Calcium Antagonists

Prisant, L. Michael

doi:10.1016/b978-0-7216-0258-5.50156-3

Cited by 10 publications

(6 citation statements)

References 142 publications

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“…This study has shown that a CR formulation of the β‐blocker, carvedilol, given once daily provides BP‐lowering effects during the full 24‐hour dosing interval. The magnitude of this effect is similar to that observed with other widely used antihypertensive drug classes 15–17 . Consistent with its β‐blocking effects, the higher doses (40 mg and 80 mg daily) of carvedilol CR reduced heart rate.…”

Section: Discussionsupporting

confidence: 81%

Efficacy of a Once‐Daily Formulation of Carvedilol for the Treatment of Hypertension

Weber

Bakris²,

Tarka³

et al. 2006

J of Clinical Hypertension

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4.4±0.9, 7.9±0.9, and 9.6±0.9 mm Hg, respectively (P≤.001, trend test for all carvedilol CR doses with placebo). Corresponding 24-hour systolic blood pressure changes were 0.6±1. 4, 6.8±1.3, 10.1±1.4, and 12.5±1.3 mm Hg, respectively (P≤.001, trend test for the management of hypertension and for such indications as improving survival and reducing clinical end points in patients with heart failure (HF) or who have experienced an acute myocardial infarction. 1-3 These agents have long been part of antihypertensive drug regimens and are recommended as first-or second-stage agents by the Joint National Committee on the Prevention, Detection and Treatment of High Blood Pressure. 4 They are also appropriate for the management of hypertensive patients who have so-called compelling indications, such as HF or angina that can occur concomitantly with hypertension, and for hypertensive patients who do not have other major conditions. Recent meta-analyses of cardiovascular outcomes in hypertensive patients, however, suggest that conventional β-blockers, particularly atenolol, may be less efficacious in reducing these end points, especially stroke, than other drug classes. 5 Carvedilol differs from most other members of the β-blocker class; in addition to its β-adrenoceptor-blocking effects, it has blocking effects at vascular α 1 receptors. [6][7][8] Other pharmacologic effects include actions on vascular smooth muscle and on calcium channels, which could also contribute to

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Section: Discussionsupporting

confidence: 81%

Efficacy of a Once‐Daily Formulation of Carvedilol for the Treatment of Hypertension

Weber

Bakris²,

Tarka³

et al. 2006

J of Clinical Hypertension

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“…Following oral administration of therapeutic dosages, amlodipine is slowly absorbed from the gastrointestinal (GI) tract, and the time to peak plasma concentrations is 10 to 14 hours 25. Steady-state concentrations are reached after 7 to 8 days.…”

Section: Amlodipine/olmesartan Medoxomil: Pharmacokinetics and Mechanmentioning

confidence: 99%

Critical appraisal of amlodipine and olmesartan medoxomil fixed-dose combination in achieving blood pressure goals

Basile

2010

IBPC

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Hypertension remains a significant health burden in the United States, with almost one in three adults affected, and is an independent risk factor for cardiovascular and renal disease. The goal of antihypertensive treatment is to reduce cardiovascular and renal morbidity and mortality by reducing blood pressure (BP). Guidelines recommend a target BP of <140/90 mmHg, with a more stringent goal of <130/80 mmHg for patients with diabetes and chronic renal disease. However, BP goal attainment rates remain low and most patients require therapy with two or more antihypertensive agents. Combination antihypertensive therapy usually employs agents from different classes, thus benefitting from complementary mechanisms of action to achieve greater BP control with fewer side effects. Patient adherence to therapy is enhanced by formulating treatments as fixed-dose (single-pill) combinations. One example is the combination of amlodipine, a dihydropyridine calcium channel blocker (CCB), with olmesartan medoxomil, an angiotensin receptor blocker (ARB). Here, the rationale for the use of CCB/ARB combination therapy is discussed, as well as the pharmacology and tolerability of the amlodipine/olmesartan medoxomil combination and its efficacy in terms of achieving BP goal in patients with hypertension. Advantages of its use from the patient’s perspective are also discussed.

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“…Aging slows the metabolism of amlodipine, likely due to a reduction in hepatic blood flow. 23 Reflex sympathetic activation is not seen with long term use of amlodipine. 24…”

Section: Amlodipinementioning

confidence: 99%

Fixed-dose Combination Therapy in Hypertension: Focus on Fixed-dose combination of Amlodipine and Valsartan (Exforge®)

Aslam

2009

Clinical Medicine. Therapeutics

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Hypertension is the leading cause of disability and cardiovascular mortality world-wide. Approximately one-third of the US adult population and over a billion people world-wide have hypertension. Despite increased awareness of hypertension and availability of many effective antihypertensive agents, only one third of patients achieve their target blood pressure (BP). All expert panels now recommend use of combination therapy for stage 2 and higher hypertension and for individuals who are at increased risk of cardiovascular disease (CVD). Amlodipine, a dihydropyridine calcium channel blocker and Valsartan, an angiotensin II receptor (AT1-R) antagonist are widely used antihypertensive agents. Their efficacy in lowering systolic and diastolic BP and reducing CVD events has been demonstrated in several randomized trials. Fixed-dose combination of amlodipine and valsartan (A/V) has been shown to be more effective in lowering BP than monotherapy with either of these agents alone in randomized trials with comparable side effect profile. Approximately 80%-90% of patients with stage 1-2 hypertension receiving A/V fixed-dose combination achieve significant response, defined as a mean sitting diastolic BP < 90 mmHg or > 10 mmHg reduction from the baseline. Subgroup analyses show that A/V fixed-dose combination is equally effective in older individuals (>65), Blacks, in patients with isolated systolic hypertension, and in those who fail monotherapy. Furthermore, A/V fixed-dose combination is well tolerated and simplifies antihypertensive regimen enhancing patient adherence and a better BP control compared to monotherapy.

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Calcium Antagonists

Cited by 10 publications

References 142 publications

Efficacy of a Once‐Daily Formulation of Carvedilol for the Treatment of Hypertension

Efficacy of a Once‐Daily Formulation of Carvedilol for the Treatment of Hypertension

Critical appraisal of amlodipine and olmesartan medoxomil fixed-dose combination in achieving blood pressure goals

Fixed-dose Combination Therapy in Hypertension: Focus on Fixed-dose combination of Amlodipine and Valsartan (Exforge®)

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