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  1. Book: Therapeutic strategies for achieving cardiovascular protection through combined RAAS blockade

    Gradman, Alan H.

    (American heart journal ; 157,6, Suppl. 1)

    2009  

    Author's details guest ed. Alan H. Gradman
    Series title American heart journal ; 157,6, Suppl. 1
    Collection
    Language English
    Size S30 S. : Ill., graph. Darst.
    Publisher Mosby
    Publishing place St. Louis, Mo
    Publishing country United States
    Document type Book
    HBZ-ID HT015988458
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    Ui IV Zs 15 -157,Suppl.1- verfügbar in Königswinter Königswinter

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  2. Article ; Online: A quarter-dose quadpill for initial treatment of hypertension.

    Gradman, Alan H

    Lancet (London, England)

    2017  Volume 389, Issue 10073, Page(s) 989–990

    Language English
    Publishing date 2017-03-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(17)30331-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Elusive Search for Optimal Blood Pressure Targets.

    Gradman, Alan H

    Current hypertension reports

    2017  Volume 19, Issue 8, Page(s) 63

    Abstract: BP treatment thresholds/targets determine when to initiate treatment and to what level BP should be reduced. The Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommended a target of < ... ...

    Abstract BP treatment thresholds/targets determine when to initiate treatment and to what level BP should be reduced. The Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) recommended a target of <140/90 for most patients and a target <130/80 mmHg for patients with diabetes or chronic kidney disease. Subsequently, meta-analyses, retrospective studies relating on-treatment BP to clinical outcomes and two large, randomized clinical trials (RCTs) have re-evaluated BP targets. In Action to Control Cardiovascular Risk in Diabetes (ACCORD), a systolic blood pressure (SBP) <120 mmHg was found not to be superior to SBP <140 mmHg in diabetics. In SPRINT (Systolic Blood Pressure Intervention Trial) which studied a different population, the lower target resulted in a 25% cardiovascular event reduction. Despite unresolved issues, certain recommendations can be made with confidence. SBP >160 mmHg should, with rare exceptions, be treated. The historical threshold/target of 140/90 mmHg remains reasonable in most patients in identifying "treatable" risk, i.e., risk high enough to justify treatment and for which available treatment is effective enough to result in significant endpoint reduction. Above 140/90 mmHg, most low-to-moderate risk people should be treated and this target is also appropriate for the majority of high-risk individuals with diabetes, CKD, and/or CAD. The advisability of initiating or intensifying treatment with BPs in the 130s remains equivocal. The next steps in the search for more precise BP targets should include (1) standardization of BP measurement techniques and (2) well-designed RCTs evaluating a treatment target of SBP <130 in carefully categorized patient populations.
    Language English
    Publishing date 2017-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057367-4
    ISSN 1534-3111 ; 1522-6417
    ISSN (online) 1534-3111
    ISSN 1522-6417
    DOI 10.1007/s11906-017-0758-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Blood pressure target values: the saga continues.

    Gradman, Alan H

    European heart journal

    2016  Volume 37, Issue 12, Page(s) 965–967

    MeSH term(s) Blood Pressure ; Humans ; Trans-Activators ; Transcription Factors
    Chemical Substances Trans-Activators ; Transcription Factors
    Language English
    Publishing date 2016-03-21
    Publishing country England
    Document type Comment ; Editorial
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehv706
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: SPRINT: To Whom Do the Results Apply?

    Gradman, Alan H

    Journal of the American College of Cardiology

    2016  Volume 67, Issue 5, Page(s) 473–475

    MeSH term(s) Antihypertensive Agents ; Blood Pressure/drug effects ; Blood Pressure Monitoring, Ambulatory/methods ; Coronary Disease ; Female ; Humans ; Hypertension ; Male ; Patient Care Planning
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2016-02-09
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2015.12.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: LCZ696: the next step in improving RAS inhibition?

    Gradman, Alan H

    Current hypertension reports

    2015  Volume 17, Issue 5, Page(s) 37

    Abstract: LCZ696 is a single molecule which combines the angiotensin receptor blocker valsartan with the neprilysn inhibitor sacubitril (AHU377). In the recently published PARADIGM-HF trial, LCZ696 proved superior to enalapril in reducing overall mortality, heart ... ...

    Abstract LCZ696 is a single molecule which combines the angiotensin receptor blocker valsartan with the neprilysn inhibitor sacubitril (AHU377). In the recently published PARADIGM-HF trial, LCZ696 proved superior to enalapril in reducing overall mortality, heart failure hospitalizations, and other endpoints in patients with systolic dysfunction heart failure. Increases in counter-regulatory natriuretic peptides which oppose sodium retention, vasoconstriction, and the deleterious structural changes which follow neurohormonal activation are thought to account for these improved outcomes. In two large hypertension studies, LCZ696 has proved to be a potent, effective antihypertensive agent with tolerability similar to valsartan and placebo and potency comparable to amlodipine. Although several have occurred in the heart failure population, there have been no cases of angioedema noted in the hypertension trials, although few black patients-a group at high risk for its occurrence-have been studied. Whether LCZ696 will displace angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) as preferred renin-angiotensin system (RAS) blocking agents in hypertension will require demonstration of improved long-term outcomes compared with currently preferred first-line drugs. In this regard, experience has shown that it is difficult to extrapolate results achieved in heart failure to the treatment of hypertension, a condition in which neurohormonal activation is less critical in determining long-term prognosis. It will be particularly important to demonstrate renal protection with LCZ696 in patients with diabetes, proteinuria, and hypertension-the only therapeutic area other than heart failure in which RAS blockade has proved essential for optimal endpoint reduction. Superiority over available RAS blockers in terms of 'vascular protection' in high-risk populations represents another path to acceptance of LCZ696 as a preferred agent in cardiovascular medicine.
    MeSH term(s) Aminobutyrates/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Animals ; Drug Combinations ; Heart Failure/drug therapy ; Humans ; Hypertension/drug therapy ; Renin-Angiotensin System/drug effects ; Tetrazoles/therapeutic use ; ras Proteins/antagonists & inhibitors
    Chemical Substances Aminobutyrates ; Angiotensin-Converting Enzyme Inhibitors ; Drug Combinations ; Tetrazoles ; ras Proteins (EC 3.6.5.2) ; sacubitril and valsartan sodium hydrate drug combination (WB8FT61183)
    Language English
    Publishing date 2015-03-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057367-4
    ISSN 1534-3111 ; 1522-6417
    ISSN (online) 1534-3111
    ISSN 1522-6417
    DOI 10.1007/s11906-015-0548-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Optimal blood pressure targets in older adults: how low is low enough?

    Gradman, Alan H

    Journal of the American College of Cardiology

    2014  Volume 64, Issue 8, Page(s) 794–796

    MeSH term(s) Antihypertensive Agents/therapeutic use ; Blood Pressure ; Coronary Artery Disease/complications ; Female ; Humans ; Hypertension/drug therapy ; Male
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2014-08-26
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2014.06.1153
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Book ; Conference proceedings: Understanding the implications for angiotensin II receptor blockade in the long term management of hypertension

    Gradman, Alan H.

    based on an American College of Cardiology Roundtable [Discussion entitled Understanding the Implications for Angiotensin II Receptor Blockade in the Long Term Management of Hypertension] held March 7, 1999, in New Orleans, Louisiana

    (The American journal of cardiology ; 84,10A)

    1999  

    Title variant Understanding the implications for angiotensin II receptor blockade in the long-term management of hypertension
    Institution American College of Cardiology
    Event/congress Roundtable Discussion entitled Understanding the Implications for Angiotensin II Receptor Blockade in the Long Term Management of Hypertension (1999, NewOrleansLa.)
    Author's details Guest ed.: Alan H. Gradman
    Series title The American journal of cardiology ; 84,10A
    Collection
    Language English
    Size 41S S. : Ill., graph. Darst.
    Publisher Excerpta Medica, Inc
    Publishing place New York, NY
    Publishing country United States
    Document type Book ; Conference proceedings
    HBZ-ID HT011165112
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    Ui IV Zs 73 -84,10A- verfügbar in Königswinter Königswinter

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  9. Article ; Online: Strategies for combination therapy in hypertension.

    Gradman, Alan H

    Current opinion in nephrology and hypertension

    2012  Volume 21, Issue 5, Page(s) 486–491

    Abstract: Purpose of review: To achieve the target blood pressure (BP) mandated by current guidelines, a large majority of patients require simultaneous administration of multiple antihypertensive agents. The purpose of this review is to focus attention on the ... ...

    Abstract Purpose of review: To achieve the target blood pressure (BP) mandated by current guidelines, a large majority of patients require simultaneous administration of multiple antihypertensive agents. The purpose of this review is to focus attention on the rational selection of effective drug combinations, and upon ways to use them efficiently to achieve therapeutic objectives. The topic is widely relevant given that more than 46  million ambulatory care visits are conducted in the United States annually for hypertension management.
    Recent findings: Recommended drug combinations exhibit complimentary pharmacology and additive BP reduction, are well tolerated, and include components with demonstrated endpoint reduction in long-term clinical trials. Recently, the choice of diuretics has emerged as a controversial issue with some evidence favoring the long-acting agent, chlorthalidone, in preference to hydrochlorothiazide. For resistant hypertension, mineralocorticoid antagonists are increasingly used as preferred add-on agents. Practical strategies for the optimal use of combination therapy continue to evolve from the older stepped-care approach to the use of low-dose combinations, and to initiation of combination therapy in a broader range of hypertensive patients.
    Summary: Thoughtful use of drug combinations is critical for achieving therapeutic objectives in hypertensive individuals and populations - more rapid BP control and more effective endpoint reduction. Practical strategies for the optimal use of combination therapy continue to evolve from the older stepped-care approach to more recent recommendations favoring the use of low-dose combinations, and initiation therapy of combination treatment, particularly in patients with Stage 2 hypertension.
    MeSH term(s) Antihypertensive Agents/administration & dosage ; Antihypertensive Agents/therapeutic use ; Blood Pressure/drug effects ; Drug Administration Schedule ; Drug Therapy, Combination/methods ; Humans ; Hypertension/drug therapy ; Hypertension/physiopathology ; Treatment Outcome
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2012-09
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1151092-4
    ISSN 1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
    ISSN (online) 1473-6543 ; 1535-3842
    ISSN 1062-4813 ; 1062-4821
    DOI 10.1097/MNH.0b013e328356c551
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Renal nerve ablation for resistant hypertension.

    Gradman, Alan H

    Current hypertension reports

    2011  Volume 13, Issue 3, Page(s) 173–175

    Language English
    Publishing date 2011-02-10
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 2057367-4
    ISSN 1534-3111 ; 1522-6417
    ISSN (online) 1534-3111
    ISSN 1522-6417
    DOI 10.1007/s11906-011-0189-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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