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Mishra SK, Sonnahalli NK, Chowdhary R. Do antihypertensive medications have an effect on dental implants? A systematic review. Oral Maxillofac Surg 2024; 28:459-468. [PMID: 37330427 DOI: 10.1007/s10006-023-01167-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 06/08/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE The purpose of this systematic review was to compare the clinical outcomes of dental implants in users of antihypertensive medication with those of nonusers. METHODS This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews under the number CRD42022319336. The electronic databases Medline (PubMed) and Central Cochrane were searched for relevant scientific literature published in English through May 2022. The focused question was, "Do patients taking antihypertensive medications have a similar impact on the clinical outcome and survival of dental implants compared with nonusers?". RESULTS A total of 49 articles were found, of which 3 articles were finally selected for a qualitative synthesis. The three studies included 959 patients. In all three studies, the commonly used medication was renin-angiotensin system (RAS) inhibitors. Two studies mentioned implant survival rate, which was 99.4% in antihypertensive medication users and 96.1% in the nonusers. One study found a higher implant stability quotient (ISQ) in patients taking antihypertensive medication (75.7 ± 5.9) compared with patients not taking antihypertensive medication (73.7 ± 8.1). CONCLUSIONS The limited available evidence showed that patient taking antihypertensive medications had comparable success rate and implant stability to patients not taking medications. The studies included patients taking different antihypertensive medications, so a drug-specific conclusion regarding the clinical outcome of dental implants is not possible. Further studies are needed, including patients taking certain antihypertensive medications, to determine their effects on dental implants.
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Affiliation(s)
- Sunil Kumar Mishra
- Department of Prosthodontics, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, 208024, India.
| | - Nithin Kumar Sonnahalli
- Department of Prosthodontics, Sri Siddhartha Dental College and Hospital, Tumkur, Karnataka, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Sri Siddhartha Dental College and Hospital, Tumkur, Karnataka, India
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Martinez VR, Martins Lima A, Stergiopulos N, Velez Rueda JO, Islas MS, Griera M, Calleros L, Rodriguez Puyol M, Jaquenod de Giusti C, Portiansky EL, Ferrer EG, De Giusti V, Williams PAM. Effect of the structural modification of Candesartan with Zinc on hypertension and left ventricular hypertrophy. Eur J Pharmacol 2023; 946:175654. [PMID: 36930883 DOI: 10.1016/j.ejphar.2023.175654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/25/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
Hypertension is the most common cause of left ventricular hypertrophy, contributing to heart failure progression. Candesartan (Cand) is an angiotensin receptor antagonist widely used for hypertension treatment. Structural modifications were previously performed by our group using Zinc (ZnCand) as a strategy for improving its pharmacological properties. The measurements showed that ZnCand exerts a stronger interaction with the angiotensin II receptor, type 1 (AT1 receptor), reducing oxidative stress and intracellular calcium flux, a mechanism implied in cell contraction. These results were accompanied by the reduction of the contractile capacity of mesangial cells. In vivo experiments showed that the complex causes a significant decrease in systolic blood pressure after 8 weeks of treatment in spontaneously hypertensive rats (SHR). The reduction of heart hypertrophy was evidenced by echocardiography, the histologic cross-sectional area of cardiomyocytes, collagen content, the B-type natriuretic peptide (BNP) marker and connective tissue growth factor (CTGF) and the matrix metalloproteinase 2 (MMP-2) expression. Besides, the complex restored the redox status. In this study, we demonstrated that the complexation with Zn(II) improves the antihypertensive and cardiac effects of the parental drug.
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Affiliation(s)
- Valeria R Martinez
- CEQUINOR-CONICET-CICPBA-UNLP, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Bv. 120 N◦ 1465, 1900, La Plata, Argentina; CIC-CONICET-UNLP, Facultad de Médicas, Universidad Nacional de La Plata, 60 y 120, 1900, La Plata, Argentina
| | - Augusto Martins Lima
- Laboratory of Hemodynamics & Cardiovascular Technology (LHTC), Institute of Bioengineering (Bâtiment MED), Station 9, École Polytechnique Fédérale de Lausanne, 1015, Lausanne, Switzerland
| | - Nikolaous Stergiopulos
- Laboratory of Hemodynamics & Cardiovascular Technology (LHTC), Institute of Bioengineering (Bâtiment MED), Station 9, École Polytechnique Fédérale de Lausanne, 1015, Lausanne, Switzerland
| | - Jorge O Velez Rueda
- CIC-CONICET-UNLP, Facultad de Médicas, Universidad Nacional de La Plata, 60 y 120, 1900, La Plata, Argentina
| | - Maria S Islas
- Departamento de Química y Bioquímica, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, 7600, Mar del Plata, Argentina
| | - Mercedes Griera
- Departamento de Fisiología, Universidad de Alcalá, Campus Universitario, 28871, Alcalá de Henares, Madrid, Spain
| | - Laura Calleros
- Departamento de Fisiología, Universidad de Alcalá, Campus Universitario, 28871, Alcalá de Henares, Madrid, Spain
| | - Manuel Rodriguez Puyol
- Departamento de Fisiología, Universidad de Alcalá, Campus Universitario, 28871, Alcalá de Henares, Madrid, Spain
| | - Carolina Jaquenod de Giusti
- CIC-CONICET-UNLP, Facultad de Médicas, Universidad Nacional de La Plata, 60 y 120, 1900, La Plata, Argentina
| | - Enrique L Portiansky
- Laboratorio de Análisis de Imágenes-UNLP, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, 60 y 118, 1900, La Plata, Argentina
| | - Evelina G Ferrer
- CEQUINOR-CONICET-CICPBA-UNLP, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Bv. 120 N◦ 1465, 1900, La Plata, Argentina
| | - Verónica De Giusti
- CIC-CONICET-UNLP, Facultad de Médicas, Universidad Nacional de La Plata, 60 y 120, 1900, La Plata, Argentina.
| | - Patricia A M Williams
- CEQUINOR-CONICET-CICPBA-UNLP, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, Bv. 120 N◦ 1465, 1900, La Plata, Argentina.
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Choi MG, Seo JY, Cho EJ, Chang SK. Colorimetric analysis of palladium using thiocarbamate hydrolysis and its application for detecting residual palladium in drugs. J Photochem Photobiol A Chem 2022. [DOI: 10.1016/j.jphotochem.2022.113920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Soe HMSH, Sripetch S, Loftsson T, Stefánsson E, Jansook P. Effect of Soluplus ® on γ-cyclodextrin solubilization of irbesartan and candesartan and their nanoaggregates formation. Pharm Dev Technol 2021; 27:9-18. [PMID: 34895036 DOI: 10.1080/10837450.2021.2017968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The poor aqueous solubility of irbesartan (IRB) and candesartan cilexetil (CAC) may hamper their bioavailability when orally or topically administered. Among several attempts, the promising nanoaggregate formation by γ-cyclodextrin (γCD) complexation of drugs in aqueous solution with or without water-soluble polymers was investigated. According to phase solubility studies, Soluplus® showed the highest complexation efficiency (CE) of drug/γCD complexes among the polymers tested. The aqueous solubility of IRB and CAC was markedly increased as a function of Soluplus® concentrations. The binary drug/γCD and ternary drug/γCD/Soluplus® complex formations were supported and confirmed by solid-state characterizations, including differential scanning calorimetry (DSC), powder X-ray diffraction (PXRD), and Fourier transform infrared (FT-IR) spectroscopy. The true inclusion mode was also proved by proton nuclear magnetic resonance (1H-NMR) spectroscopy. The nanoaggregate size and morphology of binary and ternary systems were observed using dynamic light scattering (DLS), and transmission electron microscopy (TEM) techniques. The size of these nanocarriers depends on the concentration of Soluplus®. The use of Soluplus® could significantly enhance drug solubility and stabilize complex nanoaggregates, which could be a prospective platform for drug delivery systems.
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Affiliation(s)
| | - Suppakan Sripetch
- Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland
| | - Thorsteinn Loftsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland
| | - Einar Stefánsson
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Reykjavik, Iceland
| | - Phatsawee Jansook
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
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Liu X, Hu T. Simultaneous Determination of Nitrite and Azide Ions in Valsartan. J Chromatogr Sci 2021; 59:758-761. [PMID: 33420497 DOI: 10.1093/chromsci/bmaa131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study aimed to establish an ion chromatography for the simultaneous determination of nitrite and azide ions in valsartan. METHODS Dionex IonpacAG18 (4 × 50 mm2) and Dionex IonpacAS18 (4 × 250 mm2) were used as the 2D guard column and analytical column, respectively. Dionex AMGTMC18 (4 × 30 mm2) was used as a 1D pre-separation column and Dionex UTAC-ULP1 as the concentration column. KOH solution generated by an online eluent generator (EG) was used as the 2D mobile phase, and gradient elution was performed at 1 mL/min. Water and acetonitrile were used as 1D mobile phase, and gradient elution was performed at 0.5 mL/min. Suppressed conductivity detector (suppressor, ASRS 300 4 mm) was used for detection. The column temperature was 30°C, while that of the detector was 35°C. RESULTS This method showed satisfactory reproducibility and recovery. The linear range and the correlation coefficient for both nitrite and azide ions were 0.01-0.2 mg/L and 0.9998, respectively. However, the recovery rate was 85-115% for nitrite and 90-110% for azide ions. CONCLUSION This method was suitable for the simultaneous determination of nitrite and azide ions in valsartan and other sartan drugs.
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Affiliation(s)
- Xueyun Liu
- Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Tianjiao Hu
- Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
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Mulinari-Santos G, Santos JSD, Palin LP, Silva ACED, Antoniali C, Faverani LP, Okamoto R. Losartan improves alveolar bone dynamics in normotensive rats but not in hypertensive rats. J Appl Oral Sci 2019; 27:e20180574. [PMID: 31596365 PMCID: PMC6768119 DOI: 10.1590/1678-7757-2018-0574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 04/09/2019] [Indexed: 12/14/2022] Open
Abstract
Hypertension is one of the main causes of premature death in the world; also, it is associated with several bone alterations. Preclinical studies have demonstrated delayed alveolar bone healing in hypertensive rats. However, losartan has been favorable for consolidation of bone grafts and reduction in active periodontitis. Therefore, losartan is suggested to be effective in bone formation stages, as well as in the synthesis of matrix proteins and mineralization.
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Affiliation(s)
- Gabriel Mulinari-Santos
- Universidade Estadual Paulista - UNESP, Departmento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Jaqueline Silva Dos Santos
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Letícia Pitol Palin
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Ana Cláudia Ervolino da Silva
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Cristina Antoniali
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Leonardo Perez Faverani
- Universidade Estadual Paulista - UNESP, Departmento de Cirurgia e Clínica Integrada, Faculdade de Odontologia de Araçatuba, Araçatuba, São Paulo, Brasil
| | - Roberta Okamoto
- Universidade Estadual Paulista - UNESP, Departamento de Ciências Básicas, Faculdade de odontologia de Araçatuba, Araçatuba, São Paulo, Brasil.,Affiliated with Research productivity scholarship (Process:306389/2017-7)
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Fabris ALDS, Mulinari-Santos G, Hassumi JS, Freire AR, Faverani LP, Gruber R, Okamoto R. Morphometric and histologic characterization of alveolar bone from hypertensive patients. Clin Implant Dent Relat Res 2017; 19:1106-1113. [DOI: 10.1111/cid.12548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/08/2017] [Accepted: 09/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- André Luís da Silva Fabris
- Department of Surgery and Integrated Clinic; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Gabriel Mulinari-Santos
- Department of Surgery and Integrated Clinic; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Jaqueline Suemi Hassumi
- Division of Anatomy, Department of Basic Science; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Alexandre Rodrigues Freire
- Department of Morphology; Piracicaba Dental School, State University of Campinas; Piracicaba São Paulo Brazil
| | - Leonardo Perez Faverani
- Department of Surgery and Integrated Clinic; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry; Medical University of Vienna; Vienna Austria
- Department of Periodontology, School of Dental Medicine; University of Bern; Bern Switzerland
| | - Roberta Okamoto
- Division of Anatomy, Department of Basic Science; Araçatuba Dental School, UNESP-Universidade Estadual Paulista “Júlio de Mesquita Filho”; Araçatuba São Paulo Brazil
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8
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Gealh WC, Pereira CCS, Luvizuto ER, Garcia-Júnior IR, Antoniali C, Okamoto R. Healing Process of Autogenous Bone Graft in Spontaneously Hypertensive Rats Treated With Losartan: An Immunohistochemical and Histomorphometric Study. J Oral Maxillofac Surg 2014; 72:2569-81. [DOI: 10.1016/j.joms.2014.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 12/29/2022]
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Ferrario CM, Panjabi S, Buzinec P, Swindle JP. Clinical and economic outcomes associated with amlodipine/renin–angiotensin system blocker combinations. Ther Adv Cardiovasc Dis 2013; 7:27-39. [DOI: 10.1177/1753944712470979] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objectives: Since treatment regimen type can influence adherence and other outcomes, this study examined adherence, cardiovascular events, and economic outcomes in patients with hypertension treated with fixed-dose combination (FDC) amlodipine/olmesartan (AML/OM), FDC AML/benazepril (AML/BEN), and loose-dose combination AML plus angiotensin II receptor blockers (LDC AML/ARBs). Methods: Commercial health plan enrolees aged at least 18 years with index claim(s) for AML/OM, AML/BEN, or LDC AML/ARB were identified. Absence of study drug 6 months pre index, and continuous enrolment for at least 12 months post index were required. Descriptive analyses were executed to make comparisons between treatments, as well as multivariate models adjusting for baseline demographic and clinical characteristics, including propensity for assignment to study drug. Results: Descriptive results suggested mean follow-up adherence was higher in the AML/OM cohort [proportion of days covered (PDC) = 0.63] compared with the AML/BEN (PDC = 0.55; p < 0.001) and LDC AML/ARB cohorts (PDC = 0.34; p < 0.001). The proportion of individuals with an incident follow-up cardiovascular event composite was lower in the AML/OM cohort versus the AML/BEN and LDC AML/ARB cohorts (5.94% versus 7.85% and 16.89% respectively). Adjusted Cox models suggested that patients initiated on LDC AML/ARB (hazard ratio 1.35; p < 0.001), but not on AML/BEN, were at greater risk of a follow-up cardiovascular event (composite) compared with AML/OM. Adjusted generalized linear models suggested that mean follow-up per-member-per-month overall costs were higher in the AML/BEN (cost ratio = 1.169; p < 0.001; unadjusted mean cost US$780) and LDC AML/ARB cohorts (cost ratio = 1.286; p < 0.001; unadjusted mean cost US$1394) compared with the AML/OM cohort (unadjusted mean cost US$740). Conclusion: The results suggested that treatment with FDC AML/OM was associated with greater likelihood of adherence and lower overall costs than with FDC AML/BEN and LDC AML/ARB, and lower risk of cardiovascular event composite versus LDC AML/ARB.
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Affiliation(s)
- Carlos M. Ferrario
- Departments of Surgery, Internal Medicine–Nephrology, and Physiology–Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | | | - Jason P. Swindle
- OptumInsight, 200 West Madison Street, Suite 2000, Chicago, IL 60606, USA
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Oparil S, Weber M. Angiotensin receptor blocker and dihydropyridine calcium channel blocker combinations: an emerging strategy in hypertension therapy. Postgrad Med 2009; 121:25-39. [PMID: 19332960 DOI: 10.3810/pgm.2009.03.1974] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hypertension is a leading contributor to the burden of cardiovascular disease. The importance of lowering blood pressure (BP) to reduce the risk of cardiovascular events has been demonstrated in numerous clinical trials. Most patients require combination antihypertensive therapy utilizing agents from complementary drug classes to achieve BP goals. A calcium channel blocker (CCB)/angiotensin receptor blocker (ARB) combination is a rational approach for such an antihypertensive strategy. Benefits of CCB/ARB combination therapy include additive BP-lowering effects and lower incidences of adverse events (AEs). These agents demonstrate benefits associated with their respective drug classes. The ARBs confer stroke protection, renal protection, and tolerability similar to placebo, without dose-related symptomatic and metabolic AEs, while CCBs are beneficial in reducing stroke and treating angina and cardiac ischemia. The efficacy of this combination has been recently investigated in clinical trials wherein amlodipine was combined with olmesartan medoxomil or valsartan. This article discusses the rationale for using CCB/ARB combinations in patients with hypertension.
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Affiliation(s)
- Suzanne Oparil
- Vascular Biology and Hypertension Program, Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.
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Neutel JM. Prescribing patterns in hypertension: the emerging role of fixed-dose combinations for attaining BP goals in hypertensive patients. Curr Med Res Opin 2008; 24:2389-401. [PMID: 18616863 DOI: 10.1185/03007990802262457] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The attainment of clinical blood pressure (BP) goals can markedly reduce cardiovascular morbidity and mortality, yet approximately two-thirds of treated hypertensive patients in the United States have uncontrolled BP. Consequently, more aggressive management of hypertension, frequently involving combination therapy (e.g., fixed-dose combination [FDC] therapy), is needed to achieve the recommended BP goals of <140/90 mmHg for most patients, and <130/80 mmHg for high-risk patients. SCOPE This article, based on data from an extensive Medline search ('hypertension' AND 'prescribe', 'prescribing' OR 'prescription', date range: 1995-2007), focuses on prescribing patterns for antihypertensive medication, and on the emerging role of combination therapy, specifically FDC therapy, in treating hypertensive patients to target BP levels. FINDINGS Although the use of antihypertensive combination therapy has increased substantially in US adults over the last 20 years, such therapy remains considerably underutilized. Numerous studies have shown that combination therapies, including FDCs, can markedly reduce BP and adverse events relative to monotherapies, and this paper overviews data for various combination therapies: angiotensin-receptor blocker (ARB) + diuretic; angiotensin-converting enzyme (ACE) inhibitor + diuretic; calcium-channel blocker (CCB) + ACE inhibitor; and CCB + ARB. Specifically, fixed-dose CCB/ARB combinations of amlodipine with losartan, valsartan, or olmesartan medoxomil have recently been developed, and combination therapy schedules of amlodipine plus one of these ARBs have shown greater BP-lowering efficacy compared with the constituent monotherapies. Furthermore, in two large studies in a total of >3000 patients, CCB + ARB combination therapy was associated with significantly lower incidences of headache and peripheral edema than CCB monotherapy. CONCLUSION Guidelines for hypertension management clearly support the greater use of multidrug therapy, especially in high-risk patients. FDCs (e.g., various emerging CCB/ARB combinations) are a valuable option for such high-risk patients, as these combinations offer the potential to reduce adverse events, increase compliance, lower treatment costs, and improve BP goal-attainment rates.
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Affiliation(s)
- Joel M Neutel
- Orange County Research Center, Tustin, CA 92780, USA.
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Affiliation(s)
- Steven G Chrysant
- University of Oklahoma College of Medicine, Oklahoma Cardiovascular Hypertension Center, Oklahoma City, Oklahoma 73132-4904, USA.
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13
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Nearchou NS, Tsakiris AK, Lolaka MD, Karatzis EN, Tsiafoutis IN, Flessa CD, Bogiatzis DT, Zarcos I, Skoufas PD. Influence of angiotensin II receptors blocking on overall left ventricle's performance of patients with acute myocardial infarction of limited extent. Echocardiographic assessment. Int J Cardiovasc Imaging 2005; 22:191-8. [PMID: 16265603 DOI: 10.1007/s10554-005-9027-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2004] [Accepted: 08/11/2005] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Recent studies documented the beneficial effect of angiotensin-receptor blockers (ARBs) on patients (pts) with acute myocardial infarction (AMI) combined with left ventricle (LV) systolic dysfunction. The present study intended to assess the impact of the ARB irbesartan, on the overall LV performance in pts with uncomplicated AMI of limited extent. METHODS Forty consecutive pts with first inferior AMI (AMI-I) and preserved LV-systolic function were enrolled. They were allocated into two groups: (a) 20 pts received the conventional treatment of AMI-I and placebo (CT) and (b) 20 pts administered irbesartan additionally to the conventional treatment (IR). Twenty four healthy individuals of matching age and sex were recruited as control group (CG). Complete echocardiographic examination, Tei index of overall LV function and systolic blood pressure (SBP) were measured on the 8th post-infarct day. RESULTS The Tei index of IR group (0.53+/-0.03) was significantly lower compared to that of CT group (0.78+/-0.05) (p<0.001) and was similar to that of CG (0.45+/-0.03)(p=NS). Irbesartan induced a considerable decrease in both isovolumic relaxation (115+/-7 ms vs 140+/-7 ms; p<0.01) and contraction time (52+/-2 ms vs 64+/-3 ms; p<0.01) and a significant increase in ejection time (279+/-6 ms vs 256+/-8 ms; p<0.05). SBP in pts of IR group was similar to that of CT group (112+/-3 mmHg vs 113+/-4 mmHg; p=NS). CONCLUSIONS Therapy with Irbesartan improves overall LV function of pts with AMI-I. Irbesartan leads to acceleration of the LV relaxation, which possibly indirectly ameliorates LV systolic performance too. This beneficial influence is possible attributed to a direct tissue effect of the drug and not to its hemodynamic action.
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Abstract
Today, the lifetime risk of patients aged 55-65 years to receive antihypertensive drugs approaches 60%. Yet, recent trials suggest that hypertension is not adequately controlled in the majority of patients. The prevalence of hypertension increases with advancing age, as does the prevalence of comorbid conditions and the total number of medications taken. Multi-drug therapy, advancing age and comorbid conditions are also key risk factors for adverse drug reactions and drug interactions. In this review, the authors evaluate the most frequently used antihypertensive drugs (diuretics, beta-adrenergic blockers, angiotensin-converting enzyme inhibitors, calcium channel blockers, angiotensin II receptor Type 1 blockers and alpha-adrenergic blockers) with special reference to pharmacodynamic and pharmacokinetic drug interactions. As the spectrum of drugs prescribed is constantly changing, safety yesterday does not imply safety today and safety today does not imply safety tomorrow. Furthermore, therapeutic efficacy should not be neglected over concerns regarding drug interactions. Many patients are at risk of clinically relevant drug interactions involving antihypertensive drugs but, presently, even more patients may be at risk of suffering from the consequences of their inadequately treated hypertension. In this respect, the authors discuss controversial viewpoints on the overall clinical relevance of drug interactions occurring at the level of cytochrome P450 metabolism.
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Affiliation(s)
- Renke Maas
- Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum HamburgEppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
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Stevenson HA, Steele JC, Field EA, Darroch CJ. Angioedema of the Lips and Tongue Induced by Angiotensin-Converting Enzyme Inhibitor. A Report of Two Cases. ACTA ACUST UNITED AC 2004; 11:17-9. [PMID: 14768205 DOI: 10.1308/135576104322702769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The following case reports describe the clinical presentation, diagnosis and management of two patients who attended Liverpool University Dental Hospital with rapidly increasing swelling of the lips and tongue. Both patients were suffering from angioedema and were taking an angiotensin-converting enzyme (ACE) inhibitor (ACEI). A provisional diagnosis of ACEI-induced angioedema was made. An intramuscular injection of chlorpheniramine maleate was given to both patients and they were immediately transferred to the local accident and emergency department. These cases illustrate the potential role of the general dental practitioner in the early recognition and management of this potentially life-threatening condition.
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Affiliation(s)
- Helen A Stevenson
- Liverpool University, Dental Hospital and School of Dentistry, Liverpool, UK
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De Salvia MA, Macchiarulo C, Lerro G, Pieri R, Renna G, Siro-Brigiani G, Natale L, Pirrelli A, Mitolo-Chieppa D. Prescribing patterns for angiotensin II-receptor blockers in an Italian antihypertensive division: A retrospective chart review. Curr Ther Res Clin Exp 2002. [DOI: 10.1016/s0011-393x(02)80083-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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