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J Lenis

Publications and source records attributed to J Lenis.

10 recordsLinked to original sources

Clinical efficacy and safety of once-daily diltiazem in patients with stable angina pectoris switched from twice-daily diltiazem.

The maintenance of angina control was assessed in this multicenter (three sites), randomized, double-blind, parallel-group study. Patients with stable angina pectoris receiving twice-daily sustained-release (SR) diltiazem were switched to equivalent doses of once-daily controlled-delivery (CD) diltiazem or to diltiazem SR. Patients who were switched from diltiazem SR to diltiazem CD (n = 28) experienced a 5% increase in time to termination (p = 0.0004) on the exercise tolerance test (ETT), as well as an 8% improvement in time to onset of angina (p < 0.0001) on the ETT. A similar trend was observed in patients randomized to diltiazem SR (n = 7), which suggested a training effect, and, therefore, equal efficacy between diltiazem SR and diltiazem CD. During exercise testing in the diltiazem SR baseline phase, 77% of the patients did not experience angina, whereas 60% of the patients did not experience ST-segment depression. Following transfer to diltiazem CD, 79 and 61% of patients, respectively, remained angina- and ST-segment depression free. No significant changes in the number of angina attacks, nitroglycerin use, or any hemodynamic-related parameters were observed following transfer to diltiazem CD. Eleven percent of the patients receiving diltiazem CD experienced treatment-related adverse events, which were limited to headache and abdominal pain; these adverse events did not lead to discontinuation of treatment. These findings suggest that patients whose angina is controlled with twice-daily diltiazem SR can be safely and effectively switched to an equivalent daily dose of the once-daily diltiazem CD.

Aged

Treatment of mild-to-moderate hypertension: comparison between a calcium-channel blocker and a potassium-sparing diuretic.

In a multicenter study, 61 patients, 18-70 years of age, with mild-to-moderate hypertension [diastolic blood pressure (DBP) 95/114] completed a 28-week treatment. After initial placebo washout, patients were randomly allocated either to diltiazem or hydrochlorothiazide/triamterene. At the end of 12 weeks, the patients continued on the same medication if their goal blood pressure achieved (DBP less than 90; or 10 mm Hg below baseline). If not, the alternate agent was added (either diltiazem + hydrochlorothiazide/triamterene or hydrochlorothiazide/triamterene + diltiazem). At the end of 28 weeks, the intent-to-treat analysis showed that 90% on diltiazem alone, 73.7% on hydrochlorothiazide/triamterene alone, 71.4% on (diltiazem + hydrochlorothiazide/triamterene), and 57.1% on (hydrochlorothiazide/triamterene + diltiazem) achieved goal BP. End point mean values of BP and heart rate after adjusting for sex, baseline values, age, and weight showed no significant difference between groups. Forty-six percent on hydrochlorothiazide/triamterene alone and 24% on diltiazem alone reported one or more adverse events, possibly related to study medication. Patients with diltiazem as the first choice had better BP control than those on hydrochlorothiazide/triamterene alone (81.5% vs. 69.7%). Furthermore, among non-goal achievers at week 12, there was a greater response in the group when hydrochlorothiazide/triamterene was added to diltiazem than when diltiazem was added to hydrochlorothiazide/triamterene. This study suggests that in mild-to-moderate hypertension, diltiazem is better than hydrochlorothiazide/triamterene as first line therapy.

Adolescent

Secondary prevention of coronary events after myocardial infarction. Beta-blockers and/or anti-platelets: to whom, when and for how long. A review.

The institution of a "Cardioprophylactic" drug regimen after myocardial infarction should take into consideration the concept of high or low risk patients for secondary coronary events and the concept of a decremential mortality rate as time elapses after myocardial infarction. Thus, the efficacy of a particular drug in preventing secondary coronary events may vary with the time elapsed from infarction and thus with the underlying patho-physiologic mechanism. Furthermore, the administration of a possible effective or proven effective "Cardioprophylactic" drug or drug regimen at a specific time from infarction must take into account the balance between expected benefit and untoward side effects.

Adrenergic beta-Antagonists

Danger at work.

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Education, Nursing

Comparison of the short-term efficacy and tolerability of lovastatin and pravastatin in the management of primary hypercholesterolemia.

Few data are available on the relative efficacy and tolerability of lovastatin and pravastatin, two 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, currently available in North America for treatment of hypercholesterolemia. The recommended starting dose is 20 mg QD with the evening meal for lovastatin. The recommended starting dose is 10 mg or 20 mg once daily at bedtime for pravastatin. In a double blind, double placebo, multicenter, randomized study, we compared the changes in plasma lipids and apolipoproteins in 217 patients with primary hypercholesterolemia treated for eight weeks with lovastatin 20 mg QD to pravastatin 10 mg QD or pravastatin 20 mg QD. The reductions in total cholesterol (TC) (21%), low-density lipoprotein cholesterol (LDL-C) (28%), and apolipoprotein B (apo B) (22%) were comparable for the lovastatin 20-mg and pravastatin 20-mg groups. Lovastatin 20 mg QD was significantly more effective than pravastatin 10 mg QD in lowering TC and LDL-C after four weeks of therapy and in the reduction of apo B after four and eight weeks of therapy. At the end of eight weeks of therapy, the mean reductions in TC and LDL-C were numerically greater with lovastatin 20 mg QD compared with pravastatin 10 mg QD, but the differences were not statistically significant. At the end of eight weeks, there was no difference between pravastatin 20 mg and pravastatin 10 mg in lowering TC and LDL-C. The frequency of overall side effects, including central nervous system-related symptoms and headache, was similar and low in all groups.

Adolescent

Treatment of stable angina pectoris with calcium antagonists alone or combined with beta-blocking agents: a review of the literature.

The calcium antagonists are presently accepted as the treatment of choice for vasospastic angina. They are accepted by some as a good second choice therapy in the treatment of stable angina pectoris, while by others as an excellent first choice in its treatment. When introduced to the North American market, warning was given of the risk of left ventricular failure and/or atrioventricular block from their combination with beta-blockers. Perhaps now a deeper knowledge of their hemodynamic and electrophysiologic properties allows us to conceptualize potent and safe anti-anginal associations by use, in specific patients, of differing combinations. Thus we must learn to use with care and flair this new form of treatment which offers our severely afflicted patients much greater symptomatic relief.

Adrenergic beta-Antagonists