Table 2.

An Outline of the Stratified Therapeutic Intervention Implemented in the Illustrative Case Presented.

Stratified Therapeutic Intervention Implemented in the Illustrative Patient
Behavior modification– smoking cessation, specific instructions for home-based exercise and heart healthy diet
Anti-thrombogenic therapy– Rosuvastatin was added to her existing low dose aspirin regimen
Control of Hypertension– An angiotensin converting enzyme inhibitor (ACEi) was chosen based on its documented additional beneficial effects on the renin-angiotensin and endothelin systems, and effects on ameliorating hypertrophy. Calcium antagonist, amlodipine, was also instituted based on consideration of documented diastolic dysfunction, with the aim to improve energetics-dependent calcium uptake and thus relaxation contractile function
Anti-anginal Therapy– Long-acting nitrate isosorbide was also added because of its beneficial effects on dyspnea and diastolic function
Multidisciplinary specialty care– Evaluation and management of sleep apnea, and intensive management of diabetes by endocrinologist