cardiovascular-agents and Constipation

Ranolazine is approved for patients with chronic stable angina but has not been formally studied in patients with refractory angina pectoris (RAP). Patients with RAP have limited therapeutic options and significant limitations in their quality of life. The Ranolazine Refractory Angina Registry was designed to evaluate the safety, tolerability, and effectiveness of ranolazine in RAP patients in order to expand treatment options for this challenging patient population. Using an extensive prospective database, we enrolled 158 consecutive patients evaluated in a dedicated RAP clinic. Angina class, medications, major adverse cardiac events including death, myocardial infarction, and revascularization were obtained at 12, 24, and 36 months. At 3 years, 95 (60%) patients remained on ranolazine. A ≥2 class improvement in angina was seen in 48% (38 of 80 patients with known Canadian Cardiovascular Society class) of those who remained on ranolazine. Discontinuation due to side effects, ineffectiveness, cost, and progression of disease were the principle reasons for discontinuation, but primarily occurred within the first year. In conclusion, ranolazine is an effective antianginal therapy at 3-year follow-up in patients with RAP and may reduce cardiac readmission.

Topics: Aged; Angina Pectoris; Cardiovascular Agents; Constipation; Deprescriptions; Diabetes Mellitus; Disease Progression; Dizziness; Drug Costs; Dyslipidemias; Edema; Female; Humans; Hypertension; Male; Medication Adherence; Middle Aged; Mortality; Myocardial Infarction; Myocardial Revascularization; Nausea; Ranolazine; Registries; Smoking; Treatment Failure; Treatment Outcome

Cardiovascular diseases are the first cause of death in elderly patients. So it seems important to estimate the adequacy of the medical prescriptions to the guidelines in this population and for these diseases. A retrospective analysis was performed in nine hospitals on 736 patients aged 65 years old and over hospitalized in the acute care geriatric unit. Cardiovascular prescribing were analyzed for each patient according to STOPP and START. The population (n=736) has a mean age of 86.7 years and belongs in 45.0% of the cases to the group of dependence GIR3-4. According to STOPP, two inappropriate prescriptions are noticed: calcium channel blockers with chronic constipation concerning 9% of the included population and aspirin at dose > 150 mg/day representing 8.4% of this population. According to START, angiotensin converting enzyme inhibitor are under-prescribed in elderly patients with heart failure (140 patients = 19.0% of the population) and following acute myocardial infarction (116 patients = 15.8%). Anticoagulation in patients with atrial fibrillation is also under-prescribed: 82 patients are concerned (11.0% of the population). The prescription of ACE inhibitor is influenced by renal insufficency in patients with heart failure. The anticoagulation in atrial fibrillation is age and dependence-related. This analysis demonstrates an inadequacy between the clinical practice and guidelines for two major cardiovascular diseases: the heart failure and the atrial fibrillation. The importance of the inadequacy was suspected of opportunities for improvement, in particular in the presence of their risk factors: very elderly patients, loss of autonomy and renal insufficiency.

Topics: Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors; Anticoagulants; Atrial Fibrillation; Calcium Channel Blockers; Cardiovascular Agents; Cardiovascular Diseases; Comorbidity; Constipation; Drug Utilization; Female; France; Guideline Adherence; Heart Failure; Humans; Hypertension; Inappropriate Prescribing; Male; Myocardial Infarction; Retrospective Studies

Topics: Adolescent; Cardiovascular Agents; Constipation; Geriatrics; Infant; Muscle Relaxants, Central; Sorbitol

Topics: Alcohols; Cardiovascular Agents; Constipation; Gastroenterology; Language; Muscle Relaxants, Central; Ocimum basilicum; Plants, Medicinal

Topics: Cardiovascular Agents; Constipation; Humans; Muscle Relaxants, Central

Topics: Administration, Rectal; Cardiovascular Agents; Cathartics; Constipation; Humans; Muscle Relaxants, Central; Pessaries; Suppositories

Twenty-one patients have been treated for hypertension with oral doses of hexamethonium salts, Apresoline(R) or combinations of both. Three of 18 patients had good or excellent response to hexamethonium alone. Five of 13 treated with hexamethonium salts plus Apresoline had good or excellent results, as did 8 of 14 treated with Apresoline alone. The addition of very small doses of hexamethonium chloride to optimal doses of Apresoline improved the effect of the Apresoline in three patients. Postural hypotension and constipation due to hexamethonium were the most serious undesirable effects.

Topics: Cardiovascular Agents; Constipation; Hexamethonium; Hydralazine; Hypertension; Hypotension, Orthostatic; Muscle Relaxants, Central; Salts; Sympatholytics

Topics: Atropine; Cardiovascular Agents; Constipation; Diphenylacetic Acids; Humans; Meperidine; Muscle Relaxants, Central; Sulfur Compounds

Topics: Cardiovascular Agents; Constipation; Diphenylacetic Acids; Humans; Muscle Relaxants, Central; Sulfur Compounds