Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The safety and pharmacodynamic compatibility of clopidogrel with medications commonly used in patients with atherosclerosis, such as, a beta-adrenergic receptor antagonist (atenolol) and a calcium uptake inhibitor (nifedipine) were assessed. Atenolol and nifedipine interactions with clopidogrel were studied in patients with peripheral arterial obstructive disease taking a well-established regimen of nifedipine (N group of 6 patients) and in patients with coronary artery disease taking a well-established regimen of either atenolol (A group of 8 patients) or of atenolol and nifedipine (AN group of 8 patients). The study was conducted as a double-blind, randomized, crossover comparison of clopidogrel, 75 mg once daily, and placebo treatment for 7 days, with a 14-day washout between treatments. Pharmacodynamic interactions between atenolol and nifedipine, either alone or in combination, and clopidogrel were assessed primarily on the clinical control of angina or hypertension and, secondarily, by comparing the extent of inhibition of ADP (5 microM)-induced platelet aggregation achieved between the 3 groups. The mean number of anginal episodes per patient during the placebo week was 1.50, 9.0 and 11.5 in the A, N and AN groups, respectively; during the week of clopidogrel treatment, it was 1.39, 7.3 and 9.0, respectively, indicating no change in occurrence. Likewise, review of the use of nitrates (long or short acting) did not suggest any major change in usage during any period of the study. ECGs did not change between the three recording times (at screening and at the end of each treatment period). Vital signs were also unchanged throughout. Percent inhibition of platelet aggregation on day 7 was 31% in the N group, 39% in the A group, 28% in the AN group, and 33% overall. In conclusion, the coadministration of clopidogrel did not interfere with the clinical control of hypertension or angina established with atenolol or nifedipine, or both. Clopidogrel retained its full antiplatelet effect, and there were no safety problems caused by the coadministration.
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PMID:Clopidogrel compatibility with concomitant cardiac co-medications: a study of its interactions with a beta-blocker and a calcium uptake antagonist. 1044 Apr 25

The aim of our investigation was to determine whether the presence of additional risk factors or type of hypertension (diastolic or isolated systolic) influences blood pressure (BP) response to treatment. The International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study is a double-blinded outcome comparison of calcium channel blockade with diuretics in high-risk patients aged 55 to 80 years. Dynamic randomization between nifedipine once daily and hydrochlorothiazide/amiloride was performed to ensure that approximately equal numbers of patients in the 2 groups had each of the major cardiovascular risk factors. Patients with isolated systolic hypertension were also separately randomized. Atenolol or enalapril was the mandatory second-line drug. In 5669 patients who completed the 18-week titration, BP fell from 172+/-15/99+/-9 mm Hg (mean+/-SD) while receiving placebo to 139+/-12/82+/-7 mm Hg. Twenty-six percent of patients required 2 drugs, and 4% required 3 drugs. Patients with diabetes were the most resistant to treatment, requiring second and third drugs 40% and 100% more frequently than patients without diabetes and achieving marginally the highest final BP, for any risk group, of 141+/-13/82+/-8 mm Hg. Age, smoking, gender, hypercholesterolemia, left ventricular hypertrophy, and existing atherosclerosis had little (<1 mm Hg) or no influence on BP at the end of titration, but all except smoking slightly reduced the initial response of either systolic or diastolic BP. Patients with isolated systolic hypertension were slightly more responsive than average to treatment. Our findings suggest that in patients at high absolute risk of cardiovascular complications from hypertension, the risk factors themselves do not prevent the recommended BP targets from being achieved.
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PMID:Influence of diabetes and type of hypertension on response to antihypertensive treatment. 1081 61