scholarly journals The Impact of Hypertension and Use of Calcium Channel Blockers on Tuberculosis Treatment Outcomes

2020 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Akshay Gupte ◽  
Jann-Yuan Wang ◽  
Jonathan E Golub ◽  
Petros C Karakousis
Keyword(s):  
Calcium Channel ◽  
Treatment Outcomes ◽  
Calcium Channel Blockers ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Channel Blockers ◽  
Tb Treatment ◽  
All Cause Mortality ◽  
The Impact ◽  
Related Mortality

Abstract Background Hypertension induces systemic inflammation, but its impact on the outcome of infectious diseases like tuberculosis (TB) is unknown. Calcium channel blockers (CCB) improve TB treatment outcomes in pre-clinical models, but their effect in patients with TB remain unclear. Methods This retrospective cohort study, including all patients > 18 years receiving treatment for culture-confirmed, drug-sensitive TB from 2000 to 2016 at the National Taiwan University Hospital, assessed the association of hypertension and CCB use with all-cause and infection-related mortality during the first 9 months of TB treatment, as well as sputum-smear microscopy and sputum-culture positivity at 2 and 6 months. Results 1052 of the 2894 patients (36.4%) had hypertension. Multivariable analysis revealed that hypertension was associated with increased mortality due to all causes (HR 1.57, 95% confidence interval[CI], 1.23-1.99) and infections (HR 1.87, 95%CI, 1.34-2.6), but there was no statistical difference in microbiological outcomes when stratified based on hypertensive group. Dihydropyridine-CCB (DHP-CCB) use was associated with reduced all-cause mortality (HR 0.67, 95%CI: 0.45-0.98) only by univariate Cox regression. There was no association between DHP-CCB use and infection-related mortality (HR 0.78, 95%CI: 0.46-1.34) or microbiological outcomes in univariate or multivariate regression analyses. Conclusions Patients with hypertension have increased all-cause mortality and infection-related mortality during the 9 months following TB treatment initiation. DHP-CCB use may lower all-cause mortality in TB patients with hypertension. The presence of hypertension or the use of CCB did not result in a significant change in microbiological outcomes.

scholarly journals The impact of hypertension and use of calcium channel blockers on tuberculosis treatment outcomes

2020 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Akshay Gupte ◽  
Jann-Yuan Wang ◽  
Jonathan Golub ◽  
Petros Karakousis
Keyword(s):  
Calcium Channel ◽  
Treatment Outcomes ◽  
Calcium Channel Blockers ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Channel Blockers ◽  
Tb Treatment ◽  
All Cause Mortality ◽  
The Impact ◽  
Related Mortality

Background: Hypertension induces systemic inflammation, but its impact on the outcome of infectious diseases like tuberculosis (TB) is unknown. Calcium channel blockers (CCB) improve TB treatment outcomes in pre-clinical models, but their effect in patients with TB remain unclear. Methods: This retrospective cohort study, including all patients > 18 years receiving treatment for culture-confirmed, drug-sensitive TB from 2000 to 2016 at the National Taiwan University Hospital, assessed the association of hypertension and CCB use with all-cause and infection-related mortality during the first 9 months of TB treatment, as well as sputum-smear microscopy and sputum-culture positivity at 2 and 6 months. Results: 1052 of the 2894 patients (36.4%) had hypertension. Multivariable analysis revealed that hypertension was associated with increased mortality due to all causes (HR 1.57, 95% confidence interval[CI], 1.23-1.99) and infections (HR 1.87, 95%CI, 1.34-2.6), but there was no statistical difference in microbiological outcomes when stratified based on hypertensive group. Dihydropyridine-CCB (DHP-CCB) use was associated with reduced all-cause mortality (HR 0.67, 95%CI: 0.45-0.98) only by univariate Cox regression. There was no association between DHP-CCB use and infection-related mortality (HR 0.78, 95%CI: 0.46-1.34) or microbiological outcomes in univariate or multivariate regression analyses. Conclusions: Patients with hypertension have increased all-cause mortality and infection-related mortality during the 9 months following TB treatment initiation. DHP-CCB use may lower all-cause mortality in TB patients with hypertension. The presence of hypertension or the use of CCB did not result in a significant change in microbiological outcomes. Keywords: Tuberculosis, hypertension, calcium channel blockers, mortality, treatment outcomes

P2650Antihypertensive treatment with calcium channel blockers in patients with moderate or severe aortic stenosis: relationship with all-cause mortality

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Saeed ◽  
G Mancia ◽  
R Rajani ◽  
D Parkin ◽  
J B Chambers
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Cox Regression ◽  
Channel Blockers ◽  
Aortic Valve Area ◽  
Stroke Work ◽  
All Cause Mortality ◽  
Valve Area

Abstract Background Hypertension is prevalent in patients with aortic stenosis (AS) and optimal blood pressure (BP) control is advised to reduce arterial load and avoid cardiovascular events. Whether calcium channel blockers (CCB) are safe is not known. Methods A total of 314 patients (age 65±12 y, 68% men) with moderate or severe asymptomatic AS were included. Results The prevalence of hypertension was 73.6%, and 65% took antihypertensive treatment. Patients who used a CCB (25%) (CCB+) were older, had higher clinic systolic BP, were more likely to have hypercholesterolemia and coronary artery disease (CAD), and to use a diuretic or alpha blocker compared to CCB- patients (all p<0.05) (Table). During the baseline ETT, patients who used a CCB achieved a lower peak heart rate, a shorter exercise time and were more likely to have a blunted BP response compared to those who did not use a CCB (all p<0.05) (Table). Event-free survival was significantly lower in CCB+ than CCB- patients (Fig) (all-cause mortality 16 [20.3%] versus 13 (5.6%); p<0.001). In a multivariable Cox regression model, CCB+ was associated with a 6.8-fold increased hazard ratio (HR) for all-cause mortality (HR 6.77 95% CI 1.66–27.54, p=0.008), independent of age, gender, systolic BP, hypertension, diabetes, CAD, hypercholesterolemia and aortic valve area. Table 1. Baseline characteristics of patients CCB− (n=234) CCB+ (n=80) p Age, y 64±12 70±10 <0.001 CAD, % 45 66 0.006 Hypercholesterolemia, % 62 78 0.015 Clinic systolic BP, mmHg 139±19 150±17 <0.001 Left atrial diameter, cm 3.7±0.7 3.9±0.6 0.007 LV end-diastolic diameter, cm 4.5±0.7 4.8±0.6 0.002 LV mass index, g/m2.7 50±17 57±17 0.007 Aortic valve area, cm2 0.94±0.22 0.93±0.22 0.716 LV stroke work, g-m/bmp 155±46 175±69 0.046 Peak HR at baseline ETT, bmp 138±24 120±25 <0.001 Blunted BP response, % 33 49 0.013 Exercise duration, min 10.1±4.5 8.3±3.7 0.001 Double Product, mmHg·bmp 1.85±0.43 2.08±0.54 <0.001 Figure 1 Conclusion The use of calcium channel blockers was associated with an adverse effect on treadmill exercise and reduced survival in apparently asymptomatic patients with moderate or severe AS. Acknowledgement/Funding None

scholarly journals Impact of antihypertensive therapy on the functional state of the pituitary-gonadal system in patients with arterial hypertension

2005 ◽  
Vol 11 (1) ◽  
pp. 34-38 ◽  
Author(s):  
N. V. Ivanov
Keyword(s):  
Arterial Hypertension ◽  
Calcium Channel ◽  
Antihypertensive Therapy ◽  
Calcium Channel Blockers ◽  
Ace Inhibitors ◽  
Antihypertensive Agents ◽  
Free Testosterone ◽  
Blood Levels ◽  
Channel Blockers ◽  
The Impact

The aim of the study was to evaluate the impact of antihypertensive therapy with slow calcium-channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and ß-adrenergic receptor blockers on the metabolism and blood levels of major adrenal androgens and gonads, as well as the insulin resistance in males with arterial hypertension (AH) Ninety-one patients with AH and 15 age-matched healthy male controls were examined The hypertensive males treated with slow calcium-channel blockers or ACE inhibitors were found to have a lower level of insulin and higher levels of dehydroepiandrosterone sulfate and free testosterone on the 30th day of treatment Those on blockers were observed to have a higher level of insulin and lower levels of major adrenal and testicular androgens as compared with their baseline levels Therapy did not alter the levels of gonadotropic hormones, estradiol, and cortisol and they did not differ in the compared groups The family history of AH has a modulating effect on a hormonal response in males with AH treated with antihypertensive agents

Beta-blocker and calcium-channel blocker therapy in patients with cardiovascular pathologies during post-COVID period

2021 ◽  
Author(s):  
А.Г. Арутюнов ◽  
Г.П. Арутюнов ◽  
Е.И. Тарловская ◽  
Т.И. Батлук ◽  
Р.А. Башкинов ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Beta Blocker ◽  
Calcium Channel Blockers ◽  
Large Scale ◽  
Channel Blockers ◽  
Blocker Therapy ◽  
Cardiovascular Patients ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
The Impact

С начала 2020 г. в мире распространилась инфекция, вызванная вирусом SARS-CoV-2, что в дальнейшем привело к пандемии COVID-19. Долгое время вопросы ведения пациентов с новой коронавирусной инфекцией в остром периоде рассматривались как первоочередные. По мере накопления клинического опыта и данных о возбудителе новой коронавирусной инфекции стало очевидно, что проблема последствий перенесенного COVID-19 и ведения пациентов на постгоспитальном этапе является такой же важной. В силу прямой и опосредованной кардиотоксичности вируса SARS-CoV-2 особую группу риска на всех этапах составляют пациенты с сердечно-сосудистыми заболеваниями. Поэтому одной из важных задач мирового медицинского сообщества стала разработка способов улучшения качества и прогноза жизни пациентов с сердечно-сосудистыми заболеваниями в постковидном периоде. В статье сделан обзор наиболее крупных исследований, включая данные регистра «Анализ динамики коморбидных заболеваний пациентов, перенесших инфицирование SARS-CoV-2 (AКТИВ SARS-CoV-2)», по вопросу медикаментозной терапии пациентов с сердечно-сосудистыми заболеваниями с акцентом на бета-адреноблокаторы и блокаторы кальциевых каналов. В представленных работах терапия бета-адреноблокаторами продемонстрировала благоприятное влияние на тяжесть течения новой коронавирусной инфекции у пациентов с сердечно-сосудистыми заболеваниями, снижение смертности на госпитальном и в отдаленном постгоспитальном периодах. Данные по применению блокаторов кальциевых каналов изучены в меньшей степени, но можно отметить, что данная группа препаратов является одной из самых часто назначаемых в терапии пациентов с сохранением стойких жалоб на повышение артериального давления на постгоспитальном этапе. Требуется дальнейшее изучение влияния отдельных классов антигипертензивных препаратов на прогноз пациентов с сердечно-сосудистыми заболеваниями и COVID-19. Early in 2020, the infection caused by SARS-CoV-2 emerged and caused the COVID-19 pandemic. For a long time, management of patients with the acute novel coronavirus infection was of primary importance. With accumulation of clinical information and data on the causative agents of novel coronavirus infection it became obvious that the COVID-19 consequences and post-hospital follow-up of patients are important as well. Due to the direct and mediated cardiac toxicity of SARS-CoV-2 virus, cardiovascular patients are at high risk at any stage of the disease. Therefore, one of the priorities for healthcare professionals is development of the ways to improve the quality and prognosis of life for cardiovascular patients in the post-COVID period. The article discusses large-scale studies including the data from the International Register «Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients» (AСTIV-SARS-CoV-2), as regards drug therapy of cardiovascular patients with a focus on beta-blockers and calcium-channel blockers. In mentioned publications, beta-blocker therapy demonstrated favourable impact on the novel coronavirus infection severity in cardiovascular patients, reduction in mortality rates during the hospital and post-hospital periods. Data on the use of calcium-channel blockers have been studied to a lesser extent; however, calcium-channel blockers are thought to be one of the most commonly prescribed groups in the therapy of patients with persistent complaints of high blood pressure at the post-hospital period. A study of the impact of some categories of antihypertensives on the outcome for cardiovascular patients with COVID-19 is warranted.

Abstract P164: Self-reported Use Of Recommended Calcium Channel Blockers And Diuretics In Non-hispanic Blacks With Hypertension: An Opportunity To Improve Evidence-based Prescribing

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Brent M Egan ◽  
Jianing Yang ◽  
Michael Rakotz ◽  
Susan E Sutherland ◽  
Gregory Wozniak
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Multivariable Analysis ◽  
Initial Therapy ◽  
Evidence Based ◽  
Channel Blockers ◽  
Health And Nutrition ◽  
Drug Classes ◽  
Before And After ◽  
Time Periods

Background: Non-Hispanic Blacks (NHBs) have a higher prevalence of hypertension and incidence of cardiovascular events than NH(W)hites and Hispanics. To improve hypertension control and outcomes in NHBs, the U.S. High Blood Pressure (BP, mmHg) Guidelines recommended calcium channel blockers (CCBs) and diuretics over other drug classes as initial therapy in 2014 and 2017. Among adults with hypertension, percentages of NHBs who reported taking CCBs and diuretic monotherapy before and after 2014 were assessed and compared to NHWs and Hispanics. Methods: National Health and Nutrition Examination Surveys data in 2-year cycles from 2007-2012 and 2015-2018 were analyzed and included self-identified NHB, NHW, and Hispanic adults ≥18 years with recorded BP values and hypertension defined as self-reported BP medication use in the previous month, which included medication class, e.g., CCBs and diuretics. Multivariable logistic regression was used to assess the independent contribution of NHB race/ethnicity to prevalence of CCB and diuretic use as monotherapy. Results: Self-reported CCB or diuretic monotherapy did not increase significantly from 2007-2012 to 2015-2018 among NHBs (44% vs. 50%, p=0.12) or Hispanics (22% vs 29%, p=0.12) and a non-significant decline in NHWs (26% vs 22%, p=0.14). NHBs were more likely to report taking CCBs or diuretics as monotherapy than NHWs or Hispanics in both time periods (p<0.001). In multivariable analysis, NHBs were more likely to report taking a CCB (multivariable odds ratios 3.57 [95% confidence interval 2.6-4.9]) and diuretic monotherapy (1.63 [1.2-2.3]) than NHWs. Conclusions: NHBs had a non-significant increase in self-reported CCB or diuretic as monotherapy from 2007-2012 to 2015-2018, suggesting limited impact for this prescribing recommendation in the 2014 and 2017 High BP Guidelines. NHBs more often reported CCB or diuretic monotherapy than NHWs and Hispanics in both time periods, suggesting some clinicians were aware of evidence prior to the 2014 Guideline. Yet, half of NHBs did not report taking CCBs or diuretics as monotherapy in 2015-2018, indicating further opportunity to prescribe evidence-based initial therapy in NHBs that could improve BP control, cardiovascular outcomes and health equity.

scholarly journals Adenosine modulators and calcium channel blockers as add-on treatment for schizophrenia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jonne Lintunen ◽  
Markku Lähteenvuo ◽  
Jari Tiihonen ◽  
Antti Tanskanen ◽  
Heidi Taipale
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Drug Class ◽  
Cox Regression ◽  
Negative Control ◽  
Channel Blockers ◽  
Thiazide Diuretics ◽  
Psychiatric Rehospitalization ◽  
Class Level ◽  
Reduced Risk

AbstractRelapses remain common among individuals with schizophrenia indicating a need for improved treatments. Creating a completely new drug molecule is expensive and time consuming, and therefore drug repurposing should be considered. Aim of this study was to investigate the risk of psychiatric rehospitalization associated with use of adenosine modulators (AMs) and calcium channel blockers (CCBs) in schizophrenia. Individuals diagnosed with schizophrenia (N = 61,889) in inpatient care between 1972–2014 in Finland were included. The follow-up lasted from 1996 to 2017. Main exposures were use of AMs (allopurinol and dipyridamole) and CCBs (dihydropyridines, diltiazem, and verapamil). Thiazide diuretics were used as a negative control. Within-individual models in stratified Cox regression were used and adjusted hazard ratios (HR) with 95% confidence intervals (CIs) are reported. Use of AMs was associated with a reduced risk of psychiatric rehospitalization on drug class level (HR 0.74, 95% CI 0.65–0.84, P < 0.0001), as well as on the level of individual drugs (allopurinol HR 0.82, 95% CI 0.70–0.97, P = 0.02; dipyridamole HR 0.65, 95% CI 0.55–0.77, P < 0.0001). Use of CCBs was associated with a reduced risk of psychiatric rehospitalization on drug class level (HR 0.81, 95% CI 0.77–0.86, P < 0.0001). From the different CCBs, only exposure to dihydropyridines was associated with a reduced risk (HR 0.79, 95% CI 0.74–0.84, P < 0.0001). No effect was observed for the negative control, thiazide diuretics (HR 0.96, 0.90–1.02, P = 0.20). The effects of dipyridamole and dihydropyridines were more pronounced among younger persons and combination of AMs, and CCBs was associated with a lower risk than either drug class as monotherapy. These results indicate a need for randomized controlled trials of these drugs.

scholarly journals Synergistic effect of doxycycline and fluconazole againstCandida albicansbiofilms and the impact of calcium channel blockers

2013 ◽  
Vol 13 (5) ◽  
pp. 453-462 ◽  
Author(s):  
Yuan Gao ◽  
Caiqing Zhang ◽  
Chunyan Lu ◽  
Ping Liu ◽  
Yan Li ◽  
...  
Keyword(s):  
Synergistic Effect ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Channel Blockers ◽  
The Impact

scholarly journals Use of calcium channel blockers as antihypertensives in relation to mortality. A population based observational study.

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1360-1360
Author(s):  
Gunnar Lindberg ◽  
Ulf Lindblad ◽  
Bent Low-Larsen ◽  
Juan Merlo ◽  
Arne Melander ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Cox Regression ◽  
Antihypertensive Drugs ◽  
Population Based ◽  
Channel Blockers ◽  
Cox Regression Analysis ◽  
Co Morbidity ◽  
Standardised Patient ◽  
Line Drug

P51 The beneficial effect of pharmacological treatment of hypertension is well established. However, the outcome may depend on the specific antihypertensive drug used. This study, aimed to compare mortality in users of calcium channel blockers (CCBs) with that in users of other antihypertensive drugs (AHDs), includes 719 patients on antihypertensive drugs at an outpatient clinic in primary care in 1989-90. They were classified as users of CCBs (mostly felodipine) or users of other ADHs according to status at inclusion. Co-morbidity, systolic blood pressure, and smoking data were derived from standardised patient records. The Swedish mortality register was used to follow patients until death or until the end of 1995. Odds ratios were calculated by Cox regression analysis (the table). Although adjustment was made for confounders, mortality was higher in CCB users. This adds support to the view that CCBs may be inferior to other ADHs in reducing mortality when used to treat hypertension and should not be considered a first-line drug. Table 1.

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