Use of calcium antagonists and hemoglobin loss in hospitalized elderly patients: A cohort study

Zuccalà, Giuseppe; Cocchi, A; Pahor, Marco; Carosella, Luciana; Carbonin, Pierugo; Bernabei, Roberto

doi:10.1067/mcp.2000.104787

Cited by 19 publications

(17 citation statements)

References 37 publications

(45 reference statements)

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“…However, an (Ϸ20%) excess of GI bleeding was observed among individuals assigned to lisinopril compared with amlodipine. This finding is at odds with the observations by Pahor et al 11 and Zuccala et al 12 Other investigators 27,28 have reported observations contrary to those of Pahor et al 11 and Zuccala et al 12 as well. Fogari et al 29 suggest that plasma fibrinogen levels are significantly decreased by treatment with lisinopril, providing a plausible mechanism to explain our observation.…”

Section: Leenen Et Al Ccb Vs Ace-inhibitor Results In Allhat 379contrasting

confidence: 56%

“…7,8 In addition, concerns were raised regarding the overall safety of chronic use of CCBs, specifically, increased incidence of cancer 9,10 and gastrointestinal (GI) bleeding. 11, 12 The protocol of ALLHAT prespecified 3 comparisons: amlodipine, doxazosin, or lisinopril compared with chlorthalidone. The database from ALLHAT also provides a unique opportunity to compare the long-term relative safety and outcomes of ACE inhibitor-and CCB-based regimens in a randomized double-blind clinical trial setting, although this was not a prespecified comparison.…”

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confidence: 99%

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Clinical Events in High-Risk Hypertensive Patients Randomly Assigned to Calcium Channel Blocker Versus Angiotensin-Converting Enzyme Inhibitor in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

et al. 2006

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Abstract-The Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial (ALLHAT) provides a unique opportunity to compare the long-term relative safety and efficacy of angiotensin-converting enzyme inhibitor and calcium channel blocker-initiated therapy in older hypertensive individuals. Patients were randomized to amlodipine (nϭ9048) or lisinopril (nϭ9054). The primary outcome was combined fatal coronary heart disease or nonfatal myocardial infarction, analyzed by intention-to-treat. Secondary outcomes included all-cause mortality, stroke, combined cardiovascular disease (CVD), end-stage renal disease (ESRD), cancer, and gastrointestinal bleeding. Mean follow-up was 4.9 years. Blood pressure control was similar in nonblacks, but not in blacks. No significant differences were found between treatment groups for the primary outcome, all-cause mortality, ESRD, or cancer. Stroke rates were higher on lisinopril in blacks (RRϭ1.51, 95% CI 1.22 to 1.86) but not in nonblacks (RRϭ1.07, 95% CI 0.89 to 1.28), and in women (RRϭ1.45, 95% CI 1.17 to 1.79), but not in men (RRϭ1.10, 95% CI 0.92 to 1.31). Rates of combined CVD were higher (RRϭ1.06, 95% CI 1.00 to 1.12) because of higher rates for strokes, peripheral arterial disease, and angina, which were partly offset by lower rates for heart failure (RRϭ0.87, 95% CI 0.78 to 0.96) on lisinopril compared with amlodipine. Gastrointestinal bleeds and angioedema were higher on lisinopril. Patients with and without baseline coronary heart disease showed similar outcome patterns. We conclude that in hypertensive patients, the risks for coronary events are similar, but for stroke, combined CVD, gastrointestinal bleeding, and angioedema are higher and for heart failure are lower for lisinopril-based compared with amlodipine-based therapy. Some, but not all, of these differences may be explained by less effective blood pressure control in the lisinopril arm. Key Words: antihypertensive therapy Ⅲ hypertension, detection and control Ⅲ calcium channel blockers Ⅲ angiotensin-converting enzyme Ⅲ cardiovascular diseases Ⅲ stroke Ⅲ heart failure T he success in the management of hypertension and prevention of its sequelae is owed, in part, to the many antihypertensive drugs available to physicians and patients. By the early 1990s, all of the classes of antihypertensive drugs were shown effective in lowering blood pressure (BP), but few morbidity and mortality efficacy data were available except for thiazide-type diuretics and ␤-blockers. Angiotensin-converting enzyme (ACE) inhib-

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Section: Leenen Et Al Ccb Vs Ace-inhibitor Results In Allhat 379contrasting

confidence: 56%

mentioning

confidence: 99%

Clinical Events in High-Risk Hypertensive Patients Randomly Assigned to Calcium Channel Blocker Versus Angiotensin-Converting Enzyme Inhibitor in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

et al. 2006

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“…The methods of the GIFA have been described in detail elsewhere (Zuccalà et al, 2000). Briefly, all patients admitted to 81 academic centers throughout Italy from May 1 to June 30 and September 1 to October 31, 1993October 31, , 1995October 31, , and 1997 were enrolled and observed until discharge.…”

Section: Data Sourcementioning

confidence: 99%

“…Drugs were coded according to the Anatomic Therapeutic and Chemical codes; daily dosages were calculated by multiplying the strength of the drug product by the number of daily administrations (Zuccalà et al, 2000). Diagnoses were coded according to the ICD-9 Clinical Modification codes.…”

Section: Data Sourcementioning

confidence: 99%

Dose‐Related Impact of Alcohol Consumption on Cognitive Function in Advanced Age: Results of a Multicenter Survey

Zuccalà

Onder

Pedone

et al. 2001

Alcoholism Clin & Exp Res

100

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“…Thrombin affects all cell types so far tested via their protease activated receptors (PAR), which vary in type and number according to individual cell types [27,55,[57][58][59][60][61][62][63][64][65]. Thrombin activity requires Ca + , and parathyroid glands regulate extracellular Ca + to optimize its activity [26,[66][67][68][69][70][71][72][73][74][75][76][77][78][79]. Mg + competitively inhibits Ca + and mitigates thrombin activity [66,75,[80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96].…”

Section: The Three Srm Productsmentioning

confidence: 99%

A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress

Coleman

2010

CHDDT

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Based on Capillary Gate Theory and Tissue Repair Theory, this paper describes the "Stress Repair Mechanism" (SRM) that maintains and repairs vertebrate tissues. It accounts for most of the mysterious manifestations of allostasis that remain unexplained by Hypothalamic-Pituitary-Axis (HPA) hormones and thereby enables the Universal Theory of Medicine predicted by Hans Selye. SRM activity explains hemodynamic physiology, capillary hemostasis, infarction, Korotkoff sounds, blood pressure, hypertension, diabetes, allostasis, allostatic load, anesthesia, analgesia, atherosclerosis, apoptosis, malignancy, eclampsia, sepsis, Multi-System Organ Failure (MSOF), the surgical stress syndrome, the fight or flight response, and numerous other manifestations of physiology and pathology. SRM function comprises the autonomic nervous system, the vascular endothelium, and the dynamic enzymatic interaction of blood-borne hepatic Factors VII, VIIIC, IX and X that produces thrombin, soluble fibrin and insoluble fibrin, whose combined effects account for all SRM manifestations. The vascular endothelium is a diaphanous neuroendocrine organ that lines all blood vessels and is the sole constituent of capillary walls. It secretes tissue factor into extravascular tissues, and insulates those tissues from the hepatic enzymes, so that tissue disruption exposes tissue factor to the enzymatic interaction and activates tissue repair. The vascular endothelium also releases nitric oxide and von Willebrand Factor into blood in accord with autonomic balance to regulate the enzymatic interaction to govern tissue perfusion and organ function. Therefore, continuously fluctuating combinations of nervous stimuli that affect autonomic balance and forces that disrupt tissues determine SRM activity.

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Use of calcium antagonists and hemoglobin loss in hospitalized elderly patients: A cohort study

Cited by 19 publications

References 37 publications

Clinical Events in High-Risk Hypertensive Patients Randomly Assigned to Calcium Channel Blocker Versus Angiotensin-Converting Enzyme Inhibitor in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

Clinical Events in High-Risk Hypertensive Patients Randomly Assigned to Calcium Channel Blocker Versus Angiotensin-Converting Enzyme Inhibitor in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

Dose‐Related Impact of Alcohol Consumption on Cognitive Function in Advanced Age: Results of a Multicenter Survey

A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress

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