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By Albert F. Blakeslee

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Extra info for An Apparent Case of Non-Mendelian Inheritance in Datura Due to a Disease

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Work-Up It is important to assess for the presence of hypertensive urgency or emergency. If present, proceed to immediate therapy as outlined below. Assess for major cardiovascular risk factors: • HTN • Smoking • Body mass index (BMI) >30 • Dyslipidemia • Diabetes mellitus • Chronic kidney disease • Age (>55 in men; >65 in woman) • Family history of premature cardiovascular disease (men <55 years; women <65 years). Assess for chronic end-organ damage: • Left ventricular hypertrophy (LVH), angina, or prior MI, CHF • Stroke, transient ischemic attack, intracranial hemorrhage • Chronic kidney disease (reduced eGFR or elevated albumin excretion) • Peripheral vascular disease • Retinopathy.

EV I DE NC E - B ASE D P R AC T I C E Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) Context: Assess whether beta-blockers are useful in preventing cardiovascular events as compared to CCBs. Goal: To compare whether atenolol or amlodipine is more effective in preventing fatal and nonfatal CVD events. Method: Multicenter RCT involving 19 257 participants 40–79 years of age with HTN and ≥3 other CHD risk factors were assigned to either amlodipine (with ACE-I as required) versus atenolol (with thiazide as required).

Method: Multicenter RCT involving 11 506 participants with HTN and high cardiovascular risk. The primary endpoint was the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, resuscitation after sudden cardiac arrest, and coronary revascularization. Results: Study stopped prematurely after a mean follow-up of 36 months. Though BP goals were reached in both arms equally, the combination of benazepril–amlodipine was superior to benazepril–hydrochlorothiazide in terms of primary endpoint.

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An Apparent Case of Non-Mendelian Inheritance in Datura Due to a Disease by Albert F. Blakeslee


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