Cardiology medications

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Cardiology Medications: A Comprehensive Overview

Cardiovascular Drugs with Anticancer Properties

Repurposing Cardiovascular Drugs for Cancer Treatment

Recent research has highlighted the potential anticancer properties of several cardiovascular drugs. These include angiotensin-converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs), beta-blockers, statins, and heparins. These drugs have shown promise in attenuating cancer development through various mechanisms. For instance, renin-angiotensin system inhibitors reduce inflammation, angiogenesis, and immunosuppression, while beta-blockers repress migration and metastasis. Heparins decrease metastasis, and statins influence cell growth, apoptosis, migration, and angiogenesis . However, despite these promising findings, more clinical data is needed to establish strong indications for their repurposing in oncology.

Traditional Chinese Medication (TCM) in Cardiovascular Disease

Efficacy and Safety of TCM

Traditional Chinese medication (TCM) is increasingly used to treat cardiovascular diseases (CVD) in China and other Asian countries. A review of 68 randomized controlled trials (RCTs) involving 16,171 patients found that TCM was associated with significant improvements in surrogate endpoints for hypertension, coronary heart disease, cardiac arrhythmias, and heart failure. However, the methodological quality of these trials was generally low, and only a few reported adverse cardiovascular events. The risk of adverse effects was not increased compared to no intervention, placebo, or Western medications. Nonetheless, the effectiveness of TCM in reducing all-cause or cardiovascular mortality remains unknown and requires further large-scale RCTs.

Cardiovascular Drug Therapy in Elderly Patients

Age-Related Pharmacokinetic and Pharmacodynamic Effects

The aging population has led to an increased number of elderly patients receiving cardiovascular drugs for both acute and chronic conditions. Traditionally, these patients had significant organ impairments that influenced drug pharmacokinetics and pharmacodynamics. However, many elderly patients now receive cardiovascular therapy for primary or early secondary prevention without significant organ impairment. Despite this, there is limited evidence on the specific age-related effects of these drugs, particularly for patients over 80 years old. This gap in knowledge raises concerns about the correct use of cardiovascular drugs in this growing population.

Psychiatric Aspects of Cardiological Drugs

Mental Health Implications

Cardiological drugs, such as beta-blockers, calcium channel blockers, ACE inhibitors, ARBs, nitrates, cilostazol, amiodarone, and clonidine, can significantly impact mental health. Beta-blockers, for example, have been noted for their therapeutic importance in conditions like PTSD and stage fright. Although previously believed to worsen depression, recent research contradicts this, suggesting potential benefits in treating depression. Calcium channel blockers also play a role in regulating mood in bipolar disorder. Thus, many cardiac drugs can influence psychiatric conditions, making their use clinically desirable in patients with both cardiac and psychiatric issues.

Drug-Drug Interactions in Onco-Cardiology

Managing Polypharmacy in Cancer and Cardiovascular Disease

Patients with coexisting cardiovascular diseases and cancer often face drug-drug interactions (DDIs) due to polypharmacy. Common etiologic factors like smoking and obesity contribute to the coexistence of these conditions. Multidisciplinary collaboration between oncologists and cardiologists is crucial to manage these interactions and reduce serious morbidity and mortality. Awareness and preventive approaches to DDIs can significantly improve patient outcomes.

Cardiovascular Effects of Doping Substances and Ergogenic Aids

Risks in Sports and Physical Activity

The use of substances and medications with potential cardiovascular effects has increased among athletes and individuals engaging in physical activity. These substances, including doping agents, prescribed medications, and ergogenic aids, can lead to dangerous cardiovascular consequences. The cardiovascular effects depend on the type, amount, duration of use, and individual response to these substances. It is essential to inform physicians, athletes, and coaches about these risks to prevent adverse cardiovascular events.

Herbal Medicine and Medication Adherence in Cardiology Patients

Impact on Adherence

Herbal medicine use is common among cardiology patients, but it can negatively impact medication adherence. A study found that patients using herbal medicines had significantly higher rates of low adherence to prescribed cardiovascular drugs. This association highlights the need for further research to understand the effects of herbal medicine on medication adherence and to develop strategies to improve adherence among cardiology patients.

Potentially Inappropriate Medications in Older Cardiovascular Patients

Risks and Management

Older patients with cardiovascular disease often use potentially inappropriate medications (PIMs), which can lead to serious adverse drug reactions. A study found that 87.4% of older patients were receiving at least one PIM, with significant associations between PIM use and factors like the number of home medications, female gender, and specific comorbidities. Provider education and detailed medication assessments upon hospital admission can help prevent the use of PIMs and improve patient outcomes.

Chemotherapy-Induced Cardiotoxicity

Prevention and Management

Anthracycline-based chemotherapeutics are effective in treating various malignancies but can cause significant cardiotoxic side effects. Strategies to prevent cardiotoxicity include limiting free-radical production and using cardioprotective medications like dexrazoxane. While beta-blockers and ACE inhibitors are proven in treating heart failure, their role in preventing and treating chemotherapy-induced cardiotoxicity is not well established and requires further research.

Conclusion

Cardiology medications play a crucial role in managing cardiovascular diseases, with emerging evidence suggesting their potential in treating other conditions like cancer and psychiatric disorders. However, challenges such as drug-drug interactions, age-related effects, and medication adherence need to be addressed through multidisciplinary collaboration and further research to optimize patient outcomes.