Effects of chlorthalidone and diltiazem on myocardial ischemia in elderly patients with hypertension and coronary artery disease
AUTOR(ES)
Serro-Azul, João Batista, Paula, Rogério Silva de, Gruppi, César, Pinto, Lígia, Pierri, Humberto, Nussbacher, Amit, Gebara, Otávio, Moffa, Paulo, Pereira-Barreto, Antônio Carlos, Wajngarten, Maurício
FONTE
Arquivos Brasileiros de Cardiologia
DATA DE PUBLICAÇÃO
2001-04
RESUMO
OBJETIVE: Antihypertensive therapy with thiazides decreases coronary events in elderly patients. However, the influence of diuretics on myocardial ischemia has not been fully investigated. The aim of this study was to compare the effect of chlorthalidone and diltiazem on myocardial ischemia. METHODS: Following a randomized, double-blind, crossover protocol, we studied 15 elderly hypertensive patients aged 73.6±4.6 years with myocardial ischemia. All patients had angiographically documented coronary artery disease. We measured patients using 48- hour ambulatory electrocardiogram monitoring and exercise testing. After a 2-week period using placebo, patients received chlorthalidone or diltiazem for 4 weeks. RESULTS: Both treatments lowered systolic and diastolic blood pressures. The number of ischemic episodes on ambulatory electrocardiogram recordings was reduced with the use of chlorthalidone (2.5±3.8) and diltiazem (3.2±4.2) when compared with 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: In elderly hypertensive patients with coronary artery disease, chlorthalidone reduced myocardial ischemia similarly to diltiazem. This result is consistent with epidemiological studies and suggests that reduction of arterial blood pressure with thiazide therapy plays an important role in decreasing myocardial ischemia.
Documentos Relacionados
- Diltiazem Cold Cardioplegia in Coronary Artery Surgery: Effects on Myocardial Function and Ischemia
- Effects of physical training on myocardial ischaemia in patients with coronary artery disease.
- Beneficial effects of diltiazem in coronary artery disease.
- Effects of short term beta adrenoreceptor blockade on serum lipids and lipoproteins in patients with hypertension or coronary artery disease.
- Regional Myocardial Perfusion Rates in Patients with Coronary Artery Disease