Biomedical subjects
Publications and source records attributed to P M Da Silva.
The accurate treatment of a dyslipidaemia is based on correct diagnosis. Together with the laboratory values. A good clinical interview, focusing on the family history, is the bases for a good diagnosis strategy. The author schematze the rules of etiological diagnosis of inherited defects of lipid metabolism.
The goal of the accurate treatment of an hypertensive crisis is to reduce the critically elevated blood pressure to a safer level, in an hemodynamic point of view, although not necessarily normal. The authors stress that a prompt and correct diagnosis in distinguishing hypertensive emergencies from urgencies, in understanding its pathophysiology and the knowledge of available drugs is essential for a successful management.
A multicentric, non-comparative study was made to evaluate the efficacy and safety of diltiazem 180 mg in the elderly, with dose titration in subjects above the age of 60 years. The blood pressure measurements were done by ambulatory blood pressure monitoring (ABPM). We achieved a reduction of at least 10 mmHg in systolic blood pressure in 52.2% and in diastolic blood pressure in 42.5% of the patients. The estimated differences between the initial values and those after treatment are 30% (CI95%: 22-38%) for diurnal blood pressure load, 22% (CI95%: 14-29%) for nocturnal blood pressure load, 13 mmHg (CI95%: 10-16 mmHg) for median systolic BP, and 8 mmHg (CI95%: 6-10 mmHg) for median diastolic BP. In 62.5% of the subjects the daily dose of diltiazem was increased to 240 mg (180 mg in the morning and 60 mg at night). All the cardiovascular parameters evaluated showed a significant decrease at the end of the study. A significant change was not recorded in the laboratory parameters and the adverse event average was minimal. The results showed that diltiazem in monotherapy is effective in the control of hypertension in the elderly and can improve compliance to the treatment.