Humanities and medicine| Volume 22, ISSUE 4, P423-424, May 2002

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Silent ischemia1

  • Ijaz A Khan
    Reprint Address: Ijaz A. Khan, MD, FACP, Creighton University Cardiac Center, 3006 Webster Street, Omaha, NE 68131 USA
    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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