Showing papers by "Roland E. Schmieder published in 1990"
TL;DR: An increasing number of prospective studies document that left ventricular hypertrophy in essential hypertension represents an independent risk factor for cardiovascular mortality and morbidity, in particular for sudden cardiac death.
Abstract: It is controversial whether myocardial hypertrophy in essential hypertension represents an adaptive physiologic or pathological response to increased pressure load imposed on the heart. Structural changes of the coronary circulation may represent one confounding factor in the relationship between left ventricular hypertrophy and its cardiovascular risk. As a consequence, optimal antihypertensive therapy should aim at reducing both arterial hypertension and left ventricular hypertrophy. Whether regression of myocardial hypertrophy indeed reduces cardiovascular risk cannot be definitively answered from the available data
13 citations
TL;DR: The attempt is made to clarify the controversial results in order to provide possible selection criteria for patients who can be assumed to benefit from the withdrawal of antihypertensive medication and the issue of whether a genuine hypertensive can ever become normal is critically reviewed.
Abstract: Major advances have been established in the handling of hypertensive vascular disease in recent years. However, drug compliance, drug costs, and the side effects of antihypertensive agents have prompted the question of whether intermittent therapy or even possible removal of medication represents an alternative to life-long antihypertensive therapy. Several case reports, and controlled and uncontrolled studies, have focused on this subject, delivering promising but inconsistent results. In this review the attempt is made to clarify the controversial results in order to provide possible selection criteria for patients who can be assumed to benefit from the withdrawal of antihypertensive medication. In addition, the issue of whether a genuine hypertensive can ever become normal is critically reviewed, and an evaluation of the reported success rates is performed. Factors that predicted a successful withdrawl of medication wre young age, normal body weight, low salt intake, low pretreatment blood pressure, successful therapy with one drug, and only minimal signs of target organ damage. Additional modification, such as a low-salt or a weight-loss diet, were demonstrated to extend the period of nonpharmacologic treatment. Nevertheless, further studies would be of great help in elucidating how long and how intensively hypertensive patients should be treated before the discontinuation of medication can be tested.
4 citations
TL;DR: It is demonstrated that enalapril effectively lowers BP without altering the physiologic hemodynamic pattern during emotional stress.
Abstract: We examined whether long-term antihypertensive monotherapy with enalapril decreased clinical casual blood pressure (BP) as well as BP at work and during stress, and whether this angiotensin-converting
1 citations