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5 Cards in this Set
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HYVET
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Hypertension in the Very Elderly Trial
N. Engl J Med 2008 |
Proven that treatment is good.
Older pts w/ HTN receive significant benefit (e.g., lower risk of a stroke) from antihypertensive therapy. |
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ACCOMPLISH
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N Engl J Med 2008
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Deomonstrated that initial 2 drug therapy is very effective in attaning goal BP values, and that some combinations may be more effective in lowering CV events than others.
1*endpt: composite measure of CV morbidity or mortality. Result: very good to start with 2 drugs, esp. in pt w/ Stage 2 HTN (BP >/= 160/100), unless very old or frail. Also, incidence of 1*endpt (CV events) ~20% lower w/ ACEi/CCB than w/ ACEi/HCTZ. (anyway, avoid starting 2 drugs in orthostatic hypotensionunstable pts too) |
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CONVICE
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no difference in CV events w/ chronotherapeutic verapamil vs std therapy
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ONTARGET
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Ongoing Telmisartan Alone and in Combination with Ramipril
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The combination of an ACEi and an ARB should not be used for managing HTN. Not an additive combo, no long term benefit no difference than use alone. Increase s/e esp in CKD. Recommend alternative. Don't use drug w/in the same class, except diuretics (i.e. loop w/ thiazide) tend to use to tx resistant HTN.
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TROPHY
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Fact: pt w/ preHTN @ BP goal - always recommend life-style modifications.
Unk: Have tx them w/ ARB and have reduced BP, but this is not STD, don't know if that is the best other than recommending life-style modifications. |
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