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Antihypertensive therapy in patients with chronic obstructive pulmonary disease: advantages of calcium antagonists  [cached]
T.V. Adasheva,I.V. Fedorova,V.S. Zadionchenko,M.V. Macievich
Rational Pharmacotherapy in Cardiology , 2008,
Abstract: Aim. To study effect of antihypertensive therapy with amlodipine maleat (StamloR M, “Dr. Reddy’s”, India) on morphofunctional heart indices, intensity of systemic inflammation and oxidative stress in patients with arterial hypertension (HT) with chronic obstructive pulmonary disease (COPD).Material and methods. 20 patients with COPD II-III stage (GOLD 2006) in remission and HT 1-2 stage were involved in the study. Morphofunctional heart indices, respiratory function, levels of C-reactive protein (CRP) and oxidative stress (lipid peroxidation products (LPP) – acilhydroperoxides) were evaluated.Results. Amlodipine maleat therapy provides target level of blood pressure (BP) according to ambulatory BP monitoring with improvement of pathological type of daily BP profile. Reduction of diastolic dysfunction of left and right ventricles was revealed. Therapy was safe in terms of respiratory function. Significant CRP and LPP levels reduction was observed.Conclusion. Amlodipinemaleat therapy has high antihypertensive effect, organoprotective properties and safety in hypertensive patientswith COPD. Besides this therapy demonstrates systemic anti-inflammatory action and reduces oxidative stress.
Dihydropyridine calcium antagonists: data of evidence based medicine and recom-mendations on practical use  [cached]
S. Y. Martsevich
Rational Pharmacotherapy in Cardiology , 2007,
Abstract: The classification of calcium antagonists is presented. There were considered the results of large randomized trials, which were devoted to study of influence of dihydropyridine calcium antagonists on the risk of cardiovascular complications. The place of dihydropyridine calcium antagonists in modern recommendations on treatment of arterial hypertension and ischemic heart disease is defined. The clinical importance of differences between various presentations of dihy-dropyridine calcium antagonists is stressed.
Antihypertensive treatment in elderly patients with dihydropyridine calcium antagonists.  [cached]
Y.A. Karpov,V.V. Buza
Rational Pharmacotherapy in Cardiology , 2006,
Abstract: The proofs of necessity of active arterial hypertension (AH) treatment in elderly patients are given. Peculiarities of pathogenesis of AH in elderly patients, connected predominantly with loss of big arteries elasticity and reasoning widely spread of isolated systolic AH in these patients, are discussed. Advantages of dihydropyridine calcium antagonists (DPCA) for AH treatment in elderly patients are proved, safety of treatment with DPCA is discussed. Data of clinical studies is analyzed. Analysis of target levels of blood pressure for antihypertensive treatment in elderly hypertensive patients is made. As a conclusion DPCA are the medicines of choice for AH treatment in elderly patients.
Dihydropyridine calcium antagonists: the role in current therapy of cardio-vascular diseases  [cached]
E.V. Shilova,S.Y. Martsevich
Rational Pharmacotherapy in Cardiology , 2008,
Abstract: Classification of calcium antagonists (CA) is presented. Results of the large clinical trials (STONE, STOP-Hypertension-2, ALLHAT, ASCOT-BPLA etc.) devoted to estimation of CA effects on the risk of cardiovascular complications are analyzed. The significant place of dihydropyridine CA in current guidelines on arterial hypertension and ischemic heart disease therapy is underlined. Results of a pilot study on comparison of two amlodipines (original Norvasc and generic Stamlo M) are discussed.
Calcium antagonists in the treatment of arterial hypertension during pregnancy  [cached]
R.I. Striuk
Rational Pharmacotherapy in Cardiology , 2006,
Abstract: According to WHO data, arterial hypertension (HT) is revealed in 15-20% of pregnant women. In different regions of Russia the incidence of pregnancy HT varies from 7 to 29%. In women with HT started before pregnancy, perinatal losses are observed in 3, 8%, premature births — in 15, 3% and intrauterine growth retardation — in 16, 6%.Physiological gestational changes of hemodynamics are described. Hypertensive pregnant patients of high and low risk are defined. Non-pharmacological treatment of pregnant women with HT is presented in details. Antihypertensive therapy may not be used in hypertensive patients of low risk with blood pressure (BP) of 140-16090-110 mm Hg. If BP is higher antihypertensive therapy should be used immediately.Dihydropyridine calcium antagonists (CA) is drugs of choice for HT treatment during pregnancy, especially “advanced” CA of the third generation. They have predictable efficacy. It is possible to use short-acting nifedipine for treatment of acute HT in pregnant patients.
Effects of calcium antagonists on brain ischemia  [PDF]
Naumovi? Nada,Slankamenac Petar,Filipovi? Danka,Iveti? Vesna
Medicinski Pregled , 2011, DOI: 10.2298/mpns1106257n
Abstract: Introduction. Stroke is the second leading cause of death in the world and the leading cause of serious, long term disability in adults; about half of those who survive become dependent on others in performing personal activities of daily living. Ischemia disturbs calcium cellular homeostasis, whereas calcium channel blockers re-establish it. This study was aimed at assessing benefits of calcium channel blockers on the outcome of rehabilitation of the patients afflicted by ischemic stroke. Material and Methods. The functional independence was measured by the Barthel index in 90 patients subjected to rehabilitative therapeutic treatment. The functional recovery of patients treated with calcium channel blockers and with other drugs (control) was compared and tested. Results. The analysis of variance (ANOVA) for the 0.5 confidence interval showed that the increases of the Barthel index values were significantly higher in the patients treated with calcium antagonists (p<0.5). Discussion. According to the literature, such an outcome is the result of improved brain blood f low auto-regulation, increased brain perfusion as well as of neuroprotective, antioxidative, platelet antiaggregatory effects of investigated drugs. Conclusion. The calcium channel blockers improved the outcome of rehabilitative therapeutic treatment significantly in the patients afflicted by ischemic stroke.
Efficacy and safety of amlodipine maleate in patients with chronic obstructive pulmonary disease and bronchial asthma with concomitant arterial hypertension  [cached]
N.A. Karoli,A.P. Rebrov,A.A. Roshchina,V.A. Sergeeva
Rational Pharmacotherapy in Cardiology , 2010,
Abstract: Aim. To evaluate efficacy and safety of amlodipine maleate in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA) and concomitant arterial hypertension.Methods. Patients (n=40) with COPD (n=20) or BA (n=20) and hypertension of 1-2 degree were examined. Amlodipine maleate was used as antihypertensive drug. The spirometry, ambulatory blood pressure monitoring, vascular oscillometry (evaluation of arterial stiffness), vascular Doppler imaging (evaluation of endothelial function) was performed initially and in 6 months of treatment.Results. The high efficacy of amlodipine maleate as antihypertensive drug was found in patients with COPD or BA and hypertension without dependence on bronchial obstruction severity. The positive influence of amlodipine on endothelial function and vascular rigidity was also observed.Conclusion: study results confirm the rationales of amlodipine use in patients with COPD or BA and hypertension.
Voltage-Gated Calcium Channel Antagonists and Traumatic Brain Injury  [PDF]
Gene Gurkoff,Kiarash Shahlaie,Bruce Lyeth,Robert Berman
Pharmaceuticals , 2013, DOI: 10.3390/ph6070788
Abstract: Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Despite more than 30 years of research, no pharmacological agents have been identified that improve neurological function following TBI. However, several lines of research described in this review provide support for further development of voltage gated calcium channel (VGCC) antagonists as potential therapeutic agents. Following TBI, neurons and astrocytes experience a rapid and sometimes enduring increase in intracellular calcium ([Ca 2+] i). These fluxes in [Ca 2+] i drive not only apoptotic and necrotic cell death, but also can lead to long-term cell dysfunction in surviving cells. In a limited number of in vitro experiments, both L-type and N-type VGCC antagonists successfully reduced calcium loads as well as neuronal and astrocytic cell death following mechanical injury. In rodent models of TBI, administration of VGCC antagonists reduced cell death and improved cognitive function. It is clear that there is a critical need to find effective therapeutics and rational drug delivery strategies for the management and treatment of TBI, and we believe that further investigation of VGCC antagonists should be pursued before ruling out the possibility of successful translation to the clinic.
Application of calcium antagonists in prevention of cardiovascular complications during cardiac surgery  [cached]
S.V. Nedogoda
Rational Pharmacotherapy in Cardiology , 2006,
Abstract: Results of randomized clinical trials on the usage of calcium antagonists (CA) in order to prevent perioperative complications during aortocoronary bypass procedure and operations on heart valves are analyzed. CA reduced the risk of perioperative myocardial infarctions and episodes of reversible myocardial ischemia. After angioplasty of coronary arteries CA (particularly amlodipine) show positive effects on restenosis incidence and reduce about 3 times a number of repeated angioplasty and aortocoronary bypass operations. The use of CA was accompanied by more often need in heart electro stimulation without any subclass differences. It is also registered that nimodipine can strengthen intraoperative blood loss.It is concluded, that CA have significant evident base that allows recommending them to patients undertaken by cardiological surgery.
Resistant Hypertension and Obstructive Sleep Apnea: The Sparring Partners  [PDF]
Costas Thomopoulos,Helena Michalopoulou,Alexandros Kasiakogias,Anna Kefala,Thomas Makris
International Journal of Hypertension , 2011, DOI: 10.4061/2011/947246
Abstract: Enhanced target organ damage and cardiovascular morbidity represent common issues observed in both resistant hypertension and obstructive sleep apnea. Common pathophysiological features and risk factors justify their coexistence, especially in individuals with increased upper-body adiposity. Impaired sodium handling, sympathetic activation, accelerated arterial stiffening, and impaired cardiorenal hemodynamics contribute to drug-resistant hypertension development in obstructive sleep apnea. Effective CPAP therapy qualifies as an effective “add-on” to the underlying antihypertensive pharmacological therapy, and emerging evidence underlines the favorable effect of mineralocorticoid antagonists on both resistant hypertension and obstructive sleep apnea treatment.
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