Effect of Diuretic Therapy on Exercise Capacity in Patients With Chronic Angina and Preserved Left Ventricular Function

Finimundi, Helius Carlos; Caramori, Paulo; Parker, John D.

doi:10.1097/fjc.0b013e3180385ad7

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…All articles included were published between 2000 and 2020, referring to studies conducted between 1993 and 2017. Most studies were conducted in Brazil [ 3 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 ]. Six studies were conducted in Argentina [ 59 60 61 62 63 64 ], four in Chile [ 65 66 67 68 ], four in Colombia [ 69 70 71 72 ], three in Uruguay [ 73 74 75 ] and two were multi-country studies conducted in Argentina, Brazil, Chile and Colombia [ 12 ] and Brazil and Suriname [ 76 ].…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Marzà-Florensa

Drotos

Gulayin

et al. 2022

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Background: Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but information from South America is scarce. Methods: We conducted a systematic review on prevalence of secondary prevention medication in South America. We pooled prevalence estimates, analysed time-trends and guideline compliance, and identified factors associated with medication use with meta-regression models. Results: 73 publications were included. Medication prevalence varied by class: beta-blockers 73.4%(95%CI 66.8%–79.1%), ACEI/ARBs 55.8%(95%CI 49.7%–61.8), antiplatelets 84.6%(95%CI 79.6%–88.5%), aspirin 85.1%(95%CI 79.7%–89.3%) and statins 78.9%(95%CI 71.2%–84.9%). The use of beta-blockers, ACEI/ARBs and statins increased since 1993. Ten publications reported low medication use and nine reported adequate use. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres. Conclusion: Cardioprotective medication use has increased, but could be further improved particularly in community settings.

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Section: Resultsmentioning

confidence: 99%

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Marzà-Florensa

Drotos

Gulayin

et al. 2022

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“…In fact, older hypertensive adults using 25–50 mg of HCTZ daily did not presented alterations in VO2 peak after treatment [ 34 ]. However, clinical evidence has showed an increase in the treadmill walking time after combination of HCTZ and amiloride in patient with chronic stable angina [ 35 ]. Furthermore, impaired muscle adaptation has been reported when aerobic and resistance exercise are including in a same exercise training program [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Concurrent exercise training induces additional benefits to hydrochlorothiazide: Evidence for an improvement of autonomic control and oxidative stress in a model of hypertension and postmenopause

Ferreira,

Santos Ferreira Silva,

da Silva Dias

et al. 2023

PLoS ONE

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Objective This study aimed to evaluate whether exercise training could contribute to a better modulation of the neurohumoral mechanisms linked to the pathophysiology of arterial hypertension (AH) in postmenopausal hypertensive rats treated with hydrochlorothiazide (HCTZ). Methods Female spontaneously hypertensive rats (SHR) (150−200g, 90 days old) were distributed into 5 hypertensive groups (n = 7–8 rats/group): control (C), ovariectomized (O), ovariectomized treated with HCTZ (OH), ovariectomized submitted to exercise training (OT) and ovariectomized submitted to exercise training and treated with HCTZ (OTH). Ovarian hormone deprivation was performed through bilateral ovariectomy. HCTZ (30mg/kg/day) and concurrent exercise training (3d/wk) were conducted lasted 8 weeks. Arterial pressure (AP) was directly recorded. Cardiac effort was evaluated using the rate-pressure product (RPP = systolic AP x heart rate). Vasopressin V1 receptor antagonist, losartan and hexamethonium were sequentially injected to evaluate the vasopressor systems. Inflammation and oxidative stress were evaluated in cardiac tissue. Results In addition to the reduction in AP, trained groups improved RPP, AP variability, bradycardic (OT: −1.3 ± 0.4 and OTH: −1.6 ± 0.3 vs. O: −0.6 ± 0.3 bpm/mmHg) and tachycardic responses of baroreflex sensitivity (OT: −2.4 ± 0.8 and OTH: −2.4 ± 0.8 vs. O: −1.3 ± 0.5 bpm/mmHg), NADPH oxidase and IL-10/TNF-α ratio. Hexamethonium injection revealed reduced sympathetic contribution on basal AP in OTH group (OTH: −49.8 ± 12.4 vs. O: −74.6 ± 18.1 mmHg). Furthermore, cardiac sympathovagal balance (LF/HF ratio), IL-10 and antioxidant enzymes were enhanced in OTH group. AP variability and baroreflex sensitivity were correlated with systolic AP, RPP, LF/HF ratio and inflammatory and oxidative stress parameters. Conclusion The combination of HCTZ plus concurrent exercise training induced additional positive adaptations in cardiovascular autonomic control, inflammation and redox balance in ovariectomized SHR. Therefore, combining exercise and medication may represent a promising strategy for managing classic and remaining cardiovascular risks in AH.

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“…The combination of hydrochlorothiazide and the potassium-sparing diuretic amiloride has also been shown to be effective in relieving the symptoms of angina pectoris and improving exercise tolerance in patients with chronic stable angina pectoris [ 21 ]. Their effectiveness has in part been attributed to a reduction in intravascular volume (and thus left ventricular end-diastolic pressure), myocardial oxygen demands, and/or amiloride's inhibition of Na + /H + exchangers.…”

Section: Medical Therapy Versus Pci In Patients With Stable Cadmentioning

confidence: 97%

Medical therapy versus percutaneous coronary interventions for patients with stable and unstable coronary artery disease

Pitt

2008

Curr Atheroscler Rep

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The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial has evoked renewed and intense discussion as to whether to recommend medical therapy or coronary revascularization for patients with coronary artery disease (CAD), especially in those patients with stable CAD who are at low to intermediate risk for future cardiovascular events. The decision in regard to the timing and role of revascularization in patients with unstable CAD, although still evolving, is somewhat less controversial. The major focus of this discussion is, therefore, on the patient with stable CAD.

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Effect of Diuretic Therapy on Exercise Capacity in Patients With Chronic Angina and Preserved Left Ventricular Function

Cited by 6 publications

References 16 publications

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Prevalence of Cardioprotective Medication Use in Coronary Heart Disease Patients in South America: Systematic review and Meta-Analysis

Concurrent exercise training induces additional benefits to hydrochlorothiazide: Evidence for an improvement of autonomic control and oxidative stress in a model of hypertension and postmenopause

Medical therapy versus percutaneous coronary interventions for patients with stable and unstable coronary artery disease

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