6 +/- 10 years; 54% male; baseline blood pressure (BP) 161/98 mm Hg, 32% stage 1). Patients were randomized to valsartan 80 mg (V-low), valsartan 160 mg (V-high) or valsartan/HCTZ 160/12.5 mg (V/HCTZ), and electively titrated after weeks 2 and 4 to the next dosage level (maximum dose valsartan/HCTZ 160/25 mg) if BP remained
4140/90 mm Hg. At end of the study, patients initiated with V/HCTZ required less titration steps compared with the initial valsartan monotherapy groups (63 vs 86% required titration by study end, respectively) and reached the target BP goal of <140/90 mm Hg in a shorter period of time (2.8 weeks) (P < 0.0001) vs V-low (4.3 weeks) and V-high (3.9 weeks). Initial combination therapy was also associated with higher BP control rates
and greater reductions check details in both systolic and diastolic BP RepSox chemical structure from baseline (63%, -27.7 +/- 13/- 15.1 +/- 8 mm Hg) compared with V-low (46%, -21.2 +/- 13/- 11.4 +/- 8 mm Hg, P < 0.0001) or V-high (51%, -24.0 +/- 13/- 12.0 +/- 10 mm Hg, P < 0.01). Overall and drug-related AEs were mild to moderate and were similar between V/HCTZ (53.1 and 14.1%, respectively) and the two monotherapy groups, V-low (50.5 and 13.8%) and V-high (50.7 and 11.8%). In conclusion, initiating therapy with a combination of valsartan and low-dose HCTZ results in early, improved BP efficacy with similar tolerability as compared with starting treatment with a low or higher dose of valsartan for patients with stage-1 and stage- 2 hypertension. Journal of Human Hypertension (2010) 24, 483-491; doi: 10.1038/jhh.2009.90; published online 10 December 2009″
“Over the years, policies adopted by United Network of Organ Sharing (UNOS) have directed allocation of donor hearts in the USA. These policies have been based on algorithms that allocate a higher priority status to those patients who are the most infirm, and would thereby benefit patients in the most dire of circumstances. Over the last 2 decades, the increased
use of LVADs as a bridge to transplantation has had a major impact GSI-IX order on lowering the mortality among those on the heart transplant waiting list. Given the constant risk of potential complications related to these devices, early UNOS policies were implemented to specifically allocate higher priority status to patients on LVADs. However, recent advances in LVAD technology coupled with refinements in patient selection and management have dramatically improved patient survival and led to a reduction in complications. It is inevitable that favorable experiences with the current generation of LVADs coupled with continued improvements in technology will lead to increased use of these devices as a bridge to transplantation or to candidacy. J Heart Lung Transplant 2011;30:971-4 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved.