Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)

Poulter, Neil; Wedel, Hans; Dahlöf, Björn; Sever, Peter; Beevers, D. G.; Caulfield, Mark; Kjeldsen, Sverre E.; Kristinsson, A; McInnes, Gordon T.; Mehlsen, Jesper; Nieminen, Markku S.; O’Brien, Eoin; Östergren, Jan; Pocock, Stuart

doi:10.1016/s0140-6736(05)67186-3

Cited by 288 publications

(122 citation statements)

References 18 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…Sur les fibres lisses intestinales, les anticalciques tels que la nifédipine et le diltiazem réduisent sélectivement l'amplitude et la fréquence des potentiels de pacemaker [35,41] et entraînent une réduction de l'amplitude et de la durée des contractions rythmiques [35] par blocage des canaux calciques de type L [38,51].…”

Section: Discussionunclassified

Effets pharmacodynamiques d’un extrait hydroalcoolique de Curcuma longa Linné (Zingiberaceae) sur le système cardiovasculaire, la respiration et l’activité mécanique intestinale de mammifères

Bleu¹,

Traoré²,

Coulibaly³

et al. 2011

Phytothérapie

View full text Add to dashboard Cite

L'étude des effets pharmacologiques d'un extrait hydroalcoolique de Curcuma longa Linné (Zingiberaceae) [Cl] sur la pression artérielle couplée à la respiration du lapin dans un intervalle de concentrations compris entre 5,5 × 10 -4 et 4,4 × 10 -2 g/kg de PC montre que cette substance d'origine végétale induit des effets hypotenseurs dose-dépendants. Ces effets s'accompagnent d'une augmentation de la fréquence et d'une diminution de l'amplitude respiratoire. Dans un intervalle de concentrations compris entre 10 -6 et 10 -3 mg/ml, ce même extrait provoque des effets inotrope et chronotrope négatifs dose-dépendants sur le coeur isolé de rat. Par ailleurs, il induit une forte diminution dose-dépen-dante des contractions rythmiques du duodénum isolé du lapin à des concentrations comprises entre 2 × 10 -2 et 1,2 × 10 -1 mg/ml. Ces effets négatifs de l'extrait hydroalcoolique de cette espèce végétale rappellent les effets bien connus des antagonistes calciques. Afin de comprendre le mécanisme d'action des substances contenues dans cet extrait, nous avons comparé les interactions entre acé-tylcholine (ACH)-Cl et ACH-atropine (ATR) et chlorure de baryum (BaCl 2 )-ATR-Cl pour trois concentrations différentes de BaCl 2 . La présence de substances anticalciques dans l'extrait hydroalcoolique de cette plante est confirmée par le fait que, contrairement à l'ATR qui est un inhibiteur compétitif des récepteurs cholinergiques muscariniques, Cl inhibe les effets inotropes positifs induits par le BaCl 2 qui est un stimulateur de la motilité intestinale comparable au calcium. L'augmentation du rythme respiratoire du lapin induit par l'extrait brut de Curcuma longa pourrait être due à l'existence dans cet extrait de substances autres que les substances anticalciques. Mots clés : Curcuma longa -Anticalcique -Acétylcholine -Atropine Pharmacodynamic effects of a hydroalcoholic extract of Curcuma longa Linné (Zingiberaceae) on the cardiovascular system, respiratory activity and mechanical activity of duodenal strips of mammaliansAbstract: The pharmacological effects of a hydroalcoholic extract of Curcuma longa Linné (Zingiberaceae) [Cl] were studied on blood pressure coupled to respiratory activity of rabbit in concentration ranging from 5,5 × 10 -4 to 4,4 × 10 -2 g/kg of b.w. showed that this vegetal extract induced dose-dependent hypotension effect. These effects were accompanied by a increase of frequency and decrease of respiratory range. At the concentrations ranging from 10 -6 to 10 -3 mg/ml, this same extract induced dose-dependent negative inotropic and chronotropic effects on the heart isolated from rat. Moreover, it induced a significant dose-dependent decrease of the rhythmical contractions of the isolated duodenal from rabbit at the concentrations ranging 2 × 10 -2 to 1,2 × 10 -1 mg/ml. The negative effects caused by this vegetable specie recalled those of calcium channel blockers. Therefore, the interaction ACH-Cl and ACH-ATR on the one hand and BaCl 2 -ATR-Cl on the other hand were achieved to understand the action mechan...

show abstract

Section: Discussionunclassified

Effets pharmacodynamiques d’un extrait hydroalcoolique de Curcuma longa Linné (Zingiberaceae) sur le système cardiovasculaire, la respiration et l’activité mécanique intestinale de mammifères

Bleu¹,

Traoré²,

Coulibaly³

et al. 2011

Phytothérapie

View full text Add to dashboard Cite

show abstract

“…By the end of the trial, 78% of patients were taking the second antihypertensive drug, and the amlodipine/perindopril regimen was superior to atenolol atenolol/bendroflumethiazide in reducing all-cause mortality, stroke, total cardiovascular events, and new-onset diabetes. When several variables of the ASCOT-BPLA were analyzed, BP reduction was not the only contributor to the amlodipine/ perindopril reduction in cardiovascular events (5). It is interesting that although BP was the most important variable associated with the incidence of stroke, differences in HDL cholesterol were more important for coronary events.…”

Section: Combined Antihypertensive and Lipidlowering Therapies In Thementioning

confidence: 98%

Vascular Protection of Dual Therapy (Atorvastatin-Amlodipine) in Hypertensive Patients

Martı́n-Ventura¹,

Tuñón²,

Duran³

et al. 2006

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Hypertension frequently coexists with other cardiovascular risk factors, such as hypercholesterolemia, and their combination is associated with a greater rate of cardiovascular events. Recent clinical data support that treatment of hypertensive patients with a combination of antihypertensive and lipid-lowering therapies leads to a higher reduction in the incidence of cardiovascular events. In the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA), an optimal prevention of cardiovascular events was reached in patients who were randomly assigned to atorvastatin and the amlodipine treatment. However, the potential underlying mechanisms of these vascular protective effects are not fully elucidated. Because experimental studies have shown that statins and calcium channel blockers have antiatherosclerotic effects, the effect of atorvastatin alone or in combination with amlodipine was analyzed in the protein secretion profile of atherosclerotic plaques that were cultured ex vivo. In this respect, the addition of atorvastatin and amlodipine to atherosclerotic plaques normalized the levels of the different released proteins to that obtained from healthy arteries. This review highlights recent clinical and experimental studies that support that a combined treatment of hypertensive patients with both statins and calcium channel blockers could promote a higher reduction in their global cardiovascular risk profile and associated mortality. As an example, the application of a proteomic approach to assess the modulation by atorvastatin alone or in combination with amlodipine on the proteins that are released by atherosclerotic plaques has allowed the identification of novel therapeutic targets by which these drugs could promote their additive/synergic effects.J Am Soc Nephrol 17: S189 -S193, 2006. doi: 10.1681/ASN.2006080913 N ephrologists traditionally have been involved in the care of patients with hypertension, because this disorder is both cause and consequence of kidney disease. However, hypertension frequently coexists with other cardiovascular risk factors, such as hypercholesterolemia, and their combination is associated with a greater rate of cardiovascular events (1). Clinical and experimental studies that were performed in the past few years suggested that when treating hypertensive patients, all of these factors should be considered to achieve a higher reduction in cardiovascular morbidity and mortality on these patients. Combined Antihypertensive and LipidLowering Therapies in the Clinical PracticeA large number of clinical trials have demonstrated that treatment of either hypercholesterolemia or hypertension leads to a reduction in the incidence of cardiovascular events. Moreover, subgroup analyses that were performed in the Heart Outcomes Prevention Evaluation (HOPE) study showed the benefits of angiotensin-converting enzyme inhibitors in patients who received concomitant statin therapy (2). Similarly, in the Heart Protection Study (HPS), simvastatin diminished cardiovascular even...

show abstract

“…The simple message of the ALLHAT, SYST-EUR, ASCOT, VALUE [11] and LIFE trials is that, in old patients (at risk of stroke) and because aging of arteries is associated with loss in intrinsic arterial vasodilatative properties, it is a good idea to target blood volume by using diuretics and try vasodilatative agents by using CCBs or ARBs (and probably also BBs that have vasodilatative properties). At the same target BP level, it is not clear whether ARBs or CCBs are more effective for stroke prevention compared with ACEIs, because in the recent trials, the difference may have been confounded by a more rapid BP-lowering effect in the ARB or CCB arm than in the ACEI arm as shown by post hoc analyses [12, 13]. Indeed these studies included mostly hypertensive patients who were non- naïve to BP-lowering treatment.…”

Section: Lowering Blood Pressurementioning

confidence: 99%

Polypill Strategy vs. Prevention Clinics for Stroke Prevention

Amarenco

2006

Cerebrovasc Dis

View full text Add to dashboard Cite

Thirty years of clinical trials have demonstrated that stroke can be prevented by reducing blood pressure to less than 140/90 mm Hg or by a further decrease of 10/5 mm Hg when blood pressure is controlled, by reducing LDL cholesterol by at least 1 mmol/l (39 mg/dl), and by inhibiting platelet aggregation. The (too simplistic) concept of the polypill strategy combining pharmacologic agents to achieve these goals is supposed to reduce the risk by 80% overall. However, reducing general salt and sugar intake, giving up smoking, developing prevention clinics with prevention nurses to improve adherence to preventive treatments, as well as decreasing poverty and malnutrition, increasing the level of hygiene, fighting against infectious diseases and financially helping developing countries are all combined necessary approaches to decrease the worldwide burden of stroke and other vascular diseases.

show abstract

Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)

Cited by 288 publications

References 18 publications

Effets pharmacodynamiques d’un extrait hydroalcoolique de Curcuma longa Linné (Zingiberaceae) sur le système cardiovasculaire, la respiration et l’activité mécanique intestinale de mammifères

Effets pharmacodynamiques d’un extrait hydroalcoolique de Curcuma longa Linné (Zingiberaceae) sur le système cardiovasculaire, la respiration et l’activité mécanique intestinale de mammifères

Vascular Protection of Dual Therapy (Atorvastatin-Amlodipine) in Hypertensive Patients

Polypill Strategy vs. Prevention Clinics for Stroke Prevention

Contact Info

Product

Resources

About