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antihypertensive therapy

L A Dobrynina, M R Zabitova, L A Kalashnikova, E V Gnedovskaya, M A Piradov
Hypertension (HT) and its cerebral complications are extremely vexing medical and social problems. Despite the obvious association between hypertension and the clinical and neuroimaging features of cerebral microangiopathy (CMA) (also known as cerebral small vessel disease), the causal links between them remain ambiguous. Besides, antihypertensive therapy as the only way to manage these patients does not always prevent brain damage. Knowledge about the key factors and mechanisms involved in HT and CMA development is important for predicting the risk of cerebral complications and developing new approaches to their prevention and treatment...
April 2018: Acta Naturae
María D Paredes, Paola Romecín, Noemí M Atucha, Francisco O'Valle, Julián Castillo, María Clara Ortiz, Joaquín García-Estañ
Many studies have shown that flavonoids are effective as antihypertensive drugs in arterial hypertension. In the present work, we have analyzed the effects of some flavonoid extracts in the spontaneous hypertensive rat model (SHR). An important feature of this study is that we have used a low dose, far from those that are usually applied in human therapy or experimental animals, a dose that responded to the criterion of a potential future commercial use in human subjects. Treatments were carried out for 6 and 12 weeks in two groups of SHR rats, which received apigenin, lemon extract, grapefruit + bitter orange (GBO) extracts, and cocoa extract...
August 16, 2018: Nutrients
Kyoung Hwa Ha, Yong Ho Lee, Sun Ok Song, Jae Woo Lee, Dong Wook Kim, Kyung Hee Cho, Dae Jung Kim
BACKGROUND: A diabetes risk score in Korean adults was developed and validated. METHODS: This study used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) of 359,349 people without diabetes at baseline to derive an equation for predicting the risk of developing diabetes, using Cox proportional hazards regression models. External validation was conducted using data from the Korean Genome and Epidemiology Study. Calibration and discrimination analyses were performed separately for men and women in the development and validation datasets...
July 6, 2018: Diabetes & Metabolism Journal
Gustavo H Oliveira-Paula, Jose E Tanus-Santos
Hypertension is usually associated with deficient nitric oxide (NO) bioavailability, and therefore stimulating NO activity is an important antihypertensive strategy. Recently, many studies have shown that both nitrite and nitrate anions are not simple products of NO metabolism and indeed may be reduced back to NO. While enzymes with nitrite-reductase activity capable of generating NO from nitrite may contribute to antihypertensive effects of nitrite, another mechanism involving the generation of NO-related species in the stomach from nitrite has been validated...
August 16, 2018: Current Drug Targets
Miklos Rohla, Maximilian Tscharre, Kurt Huber, Thomas W Weiss
BACKGROUND: In Austria only 41% of patients with treated hypertension (HTN) have their blood pressure (BP) controlled. This study investigated a strategy to improve BP control in primary care. METHODS: General practitioners (GPs) were randomized to interventional care vs. standard care and included patients with uncontrolled office BP > 140/90 mm Hg. In interventional care, antihypertensive therapy was up-titrated using a single pill combination (olmesartan, amlodipine and/or hydrochlorothiazde) in 4‑week intervals...
August 15, 2018: Wiener Klinische Wochenschrift
Daniela Sandoval, Carolina Nazzal, Tomás Romero
Background: Limited information exists on blood pressure (BP) control factors and adherence to antihypertensive drug therapy (Rx) in developing countries. Methods: Cross-sectional study in randomly selected 992 hypertensive patients under a Chilean national comprehensive Cardiovascular Health Program (CVHP). Association of education, income, diabetes, obesity, physical activity, psychosocial characteristics, smoking, and alcohol abuse with BP control and adherence were evaluated by multivariate logistic regression...
2018: International Journal of Hypertension
Eerik Ee Santala, Antti Rannikko, Teemu J Murtola
Antihypertensive (anti-HT) drugs targeting renin-angiotensin-aldosterone (RAA)- system have been associated with improved prostate cancer (PCa)-specific survival. Challenge is that often multiple drugs are used simultaneously. We evaluated the association between use of anti-HT drugs and PCa survival among 14,422 surgically treated Finnish PCa patients. Information on drug purchases was obtained from a national prescription database. We used Cox regression to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for risk of PCa death and initiation of androgen deprivation therapy (ADT) with adjustment for age, tumor extent, use of statins and for Charlson Comorbidity Index...
August 15, 2018: International Journal of Cancer. Journal International du Cancer
M-A Quera-Salva, B Claustrat
Melatonin is a hormone secreted by the pineal gland. It displays a very marked nycthohemeral rhythm, which is entrained to the light dark cycle. The secretion spreads over 8-10 hours, with a maximum around 3-4 a.m. Melatonin plays the role of an endogenous synchronizer which regulates circadian rhythms, especially the sleep/wake and temperature rhythms. Acute melatonin administration reduces sleep latency, increases theta/alpha power and spindle activity (soporific activity). Fast-release melatonin preparations showed inconstant effects in insomnia...
August 11, 2018: L'Encéphale
Ruoxi Liao, Jiameng Li, Yuqin Xiong, Liping Lin, Liya Wang, Si Sun, Baihai Su
BACKGROUND/AIMS: Blood pressure variability (BPV) is a novel cardiovascular risk factor for the population undergoing hemodialysis (HD). METHODS: We conducted a retrospective cohort study of 526 HD patients. Four short-term peridialysis BPV metrics were analyzed: systolic blood pressure (SBP) change, SBP coefficient of variation (CV), SBP intradialytic average real variability (ARV), and absolute SBP residual. Multi variate analysis with Cox regression models were used to account for the potential confounders...
August 10, 2018: Kidney & Blood Pressure Research
Randall S Stafford
The recently released 2017 High Blood Pressure Guidelines depart from past guidelines in both their approach and recommendations. Developed by multiple health organizations, including the American College of Preventive Medicine, the guidelines continue to define normal blood pressure as <120/80 mmHg, but now define hypertension as ≥130/80 mmHg (previously ≥140/90 mmHg). This change categorizes 101 million Americans (46% of adults) as hypertensive (compared to 32% previously). The guidelines rely heavily on findings from the Systolic Blood Pressure Intervention Trial (SPRINT)...
August 6, 2018: American Journal of Preventive Medicine
J Nossent, W Raymond, A Kang, D Wong, M Ognjenovic, A Chakera
Objectives To investigate the current demographic, clinical and histological characteristics of patients with lupus nephritis (LN) in Western Australia (WA) with regards to their predictive value for patient and renal outcome. Methods Retrospective study of adult systemic lupus erythematosus (SLE) patients with a first renal biopsy demonstrating LN between 1997 and 2017 at a metropolitan tertiary hospital in WA. Clinical data were collected at baseline and last follow-up with renal biopsy findings classified by International Society of Nephrology (ISN) criteria...
August 9, 2018: Lupus
Omar Mukhtar, Joseph Cheriyan, John R Cockcroft, David Collier, James M Coulson, Indranil Dasgupta, Luca Faconti, Mark Glover, Anthony M Heagerty, Teck K Khong, Gregory Y H Lip, Adrian P Mander, Mellone N Marchong, Una Martin, Barry J McDonnell, Carmel M McEniery, Sandosh Padmanabhan, Manish Saxena, Peter J Sever, Julian I Shiel, Julie Wych, Phil J Chowienczyk, Ian B Wilkinson
BACKGROUND: Ethnicity, along with a variety of genetic and environmental factors, is thought to influence the efficacy of antihypertensive therapies. Current UK guidelines use a "black versus white" approach; in doing so, they ignore the United Kingdom's largest ethnic minority: Asians from South Asia. STUDY DESIGN: The primary purpose of the AIM-HY INFORM trial is to identify potential differences in response to antihypertensive drugs used as mono- or dual therapy on the basis of self-defined ethnicity...
May 20, 2018: American Heart Journal
Mauro Carrara, Eleonora Massari, Alessandro Cicchetti, Tommaso Giandini, Barbara Avuzzi, Federica Palorini, Claudio Stucchi, Giovanni Fellin, Pietro Gabriele, Vittorio Vavassori, Claudio Degli Esposti, Cesare Cozzarini, Emanuele Pignoli, Claudio Fiorino, Tiziana Rancati, Riccardo Valdagni
OBJECTIVES: To apply artificial neural network (ANN) classification methods for the prediction of late fecal incontinence (LFI) following high-dose prostate cancer radiotherapy (RT) and to develop a "ready to use" graphical-tool. MATERIAL & METHODS: 598 men recruited in two national multicentre trials were analyzed. Information was recorded on comorbidity, previous abdominal surgery, use of drugs and dose distribution. Fecal incontinence was prospectively evaluated through self-reported questionnaires...
August 6, 2018: International Journal of Radiation Oncology, Biology, Physics
Khafsa Malik, Mushtaq Ahmad, Rainer W Bussmann, Akash Tariq, Riaz Ullah, Ali S Alqahtani, Abdelaaty A Shahat, Neelam Rashid, Muhammad Zafar, Shazia Sultana, Syed N Shah
Hypertension is one of the most important factors responsible for cardiovascular ailments worldwide. It has been observed that herbal products and alternative herbal therapies played a significant role in decreasing hypertension. The aim of the current study is to provide significant ethnopharmacological information, both qualitative and quantitative on medicinal plants related to hypertension from Northern Pakistan. The documented data were quantitatively analyzed for the first time in this area. A total of 250 participants were interviewed through semi-structured discussions and questionnaires...
2018: Frontiers in Pharmacology
Panagiotis I Georgianos, Rajiv Agarwal
Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves clinical outcomes in hemodialysis patients. BP-lowering in these individuals should initially utilize nonpharmacological strategies aiming to control sodium and volume overload. Accordingly, restricting dietary sodium intake, eliminating intradialytic sodium gain via individualized dialysate sodium prescription, optimally assessing and managing dry-weight and providing a sufficient duration of dialysis are first-line treatment considerations to control BP...
August 6, 2018: Seminars in Dialysis
Gerald W Smetana, Jennifer Beach, Lewis Lipsitz, Howard Libman
Hypertension is prevalent and the most important risk factor for cardiovascular disease. Controversy exists regarding the optimum threshold above which to begin antihypertensive therapy and the optimum target blood pressure once medication is begun. This controversy is particularly true for older patients, who may be more likely to benefit from treatment because of their higher risk for cardiovascular events, but may also be more at risk for adverse effects of treatment. Two guidelines published in 2017 address this issue...
August 7, 2018: Annals of Internal Medicine
E N Dudinskaya, O N Tkachyeva, E V Bazaeva, N V Sharashkina, I D Strazhesko, Y V Kotovskaya, V N Larina
OBJECTIVE: To assess the effect of moxonidine on bone metabolism and bone mineral density (BMD) in postmenopausal patients with arterial hypertension (AH) and osteopenia. MATERIALS AND METHODS: A randomized, open, clinical trial included 114 postmenopausal patients with AH. All participants were evaluated bone metabolism), BMD, telomerase activity (TA). Randomization was carried out into 2 groups (moxonidine and bisoprolol therapy) using simple envelopes. After 12 months of therapy, a dynamic examination was performed...
2018: Kardiologiia
Norimitsu Murai, Tetsushi Azami, Tatsuya Iida, Kentaro Mikura, Hideyuki Imai, Mariko Kaji, Mai Hashizume, Yasuyoshi Kigawa, Go Koizumi, Rie Tadokoro, Kei Endo, Toru Iizaka, Ryo Saiki, Fumiko Otsuka, Tomoko Norose, Motoki Yamagishi, Ippei Kurokawa, Nobuyuki Oike, Haruaki Sasaki, Shoichiro Nagasaka
Changes in imaging findings and hormone levels before and after pheochromocytoma rupture, as well as detailed histopathology of resected tumors, have rarely been reported. A 52-year-old woman developed hypertension and diabetes mellitus in 2014, but despite treatment with antihypertensive and hypoglycemic drugs, good control was not achieved. On April 2, 2016, the patient started to have headaches and palpitations, and on April 6, she visited our hospital. Plain computed tomography (CT) of the abdomen showed a 4-cm, isodense mass in the left adrenal gland, and the patient was hospitalized for further examination...
August 4, 2018: Endocrine Journal
MarySue Beran, Stephen E Asche, Anna R Bergdall, Benjamin Crabtree, Beverly B Green, Sarah E Groen, Krissa J Klotzle, Ryan D Michels, Rachel A Nyboer, Patrick J O'Connor, Pamala A Pawloski, Daniel J Rehrauer, JoAnn M Sperl-Hillen, Nicole K Trower, Karen L Margolis
OBJECTIVES: The Hyperlink trial tested a 12-month intervention of home blood pressure (BP) telemonitoring with pharmacist case management in adults with uncontrolled hypertension. The intervention resulted in improved BP control compared with usual care at both 6 (72% vs. 45%; P < 0.001) and 12 months (71% vs. 53%; P = 0.005). We sought to investigate factors contributing to intervention success. DESIGN: Mixed-methods analysis of process of care data, patient focus groups, and pharmacist interviews...
August 1, 2018: Journal of the American Pharmacists Association: JAPhA
Valentina Cannone, Alessia Buglioni, S Jeson Sangaralingham, Christopher Scott, Kent R Bailey, Richard Rodeheffer, Margaret M Redfield, Riccardo Sarzani, John C Burnett
OBJECTIVE: To investigate the relationships among aldosterone level, use of antihypertensive (anti-HTN) medications, clinical profile, and atrial natriuretic peptide (ANP) level in individuals with HTN. PARTICIPANTS AND METHODS: In a community-based cohort, we analyzed aldosterone plasma levels based on the presence (n=477) or absence (n=1073) of HTN. In individuals with HTN, we evaluated circulating aldosterone levels according to the number of anti-HTN drugs used, analyzed the associated clinical characteristics, and determined the relationship to the counterregulatory cardiac hormone ANP...
August 2018: Mayo Clinic Proceedings
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