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antihypertensive therapy

Thompson G Robinson, William J Davison, Peter M Rothwell, John F Potter
INTRODUCTION: Raised blood pressure (BP) is common after stroke and is associated with a poor prognosis, yet trials of BP lowering in the immediate poststroke period have not demonstrated a benefit. One possible explanation for this may be that BP variability (BPV) rather than absolute levels predicts outcome, as BPV is increased after stroke and is associated with poor outcomes. Furthermore, there is evidence of distinct antihypertensive class effects on BPV despite similar BP-lowering effects...
February 19, 2019: BMJ Open
Ahmet Firat, Bulent Kaya, Mustafa Balal, Saime Paydas, Rabia Akilli
OBJECTIVES: Hypertension is a common and important problem in kidney transplant recipients, directly affecting graft and patient survival. Here, we evaluated the relationship between renal-cardiac damage and peripheral and central aortic blood pressure levels in renal transplant recipients. MATERIALS AND METHODS: We measured peripheral blood pressure (office, daytime ambulatory, and central aortic) in 46 kidney transplant recipients. Biochemical parameters were simultaneously measured...
January 2019: Experimental and Clinical Transplantation
Mehdi Siddiqui, Joshua Iltis, Petar Yanev, John Sladic, Charles Huynh, Daniel Nolan, Michael Singer
Purpose: There is a limited understanding of factors that influence the efficacy of topical glaucoma medication. Our study is a long-term, case-control analysis of how systemic antihypertensive (anti-HTN) medications influence the change in IOP after initiating prostaglandin (PG) drop therapy. Materials and methods: A retrospective chart review of 3,781 patients was performed on patients with a diagnosis of glaucoma suspect that progressed to primary open-angle glaucoma (POAG) by ICD-9 codes over a 10-year period...
2019: Clinical Ophthalmology
Ben Li, Konrad Salata, Charles de Mestral, Mohamad A Hussain, Badr A Aljabri, Thomas F Lindsay, Subodh Verma, Mohammed Al-Omran
BACKGROUND: Vascular surgeons have a central role in managing peripheral artery disease (PAD). This study assessed their knowledge, attitudes, and behaviours regarding pharmacologic risk reduction in PAD and results were compared to a similar 2004 survey conducted by our group. METHODS: An online questionnaire was administered to 161 active members of the Canadian Society for Vascular Surgery. RESULTS: Forty-eight participants (30%) completed the survey...
February 13, 2019: Annals of Vascular Surgery
Michihiro Satoh, Takayoshi Ohkubo, Kei Asayama, Yoshitaka Murakami, Daisuke Sugiyama, Michiko Yamada, Shigeyuki Saitoh, Kiyomi Sakata, Fujiko Irie, Toshimi Sairenchi, Shizukiyo Ishikawa, Masahiko Kiyama, Hirofumi Ohnishi, Katsuyuki Miura, Yutaka Imai, Hirotsugu Ueshima, Tomonori Okamura
Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. The present metaanalysis included 107 737 Japanese (42.4% men; mean age, 55.1 years) from 13 cohorts. During the mean follow-up of 15.2±5.3 years (1 559 136 person-years), 1922 died from stroke and 913 from CHD...
January 2019: Hypertension
Zhiwen Xie, Patricia St Clair, Dana P Goldman, Geoffrey Joyce
OBJECTIVE: To examine the association between socioeconomic status (SES) and racial and ethnic disparities in medication adherence for three widely prescribed therapeutic classes. METHODS: We linked longitudinal claims data from a large US-based insurance provider (2011-2013) to detailed SES information to identify patients treated with oral antidiabetic (N = 56,720), antihypertensive (N = 156,468) or antihyperlipidemic (N = 144,673) medications. We measured adherence and discontinuation by therapeutic class, and conducted regression analysis to quantify the contributions of different factors in the association between race/ethnicity and medication adherence...
2019: PloS One
Qin Lu, Sheng-Ming Wang, Yi-Xiao Liu, Hong Chen, Rui Zhang, Wen-Hui Zhang, Yuan-Yuan Zou, Jia-Wei Zhou, Xin-Yi Guo, Ying Zhang, Teng-Li Huang, Yu-Hang Liu, Si-Qi Zhang, Kyosuke Yamanishi, Hiromichi Yamanishi, Hideaki Higashino, Haruki Okamura
Successful prevention and treatment of hypertension depend on the appropriate combination of antihypertensive drug therapy and nondrug lifestyle modification. While most hypertension guidelines recommend moderate- to high-intensity exercise, we decided to explore a mild yet effective type of exercise to add to hypertension management, especially in populations with complications or frailty. After comparing the short-term cardiovascular effects of low-speed walking versus high-speed walking for 3 kilometers (km) (3 km/h versus 6 km/h) in young, healthy volunteers, we delivered low-speed walking (low-intensity walking, 2...
February 13, 2019: Acta Pharmacologica Sinica
Kazuomi Kario, Eiichiro Yamamoto, Hirofumi Tomita, Takafumi Okura, Shigeru Saito, Takafumi Ueno, Daiki Yasuhara, Kazuyuki Shimada
BACKGROUND: SYMPLICITY HTN-Japan is a prospective, randomized, controlled trial comparing renal denervation (RDN) with standard pharmacologic therapy for treatment of uncontrolled hypertension (HTN). Methods and Results: Patients enrolled had uncontrolled HTN, defined as office systolic blood pressure (SBP) ≥160 mmHg and 24-h ambulatory SBP ≥135 mmHg, on ≥3 antihypertensive drugs of maximally tolerated dose for at least 6 weeks prior to enrollment. Randomization was 1:1 to RDN or maintenance of current medical therapy (control)...
February 13, 2019: Circulation Journal: Official Journal of the Japanese Circulation Society
Elizabeth Thithi Ndichu, Kelechi Ohiri, Oluwafemi Sekoni, Olasunmbo Makinde, Kevin Schulman
BACKGROUND: As the burden of noncommunicable diseases grows, access to safe medical therapy is increasing in importance. The aim of this study was to develop a method for evaluating the quality of antihypertensive drugs and to examine whether this prevalence varies by socioeconomic variables. METHODS: We conducted a cross-sectional survey of registered pharmacies in 6 local government areas (LGAs) in Lagos State, Nigeria. In each LGA, we sampled 17 pharmacies from a list of all registered pharmacies derived from the Pharmacists Council of Nigeria...
2019: PloS One
Dan Pugh, Peter J Gallacher, Neeraj Dhaun
Chronic kidney disease (CKD) is an increasingly prevalent condition globally and is strongly associated with incident cardiovascular disease (CVD). Hypertension is both a cause and effect of CKD and affects the vast majority of CKD patients. Control of hypertension is important in those with CKD as it leads to slowing of disease progression as well as reduced CVD risk. Existing guidelines do not offer a consensus on optimal blood pressure (BP) targets. Therefore, an understanding of the evidence used to create these guidelines is vital when considering how best to manage individual patients...
February 13, 2019: Drugs
Mai Mehanna, Zhiying Wang, Yan Gong, Caitrin W McDonough, Amber L Beitelshees, John G Gums, Arlene B Chapman, Gary L Schwartz, Kent R Bailey, Julie A Johnson, Stephen T Turner, Rhonda M Cooper-DeHoff
Background: Inter-individual variability in blood pressure (BP) response to antihypertensives has been reported. Although plasma renin activity (PRA) is a potential biomarker for personalizing antihypertensive therapy in European-American (EA) and African-American (AA) hypertensives, clinical utility of PRA-guided prescribing is incompletely understood. Methods: sing systematic-phased-approach, PRA's clinical utility was assessed. After categorizing by baseline-PRA, clinic systolic-BP (SBP) responses to metoprolol and chlorthalidone were compared in 134 EAs and 102 AAs enrolled in the Pharmacogenomics Evaluation of Antihypertensive Responses-2 (PEAR-2) trial...
February 9, 2019: American Journal of Hypertension
Nadia Liyanage-Don, Deborah Fung, Erica Phillips, Ian M Kronish
PURPOSE OF REVIEW: To review data supporting the use of home blood pressure monitoring (HBPM) and provide practical guidance to clinicians wishing to incorporate HBPM into their practice. RECENT FINDINGS: HBPM more accurately reflects the risk of cardiovascular events than office blood pressure measurement. In addition, there is high-quality evidence that HBPM combined with clinical support improves blood pressure control. Therefore, HBPM is increasingly recommended by guidelines to confirm the diagnosis of hypertension and evaluate the efficacy of blood pressure-lowering medications...
February 12, 2019: Current Hypertension Reports
Georgi Tchernev, Ivanka Temelkova
BACKGROUND: Melanoma appears to be a malignant disease, whose development can be potentiated by different drug groups. More and more data are in favour of the claim that commonly used antihypertensive drugs also contain the risk of developing melanoma. The most evidence is that angiotensin receptor blockers may be carcinogenic. Two representatives from this group, valsartan and irbesartan, produced by certain pharmaceutical companies are being withdrawn from the market due to finding content of NDMA and NDEA, which are believed to be potent carcinogens...
January 15, 2019: Open Access Macedonian Journal of Medical Sciences
K Kamishima, H Ogawa, K Jujo, J Yamaguchi, N Hagiwara
OBJECTIVE: The effects of intensive blood pressure (BP) lowering for hypertensive patients with coronary artery disease (CAD) and diabetes mellitus on their clinical outcomes have not been fully evaluated. The aim was to explore the optimal systolic BP target in such patients in a substudy of a prospective, randomized trial. METHODS: Of a total of 2,049 hypertensive patients with CAD who were enrolled in the HIJ-CREATE study, type 2 diabetes was diagnosed in 780 (38...
February 5, 2019: Diabetes Research and Clinical Practice
Wen-Fang Chiang, Pei-Ti Chen, Yen-Lin Chen, Ming-Hua Chen
Posterior reversible encephalopathy syndrome (PRES) is a reversible vasogenic brain edema in patients who present with seizure, headache, visual disturbance, and altered mental status, and a characteristic neuroimaging profile. Although PRES predominantly affects the bilateral parieto-occipital areas, involvement of the frontal and temporal lobes, basal ganglia, brainstem, and cerebellum is not uncommon. Isolated involvement of the brainstem and cerebellum sparing the parieto-occipital lobe is rarely reported...
February 8, 2019: Hemodialysis International
Weiping Cao, Xinzhi Wang, Tingmei Chen, Mingmei Qin, Zuxian Wang, Qin Wang, Bing Xie, Wenlin Xu
RATIONALE: Eclampsia is a life-threatening complication of pregnancy. Eclampsia is a leading cause of maternal and neonatal morbidity and mortality with most injury being associated with the seizures that mark the onset of the disease. It is vital that medical worker managing eclampsia have an understanding of the disease process. PATIENT CONCERNS: A 28-year-old female, G4P1, with history of caesarean section was admitted at GA34+6, in addition to headache and severe hypertension (180/120 mm Hg) and proteinuria (+++)...
February 2019: Medicine (Baltimore)
Bartosz Uchmanowicz, Anna Chudiak, Izabella Uchmanowicz, Grzegorz Mazur
Background: Hypertension is considered to be the most common condition in the general population. It is the most important risk factor for premature deaths in the world. Treatment compliance at every stage is a condition for successful antihypertensive therapy, and improving the effectiveness of treatment is a major goal in preventing cardiovascular incidents. Treatment noncompliance and lack of cooperation stem from numerous problems of older age, including frailty syndrome. Objective: To evaluate the effect of frailty syndrome on treatment compliance in older patients with hypertension...
2019: International Journal of Hypertension
Attilio Dalla Via
The author presents the results of a personal audit proposed to the GPs by the ASL 6 Euganea of the Veneto Region. The results obtained show significant differences between the data provided by the pharmaceutical sector and those obtained by consulting the individual database. The therapeutic adherence of antihypertensive drugs appears to be particularly discordant. The audit also suggests inappropriate use of PPIs, improper use of corticosteroids for aerosols after modification of the prescribability and reduced adherence to statin therapy...
January 2019: Recenti Progressi in Medicina
Hua Fan, Feng Lu, Ailing Yang, Yidan Dong, Ping Liu, Youhua Wang
Hypertension is a global health concern. Although the pharmacological treatment has obvious antihypertensive effects, there are still some limitations on management of hypertension by drug therapy alone. In recent years, the nonpharmacological therapy of traditional Chinese medicine (TCM) has gradually become an important mean to help the prevention and treatment of hypertension in some Eastern countries. In this review, the nonpharmacological TCM therapies, including acupuncture, tuina, Tai Chi, and auricular-plaster, are covered along with the mechanism...
2019: Evidence-based Complementary and Alternative Medicine: ECAM
Vikas Jhawat, Sumeet Gupta, Bimal K Agarwal, Partha Roy, Vipin Saini
Background: Antihypertensive drug therapies have been reported to be associated with new onset of type 2 diabetes mellitus in some hypertensive patients after prolonged use. Angiotensin converting enzyme (ACE) gene has been found to affect essential hypertension, response of antihypertensive therapies, and glycemic disturbances. Therefore, ACE gene I/D polymorphism may be associated with risk of new onset of type 2 diabetes via metabolic disturbances, glycemic dysregulation, and insulin resistance...
2019: Clinical Medicine Insights. Endocrinology and Diabetes
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