1.Would male hormonal contraceptives affect cardiovascular risk?
Asian Journal of Andrology 2018;20(2):145-148
The aim of hormonal male contraception is to prevent unintended pregnancies by suppressing spermatogenesis. Hormonal male contraception is based on the principle that exogenous administration of androgens and other hormones such as progestins suppress circulating gonadotropin concentrations, decreasing testicular Leydig cell and Sertoli cell activity and spermatogenesis. In order to achieve more complete suppression of circulating gonadotropins and spermatogenesis, a progestin has been added testosterone to the most recent efficacy trials of hormonal male contraceptives. This review focusses on the potential effects of male hormonal contraceptives on cardiovascular risk factors, lipids and body composition, mainly in the target group of younger to middle-aged men. Present data suggest that hormonal male contraception can be reasonably regarded as safe in terms of cardiovascular risk. However, as all trials have been relatively short (< 3 years), a final statement regarding the cardiovascular safety of hormonal male contraception, especially in long-term use, cannot be made. Older men with at high risk of cardiovascular event might not be good candidates for hormonal male contraception. The potential adverse effects of hormonal contraceptives on cardiovascular risk appear to depend greatly on the choice of the progestin in regimens for hormonal male contraceptives. In the development of prospective hormonal male contraception, data on longer-term cardiovascular safety will be essential.
Age Factors
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Androgens/therapeutic use*
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Antispermatogenic Agents
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Cardiovascular Diseases/epidemiology*
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Contraceptive Agents, Male/therapeutic use*
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Gonadotropins/metabolism*
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Humans
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Male
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Progestins/therapeutic use*
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Testosterone/therapeutic use*
2.Association between common cardiovascular drugs and depression.
Shu-Hui TAO ; Xue-Qun REN ; Li-Jun ZHANG ; Mei-Yan LIU
Chinese Medical Journal 2021;134(22):2656-2665
OBJECTIVE:
Cardiovascular diseases are associated with an increased risk of depression, but it remains unclear whether treatment with cardiovascular agents decreases or increases this risk. The effects of drugs on individual usage are also often unknown. This review aimed to examine the correlation between depression and common cardiovascular drugs, develop more potent interventions for depression in cardiovascular patients, and further research on the bio-behavioural mechanisms linking cardiovascular drugs to depression.
DATA SOURCES:
The data in this review were obtained from articles included in PubMed, EMBASE, and Web of Science.
STUDY SELECTION:
Clinical trials, observational studies, review literature, and guidelines about depression and cardiovascular drugs were selected for the article.
RESULTS:
We systematically investigated whether the seven most used cardiovascular drugs were associated with altered risk of incident depression in this literature review. Statins have been proven to have antidepressant effects. Some studies believe angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARB) can exert an antidepressant influence by acting on the renin-angiotensin system, but further clinical trials are needed to confirm this. Beta-blockers have previously been associated with depression, but the current study found no significant association between beta blockers and the risk of depression. Aspirin may have antidepressant effects by suppressing the immune response, but its role as an antidepressant remains controversial. calcium channel blockers (CCBs) can regulate nerve signal transduction by adjusting calcium channels, but whether this effect is beneficial or harmful to depression remains unclear. Finally, some cases have reported that nitrates and diuretics are associated with depression, but the current clinical evidence is insufficient.
CONCLUSIONS
Statins have been proven to have antidepressant effect, and the antidepressant effects of ACEIs/ARB and aspirin are still controversial. CCBs are associated with depression, but it is unclear whether it is beneficial or harmful. No association has been found with β-blockers, diuretics, and nitrates.
Angiotensin Receptor Antagonists/therapeutic use*
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Angiotensin-Converting Enzyme Inhibitors/therapeutic use*
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Antihypertensive Agents/therapeutic use*
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Calcium Channel Blockers/therapeutic use*
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Cardiovascular Agents/therapeutic use*
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Cardiovascular Diseases/drug therapy*
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Depression/drug therapy*
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Humans
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Hypertension/drug therapy*
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Renin-Angiotensin System
3.Re-evaluation of marketed chemical drugs and biological products of therapeutic - a systematic review of literature.
Qing LI ; Min YAN ; Ye WU ; Lin-bin WU ; Ya-ming YUAN ; Chang-kai YAN ; Lu-yuan SHI ; Fan-dian ZENG
Chinese Journal of Epidemiology 2004;25(5):435-438
OBJECTIVETo assess the current status on re-evaluation of marketed drug in China since the promulgation of drug law in 1985.
METHODSReview of literature on Chinese pharmaceutical abstract and CBMdisc from 1985 to 2001 year was done.
RESULTS4029 papers and 855 marketed drugs from 1985 to 2001 were included. Drugs on anti-infection agent, cardiovascular system and digestive system were the main drugs being re-evaluated, with the proportions of 27.1%, 20.1% and 11.1% respectively. The amounts of both marketed drugs and literature were increasing year by year. The method used for re-evaluation were random and non-random clinical trial. 41.4% of all the samples had a sample size of 50 - 100 research subjects. There were 13 papers with more than 5000 samples. The level on evidence based literature was assessed. 44 papers were graded as first class, and 182 papers the second, 2466 papers the third and 1337 papers the fourth. The quality of literature was improved year by year.
CONCLUSIONThe amount, quality as well as the sample size of literature being re-evaluated on marketed drug were increased from 1985 to 2001. However, the design and evaluation of those trials were not standardized.
Anti-Infective Agents ; therapeutic use ; Biological Products ; therapeutic use ; Cardiovascular Agents ; therapeutic use ; China ; Clinical Trials as Topic ; Cost-Benefit Analysis ; Evidence-Based Medicine ; Humans ; Product Surveillance, Postmarketing
5.Risk of cardiovascular disease and all-cause mortality among diabetic patients prescribed rosiglitazone or pioglitazone: a meta-analysis of retrospective cohort studies.
Xin CHEN ; Li YANG ; Suo-di ZHAI
Chinese Medical Journal 2012;125(23):4301-4306
BACKGROUNDThe difference of cardiovascular effects between rosiglitazone and pioglitazone treatment for diabetic patients has not been thoroughly studied. We performed a meta-analysis to compare the risk of cardiovascular adverse effects in patients with type 2 diabetes treated with rosiglitazone compared to pioglitazone.
METHODSThe Cochrane Library, PubMed, and Embase were searched to identify retrospective cohort studies assessing cardiovascular outcomes with rosiglitazone and pioglitazone. Meta-analysis of retrospective cohort studies was conducted using RevMan 5.0 software to calculate risk ratios.
RESULTSOf the 74 references identified, eight studies involving 945 286 patients fit the inclusion criteria for the analysis. The results of meta-analyses showed that, compared with pioglitazone, rosiglitazone therapy significantly increased the risk of myocardial infarction (risk ratios (RR) 1.17, 95% confidence interval (CI) 1.04 - 1.32; P = 0.01), the risk of heart failure (RR 1.18, 95%CI 1.02 - 1.36; P = 0.03), and total mortality (RR 1.13, 95%CI 1.08 - 1.20; P < 0.000 01).
CONCLUSIONCompared with pioglitazone, rosiglitazone was associated with an increased risk of myocardial infarction, heart failure, and all-cause mortality in diabetic patients.
Cardiovascular Diseases ; epidemiology ; Diabetes Mellitus ; drug therapy ; epidemiology ; mortality ; Humans ; Hypoglycemic Agents ; therapeutic use ; Retrospective Studies ; Thiazolidinediones ; therapeutic use
7.Clinical observation of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in patients with acute heart failure.
Ming YE ; Xin WANG ; Yue SUN ; Ji HUANG ; Yu Jie ZENG ; Hai GAO
Chinese Journal of Internal Medicine 2023;62(4):422-426
Objective: To observe the clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in acute left heart failure patients 7 days after onset as well as the effects of plasma MDA and ET-1. Methods: In total, 240 hospitalized patients with acute left heart failure from October 2017 to May 2021 were selected from the Department of Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University and the Department of Cardiology of the Jilin Provincial People's Hospital. They were randomly divided into routine treatment group and combined treatment group, with 120 cases in each group. The routine treatment group was treated with vasodilation, diuresis, cardiotonic and recombinant human brain natriuretic peptide. The combined treatment group was treated with Qiliqiangxin capsules based on the routine treatment group. One week later, the changes in clinical efficacy, ejection fraction, left ventricular commoid diameter, and plasma BNP, MDA, and ET-1 were compared between the two groups before and after treatment. SPSS 11.5 statistical software was used. The measurement data was expressed in x¯±s, the independent sample t-test was used for comparison between groups, and the paired t-test was used for comparison before and after treatment within groups. Counting data was expressed as case (%), and the rank sum test was used for inter-group comparison. Result: In terms of clinical efficacy, the total effective rate of the combined treatment group was significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05). Compared with the routine treatment group, the left ventricular ejection fraction in the combined treatment group was significantly increased (P<0.05). The levels of plasma BNP, MDA and ET-1 were significantly decreased (P<0.05). Conclusion: Qiliqiangxin capsule combined with rhBNP treatment can effectively improve the clinical symptoms of acute heart failure, as well as reduce the lipid peroxidation product MDA content and endothetin ET-1 level in blood. The clinical application value of the Qiliqiangxin capsule needs to be further confirmed by further trials.
Humans
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Heart Failure/physiopathology*
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Natriuretic Peptide, Brain/therapeutic use*
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Stroke Volume/physiology*
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Ventricular Function, Left/physiology*
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Cardiotonic Agents/therapeutic use*
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Drugs, Chinese Herbal/therapeutic use*
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Recombinant Proteins/therapeutic use*
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Cardiovascular Agents/therapeutic use*
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Drug Therapy, Combination
9.Ion channel therapy of ischemic heart disease.
Chinese Journal of Cardiology 2012;40(3):254-255
Basic studies have shown a variety of ion channels are involved in the pathogenesis of ischemic heart disease, including L type Ca(2+) channel, T type Ca(2+) channel, ATP-sensitive potassium channel, If (funny) channel and late Na(+) channel. Clinical studies showed that the regulation of these channels function can improve myocardial blood supply and metabolism of myocardium. What is summarized below relates to the clinical usefulness of various ion channel antagonists reviewed by a clinical cardiologist, not a basic scientist working on ion channel biology.
Cardiovascular Agents
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therapeutic use
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Humans
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Ion Channels
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antagonists & inhibitors
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Myocardial Ischemia
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drug therapy