Rodríguez Padial Luis, Barón-Esquivias Gonzalo, Hernández Madrid Antonio, Marzal Martín Domingo, Pallarés-Carratalá Vicente, de la Sierra Alejandro
Department of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain.
Department of Cardiology, University Hospital Virgen del Rocío, University of Sevilla, Seville, Spain.
Cardiol Ther. 2016 Jun;5(1):75-82. doi: 10.1007/s40119-016-0059-1. Epub 2016 Mar 25.
Cardiovascular diseases are the leading cause of death in the world. Coronary artery diseases, atrial fibrillation or hypertensive heart disease, are among the most important cardiovascular disorders. Hypertension represents a significant risk factor for cardiovascular mortality; thus, control of high blood pressure has become a priority to prevent major complications. Although the choice of drugs for treating hypertension remains controversial, extensive clinical evidences point to calcium channel blockers as first-line agents. Diltiazem, a non-dihydropyridine calcium channel blocker, is an effective and safe antihypertensive drug, alone or in combination with other agents. Diltiazem lowers myocardial oxygen demand through a reduction in heart rate, blood pressure, and cardiac contractility, representing also a good alternative for the treatment of stable chronic angina. Furthermore, diltiazem reduces conduction in atrioventricular node, which is also useful for heart rate control in patients with atrial fibrillation. In this review, clinical experts highlight studies on diltiazem effectiveness and safety for the treatment of several cardiovascular diseases and make evidence-based recommendations regarding the management of diltiazem in the clinical practice.
Lacer Spain.
心血管疾病是全球主要死因。冠状动脉疾病、心房颤动或高血压性心脏病是最重要的心血管疾病。高血压是心血管死亡的重要危险因素；因此，控制高血压已成为预防主要并发症的首要任务。尽管治疗高血压的药物选择仍存在争议，但大量临床证据表明钙通道阻滞剂是一线药物。地尔硫䓬，一种非二氢吡啶类钙通道阻滞剂，单独使用或与其他药物联合使用时都是一种有效且安全的抗高血压药物。地尔硫䓬通过降低心率、血压和心肌收缩力来降低心肌需氧量，也是治疗稳定型慢性心绞痛的良好选择。此外，地尔硫䓬可降低房室结传导，这对心房颤动患者的心率控制也很有用。在本综述中，临床专家强调了关于地尔硫䓬治疗几种心血管疾病有效性和安全性的研究，并就临床实践中地尔硫䓬的管理提出了基于证据的建议。
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