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Biomedical subjects

V E Friedewald

Publications and source records attributed to V E Friedewald.

At least 19 recordsLinked to original sources
PubMed2000

Case 6: Renovascular hypertension.

Renovascular hypertension is a progressive disorder that can result in serious complications without adequate treatment. Unfortunately, identification of patients with the condition is often difficult, and the optimal approach to management continues to be debated.

Aged↗
PubMed2000

Case 3: Insulin-dependent diabetes mellitus.

Dyslipidemia secondary to insulin-dependent diabetes mellitus is common among patients whose plasma glucose levels are poorly controlled. Because of the high mortality associated with diabetes, prompt intervention to correct the dyslipidemia is warranted.

Blood Glucose↗
PubMed2000

Case 4: a patient with symptomatic bradycardia.

Both the clinical and electrocardiographic presentations of sick sinus syndrome are highly variable. As illustrated by this month's case of Interactive Grand Rounds, the initial challenge to the clinician is to establish the correct diagnosis in the patient who has symptomatic bradyarrhythmias.

Aged↗
PubMed2000

Case 3: A patient with systemic hypertension and left ventricular hypertrophy.

Hypertension is often referred to as the "silent killer" because most hypertensive patients are asymptomatic until cardiovascular sequelae such as stroke, myocardial infarction, heart failure, or renal failure occur. LVH is a common finding in patients with hypertension, especially African-Americans. Data from the Framingham Heart Study indicate that LVH is an independent risk factor for major cardiovascular events. In the Amlodipine Cardiovascular Community Trial, 37% of 124 hypertensive patients screened by means of echocardiography had LVH at baseline. Although there was no difference in the prevalence of LVH by gender or age, African-American patients were nearly twice as likely to have LVH than white patients (64% vs. 34%, p<0.05). Hence, aggressive therapy to reach target goals outlined in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) is especially important in this group of patients. Even lifestyle modifications such as weight reduction and limitation of salt intake, if sufficiently aggressive, can lead to regression of LVH, as demonstrated by results of the Treatment of Mild Hypertension Study (TOMHS). Most classes of antihypertensive drugs are effective in causing regression of LVH. Vasodilators, such as minoxidil and hydralazine, do not have an effect on regression, possibly because reflex tachycardia and stimulation of catecholamines and the renin-angiotensin system associated with these agents may negate the benefit of reduced afterload. There is some controversy regarding the ability of the angiotensin receptor blockers to reduce LVH. In some studies, these agents were associated with regression, whereas in others they were not. Whether targeting LVH as the primary treatment goal in hypertensive patients will have long-term benefits on outcome above and beyond simply reducing blood pressure is not clear.

Aged↗
PubMed2000

Case 2: a patient with low levels of high-density lipoprotein cholesterol.

Approximately 11% of all American men >20 years of age have low levels of high-density lipoprotein cholesterol (<35 mg/dl) in isolation, with an even higher prevalence in high-risk populations. One feature of the 1993 National Cholesterol Education Program guidelines-and the focus of this month's CME-accredited case study-is an increased emphasis on high-density lipoprotein cholesterol levels as an important aspect of risk stratification for coronary heart disease.

Cholesterol, HDL↗
PubMed1999

Case 1: isolated systolic hypertension.

Despite the prevalence of isolated systolic hypertension (ISH) in the elderly, many physicians are reluctant to treat the disorder. Recently identified as one of the major health challenges of the new millennium, ISH is the focus of this month's CME-accredited case study in hypertension, featured at www.CardiovascularEd. com.

Age Factors↗
PubMed1999

Case 2: a patient with an intermittent racing heartbeat.

Most clinicians currently rely on patient history and specific electrocardiographic criteria to establish the diagnosis of arrhythmias. However, as illustrated by this case, the physical examination-especially auscultation of the first heart sound-can also provide useful diagnostic clues.

Adolescent↗