Interventions used to improve the control of blood pressure in patients with hypertension taking antihypertensive medication

2005 ◽  
Author(s):  
T Fahey ◽  
K Schroeder ◽  
S Ebrahim
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication

scholarly journals Association Between Antihypertensive Medication Adherence and Visit-to-Visit Variability of Blood Pressure

2012 ◽  
Vol 15 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Paul Muntner ◽  
Emily B. Levitan ◽  
Cara Joyce ◽  
Elizabeth Holt ◽  
Devin Mann ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Antihypertensive Medication

scholarly journals Effects of eplerenone on resistance to antihypertensive medication in patients with primary or secondary hyperaldosteronism

2017 ◽  
Vol 5 (2) ◽  
pp. 93-99 ◽  
Author(s):  
J. David Spence ◽  
Chrysi Bogiatzi ◽  
Mariya Kuk ◽  
George K. Dresser ◽  
Daniel G. Hackam
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Concomitant Medication ◽  
Antihypertensive Medication ◽  
Pressure Control ◽  
Blinded Study ◽  
History Of ◽  
Secondary Hyperaldosteronism ◽  
One Year ◽  
Resistance Score

Abstract Background and Objectives Resistant hypertension is an important problem; nearly half of diagnosed hypertensives are not controlled to target blood pressure levels, and approximately 90% of strokes occur among patients with resistant hypertension. Primary aldosteronism accounts for approximately 20% of resistant hypertension, but the role of secondary hyperaldosteronism in resistant hypertension is seldom considered. We assessed the effects of eplerenone in patients with hypertension and either primary or secondary hyperaldosteronism. Methods Patients with a history of resistant hypertension and a supine plasma aldosterone level ≥ 360 pmol/L were randomized to eplerenone versus placebo in a fully blinded study for one year. A medication intensity score was developed to assess the resistance of hypertension to medication (blood pressure × medication intensity). We assessed the effects of eplerenone on blood pressure and on resistance to concomitant medication. Results Final results were available in 37 patients (19 on eplerenone and 18 on placebo). Resistance to medication, as assessed by the intensity of concomitant medication required to maintain blood pressure control, was markedly reduced by eplerenone: medication intensity scores declined by –0.50 ± 1.04 (SD) on placebo versus –2.11 ± 1.45 with eplerenone (P = 0.0001), the Systolic Resistance Score declined by –80.00 ± 122.93 on placebo versus –334.05 ± 21.73 on eplerenone (P = 0.0001), and the Diastolic Resistance Score increased by 1.28 ± 31.65 on placebo and declined by –40.74 ± 57.08 on eplerenone (P = 0.009). Conclusions Eplerenone significantly reduced resistance to concomitant antihypertensive medication in both primary and secondary hyperaldosteronism.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Zambia

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B158-B160
Author(s):  
Fastone Goma ◽  
Charity Syatalimi ◽  
Penias Tembo ◽  
Musawa Mukupa ◽  
Theresa Chikopela ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Blood Pressure ◽  
Public Health Policy ◽  
Antihypertensive Medication ◽  
Population Level ◽  
Multiple Imputations ◽  
The Individual ◽  
Treatable Condition

Abstract In Zambia, hypertension accounts for the highest proportion of deaths due to cardiovascular diseases causing 3.3% of all deaths, killing an average of 670 people per year. May Measurement Month (MMM) is an annual global screening campaign aiming to improve awareness of blood pressure (BP) at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at multiple sites within Lusaka during May and June 2019. Ideally, three BP readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Data were analysed centrally by the MMM project team and multiple imputations were performed where necessary. Of the total of 9232 enrolled, 8.7% of them had never had their BP measured, 2.5% had diabetes mellitus, 1.9% had had a myocardial infarction, 1.5% had had a stroke, 10.6% were current smokers, and 10.0% consumed alcohol once or more per week. Blood pressure fell from a mean of 128.6/82.9 mmHg for the 1st reading to a mean of 123.2/80.0 mmHg for the 3rd reading. The lowest proportion of participants with hypertension was identified by the 3rd reading alone (30.0%). Of all the participants, 30.7% had hypertension, though only 42.6% of them were aware of their diagnosis. Seven hundred and eighty-three (27.6%) were on antihypertensive medication though only 35.0% of them had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). Compared with MMM17 data, there is deterioration of the monitored parameters calling for urgent and accelerated public health policy and clinical practice interventions. We think that the MMM campaign should continue annually to raise awareness of this treatable condition.

scholarly journals Smoking and Antihypertensive Medication: Interaction between Blood Pressure Reduction and Arterial Stiffness

2005 ◽  
Vol 28 (8) ◽  
pp. 631-638 ◽  
Author(s):  
Yoshio MATSUI ◽  
Kazuomi KARIO ◽  
Joji ISHIKAWA ◽  
Satoshi HOSHIDE ◽  
Kazuo EGUCHI ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Antihypertensive Medication ◽  
Blood Pressure Reduction ◽  
Pressure Reduction

scholarly journals OPtimising Treatment for MIld Systolic hypertension in the Elderly (OPTiMISE): protocol for a randomised controlled non-inferiority trial

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022930 ◽  
Author(s):  
James P Sheppard ◽  
Jenni Burt ◽  
Mark Lown ◽  
Eleanor Temple ◽  
John Benson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Usual Care ◽  
Antihypertensive Medication ◽  
Clinical Care ◽  
Economic Modelling ◽  
Host Institution ◽  
South Central ◽  
Randomised Controlled

IntroductionRecent evidence suggests that larger blood pressure reductions and multiple antihypertensive drugs may be harmful in older people, particularly frail individuals with polypharmacy and multimorbidity. However, there is a lack of evidence to support deprescribing of antihypertensives, which limits the practice of medication reduction in routine clinical care. The aim of this trial is to examine whether antihypertensive medication reduction is possible in older patients without significant changes in blood pressure control at follow-up.Methods and analysisThis trial will use a primary care-based, open-label, randomised controlled trial design. A total of 540 participants will be recruited, aged ≥80 years, with systolic blood pressure <150 mm Hg and receiving ≥2 antihypertensive medications. Participants will have no compelling indication for medication continuation and will be considered to potentially benefit from medication reduction due to existing polypharmacy, comorbidity and frailty. Following a baseline appointment, individuals will be randomised to a strategy of medication reduction (intervention) with optional self-monitoring or usual care (control). Those in the intervention group will have one antihypertensive medication stopped. The primary outcome will be to determine if a reduction in medication can achieve a proportion of participants with clinically safe blood pressure levels at 12-week follow-up (defined as a systolic blood pressure <150 mm Hg), which is non-inferior (within 10%) to that achieved by the usual care group. Qualitative interviews will be used to understand the barriers and facilitators to medication reduction. The study will use economic modelling to predict the long-term effects of any observed changes in blood pressure and quality of life.Ethics and disseminationThe protocol, informed consent form, participant information sheet and all other participant facing material have been approved by the Research Ethics Committee (South Central—Oxford A; ref 16/SC/0628), Medicines and Healthcare products Regulatory Agency (ref 21584/0371/001–0001), host institution(s) and Health Research Authority. All research outputs will be published in peer-reviewed journals and presented at national and international conferences.Trial registration numberEudraCT 2016-004236-38;ISRCTN97503221; Pre-results.

scholarly journals Impact of Empagliflozin on Blood Pressure in Patients With Type 2 Diabetes Mellitus and Hypertension by Background Antihypertensive Medication

Hypertension ◽  
2016 ◽  
Vol 68 (6) ◽  
pp. 1355-1364 ◽  
Author(s):  
Giuseppe Mancia ◽  
Christopher P. Cannon ◽  
Ilkka Tikkanen ◽  
Cordula Zeller ◽  
Ludwin Ley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Antihypertensive Medication

The Correlation of Lung Function Parameters, Blood Pressure and Beta-Blocker Medication in a General Population

Pneumologie ◽  
2021 ◽  
Author(s):  
Christoph Schäper ◽  
Till Ittermann ◽  
Sven Gläser ◽  
Marcus Dörr ◽  
Henry Völzke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lung Function ◽  
Beta Blocker ◽  
Antihypertensive Medication ◽  
Reference Group ◽  
Beta Blockers ◽  
Adult Population ◽  
Population Based ◽  
Statistical Correlation ◽  
Association Analyses

Abstract Objectives Prior studies have investigated possible links between blood pressure, antihypertensive medication, especially beta-blockers and impairment of lung function. The aim of our study was to investigate an association between blood pressure, antihypertensive medication, focusing on beta-blockers, and its influence on lung function parameters in our adult population. Methods From the two analysed cohorts of the population-based Study of Health in Pomerania (SHIP-1 and SHIP-TREND), pooled data for interview-based information, lung function variables including bodyplethysmography and blood pressure variables were used to perform adjusted linear regression analyses. Association analyses were conducted for the pooled population. Results Within the whole pooled population we found some minor statistically significant interrelations in the multivariate analyses for blood pressure and lung function parameters. Statistical correlation between lung function and blood pressure were significant but too weak to be deemed clinically relevant.We also found interrelations between lung function and use of beta-blocker medication. Within the subgroup of individuals with antihypertensive medication containing beta-blockers compared to the reference group we found lower dynamic and static volumes e. g. for FEV1 (–70 ml), FVC (–90 ml), a reduction of TLC (–130 ml) and ITGV (–100 ml), however we did not find an increase in airway resistance (Rtot). Conclusion Based on the data of SHIP-1 and SHIP TREND our results confirm a minor association between blood pressure and lung function. More importantly, we have seen a significant decrease of lung volumes for hypertensive patients with beta- blocker medication as described in literature before. To the best of our knowledge, we are the first to examine the interrelation between blood pressure, medication and lung function in an epidemiological study using data of spirometry, body plethysmography and CO transfer.

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