Summary:
In 1998, nitric oxide (NO) was extensively explored. First studies demonstrating a beneficial effect of inhaled NO
in patients with pulmonary hypertension, right ventricular dysfunction and intractable heart failure were published.
It was further shown, that, in patients with essential hypertension, impaired vasodilatation can be improved by
vitamin C as an antioxidant, an effect that can be reversed by NO-synthase inhibition. Unlike arotinolol, which has
no antioxidat effect, carvedilol is a beta- and alpha-blocker with antioxidative properties that may prevent the
development of nitrate tolerance. In clinical cardiology, the main focus is on the prevention and therapy of coronary
heart disease, heart failure and hypertension: a Task force report on the prevention of coronary heart disease in
clinical practice. Proceedings on anticoagulant therapy and Guidelines for antithrombotic management were
published in 1998. There is an agreement that in mild hypertension the decision how to treat should be based on the
estimate of cardiovascular risk and not on an arbitrary blood pressure threshold. Diuretics and betablockers should
be preferred unless they are contraindicated, or there are positive indications for other drug classes. Studies also
strongly suggest that therapy with relatively small doses of two different classes of drugs is the effective way to treat
the majority of patients and minimize side effects. In heart failure, the evidence for the current treatment with
diuretics, ACE-inhibitors and digoxin, in selected patients, is well established.
Key words:
therapeutic use of nitric oxide, NO and antioxidants, carvedilol, arotinolol, prevention of coronary
heart disease, management of hypertension, diuretics, silbenafil, xenical.
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