Effects of chlorthalidone and diltiazem on myocardial ischemia in elderly patients with hypertension and coronary artery disease

Serro-Azul, João Batista; Paula, Rogério Silva de; Gruppi, C; Pinto, Lígia B.; Pierri, Humberto; Nussbacher, Amit; Gebara, Otávio; Moffa, Paulo Jorge; Pereira-Barreto, Antônio Carlos; Wajngarten, Maurı́cio

doi:10.1590/s0066-782x2001000400001

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…35 Chlorthalidone is shown to reduce myocardial ischemia similar to diltiazem in the elderly population. 36 Thus, in such a high-risk population, chlorthalidone may be a preferred diuretic for control of hypertension in addition to existing therapy with ACEIs/ARBs. Regular monitoring of blood pressure and cardiac function is necessary for patients with hypertension with CAD.…”

Section: Hypertension With Ischemic Heart Diseasementioning

confidence: 99%

Individualization of hypertension treatment: an expert review

Garg

2023

Int J Adv Med

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Management of hypertension is complex in patients with comorbid conditions and in those who are at high cardiovascular risk. Multiple guidelines recommend different treatment goals and therapeutic approaches for hypertension. In this review, we take an individualized management approach for hypertension with comorbidities mainly diabetes and chronic kidney disease (CKD), coronary artery disease, and for young patients and the elderly. Current evidence indicates a blood pressure goal of <130/80 mmHg for most patients with comorbidities except for the elderly aged >75 years in whom systolic pressure of 130-139 mmHg and diastolic pressure of 70-80 mmHg may be considered. For patients with diabetes and CKD, renin angiotensin aldosterone system (RAAS) inhibitors remain the initial choice of agents whereas in the young or elderly, any class including RAAS inhibitors, calcium channel blockers, and thiazide diuretics may be preferred. Special consideration is necessary for the elderly concerning the possible side effects of each drug class. In the presence of additional risk factors, an individualized approach is necessary to tailor the most effective therapy as per patient needs. Thus, in treating hypertension, a multipronged but individualized approach is necessary to optimize blood pressure control and clinical outcomes in the real-world setting.

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Section: Hypertension With Ischemic Heart Diseasementioning

confidence: 99%

Individualization of hypertension treatment: an expert review

Garg

2023

Int J Adv Med

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

Finimundi

Caramori²,

Parker³

2007

Journal of Cardiovascular Pharmacology

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Strategies to improve the cardiovascular risk profile of thiazide-type diuretics as used in the management of hypertension

Carter

Sica

2007

Expert Opinion on Drug Safety

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Thiazide diuretics are one of the preferred pharmacologic treatments for hypertension. However, there has been rather pointed debate during the past 20 years about the clinical significance of the biochemical and/or metabolic adverse effects caused by diuretics. This controversy centers around whether the hypokalemia, hypomagnesemia, hyperuricemia, hyperglycemia and/or hyperlipidemia occasionally seen with diuretics might lessen some of the beneficial effects on cardiovascular risk seen with reductions in blood pressure. One of the biggest controversies in the last few years has focused on whether the small increase in absolute risk of diabetes seen with diuretic therapy should be a concern. The vigilant clinician should appropriately dose and monitor diuretic therapy either when given alone or when used in combination therapy. When these strategies are employed, the adverse effects seen with diuretics can be minimized or negated, and in so doing cardiovascular benefits can be optimized.

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Effects of chlorthalidone and diltiazem on myocardial ischemia in elderly patients with hypertension and coronary artery disease

Abstract: Objective - placebo (7.9±8.8; p<0.05). The total duration of ischemic episodes was reduced in both treatments when compared with placebo (chlorthalidone: 19.2±31.9min; diltiazem: 19.3±29.6min; placebo: 46.1±55.3min; p<0.05). Conclusion -

Cited by 3 publications

References 15 publications

Individualization of hypertension treatment: an expert review

Individualization of hypertension treatment: an expert review

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

Strategies to improve the cardiovascular risk profile of thiazide-type diuretics as used in the management of hypertension

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