Optimal medical treatment of hypertension in patients with coronary artery disease

Mahtta, Dhruv; Elgendy, Islam Y.; Pepine, Carl J.

doi:10.1080/14779072.2018.1534069

Cited by 9 publications

(10 citation statements)

References 69 publications

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“…Nos pacientes com evidência de isquemia miocárdica, a PAD deve ser reduzida com cautela até 70 mmHg, especialmente nos diabéticos e nos mais idosos. 312 Convém muito cuidado na redução da PAS nos idosos com DAC e com elevada pressão de pulso, pois isso pode resultar em valores muito baixos de PAD e propiciar isquemia miocárdica. 313…”

Section: O Hipertenso Com Doença Coronáriaunclassified

“…In patients with evidence of myocardial ischemia, DBP should be cautiously lowered to 70 mm Hg, especially in diabetic patients and in the very old. 312 Lowering SBP in older patients with CAD and high pulse pressure requires great care, since they may lead to very low DBP values and trigger myocardial ischemia. 313…”

Section: 4 Hypertensive Patients With Coronary Diseasementioning

confidence: 99%

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Diretrizes Brasileiras de Hipertensão Arterial – 2020

Barroso¹,

Rodrigues²,

Bortolotto³

et al. 2021

Arquivos Brasileiros De Cardiologia

588

202

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Section: O Hipertenso Com Doença Coronáriaunclassified

Section: 4 Hypertensive Patients With Coronary Diseasementioning

confidence: 99%

Diretrizes Brasileiras de Hipertensão Arterial – 2020

Barroso¹,

Rodrigues²,

Bortolotto³

et al. 2021

Arquivos Brasileiros De Cardiologia

588

202

View full text Add to dashboard Cite

show abstract

“…Guidelines recommend antianginal medications as the first line of treatment, with PCI performed for many patients who remain with persistent symptoms [ 3 , 4 ]. Many studies have shown that optimizing pharmacological therapy, lifestyle change, and education result in significant control of risk factors and consequently reduction in cardiovascular events [ 5 , 6 , 7 ]. Patients with moderate to severe symptoms and complex lesions who remain limited by angina, despite optimum medical therapy (OMT), are usually recommended for interventional treatment with the choice of the revascularization strategy determined by the coronary anatomy, individual’s comorbidities, and medical compliance [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Coronary Intervention Is Not Superior to Optimal Medical Therapy in Chronic Coronary Syndrome: A Meta-Analysis

Bytyçi

Morina

Bytyqi³

et al. 2023

JCM

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(1) Background and Aim: Conflicting evidence exists regarding the benefits of percutaneous coronary intervention (PCI) on survival and symptomatic relief of patients with chronic coronary syndrome (CCS) compared with optimal medical therapy (OMT). This meta-analysis is to evaluate the short- and long-term clinical benefit of PCI over and above OMT in CCS. (2) Methods: Main endpoints were major adverse cardiac events (MACEs), all-cause mortality, cardiovascular (CV) mortality, myocardial infarction (MI), urgent revascularization, stroke hospitalization, and quality of life (QoL). Clinical endpoints at very short (≤3 months), short- (<12 months), and long-term (≥ 12 months) follow-up were evaluated. (3) Results: Fifteen RCTs with a total of 16,443 patients with CCS (PCI n = 8307 and OMT n = 8136) were included in the meta-analysis. At mean follow-up of 27.7 months, the PCI group had similar risk of MACE (18.2 vs. 19.2 %; p < 0.32), all-cause mortality (7.09 vs. 7.88%; p = 0.56), CV mortality (8.74 vs. 9.87%; p = 0.30), MI (7.69 vs. 8.29%; p = 0.32), revascularization (11.2 vs. 18.3%; p = 0.08), stroke (2.18 vs. 1.41%; p = 0.10), and hospitalization for anginal symptoms (13.5 vs. 13.9%; p = 0.69) compared with OMT. These results were similar at short- and long-term follow-up. At the very short-term follow-up, PCI patients had greater improvement in the QoL including physical limitation, angina frequency, stability, and treatment satisfaction (p < 0.05 for all) but such benefits disappeared at the long-term follow-up. (4) Conclusions: PCI treatment of CCS does not provide any long-term clinical benefit compared with OMT. These results should have significant clinical implications in optimizing patient’s selection for PCI treatment.

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“…Оскільки коморбідний перебіг ІХС з ГХ є однією з найбільш поширених кардіологічних проблем у сучасній клінічній практиці. Представляє інтерес визначення особливостей ремоделювання лівого шлуночка у пацієнтів з гіпертонічною хворобою при розвитку гострого інфаркту міокарда, це необхідно для стратифікації ризику розвитку можливих ускладнень ІХС і своєчасної їх корекції [9,10].…”

Section: особливості ремоделювання лівого шлуночка у пацієнтів з гіпеunclassified

The Peculiarity of Left Ventricular Remodeling in Patients with Hypertension Developing Acute Myocardial Infarction

Fushtey¹,

Sid²,

Іващук³

2021

Ukr. ž. med. bìol. sportu

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The purpose of the study was to determine the peculiarity of left ventricular remodeling among patients with hypertension developing acute myocardial infarction. Material and methods. The results of the study are based on the data of a comprehensive examination of 477 patients with coronary artery disease: 280 patients with STEMI (ST-segment elevation myocardial infarction), 91 patients with NSTEMI (non ST-segment elevation myocardial infarction) and the control group consisted of 76 patients with exertional angina (II and III functional class for 38 people). The examination of patients was carried out in the period from 2015 to January 2018 on the basis of the Regional Medical Center for Cardiovascular Diseases of the Zaporozhye Regional Council. All patients (n=477) were comparable in age, social status and gender. The proportion of patients with hypertension was comparable between the groups and amounted to 255 (91.1%) patients with STEMI, 86 (94.5%) with NSTEMI, and 71 (93.4%) patients with stable coronary artery disease. Results and discussion. The development of left ventricular hypertrophy is a long-term process in hypertensive patients. At first, there is a change in the geometry of the left ventricle, since during systole the ventricle tends to take a spherical shape. Further, dilatation of cavities, hypertrophy and an increase in the mass of the left ventricular myocardium, replacement of the myocardium with fibrous tissue develop. Whereas in patients with acute myocardial infarction, due to acute myocardial ischemia, thickening of the myocardial wall is associated with interstitial edema occurs rather quickly. These important factors make it difficult to compare different studies and to reliably identify patients with true left ventricular hypertrophy. Therefore, left ventricular myocardium mass index should be determined as early as possible in patients with hypertension after the development of acute myocardial infarction, in order to interpret the obtained data. Сonclusion. Ischemic heart disease is often associated with essential hypertension, more than 90% of patients with acute myocardial infarction developed essential hypertension. It was determined that eccentric and concentric left ventricular hypertrophy prevailed among those examined on the first day of hospitalization and was due to the presence of hypertension

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Optimal medical treatment of hypertension in patients with coronary artery disease

Cited by 9 publications

References 69 publications

Diretrizes Brasileiras de Hipertensão Arterial – 2020

Diretrizes Brasileiras de Hipertensão Arterial – 2020

Percutaneous Coronary Intervention Is Not Superior to Optimal Medical Therapy in Chronic Coronary Syndrome: A Meta-Analysis

The Peculiarity of Left Ventricular Remodeling in Patients with Hypertension Developing Acute Myocardial Infarction

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