Curriculum Update #2

• From hypertension to LVH and heart failure

This new program focuses on an area in which our understanding of vascular biology may have had the most profound impact on clinical practice to date. These 20 slides highlight major issues in the treatment and prevention of LVH and heart failure in patients with hypertension. The suggested therapeutic strategies employing ACE inhibition have the potential to favorably modify vascular pathology and reduce morbidity and mortality ... indeed, they are strategies currently recommended in JNC-VI.


The contents of the following curriculum update represent a concise overview of research in the emerging field of the endothelium and its role in cardiovascular health and disease. The focus of this program is on the association between hypertension, left ventricular hypertrophy (LVH), and heart failure, and on the treatment and prevention of these unfavorable outcomes with currently available treatment modalities.

This curriculum update explores the following:

  • Pathophysiological progression of disease: Hypertension-LVH-heart failure
  • The emerging trend in hypertension management to treat the underlying pathology: JNC-VI guidelines
  • Regression of LVH as an important therapeutic target
  • Endothelial dysfunction in coronary artery disease and the renin-angiotensin system
  • Improving endothelial function with ACE inhibition
  • The efficacy of tissue ACE inhibition in patients with heart failure

This exciting slide program addresses not only insults to the endothelium that may produce dysfunction, but also provides an update of data from clinical trials that are advancing the treatment and prevention of hypertension and blunting its potential outcomes...LVH and heart failure.

Published by Medical Education Consultants, Inc. (MEDCON), on behalf of the University of Florida College of Medicine. Supported by an unrestricted educational grant from Parke-Davis, a Division of Warner-Lambert Company.

Copyright © 2000.

The editorial content of this program expresses the views of the individual contributors and does not necessarily reflect the views or recommendations of the University of Florida College of Medicine, Parke-Davis, or the publisher. The indications and dosages of drugs discussed in this program may vary from those approved by the Food and Drug Administration (FDA). The reader is advised to consult the full prescribing information for each medication prior to use.

From hypertension to LVH and heart failure

Download CU2.ppt (20 slides - 1.1MB)

From hypertension to LVH and heart failure Content outline Progression of hypertension to LVH and heart failure JNC-VI guidelines: Compelling indications and treatment choices Relative risks for heart failure: Framingham Heart Study LVH regression: Changes in left ventricular mass index with 4 drug classes LVH reversed in most patients with long-term quinapril treatment Mechanisms of cardiac RAS activation in cardiac remodeling Hypothesized role of vascular endothelial dysfunction in chronic heart failure pathogenesis  Possible mechanisms of endothelial dysfunction in heart failure Effects of ACE inhibition on flow-dependent vasodilation Bradykinin and ACE inhibition Effect of ACE inhibition on FDD in patients with CHF Relative potency of ACE inhibitors in plasma and tissue (RIB studies) Effect of ACE inhibition on morbidity and mortality in heart failure patients —an analysis of 32 trials ACE inhibition reduces hospitalizations for heart failure: Effect of dosing ACE inhibitors and angiotensin II receptor blockers compared for heart failure treatment: RESOLVD Angiotensin II blockade vs ACE inhibition: Comparable outcomes in heart failure (ELITE-2) Evolving cardiovascular goals in hypertension therapy Summary


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Vascular Biology in Clinical Practice © Vol. 1, No. 3

From hypertension to LVH and heart failure

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