Cardiovascular Diseases

Y. Robert Li is Professor and Founding Chair of the Department of Pharmacology and Assistant Dean for Biomedical Research at Campbell University and holds Adjunct Professor appointments at Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Virginia-Maryland Regional College of Veterinary Medicine, and University of North Carolina at Greensboro. He is an author of over 110 peer-reviewed publications, three monographs, and numerous book chapters and serves on the editorial boards of several leading journals. Dr. Li has over 20 years of teaching experience in the areas of biomedical sciences, free radical biology, toxicology, pharmacology, and therapeutics.

• PREFACE xixLIST OF ABBREVIATIONS xxiiUNIT I GENERAL INTRODUCTION 11 Introduction to Cardiovascular Diseases 31.1 Overview 31.2 Definition of Cardiovascular Diseases 31.3 Classification of Cardiovascular Diseases 31.4 Prevalence, Incidence, and Trend of Cardiovascular Diseases 51.5 Risk Factors of Cardiovascular Diseases 91.6 Prevention and Control of Cardiovascular Diseases 101.7 Cardiovascular Risk Prediction and Evidence]Based Treatments 151.8 Summary of Chapter Key Points 181.9 Self-Assessment Questions 18References 192 Introduction to Principles of Pharmacology 212.1 Overview 212.2 Definitions and History 212.3 Pharmacological Paradigm: the Central Dogma in Pharmacology 242.4 Principles of Drug Discovery, Development, and Regulation 312.5 Pharmacology Subspecialties 322.6 Introduction to Cardiovascular Pharmacology 322.7 Summary of Chapter Key Points 382.8 Self]Assessment Questions 39References 40UNIT II DYSLIPIDEMIAS 433 Overview of Dyslipidemias and Drug Therapy 453.1 Introduction 453.2 Lipoprotein Metabolism 453.3 Dyslipidemias and Genetic Lipoprotein Disorders 513.4 Mechanistically Based Drug Therapy of Dyslipidemias 513.5 Summary of Chapter Key Points 533.6 Self]Assessment Questions 54References 544 Drugs for Dyslipidemias 564.1 Overview 564.2 Statins 564.3 Bile Acid Sequestrants 644.4 Cholesterol Absorption Inhibitors 694.5 Fibrates 724.6 Niacin 754.7 New Drugs for HoFH 804.8 Phytosterols and Phytostanols 834.9 Omega]3 Fatty Acids 864.10 Emerging Therapeutic Modalities for Dyslipidemias 884.11 Summary of Chapter Key Points 934.12 Self-Assessment Questions 93References 955 Management of Dyslipidemias: Principles and Guidelines 995.1 Overview 995.2 General Principles of the Management of Dyslipidemias 995.3 Current Evidence]Based Guidelines on the Management of Dyslipidemias 1025.4 Summary of Chapter Key Points 1135.5 Self]Assessment Questions 113References 114UNIT III HYPERTENSION AND MULTITASKING CARDIOVASCULAR DRUGS 1176 Overview of Hypertension and Drug Therapy 1196.1 Introduction 1196.2 Definitions, Classifications, and Epidemiology of Hypertension 1196.3 Pathophysiology of Hypertension 1216.4 Mechanistically Based Drug Therapy of Hypertension: An Overview 1236.5 Summary of Chapter Key Points 1236.6 Self]Assessment Questions 125References 1257 Diuretics 1277.1 Overview 1277.2 Volume Regulation and Drug Targeting 1277.3 Thiazide and Thiazide]Type Diuretics 1297.4 Loop Diuretics 1347.5 Potassium]Sparing Diuretics 1387.6 Other Diuretics 1427.7 Summary of Chapter Key Points 1437.8 Self]Assessment Questions 143References 1448 Sympatholytics 1478.1 Overview 1478.2 Sympathetic Nervous System and Drug Targeting 1478.3 α]Adrenergic Receptor Antagonists 1508.4 β]Adrenergic Receptor Antagonists 1508.5 Centrally Acting Sympatholytics 1578.6 Summary of Chapter Key Points 1588.7 Self]Assessment Questions 159References 1599 Inhibitors of the Renin–Angiotensin–Aldosterone System 1619.1 Overview 1619.2 The RAAS and Drug Targeting 1619.3 Direct Renin Inhibitors 1629.4 ACE Inhibitors 1669.5 ARBs 1749.6 Comparative Pharmacology of Direct Renin Inhibitors, ACE Inhibitors, and ARBs 1799.7 Summary of Chapter Key Points 1819.8 Self-Assessment Questions 181References 18210 Calcium Channel Blockers 18510.1 Overview 18510.2 Calcium Channels and Drug Targeting 18510.3 L-TYPE CCBs 18610.4 Summary of Chapter Key Points 19210.5 Self-Assessment Questions 192References 19311 Nitrates and Other Vasodilators 19411.1 Overview 19411.2 Drug Class and Drug Targeting 19411.3 Organic Nitrates and Sodium Nitroprusside (Nitric Oxide]Releasing Vasodilators) 19611.4 ET Receptor Antagonists 20111.5 Phosphodiesterase 5 Inhibitors 20411.6 sGC Stimulators 20711.7 K+ATP Channel Openers 20911.8 Other Vasodilators 21011.9 Summary of Chapter Key Points 21211.10 Self-Assessment Questions 212References 21312 Management of Hypertension: Principles and Guidelines 21512.1 Overview 21512.2 Introduction to Current Guidelines for the Management of Systemic Hypertension 21512.3 Key Recommendations of Major Guidelines for the Management of Systemic Hypertension 21712.4 Lifestyle Modifications for the Management of Systemic Hypertension 22112.5 Drug Therapy of Systemic Hypertension 22312.6 Drug Therapy of Prehypertension 23412.7 Drug Therapy of Pulmonary Hypertension 23512.8 Summary of Chapter Key Points 23712.9 Self-Assessment Questions 238References 239UNIT IV ISCHEMIC HEART DISEASE: STABLE ISCHEMIC HEART DISEASE 24313 Overview of Ischemic Heart Disease, Stable Angina, and Drug Therapy 24513.1 Introduction 24513.2 Classification, Epidemiology, and Pathophysiology 24513.3 Stable Angina and Drug Targeting 25013.4 Summary of Chapter Key Points 25213.5 Self-Assessment Questions 252References 25314 Drugs for Stable Angina 25414.1 Overview 25414.2 β-Blockers for Treating Stable Angina 25414.3 CCBs for Treating Stable Angina 25514.4 Organic Nitrate for Treating Stable Angina 25514.5 New Antianginal Drugs: Ranolazine 25514.6 Other New and Emerging Drugs 25814.7 Summary of Chapter Key Points 25914.8 Self-Assessment Questions 259References 26015 Management of Stable Angina/Stable Ischemic Heart Disease: Principles and Guidelines 26215.1 Overview 26215.2 Introduction to Current Guidelines on Management of Stable Angina/SIHD 26215.3 General Principles of Management of Stable Angina/SIHD 26515.4 Current Guideline Recommendations on Stable Angina/SIHD Management 26615.5 Management of Special Types of Stable Angina 27115.6 Summary of Chapter Key Points 27315.7 Self-Assessment Questions 273References 273UNIT V ISCHEMIC HEART DISEASE: ACUTE CORONARY SYNDROMES 27516 Overview of Acute Coronary Syndromes and Drug Therapy 27716.1 Introduction 27716.2 Definitions and General Considerations 27716.3 Pathophysiology and Drug Targeting 27816.4 Summary of Chapter Key Points 28016.5 Self-Assessment Questions 281References 28117 Anticoagulants, Platelet Inhibitors, and Thrombolytic Agents 28317.1 Overview 28317.2 Hemostasis 28317.3 Anticoagulants 28517.4 Platelet Inhibitors 29517.5 Thrombolytic Agents 30417.6 Summary of Chapter Key Points 30717.7 Self-Assessment Questions 307References 30818 Management of Unstable Angina and Non-ST-Elevation Myocardial Infarction: Principles and Guidelines 31018.1 Overview 31018.2 Introduction to Evidence-Based Guidelines 31018.3 General Principles of Management of UA/NSTEMI 31118.4 Guideline-Based Recommendations on the Management of UA/NSTEMI 31118.5 Summary of Chapter Key Points 32418.6 Self-Assessment Questions 325References 32519 Management of ST-Elevation Myocardial Infarction: Principles and Guidelines 32719.1 Overview 32719.2 Definition and Epidemiology 32719.3 Introduction to Recent Guidelines on the Management of STEMI 32819.4 Principles and Guideline Recommendations for the Management of STEMI 32919.5 Summary of Chapter Key Points 33919.6 Self-Assessment Questions 340References 340UNIT VI HEART FAILURE 34320 Overview of Heart Failure and Drug Therapy 34520.1 Introduction 34520.2 Definition, Classification, and Epidemiology 34520.3 Pathophysiology and Drug Targeting 34820.4 Summary of Chapter Key Points 34920.5 Self-Assessment Questions 350References 35021 Drugs for Heart Failure 35221.1 Overview 35221.2 Diuretics for Heart Failure 35221.3 β-Blockers for HF 35221.4 Inhibitors of the RAAS for HF 35321.5 Vasodilators for HF 35421.6 Positive Inotropic Agents for HF 35421.7 Emerging Drugs for HF 35921.8 Summary of Chapter Key Points 36021.9 Self-Assessment Questions 360References 36122 Management of Heart Failure: Principles and Guidelines 36422.1 Overview 36422.2 Management of Hf-REF 36422.3 Management of HF-PEF 36722.4 Management of Acute Heart Failure Syndromes 36822.5 Summary of Chapter Key Points 37222.6 Self-Assessment Questions 373References 374UNIT Vii CARDIAC ARRHYTHMIAS 37523 Overview of Cardiac Arrhythmias and Drug Therapy 37723.1 Introduction 37723.2 Definition, Classification, and Epidemiology 37723.3 Pathophysiology and Drug Targeting 38023.4 Summary of Chapter Key Points 38823.5 Self-Assessment Questions 389References 39024 Drugs for Cardiac Arrhythmias 39124.1 Overview 39124.2 Classification of Antiarrhythmic Drugs 39124.3 Class I Antiarrhythmic Drugs 39224.4 Class II Antiarrhythmic Drugs 39824.5 Class III Antiarrhythmic Drugs 39924.6 Class IV Antiarrhythmic Drugs 40424.7 Other Antiarrhythmic Drugs 40624.8 Summary of Chapter Key Points 40824.9 Self-Assessment Questions 409References 41025 Management of Cardiac Arrhythmias: Principles and Guidelines 41125.1 Overview 41125.2 General Principles of Management 41125.3 Management of Supraventricular Arrhythmias 41125.4 Management of Ventricular Arrhythmias 41425.5 Summary of Chapter Key Points 42125.6 Self-Assessment Questions 423References 424UNIT Viii ISCHEMIC STROKE 42726 Overview of Ischemic Stroke and Drug Therapy 42926.1 Introduction 42926.2 Definition and Classification of Cerebrovascular Diseases 42926.3 Definition and Classification of Stroke 42926.4 Epidemiology of Stroke 43026.5 Risk Factors of Stroke 43226.6 Pathophysiology of Ischemic Stroke and Drug Targeting 43226.7 Summary of Chapter Key Points 43426.8 Self]Assessment Questions 434References 43527 Drugs for Ischemic Stroke 43627.1 Overview 43627.2 Drugs for Primary Prevention of Ischemic Stroke 43627.3 Drugs for Early Treatment of Acute Ischemic Stroke 43827.4 Drugs for Neuroprotection 43927.5 Drugs for Secondary Prevention of Ischemic Stroke 44127.6 Stem Cell Therapy for Neurorepair 44227.7 Summary of Chapter Key Points 44227.8 Self-Assessment Questions 443References 44428 Management of Ischemic Stroke: Principles and Guidelines 44728.1 Overview 44728.2 Introduction to Stroke Systems of Care 44728.3 Current AHA/ASA Guidelines on Early Management of Acute Ischemic Stroke 44928.4 Summary of Chapter Key Points 45028.5 Self-Assessment Questions 455References 456INDEX 457