PREFACE xix
LIST OF ABBREVIATIONS xxii
UNIT I GENERAL INTRODUCTION 1
1 Introduction to Cardiovascular Diseases 3
1.1 Overview 3
1.2 Definition of Cardiovascular Diseases 3
1.3 Classification of Cardiovascular Diseases 3
1.4 Prevalence, Incidence, and Trend of Cardiovascular Diseases 5
1.5 Risk Factors of Cardiovascular Diseases 9
1.6 Prevention and Control of Cardiovascular Diseases 10
1.7 Cardiovascular Risk Prediction and Evidence?]Based Treatments 15
1.8 Summary of Chapter Key Points 18
1.9 Self-Assessment Questions 18
References 19
2 Introduction to Principles of Pharmacology 21
2.1 Overview 21
2.2 Definitions and History 21
2.3 Pharmacological Paradigm: the Central Dogma in Pharmacology 24
2.4 Principles of Drug Discovery, Development, and Regulation 31
2.5 Pharmacology Subspecialties 32
2.6 Introduction to Cardiovascular Pharmacology 32
2.7 Summary of Chapter Key Points 38
2.8 Self?]Assessment Questions 39
References 40
UNIT II DYSLIPIDEMIAS 43
3 Overview of Dyslipidemias and Drug Therapy 45
3.1 Introduction 45
3.2 Lipoprotein Metabolism 45
3.3 Dyslipidemias and Genetic Lipoprotein Disorders 51
3.4 Mechanistically Based Drug Therapy of Dyslipidemias 51
3.5 Summary of Chapter Key Points 53
3.6 Self?]Assessment Questions 54
References 54
4 Drugs for Dyslipidemias 56
4.1 Overview 56
4.2 Statins 56
4.3 Bile Acid Sequestrants 64
4.4 Cholesterol Absorption Inhibitors 69
4.5 Fibrates 72
4.6 Niacin 75
4.7 New Drugs for HoFH 80
4.8 Phytosterols and Phytostanols 83
4.9 Omega?]3 Fatty Acids 86
4.10 Emerging Therapeutic Modalities for Dyslipidemias 88
4.11 Summary of Chapter Key Points 93
4.12 Self-Assessment Questions 93
References 95
5 Management of Dyslipidemias: Principles and Guidelines 99
5.1 Overview 99
5.2 General Principles of the Management of Dyslipidemias 99
5.3 Current Evidence?]Based Guidelines on the Management of Dyslipidemias 102
5.4 Summary of Chapter Key Points 113
5.5 Self?]Assessment Questions 113
References 114
UNIT III HYPERTENSION AND MULTITASKING CARDIOVASCULAR DRUGS 117
6 Overview of Hypertension and Drug Therapy 119
6.1 Introduction 119
6.2 Definitions, Classifications, and Epidemiology of Hypertension 119
6.3 Pathophysiology of Hypertension 121
6.4 Mechanistically Based Drug Therapy of Hypertension: An Overview 123
6.5 Summary of Chapter Key Points 123
6.6 Self?]Assessment Questions 125
References 125
7 Diuretics 127
7.1 Overview 127
7.2 Volume Regulation and Drug Targeting 127
7.3 Thiazide and Thiazide?]Type Diuretics 129
7.4 Loop Diuretics 134
7.5 Potassium?]Sparing Diuretics 138
7.6 Other Diuretics 142
7.7 Summary of Chapter Key Points 143
7.8 Self?]Assessment Questions 143
References 144
8 Sympatholytics 147
8.1 Overview 147
8.2 Sympathetic Nervous System and Drug Targeting 147
8.3 ??]Adrenergic Receptor Antagonists 150
8.4 ??]Adrenergic Receptor Antagonists 150
8.5 Centrally Acting Sympatholytics 157
8.6 Summary of Chapter Key Points 158
8.7 Self?]Assessment Questions 159
References 159
9 Inhibitors of the Renin-Angiotensin-Aldosterone System 161
9.1 Overview 161
9.2 The RAAS and Drug Targeting 161
9.3 Direct Renin Inhibitors 162
9.4 ACE Inhibitors 166
9.5 ARBs 174
9.6 Comparative Pharmacology of Direct Renin Inhibitors, ACE Inhibitors, and ARBs 179
9.7 Summary of Chapter Key Points 181
9.8 Self-Assessment Questions 181
References 182
10 Calcium Channel Blockers 185
10.1 Overview 185
10.2 Calcium Channels and Drug Targeting 185
10.3 L-TYPE CCBs 186
10.4 Summary of Chapter Key Points 192
10.5 Self-Assessment Questions 192
References 193
11 Nitrates and Other Vasodilators 194
11.1 Overview 194
11.2 Drug Class and Drug Targeting 194
11.3 Organic Nitrates and Sodium Nitroprusside (Nitric Oxide?]Releasing Vasodilators) 196
11.4 ET Receptor Antagonists 201
11.5 Phosphodiesterase 5 Inhibitors 204
11.6 sGC Stimulators 207
11.7 K+ATP Channel Openers 209
11.8 Other Vasodilators 210
11.9 Summary of Chapter Key Points 212
11.10 Self-Assessment Questions 212
References 213
12 Management of Hypertension: Principles and Guidelines 215
12.1 Overview 215
12.2 Introduction to Current Guidelines for the Management of Systemic Hypertension 215
12.3 Key Recommendations of Major Guidelines for the Management of Systemic Hypertension 217
12.4 Lifestyle Modifications for the Management of Systemic Hypertension 221
12.5 Drug Therapy of Systemic Hypertension 223
12.6 Drug Therapy of Prehypertension 234
12.7 Drug Therapy of Pulmonary Hypertension 235
12.8 Summary of Chapter Key Points 237
12.9 Self-Assessment Questions 238
References 239
UNIT IV ISCHEMIC HEART DISEASE: STABLE ISCHEMIC HEART DISEASE 243
13 Overview of Ischemic Heart Disease, Stable Angina, and Drug Therapy 245
13.1 Introduction 245
13.2 Classification, Epidemiology, and Pathophysiology 245
13.3 Stable Angina and Drug Targeting 250
13.4 Summary of Chapter Key Points 252
13.5 Self-Assessment Questions 252
References 253
14 Drugs for Stable Angina 254
14.1 Overview 254
14.2 ?-Blockers for Treating Stable Angina 254
14.3 CCBs for Treating Stable Angina 255
14.4 Organic Nitrate for Treating Stable Angina 255
14.5 New Antianginal Drugs: Ranolazine 255
14.6 Other New and Emerging Drugs 258
14.7 Summary of Chapter Key Points 259
14.8 Self-Assessment Questions 259
References 260
15 Management of Stable Angina/Stable Ischemic Heart Disease: Principles and Guidelines 262
15.1 Overview 262
15.2 Introduction to Current Guidelines on Management of Stable Angina/SIHD 262
15.3 General Principles of Management of Stable Angina/SIHD 265
15.4 Current Guideline Recommendations on Stable Angina/SIHD Management 266
15.5 Management of Special Types of Stable Angina 271
15.6 Summary of Chapter Key Points 273
15.7 Self-Assessment Questions 273
References 273
UNIT V ISCHEMIC HEART DISEASE: ACUTE CORONARY SYNDROMES 275
16 Overview of Acute Coronary Syndromes and Drug Therapy 277
16.1 Introduction 277
16.2 Definitions and General Considerations 277
16.3 Pathophysiology and Drug Targeting 278
16.4 Summary of Chapter Key Points 280
16.5 Self-Assessment Questions 281
References 281
17 Anticoagulants, Platelet Inhibitors, and Thrombolytic Agents 283
17.1 Overview 283
17.2 Hemostasis 283
17.3 Anticoagulants 285
17.4 Platelet Inhibitors 295
17.5 Thrombolytic Agents 304
17.6 Summary of Chapter Key Points 307
17.7 Self-Assessment Questions 307
References 308
18 Management of Unstable Angina and Non-ST-Elevation Myocardial Infarction: Principles and Guidelines 310
18.1 Overview 310
18.2 Introduction to Evidence-Based Guidelines 310
18.3 General Principles of Management of UA/NSTEMI 311
18.4 Guideline-Based Recommendations on the Management of UA/NSTEMI 311
18.5 Summary of Chapter Key Points 324
18.6 Self-Assessment Questions 325
References 325
19 Management of ST-Elevation Myocardial Infarction: Principles and Guidelines 327
19.1 Overview 327
19.2 Definition and Epidemiology 327
19.3 Introduction to Recent Guidelines on the Management of STEMI 328
19.4 Principles and Guideline Recommendations for the Management of STEMI 329
19.5 Summary of Chapter Key Points 339
19.6 Self-Assessment Questions 340
References 340
UNIT VI HEART FAILURE 343
20 Overview of Heart Failure and Drug Therapy 345
20.1 Introduction 345
20.2 Definition, Classification, and Epidemiology 345
20.3 Pathophysiology and Drug Targeting 348
20.4 Summary of Chapter Key Points 349
20.5 Self-Assessment Questions 350
References 350
21 Drugs for Heart Failure 352
21.1 Overview 352
21.2 Diuretics for Heart Failure 352
21.3 ?-Blockers for HF 352
21.4 Inhibitors of the RAAS for HF 353
21.5 Vasodilators for HF 354
21.6 Positive Inotropic Agents for HF 354
21.7 Emerging Drugs for HF 359
21.8 Summary of Chapter Key Points 360
21.9 Self-Assessment Questions 360
References 361
22 Management of Heart Failure: Principles and Guidelines 364
22.1 Overview 364
22.2 Management of Hf-REF 364
22.3 Management of HF-PEF 367
22.4 Management of Acute Heart Failure Syndromes 368
22.5 Summary of Chapter Key Points 372
22.6 Self-Assessment Questions 373
References 374
UNIT Vii CARDIAC ARRHYTHMIAS 375
23 Overview of Cardiac Arrhythmias and Drug Therapy 377
23.1 Introduction 377
23.2 Definition, Classification, and Epidemiology 377
23.3 Pathophysiology and Drug Targeting 380
23.4 Summary of Chapter Key Points 388
23.5 Self-Assessment Questions 389
References 390
24 Drugs for Cardiac Arrhythmias 391
24.1 Overview 391
24.2 Classification of Antiarrhythmic Drugs 391
24.3 Class I Antiarrhythmic Drugs 392
24.4 Class II Antiarrhythmic Drugs 398
24.5 Class III Antiarrhythmic Drugs 399
24.6 Class IV Antiarrhythmic Drugs 404
24.7 Other Antiarrhythmic Drugs 406
24.8 Summary of Chapter Key Points 408
24.9 Self-Assessment Questions 409
References 410
25 Management of Cardiac Arrhythmias: Principles and Guidelines 411
25.1 Overview 411
25.2 General Principles of Management 411
25.3 Management of Supraventricular Arrhythmias 411
25.4 Management of Ventricular Arrhythmias 414
25.5 Summary of Chapter Key Points 421
25.6 Self-Assessment Questions 423
References 424
UNIT Viii ISCHEMIC STROKE 427
26 Overview of Ischemic Stroke and Drug Therapy 429
26.1 Introduction 429
26.2 Definition and Classification of Cerebrovascular Diseases 429
26.3 Definition and Classification of Stroke 429
26.4 Epidemiology of Stroke 430
26.5 Risk Factors of Stroke 432
26.6 Pathophysiology of Ischemic Stroke and Drug Targeting 432
26.7 Summary of Chapter Key Points 434
26.8 Self?]Assessment Questions 434
References 435
27 Drugs for Ischemic Stroke 436
27.1 Overview 436
27.2 Drugs for Primary Prevention of Ischemic Stroke 436
27.3 Drugs for Early Treatment of Acute Ischemic Stroke 438
27.4 Drugs for Neuroprotection 439
27.5 Drugs for Secondary Prevention of Ischemic Stroke 441
27.6 Stem Cell Therapy for Neurorepair 442
27.7 Summary of Chapter Key Points 442
27.8 Self-Assessment Questions 443
References 444
28 Management of Ischemic Stroke: Principles and Guidelines 447
28.1 Overview 447
28.2 Introduction to Stroke Systems of Care 447
28.3 Current AHA/ASA Guidelines on Early Management of Acute Ischemic Stroke 449
28.4 Summary of Chapter Key Points 450
28.5 Self-Assessment Questions 455
References 456
INDEX 457
