scholarly journals The Interplay of Exercise Heart Rate and Blood Pressure as a Predictor of Coronary Artery Disease and Arterial Hypertension

2012 ◽  
Vol 15 (3) ◽  
pp. 162-170 ◽  
Author(s):  
Andreas P. Michaelides ◽  
Charalampos I. Liakos ◽  
Gregory P. Vyssoulis ◽  
Evangelos I. Chatzistamatiou ◽  
Maria I. Markou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Exercise Heart Rate ◽  
Artery Disease

Small, Oral Dose of Clonidine Reduces the Incidence of Intraoperative Myocardial Ischemia in Patients Having Vascular Surgery

1996 ◽  
Vol 85 (4) ◽  
pp. 706-712 ◽  
Author(s):  
Klaus-Dieter Stuhmeier ◽  
Bernd Mainzer ◽  
Jochen Cierpka ◽  
Wilhelm Sandmann ◽  
Jorg Tarnow
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Oral Dose ◽  
Fluid Volume ◽  
Arterial Blood ◽  
Artery Disease

Background Most new perioperative myocardial ischemic episodes occur in the absence of hypertension or tachycardia. The ability of alpha 2-adrenoceptor agonists to inhibit central sympathetic outflow may benefit patients with coronary artery disease by increasing the myocardial oxygen supply and -demand ratio. Methods A randomized double-blind study design was used in 297 patients scheduled to have elective vascular surgical procedures to evaluate the effects of 2 micrograms/kg-1 oral clonidine (n = 145) or placebo (n = 152) on the incidence of perioperative myocardial ischemic episodes, myocardial infarction, and cardiac death. Continuous real-time S-T segment trend analysis (lead II and V5) was performed during anesthesia and surgery and correlated with arterial blood pressure and heart rate before and during ischemic events. Dose requirements for vasoactive and antiischemic drugs to control blood pressure and heart rate as well as episodes of myocardial ischemia (i.e., catecholamines, beta-adrenoceptor antagonists, nitrates, and systemic vasodilators) and fluid volume load were recorded. Results Administration of clonidine reduced the incidence of perioperative myocardial ischemic episodes from 39% (59 of 152) to 24% (35 of 145) (P < 0.01). Hemodynamic patterns, percentage of ischemic time, and the number of ischemic episodes per patient did not differ. Nonfatal myocardial infarction developed after operation in four patients receiving placebo compared with none receiving clonidine (day 2 to 21; P = 0.07). The incidence of fatal cardiac events (1 vs. 2) was not different. Dose requirements for vasoactive and antiischemic drugs did not differ between the groups, but the amount of presurgical fluid volume was slightly greater in patients receiving clonidine (951 +/- 388 vs. 867 +/- 381 ml; P < 0.03). Conclusion A small oral dose of clonidine, given prophylactically, can reduce the incidence of perioperative myocardial ischemic episodes without affecting hemodynamic stability in patients with suspected or documented coronary artery disease.

scholarly journals Melatonin for nondippers with coronary artery disease: assessment of blood pressure profile and heart rate variability

2009 ◽  
Vol 33 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Tomasz Rechciński ◽  
Ewa Trzos ◽  
Karina Wierzbowska-Drabik ◽  
Maria Krzemińska-Pakuła ◽  
Małgorzata Kurpesa
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Coronary Artery ◽  
Pressure Profile ◽  
Disease Assessment ◽  
Blood Pressure Profile ◽  
Artery Disease

Complications in Treated Arterial Hypertension

1973 ◽  
Vol 45 (s1) ◽  
pp. 205s-208s
Author(s):  
H. Storm-Mathisen ◽  
H. Löken ◽  
U. Rian
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Essential Hypertension ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Men And Women ◽  
Artery Disease ◽  
Fatal Complications

1. The treatment of high blood pressure with modern drugs seems to improve the prospect of life for all grades of essential hypertension. 2. The fatal complications are more seldom cerebral and more often cardiovascular. Especially in men coronary artery disease seems difficult to prevent. 3. Most remarkable is the great percentage of surviving and symptom-free men and women, especially patients belonging to stage 2 and 3 at registration. 4. Blood pressure reduction therapy seems to reduce the frequency of death directly related to hypertension. The grade of arteriosclerosis does not seem to be influenced to the same degree.

scholarly journals Heart rate-lowering therapy in gout patients with stable coronary artery disease: focus on ivabradine

2020 ◽  
Vol 25 (7) ◽  
pp. 3980
Author(s):  
N. N. Kushnarenko ◽  
T. A. Medvedeva ◽  
M. Yu. Mishko ◽  
T. M. Karavaeva
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Controlled Study ◽  
Artery Disease

Aim. To study the effect of ivabradine and bisoprolol on cardiac hemodynamics and diastolic remodeling in gout patients with coronary artery disease and hypertension and without left ventricular systolic dysfunction.Material and methods. The open randomized parallel clinical trial of 35 men with intercritical gout at the age of 41,4±3,3 years, with class II-III stable angina, hypertension and sinus rhythm without data suggestive of heart failure was performed. All patients included in the study were randomly divided into two groups: eighteen patients took bisoprolol at a dose of 2,5 to 10 mg/day, 17 subjects received bisoprolol 2,5 mg/day with ivabradine (Coraxan, SERVIER, France) 5 mg 2 times a day. Adjustment of the therapy was carried out every 2 weeks until the target heart rate (HR) was reached at 55-60 beats/min and then remained unchanged until 12 weeks of therapy. All patients underwent echocardiography, 24-hour Holter and central aortic blood pressure monitoring, and 3-minute cycle ergometer test with a power of 25, 50, 75 and 100 watts.Results. There was a comparable decrease in the maximum and minimum 24-hour average heart rates in patients receiving only bisoprolol and those taking bisoprolol+ivabradine. Patients taking bisoprolol+ivabradine had a decrease of central systolic and diastolic blood pressure (BP). Pulse pressure in the bisoprolol group increased by 17,7% (p=0,02), and when ivabradine was added, on the contrary, it decreased by 7,0% (p=0,04). Twelve-week therapy with beta-blockers and ivabradine was accompanied by an effective decrease in the pulse wave velocity in both groups (p<0,05). All gout patients did not have a decrease of systolic function and there was an improvement in diastolic remodeling with beta-blockers and ivabradine therapy.Conclusion. The results obtained indicate that the addition of ivabradine to bisoprolol leads to an effective decrease in heart rate, an improvement in arterial stiffness and exercise tolerance. Combination therapy with ivabradine is accompanied by an improvement in clinical outcomes using lower doses of bet-blockers, which requires further study and a double-blind controlled study.

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