American family physician
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American family physician · Nov 1990
ReviewPatient profiling: individualization of hypertension therapy.
Although the stepped-care approach remains the cornerstone of antihypertensive therapy, the patient's profile must also be considered. Important issues include the patient's age, race and activity level, potential for hypertensive complications, presence of other diseases, cost of medications and probability of adherence to the recommended drug regimen. Nonpharmacologic treatment based on lifestyle changes is a useful adjunct to drug therapy, but it is not sufficient to control hypertension in most patients. Selection of pharmacologic therapy must be based on a knowledge of each drug's mode of action and side effects, as well as the characteristics of special patient populations.
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Major depression is a syndrome that can be triggered by numerous physical and psychosocial factors. Concurrent somatic complaints can complicate the diagnosis. Patient evaluation requires a comprehensive history, physical and mental status examinations, and a number of laboratory studies. Effective treatment of depression enhances the quality of life, reduces the probability of secondary alcoholism or suicide, frequently improves coexisting medical problems and reduces the high rate of health care use by these patients.