91934
document
Proposed synergistic effect of calcium channel blockers with lipid-lowering therapy in retarding progression of coronary atherosclerosis . Lipid-lowering therapy now has undoubtedly proven to be an effective therapeutic modality to retard the progression of coronary atherosclerosis . An additional approach for prevention of the progression of atherosclerosis is calcium channel blocker ( CCB ) treatment . Evidence indicating that CCBs inhibit atherosclerosis is less unequivocal than the clear evidence for lipid-lowering therapy . Many investigations support the view that a number of key processes in atherosclerosis may be influenced by CCBs . From the " negative " and " positive " studies with CCBs performed in animals and humans we must conclude that apparently some , but not all , types or stages of the atherosclerotic process are inhibited by CCBs . To assess whether lipid-lowering therapy and CCB treatment may have an additive or synergistic beneficial effect on human atherosclerosis , which is conceivable because their anti-atherosclerotic properties differ , data from the angiographic lipid-lowering trial REGRESS ( pravastatin vs. placebo ) were reviewed . In REGRESS , patients in the pravastatin group had significantly less progression if cotreated with CCBs as compared with those with no CCB cotreatment , whereas in the placebo ( no pravastatin ) group no effect of CCB treatment was observed . With respect to angiographic new lesion formation , in the pravastatin group there were 50 % less patients with new angiographic lesions if cotreated with CCBs as compared with no CCB cotreatment , whereas in the placebo ( no pravastatin ) group , again , no significant effect of CCB treatment was observed . No beneficial effects of CCB treatment on clinical events were observed during the 2-year study follow-up . In view of the correlation between angiographic progression and subsequent clinical events as demonstrated in several large trials , it is not unrealistic to also anticipate in this population , a beneficial effect on clinical events with longer follow-up . Although the REGRESS trial was not designed to evaluate combination therapy , the results suggest that addition of CCBs to HMG-CoA reductase inhibitor therapy ( pravastatin ) acts synergistically in retarding the progression of established coronary atherosclerosis . These results appear to warrant prospective randomized trials to determine in a more definitive manner the merits of this combination in the prevention of progression of coronary atherosclerosis . Currently a number of studies in these fields are being designed or are already underway .
91935
Intervention_Pharmacological
calcium channel blockers
91936
Intervention_Pharmacological
lipid-lowering therapy
91937
Intervention_Pharmacological
Lipid-lowering therapy
91938
Intervention_Pharmacological
calcium channel blocker ( CCB )
91939
Intervention_Pharmacological
CCBs
91940
Intervention_Pharmacological
lipid-lowering therapy .
91941
Intervention_Pharmacological
CCBs
91942
Intervention_Pharmacological
CCBs
91943
Intervention_Pharmacological
CCBs
91944
Intervention_Pharmacological
lipid-lowering therapy
91945
Intervention_Pharmacological
CCB
91946
Intervention_Pharmacological
pravastatin
91947
Intervention_Control
placebo
91948
Intervention_Pharmacological
pravastatin
91949
Intervention_Pharmacological
CCBs
91950
Intervention_Pharmacological
CCB
91951
Intervention_Control
placebo ( no pravastatin )
91952
Intervention_Pharmacological
CCB
91953
Intervention_Pharmacological
pravastatin
91954
Intervention_Pharmacological
CCBs
91955
Intervention_Pharmacological
CCB
91956
Intervention_Control
placebo ( no pravastatin )
91957
Intervention_Pharmacological
CCB
91958
Intervention_Pharmacological
CCB
91959
Intervention_Pharmacological
CCBs
91960
Intervention_Pharmacological
pravastatin
91961
Outcome_Physical
progression of coronary atherosclerosis
91962
Outcome_Physical
atherosclerosis
91963
Outcome_Physical
progression of atherosclerosis
91964
Outcome_Physical
atherosclerosis
91965
Outcome_Physical
progression
91966
Outcome_Physical
angiographic new lesion formation
91967
Outcome_Physical
angiographic lesions
91968
Outcome_Other
clinical events
91969
Outcome_Physical
angiographic progression
91970
Outcome_Other
clinical events
91971
Outcome_Physical
progression of established coronary atherosclerosis
91972
Outcome_Physical
progression of coronary atherosclerosis
91973
Participant_Condition
retarding progression of coronary atherosclerosis