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Secondary Hypertension: Discovering the Underlying Cause - American Family Physician

Oct 1, 2017 - Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p453.html

Acute Coronary Syndrome: Current Treatment - American Family Physician

Feb 15, 2017 - Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p232.html

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.html

Severe Asymptomatic Hypertension: Evaluation and Treatment - American Family Physician

Apr 15, 2017 - Hypertension affects one-third of Americans and is a significant modifiable risk factor for cardiovascular disease, stroke, renal disease, and death. Severe asymptomatic hypertension is defined as severely elevated blood pressure (180 mm Hg or more systolic, or 110 mm Hg or more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p492.html

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management - American ...

Nov 1, 2017 - Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p582.html

Edema: Diagnosis and Management - American Family Physician

Jul 15, 2013 - Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. The rapid development of generalized pitting edema associated with systemic disease requires ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0715/p102.html

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.html

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.html

Hypertensive Disorders of Pregnancy - American Family Physician

Jan 15, 2016 - Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks’ gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks’ gestation), preeclampsia, or preeclampsia superimposed on chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p121.html

High Blood Pressure in Children and Adolescents - American Family Physician

Oct 15, 2018 - High blood pressure in children and adolescents is a growing health problem that is often overlooked. Children should be screened for elevated blood pressure annually beginning at three years of age or at every visit if risk factors are present. In children younger than 13 years, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p486.html

Evaluation and Management of Orthostatic Hypotension - American Family Physician

Sep 1, 2011 - Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p527.html

Diagnosis and Management of Common Types of Supraventricular Tachycardia - American ...

Nov 1, 2015 - Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. The condition is caused by reentry phenomena or automaticity at or above the atrioventricular node, and includes atrioventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p793.html

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.html

Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults - American Family ...

Jan 15, 2017 - Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p78.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

Diagnosis and Management of Kawasaki Disease - American Family Physician

Mar 15, 2015 - Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p365.html

Cardiomyopathy: An Overview - American Family Physician

Nov 15, 2017 - The definition and classification of cardiomyopathy have evolved considerably in recent years. Cardiomyopathy can be separated into primary (genetic, mixed, or acquired) and secondary categories, which result in varied phenotypes including dilated, hypertrophic, and restrictive ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p640.html

Pulmonary Hypertension: Diagnosis and Treatment - American Family Physician

Sep 15, 2016 - Pulmonary hypertension is a common, complex group of disorders that result from different pathophysiologic mechanisms but are all defined by a mean pulmonary arterial pressure of 25 mm Hg or greater. Patients often initially present to family physicians; however, because the symptoms ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p463.html

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.html

Common Types of Supraventricular Tachycardia: Diagnosis and Management - American ...

Oct 15, 2010 - The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing accelerated heart rates. Symptoms may include palpitations (pulsation in the neck), chest pain, lightheadedness or dizziness, and dyspnea. It is unusual for supraventricular tachycardia to...

American Family Physician : Article

https://www.aafp.org/afp/2010/1015/p942.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.html

Myocardial Infarction: Management of the Subacute Period - American Family Physician

Nov 1, 2013 - Optimal management of myocardial infarction in the subacute period focuses on improving the discharge planning process, implementing therapies early to prevent recurrent myocardial infarction, and avoiding hospital readmission. Evidence-based guidelines for the care of patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p581.html

Diagnosis and Evaluation of Heart Failure - American Family Physician

Jun 15, 2012 - Heart failure is a common clinical syndrome characterized by dyspnea, fatigue, and signs of volume overload, which may include peripheral edema and pulmonary rales. Heart failure has high morbidity and mortality rates, especially in older persons. Many conditions, such as coronary ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0615/p1161.html

Diagnosis of Secondary Hypertension: An Age-Based Approach - American Family Physician

Dec 15, 2010 - Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause. A secondary etiology may be suggested by symptoms (e.g., flushing and sweating suggestive of pheochromocytoma), examina- tion findings (e.g., a renal bruit suggestive of renal artery ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1215/p1471.html

Acute Pericarditis: Diagnosis and Management - American Family Physician

Apr 1, 2014 - Acute pericarditis, inflammation of the pericardium, is found in approximately 5% of patients admitted to the emergency department for chest pain unrelated to acute myocardial infarction. It occurs most often in men 20 to 50 years of age. Acute pericarditis has a number of potential ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0401/p553.html

High Blood Pressure in Children and Adolescents - American Family Physician

Apr 1, 2012 - High blood pressure in children and adolescents is a growing health problem that is often overlooked by physicians. Normal blood pressure values for children and adolescents are based on age, sex, and height, and are available in standardized tables. Prehypertension is defined as a ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0401/p693.html

Management of Hypertriglyceridemia - American Family Physician

May 1, 2007 - Hypertriglyceridemia is associated with an increased risk of cardiovascular events and acute pancreatitis. Along with lowering low-density lipoprotein cholesterol levels and raising high-density lipoprotein cholesterol levels, lowering triglyceride levels in high-risk patients (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0501/p1365.html

Evaluation of Syncope - American Family Physician

Sep 15, 2011 - Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p640.html

Considerations for Safe Use of Statins: Liver Enzyme Abnormalities and Muscle Toxicitiy...

Mar 15, 2011 - Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p711.html

Outpatient Approach to Palpitations - American Family Physician

Jul 1, 2011 - Palpitations are a common problem seen in family medicine; most are of cardiac origin, although an underlying psychiatric disorder, such as anxiety, is also common. Even if a psychiatric comorbidity does exist, it should not be assumed that palpitations are of a noncardiac etiology. ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0701/p63.html

ACC/AHA Release Updated Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD...

Aug 15, 2014 - The Blood Cholesterol Expert Panel from the American College of Cardiology (ACC) and the American Heart Association (AHA) issued an updated evidence-based guideline in 2013 that addresses the use of fixed doses of cholesterol-lowering drugs (statins) to reduce the risk of ASCVD in ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/0815/p260.html

Diagnosis and Management of Diastolic Dysfunction and Heart Failure - American Family ...

Mar 1, 2006 - Diastolic heart failure occurs when signs and symptoms of heart failure are present but left ventricular systolic function is preserved (i.e., ejection fraction greater than 45 percent). The incidence of diastolic heart failure increases with age; therefore, 50 percent of older patients...

American Family Physician : Article

https://www.aafp.org/afp/2006/0301/p841.html

Perioperative Cardiac Risk Reduction - American Family Physician

Feb 1, 2012 - Cardiovascular complications are the most common cause of perioperative morbidity and mortality. Noninvasive stress testing is rarely helpful in assessing risk, and for most patients there is no evidence that coronary revascularization provides more protection against perioperative ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0201/p239.html

Secondary Prevention of Coronary Artery Disease - American Family Physician

Feb 1, 2010 - Coronary artery disease is the leading cause of mortality in the United States. In patients who have had a myocardial infarction or revascularization procedure, secondary prevention of coronary artery disease by comprehensive risk factor modification reduces mortality, decreases ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0201/p289.html

Pharmacologic Management of Hypertension in Patients with Diabetes - American Family ...

Dec 1, 2008 - Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macrovascular and microvascular complications. Patients with diabetes should achieve a target blood pressure of less than 130/80 mm Hg. The use of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1277.html

Managing Hypertension Using Combination Therapy - American Family Physician

May 1, 2008 - Combination therapy of hypertension with separate agents or a fixed-dose combination pill offers the potential to lower blood pressure more quickly, obtain target blood pressure, and decrease adverse effects. Antihypertensive agents from different classes may offset adverse reactions ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0501/p1279.html

ACC/AHA Guideline Update for the Management of ST-Segment Elevation Myocardial ...

Jun 15, 2009 - The American College of Cardiology and American Heart Association, in collaboration with the Canadian Cardiovascular Society, have issued an update of the 2004 guideline for the management of patients with ST-segment elevation myocardial infarction. The American Academy of Family ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0615/p1080.html

Diagnostic Approach to Palpitations - American Family Physician

Feb 15, 2005 - Palpitations-sensations of a rapid or irregular heartbeat-are most often caused by cardiac arrhythmias or anxiety. Most patients with arrhythmias do not complain of palpitations. However, any arrhythmia, including sinus tachycardia, atrial fibrillation, premature ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p743.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Sep 15, 2008 - Aortic stenosis is the most important cardiac valve disease in developed countries, affecting 3 percent of persons older than 65 years. Although the survival rate in asymptomatic patients with aortic stenosis is comparable to that in age- and sex-matched control patients, the average ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0915/p717.html

Diagnosing the Cause of Chest Pain - American Family Physician

Nov 15, 2005 - Chest pain presents a diagnostic challenge in outpatient family medicine. Noncardiac causes are common, but it is important not to overlook serious conditions such as an acute coronary syndrome, pulmonary embolism, or pneumonia. In addition to a thorough history and physical ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2012.html

Evaluation and Management of the Patient with Difficult-to-Control or Resistant ...

May 15, 2009 - High blood pressure is often difficult to control. Resistant hypertension is blood pressure above goal despite adherence to a combination of at least three antihypertensive medications of different classes, optimally dosed and usually including a diuretic. The approach to blood pressure...

American Family Physician : Article

https://www.aafp.org/afp/2009/0515/p863.html

Evaluation of Syncope - American Family Physician

Oct 15, 2005 - Though relatively common, syncope is a complex presenting symptom defined by a transient loss of consciousness, usually accompanied by falling, and with spontaneous recovery. Syncope must be carefully differentiated from other conditions that may cause a loss of consciousness or ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1015/p1492.html

Evaluating Obesity and Cardiovascular Risk Factors in Children and Adolescents - ...

Nov 1, 2008 - Obesity continues to be a growing public health problem. According to the 2003-2004 National Health and Nutrition Examination Survey, 17 percent of persons two to 19 years of age are overweight. The number of obese children and adolescents has tripled in the past 20 years. Obesity in ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1101/p1052.html

Preoperative Cardiac Risk Assessment - American Family Physician

Nov 15, 2002 - Heart disease is the leading cause of mortality in the United States. An important subset of heart disease is perioperative myocardial infarction, which affects approximately 50,000 persons each year. The American College of Cardiology (ACC) and American Heart Association (AHA) have ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1115/p1889.html

Orthostatic Hypotension - American Family Physician

Dec 15, 2003 - Orthostatic hypotension is a physical finding defined by the American Autonomic Society and the American Academy of Neurology as a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing. The ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1215/p2393.html

Digoxin Therapy for Heart Failure: An Update - American Family Physician

Aug 15, 2006 - Digoxin therapy has long been used to treat heart failure; however, its effectiveness was not completely known until recently. Results of the Digitalis Investigation Group trial showed that adding digoxin to standard heart failure therapy had no effect on mortality. However, adding ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0815/p613.html

Preparation of the Cardiac Patient for Noncardiac Surgery - American Family Physician

Mar 1, 2007 - Approximately 20 to 40 percent of patients at high risk of cardiac-related morbidity develop myocardial ischemia perioperatively. The preferred approach to diagnostic evaluation depends on the interactions of patient-specific risk factors, surgery-specific risk factors, and exercise ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0301/p656.html

Noninvasive Cardiac Imaging - American Family Physician

Apr 15, 2007 - Noninvasive cardiac imaging can be used for the diagnostic and prognostic assessment of patients with suspected or known coronary artery disease. It is central to the treatment of patients with myocardial infarction, coronary artery disease, or acute coronary syndromes with or without ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0415/p1219.html

Arrhythmogenic Right Ventricular Dyplasia - American Family Physician

Apr 15, 2006 - Arrhythmogenic right ventricular dysplasia (ARVD) is a disorder in which normal myocardium is replaced by fibrofatty tissue. This disorder usually involves the right ventricle, but the left ventricle and septum also may be affected. Although the exact prevalence of ARVD is unknown, it ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0415/p1391.html

Outpatient Treatment of Systolic Heart Failure - American Family Physician

Dec 1, 2004 - Optimal outpatient treatment of systolic heart failure has three goals that should be pursued simultaneously: (1) control of risk factors for the development and progression of heart failure, (2) treatment of heart failure, and (3) education of patients. Control of risk factors includes...

American Family Physician : Article

https://www.aafp.org/afp/2004/1201/p2157.html

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