Beta Blockers and Calcium Channel Blockers

Neagoe, Alexandra-Maria; Rexhaj, Emrush; Grossman, Ehud; Messerli, Franz H.

doi:10.1007/978-3-030-19131-3_6

“…Approach, such that women spent time in the lowest category before moving into the next dose category. In order to compare patterns of risk observed for BBs to those of another cardiovascular medication with similar indications [41], the same analyses were carried out for calcium channel blockers.…”

Section: Statistical Analysesmentioning

confidence: 99%

Post-diagnostic beta blocker use and breast cancer-specific mortality: a population-based cohort study

Scott

¹

,

Tin

²

,

Elwood

³

et al. 2022

Breast Cancer Res Treat

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Purpose Beta blockers (BB) have been associated with improved, worsened, or unchanged breast cancer outcomes in previous studies. This study examines the association between the post-diagnostic use of BBs and death from breast cancer in a large, representative sample of New Zealand (NZ) women with breast cancer. Methods Women diagnosed with a first primary breast cancer between 2007 and 2016 were identified from four population-based regional NZ breast cancer registries and linked to national pharmaceutical data, hospital discharges, and death records. The median follow-up time was 4.51 years. Cox proportional hazard models were used to estimate the hazard of breast cancer-specific death (BCD) associated with any post-diagnostic BB use. Results Of the 14,976 women included in analyses, 21% used a BB after diagnosis. BB use (vs non-use) was associated with a small and nonstatistically significant increased risk of BCD (adjusted hazard ratio: 1.11; 95% CI 0.95–1.29). A statistically significant increased risk confined to short-term use (0–3 months) was seen (HR = 1.40; 1.14–1.73), and this risk steadily decreased with increasing duration of use and became a statistically significant protective effect at 3 + years of use (HR = 0.55; 0.34–0.88). Conclusion Our findings suggest that any increased risk associated with BB use may be driven by risk in the initial few months of use. Long-term BB use may be associated with a reduction in BCD.

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“…Non-dihydropyridine (verapamil, diltiazem) is less tissuespecific; it binds both cardiac and vascular smooth muscle-expressed L-type calcium channels, resulting in diminished cardiac output due to negative ionotropic, chronotropic, and dromotropic effects. Although non-dihydropyridines decrease heart rate dihydropyridine is prone to increase heart rate due to sympathetic activation by pronounced vasodilation [123,124]. Some of the most typical side effects associated with dihydropyridine calcium channel blockers are peripheral edema, lightheadedness, flushing, headaches, and gingival hyperplasia, as well as the treatment with nondihydropyridine calcium channel blockers associated with constipation (25%) and bradycardia.…”

Section: Calcium Channel Blockermentioning

confidence: 99%

Combination Therapy in Hypertension: Renin-Angiotensin-Aldosterone System Inhibitor with a Diuretic or Calcium Channel Blocker

Hossain

2024

Preprint

0

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Hypertension is a frequent risk factor for cardiovascular diseases and the prevalence rate is continuously rising. Multiple pathophysiological mechanisms are responsible for hypertension, necessitating a combination of drugs from different classes for best management. Combination therapy is five times more effective in decreasing blood pressure compared to escalating the dose of a single agent. As per the ACCOMPLISH trial analysis, coupling a renin-angiotensin system inhibitor with a calcium channel blocker is more effective than the combination of a renin-angiotensin system inhibitor with diuretics in reducing major cardiovascular events, cardiovascular-related mortality, and the progression of chronic kidney disease. The renin-angiotensin system can be suppressed by inhibiting the angiotensin-converting enzyme or angiotensin type 1 receptor (AT1R), resulting, in decreased vascular smooth muscle contraction, heart performance, and reduced aldosterone synthesis. Calcium channel blockers work by inhibiting L-type calcium channels, reducing heart performance via negative inotropic, chronotropic, and bathmotropic effects, along with reducing vascular smooth muscle contraction. Diuretics exert their antihypertensive impact by changing body fluid volume and electrolytes. Initially, hypertension treatment commences with a single medication but often, different classes of two or more antihypertensive medications are necessary for achieving the target blood pressure goal. Sometimes, for Resistant hypertension four different classes of antihypertensive medications are necessary to reach the target blood pressure goal.

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“…Non-dihydropyridine (verapamil, diltiazem) is less tissuespecific; it binds both cardiac and vascular smooth muscle-expressed L-type calcium channels, resulting in diminished cardiac output due to negative ionotropic, chronotropic, and dromotropic effects. Although non-dihydropyridines decrease heart rate dihydropyridine is prone to increase heart rate due to sympathetic activation by pronounced vasodilation [123,124]. Some of the most typical side effects associated with dihydropyridine calcium channel blockers are peripheral edema, lightheadedness, flushing, headaches, and gingival hyperplasia, as well as the treatment with nondihydropyridine calcium channel blockers associated with constipation (25%) and bradycardia.…”

Section: Calcium Channel Blockermentioning

confidence: 99%

Combination Therapy in Hypertension: Renin-Angiotensin-Aldosterone System Inhibitor with a Diuretic or Calcium Channel Blocker

Hossain

2024

Preprint

0

View full text Add to dashboard Cite

Hypertension is a frequent risk factor for cardiovascular diseases and the prevalence rate is continuously rising. Multiple pathophysiological mechanisms are responsible for hypertension, necessitating a combination of drugs from different classes for best management. Combination therapy is five times more effective in decreasing blood pressure compared to escalating the dose of a single agent. As per the ACCOMPLISH trial analysis, coupling a renin-angiotensin system inhibitor with a calcium channel blocker is more effective than the combination of a renin-angiotensin system inhibitor with diuretics in reducing major cardiovascular events, cardiovascular-related mortality, and the progression of chronic kidney disease. The renin-angiotensin system can be suppressed by inhibiting the angiotensin-converting enzyme or angiotensin type 1 receptor (AT1R), resulting, in decreased vascular smooth muscle contraction, heart performance, and reduced aldosterone synthesis. Calcium channel blockers work by inhibiting L-type calcium channels, reducing heart performance via negative inotropic, chronotropic, and bathmotropic effects, along with reducing vascular smooth muscle contraction. Diuretics exert their antihypertensive impact by changing body fluid volume and electrolytes. Initially, hypertension treatment commences with a single medication but often, different classes of two or more antihypertensive medications are necessary for achieving the target blood pressure goal. Sometimes, for Resistant hypertension four different classes of antihypertensive medications are necessary to reach the target blood pressure goal.

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Beta Blockers and Calcium Channel Blockers

Cited by 5 publications

References 112 publications

Post-diagnostic beta blocker use and breast cancer-specific mortality: a population-based cohort study

Post-diagnostic beta blocker use and breast cancer-specific mortality: a population-based cohort study

Combination Therapy in Hypertension: Renin-Angiotensin-Aldosterone System Inhibitor with a Diuretic or Calcium Channel Blocker

Combination Therapy in Hypertension: Renin-Angiotensin-Aldosterone System Inhibitor with a Diuretic or Calcium Channel Blocker

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