TY - JOUR. T1 - The effect of antihypertensive agents on new-onset diabetes mellitus. T2 - Time to amend the guidelines?. AU - Aksnes, Tonje Amb. AU - Kjeldsen, Sverre Erik. AU - Mancia, Giuseppe. PY - 2006. Y1 - 2006. N2 - Recent large hypertension trials have shown great differences in incidence of new-onset diabetes mellitus among patients receiving different antihypertensive drug therapies. The incidence of diabetes is unchanged or increased by the use of thiazide diuretics and β-adrenoceptor antagonists (β-blockers) and unchanged or decreased by ACE inhibitors, calcium channel blockers (CCBs), and angiotensin II type 1 receptor antagonists (angiotensin receptor blockers). Recent results from ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) showed superiority of the new combination of CCBs and ACE inhibitors over the old or conventional combination of β-blockers and diuretics. In this review, the results from some of the large hypertension trials are discussed, and the hypotheses ...
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Strengths of our study design included its prospective design, large number of participants, a general population-based setting, and the long follow-up period of over 8 years average. Moreover, we used pharmacy records for the assessment of antihypertensive drug use. This greatly reduces the chance of exposure misclassification as opposed to baseline exposure data or periodic reassessment of drug use and allows for an accurate estimation of exposure duration. In an earlier study, we demonstrated that there was a high concordance between pharmacy filling data of cardiovascular drugs and actual use according to a patient interview.19 Moreover, we were able to subtract 4 years from the date of clinical diagnosis of dementia to avoid potentially biased risk estimates as a result of changes in antihypertensive prescription due to blood pressure changes or cognitive decline in the prodromal phase of dementia. Nevertheless, some issues warrant consideration. First, the 4-year period is an average ...
The mechanism of action of prazosin hydrochloride, a new antihypertensive agent was studied in 14 patients with essential hypertension. Mean supine blood pressure for the group fell from 148/102 +/- 3/2 (SE) mm Hg at baseline to 139/91 +/- 5/4 after eight weeks of therapy (P less than 0.05). No significant postural hypotension was noted in the patients who responded to therapy. Glomerular filtration rate (endogenous creatinine or inulin clearance) and effective renal plasma flow (PAH clearance) remained unchanged during therapy as did supine and stimulated peripheral plasma renin activity. Cardiac output did not change significantly although plasma volume increased in ten out of 12 patients in whom it was measured (P less than 0.025). Among the patients whose mean blood pressure fell 10 mm Hg or more, peripheral vascular resistance fell significantly (P less than 0.025), and the change in plasma volume was not statistically significant. Among the patients whose mean blood pressure changed less ...
The American Diabetes Association is recommending changes in blood pressure goals for people with diabetes and clarifying how frequently people with type 1 diabetes should test their blood glucose levels.. The revised recommendations include raising the treatment goal for high blood pressure from ,130 mm Hg to ,140 mm Hg, based on several new meta-analyses showing there is little additional benefit to achieving the lower targets. Clinical trials have demonstrated health benefits to achieving a goal of ,140 mm Hg, such as reducing cardiovascular events, stroke, or nephropathy, but limited benefit to more intensive blood pressure treatment, with no significant reduction in mortality or nonfatal heart attacks. There is a small but statistically significant benefit in terms of reducing risk of stroke, but at the expense of a need for more medications and higher rates of side effects.. The new standards also clarify when people who are taking multiple daily doses of insulin (MDI) or using insulin ...
The American Diabetes Association is recommending changes in blood pressure goals for people with diabetes and clarifying how frequently people with type 1 diabetes should test their blood glucose levels.. The revised recommendations include raising the treatment goal for high blood pressure from ,130 mm Hg to ,140 mm Hg, based on several new meta-analyses showing there is little additional benefit to achieving the lower targets. Clinical trials have demonstrated health benefits to achieving a goal of ,140 mm Hg, such as reducing cardiovascular events, stroke, or nephropathy, but limited benefit to more intensive blood pressure treatment, with no significant reduction in mortality or nonfatal heart attacks. There is a small but statistically significant benefit in terms of reducing risk of stroke, but at the expense of a need for more medications and higher rates of side effects.. The new standards also clarify when people who are taking multiple daily doses of insulin (MDI) or using insulin ...
There are many hypertension medications that sound or look very close to other medications. You should make sure that you receive your specific hypertension medication and not one that has been confused with your medication. Here is a list of possible hypertension medication errors. The hypertension medication is listed first. The medication in parenthesis is the medication that looks and/or sounds similar.) ...
TY - JOUR. T1 - Initial therapy for uncomplicated hypertension. T2 - Insights from the alphabetic maze of recent studies. AU - Stewart, J. R.. AU - Yeun, Jane Y. PY - 2003/8. Y1 - 2003/8. N2 - Some hypertension treatment guidelines published in the late 1990s recommended that diuretics and β-blockers be used as 1st line drugs for treating uncomplicated hypertension, reserving new antihypertensive drugs for special indications. This recommendation is predicated on the fact that large trials showing cardiovascular protection with antihypertensive drugs used β-blockers and diuretics. Other guidelines suggested all antihypertensives are equal and that drug selection should be individualized. These disparate guidelines arise from the controversy over "are all antihypertensives created equal?" Since these guidelines, many large hypertension trials have been conducted. This paper will review the recent hypertension trials, the meta-analyses of some of these trials, highlight some of the flaws ...
DR. WRIGHT: The results of SPRINT are very exciting. This study shows that intensive blood pressure management can prevent the cardiovascular complications of hypertension and save lives. As the NHLBI reported, treating high-risk hypertensive adults age 50 and older reduced cardiovascular events by 30 percent and reduced all-cause mortality by nearly 25 percent when compared with patients treated to a systolic target of 140 mm Hg. SPRINT was designed as a target-based study, which gave physicians flexibility in selecting antihypertensive medications to achieve the assigned blood pressure target. Hypertensive patients with a 10-year Framingham General cardiovascular risk ?15%, age ,75 years of age or pre-existing kidney disease were randomized to intensive blood pressure control (less than 120 mm Hg) or standard blood pressure control (less than 140 mm Hg). In the intensive-therapy arm, patients were treated with three or more antihypertensive medications, including diuretics, calcium channel ...
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Definition of antihypertensive agent in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is antihypertensive agent? Meaning of antihypertensive agent as a legal term. What does antihypertensive agent mean in law?
Use this listing to find an international brand name of a hypertension medication. The United States generic names and brand names will be listed first, followed by the international brand names. This will enable you to look up information on this site using the generic names. This list does not contain every hypertension medications international brand names nor does it contain every international brand name of hypertension medications ...
The cost-effectiveness study reports that the healthcare costs associated with intensive blood pressure control are balanced by gains in health, making it cost-effective over the course of a lifetime. Intensive control costs less than $50,000 for each quality-adjusted life-year gained, a measure of improvements in length and quality of life.. "The price is one that many experts believe U.S. society is willing to pay, making it a high value investment," says Bress.. A research team led by Bress and Brandon Bellows, PharmD, MS, a research assistant professor of Pharmacotherapy at U of U Health, modeled intensive and standard treatment in 10,000 hypothetical SPRINT-eligible patients to arrive at the conclusion. They gauged benefits and costs of intensive therapy in the face of uncertainties encountered in real life by incorporating over 250 variables, including a range of health histories and side effects.. "Its not possible to run clinical trials that last for decades for every type of patient," ...
See related article, pp 642-653. In this issue of the journal, Verdecchia et al1 report an important analysis of the accumulation of evidence comparing more versus less intensive blood pressure (BP)-lowering strategies. Their key message is critical for guidelines and practice internationally: with the addition of SPRINT (Systolic Blood Pressure Intervention Trial),2 this set of trials now provides compelling evidence that more intensive BP-lowering reduces stroke and myocardial infarction (MI), and significant reductions are now also seen in cardiovascular death and heart failure. The authors have also assessed sequential monitoring boundaries for each outcome, making the analogy of a hypothetical Data and Safety Monitoring Board (DSMB) assessing the accumulation of evidence in the field.. Before examining the implications, it is worth reviewing the techniques and aims of the cumulative meta-analysis and trial sequential analysis methods used by Verdecchia et al.1 Cumulative meta-analysis ...
The proposed work should help move toward the long-term goal of selection of antihypertensive drug therapy based on a patients genetic make-up. Hypertension (HTN) is the most common chronic disease for which drugs are prescribed, and the most prevalent risk factor for heart attack, stroke, renal failure and heart failure. Responses to antihypertensive drug therapy exhibit considerable interpatient variability, contributing to poor rates of HTN control (currently about 40-50% in the US), and frequent nonadherence and dropout from therapy. We propose to identify genetic predictors of the antihypertensive and adverse metabolic responses to two preferred and pharmacodynamically contrasting drugs, a beta-blocker (metoprolol) and a thiazide diuretic (chlorthalidone) in a sequential monotherapy design in 400 hypertensive individuals. Data collected will include home and clinic blood pressure, blood samples for testing for adverse metabolic effects and other biomarkers, RNA, and DNA and urine sample. ...
Types of Blood Pressure Medications - American Heart Association. Treating High Blood Pressure With Medication - Hypertension. High Blood Pressure Medications With Less Side Effects. Alcohol And Blood Pressure Medication Side Effects - OnTheMicDJs. Prescription Medications Can Cause Sexual Dysfunction - AARP.
High blood pressure? Do you know what are common side effects or contraction of angiotensin receptors. dont get enough exercise or have high blood pressure physical inactivity and high blood pressure increased the likelihood of memory complaints in younger adults (ages 18 University of Hypertension Medications List Australia Monitor Omron Use Hem-806f How California Los Angeles (UCLA) Health Sciences. Hypertension Medications List Australia Monitor Omron Use Hem-806f How after measuring your lying blood pressure stand up and wait 3 minutes in .. What Is AFib? Symptoms and causes. After five weeks I took an extra half pill (5 mg 14 months ago I gave birth to beautiful daughter upon giving birth I developed high blood pressure . Hypertension Treatment: Latest Medical Breakthroughs.. The technique of using the eath to lower blood pressure is not new but a device like the Resperate Ultra to help you do it is. Along with certain savings reports including on-line and standard cheap generic viagra the ...
Title:Differential Impacts of Antihypertensive Drugs on Central Blood Pressure and Their Clinical Significance. VOLUME: 8 ISSUE: 2. Author(s):Yoshio Matsui and Kazuomi Kario. Affiliation:Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.. Keywords:Angiotensin converting enzyme inhibitor, angiotensin II receptor blocker, β-blocker, calcium channel blocker, central blood pressure, left ventricular mass, pulse wave velocity, reflection wave magnitude, thiazide diuretic. Abstract:Recent evidence suggests that central blood pressure (BP) is a more important determinant of cardiovascular risk than is brachial BP. Antihypertensive drugs with vasodilating properties have a more beneficial effect on central systolic BP and pulse pressure by decreasing arterial stiffness and/or the magnitude of wave reflections than thiazide diuretics and β-blockers. These differential effects of ...
Blood pressure medication side effects are a common cause of trouble amongst the urban crowd. This article here talks at great lengths about the side effects of blood pressure medication.
A new study by investigators at Brigham and Womens Hospital puts the results of a landmark trial about blood pressure control into terms that may be easier to interpret and communicate to patients. When data from The Systolic Blood Pressure Intervention Trial (SPRINT) were published in 2015, the medical community responded enthusiastically to the news that reducing blood pressure lower than the normal targets could reduce overall death rates by 27 percent for adults at high cardiovascular risk. While these study results are being integrated into clinical practice, explaining what they mean and why they are important to patients can be challenging. Investigators from the Brigham describe how aggressively lowering blood pressure levels can extend a persons life expectancy. They report that having a blood pressure target of less than 120 mm Hg-rather than the standard 140 mm Hg-can add six months to three years to a persons lifetime, depending upon how old they are when they begin intensive blood
The American Diabetes Association is recommending changes in blood pressure goals for people with diabetes as well as clarifying how frequently people with type 1 diabetes should test their blood glucose levels.
Market Insights Anti-hypertensive drugs are indicated by doctors to treat hypertension or high blood pressure. Long-term hypertension is a major cause of
The UKPDS shows that meticulous blood pressure reduction is important in patients with type 2 diabetes. This finding has major implications for health care because of the projected dramatic increase in diabetes in the future and the clear relation between diabetes and hypertension. The Systolic Hypertension in the Elderly Program (SHEP) has shown that antihypertensive treatment reduces cardiovascular events in elderly patients with and without diabetes (1). The present trial consolidates this information and extends the findings to younger patients and to patients with newly detected diabetes. The results are consistent with the recently published Hypertension Optimal Treatment (HOT) study, in which intensive blood pressure lowering was more effective in reducing cardiovascular events among patients with diabetes than among those without diabetes (2). In addition, the UKPDS shows that intensive blood pressure control reduces microvascular complications, which is an outcome that has not been ...
Get this from a library! Heart medications. Blood pressure medications & anticoagulants. [Marsha Scott, RN.; Medcom, inc.;] -- (Producer) Discusses high blood pressure and provides an overview of blood pressure medications, including ACE inhibitors, beta blockers, calcium channel blockers, and central adrenergic inhibitors. ...
In September 2019, the Food and Drug Administration (FDA), expanded a recall of a common blood pressure medication called losartan. Losartan is made by the manufacturer Torrent Pharmaceuticals. The FDA found a possibly carcinogenic impurity in several batches of the drug. The losartan potassium tablets contained excessive levels of N-Nitroso-N-methyl-4-aminobutyric acid (NMBA). These levels were catagorized by the FDA as a "potential human carcinogen.". The recall comes as part of a larger string of recalls of blood pressure medications valsartan, losartan and irbesartan that contain trace levels of carcinogens NMBA, N-Nitrosodimethylamine (NDMA) and N-Nitrosodiethylamine (NDEA). In January, the FDA admitted that some versions of the drug valsartan have contained a carcinogen for four years before regulators detected the impurity in the summer of 2019.. It is disconcerting to find out that ingredients in our medications can contribute to cancer. Prevention is always the wisest course of action. ...
Lebatalol blood pressure medication - Blood Pressure : Beta-blockers - blood pressure medication. The Hypercet Cholesterol and Blood Pressure Formulas can help support and maintain normal body functions to help maintain optimum health.
Antihypertensive Drug. Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure). Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Evidence suggests that reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34%, of ischaemic heart disease by 21%, and reduce the likelihood of dementia, heart failure, and mortality from cardiovascular disease. There are many classes of antihypertensives, which lower blood pressure by different means; among the most important and most widely used are the thiazide diuretics, the ACE inhibitors, the calcium channel blockers, the beta blockers, and the angiotensin II receptor antagonists or ARBs.. Which type of medication to use initially for hypertension has been the subject of several large studies and resulting national guidelines. The fundamental goal of treatment should be the prevention of the important endpoints of ...
Research Report on Global Anti-Hypertensive Drugs Sales Market Report 2017. The Report includes market price, demand, trends, size, Share, Growth, Forecast, Analysis & Overview.
Its always a good idea to tell your health care providers about any side effects you may be experiencing as soon as you notice them. However, even though gum tissue overgrowth may be a worrisome issue, it doesnt mean you should stop taking your blood pressure medication! There are several options for controlling this condition, which should be discussed with all members of your medical team.. With your doctors consent, it may be possible for you to change your dosage or switch to a different blood pressure medication that produces fewer side effects. It can take a few months for your gums to return to normal after the change, while you are maintaining good oral hygiene at home. But even if its not possible for you to change your medication, there are a number of in-office treatments that can be used to help alleviate the problem.. Non-surgical treatments like scaling and root planing (a type of deep cleaning) are sometimes the first step to controlling gum overgrowth. These relatively minor ...
Its always a good idea to tell your health care providers about any side effects you may be experiencing as soon as you notice them. However, even though gum tissue overgrowth may be a worrisome issue, it doesnt mean you should stop taking your blood pressure medication! There are several options for controlling this condition, which should be discussed with all members of your medical team.. With your doctors consent, it may be possible for you to change your dosage or switch to a different blood pressure medication that produces fewer side effects. It can take a few months for your gums to return to normal after the change, while you are maintaining good oral hygiene at home. But even if its not possible for you to change your medication, there are a number of in-office treatments that can be used to help alleviate the problem.. Non-surgical treatments like scaling and root planing (a type of deep cleaning) are sometimes the first step to controlling gum overgrowth. These relatively minor ...
Its always a good idea to tell your health care providers about any side effects you may be experiencing as soon as you notice them. However, even though gum tissue overgrowth may be a worrisome issue, it doesnt mean you should stop taking your blood pressure medication! There are several options for controlling this condition, which should be discussed with all members of your medical team.. With your doctors consent, it may be possible for you to change your dosage or switch to a different blood pressure medication that produces fewer side effects. It can take a few months for your gums to return to normal after the change, while you are maintaining good oral hygiene at home. But even if its not possible for you to change your medication, there are a number of in-office treatments that can be used to help alleviate the problem.. Non-surgical treatments like scaling and root planing (a type of deep cleaning) are sometimes the first step to controlling gum overgrowth. These relatively minor ...
This study prospectively investigated in hypertensive patients with type 2 diabetes the hypothesis that bedtime treatment with ≥1 hypertension medications exerts better blood pressure control and CVD risk reduction than conventional therapy, in which all medications are ingested upon waking. The results document, first, greater ambulatory blood pressure control in patients ingesting ≥1 hypertension medications at bedtime than in those ingesting all their medications upon awakening. The main differences between groups in terms of blood pressure control were achievement in patients treated at bedtime of 1) significantly lower asleep blood pressure mean and 2) greater sleep time relative blood pressure decline, without loss of awake blood pressure lowering efficacy (Table 2). These administration-time-dependent effects on sleep time blood pressure control were strongly associated with lower CVD risk and increased event-free survival. Indeed, the progressive reduction in the asleep blood ...
DynaMed™ is a clinical reference tool created by physicians for physicians and other health care professionals for use at the point-of-care. This clinical care tool summaries for more than 3,200 topics.
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In these analyses of the VA Single-Drug Therapy for Hypertension Study, we have shown that there are differences in the effects of 6 classes of antihypertensive agents on PP calculated by subtracting mean visit DBP from mean visit SBP. Although clonidine was very effective in reducing SBP, DBP, and PP during the titration phase, and SBP and PP quantitatively more than any other drug, it was associated with a much higher incidence of symptomatic adverse effects and drug withdrawals.14 The diuretic hydrochlorothiazide, which was well tolerated, also reduced PP as effectively as clonidine during titration and quantitatively the most, and it was statistically superior to the β-blocker and ACE inhibitor after 1 year of maintenance monotherapy. This greater reduction in PP with a diuretic compared with a β-blocker is similar to the experience in the Medical Research Council Mild Hypertension Trial.7 In each of the 4 age-race groups, clonidine and hydrochlorothiazide also reduced PP quantitatively ...
Olmesartan medoxomil tablets are indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. There are no controlled trials demonstrating risk reduction with olmesartan medoxomil.. Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Programs Joint National Committee on Prevention, ...
High blood pressure requires treatment with anti-hypertensive medications. This article describes the various classes of high blood pressure medications and the general approach to pharmacological management of hypertension.
Main results. Mean SBP was reduced from 139 mm Hg at baseline to 119 mm Hg at 1 year in the intensive-therapy group and 134 mm Hg in the standard-therapy group. These levels were maintained throughout the trial. Intensive therapy did not reduce major CV events or death, except stroke (Table). Patients in the intensive-therapy group were more likely to have serious adverse events attributable to antihypertensive medications (3.3% vs 1.3%), hypokalemia (2.1% vs 1.1%), elevated serum creatinine levels (24% vs 15%), and low estimated glomerular filtration rate (4.2% vs 2.2%). However, they were less likely to have macroalbuminuria (6.6% vs 8.7%). ...
Baltimore, MD, USA - High blood pressure affects about 70-80 percent of those with type 2 diabetes. To prevent complications associated with hypertension, such as heart attack, chronic kidney disease or blindness, in adults with diabetes, medical guidelines suggest tight blood pressure control, with prescription medications as a key treatment.. Researchers at the University of Maryland Schools of Nursing and Medicine, and University of South Carolina College of Pharmacy compared the differences in health services utilization and medical costs between those using medications to control blood pressure versus non-users [in adults with diabetes and a diagnosis of hypertension]. They found that 16 percent of the estimated 38.7 million non-institutionalized U.S. adults with diabetes and coexistent essential hypertension did not use blood pressure controlling (antihypertensive) medications during a two-year span.. Antihypertensive medication non-users had lower numbers of diabetes and hypertension ...
This is part of the recently published KDIGO guidelines for blood pressure management. As opposed to other sections of these guidelines, the authors recommend a target blood pressure < 130/80 for all patients regardless of degree of proteinuria. No specific class of antihypertensive agent is preferred in these guidelines.. ...
Background: Hypertension is one of the leading causes of cardiovascular disease (CVD). A range of antihypertensive drugs exists, and their prices vary widely mainly due to patent rights. The objective of this study was to explore the cost-effectiveness of different generic antihypertensive drugs as first, second and third choice for primary prevention of cardiovascular disease.. Methods: We used the Norwegian Cardiovascular Disease model (NorCaD) to simulate the cardiovascular life of patients from hypertension without symptoms until they were all dead or 100 years old. The risk of CVD events and costs were based on recent Norwegian sources.. Results: In single-drug treatment, all antihypertensives are cost-effective compared to no drug treatment. In the base-case analysis, the first, second and third choice of antihypertensive were calcium channel blocker, thiazide and angiotensin-converting enzyme inhibitor. However the sensitivity and scenario analyses indicated considerable uncertainty in ...
Subject is taking ≥ 3 antihypertensive medications concurrently at full tolerated doses (this must include one diuretic) or subject is taking a diuretic and has a documented intolerance to at least two (2) out of the three (3) remaining major classes of anti-hypertensives (ACE / ARB, Calcium Channel Blockers, Beta blockers and is unable to take 3 anti-hypertensive drugs). o Intolerance is defined as an absolute contraindication to an anti-hypertensive medication according to the approved labeling or an inability to take an anti-hypertensive medication as prescribed due to an adverse drug effect including an immune mediated response or interaction with other medications.. ...
Management of type 2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range.[24] Self-monitoring of blood glucose for people with newly diagnosed type 2 diabetes may be used in combination with education,[70] however the benefit of self monitoring in those not using multi-dose insulin is questionable.[24][71] In those who do not want to measure blood levels, measuring urine levels may be done.[70] Managing other cardiovascular risk factors, such as hypertension, high cholesterol, and microalbuminuria, improves a persons life expectancy.[24] Decreasing the systolic blood pressure to less than 140 mmHg is associated with a lower risk of death and better outcomes.[72] Intensive blood pressure management (less than 130/80 mmHg) as opposed to standard blood pressure management (less than 140/85-100 mmHg) results in a slight decrease in stroke risk but no effect on overall risk of death.[73]. Intensive blood ...
Management of type 2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range.[24] Self-monitoring of blood glucose for people with newly diagnosed type 2 diabetes may be used in combination with education,[70] however the benefit of self monitoring in those not using multi-dose insulin is questionable.[24][71] In those who do not want to measure blood levels, measuring urine levels may be done.[70] Managing other cardiovascular risk factors, such as hypertension, high cholesterol, and microalbuminuria, improves a persons life expectancy.[24] Decreasing the systolic blood pressure to less than 140 mmHg is associated with a lower risk of death and better outcomes.[72] Intensive blood pressure management (less than 130/80 mmHg) as opposed to standard blood pressure management (less than 140/85-100 mmHg) results in a slight decrease in stroke risk but no effect on overall risk of death.[73]. Intensive blood ...
Interest in identifying the most appropriate targets for systolic blood pressure (SBP) lowering to reduce cardiovascular events in persons with hypertension has been piqued by the widely publicized results of the Systolic Blood Pressure Intervention Trial (SPRINT)1,2. SPRINT found overwhelming benefit (25% reduction in the primary composite outcome of myocardial infarction (MI), acute coronary syndrome not resulting in MI, stroke, acute decompensated heart failure, or death from cardiovascular causes) and 27% reduction in all-cause mortality among participants randomized to a SBP target of , 120 mm Hg (intensive treatment) compared to , 140 mm Hg (standard treatment). In contrast, serious adverse events, including acute kidney injury or acute renal failure that contributed to hospitalizations or emergency department visits were significantly more common in the intensive treatment group (4.4% vs. 2.6%, HR 1.71, P ,0.001). Among those who did not have chronic kidney disease (CKD) at baseline, ...
Beta-blockers are less beneficial than other antihypertensive drugs in the elderly with hypertension. All elderly patients in Ontario, Canada (population over 3.5 million elderly) without co-morbidities who were first treated for hypertension with a beta-blocker were studied in this retrospective, population-based cohort study (1994-2002) to determine the characteristics of those prescribed beta-blockers. Of the 194,761 patients in the cohort, 25,485 (13%) were prescribed a beta-blocker as their first antihypertensive agent. On multivariate analysis, factors significantly associated with being prescribed a beta-blocker as first-line therapy included male sex (adjusted odds ratio (OR) 1.06 [95% CI 1.03-1.09] vs. women), younger age (adjusted OR 1.67 [95% CI 1.55-1.79] for patients aged 66-69 vs. those aged 85 or older), residence in a long-term care facility (adjusted OR 1.19 [95% CI 1.04-1.35] vs. living in the community) and lower socioeconomic status (adjusted OR 1.07 [95% CI 1.02-1.12], for ...
Severe hypertension during pregnancy is a relevant health problem, particularly in developing countries. The review by Duley and Henderson-Smart compared different antihypertensive drugs with the aim of identifying those with the greatest comparative benefit and least risk for adverse outcomes. Strengths of the review include a clear statement of the objective and a comprehensive literature search without language restrictions. A limitation is data heterogeneity. Contributing factors to the data heterogeneity include different criteria for severe hypertension, doses, diagnoses, and outcome definitions. Hydralazine has been the first-line drug for decades and based on this systematic review, it will continue to be. Diazoxide causes a rapid decrease in blood pressure, and as expected, this systematic review shows some probable consequences, such as an increased number of maternal hypotension episodes and the need for cesarean section due to fetal distress. Although the initial use of hydralazine ...
Long-term nursing home residents with hypertension do not experience significant benefits from more intensive antihypertensive treatment, according to a study published online July 22 in the Journal of the American Geriatrics Society.