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Titolo:
THE ROLE OF DILTIAZEM IN TREATING HYPERTENSION AND CORONARY-ARTERY DISEASE - NEW APPROACHES TO PREVENTING FIRST EVENTS
Autore:
FODOR JG; BOULET AP; SAVARD D; NADEAU C; RAKUSAN K; CHOCKALINGAM A; LANGER A;
Indirizzi:
UNIV OTTAWA,INST HEART,PREVENT & REHABIL CTR,HEART CHECK UNIT,1053 CARLING AVE OTTAWA ON K1Y 4E9 CANADA
Titolo Testata:
Canadian journal of cardiology
fascicolo: 5, volume: 13, anno: 1997,
pagine: 495 - 503
SICI:
0828-282X(1997)13:5<495:TRODIT>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
CALCIUM-CHANNEL BLOCKERS; SUDDEN CARDIAC DEATH; CHRONIC ATRIAL-FIBRILLATION; WAVE MYOCARDIAL-INFARCTION; LEFT-VENTRICULAR MASS; CIRCADIAN VARIATION; PLATELET-AGGREGATION; DOUBLE-BLIND; CARDIOVASCULAR-DISEASE; DIURNAL-VARIATION;
Keywords:
ATHEROSCLEROSIS; CORONARY ARTERY DISEASE; DILTIAZEM; HYPERTENSION; ISCHEMIA; THROMBOSIS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
84
Recensione:
Indirizzi per estratti:
Citazione:
J.G. Fodor et al., "THE ROLE OF DILTIAZEM IN TREATING HYPERTENSION AND CORONARY-ARTERY DISEASE - NEW APPROACHES TO PREVENTING FIRST EVENTS", Canadian journal of cardiology, 13(5), 1997, pp. 495-503

Abstract

OBJECTIVE: To review the role of diltiazem in treating and preventinga group of cardiovascular diseases, including painful and silent cardiac ischemia, stroke, nonfatal myocardial infarction and sudden cardiac death, by modulating certain physiological causes that they appear to share. DATA SOURCES: A MEDLINE search was conducted for all clinicalarticles on the use of diltiazem for hypertension and coronary arterydisease. When clinical data were not available, basic research findings were reviewed. DATA EXTRACTION AND SYNTHESIS: Because many cardiovascular events show a marked daily periodicity - which appears to coincide with circadian peaks in the ability of platelets to aggregate, sympathetic activity, coronary tone, blood pressure, heart rare and hematocrit, and a trough in fibrinolytic activity the impact of diltiazem on these physiological changes was assessed. CONCLUSIONS: Diltiazem influences many of these events by increasing myocardial bloodflow, and reducing myocardial oxygen demand and cardiac workload. However, it differs from other calcium antagonists in its mild negative inotropic andmoderate negative dromotropic effects, without apparent stimulation of cardiac performance or contractility. In addition, it inhibits platelet aggregation, decreases catecholamine release, diminishes coronary tone and blocks the vasoconstrictive actions of endothelin-1. This appears to translate into a beneficial effect on ischemia, thrombolysis, arrhythmias, infarct parameters, atherosclerosis and hypertension. Diltiazem has a relatively favourable safety and tolerability profile, and is available in a once-dairy dosage form. The most common adverse effects are related to vasodilation (eg, edema and headache), and the most frequent serious adverse event is atrioventricular block, which occurs rarely. In summary, diltiazem appears to be well suited to preventing the first occurrence of cardiovascular events and may even have a role in preventing certain types of secondary events. The data accumulated so far indicate the need for a large scale random clinical trial addressing these outcomes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 12:13:48