scholarly journals Ranolazine: A true pluripotent cardiovascular drug or jack of all trades, master of none?

2018 ◽  
Vol 18 (1) ◽  
pp. 13 ◽  
Author(s):  
Alice Mezincescu ◽  
V. J. Karthikeyan ◽  
Sunil K. Nadar
Keyword(s):  
Blood Pressure ◽  
Interventional Procedures ◽  
Symptomatic Relief ◽  
Reduce Blood Pressure ◽  
Review Article ◽  
Current Evidence ◽  
Channel Blockers ◽  
Promising Agent ◽  
Cardiovascular Agent ◽  
Β Blockers

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. Although the majority of patients with CVD are treated with interventional procedures, a substantial number require medical therapy in terms of both prognosis and symptomatic relief. However, commonly used agents such as β-blockers and calcium channel blockers reduce blood pressure in patients whose resting pressures are often already low. Ranolazine is a promising agent that does not have significant effects on blood pressure or heart rate. Use of this drug has been documented in various cardiovascular conditions, including ischaemic heart disease, heart failure and arrhythmias. This review article aimed to examine current evidence on the use of ranolazine in various cardiovascular conditions in order to determine whether it is a true pluripotent cardiovascular agent or, on the other hand, a “jack of all trades, master of none.”

scholarly journals Control of blood pressure and cardiovascular outcomes in type 2 diabetes

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 304-323 ◽  
Author(s):  
Hernando Vargas-Uricoechea ◽  
Manuel Felipe Cáceres-Acosta
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Angiotensin Receptor Blockers ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Patients With Diabetes ◽  
The Impact

AbstractHigh blood pressure in patients with diabetes mellitus results in a significant increase in the risk of cardiovascular events and mortality. The current evidence regarding the impact of intervention on blood pressure levels (in accordance with a specific threshold) is not particularly robust. Blood pressure control is more difficult to achieve in patients with diabetes than in non-diabetic patients, and requires using combination therapy in most patients. Different management guidelines recommend initiating pharmacological therapy with values >140/90 mm/Hg; however, an optimal cut point for this population has not been established. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90mmHg, and that values approaching 130/80mmHg should be recommended. Initial treatment of hypertension in diabetes should include drug classes demonstrated to reduce cardiovascular events; i.e., angiotensin converting-enzyme inhibitors, angiotensin receptor blockers, diuretics, or dihydropyridine calcium channel blockers. The start of therapy must be individualized in accordance with the patient's baseline characteristics, and factors such as associated comorbidities, race, and age, inter alia.

Anti-anginal agents in critical illness

2016 ◽  
Author(s):  
Ajay Suri ◽  
Jean R. McEwan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Sodium Current ◽  
Beta Blockers ◽  
Reduce Blood Pressure ◽  
Critically Ill Patient ◽  
Haemodynamic Monitoring ◽  
Coronary Perfusion ◽  
Channel Blockers ◽  
Treatment Unit

Angina is chest pain resulting from the lack of blood supply to heart muscle most commonly due to obstructive atherosclerotic. Intensive care unit patients are subject to various stresses that will increase the demand on the heart and are in a pro-thrombotic state. Patients in an intensive treatment unit may be sedated and so cardiac ischaemia may be detected by electrocardiogram, haemodynamic monitoring, and echocardiographic imaging of function. These signs may indicate critical coronary perfusion heralding a myocardial infarction and are alleviated by anti-anginal drugs. Beta-blockers and calcium channel blockers are the usual first-line treatments for angina, but may not be ideal in the critically-ill patient. Nitrates reduce blood pressure without typically affecting heart rate. Nicorandil is a similar mechanism of action and tends to be given orally, while ivabridine, an If channel blocker, is a newer anti-anginal, which acts by reducing heart rate, while not affecting blood pressure. Ranolazine is the one of the newest anti-anginal agents and is believed to alter the transcellular late sodium current thereby decreasing sodium entry into ischaemic myocardial cells.

scholarly journals Renal Denervation for Treating Resistant Hypertension: Current Evidence and Future Insights from a Global Perspective

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Y. Castro Torres ◽  
Richard E. Katholi
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Pressure Control ◽  
Reduce Blood Pressure ◽  
Global Perspective ◽  
Current Evidence ◽  
Consensus Statements ◽  
Stage 1

Adequate blood pressure control represents an important goal for all physicians due to the complications of hypertension which reduce patients' quality of life. A new interventional strategy to reduce blood pressure has been developed for patients with resistant hypertension. Catheter-based renal denervation has demonstrated excellent results in recent investigations associated with few side effects. With the growing diffusion of this technique worldwide, some medical societies have published consensus statements to guide physicians how to best apply this procedure. Questions remain to be answered such as the long-term durability of renal denervation, the efficacy in patients with other sympathetically mediated diseases, and whether renal denervation would benefit patients with stage 1 hypertension.

Clinical Perspective on the Management of Hypertension

2011 ◽  
Vol 2 ◽  
pp. IJCM.S5475
Author(s):  
Muzaffar Iqbal
Keyword(s):  
Blood Pressure ◽  
Pharmacological Treatment ◽  
Antihypertensive Drugs ◽  
Public Health Issue ◽  
Morbidity Rate ◽  
Routine Practice ◽  
Channel Blockers ◽  
Uncomplicated Hypertension ◽  
Cardiovascular Morbidity And Mortality ◽  
Β Blockers

Hypertension is an important medical and public health issue all over the world. It is one of the most prevalent conditions seen today by clinicians in both developed and developing countries. Depending upon progression of systolic and diastolic blood pressure it is classified into stage 1, 2 and 3 hypertension. Life style modifications may be helpful in initial stage but pharmacological treatment is necessary when it become difficult to control it. In routine practice, pharmacological treatment is being selected from diuretics, β-blockers, calcium channel blockers and renin angiotensin system inhibitors either alone or in combination for both initial and maintenance therapy. Choice of drug depends upon favourable effects in specific clinical setting. Thiazide type diuretics are being preferred for most patients with uncomplicated hypertension whereas β-blockers show strong benefits in patients with a variety of cardiovascular complications. ACE-Inhibitors and ARBs are superior to other class in patients with multiple risk factors like obesity, insulin resistance or diabetes. CCBs compared with other class of hypertensive drugs demonstrate similar blood pressure lowering effects and similar reductions in cardiovascular morbidity and mortality but higher incidence of heart failure and fatal myocardial infarction in some patients. Despite the continued decrease in mortality and morbidity rate by these antihypertensive drugs, some documented increasing prevalence of cardiac failure and end stage renal disease remains to be explained.

Extravagant advertising for xipamide

1980 ◽  
Vol 18 (23) ◽  
pp. 92.1-92
Keyword(s):  
Blood Pressure ◽  
Potassium Concentration ◽  
Reduce Blood Pressure ◽  
Research Centre ◽  
Serum Potassium Concentration ◽  
Treatment Of Hypertension ◽  
Β Blockers ◽  
New Evidence ◽  
Hypertensive Therapy

Current 4-page advertisements1 for the diuretic xipamide (Diurexan - Merck) which we discussed last year2 cite “IMPORTANT NEW EVIDENCE (that) it is ‘as effective as many β-blockers but without their side effects, and produces better control of blood pressure throughout the whole day and night’”. This quotation comes from workers at Northwick Park3 and is accompanied by a photograph of the Clinical Research Centre. It is true that in their study the drug appeared to reduce blood pressure to much the same degree as β-blockers throughout the 24-hour cycle. But there is no reason to believe that xipamide differs from any other diuretic in its anti-hypertensive effect. As we noted some years ago, a thiazide diuretic alone can control even severely raised blood pressure in some patients.4 The advertising gives no prominence to the finding at Northwick Park (and elsewhere) that xipamide can cause a disturbing fall in the serum potassium concentration, and might thus be unsuitable for long-term anti-hypertensive therapy. It has still not been shown to have any advantage over other diuretics in the treatment of hypertension,2 and is relatively expensive.

Effects of β blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke

2010 ◽  
Vol 9 (5) ◽  
pp. 469-480 ◽  
Author(s):  
Peter M Rothwell ◽  
Sally C Howard ◽  
Eamon Dolan ◽  
Eoin O'Brien ◽  
Joanna E Dobson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Individual Variability ◽  
Channel Blockers ◽  
Β Blockers

Facet joint syndrome treated with interventional procedures: a review article with an update on the current evidence and practice

2020 ◽  
Vol 31 (6) ◽  
pp. 571-578
Author(s):  
Pace Valerio ◽  
Fabrizio Marzano ◽  
Federico Milazzo ◽  
Antonio Eduardo De Larrea ◽  
Giacomo Placella ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Facet Joint ◽  
Review Article ◽  
Current Evidence

scholarly journals The Effects of Flavonoids on Cardiovascular Health: A Review of Human Intervention Trials and Implications for Cerebrovascular Function

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1852 ◽  
Author(s):  
Amy Rees ◽  
Georgina Dodd ◽  
Jeremy Spencer
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Health ◽  
Blood Perfusion ◽  
Reduce Blood Pressure ◽  
Current Evidence ◽  
Potential Health ◽  
Beneficial Effects ◽  
Cerebrovascular Function ◽  
Intervention Trials ◽  
Randomised Controlled

Research has suggested a number of beneficial effects arising from the consumption of dietary flavonoids, found in foods such as cocoa, apples, tea, citrus fruits and berries on cardiovascular risk factors such as high blood pressure and endothelial dysfunction. These effects are thought to have a significant impact upon both vascular and cerebrovascular health, ultimately with the potential to prevent cardiovascular and potentially neurodegenerative disease with a vascular component, for example vascular dementia. This review explores the current evidence for the effects of flavonoid supplementation on human endothelial function and both peripheral and cerebral blood flow (CBF). Evidence presented includes their potential to reduce blood pressure in hypertensive individuals, as well as increasing peripheral blood perfusion and promoting CBF in both healthy and at-risk populations. However, there is great variation in the literature due to the heterogeneous nature of the randomised controlled trials conducted. As such, there is a clear need for further research and understanding within this area in order to maximise potential health benefits.

Mindfulness Training Helps to Reduce Blood Pressure

2014 ◽  
Author(s):  
I. Nyklicek ◽  
P. M. C. Mommersteeg ◽  
S. Van Beugen ◽  
C. Ramakers ◽  
G. J. Van Boxtel
Keyword(s):  
Blood Pressure ◽  
Reduce Blood Pressure ◽  
Mindfulness Training
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