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The decision to initiate drug therapy is relatively straightforward once hypertension has been unequivocally diagnosed (Table 11 1 and Figure 11 1), but less clear in persons with prehypertension (blood pressure of 120 139/80 89 mm Hg) Some experts have suggested that early blood pressure elevation, and perhaps antecedent metabolic abnormalities, lead to vascular damage that propels further blood pressure elevation in an ever accelerating spiral of progression If so, then interception early in the course might modify the natural history of the disease, leading to diminished requirements for multiple antihypertensive agents and, perhaps, a much more dramatic effect on cardiovascular risk than can be attained with initiation of treatment once hypertension is established In beginning to address this question, the TROPHY study showed that treatment of prehypertension in a population at no particular risk for cardiovascular events only seemed to delay the onset of hypertension, since blood pressure in the treated group increased toward the placebo group when treatment was discontinued The situation is a little clearer in nonhypertensive patients at elevated cardiovascular risk, in whom the HOPE and PROGRESS trials indicated improved outcomes with antihypertensive medication (ACE inhibitor and ACE inhibitor plus diuretic, respectively) These observations have prompted some to think in terms of optimizing blood pressure to a suggested 120/80 mm Hg However, the public health consequences of recommendations to treat prehypertension would be enormous Forty-eight percent of all Americans have hypertension or prehypertension, and much higher proportions fit these categories in a typical family medicine population The JNC 7 guidelines suggest that antihypertensive medications be offered to persons with prehypertension with compelling indications for treatment such as chronic kidney disease or diabetes mellitus (Table 11 4) According to the British Hypertension Society (BHS) recommendations, risk analysis should be used to target treatment to patients with borderline hypertension who are most likely to benefit, particularly individuals at high combined risk of coronary heart or stroke event (> 20 30% within 10 years) (Figure 11 2) Risk is calculated according to Framingham study criteria (calculated from several of the risk factors listed in Table 11 5) A low-risk patient with blood pressure between 120 139/80 89 mm Hg may be advised to make lifestyle. how to read pdf file in asp.net using c# how to read pdf file in asp . net using c# .net - C# Corner
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Resources and example code for reading data from Adobe PDF files by writing software using C# and . NET . ... How to read pdf files using C# . NET including iText, PDFBox, PDF -Excel, etc. A summary of ... NET ; Winnovative PDF Viewers ASP . For overall cardiovascular risk reduction, stop smoking The effects of implementing these modifications are dose and time dependent and could be higher for some individuals BMI, body mass index calculated as weight in kilograms divided by the square of height in meters; BP, blood pressure; DASH, Dietary Approaches to Stop Hypertension Source: Chobanian AV et al The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report JAMA 2003 May 21;289(19):2560 72 public Fraction(int wholeNumber) { Console.WriteLine("In constructor taking a whole number"); numerator = wholeNumber; denominator = 1; } asp.net pdf editor component, birt barcode plugin, birt qr code download, birt code 128, how to edit pdf file in asp.net c#, asp.net pdf editor read pdf in asp.net c# Extract Text from PDF in C# (100% . NET ) - CodeProject
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How to read pdf files using C# .NET including iText, PDFBox, PDF -Excel, etc. A summary of some ... NET; Winnovative PDF Viewers ASP . NET and Windows ... risk factors should be counseled about nonpharmacologic approaches to lowering blood pressure Approaches of proved but modest value include weight reduction, reduced alcohol consumption and, in some patients, reduced salt intake Gradually increasing activity levels should be encouraged in previously sedentary patients, but strenuous exercise training programs in already active individuals may have less benefit Calcium and potassium supplements have been advocated, but their ability to lower blood pressure is limited Smoking cessation will reduce overall cardiovascular risk Overall, the effects of lifestyle modification on blood pressure are modest Although all patients should be urged to modify risk factors, Table 11 4 Clinical trial and guideline basis for compelling indications for individual drug classes1 High-Risk Conditions with Compelling Indication2 Heart failure Recommended Drugs Diuretic -Blockers ACE Inhibitors ARB CCB Aldosterone Antagonist Clinical Trial Basis ACC/AHA Heart Failure Guideline, MERIT-HF, COPERNICUS, CIBIS, SOLVD, AIRE, TRACE, ValHEFT, RALES ACC/AHA Post-MI Guideline, BHAT, SAVE, Capricorn, EPHESUS ALLHAT, HOPE, ANBP2, LIFE, CONVINCE NKF-ADA Guideline, UKPDS, ALLHAT NKF Guideline, Captopril Trial, RENAAL, IDNT, REIN, AASK PROGRESS Post-myocardial infarction High coronary disease risk Diabetes mellitus Chronic kidney disease Recurrent stroke prevention You see this sequence of events represented in the output: read pdf file in asp.net c# how to read pdf file in asp . net using c# .net - C# Corner
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How to read pdf files using C# .NET including iText, PDFBox, PDF -Excel, etc. A summary of some ... NET; Winnovative PDF Viewers ASP . NET and Windows ... Compelling indications for antihypertensive drugs are based on benefits from outcome studies or existing clinical guidelines; the compelling indication is managed in parallel with the blood pressure 2 Conditions for which clinical trials demonstrate benefit of specific classes of antihypertensive drugs AASK, African American Study of Kidney Disease and Hypertension; ACC/AHA, American College of Cardiology/American Heart Association; ACE, angiotensin converting enzyme; AIRE, Acute Infarction Ramipril Efficacy; ALLHAT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; ANBP2, Second Australian National Blood Pressure Study; ARB, angiotensin receptor blocker; BHAT, -Blocker Heart Attack Trial; CCB, calcium channel blocker; CIBIS, Cardiac Insufficiency Bisoprolol Study; CONVINCE, Controlled Onset Verapamil Investigation of Cardiovascular End Points; COPERNICUS, Carvedilol Prospective Randomized Cumulative Survival Study; EPHESUS, Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study; HOPE, Heart Outcomes Prevention Evaluation Study; IDNT, Irbesartan Diabetic Nephropathy Trial; LIFE, Losartan Intervention For Endpoint Reduction in Hypertension Study; MERIT-HF, Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure; NKF-ADA, National Kidney Foundation American Diabetes Association; PROGRESS, Perindopril Protection Against Recurrent Stroke Study; RALES, Randomized Aldactone Evaluation Study; REIN, Ramipril Efficacy in Nephropathy Study; RENAAL, Reduction of Endpoints in Non-Insulin-Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan Study; SAVE, Survival and Ventricular Enlargement Study; SOLVD, Studies of Left Ventricular Dysfunction; TRACE, Trandolapril Cardiac Evaluation Study; UKPDS, United Kingdom Prospective Diabetes Study; ValHEFT, Valsartan Heart Failure Trial Source: Chobanian AV et al The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report JAMA 2003 May 21;289(19):2560 72 read pdf file in asp.net c# How to read text on PDF file and Image File using C# ? - C# Corner
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