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Biomedical subjects

Marvin Moser

Publications and source records attributed to Marvin Moser.

At least 73 records · Page 4Linked to original sources
PubMed1999

World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension-Do These Differ From the U.S. Recommendations? Which Guidelines Should the Practicing Physician Follow?

The recent World Health Organization-International Society of Hypertension (WHO-ISH) recommendations for the treatment of hypertension are consistent with the guidelines established by the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) in the U.S. with several exceptions. Both reports define hypertension as a persistent elevation of blood pressure greater than 140/90 mm Hg and advocate the lowering of blood pressure for all patients with cardiovascular (CV) risk factors in addition to hypertension. The WHO-ISH report, however, suggests continuing monitoring without medication for subjects without other risk factors if pressures are not greater than 150/95 mm Hg. The JNC VI recommends drug therapy even in these subjects if blood pressures remain greater than 140/90 mm Hg after a 6-12 month period of nonpharmacologic interventions. Based on available data this would appear to be a more reasonable recommendation. The WHO-ISH indicates that all classes of medication are suitable initial therapy, despite the lack of morbidity and mortality data with several of them. The JNC VI continues to use outcome data to recommend diuretics or à -blockers as initial treatment. The WHO-ISH recommendations may prove to be appropriate-i.e., the lowering of blood pressure makes the difference and not which medication is used-There are some data to support this position but at present the strongest outcome data support the JNC VI recommendations. Both reports stress the importance of lowering blood pressure to levels of 130/85 mm Hg or even lower in patients with diabetes, renal, or heart failure. The addition of the WHO-ISH report should help to focus more clearly the need for better blood pressure control. (c)1999 by Le Jacq Communications, Inc.

Journal Article↗
PubMed1998

The Effect of Hypertension Treatment on the Prevention of Coronary Artery Disease Events in the Elderly.

Both isolated systolic (greater than 140/ less than 90 mm Hg) and systolic/diastolic ( greater than 140/ greater than 90 mm Hg) hypertension have been identified as major risk factors for cardiovascular disease in the elderly. Effective specific antihypertension therapy is available if lifestyle intervention fails to reduce blood pressure to normal levels. Long term placebo-controlled trials, primarily with diuretics and beta-blockers, have demonstrated not only a reduction in cerebrovascular events but in CHD events as well. A significant reduction in the occurrence of CHF and progression of less severe to severe hypertension has also been demonstrated in treated compared to placebo subjects. A recent study suggests that the use of one of the moderately long acting dihydropyridine CCBs nitrendipine (not available in the U.S.) may also reduce the occurrence of strokes in elderly subjects with ISH

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PubMed1996

Are the Hemodynamic Changes in Elderly Hypertensive Patients of Clinical Importance? Do They Influence the Choice of Medication?

Despite the fact that elderly hypertensive patients have numerous concomitant diseases and changes in physiologic responses compared to middle-aged or younger individuals, they generally repond well to antihypertensive drug therapy without significant adverse reactions-provided that medication is started at low dosages and that dosages are increased slowly. There is little doubt that the benefit of treatment outweighs the risk.

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