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calcium channel blockers

A Muruganathan, Mangesh Tiwaskar
While the incidence and prevalence of stroke is gradually decreasing in the western world, a parallel increase is seen in the developing world. It is a matter of special concern to us as approximately 20-30% of stroke occur in people younger than 45 years in India. Indians are prone to higher stroke risk because of urbanization, diabetes, cigarette smoking and high incidence of hypertension. Unfortunately, there is an inadequate awareness about the risk of stroke with hypertension among general public. Hypertension is considered to be the most important risk factor for stroke, and all forms of hypertension are associated with an increased risk of both ischemic and haemorrhagic stroke...
September 2016: Journal of the Association of Physicians of India
M Nagai, K Dote, M Kato, S Sasaki, N Oda, E Kagawa, Y Nakano, A Yamane, Y Kubo, T Higashihara, S Miyauchi, W Harada, H Masuda
In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors...
October 20, 2016: Journal of Human Hypertension
Ricardo Rodrigues Figueiredo, Andréia Aparecida Azevedo, Norma De Oliveira Penido
INTRODUCTION: Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multifactorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme. PURPOSE: To analyze the presence of arterial hypertension in tinnitus and non-tinnitus patients, to analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients, and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed...
2016: Frontiers in Neurology
Almotasembellah Aljaafareh, Jose Ruben Valle, Yu-Li Lin, Yong-Fang Kuo, Gulshan Sharma
OBJECTIVES: Long-acting bronchodilators are mainstay treatment for moderate to severe chronic obstructive pulmonary disease. A growing body of evidence indicates an increased risk of cardiovascular events upon initiation of these medications. We hypothesize that this risk is higher in patients with chronic obstructive pulmonary disease who had a preexisting cardiovascular disease regardless of receipt of any cardiovascular medication. METHODS: A retrospective cohort of patients with a diagnosis of chronic obstructive pulmonary disease based on two outpatient visits or one inpatient visit for chronic obstructive pulmonary disease (International Classification of Diseases, 9th Edition, Clinical Modification codes 491...
2016: SAGE Open Medicine
Emmanuel Bourinet, Gerald W Zamponi
Venoms from various predatory species, such as fish hunting mollusks scorpions, snakes and arachnids contain a large spectrum of toxins that include blockers of voltage-gated calcium channels. These peptide blockers act by two principal manners - physical occlusion of the pore and prevention of activation gating. Many of the calcium channel-blocking peptides have evolved to tightly occupy their binding pocket on the principal pore forming subunit of the channel, often rendering block poorly reversible. Moreover, several of the best characterized blocking peptides have developed a high degree of channel subtype selectivity...
October 15, 2016: Neuropharmacology
Eun Joo Cho, Hae Young Lee, Ki Chul Sung, Sungha Park, Chang Gyu Park, Dong-Ju Choi, Jong Won Ha, Young Keun Ahn, Jinho Shin, Soon-Jun Hong, Soon Kil Kim, Wook-Jin Chung, Byung Su Yoo, Taek Jong Hong, Ho Joong Youn, Myeong-Chan Cho, Shung Chull Chae, Young Jo Kim, Chong-Jin Kim
BACKGROUND: The aim of this study was to compare 24-hour central blood pressure (24 hr c-BP) reduction efficacy between angiotensin II receptor blocker (ARB) combined with calcium channel blocker and with diuretics. METHODS: We conducted a prospective, randomized, double-blind trial in 220 hypertensive patients [mean age = 59.6 ± 12.3 years, men = 154(70%)]. Patients received losartan 50 mg monotherapy for 4 weeks, followed by additional use of amlodipine 5 mg (L/A group) or hydrochlorothiazide 12...
September 2016: Journal of Hypertension
Yu Guan, Daisuke Nakano, Zhang Yifan, Akira Nishiyama
OBJECTIVE: Previous studies have indicated the beneficial effects of N-type calcium channel blocker, cilnidipine, on protecting renal podocyte injury in metabolic syndrome model rats. In the present study, we examined the effects of cilnidipine (L/N-type calcium channel blocker) and nifedipine (L-type calcium channel blocker) on the glomerular filtration barrier damage in the doxorubicin-induced nephropathy mice model. DESIGN AND METHOD: Balb/c mice (male, 5 week-old) were treated with vehicle (n = 5), doxorubicin (20 mg/kg, i...
September 2016: Journal of Hypertension
Rha Seung-Woon, Choi Byoung Geol, Li Hu, Na Jin Oh, Choi Cheol Ung, Park Chang Gyu, Seo Hong Seog, Oh Dong Joo, Kim Yong Hoon, Her Ae-Young, Park Sang-Ho
OBJECTIVE: Recently several studies reported that anti-hypertensive drugs were associated with development of new-onset diabetes mellitus (NODM). However, data on the relationship between detailed prescription types and long-term incidence of NODM are still limited in Asian patients (pts). DESIGN AND METHOD: A total of 3,208 consecutive hypertension pts prescribed with calcium channel blockers (CCB) were enrolled with the exclusion of diabetic pts. Pts were divided into two groups according to the additional prescription of renin angiotensin system (RAS) blockers; 1) the CCB group (n = 1,987) and 2) CCB + RAS group (n = 1,221)...
September 2016: Journal of Hypertension
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: In most cases, the 5 first line drugs are recommended for management of hypertension without preference for one or the other. However, it is unclear whether different classes of anti-hypertensive agents have different effect on survival in low risk, uncomplicated hypertension. The aim of this study was to evaluate effects of 4 classes of first line anti-hypertensive agents on improving survival in patients with low risk, uncomplicated hypertension. DESIGN AND METHOD: Adult hypertensive patients without chronic kidney disease, end stage renal disease, diabetes mellitus, acute coronary syndrome, and heart failure in 2002 were selected from Korean National Health Insurance sample cohort consisting of one million subjects...
September 2016: Journal of Hypertension
Naoki Nakagawa, Keisuke Maruyama, Motoki Matsuki, Nobuyuki Sato, Kenjiro Kikuchi, Naoyuki Hasebe
OBJECTIVE: Uric acid is a risk factor for cardiovascular disease. We investigated the relationship between the change of urinary albumin excretion (UAE) and the changes of serum uric acid (SUA) during antihypertensive treatment in hypertensive patients with microalbuminuria as a subanalysis of the results of the NICE Combi (Nifedipine and Candesartan Combination) Study. DESIGN AND METHOD: A total of 86 subjects with essential hypertension with microalbuminuria (UAE < 300 mg•g-1 creatinine) were randomly assigned in a double-blind manner to a combination therapy group (standard-dose candesartan at 8 mg/day plus controlled-release (CR) nifedipine 20 mg/day) (n = 42) or an up-titrated monotherapy group (candesartan 12 mg/day) (n = 44) for 8 weeks of continuous treatment after initially receiving standard-dose candesartan (8 mg/day) monotherapy for 8 weeks (initial treatment)...
September 2016: Journal of Hypertension
Michal Behuliak, Michal Bencze, Anna Vavrinova, Ivana Vaneckova, Josef Zicha
OBJECTIVE: Voltage-dependent calcium channels (VDCCs) play an important role in two major abnormalities observed in spontaneously hypertensive rats (SHR) - hyperactivity of sympathetic nervous system (SNS) and enhanced Ca influx to vascular smooth muscle cells (VSMC). α2δ subunit of VDCC, which promotes surface trafficking and modulates the biophysical properties of VDCC, was identified as a critical component of increased L-type VDCC calcium currents in arterial myocytes of SHR. On the other hand, N-type VDCCs control a neurotransmitter release in the peripheral sympathetic nervous system and play an important role in sympathetic hyperactivity in SHR...
September 2016: Journal of Hypertension
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
William C Cushman
Beginning with the Veterans Administration (VA) Cooperative Hypertension Study of the 1960 s, blood pressure (BP) lowering with antihypertensive medications has been shown to reduce major cardiovascular (CV) outcomes, including coronary heart disease, stroke, heart failure (HF) and CV and all-cause mortality in randomized controlled CV outcome trials. Multiple drugs were usually required in these trials to lower BP in treated participants. Medication regimens in the early trials, including the VA trial, included a thiazide-type diuretic (TTD) as initial therapy...
September 2016: Journal of Hypertension
Kazuyuki Shimada
Stroke is known to frequently recur in patients with a history of cerebrovascular disease, and the control of hypertension is extremely important for the treatment of those patients. The robust relationship between the recurrent cerebrovascular disease and blood pressure control has been demonstrated in large-scale clinical studies. The antihypertensive drug therapy significantly reduces the recurrence rate of all types of cerebrovascular disease, incidences of myocardial infarction and all vascular events...
September 2016: Journal of Hypertension
Michael Weber
: Age is the most powerful cardiovascular risk factor. Based on a meta-analysis of a million control patients in hypertension trials, the Clinical Trialists Collaboration has estimated that doubling of major cardiac and stroke events occurs with age increments of < 10 years (1). Data from the ACCOMPLISH trial, which will be presented at this ISH meeting for the first time, show that patients aged > 70 (mean: 75.2), compared with those < 70 (mean: 63.7), had a 2.82-fold greater event rate for cardiovascular death and a 2...
September 2016: Journal of Hypertension
Rhian M Touyz
Pathophysiological mechanisms contributing to hypertension include injury to small arteries, characterised by endothelial dysfunction, vascular remodeling, fibrosis and inflammation, (so called hypertensive vascular phenotype). These changes are initially adaptive but in the long term become maladaptive leading to vascular damage and loss of function, particularly important in small resistance arteries, critically involved in the regulation of peripheral vascular resistance and consequently in blood pressure control...
September 2016: Journal of Hypertension
Kazuomi Kario
The essential benefit of the management of hypertension is derived from the blood pressure (BP) lowering per se, indicating the importance of BP throughout 24 hours. Recent guidelines stressed the importance of home BP for the diagnosis and management of hypertension. It is well-known that cardiovascular events occur more frequently in the morning BP levels have been shown to increase during the period from night to early morning. Clinical research using ambulatory BP monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than office BP (Kario et al...
September 2016: Journal of Hypertension
Franz Messerli
OBJECTIVE: To evaluate the outcomes with use of renin angiotensin system (RAS) blockers compared with other antihypertensive agents in people with diabetes. DESIGN: Meta-analysis. DATA SOURCES AND STUDY SELECTION: PubMed, Embase, and the Cochrane central register of controlled trials databases for randomized trials of RAS blockers versus other antihypertensive agents in people with diabetes mellitus. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, and end stage renal disease...
September 2016: Journal of Hypertension
Milan S Geybels, Karen D McCloskey, Ian G Mills, Janet L Stanford
BACKGROUND: Calcium channel blockers (CCBs) may affect prostate cancer (PCa) growth by various mechanisms including those related to androgens. The fusion of the androgen-regulated gene TMPRSS2 and the oncogene ERG (TMPRSS2:ERG or T2E) is common in PCa, and prostate tumors that harbor the gene fusion are believed to represent a distinct disease subtype. We studied the association of CCB use with the risk of PCa, and molecular subtypes of PCa defined by T2E status. METHODS: Participants were residents of King County, Washington, recruited for population-based case-control studies (1993-1996 or 2002-2005)...
October 18, 2016: Prostate
Hassan Fares, James J DiNicolantonio, James H O'Keefe, Carl J Lavie
OBJECTIVES: Hypertension is well established as a major risk factor for cardiovascular disease. Although there is undeniable evidence to support the beneficial effects of antihypertensive therapy on morbidity and mortality, adequate blood pressure management still remains suboptimal. Research into the treatment of hypertension has produced a multitude of drug classes with different efficacy profiles. These agents include β-blockers, diuretics, ACE inhibitors, angiotensin receptor blockers and calcium channel blockers...
2016: Open Heart
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