Abstract:
:Recent publications purporting to show that calcium antagonists, when used for the treatment of hypertension or in the post myocardial infarction patient, would paradoxically increase the rate of heart attack and mortality have cast doubts on the safety and efficacy of this drug class. All three studies are retrospective, and have various drawbacks. Specifically, the metaanalysis of Furberg et al is fraught with mistakes, of borderline significance, and based on old data pertaining to short-acting nifedipine only (which should not be given in patients who have suffered an acute heart attack). The case control study of Psaty et al suggested that hypertensive patients who were treated with short-acting verapamil, diltiazem, and nifedipine had an excessive rate of myocardial infarction when compared with patients who were treated with diuretics. Two out of the three calcium antagonists that were used in this study were not approved for the treatment of hypertension by the US Food and Drug Administration. Some patients were taking these drugs only once a day whereas, because of their short duration of action, at least a three or four times daily regimen would be required to achieve an acceptable blood pressure control throughout a 24-h period. The cohort study of Pahor et al suggested distinct differences among various calcium antagonists with regard to survival. Blood pressure was controlled in < 40% of all patients, and in some patients blood pressure was never even measured. Recent studies, such as the Prospective Randomized Amlodipine Survival Evaluation (PRAISE), the third Vasodilator-Heart Failure Trial (VHeFT-III), the second Doppler Flow and Echocardiography in Functional Cardiac Insufficiency Assessment of Nisoldipine Therapy (DEFIANT II), the Angina Prognosis Study in Stockholm (APSIS), and the Shanghai Trial of Nifedipine in the Elderly (STONE), attest to the safety and efficacy of the newer long-acting calcium antagonists in patients with a wide spectrum of heart disease. Several ongoing trials including the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) with amlodipine, the International Nifedipine-GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) with nifedipine, the Hypertension Optimal Treatment study (HOT) with felodipine, the Systolic Hypertension in the Elderly in Europe Trial (SYST-EUR) with nicardipine, the Second Swedish Trial in Old Patients with Hypertension (STOP II) with felodipine, and Nordic Diltiazem Study (NORDIL) with diltiazem, will give us morbidity and mortality data in patients with high blood pressure within the next few years. Until these results are available, we can be confident that the lowering of blood pressure and providing relief of patients with symptomatic angina can be achieved safely and efficiently with the presently available long-acting calcium antagonists.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Messerli FHdoi
10.1016/s0895-7061(96)00387-1subject
Has Abstractpub_date
1996-12-01 00:00:00pages
177S-181Sissue
12 Pt 2eissn
0895-7061issn
1941-7225pii
S0895-7061(96)00387-1journal_volume
9pub_type
杂志文章,评审abstract:BACKGROUND:The aim of this study was to clarify the response of endothelial connexins to hypertension and antihypertensive drugs. METHODS:Rats remained normotensive (group 1, N = 10) or were made hypertensive using N(omega)-nitro-L-arginine methyl ester (L-NAME) (groups 2 to 4, N = 10/group). Seven weeks later groups ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.08.020
更新日期:2006-02-01 00:00:00
abstract::Although the most direct way to interfere with the renin-angiotensin system (RAS) is at the level of the angiotensin II (AII) receptor, the currently available AII receptor antagonists are peptides still retaining significant agonistic properties with the obvious drawbacks of limited stability and lack of oral activit...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/3.8.599
更新日期:1990-08-01 00:00:00
abstract::The polymorphism of the angiotensin-converting enzyme gene is considered to be associated with increased risk for stroke, but there is a diversity in the results obtained. The genetic involvement of the renin-angiotensin system in stroke also remains unclear. To predict the genetic risk of lacunar infarction, we condu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00184-3
更新日期:2000-02-01 00:00:00
abstract::Apart from the well-known role of hypertension in cerebrovascular disease, visit-to-visit blood pressure (BP) variability is emerging as an independent risk factor for stroke. Although the underlying mechanism is not fully understood, artery remodeling is thought to be closely involved in the relationship between visi...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/hpt167
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The GTPase Rac1 has been implicated in hypertension as a modulator of mineralocorticoid receptor activity. Our aim is to investigate the frequency of polymorphisms rs10951982 (intron 1, G>A) and rs836478 (intron 3, T>C) in the RAC1 gene and perform association studies with clinical and biochemical parameters...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt277
更新日期:2014-03-01 00:00:00
abstract::The changes induced by transient hypertension on cardiac structure and function are unclear. Pregnancy-induced hypertension offers a natural and spontaneous model of this condition. To assess the potential of echocardiographic Doppler to unmask left ventricular function impairment, we studied 28 women aged 26.4 +/- 7....
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01264-4
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Microalbuminuria is recognized as a marker of generalized vascular dysfunction. However, the associations between microalbuminuria and pulse wave velocity (PWV), carotid intima-media thickness (IMT), and ambulatory blood pressure (ABP), respectively, have not been investigated. METHODS:Brachial-ankle PWV (b...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.77
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Ascending aortic fractional pulse pressure and fractional systolic pressure (FSP) were demonstrated to differentiate patients with and without coronary artery disease. However, no study so far has analyzed the relationship between FSP and fractional diastolic pressure (FDP) and the extent of coronary artery ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.01.009
更新日期:2004-08-01 00:00:00
abstract::Since young SHR excrete less urinary kallikrein than WKY, active and total kallikrein (A and T Kall, respectively) was measured (amidolytic assay) in the renal cortex of both strains. Neither at birth nor at age 4 weeks did renal T Kall differ between SHR and WKY. Renal A Kall was significantly lower in newborn SHR an...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.53s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:High blood pressure (BP) is associated with the presence and severity of subclinical disease. Less is known about associations between normal levels of BP and various measures of subclinical disease. METHODS:The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled 6814 participants free of clinical cardiov...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.04.002
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Subclinical cardiac damage has recently emerged as a potential predictor of adverse renal outcome. We therefore retrospectively evaluated the effect of left-ventricular hypertrophy (LVH), diagnosed electrocardiographically, on the renal outcome of hypertensive patients managed in primary care. METHODS:From ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hps100
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:We reported that insulin modestly stimulates NAD(P)H oxidase activity in cultured rat vascular smooth muscle cells (VSMC) and synergistically stimulates enzyme activity with angiotensin II (Ang II), leading to synergistic stimulation of VSMC migration. The aim of this study was to determine the mechanism of ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.11.017
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Subjects with resistant hypertension present high prevalence of a nondipper blood pressure (BP) pattern, associated with increased risk of cardiovascular events. Nondipping is partly related to the absence of 24-h therapeutic coverage in hypertensives treated with single morning doses. METHODS:We studied th...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.260
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Anthropometric measurements and indexes that assess excess of adiposity are associated with cardiovascular risk factors, and predict diabetes mellitus. METHODS:This cross-sectional study reported the performance of adiposity indexes to detect or turn diabetes unlikely in patients with hypertension. Patients...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.212
更新日期:2011-02-01 00:00:00
abstract::The comparative efficacy of the calcium antagonists isradipine and nifedipine in reducing left ventricular peak systolic wall tension was assessed in 25 patients with essential hypertension (20 men, 5 women; mean age: 49 years). After 2 weeks of treatment with either isradipine (2.5 mg twice daily) or slow-release nif...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/6.3.92s
更新日期:1993-03-01 00:00:00
abstract::It has been speculated for some time that various antihypertensive medications may have a deleterious effect on respiration during sleep and thereby enhance the apparent association between hypertension and sleep apnea/hypopnea (SAH). However, there are few data to support this contention. The present study used a dou...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0895-7061(96)00507-9
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:B-type natriuretic peptide (BNP) increases the risk of death and cardiovascular events in patients without heart failure, even at BNP values within the "normal" range. The reasons for this are unclear. METHODS:We performed two separate studies (n = 33 and n = 129) on subjects with type 2 diabetes mellitus i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.06.016
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Our aim was to assess whether home blood pressure (HBP) and ambulatory BP monitoring measurement (ABPM), in addition to office BP (OBP) predict changes of cardiovascular biomarkers during antihypertensive treatment. METHODS:Two hundred and fifty-two hypertensive patients (mean age, 68 years; men: 41%) under...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/ajh.2011.229
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The role of pulsatile hemodynamics in the management of patients with acute heart failure syndrome (AHFS) remains to be elucidated. We investigated the changes of the pulsatile hemodynamics along the hospital course of AHFS in relation to short-term outcomes. METHODS:A total of 80 AHFS patients (73.2 ± 14.1...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.26
更新日期:2011-07-01 00:00:00
abstract::We studied how closely changes in electronically monitored physical activity are reflected in changes in blood pressure and heart rate in a group of untreated hypertensive subjects. Thirty-nine hypertensive patients (office blood pressure > 140/ 90 mm Hg) of mean age 57 +/- 10 years (mean +/-SD) wore an ambulatory blo...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00147-8
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Central artery reservoir-excess pressure parameters are clinically important but impractical to record directly. However, diastolic waveform morphology is consistent across central and peripheral arteries. Therefore, peripheral artery reservoir-excess pressure parameters related to diastolic waveform morphol...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa013
更新日期:2020-04-01 00:00:00
abstract::Patients with hypertension tend to be glucose intolerant, hyperinsulinemic, and dyslipedemic. Since all of these changes increase risk of coronary heart disease (CHD), it is important to know what effect antihypertensive treatment has on these variables. The current open-labelled, uncontrolled study was initiated in o...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1093/ajh/5.8.506
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:In patients free from overt cardiac disease, R wave in aVL lead (RaVL) is strongly correlated with left ventricular mass index (LVMI) assessed by transthoracic echocardiography. The aim of the present study was to extend this finding to other settings (cardiomyopathy or conduction disorders), by comparing EC...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu268
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Hypertension is a significant global public health challenge. Low-grade inflammation is known to facilitate the development of essential hypertension and target-organ hypertensive damage. Neutrophil to lymphocyte ratio (NLR) is a simple and reliable indicator of inflammation that may also be useful in the pr...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv034
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The elevation of left ventricular filling pressure (LVFP) could be an important prognostic factor in patients with hypertension. We hypothesized that noninvasive brachial-ankle pulse wave velocity (baPWV) is associated with increased LVFP in hypertensive patients with LV hypertrophy (LVH). METHODS:We enroll...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.243
更新日期:2010-03-01 00:00:00
abstract::In a 10-year prospective study, we investigated the utility of the serum creatinine level in predicting the development of hypertension in Japanese adults, all of whom lived in a rural community. The study included 229 subjects, 91 men and 138 women aged 30 to 69 years, who were normotensive (systolic blood pressure 1...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/7.5.390
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:A successful weight loss program is essential treatment for obesity-related diseases, but it is well known that the majority of individuals do not succeed in weight loss maintenance. The present study evaluates hormonal mechanisms and the relationship of beta2-adrenoceptor polymorphisms involved in individua...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.05.006
更新日期:2005-11-01 00:00:00
abstract::This study was designed to clarify the relationship between the antihypertensive effects of the calcium antagonist nilvadipine, and circadian changes in blood pressure. Based on measurements using an ambulatory blood pressure monitoring system (ABPM), 17 outpatients with untreated essential hypertension were divided i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00406-8
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:High salt diet causes cardiac hypertrophy and fibrosis and increases cardiac aldosterone, while decreasing plasma aldosterone. The present study assessed, in Wistar rats, the effect of high salt diet on left and right ventricle (LV and RV, respectively) weight and fibrosis both with and without the aldostero...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)03268-5
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Hypertension and proteinuria are risk factors for adverse renal outcomes in patients with chronic kidney disease. This study investigated the associations of blood pressure and proteinuria on renal function in a community-based population. METHODS:We analyzed data from a nationwide database of 141,514 subje...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv003
更新日期:2015-09-01 00:00:00