TY - JOUR
T1 - The challenge of managing multiple cardiovascular risk factors
AU - Kaplan, Norman M
PY - 1997
Y1 - 1997
N2 - Hypertensive patients have an excess of other cardiovascular risk factors. Moreover, traditional therapy based on diuretics and β-blockers may aggravate these risk factors. Therefore, attention must be given to the identification of all pertinent risk factors and their amelioration by appropriate therapy. Such therapy must include lifestyle changes including cessation of smoking, reduction of obesity, moderation of sodium intake and alcohol consumption, and increased physical activity. When antihypertensive drugs are chosen, consideration should be given to their potential influences, either negative or positive, on other cardiovascular risk factors. In particular, the adverse effects of diuretics and β-blockers on lipids and insulin sensitivity may preclude their use. α-Blockers and ACE inhibitors may have beneficial effects on these metabolic indices. Calcium antagonists are neutral in most regards. Whatever agents are chosen, the use of low doses in combination is being increasingly recognized as a better way to achieve the desired antihypertensive efficacy while minimizing adverse effects. As has been noted in the other papers in this supplement, the combination of an ACE inhibitor and a calcium antagonist is particularly attractive, not only to treat hypertension, but also to ameliorate other cardiovascular risk factors.
AB - Hypertensive patients have an excess of other cardiovascular risk factors. Moreover, traditional therapy based on diuretics and β-blockers may aggravate these risk factors. Therefore, attention must be given to the identification of all pertinent risk factors and their amelioration by appropriate therapy. Such therapy must include lifestyle changes including cessation of smoking, reduction of obesity, moderation of sodium intake and alcohol consumption, and increased physical activity. When antihypertensive drugs are chosen, consideration should be given to their potential influences, either negative or positive, on other cardiovascular risk factors. In particular, the adverse effects of diuretics and β-blockers on lipids and insulin sensitivity may preclude their use. α-Blockers and ACE inhibitors may have beneficial effects on these metabolic indices. Calcium antagonists are neutral in most regards. Whatever agents are chosen, the use of low doses in combination is being increasingly recognized as a better way to achieve the desired antihypertensive efficacy while minimizing adverse effects. As has been noted in the other papers in this supplement, the combination of an ACE inhibitor and a calcium antagonist is particularly attractive, not only to treat hypertension, but also to ameliorate other cardiovascular risk factors.
KW - Drug side effects
KW - Risk factors
KW - Risk management
KW - Treatment
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U2 - 10.1016/S0895-7061(97)00106-4
DO - 10.1016/S0895-7061(97)00106-4
M3 - Article
C2 - 9231894
AN - SCOPUS:0030785603
SN - 0895-7061
VL - 10
SP - 167S-169S
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 7 SUPPL. 1
ER -