Assuntos
Anticoagulantes/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , Inibidores da Agregação Plaquetária/uso terapêutico , Síndrome Coronariana Aguda/tratamento farmacológico , Fibrilação Atrial/tratamento farmacológico , Brasil , Doença de Chagas/tratamento farmacológico , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Ataque Isquêmico Transitório/tratamento farmacológico , Infarto do Miocárdio/tratamento farmacológico , Período Perioperatório , Sociedades Médicas , Acidente Vascular Cerebral/tratamento farmacológico , Tromboembolia Venosa/tratamento farmacológicoAssuntos
Humanos , Feminino , Anticoagulantes/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , Inibidores da Agregação Plaquetária/uso terapêutico , Síndrome Coronariana Aguda/tratamento farmacológico , Fibrilação Atrial/tratamento farmacológico , Brasil , Doença de Chagas/tratamento farmacológico , Insuficiência Cardíaca/tratamento farmacológico , Ataque Isquêmico Transitório/tratamento farmacológico , Infarto do Miocárdio/tratamento farmacológico , Período Perioperatório , Sociedades Médicas , Acidente Vascular Cerebral/tratamento farmacológico , Tromboembolia Venosa/tratamento farmacológicoRESUMO
BACKGROUND: Several international studies have discussed whether serum ferritin is a risk marker in coronary heart disease. The objective of this study was to evaluate the importance of serum ferritin levels and other indicators of organic iron as possible risk factors or markers in coronary artery disease. Secondly, the classical factors were studied in order to identify possible associations with organic iron markers. METHODS AND RESULTS: In a medical institution, 1263 patients underwent cinecoronary arteriography from December 1997 to May 1998. A sample of 400 patients was separated, at random, to establish a comparative clinical study between two groups: group A, comprising 200 individuals with coronary atherosclerosis and group B, comprising 200 patients without coronary atherosclerosis, as confirmed by cinecoronary teriography. From group A,182 patients (130 males) and from group B, 157 (96 females) did not show any exclusion criteria and were considered eligible. All women were in the postmenopausal period. The blood samples were collected by a biologist,between 8.30 and 9.0 a.m., after a 12-hour fast and a 36-hour non-smoking period. In order to analyze all results, univariate analysis, the logistic regression technique and the interactive forward stepwise method were used in order to optimize the model and to predict the chances of coronary atherosclerosis. The results of the logistic regression with all the variables analyzed showed that male gender, age, smoking, triglycerides/VLDL interaction, increased serum LDL-C levels and decreased serum HDL-C levels are important to predict the chances of coronary atherogenesis. CONCLUSION: Serum levels of ferritin and of other organic iron indicators--transferrin saturation, total iron-binding capacity,hemoglobin and hematocrit--were neither risk factors nor risk markers for coronary atherosclerosis. Paradoxically, serum iron levels were higher in the group without atherosclerosis. In this study, variables classically considered as risk factors were similar to those in the literature
Assuntos
Masculino , Feminino , Pessoa de Meia-Idade , Humanos , Fatores Sexuais , Fatores de Risco , Ferritinas/sangue , HDL-Colesterol , Lipoproteína(a) , VLDL-Colesterol , VLDL-Colesterol/sangue , Estatística , LDL-Colesterol/sangue , Triglicerídeos/sangueRESUMO
The objective of this study was to assess the efficacy and tolerability of valsartan (Diovan) when given alone or as part of a combination regimen in normal clinical practice, in general practice patients in Brazil. In an open, multicentre post-marketing surveillance (PMS) study, 7256 hypertensive patients were evaluated. Therapy with valsartan either as monotherapy or in combination with 12.5 mg chlorthalidone was observed for up to six months. Assessments at baseline and study endpoints included analysis of adverse events and measurement of systolic and diastolic blood pressure (BP). A total of 3855 patients (53%) received valsartan as monotherapy (mostly as 80 mg once daily), 1162 (16%) received 80 mg valsartan + 12.5 mg chlorthalidone, and 347 (4.8%) received valsartan together with other antihypertensive agents; 858 patients were not evaluable because of inadequate records. A control group of 1034 patients received other antihypertensives. Overall tolerability was high, with 98.5% of patients receiving valsartan alone, 97.7% of those receiving valsartan + chlorthalidone and 92.4% of those receiving other antihypertensives giving tolerability ratings of 'excellent' or 'good'. In this large PMS study, valsartan alone and in combination with chlorthalidone was associated with excellent safety and tolerability in general practice patients in Brazil with primary hypertension, irrespective of age, sex or concomitant diseases.
Assuntos
Anti-Hipertensivos/uso terapêutico , Clortalidona/uso terapêutico , Tetrazóis/uso terapêutico , Valina/análogos & derivados , Valina/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Quimioterapia Combinada , Medicina de Família e Comunidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância de Produtos Comercializados , ValsartanaRESUMO
The objective of this study was to access of efficacy and tolerability of valsartan (Diovan) when give alone or as part of a combination regimen in normal clinical practice, in gneral practice of patients in Brazil. In an open, multicentre post-marketing surveillance (PMS) study, 7256 hypertensive patients were evaluated. Therapy with valsartan either as monotherapy or in combination with 12.5mg chlorthalidone was observed for up to six months. Assessment at baseline and study endpoints includded analysis of adverse events and measurement of systolic and dyastolic blood pressures (bp). A total of 3855 patients(53%) received valsartan as monotherapy (mostly as 80 once daily), 1162 (16%) received 80 mg valsartan 12,5 mg chlorthalidone, and 347 (4,8%) received valsartan togheter with other antihypertensive agents.
Assuntos
Anti-Hipertensivos/uso terapêutico , Contrapulsação , Hipertensão , Pressão Arterial , Quimioterapia Combinada , Tratamento FarmacológicoRESUMO
PURPOSE: To compare the efficacy and tolerance of felodipine-ER and nifedipine OROS, both once daily, in the treatment of mild-to-moderate uncomplicated arterial hypertension (AH). METHODS: This was a multicentric, opened, randomized, paralled trial, that selected 121 patients with uncomplicated, mild to moderate essential AH (diastolic blood pressure (DBP) > or = 95 and < or = 110 mmHg; not under anti-hypertensive medication. All patients received placebo for two weeks. After that period, they would take either 5mg/day of felodipine, or 30mg/day of nifedipine OROS, both once daily, in a randomized fashion. Patients underwent laboratory tests and electrocardiogram (ECG) at the begining and at the end of the study, and heart rate and blood pressure (BP) measurements, nearly 24 hours after the last active drug dose. RESULTS: Completed the study 111 patients, 60 in the felodipine group and 51 in the nifedipine group. Compared to baseline, the average of systolic BP and DBP decreased from 162.5 +/- 14.3mmHg and from 102.2 +/- 5.1mmHg to 143.3 +/- 14.6 and 87.9 +/- 7.2mmHg, respectively, at the end of the treatment in the felodipine group; and from 160.5 +/- 16.3mmHg and 102.5 +/- 6.2mmHg to 136.1 +/- 14.2 and 86.7 +/- 7.0mmHg, respectively in nifedipine group (p < 0.0001 for all diferences). Adequate BP response to the treatment (DBP normalization or reduction > 10mmHg from baseline) occured in 47/60 (78.3%) patients in the felodipine group and in 38/51 (74.5%) in the nifedipine group (NS). Side effects, occured in approximately 15% of the cases, and were similar in both groups. These were usually moderate and transient, but were responsible for the withdrawal from the study of two cases in the felodipine group and of three cases in the nifedipine group. CONCLUSION: Felodipine-ER and nifedipine OROS, are similarly effective and generally well tolerated in patients with mild-to-moderate essential hypertension.
Assuntos
Felodipino/uso terapêutico , Hipertensão/tratamento farmacológico , Nifedipino/uso terapêutico , Adulto , Idoso , Análise de Variância , Distribuição de Qui-Quadrado , Tolerância a Medicamentos , Felodipino/farmacologia , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Nifedipino/farmacologiaRESUMO
PURPOSE: Evaluation of the clinical effects of captopril addition to the conventional therapy of functional class II and III (NYHA) congestive heart failure (CHF). METHODS: One hundred and fifteen patients with CHF, 46 (40%) class II and 69 (60%) class III, on conventional treatment (digitalis and diuretic) were the subject of this study. The age ranged from 22 to 75 years (mean 56.6 +/- 11); 67 were male and 66 were caucasians. The etiologies of the heart failure were: hypertensive heart disease 47 (40.9%), ischemic heart disease 27 (23.5%), Chagas cardiomyopathy 20 (17.4%), idiopathic cardiomyopathy 15 (13.0%), and other causes 6 (5.2%). Diuretic and digitalis were maintained in the same dosage during all the treatment. Captopril therapy was started with 6.25 mg b.i.d. or t.i.d., and the dosage was increased gradually to 25 mg b.i.d. or t.i.d. The duration of the study was 12 weeks. Clinical visits occurred every four weeks and laboratory tests were performed in the beginning and at the end of the study. RESULTS: The dosage of captopril ranged from 12.5 to 75 mg (mean 28.5 +/- 13.1 mg/day). The addition of captopril to the conventional therapy of CHF was associated with significant reduction (p < 0.01) of heart rate, systolic and diastolic blood pressure. In the end of the study 13 patients (11.3%) were in functional class III, 50 (43.5%) in class II and 52 (45.2%) in class I. Globally, functional class was improved in 98 (85.2%) patients and remained unchanged in 17 (14.8%) (p < 0.01). The side effects (dizziness, cough, hypotension and headache) were moderate and uncommon and did not need interruption of the treatment. CONCLUSION: The addition of captopril to the conventional therapy of class II and III CHF was associated with significant improvement of functional class and with good tolerability.
Assuntos
Captopril/administração & dosagem , Insuficiência Cardíaca/tratamento farmacológico , Adulto , Idoso , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The clinical efficacy and tolerability of isradipine was evaluated in 63 patients with mild-to-moderate hypertension [supine systolic blood pressure (SBP) greater than or equal to 160 mm Hg and diastolic blood pressure (DBP) greater than or equal to 95 mm Hg]. Patients were divided into two groups according to age: group A (n = 41), aged 37-69 years (mean age of 54 +/- 7 years); group B (n = 22), aged 70-80 years (mean age of 72.8 +/- 2.4 years). After a 3-week washout period, group A received 2.5 mg of isradipine twice daily for 6 weeks. Group B received 1.25 mg of isradipine initially, increasing to 2.5 mg twice daily according to treatment response and tolerability. At the end of treatment (week 6), there were statistically significant decreases (p less than 0.01) in supine SBP and DBP in both groups compared with baseline values: the mean SBP in groups A and B decreased from 160.0 +/- 14.7 to 133.6 +/- 10.0 mm Hg and from 161.6 +/- 17.8 to 134.8 +/- 10.9 mm Hg, respectively; the mean DBP in groups A and B decreased from 101.3 +/- 3.0 to 83.6 +/- 5.5 mm Hg and from 101.3 +/- 8.4 to 84.2 +/- 3.6 mm Hg, respectively. Clinical and laboratory parameters did not change significantly during treatment. Side effects (headache, flushing, palpitations, and edema) were mild/moderate and disappeared after the first 2 weeks of treatment. In conclusion, 2.5 mg of isradipine twice daily is effective and well tolerated in the treatment of mild-to-moderate hypertension regardless of patient age.