Skip to main content

Abstract

After the 1930s, cardiovascular disease displaced infectious disease as the leading cause of death in the United States. By 1968, cardiovascular disease accounted for 54% of all deaths in this country. Coronary artery disease alone accounted for 35% of all deaths in that year, more than the total that resulted from all types of cancer (17%) plus stroke (11%) combined. Beginning in the mid-1950s and increasing after 1968, however, there has been an abrupt decline in the mortality from coronary artery disease in this country (now 28% of all deaths) while death caused by cancer has sharply increased (now 22%) (1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Feinleib M: The magnitude and nature of the decrease in coronary heart disease mortality rate. Am J Cardiol 54: 2C–6C, 1984.

    Article  Google Scholar 

  2. Lipid Research Clinics Program: The lipid research clinic’s coronary primary prevention trial results. I. Reduction in incidence of coronary heart disease. JAMA 251: 351–363, 1984.

    Article  Google Scholar 

  3. Lipid Research Clinics Program: The lipid research clinics coronary primary prevention trial results. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 251: 365–374, 1984.

    Article  Google Scholar 

  4. European Coronary Surgery Study Group: Prospective randomized study of coronary artery bypass surgery in stable angina pectoris: a progress report on survival. Circulation 65:11–67–11–71, 1982.

    Google Scholar 

  5. Levy RI: Causes of the decrease in cardiovascular mortality. Am J Cardiol 54: 7C–13C, 1984.

    Article  Google Scholar 

  6. Weber KT, Janicki JS: The metabolic demand and oxygen supply of the heart: physiologic and clinical considerations. Am J Cardiol 44: 722–729, 1979.

    Article  PubMed  CAS  Google Scholar 

  7. Graham TP, Covell JW, Sonnenblick EH, Ross J, Braunwald E: Control of myocardial oxygen consumption: relative influence of contractile state and tension development. J Clin Invest 47: 375–385, 1968.

    Article  PubMed  Google Scholar 

  8. Braunwald E: Control of myocardial oxygen consumption: physiologic and clinical considerations. Am J Cardiol 27: 416–432, 1971.

    Article  PubMed  CAS  Google Scholar 

  9. Urschel CW, Covell JW, Graham TP, et al.: Effects of acute valvular regurgitation on the oxygen consumption of the canine heart. Circ Res 23: 33–43, 1968.

    PubMed  CAS  Google Scholar 

  10. Sarnoff SJ, Braunwald E, Welch GH, Case RB, Stainsby WN, Macruz R: Hemodynamic determinants of oxygen consumption of the heart with special reference to the tension-time index. Am J Physiol 192: 148–156, 1958.

    PubMed  CAS  Google Scholar 

  11. Nellis SH, Liedtke AJ, Whitesell L: Small coronary vessel pressure and diameter in an intact beating rabbit heart using fixed-position and free-motion techniques. Circ Res 49: 342–353, 1981.

    PubMed  CAS  Google Scholar 

  12. Tillmanns H, Steinhausen M, Leinberger H, Thederan H, Kubler W: Pressure measurements in the terminal vascular bed of the epimyocardium of rats and cats. Circ Res 49: 1202–1211, 1981.

    PubMed  CAS  Google Scholar 

  13. Bellamy RF: Diastolic coronary artery pressure-flow relations in the dog. Circ Res 43: 92–101, 1978.

    PubMed  CAS  Google Scholar 

  14. Hoffman JIE: Maximal coronary flow and the concept of coronary vascular reserve. Circulation 70: 153–158, 1984.

    Article  PubMed  CAS  Google Scholar 

  15. Robertson RM, Robertson D, Roberts L, et al.: Thromboxane A2 in vasotonic angina pectoris: evidence from direct measurements and inhibitor trials. N Engl J Med 304: 998–1003, 1981.

    Article  PubMed  CAS  Google Scholar 

  16. Hirsch PD, Hillis LD, Campbell WB, Firth BG, Willerson JT: Release of prostaglandins and throm-boxane into the coronary circulation in patients with ischemic heart disease. N Engl J Med 304: 685–691, 1981.

    Article  Google Scholar 

  17. Brunton TI: On the use of nitrate of amyl in angina pectoris. Lancet 2: 97–98, 1867.

    Article  Google Scholar 

  18. Needleman P, Johnson EM: Mechanism of tolerance development to organic nitrates. J Pharmacol Exp Ther 184: 709–715, 1973.

    PubMed  CAS  Google Scholar 

  19. Glancy DL, Richter MA, Ellis EV, Johnson W: Effect of swallowed isosorbide dinitrate on blood pressure, heart rate, and exercise capacity in patients with coronary artery disease. Am J Med 62: 39–46, 1977.

    Article  PubMed  CAS  Google Scholar 

  20. Danahy DT, Burwell DT, Aronow WS, Prakash R: Sustained hemodynamic and antianginal effect of high dose oral isosorbide dinitrate. Circulation 55: 381–387, 1977.

    PubMed  CAS  Google Scholar 

  21. Danahy DT, Aronow WS: Hemodynamics and antianginal effects of high dose oral isosorbide dinitrate after chronic use. Circulation 56: 205–212, 1977.

    PubMed  CAS  Google Scholar 

  22. Markis JE, Gorlin R, Mills RM, Williams RA, Schweitzer P, Ransil BJ: Sustained effect of orally administered isosorbide dinitrate on exercise performance of patients with angina pectoris. Am J Cardiol 43: 265–271, 1979.

    Article  PubMed  CAS  Google Scholar 

  23. Thadani U, Fung H, Darke AC, Parker JO: Oral isosorbide dinitrate in the treatment of angina pectoris: dose-response relationship and duration of action during acute therapy. Circulation 62: 491–502, 1980.

    PubMed  CAS  Google Scholar 

  24. Abrams J: Nitroglycerin and long-acting nitrates. N Engl J Med 302: 1234–1237, 1980.

    Article  PubMed  CAS  Google Scholar 

  25. Feldman RL, Pepine CJ, Conti CR: Magnitude of dilatation of large and small coronary arteries by nitroglycerin. Circulation 64: 324–333, 1981.

    Article  PubMed  CAS  Google Scholar 

  26. Brown BG, Bolson E, Petersen RB, Pierce CD, Dodge HT: The mechanisms of nitroglycerin action: stenosis vasodilatation as a major component of the drug response. Circulation 64: 1089–1097, 1981.

    Article  PubMed  CAS  Google Scholar 

  27. Conti CR, Feldman RL, Pepine CJ, Hill JA, Conti JB: Effect of glyceryl trinitrate on coronary and systemic hemodynamics in man. Am J Med 74: 28–32, 1983.

    Article  PubMed  CAS  Google Scholar 

  28. Goldstein RE, Stinson EB, Scherer JL, Seningen RP, Grehl TM, Epstein SE: Intraoperative coronary collateral function in patients with coronary occlusive disease: nitroglycerin responsiveness and angiographic correlations. Circulation 49: 298–308, 1974.

    PubMed  CAS  Google Scholar 

  29. Ganz W, Marcus HS: Failure of intracoronary nitroglycerin to alleviate pacing-induced angina. Circulation 46: 880–889, 1972.

    PubMed  CAS  Google Scholar 

  30. Fuchs RM, Brinker JA, Guzman PA, Kross DE, Yin FCP: Regional coronary blood flow during relief of pacing-induced angina by nitroglycerin: implications for mechanism of action. Am J Cardiol 51: 19–23, 1983.

    Article  PubMed  CAS  Google Scholar 

  31. Feldman RL, Pepine CJ, Curry RC, Conti CR: Coronary arterial responses to graded doses of nitro-glycerin. Am J Cardiol 43: 91–97, 1979.

    Article  PubMed  CAS  Google Scholar 

  32. Ferrer MI, Bradley SE, Wheeler HO, et al.: Some effects of nitroglycerin upon the splanchnic, pulmonary, and systemic circulations. Circulation 33: 357–373, 1966.

    PubMed  CAS  Google Scholar 

  33. Reichek N, Priest C, Zimrin D, Chandler T, Sutton MSJ: Antianginal effects of nitroglycerin patches. Am J Cardiol 54: 1–7, 1984.

    Article  PubMed  CAS  Google Scholar 

  34. Parker JO, Fung HL: Transdermal nitroglycerin in angina pectoris. Am J Cardiol 54: 471–476, 1984.

    Article  PubMed  CAS  Google Scholar 

  35. Abrams J: The brief saga of transdermal nitroglycerin discs: paradise lost? Am J Cardiol 54: 220–224, 1984.

    Article  PubMed  CAS  Google Scholar 

  36. Lange RL, Reid MS, Tresch DD, Keelan MH, Bernhard VM, Coolidge G: Nonatheromatous ischemic heart disease following withdrawal from chronic industrial nitroglycerin exposure. Circulation 46: 666–678, 1972.

    PubMed  CAS  Google Scholar 

  37. Armstrong PW, Moffat J A: Tolerance to organic nitrates: clinical and experimental perspectives. Am J Med 74: 73–84, 1983.

    Article  PubMed  CAS  Google Scholar 

  38. Dalai JJ, Yao L, Parker JO: Nitrate tolerance: influence of isosorbide dinitrate on the hemodynamic and antianginal effects of nitroglycerin. J Am Coll Cardiol 2: 115–120, 1983.

    Article  Google Scholar 

  39. Ahlquist RP: A study of the adrenotropic receptors. Am J Phys 153: 586–600, 1948.

    CAS  Google Scholar 

  40. Powell CE, Slater IH: Blocking of inhibitory adrenergic receptors by a dichloro analog of isoproterenol. J Pharmacol Exp Ther 122: 480–488, 1958.

    PubMed  CAS  Google Scholar 

  41. Lands AM, Arnold A, McAuliff JP, et al.: Differentiation of receptor systems activated by sympathomimetic amines. Nature 214: 597–598, 1967.

    Article  PubMed  CAS  Google Scholar 

  42. Dunlop D, Shanks RG: Selective blockade of adrenoceptive beta receptors in the heart. Br J Pharmac Chemother 32: 201–218, 1968.

    CAS  Google Scholar 

  43. Lefkowitz RJ: Beta-adrenergic receptors: recognition and regulation. N Engl J Med 295: 323–328, 1976.

    Article  PubMed  CAS  Google Scholar 

  44. Kern M, Ganz P, Horowitz J, Mudge GH, Grossman W. Potentiation of coronary vasoconstriction by beta-adrenergic blockade. Circulation 64: IV–82, 1981.

    Google Scholar 

  45. Vatner SF, Baig H, Manders WT, Ochs H, Pagani M: Effects of propranolol on regional myocardial function, electrograms, and blood flow in conscious dogs with myocardial ischemia. J Clin Invest 60: 353–360, 1977.

    Article  PubMed  CAS  Google Scholar 

  46. Vatner SF, Baig H, Manders WT, Murray PA: Effects of a cardiac glycoside in combination with propranolol on the ischemic heart of conscious dogs. Circulation 57: 568–575, 1978.

    PubMed  CAS  Google Scholar 

  47. Frishman WH, Weksler B, Christodoulou JP, Smithen C, Killip T: Reversal of abnormal platelet aggregability and change in exercise tolerance in patients with angina pectoris following oral propranolol. Circulation 50: 887–896, 1974.

    PubMed  CAS  Google Scholar 

  48. Mehta J, Mehta P, Pepine C: Differences in platelet aggregation in coronary artery sinus and aortic blood in patients with coronary artery disease: effect of propranolol. Clin Cardiol 1: 96–104, 1978.

    PubMed  CAS  Google Scholar 

  49. Walsh PN, Pareti FI, Corbett JJ: Platelet coagulant activities and serum lipids in transient cerebral ischemia. N Engl J Med 295: 854–858, 1976.

    Article  PubMed  CAS  Google Scholar 

  50. Weksler BB, Gillick M, Pink J: Effect of propranolol on platelet function. Blood 49: 185–196, 1977.

    PubMed  CAS  Google Scholar 

  51. Frishman WH: Multifactorial actions of beta-adrenergic blocking drugs in ischemic heart disease: current concepts. Circulation 67:1–11–1–18, 1983.

    Article  Google Scholar 

  52. Pendleton RG, Newman DJ, Sherman SS, Brann EG, Maya WE: Effect of propranolol upon the hemoglobin-oxygen dissociation curve. J Pharmacol Exp Ther 180: 647–656, 1972.

    PubMed  CAS  Google Scholar 

  53. Kjekshus JK, Mjos OD: Effect of inhibition of lipolysis on infarct size after experimental coronary artery occlusion. J Clin Invest 52: 1770–1778, 1973.

    Article  PubMed  CAS  Google Scholar 

  54. Clark BJ: Beta-adrenoceptor-blocking agents: are pharmacologic differences relevant? Am Heart J 104: 334–345, 1982.

    Article  PubMed  CAS  Google Scholar 

  55. Woosley RL, Kornhauser D, Smith R, et al.: Suppression of chronic ventricular arrhythmias with propranolol. Circulation 60: 819–827, 1979.

    PubMed  CAS  Google Scholar 

  56. Feely J, Wilkinson GR, Wood AJJ. Reduction of liver blood flow and propranolol metabolism by cimetidine. N Engl J Med 304: 692–695, 1981.

    Article  PubMed  CAS  Google Scholar 

  57. Watanabe AM: Recent advances in knowledge about beta-adrenergic receptors: application to clinical cardiology. J Am Coll Cardiol 1: 82–89, 1983.

    Article  PubMed  CAS  Google Scholar 

  58. Fleckenstein A: Specific pharmacology of calcium in myocardium, cardiac pacemakers, and vascular smooth muscle. Ann Rev Pharmacol Toxicol 17: 149–166, 1977.

    Article  CAS  Google Scholar 

  59. Braunwald E: Mechanism of action of calcium-channel-blocking agents. N Engl J Med 307: 1618–1627, 1982.

    Article  PubMed  CAS  Google Scholar 

  60. Braunwald E: Calcium-channel blockers: pharmacologic considerations. Am Heart J 104: 665–671, 1982.

    Article  PubMed  CAS  Google Scholar 

  61. Singh BN, Hecht HS, Nademanee K, Chew CYC: Electrophysiologic and hemodynamic effects of slow-channel blocking drugs. Prog Cardiovasc Dis 25: 103–132, 1982.

    Article  PubMed  CAS  Google Scholar 

  62. Kohlhardt M, Fleckenstein A: Inhibition of slow inward current by nifedipine in mammalian ventricular myocardium. Naunyn-Schmiedeberg’s Arch Pharmacol 298: 267–272, 1977.

    Article  CAS  Google Scholar 

  63. Ono H, Hashimoto K: Calcium antagonism in various parameters of cardiac function including coronary dilatation with the use of nifedipine, perhexilene, and verapamil. In Winburg MM, Abiko Y (eds): Ischemic myocardium and antianginal drugs. Raven Press, New York, pp 77–88, 1979.

    Google Scholar 

  64. Simonsen S, Nitter-Hauge S: Effect of nifedipine (adalat) on coronary haemodynamics in patients with coronary arteriosclerotic disease. Acta Med Scand 204: 179–184, 1978.

    Article  PubMed  CAS  Google Scholar 

  65. Kaltenbach M, Schulz W, Kober G: Effects of nifedipine after intravenous and intracoronary administration. Am J Cardiol 44: 832–838, 1979.

    Article  PubMed  CAS  Google Scholar 

  66. Himori N, Ono H, Taira N: Dual effects of a new coronary vasodilator, diltiazem, on the contractile force of blood perfused papillary muscle of the dog. Jpn H Pharmacol 25: 350–352, 1975.

    Article  CAS  Google Scholar 

  67. Takeda K, Nakagawa Y, Katano Y, Imai S: Effects of coronary vasodilators on large and small coronary arteries of dogs. Jap Heart J 18: 92–101, 1977.

    Article  PubMed  CAS  Google Scholar 

  68. Stone PH, Antman EM, Muller JE, Braunwald E: Calcium channel blocking agents in the treatment of cardiovascular disorders. Part II. Hemodynamic effects and clinical applications. Ann Intern Med 93: 886–904, 1980.

    PubMed  CAS  Google Scholar 

  69. Henry PD, Shuchlieb R, Clark RE, Perez JE: Effect of nifedipine on myocardial ischemia: analysis of collateral flow, pulsatile heat and regional muscle shortening. Am J Cardiol 44: 817–824, 1979.

    Article  PubMed  CAS  Google Scholar 

  70. da Luz PL, Monteiro de Barros LF, Leite JJ, Pileggi F, DeCourt LV: Effect of verapamil on regional coronary and myocardial perfusion during acute coronary occlusion. Am J Cardiol 45: 269–275, 1980.

    Article  PubMed  Google Scholar 

  71. Rich S, Ford LE, Sadir JA: The angiographic effect of ergonovine and nifedipine in coronary artery spasm. Circulation 62: 1127–1130, 1980.

    PubMed  CAS  Google Scholar 

  72. McAllister RG: Clinical pharmacology of slow channel blocking agents. Prog Cardiovasc Dis 25: 83–102, 1982.

    Article  PubMed  CAS  Google Scholar 

  73. Mueller HS, Chahine RA: Interim report of multi-center double-blind, placebo-controlled studies of nifedipine in chronic stable angina. Am J Med 71: 645–657, 1981.

    Article  PubMed  CAS  Google Scholar 

  74. Jariwalla AG, Anderson EG: Side effects of drugs: production of ischaemic cardiac pain by nifedipine. Br Med J 1: 1181–1182, 1978.

    Article  PubMed  CAS  Google Scholar 

  75. Antman EM, Stone PH, Muller JE, Braunwald E: Calcium channel blocking agents in the treatment of cardiovascular disorders. Part I. Basic and clinical electrophysiologic effects. Ann Intern Med 93: 875–885, 1980.

    PubMed  CAS  Google Scholar 

  76. Epstein SE, Talbot TL: Dynamic coronary tone in precipitation, exacerbation and relief of angina pectoris. Am J Cardiol 48: 797–803, 1981.

    Article  PubMed  CAS  Google Scholar 

  77. Thadani U, Park JO: Propranolol in angina pectoris: comparison of therapy given two and four times daily. Am J Cardiol 46: 117–123, 1980.

    Article  PubMed  CAS  Google Scholar 

  78. The Norwegian Multicenter Study Group: Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 304: 801–807, 1981.

    Article  Google Scholar 

  79. Beta Blocker Heart Attack Trial Research Group: A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. JAMA 247: 1707–1714, 1982.

    Article  Google Scholar 

  80. Goldman GJ, Pichard AD: The natural history of coronary artery disease: does medical therapy improve the prognosis? Prog Cardiovasc Dis 25: 513–552, 1983.

    Article  PubMed  CAS  Google Scholar 

  81. Plotnick GD, Greene HL, Carliner NH, Becker LC, Fisher ML: Clinical indicators of left main coronary artery disease in unstable angina. Ann Intern Med 91: 149–153, 1979.

    PubMed  CAS  Google Scholar 

  82. Neill WA, Wharton TP, Fluri-Lundeen J, Cohen IS: Acute coronary insufficiency—coronary occlusion after intermittent ischemic attacks. N Engl J Med 302: 1157–1162, 1980.

    Article  PubMed  CAS  Google Scholar 

  83. Moise A, Theroux P, Taeymans Y, et al.: Unstable angina and progression of coronary atherosclerosis. N Engl J Med 309: 685–689, 1983.

    Article  PubMed  CAS  Google Scholar 

  84. Biagini A, Mazzei MG, Carpeggiani C, et al.: Vaso-spastic ischemic mechanism of frequent asymptomatic transient ST-T changes during continuous electrocardiographic monitoring in selected unstable angina patients. Am Heart J 103: 13–20, 1982.

    Article  PubMed  CAS  Google Scholar 

  85. Lewis HD, Davis JW, Archibald DG, et al.: Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. N Engl J Med 309: 396–403, 1983.

    Article  PubMed  Google Scholar 

  86. Braunwald E, Muller JE, Kloner RA, Maroko PR: Role of beta-adrenergic blockade in the therapy of patients with myocardial infarction. Am J Med 74: 113–123, 1983.

    Article  PubMed  CAS  Google Scholar 

  87. Griggs TR, Wagner GS, Gettes LS: Beta-adrenergic blocking agents after myocardial infarction: an undocumented need in patients at lowest risk. J Am Coll Cardiol 1 (6): 1530–1533, 1983.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1986 Springer-Verlag New York Inc.

About this chapter

Cite this chapter

Follansbee, W.P., Shaver, J.A. (1986). Pharmacologic Interventions in Angina. In: Maronde, R.F. (eds) Topics in Clinical Pharmacology and Therapeutics. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4864-4_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-4864-4_4

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-9336-1

  • Online ISBN: 978-1-4612-4864-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics