Alan H. Gradman

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BACKGROUND Stopping the detrimental effects of the renin-angiotensin system at the most upstream point of the cascade offers theoretical advantages for cardiovascular protection. This study compares the antihypertensive efficacy and safety of the novel oral renin inhibitor aliskiren with placebo and an active comparator. METHODS AND RESULTS The study was(More)
The goal of antihypertensive therapy is to abolish the risks associated with blood pressure (BP) elevation without adversely affecting quality of life. Drug selection is based on efficacy in lowering BP and in reducing cardiovascular (CV) end points including stroke, myocardial infarction, and heart failure. Although the choice of initial drug therapy(More)
This longitudinal study investigated the relationship between denial of illness and the course of recovery in patients with coronary heart disease. Using a newly developed interview instrument, the Levine Denial of Illness Scale (LDIS), the level and modes of denial were assessed in 45 male patients who were hospitalized for myocardial infarction or for(More)
BACKGROUND Aliskiren is the first in a new class of orally effective renin inhibitors for the treatment of hypertension. METHODS In 569 patients with mild-to-moderate hypertension, blood pressure (BP), plasma renin activity (PRA) and plasma renin concentration (PRC) were measured before and after 8 weeks of double-blind treatment with once-daily oral(More)
Since its discovery in the late 19th century, our may limit the degree of RAAS suppression that is conceptual understanding of the renin-angiotensin-aldosterone system (RAAS) has undergone a process of continuous evolution. Renin was first described by Tigerstedt and Bergman, who, in 1898, documented pressor effects of tissue extracts from rabbit kidneys.(More)
Fifty years ago, investigators identified renin inhibition as the preferred pharmacologic approach to blockade of the renin-angiotensin system. Renin is a monospecific enzyme that catalyzes the rate-limiting step in the synthesis of angiotensin II. Amplified enzymatic activity and additional physiological effects occur when renin and pro-renin bind to the(More)
The relation between baseline clinical variables and subsequent mortality was examined in 295 patients with mild to moderate heart failure who participated in a multicenter trial comparing the effect on treadmill exercise tolerance of captopril, digoxin and placebo given in addition to a diuretic drug. At baseline study, all patients had a left ventricular(More)
A series of eight patients admitted to a single-centre coronary care unit over a two-year period is described. All of the patients presented with an acute coronary syndrome within less than 48 h from the onset of an allergic reaction (six patients), or during an acute asthmatic paroxysm (two patients). None of the patients had any history of cardiac(More)
Other than age, left ventricular hypertrophy (LVH) is the most potent predictor of adverse cardiovascular outcomes in the hypertensive population, and is an independent risk factor for coronary heart disease, sudden death, heart failure and stroke. Although directly related to systolic blood pressure, other factors including age, sex, race, body mass index(More)
A multicenter, randomized, double-masked, placebo-controlled trial was conducted to assess the efficacy of once-daily eprosartan, a nonbiphenyl, nontetrazole angiotensin II-receptor antagonist, in 243 patients with mild-to-moderate systemic hypertension (sitting diastolic blood pressure [SitDBP], 95-114 mm Hg). After a 3-to 5-week single-masked placebo(More)