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L Michael Prisant

Publications and source records attributed to L Michael Prisant.

40 records · Page 3Linked to original sources
PubMedDate not supplied

Calcium channel blocker induced gingival overgrowth.

Gingival overgrowth occurs with phenytoin, cyclosporin, and calcium antagonists. It can be disfiguring and painful. The prevalence of gingival overgrowth with the use of calcium antagonists may be as high as 38%. The prevalence with nifedipine may be greater than with other calcium blockers. Overgrowth occurs 3.3-times more commonly in men than in women. Plaque control is necessary. Some patients may require gingival surgery.

Calcium Channel Blockers↗
PubMedDate not supplied

Should beta blockers be used in the treatment of hypertension in the elderly?

The lack of benefit and the potential negative side effects of beta blockers are overstated, especially in the elderly. This emphasis has led to recommendations by some investigators that these agents not be used in the management of hypertension in this age group. There are numerous reasons why these recommendations should not be followed. The use of beta blockers in the elderly hypertensive has resulted in a reduction in strokes and congestive heart failure. In addition, it should be emphasized that elderly patients are more likely to have silent coronary artery disease or sustain myocardial infarctions. There is abundant evidence that beta blockers are effective therapy in reducing mortality once a myocardial infarction has occurred. In fact, there is a clear reduction in sudden cardiac death. Furthermore, national statistics document that elderly patients have a prevalence of congestive heart failure that varies from 6%-10%. Multiple studies have now documented that beta blockers are additive to angiotensin-converting enzyme inhibitors in reducing mortality for congestive heart failure. Thus, elderly hypertensive patients may benefit from the use of beta blockers, especially if there is evidence of ischemic heart disease, cardiac arrhythmias, or congestive heart failure.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Scleroderma renal crisis.

Abrupt onset of severe uncontrolled hypertension and rapidly progressive oliguric renal failure characterizes scleroderma renal crisis. The etiology is unclear, but very high renin levels are present. While scleroderma is more common in women and whites, there is no difference in the prevalence of scleroderma renal crisis by gender. However, there appears to be a higher prevalence of scleroderma renal crisis among African Americans than whites. Survival was dismal prior to the introduction of the vigorous treatment of hypertension and use of converting-enzyme inhibitors. However, most data on the benefit of these medications are derived from uncontrolled and unblinded studies. Prospective, randomized controlled trials are needed to assess the role of angiotensin receptor blockers. Prevention trials could define the role of various drugs in decreasing the rate of scleroderma renal crisis.

Angiotensin-Converting Enzyme Inhibitors↗