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- W1036106917 abstract "Cardiovascular disease accounts for more expenditures on health care than any other diagnostic category and hypertension is the most prevalent cardiovascular condition. While unit costs for hypertension treatment are low, aggregate costs are enormous because of the large and growing population of patients who are treated. Pharmacologic therapy of hypertension decreases the overall cardiovascular morbidity and mortality but fails to show a clear reduction in the risk of coronary heart disease (CHD). Although many explanations have been offered for the lack of demonstrated benefit for CHD, the hypothesis that has been under continued focus involves the unfavorable metabolic and biochemical changes caused by diuretics or β-adrenoceptor antagonists devoid of intrinsic sympathomimetic activity. These drugs are used in majority of the hypertensive clinical trials and adversely affect many of the known risk factors for CHD, including hyperlipidemia, hyperglycemia, and elevated plasma catecholamine levels. These potentially deleterious changes might have offset expected benefits of blood pressure reduction. As CHD is still the primary cause of death, long-acting calcium entry blockers, angiotens in converting enzyme (ACE) inhibitors, α1-adrenoceptor antagonists and centrally acting α2-adrenoceptor agonists, which have less negative impact on the risk factors, continue to gain support as alternate choices for first-line therapy. Proponents of the traditional drugs argue that diuretics and beta-blockers have been shown to reduce the cardiovascular morbidity and mortality in long-term clinical trials and that the lower doses of diuretics now used may not have persistent adverse effects on serum lipids." @default.
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- W1036106917 date "1990-01-01" @default.
- W1036106917 modified "2023-10-16" @default.
- W1036106917 title "Chapter 6. Antihypertensive Agents" @default.
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- W1036106917 doi "https://doi.org/10.1016/s0065-7743(08)61582-1" @default.
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