Search PubMed⌕ Search

Biomedical subjects

Marvin Moser

Publications and source records attributed to Marvin Moser.

87 records · Page 5Linked to original sources
PubMedDate not supplied

Clinical impact of renin-angiotensin system blockade: angiotensin-converting enzyme inhibitors vs. angiotensin receptor antagonists.

Clinical trials have proved that blockade of the renin-angiotensin-aldosterone system (RAAS) offers primary and secondary protection of the cardiovascular system, brain, and kidneys. Drugs that interrupt the RAAS do so by several diverse mechanisms but it remains to be fully proved whether these mechanistic differences are associated with meaningful differences in clinical outcomes. This review summarizes current information about the basic mechanisms of action of three classes of anti-RAAS drugs: angiotensin-converting enzyme (ACE) inhibitors, combined ACE-neutral endopeptidase inhibitors, and angiotensin receptor antagonists as well as results of major clinical outcome trials with these agents. Basic and clinical science information is then blended with insights from the clinical pharmacology of anti-RAAS drugs to address four current controversies in clinical medicine: whether ACE inhibitors and angiotensin receptor antagonists are interchangeable, optimal dosing of available agents, potential justification of ACE inhibitor/angiotensin receptor antagonist combinations, and first-line use of anti-RAAS drugs in antihypertensive therapy.

Angiotensin II Type 1 Receptor Blockers↗
PubMedDate not supplied

Update on the management of hypertension: do recent clinical trial results indicate a change in national recommendations for therapy?

Numerous hypertension treatment trials have been reported during the past several years. In comparative studies it has been shown that the use of diuretics or diuretics/beta blockers has resulted in a reduction in morbidity/mortality equivalent to the use of other antihypertensive medications. This is true in both young and elderly patients. In one large 8-year study in diabetics, the use of a beta blocker/diuretic combination was shown to be as effective in reducing overall cardiovascular events as an angiotensin-converting enzyme (ACE) inhibitor/diuretic treatment program. Although most data indicate that the degree of blood pressure lowering accounts for most of the benefit, there are some differences in outcome that may be explained by different mechanisms of drug action. For example: 1) diuretics are more effective in preventing heart failure and overall cardiovascular events than alpha blockers; 2) an ACE inhibitor-based program is more effective in the elderly in reducing myocardial infarctions and heart failure than a calcium channel blocker-based program; and 3) a nondihydropyridine is more effective in reducing strokes, but less effective in preventing myocardial infarctions or heart failure, than a program based on diuretic therapy. There is also abundant evidence that the use of ACE inhibitors may prevent the occurrence of diabetes in hypertensive individuals and will reduce cardiovascular events in diabetics. Finally, the angiotensin receptor blockers have been shown to slow the progression of renal disease and prevent the occurrence of end-stage renal disease when compared to treatment regimens that do not include an angiotensin receptor blocker or ACE inhibitor. Updated treatment recommendations should include an ACE inhibitor and possibly an angiotensin receptor blocker along with diuretics and beta blockers as initial therapy. In addition, recommendations for the use of multiple-drug therapy have been reinforced by recent trials. Goal pressures are not readily achieved with monotherapy, especially in high-risk patients.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Here we go again.

Explore the source record for details and available documents.

Antihypertensive Agents↗
PubMedDate not supplied

Rationale for combination therapy in the management of hypertension.

Combination drug therapy in the management of hypertension has been used for many years. Recent recommendations of the Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and the results of several new multiple-drug trials have focused on using the approach as initial therapy in many hypertensive patients. Results of these long-term outcome trials, as well as short-term and smaller studies, indicate the advantage of multiple-drug therapy in the management of hypertension.

Antihypertensive Agents↗