Showing papers by "Joseph L. Izzo published in 2009"

Hypertension in athletes.

Abstract: Regular physical activity and training are associated with reductions in blood pressure (BP), yet elevated BP is one of the most common abnormalities found during the pre-participation physical evaluation of athletes. Hypertension (HTN) remains the most common cardiovascular condition encountered in athletic populations, therefore all athletes require screening for HTN. Because athletes often have white coat HTN, BP recordings outside the office are also necessary. The 36th Bethesda Conference classified sports according to their varying physiologic demands and provided specific recommendations for the evaluation, treatment, and sport participation of athletes with HTN. In general, angiotensin-converting enzyme inhibitors and other vasodilators are the medications of choice for active and athletic patients because of their limited interference with cardiovascular conditioning. Other agents can be used but some sports governing bodies proscribe the use of certain antihypertensive medications such as beta-blockers for elite athletes.

Lessons from the ACCOMPLISH trial.

Abstract: 1 Clinical trials in cardiovascular medicine have be‐ come major foci for “evidence‐based medicine”. Yet it is not always clear that the results of the tri‐ als, which are often subject to bias introduced by restrictive selection criteria from heterogenous clinical populations, co‐mingling of poorly docu‐ mented mortalities with endpoints representing diverse disease mechanism and subjective inter‐ pretation, should be applied uniformly to clin‐ ical practice. The ACCOMPLISH (Avoiding Car‐ diovascular Events through Combination Thera‐ py in Patients Living with Systolic Hypertension) trial is instructive in this regard.