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Hypertension in the elderly

More important than the choice of pharmaceutical agent in the treatment of elderly hypertensive patients is the achievement of goal blood pressure. Low-dose diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers are equally effective in reducing cardiovascular end points. Most patients will require 2 or more drugs to achieve target blood pressure, and physicians should feel comfortable prescribing 3 to 4 agents to a significant proportion of patients.

Testosterone Deficiency a Side Effect of Opioids

The opioid-induced deficiency worsens quality of life and body composition.

Coronary risk and statin use in the elderly: Discordance between disease burden and treatment

In the United States, 42% of acute myocardial infarctions (MIs) and more than 60% of deaths attributable to acute MIs occur in the 6.1% of the population 75 years of age or older.

Physician Assistants Deserve More Pay than Doctors

PAs, NPs and others have done a phenomenal job of banding together and carving out a niche for themselves. They have successfully pushed into doctors' domain and have grabbed market share - and ultimately money - away from physicians.

Time to Unload Your Financial Advisor?

Value of the 6-minute walk test in older patients with chronic heart failure

We assessed the prognostic value of the 6-minute walk test (6-MWT) among 1592 subjects with differing degrees of left ventricular systolic dysfunction (LVSD). We found that the 6-MWT was an independent predictor of mortality, particularly among patients with more than mild LVSD. The 6-MWT provides less prognostic utility in patients with mild or lesser LVSD, however.

Prepare Today for a Loved One's Passing

Contemporary cardiac imaging in hypertrophic obstructive cardiomyopathy

Features of hypertrophic obstructive cardiomyopathy (HOCM) include obstruction at the left ventricular outflow tract (caused by a markedly thickened proximal interventricular septum) and systolic anterior motion of the mitral valve. The case discussed here illustrates several classic features of this disease including clinical presentation, diagnostic workup, and noninvasive and invasive management.

Weigh the Facts in Investing Tendencies

Metoprolol for the prevention of vasovagal syncope

In the Prevention of Syncope Trial, we evaluated whether beta-blocker treatment with metoprolol was beneficial for the treatment of patients with vasovagal syncope. Results showed little evidence that metoprolol was effective in reducing the burden of syncopal symptoms. In a substudy analysis, neither age nor response to isoproterenol was useful in selecting which patients might benefit from metoprolol.