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Most-download articles are from the articles published in 2022 during the last three month.

Review Articles
Calcium channel blockers for hypertension: old, but still useful
Eun Mi Lee
Cardiovasc Prev Pharmacother. 2023;5(4):113-125.   Published online October 30, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e16
  • 6,516 View
  • 450 Download
  • 2 Citations
Abstract PDF
Calcium channel blockers (CCBs) constitute a heterogeneous class of drugs that can be divided into dihydropyridines (DHPs) and non-DHPs. DHP-CCBs are subcategorized into four generations based on the duration of activity and pharmacokinetics, while non-DHP-CCBs are subcategorized into phenylethylamine and benzodiazepine derivatives. DHP-CCBs are vascular-selective and function as potent vasodilators, whereas non-DHP-CCBs are cardiac-selective and are useful for treating tachyarrhythmia, but reduce cardiac contractility and heart rate. Traditional DHP-CCBs (nifedipine) mainly block L-type calcium channels, whereas novel CCBs block N-type (amlodipine) and/or T-type channels (efonidipine) in addition to L-type channels, leading to organ-protective effects. DHP-CCBs have a potent blood pressure–lowering effect and suppress atherosclerosis and coronary vasospasm. Diltiazem, a non-DHP-CCB, is highly effective for vasospasm control. CCBs reduce left ventricular hypertrophy and arterial stiffness. Amlodipine, a DHP-CCB, reduces blood pressure variability. L/N- and L/T-type CCBs combined with renin-angiotensin system blockers reduce proteinuria and improve kidney function compared with L-type CCBs. According to large-scale trials, DHP-CCBs reduce cardiovascular events in patients with isolated systolic hypertension, as well as in elderly and high-risk patients. Accordingly, CCBs are indicated for hypertension in elderly patients, isolated systolic hypertension, angina pectoris, and coronary vasospasm. Non-DHP-CCBs are contraindicated in high-grade heart block, bradycardia (<60 beats per minute [bpm]), and heart failure with reduced ejection fraction (HFrEF). DHP-CCBs should be used with caution in patients with tachyarrhythmia, HFrEF, and severe leg edema, and non-DHP-CCBs should be used carefully in those with constipation. Each CCB has distinct pharmacokinetics and side effects, underscoring the need for meticulous consideration in clinical practice.

Citations

Citations to this article as recorded by  
  • Design of Experimental Approach for Development of Rapid High Performance Liquid Chromatographic Process for Simultaneous Estimation of Metoprolol, Telmisartan, and Amlodipine from Formulation: Greenness and Whiteness Evaluation
    Mahesh Attimarad, Mohammed Jassim Alali, Hussain Ali Alali, Dana Hisham Alabdulmuhsin, Aljohara Khalid Alnajdi, Katharigatta Narayanaswamy Venugopala, Anroop B. Nair
    Molecules.2024; 29(5): 1087.     CrossRef
  • The Evolving Role of Calcium Channel Blockers in Hypertension Management: Pharmacological and Clinical Considerations
    Kamryn E. Jones, Shaun L. Hayden, Hannah R. Meyer, Jillian L. Sandoz, William H. Arata, Kylie Dufrene, Corrado Ballaera, Yair Lopez Torres, Patricia Griffin, Adam M. Kaye, Sahar Shekoohi, Alan D. Kaye
    Current Issues in Molecular Biology.2024; 46(7): 6315.     CrossRef
Decision-making for recurrent atrial fibrillation after catheter ablation
Jum Suk Ko, Sung Soo Kim, Hyung Ki Jeong, Nam Ho Kim
Cardiovasc Prev Pharmacother. 2023;5(4):102-112.   Published online October 27, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e15
  • 7,646 View
  • 194 Download
Abstract PDF
Catheter ablation for atrial fibrillation (AF), especially pulmonary vein (PV) isolation, is widely used for rhythm control. However, AF recurrence remains a challenge, affecting 20% to 50% of cases. This review focuses on AF recurrence after catheter ablation. AF recurrence can be categorized into early recurrence (ER) within 3 months after index procedure, late recurrence (LR) within 1 year, and very LR (VLR) occurring beyond 1 year. ER has emerged as a significant predictor of LR, contrary to the traditional understanding. LR is primarily caused by PV reconnection, while VLR more involves non-PV triggers or substrates. Managing AF recurrence includes antiarrhythmic drugs, steroids, colchicine, and repeat ablation. Antiarrhythmic drugs reduce ER but have a limited impact on LR. Steroids have been shown to reduce ER, but not long-term recurrence. Colchicine, an anti-inflammatory agent, shows promise in reducing both ER and LR, although further research is necessary. Whether to perform early repeat ablation after ER remains uncertain, as not all patients require immediate intervention. In conclusion, AF recurrence after ablation remains a complex issue. Understanding the underlying mechanisms is essential for personalized management. Tailored approaches, considering individual characteristics, are crucial for long-term success. Future research should focus on improving therapeutic strategies for AF recurrence.
Adverse effects of statin therapy and their treatment
Dae Young Cheon, Sang-Ho Jo
Cardiovasc Prev Pharmacother. 2022;4(1):1-6.   Published online January 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e4
  • 13,061 View
  • 509 Download
  • 2 Citations
Abstract PDF
Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.

Citations

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  • The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients
    Roxana Nartea, Brindusa Ilinca Mitoiu, Ioana Ghiorghiu
    Current Issues in Molecular Biology.2023; 45(4): 3146.     CrossRef
  • The effects of L-carnitine in reducing hepatotoxicity of statins in rats
    Doaa Ibrahim, Shahad Bader, Omar Bader
    Medicinski casopis.2023; 57(3): 59.     CrossRef
Optimal target blood pressure in older patients with hypertension
Kwang-il Kim
Cardiovasc Prev Pharmacother. 2023;5(2):41-48.   Published online April 24, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e4
  • 3,814 View
  • 211 Download
Abstract PDF
Hypertension is a common condition among older adults, and blood pressure (BP) control is effective for preventing cardiovascular morbidity and mortality even among the oldest-old adults. However, the optimal target BP for older patients with hypertension has been a subject of debate, with previous clinical trials providing conflicting evidence. Determining the optimal target BP for older adults is a complex issue that requires considering comorbidities, frailty, quality of life, and goals of care. As such, BP targets should be individualized based on each patient's unique health status and risk factors, and treatment should be closely monitored to ensure that it is effective and well-tolerated. The benefits and risks of intensive BP control should be carefully weighed in the context of the patient's overall health status and treatment goals. Ultimately, the decision to pursue intensive BP control should be made through shared decision-making between patients and their healthcare providers.
Recent evidence on target blood pressure in patients with hypertension
Hack-Lyoung Kim
Cardiovasc Prev Pharmacother. 2024;6(1):17-25.   Published online January 22, 2024
DOI: https://doi.org/10.36011/cpp.2024.6.e3
  • 1,247 View
  • 54 Download
Abstract PDF
Hypertension is a significant risk factor for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral arterial disease. Achieving and maintaining a specific target blood pressure (BP) is crucial for effectively reducing the risk associated with these conditions. This involves customizing treatments to meet the individual needs of patients with hypertension, ensuring that each person receives the most appropriate care for their particular circumstances. Previously, based on the findings from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study conducted over the past decade, the target BP for patients with hypertension was set at <140/90 mmHg, regardless of the patient's risk profile. However, new insights from reanalyzed data of studies such as the SPRINT (Systolic Blood Pressure Intervention Trial), the STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) study, and ACCORD subgroup reanalysis have led to a change in this approach. These studies support a more aggressive target BP of <130/80 mmHg, especially for high-risk patients. The purpose of this article is to offer a thorough review of these updated recommendations and to explain the reasoning behind the revised target BP guidelines for individuals with hypertension.
Diabetes mellitus and cancer
Jae Won Hong
Cardiovasc Prev Pharmacother. 2023;5(3):69-73.   Published online July 27, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e9
  • 2,538 View
  • 82 Download
Abstract PDF
Diabetes mellitus and cancer are the most common life-threatening illnesses worldwide. Previous epidemiological studies have suggested a strong association between diabetes mellitus and an increased risk of cancer. Potential biological mechanisms underlying this relationship include obesity, hyperglycemia, hyperinsulinemia, chronic inflammation, and oxidative stress. The most common diabetes-related cancers are pancreatic, hepatocellular, breast, endometrial, and colorectal cancer. Special attention should be paid to patients with diabetes through careful cancer screening and preventive anticancer strategies.
Adverse reactions to antiarrhythmic drugs
Ungjeong Do
Cardiovasc Prev Pharmacother. 2023;5(1):1-14.   Published online January 16, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e1
  • 65,535 View
  • 223 Download
Abstract PDF
There are various types of adverse reactions to antiarrhythmic drugs (AADs). Proarrhythmia, which refers to an exacerbation of the preexisting arrhythmia or occurrence of a new arrhythmia, may occur under the therapeutic concentration of an AAD. Bradyarrhythmia is the most common type of proarrhythmia due to AADs, and prior myocardial infarction and old age are known risk factors. Atrial flutter with 1:1 atrioventricular conduction usually occurs during rhythm control of atrial fibrillation with class IC AADs. QT prolongation due to AADs, mainly class III AADs, elevates the risk of torsade de pointes by triggered activity due to early afterdepolarization. The addition of clinical factors that promote QT prolongation, such as hypokalemia, hypomagnesemia, female sex, and bradycardia, increases the risk of developing torsade de pointes. Proarrhythmic monomorphic ventricular tachycardia usually occurs as a result of slow conduction and disparity of refractoriness due to class IC AADs. In patients with preexisting left ventricular systolic dysfunction or structural heart disease, the risk of hypotension or cardiogenic shock caused by negative inotropic effects due to AADs should be considered. To prevent these major adverse reactions to AADs, we need to understand the electrophysiologic properties of AADs in detail. Furthermore, the risk of proarrhythmia could be heightened by interplay with clinical factors, such as electrolyte unbalances, heart rate, and hepatic/renal or myocardial dysfunction. Sufficient awareness about drug-drug interactions, which may affect the metabolism of AADs, will improve patient safety during the management of arrhythmia.
The emergence and clinical significance of artificial intelligence–enhanced electrocardiography
Yong-Soo Baek
Cardiovasc Prev Pharmacother. 2024;6(2):41-47.   Published online April 26, 2024
DOI: https://doi.org/10.36011/cpp.2024.6.e7
  • 1,165 View
  • 18 Download
Abstract PDF
The integration of artificial intelligence (AI) with electrocardiography (ECG), a technology known as AI-ECG, represents a transformative leap in the field of cardiovascular medicine. This innovative approach has significantly advanced the capabilities of ECG, traditionally used for diagnosing heart diseases. AI-ECG excels in detecting subtle changes and interconnected patterns in cardiac waveforms, offering a level of precision and sensitivity that was previously unattainable with conventional methods. The scope of AI-ECG extends beyond the realm of heart diseases. It has shown remarkable potential in predicting and identifying the impacts of noncardiac conditions on heart health, thereby broadening the diagnostic capabilities of ECG. This is especially valuable given the complex nature of cardiovascular diseases and their interactions with other health conditions. Despite its groundbreaking potential, AI-ECG faces several challenges. One of the primary concerns is the "black box" nature of AI algorithms, which can make the decision-making process opaque and difficult to interpret. This poses a challenge in medical settings where understanding the rationale behind a diagnosis is crucial. Additionally, the effectiveness of AI-ECG is dependent on the quality and diversity of the datasets used to train the algorithms. Limited or biased datasets can lead to inaccuracies and diminish the reliability of the technology. However, the benefits of AI-ECG are significant. It enables faster, more accurate diagnoses and has the potential to greatly enhance the efficiency of cardiovascular care. As research and technology continue to evolve, AI-ECG is poised to become an indispensable tool in the diagnosis and management of heart diseases.
Original Article
Cardiovascular risk assessment of newborns in Nigeria using the atherogenic index of plasma and its associations with gestational age and birth weight: a cross-sectional hospital-based study
Obinna Victory Obaji, Uche Charles Adizua, Ndubuisi Kennedy Chukwudi, Daberechi Kenneth Adiele, Justus Uchenna Onu
Cardiovasc Prev Pharmacother. 2024;6(2):65-73.   Published online April 26, 2024
DOI: https://doi.org/10.36011/cpp.2024.6.e9
  • 1,187 View
  • 26 Download
Abstract PDF
Background
The prevalence of atherosclerotic cardiovascular disease is rising, and its onset from childhood is widely studied. Prematurity and low birth weight were associated with higher atherogenic risk when assessed using some lipid ratios. However, the atherogenic index of plasma (AIP), a sensitive marker for atherosclerosis is understudied in newborns. Utilizing AIP, this study aimed to determine atherogenic risk prevalence among newborns and its association with gestational age and birth weight.
Methods
Newborns were consecutively recruited, and their lipid profiles were determined. The AIP was calculated as the logarithm to base 10 (log10) of the ratio of molar concentrations of triglyceride to high-density lipoprotein cholesterol. The atherogenic risk was operationalized using AIP: high, >0.24; medium, 0.1–0.24; and low/no risk, <0.1. The relationship between AIP values, gestational age, and birth weight was analyzed using Pearson correlation.
Results
The mean AIP of the 167 newborns studied was –0.35±0.34, which is within the global reference range. Three (1.8%), 10 (6.0%), and 154 (92.2%) newborns were in the high, medium, and low/no atherogenic risk categories, respectively. Hence, 13 newborns (7.8%) had medium to high atherogenic risk. AIP had a moderate significantly positive relationship only with gestational age (r=0.35, P<0.001).
Conclusions
The study found an atherogenic risk prevalence of 7.8% using AIP in newborns which, contrary to previous studies that used other ratios, has no significant association with birth weight, correlating positively with gestational age, though is lowest in late preterms. Follow-up studies will elucidate these findings.
Review Articles
Blood pressure control in hypertensive disorders of pregnancy
Helsi Rismiati, Hae-Young Lee
Cardiovasc Prev Pharmacother. 2022;4(3):99-105.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e16
  • 3,949 View
  • 160 Download
  • 1 Citations
Abstract PDF
Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.

Citations

Citations to this article as recorded by  
  • Combined Effects of Methyldopa and Baicalein or Scutellaria baicalensis Roots Extract on Blood Pressure, Heart Rate, and Expression of Inflammatory and Vascular Disease-Related Factors in Spontaneously Hypertensive Pregnant Rats
    Michał Szulc, Radosław Kujawski, Przemysław Ł. Mikołajczak, Anna Bogacz, Marlena Wolek, Aleksandra Górska, Kamila Czora-Poczwardowska, Marcin Ożarowski, Agnieszka Gryszczyńska, Justyna Baraniak, Małgorzata Kania-Dobrowolska, Artur Adamczak, Ewa Iwańczyk-S
    Pharmaceuticals.2022; 15(11): 1342.     CrossRef
The crosstalk between insulin resistance and nonalcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease: a culprit or a consequence?
Dae-Jeong Koo, Won-Young Lee
Cardiovasc Prev Pharmacother. 2022;4(4):132-141.   Published online October 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e17
  • 2,851 View
  • 68 Download
  • 1 Citations
Abstract PDF
Nonalcoholic fatty liver disease (NAFLD), which has recently undergone a change in its definition and acronym to “metabolic dysfunction associated fatty liver disease (MAFLD),” is clinically significant as an increasingly prevalent independent risk factor for cardiovascular diseases. Insulin resistance is considered to be a key mechanism in the development and progression of NAFLD/MAFLD, and fatty liver disease itself may exacerbate insulin resistance. In this review, we describe the mechanisms underlying the interaction between insulin resistance and fatty liver, and we summarize the therapeutic attempts based on those mechanisms.

Citations

Citations to this article as recorded by  
  • Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective
    Inha Jung, Dae-Jeong Koo, Won-Young Lee
    Diabetes & Metabolism Journal.2024; 48(3): 327.     CrossRef
Cardiovascular diseases in HIV patients
Hyun-Ha Chang
Cardiovasc Prev Pharmacother. 2022;4(3):95-98.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e14
  • 2,249 View
  • 66 Download
Abstract PDF
New and more effective antiretroviral therapy regimens have increased viral suppression and improved immune function recovery, leading to the extension of the lifespan of people living with HIV (PLWH). The extended lifespan of PLWH has recently been reported as a significant factor associated with diabetes mellitus, dyslipidemia, and long-term metabolic consequences, such as cardiovascular diseases. Therefore, this article briefly reviews the epidemiology and risk factors of cardiovascular diseases, including dyslipidemia and diabetes mellitus, in PLWH.
Lipid variability in patients with diabetes mellitus
Jeongmin Lee, Seung-Hwan Lee
Cardiovasc Prev Pharmacother. 2023;5(4):126-133.   Published online October 25, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e18
  • 1,573 View
  • 68 Download
Abstract PDF
Diabetic dyslipidemia is characterized by hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), elevated low-density lipoprotein cholesterol (LDL-C), and the predominance of small dense LDL particles caused by insulin resistance in patients with type 2 diabetes mellitus (DM) or insulin deficiency in patients with type 1 DM. Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease in individuals with DM, and lowering lipid levels can reduce the associated morbidity and mortality. The current guidelines for dyslipidemia management recommend an LDL-C goal lower than 55 to 100 mg/dL, depending on the underlying risk factors. However, greater visit-to-visit variability in cholesterol levels might be an independent predictor of major adverse cardiovascular events, high incidence of atrial fibrillation, poor renal outcomes, and cognitive dysfunction in patients with DM. This review focuses on the clinical implications of lipid variability in patients with DM.
Original Article
Modifiable risk factors for coronary artery disease in the Indonesian population: a nested case-control study
Anggoro Budi Hartopo, Maria Patricia Inggriani, Brilliant Winona Jhundy, Jajah Fachiroh, Putri Tiara Rosha, Ratri Kusuma Wardani, Fatwa Sari Tetra Dewi
Cardiovasc Prev Pharmacother. 2023;5(1):24-34.   Published online January 31, 2023
DOI: https://doi.org/10.36011/cpp.2023.5.e3
  • 2,472 View
  • 96 Download
Abstract PDF
Background
There is a lack of data on modifiable coronary artery disease (CAD) risk factors in the Indonesian population, hindering the implementation of assessments and prevention programs in this population. This study investigated modifiable risk factors for CAD among Indonesians by comparing them between CAD-proven patients and healthy subjects from a similar population.
Methods
In this nested, matched case-control study, the cases were patients from a referral hospital in Yogyakarta, Indonesia and the controls were respondents in a population surveillance system in Yogyakarta, Indonesia. The cases were 421 patients who had undergone coronary angiography, showing significant CAD. The sex- and age-matched controls were 842 respondents from the Universitas Gadjah Mada Health and Health and Demographic Surveillance System Sleman who indicated no CAD presence on a questionnaire. The modifiable CAD risk factors compared between cases and controls were diabetes mellitus, hypertension, central obesity, smoking history, physical inactivity, and less fruit and vegetable intake. A multivariate regression model was applied to determine independent modifiable risk factors for CAD, expressed as adjusted odds ratios (AORs).
Results
A multivariate analysis model of 1,263 subjects including all modifiable risk factors indicated that diabetes mellitus (AOR, 3.32; 95% confidence interval [CI], 2.09–5.28), hypertension (AOR, 2.52; 95% CI, 1.76–3.60), former smoking (AOR, 4.18; 95% CI, 2.73–6.39), physical inactivity (AOR, 15.91; 95% CI, 10.13–24.99), and less fruit and vegetable intake (AOR, 5.42; 95% CI, 2.84–10.34) independently and significantly emerged as risk factors for CAD.
Conclusions
Hypertension, diabetes mellitus, former smoking, physical inactivity, and less fruit and vegetable intake were independent and significant modifiable risk factors for CAD in the Indonesian population.
Review Article
Expectations and concerns regarding medical advertisements via large commercial medical platform advertising companies: a legal perspective
Raeun Kim, Hakyoung Park, Jiwon Shinn, Hun-Sung Kim
Cardiovasc Prev Pharmacother. 2024;6(2):48-56.   Published online April 26, 2024
DOI: https://doi.org/10.36011/cpp.2024.6.e8
  • 1,142 View
  • 12 Download
Abstract PDF
Advertising in the medical and legal fields, which are among Korea's leading professions, has increasingly utilized major advertising platforms such as LawTalk and UNNI—two of the most prominent and contentious platforms in their respective fields. While it is generally unproblematic for professionals like lawyers and doctors to promote public interest through advertising on these commercial platforms, the creation of a profit-driven structure has the potential to undermine their professional ecosystems. This article explores the issues associated with advertising in the medical field through large commercial platforms, drawing on notable examples from the legal and medical fields in Korea. Specifically, we analyze two of the most popular yet controversial platforms in these sectors, LawTalk and UNNI. In Korea, the format and method of advertising are legal as long as they do not involve referring or soliciting clients, thereby making platform advertising lawful when used solely for that purpose. Nevertheless, it is crucial to prevent medical advertising platforms from establishing market monopolies by skirting various profit regulations and laws. In response to these concerns, the Korean Bar Association has prohibited all advertisements by platform companies. The medical community should closely examine the rationale and process behind this decision. Given the significant social influence of large corporate platforms and the unique social responsibilities of the medical and legal professions, future platform advertising should be subject to distinct legal and institutional regulations that differ from those applied to general services.

CPP : Cardiovascular Prevention and Pharmacotherapy