Effects of chlorthalidone and diltiazem on myocardial ischemia in elderly patients with hypertension and coronary artery disease.
Arq Bras Cardiol
; 76(4): 268-72, 2001 Apr.
Article
em En
| MEDLINE
| ID: mdl-11323730
ABSTRACT
OBJECTIVE:
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diltiazem
/
Clortalidona
/
Isquemia Miocárdica
/
Diuréticos
/
Hipertensão
/
Anti-Hipertensivos
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Guideline
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2001
Tipo de documento:
Article