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Antihypertensive drugs guidelines

Kirsten P J Smits, Grigory Sidorenkov, Nanne Kleefstra, Steven H Hendriks, Margriet Bouma, Marianne Meulepas, Gerjan Navis, Henk J G Bilo, Petra Denig
BACKGROUND: Guideline-adherent prescribing for treatment of multiple risk factors in type 2 diabetes (T2D) patients is expected to improve clinical outcomes. However, the relationship to Health-Related Quality of Life (HRQoL) is not straightforward since guideline-adherent prescribing can increase medication burden. OBJECTIVES: To test whether guideline-adherent prescribing and disease-specific medication burden are associated with HRQoL in patients with T2D. METHODS: Cross-sectional study including 1,044 T2D patients from the e-VitaDM/ZODIAC study in 2012 in the Netherlands...
2018: PloS One
Marianne A Mahrouse
Therapeutic drug monitoring of angiotensin converting enzyme inhibitors (ACEI) has a great impact in blood pressure control in patient with heart failure, hepatic and renal impairment. To provide an efficient tool for drug assessment in plasma, UPLC-MS/MS method was developed for simultaneous determination of benazepril hydrochloride (BNZ), fosinopril sodium (FOS), captopril (CAP) and hydrochlorothiazide (HCT) in human plasma samples. Solid phase extraction was applied for sample preparation using OASIS® hydrophilic-lipophilic balanced reversed phase sorbents cartridges...
August 14, 2018: Biomedical Chromatography: BMC
Bumjung Kim, Cheolmin Jo, Ho-Young Choi, Kyungjin Lee
Historically, traditional herbal medicines (THMs) have been the conventional treatment strategy in the Korean medical system for treating many diseases. However, THMs have rarely been used to treat hypertension, and moreover few studies have investigated the interaction of blood pressure with the coadministration of synthetic antihypertensives. We aimed to evaluate the vasorelaxant and hypotensive effects of the traditional herbal prescription Cheonwangbosimdan (CWBSD; "Tianwangbuxindan" in Chinese) and the combination of CWBSD with amlodipine...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Nanny N M Soetedjo, Susan M McAllister, Cesar Ugarte-Gil, Adela G Firanescu, Katharina Ronacher, Bachti Alisjahbana, Anca L Costache, Carlos Zubiate, Stephanus T Malherbe, Raspati C Koesoemadinata, Yoko V Laurence, Fiona Pearson, Sarah Kerry-Barnard, Rovina Ruslami, David A J Moore, Mihai Ioana, Leanie Kleynhans, Hikmat Pernama, Philip C Hill, Maria Mota, Gerhard Walzl, Hazel M Dockrell, Julia A Critchley, Reinout van Crevel
OBJECTIVE: To describe the characteristics and management of Diabetes mellitus (DM) patients from low- and middle-income countries (LMIC). METHODS: We systematically characterized consecutive DM patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on DM treatment history, complications, drug treatment, obesity, HbA1c, and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines...
August 14, 2018: Tropical Medicine & International Health: TM & IH
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
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
Federico Rea, Giovanni Corrao, Luca Merlino, Giuseppe Mancia
Aims: Guidelines support use of drug combinations in most hypertensive patients, and recently treatment initiation with two drugs has been also recommended. However, limited evidence is available on whether this leads to greater cardiovascular (CV) protection compared to initial monotherapy. Methods and results: Using the healthcare utilization database of the Lombardy Region (Italy), the 44 534 residents of the region (age 40-80 years) who in 2010 started treatment with one antihypertensive drug (n = 37 078) or a two-drug fixed-dose combination (FDC, n = 7456) were followed for 1 year after treatment initiation to compare the risk of hospitalization for CV disease associated with the two treatment strategies...
July 27, 2018: European Heart Journal
Antonio Del Giudice, Andrea Fontana, Antonio Cicchella, Claudio Carmine Guida, Antonio Gesuete, Rachele Grifa, Antonio Mangiacotti, Filomena Miscio, Matteo Piemontese, Michele Prencipe, Michele Vergura, Massimiliano Copetti, Filippo Aucella
Objective: In developed countries, blood pressure (BP) control has increased over the past few decades and is now approaching 70% of patients. Herewith we report the results of a cross-sectional study carried out on hypertensive outpatients. Design and methods: In a cohort of 1,412 consecutive hypertensive outpatients (790 females, 622 males; mean age: 60.3±12.2 years) evaluated from January 2015 to December 2016, the following parameters were assessed: age, gender, body mass index (BMI), waist circumference (WC), smoking habits, BP in the sitting position, estimated glomerular filtration rate (eGFR), serum glucose, lipid profile, antihypertensive drugs prescribed...
July 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Marta Kucan, Jasenka Mrsic-Pelcic, Dinko Vitezic
PURPOSE: Possible factors that could influence changes in patterns of prescribing antihypertensives could be identified by monitoring national trends in hypertension treatment. The choice of pharmacologic treatment in people with hypertension has important therapeutic and financial implications, due to the fact that the financial costs associated with hypertension continue to increase. The aims of our study were to identify and analyze changes in the usage of antihypertensive drugs in Croatia from 2000 to 2016 and to identify the changes in prescribing patterns as well as mean prices per defined daily dose (DDD)...
July 12, 2018: Clinical Therapeutics
Rohan Khera, Yuan Lu, Jiapeng Lu, Anshul Saxena, Khurram Nasir, Lixin Jiang, Harlan M Krumholz
OBJECTIVE: To examine the effect of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guidelines on the prevalence of hypertension and eligibility for initiation and intensification of treatment in nationally representative populations from the United States and China. DESIGN: Observational assessment of nationally representative data. SETTING: US National Health and Nutrition Examination Survey (NHANES) for the most recent two cycles (2013-14, 2015-16) and China Health and Retirement Longitudinal Study (CHARLS) (2011-12)...
July 11, 2018: BMJ: British Medical Journal
Gennaro Russo, Ilaria Liguori, Luisa Aran, Giulia Bulli, Francesco Curcio, Gianluigi Galizia, Gaetano Gargiulo, Gianluca Testa, Andrea Ungar, Francesco Cacciatore, Domenico Bonaduce, Pasquale Abete
In the last years, guidelines for the treatment of hypertension recommended individualized blood pressure goals for geriatric population because of elderly susceptibility to adverse outcomes and higher mortality rate deriving from the excessive blood pressure lowering, especially in "frail" elderly. Recent findings from the SPRINT study, which demonstrated that intensive blood pressure lowering was associated with lower rates of cardiovascular events and mortality in both hypertensive fit and frail elderly subjects compared to standard treatment, heavily influenced the recent US guidelines...
July 10, 2018: Journal of Human Hypertension
Melissa J Palmer, Sharmani Barnard, Pablo Perel, Caroline Free
BACKGROUND: Cardiovascular disease (CVD) is a major cause of disability and mortality globally. Premature fatal and non-fatal CVD is considered to be largely preventable through the control of risk factors via lifestyle modifications and preventive medication. Lipid-lowering and antihypertensive drug therapies for primary prevention are cost-effective in reducing CVD morbidity and mortality among high-risk people and are recommended by international guidelines. However, adherence to medication prescribed for the prevention of CVD can be poor...
June 22, 2018: Cochrane Database of Systematic Reviews
Christine Gulla, Elisabeth Flo, Reidun Ls Kjome, Bettina S Husebo
Background: It is debatable whether treating multimorbid nursing home patients with antihypertensive drugs produces beneficial effects. Most cardiovascular guidelines promote treatment; few have advice on how to deprescribe when treatment may no longer be necessary. We investigated the effect of medication review on antihypertensive drug use and the association between cognition, blood pressure, and prescribing. Methods: From August 2014 to December 2015, 765 patients from 72 units (clusters) in 32 Norwegian nursing homes were included in a 4-month, multicentre, cluster-randomized, controlled trial, with 9-month follow-up...
April 2018: Journal of Geriatric Cardiology: JGC
Carolina Guerrero-García, Alberto Francisco Rubio-Guerra
Hypertension is a major preventable risk factor for atherosclerosis and ischemic heart disease. Although modern and effective antihypertensive drugs are available, most patients remain with a suboptimal blood pressure control. Most hypertensive patients will need a combination of antihypertensive agents to achieve the therapeutic goals - recent guidelines recommend initiating treatment with two drugs in those patients with a systolic blood pressure >20 mmHg and/or a diastolic blood pressure >10 mmHg above the goals, and in those patients with high cardiovascular risk...
2018: Drugs in Context
Bastian Schrader, Stephan Lüders, Michael Koziolek, Hermann Haller, Joachim Schrader
Following the publication of the new US guidelines, especially the new classifications of hypertension and the general reduction in treatment targets were discussed worldwide. Applying the US guidelines to a recent German cohort study would in practice lead to a significant increase in the diagnosis of "hypertension" in untreated patients. The number of under-adjusted patients would also increase sharply, increasing more than those predicted in the US Guidelines. Affected by an intensified antihypertensive therapy would be particularly elderly patients, in which adverse drug reactions but also occur more frequently...
June 2018: Deutsche Medizinische Wochenschrift
Rigas G Kalaitzidis, Moses S Elisaf
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is recognized as a worldwide epidemic. Hypertension commonly coexists with CKD and its prevalence is progressively increasing as kidney function declines. RECENT FINDINGS: For patients with established CKD and/or diabetes with albuminuria, the updated hypertension guidelines have recommended a blood pressure (BP) goal < 130/80 mmHg. Blood pressure level above 130/80 mmHg in CKD patients requires lifestyle modifications and multiple antihypertensive medications...
June 11, 2018: Current Hypertension Reports
Michael T Eadon, Sri H Kanuri, Arlene B Chapman
Introduction: Increasing clinical evidence supports the implementation of genotyping for anti-hypertensive drug dosing and selection. Despite robust evidence gleaned from clinical trials, the translation of genotype guided therapy into clinical practice faces significant challenges. Challenges to implementation include the small effect size of individual variants and the polygenetic nature of antihypertensive drug response, a lack of expert consensus on dosing guidelines even without genetic information, and proper definition of major antihypertensive drug toxicities...
2018: Expert Review of Precision Medicine and Drug Development
Anthony J Viera
Hypertension affects at least 1 in 3 American adults and is a major contributor to premature mortality. Current guidelines recommend screening all adults for hypertension. Ambulatory blood pressure (BP) monitoring should be used to confirm the diagnosis of hypertension for most adults before starting antihypertensive drugs. Ambulatory BP monitoring is the preferred method but home BP monitoring is an acceptable alternative. Management of hypertension substantially reduces the risk of heart failure, stroke, and myocardial infarction...
June 2018: FP Essentials
Dike B Ojji, Neil Poulter, Albertino Damasceno, Karen Sliwa, Wynand Smythe, Nicky Kramer, Motasim Badri, Veronica Francis, Akinyemi Aje, Felix Barasa, Anastase Dzudie, Erika Jones, Shehu S Kana, Pindile Mntla, Charles Mondo, Okechukwu Ogah, Elijah N Ogola, Gboyega Ogunbanjo, Ikechi Okpechi, Gabriel Shedul, Mahmoud U Sani, Grace Shedul, Bongani M Mayosi
BACKGROUND: Current hypertension guidelines recommend the use of combination therapy as first-line treatment or early in the management of hypertensive patients. Although there are many possible combinations of blood pressure(BP)-lowering therapies, the best combination for the black population is still a subject of debate because no large randomized controlled trials have been conducted in this group to compare the efficacy of different combination therapies to address this issue. METHODS: The comparison of 3 combination therapies in lowering BP in the black Africans (CREOLE) study is a randomized single-blind trial that will compare the efficacy of amlodipine plus hydrochlorothiazide versus amlodipine plus perindopril and versus perindopril plus hydrochlorothiazide in blacks residing in sub-Saharan Africa (SSA)...
August 2018: American Heart Journal
Takayuki Ishida, Akinori Oh, Shinzo Hiroi, Yukio Shimasaki, Takuya Tsuchihashi
In 2014, the Japanese Society of Hypertension (JSH) issued revised guidelines for hypertension management. To assess adherence to the guidelines, this retrospective study evaluated the real-world status of antihypertensive drug prescribing for Japanese patients with hypertension, classified by comorbidity: diabetes mellitus, dyslipidemia, gout/hyperuricemia and renal diseases. Data on 59,867 hypertensive patients who received their first prescription for antihypertensive therapy between April 2014 and March 2015, were obtained from a medical insurance claims database for hospitals participating in the Diagnosis Procedure Combination/Per-Diem payment system...
May 21, 2018: Clinical and Experimental Hypertension: CHE
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