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Acanfora D, Casucci G, Ciccone MM, Scicchitano P, Lonobile T, Chiariello L, Maestri R, Pedone C, Provitera V, Nolano M, Incalzi RA. Biomechanical and neuroautonomic adaptation to acute blood volume displacement in ischemic dilated cardiomyopathy: the predictive value of the CD25 test. J Appl Physiol (1985) 2020; 129:1173-1182. [PMID: 32940562 DOI: 10.1152/japplphysiol.00514.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The adaptation to volume displacement induced by tilt test was assessed in patients with heart failure and previous inferoapical/inferolateral or basal/apical septal myocardial infarction. The responsiveness of cardiac muscle to sympathetic nervous system stimulation predicts the mortality in patients with ischemic heart failure and may represent a useful tool for clinicians in the general assessment of this kind of patients.
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Affiliation(s)
- Domenico Acanfora
- San Francesco Hospital, Telese Terme, Benevento, Italy
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Telese Terme, , Italy
| | | | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari School of Medicine, Bari, Italy
| | - Pietro Scicchitano
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari School of Medicine, Bari, Italy
| | | | | | - Roberto Maestri
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Montescano, Pavia, Italy
| | - Claudio Pedone
- Unit of Geriatrics, Policlinico Universitario, Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Provitera
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Telese Terme, , Italy
| | - Maria Nolano
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Telese Terme, , Italy
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Exercise training effects on elderly and middle-age patients with chronic heart failure after acute decompensation: A randomized, controlled trial. Int J Cardiol 2016; 225:313-323. [PMID: 27750131 DOI: 10.1016/j.ijcard.2016.10.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/06/2016] [Accepted: 10/09/2016] [Indexed: 12/21/2022]
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Borghi C, Cicero AFG. Rationale for the Use of a Fixed-Dose Combination in the Management of Hypertension. Clin Drug Investig 2012; 30:843-54. [DOI: 10.1007/bf03256912] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Borghi C, Santi F. Fixed combination of lercanidipine and enalapril in the management of hypertension: focus on patient preference and adherence. Patient Prefer Adherence 2012; 6:449-55. [PMID: 22791982 PMCID: PMC3393122 DOI: 10.2147/ppa.s23232] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Hypertension is one of the most important and widespread risk factors for the development of cardiovascular disease. Once, combination therapy was traditionally reserved as a third-line or fourth-line approach in the management of hypertension. However, several major intervention trials in high-risk patient populations have shown that an average of 2-4 antihypertensive agents are required to achieve effective blood pressure control. Combination treatment should be considered as a first choice in patients at high cardiovascular risk and in individuals for whom blood pressure is markedly above the hypertension threshold (eg, more than 20 mmHg systolic or 10 mmHg diastolic), or when milder degrees of blood pressure elevation are associated with multiple risk factors, subclinical organ damage, diabetes, renal failure, or associated cardiovascular disease. A number of clinical trials have demonstrated that a fixed combination of lercanidipine and enalapril has better efficacy and tolerability than monotherapy with either agents. The fixed-dose formulation of lercanidipine-enalapril was well tolerated in all clinical trials, with an adverse event rate similar to that of the component drugs as monotherapy. The advantages of combination therapy include improved adherence to therapy and minimization of blood pressure variability. In addition, combining two antihypertensive agents with different mechanisms of action may provide greater protection against major cardiovascular events and the development of end-organ damage.
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Affiliation(s)
| | - Francesca Santi
- Correspondence: Francesca Santi, Internal Medicine, Aging and Kidney, Disease Department, University of Bologna, Via Albertoni 15, Bologna 40138, Italy, Fax +39 05 1390 646, Tel +39 05 1636 2212, Email
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Borghi C, Cicero AFG. Rationale for the use of a fixed-dose combination in the management of hypertension: efficacy and tolerability of lercanidipine/enalapril. Clin Drug Investig 2010. [PMID: 20923243 DOI: 10.2165/11584470-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Hypertension, a significant factor in the development of cerebrovascular disorders, heart disease and renal failure, is a common disorder worldwide. Despite the availability of a wide range of antihypertensive agents, almost two-thirds of hypertensive patients have poorly controlled blood pressure (BP). Numerous clinical trials have shown that most patients require at least two antihypertensive agents to achieve adequate BP control and associated significant reductions in cardiovascular morbidity and mortality. Combination therapy using two drugs with different, complementary mechanisms of action achieves better efficacy and tolerability outcomes than treatment with either component drug alone. When such a combination is administered as a fixed-dose formulation, other benefits, such as improved compliance and potentially lower costs, are also likely. The good efficacy and tolerability of the combination of a calcium channel antagonist and an angiotensin-converting enzyme inhibitor is well established, and this combination is recommended by European Society of Hypertension/European Society of Cardiology guidelines as a first choice in high-risk hypertensive patients, including those with type 2 diabetes mellitus. Lercanidipine/enalapril is a promising example of a fixed-dose combination of these drug classes. In clinical trials in hypertensive patients, including those with type 2 diabetes, lercanidipine/enalapril improved BP to a greater extent than either drug as monotherapy (in patients who were previous non-responders to lercanidipine or enalapril) or the combination of lercanidipine/hydrochlorothiazide, and was equally well tolerated. Further studies are required to evaluate the cardiovascular protective effects of lercanidipine/enalapril.
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Affiliation(s)
- Claudio Borghi
- Hypertension Research Unit, Internal Medicine, Aging and Kidney Disease Department, Sant'Orsola-Malpighi University Hospital, Bologna, Italy.
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Burnier M, Pruijm M, Wuerzner G. Treatment of essential hypertension with calcium channel blockers: what is the place of lercanidipine? Expert Opin Drug Metab Toxicol 2009; 5:981-7. [DOI: 10.1517/17425250903085135] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Pruijm MT, Maillard MP, Burnier M. Patient adherence and the choice of antihypertensive drugs: focus on lercanidipine. Vasc Health Risk Manag 2009; 4:1159-66. [PMID: 19337529 PMCID: PMC2663443 DOI: 10.2147/vhrm.s3510] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Despite the development of many effective antihypertensive drugs, target blood pressures are reached in only a minority of patients in clinical practice. Poor adherence to drug therapy and the occurrence of side effects are among the main reasons commonly reported by patients and physicians to explain the poor results of actual antihypertensive therapies. The development of new effective antihypertensive agents with an improved tolerability profile might help to partly overcome these problems. Lercanidipine is an effective dihydropyridine calcium channel blocker of the third generation characterized by a long half-life and its lipophylicity. In contrast to first-generation dihydropyridines, lercanidipine does not induce reflex tachycardia and induces peripheral edema with a lower incidence. Recent data suggest that in addition to lowering blood pressure, lercanidipine might have some renal protective properties. In this review we shall discuss the problems of drug adherence in the management of hypertension with a special emphasis on lercanidipine.
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Affiliation(s)
- Menno T Pruijm
- Service of Nephrology and Hypertension, Department of Medicine, University Hospital, Rue du Bugnon 17, Lausanne, Switzerland
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