIs, ARBs, and/or DRIs in at least 20 total adults with essential hypertension; had at least 12 weeks of followup; and reported at least one outcome of interest. Two investigators reviewed each article, and a standard protocol was used to extract data on study design, interventions, population characteristics, and outcomes; evaluate study quality; and summarize the evidence. When appropriate, quantitative meta-analysis was performed. RESULTS: We included 97 studies (36 new since 2007) directly comparing ACEIs versus ARBs and 3 studies directly comparing DRIs to ACEIs or ARBs. The strength of evidence remains high for equivalence between ACEIs and ARBs for blood pressure lowering and use of a single antihypertensive agent, and for superiority of ARBs over ACEIs for short-term adverse events (primarily due to cough). The new evidence did not strengthen our conclusions regarding long-term cardiovascular outcomes, quality of life, progression of renal disease, medication adherence or persistence, rates of angioedema, or differences in key patient subgroups: the strength of evidence for these outcomes remained low to moderate. For DRIs, we were not able to reach definitive conclusions for any of the outcomes of interest. Few studies involved a representative sample treated in a typical clinical setting over a long duration; treatment protocols had marked heterogeneity; and significant amounts of data about important outcomes and patient subgroups were missing. CONCLUSION: Evidence does not support a meaningful difference between ACEIs and ARBs for any outcome except short-term adverse events. Few, if any, of the questions that were not answered in the 2007 CER have been addressed by the 39 new studies. Future research in this area should consider areas of uncertainty and be prioritized accordingly.
Author :U. S. Department Human Services Publisher :Createspace Independent Publishing Platform ISBN 13 :9781484054734 Total Pages :0 pages Book Rating :4.0/5 (547 download)
Book Synopsis Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension by : U. S. Department Human Services
Download or read book Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension written by U. S. Department Human Services and published by Createspace Independent Publishing Platform. This book was released on 2013-04-06 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Almost 75 million American adults-approximately one-third-have hypertension. The prevalence of hypertension increases with advancing age such that more than half of people 55 to 74 years old and approximately three-fourths of those age 75 years and older are affected. In addition to being the primary attributable risk factor for death throughout the world, hypertension results in substantial morbidity because of its impact on numerous target organs, including the brain, eyes, heart, arteries, and kidneys. Despite the high rates of morbidity and mortality attributable to hypertension, control of the condition remains suboptimal. In addition to several effective nonpharmacological interventions-including diet, exercise, and control of body weight-many people require antihypertensive medication to lower blood pressure. Among the many choices in antihypertensive therapy, some of the most common are those aimed at affecting the renin-angiotensin-aldosterone (renin) system. The renin system is an important mediator of blood volume, arterial pressure, and cardiac and vascular function. Components of this system can be identified in many tissues, but the primary site of renin release is the kidney. The renin system can be triggered by sympathetic stimulation, renal artery hypotension, and decreased sodium delivery to the distal tubule. Through proteolytic cleavage, renin acts on the oligopeptide substrate angiotensinogen to produce the decapeptide angiotensin I. In turn, two terminal peptide residues of angiotensin I are removed by the angiotensinconverting enzyme (ACE) to form the octapeptide angiotensin II. Angiotensin II acts directly on the resistance vessels to: increase systemic vascular resistance and arterial pressure; stimulate the adrenal cortex to release aldosterone, which leads to increased sodium and water reabsorption and potassium excretion; promote secretion of antidiuretic hormone, which leads to fluid retention; stimulate thirst; promote adrenergic function; and increase cardiac and vascular hypertrophy. Therapies aimed at modifying the renin system have been used extensively for treatment of hypertension, heart failure, myocardial infarction, diabetes, and renal disease. Currently, three classes of drugs that interact with this system are used to inhibit the effects of angiotensin II: the angiotensin-converting enzyme inhibitors (ACEIs), the angiotensin II receptor blockers/antagonists (ARBs), and the direct renin inhibitors. ACEIs block the conversion of angiotensin I into angiotensin II; ARBs selectively inhibit angiotensin II from activating the angiotensin-specific receptor (AT1); and direct renin inhibitors block the conversion of angiotensinogen into angiotensin I. This review summarizes the evidence on the comparative long-term benefits and harms of ACEIs, ARBs, and direct renin inhibitors, focusing on their use for treating essential hypertension in adults. In that analysis, investigators assessed the conclusions from the original comparative effectiveness review, performed a limited literature search of potentially new evidence, and solicited expert opinions concerning the state of the evidence and validity of the original report. Key Questions addressed are: Key Question 1. For adult patientsa with essential hypertension, how do ACEIs (angiotensin-converting enzyme inhibitors), ARBs (angiotensin II receptor antagonists), and direct renin inhibitorsb differ in blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life, and other outcomesc? Key Question 2. For adult patients with essential hypertension, how do ACEIs, ARBs, and direct renin inhibitors differ in safety, adverse events, tolerability, persistence with drug therapy, and treatment adherence
Author :U. S. Department of Health and Human Services Publisher :Createspace Independent Pub ISBN 13 :9781484828083 Total Pages :328 pages Book Rating :4.8/5 (28 download)
Book Synopsis Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by : U. S. Department of Health and Human Services
Download or read book Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-04-27 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nearly 2,400 Americans die of cardiovascular disease each day. Cardiovascular disease claims more lives each year than cancer, chronic lower respiratory diseases, accidents, and diabetes mellitus combined. American College of Cardiology and American Heart Association guidelines support the use of angiotensin converting enzyme (ACE) inhibitors in patients who have chronic heart failure or those with myocardial infarction and left ventricular dysfunction, while angiotensin receptor blockers (ARBs) are reserved for those who cannot tolerate ACE inhibitors. Combined ACE inhibitor and ARB therapy has been shown to provide additional benefits over therapy with an ACE inhibitor alone among patients with heart failure. However, the combined use of an ACE inhibitor and ARB in post-myocardial-infarction patients with left ventricular dysfunction or heart failure was no better than the use of captopril alone and carried an increased risk of harms. This report summarizes the available evidence comparing the efficacy and safety of using ACE inhibitors, ARBs, or their combination vs. standard medical therapy in a population with stable ischemic heart disease, or an ischemic heart disease risk equivalent, and preserved left ventricular function. This report addresses the following questions: KQ1. What is the comparative effectiveness of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, the composite endpoint of the latter three items, and atrial fibrillation? What is the evidence of benefit on other outcomes such as symptom reporting, hospitalization, revascularization, and quality of life measures? KQ2. In patients who are receiving standard medical therapy, what is the comparative effectiveness of combining ACE inhibitors and ARBs vs. either an ACE inhibitor or ARB alone in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, the composite endpoint of the latter three items, and atrial fibrillation? What is the evidence of benefit on other outcomes such as symptom reporting, hospitalization, revascularization, and quality of life measures? KQ3. In patients who had to have recently undergone, or are set to undergo, a coronary revascularization procedure, what is the comparative effectiveness of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, stroke, the composite endpoint of the latter three items, and atrial fibrillation? What is the evidence of benefit on other outcomes such as symptom reporting, hospitalization, revascularization, and quality of life measures? KQ4. What are the comparative harms of adding ACE inhibitors or ARBs to standard medical therapy when compared to standard medical therapy alone? KQ5. In patients receiving standard medical therapy, what is the evidence of comparative harms of combination ACE inhibitor and ARB therapy vs. use with either an ACE inhibitor or ARB alone? KQ6. In patients who had to have recently undergone, or are set to undergo, a coronary revascularization procedure, what are the comparative harms of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone? KQ7. What is the evidence that benefits or harms differ by subpopulations, including: demographics, clinical course, dose of the ACE inhibitor or ARB used, comorbidities, and other medications?
Book Synopsis Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by :
Download or read book Comparative Effectiveness of Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by and published by . This book was released on 2009 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This is an evidence report prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center (EPC) concerning the benefits and harms associated with using angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), either alone or in combination, in people with stable ischemic heart disease or ischemic heart disease risk equivalents and intact left ventricular systolic function. While the role of ACE inhibitors and ARBs in patients with post-myocardial infarction left ventricular dysfunction or chronic heart failure is well established, the role for these modalities in patients with stable ischemic heart disease or ischemic heart disease risk equivalents and preserved left ventricular systolic function is not as clear. The aim of this report is to acquire, assess, and summarize the current evidence about the benefits and harms associated with the use of ACE inhibitors and ARBs, either alone or in combination, in this patient population. The information is intended to inform clinicians, payors, and the public, while helping to define avenues for future research.
Author :Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure Publisher : ISBN 13 : Total Pages :20 pages Book Rating :4.3/5 (121 download)
Book Synopsis Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure by : Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure
Download or read book Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure written by Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure and published by . This book was released on with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Diabetes and Hypertension by : Samy I. McFarlane
Download or read book Diabetes and Hypertension written by Samy I. McFarlane and published by Springer Science & Business Media. This book was released on 2012-10-19 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.
Book Synopsis Encyclopedia of Heart Diseases by : M. Gabriel Khan
Download or read book Encyclopedia of Heart Diseases written by M. Gabriel Khan and published by Elsevier. This book was released on 2005-12-14 with total page 678 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Encyclopedia of Heart Diseases is an accurate and reliable source of in-depth information on the diseases that kill more than 12 million individuals worldwide each year. In fact, cardiovascular diseases are more prevalent than the combined incidence of all forms of cancer, diabetes, asthma and leukemia. In one volume, this Encylopedia thoroughly covers these ailments and also includes in-depth analysis of less common and rare heart conditions to round out the volume's scope. Researchers, clinicians, and students alike will all find this resource an invaluable tool for quick reference before approaching the primary literature. * Coverage of more than 200 topics, including: applied pharmacology of current and experimental cardiac drugs, gene therapy, MRI, electron-beam CT, PET scan put in perspective, cardiac tests costs and justification, and new frontiers in cardiovascular research* More than 150 helpful figures and illustrations!* Dr. Khan is a well-published and respected expert in heart and heart diseases
Book Synopsis Network Meta-analysis by : Giuseppe Biondi-Zoccai
Download or read book Network Meta-analysis written by Giuseppe Biondi-Zoccai and published by Nova Science Publishers. This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Network meta-analyses and mixed treatment comparisons represent the uppermost level in the evidence hierarchy for decision making, in medicine as well as in other scholarly fields. This book covers the main topics which should be mastered to critically read and interpret as well as, if deemed worthwhile, perform and report independently a network meta-analysis and mixed treatment comparison. The text includes dozens of tables and illustrations to guide visually the reader in understanding the basics as well as the more refined details of network meta-analyses.
Book Synopsis Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease by :
Download or read book Future Research Needs for Angiotensin Converting Enzyme Inhibitors Or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease written by and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: A comparative effectiveness review (CER) published by the University of Connecticut Evidence-based Practice Center (EPC) in 2009 found strong evidence that ACE inhibitors reduced total mortality and nonfatal myocardial infarction (MI) in comparison to placebo among adults with stable IHD and preserved ventricular function, but increased the risk for syncope and cough. There was low to moderate evidence that ARBs reduced a composite of cardiovascular endpoints compared to placebo, and these agents were well-tolerated. The one available study directly comparing the impact of ACE inhibitors and ARBs on cardiovascular outcomes in patients with IHD revealed no significant difference between the classes in the rate of cardiovascular outcomes, but demonstrated higher rates of cough and angioedema among patients treated with ACE inhibitors, and higher rates of hypotensive symptoms among patients treated with ARBs. A list of research gaps is a common component of CERs and is an important step in outlining a future research agenda; however, such lists do not always clearly suggest how future research should be prioritized, or which projects are in fact feasible. In this pilot project, we sought to expand on the work done by the University of Connecticut EPC to identify and prioritize gaps in the evidence supporting the comparative effectiveness of ACE inhibitor and ARB therapy in patients with IHD. The prioritization process we used combined a review of recently published and ongoing studies, engagement of nine stakeholders, and participation of these stakeholders in both qualitative and quantitative exercises of research needs prioritization.
Book Synopsis From Hypertension to Heart Failure by : Michael Böhm
Download or read book From Hypertension to Heart Failure written by Michael Böhm and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 299 pages. Available in PDF, EPUB and Kindle. Book excerpt: Arterial hypertension, coronary heart disease and heart fail ure are the commonest cardiovascular conditions to present in clinical practice. Over the past few years it has become in creasingly clear that they are closely and causally interrelated and that their relationship can have a significant bearing on prognosis. Epidemiological studies have shown that arterial hypertension is one of the most important risk factors for de veloping heart failure. Only one in four patients with hyper tension is adequately managed, and in 50% of cases, the hypertension has not been recognised or treated. Patients with pre-existing hypertension who go on to suffer an acute myocardial infarction have usually not previously had typi cal angina symptoms, the infarct territory is larger, life threatening arrhythmias are commoner and hence in-hospi tal mortality and long-term prognosis are markedly worse. The presence of raised blood pressure in the post-infarct phase doubles the risk of manifest heart failure. The close relationship between hypertension, coronary heart disease and heart failure makes the choice of therapeu tic strategy particularly important. Agents and classes of agents that have prognostic value in all three conditions should be considered first, as synergy might result in addi tional benefits. In such patients, this sort of therapeutic deci sion-making might have further advantages. The use of these agents may prevent complications which are not yet clinically obvious (such as heart failure).
Book Synopsis Pediatric Nephrology by : Ellis D. Avner
Download or read book Pediatric Nephrology written by Ellis D. Avner and published by Springer Science & Business Media. This book was released on 2009-08-20 with total page 2059 pages. Available in PDF, EPUB and Kindle. Book excerpt: Here is an extensive update of Pediatric Nephrology, which has become the standard reference text in the field. It is global in perspective and reflects the international group of editors, who are well-recognized experts in pediatric nephrology. Within this text, the development of kidney structure and function is followed by detailed and comprehensive chapters on all childhood kidney diseases.
Book Synopsis Textbook of Vascular Medicine by : Rhian M. Touyz
Download or read book Textbook of Vascular Medicine written by Rhian M. Touyz and published by Springer. This book was released on 2019-08-02 with total page 503 pages. Available in PDF, EPUB and Kindle. Book excerpt: This textbook focuses on the vascular biology and physiology that underlie vascular disorders in clinical medicine. Vascular biomedicine is a rapidly growing field as new molecular mechanisms of vascular health and disease are unraveled. Many of the major cardiovascular diseases including coronary artery disease, heart failure, stroke and vascular dementia are diseases of the vasculature. In addition vascular injury underpins conditions like kidney failure and cardiovascular complications of diabetes. This field is truly multidisciplinary involving scientists in many domains such as molecular and vascular biology, cardiovascular physiology and pharmacology and immunology and inflammation. Clinically, specialists across multiple disciplines are involved in the management of patients with vascular disorders, including cardiologists, nephrologists, endocrinologists, neurologists and vascular surgeons. This book covers a wide range of topics and provides an overview of the discipline of vascular biomedicine without aiming at in-depth reviews, but rather offering up-to-date knowledge organized in concise and structured chapters, with key points and pertinent references. The structure of the content provides an integrative and translational approach from basic science (e.g. stem cells) to clinical medicine (e.g. cardiovascular disease). The content of this book is targeted to those who are new in the field of vascular biology and vascular medicine and is ideal for medical students, graduate and postgraduate students, clinical fellows and academic clinicians with an interest in the vascular biology and physiology of cardiovascular disease and related pathologies.
Book Synopsis Hepatotoxicity by : Hyman J. Zimmerman
Download or read book Hepatotoxicity written by Hyman J. Zimmerman and published by Lippincott Williams & Wilkins. This book was released on 1999 with total page 848 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by the foremost authority in the field, this volume is a comprehensive review of the multifaceted phenomenon of hepatotoxicity. Dr. Zimmerman examines the interface between chemicals and the liver; the latest research in experimental hepatotoxicology; the hepatotoxic risks of household, industrial, and environmental chemicals; and the adverse effects of drugs on the liver. This thoroughly revised, updated Second Edition features a greatly expanded section on the wide variety of drugs that can cause liver injury. For quick reference, an appendix lists these medications and their associated hepatic injuries. Also included are in-depth discussions of drug metabolism and factors affecting susceptibility to liver injury.
