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Silent ischemia1

  • Ijaz A Khan
    Correspondence
    Reprint Address: Ijaz A. Khan, MD, FACP, Creighton University Cardiac Center, 3006 Webster Street, Omaha, NE 68131 USA
    Affiliations
    Division of Cardiology, Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska, USA
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      I saw 94-year-old Mrs. M in an outreach clinic. Mrs. M was being treated for hypertension. She was enjoying a healthy life until 6 months previous when she was diagnosed with hypertension on a routine physical examination. She was told that her blood pressure was mildly elevated. Anti-hypertensive therapy was initiated with a β-adrenergic receptor blocking agent. On each of the subsequent visits, a new anti-hypertensive agent was added to her drug regimen, and eventually, to achieve the ideal control of blood pressure, her anti-hypertensive drug regimen consisted of a maximum dose of a β-adrenergic receptor blocking agent, a high dose of a calcium-channel blocker, and a high dose of an α-adrenergic receptor blocking agent, along with a high dose of a diuretic agent.
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