Enalapril versus combined enalapril and nadolol treatment: Effects on blood pressure, heart rate, humoral variables, and plasma potassium at rest and during exercise in hypertensive patients

1992 ◽  
Vol 6 (3) ◽  
pp. 261-265 ◽  
Author(s):  
Patrick A. Sullivan ◽  
Bertie Daly ◽  
Ray O'Connor
2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
MA Bejar ◽  
I Zairi ◽  
I Ben Mrad ◽  
B Besbes ◽  
K Mzoughi ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background During Ramadan, alterations in the daily patterns of sleep, activities and medication timing might contribute to changes in blood pressure (BP) and heart rate among hypertensive patients. The aim of this study was to examine the effect of medication timing during Ramadan on blood pressure and heart rate in hypertensive subjects taking their treatment once daily. Methods The study prospectively recruited 44 hypertensive patients between April and June 2019, followed up at the cardiology department of our   Hospital. A 24-hour pressure monitoring was carried out during two periods: prior to Ramadan and during the last ten days of Ramadan. Results We studied 29 women and 15 men, mean age was 58.7 years. 34% of the patients were diabetics and 16% had coronaropathy. 46% of the patients were on monotherapy, 43% on dual therapy and 11% on a triple antihypertensive therapy. During Ramadan, 57% of the patients took their treatment during the dinner (group1), whereas 43% took their treatment during the Shour (group 2). Average 24hour blood pressure in the whole group was 129 ± 18/74 ± 10 mmHg before Ramadan and 129 ± 19/74 ± 10 mmHg during Ramadan (p > 0.05). Daytime and nighttime mean values of systolic and diastolic blood pressure as well as mean values of heart rate were not different between both periods regardless of age and gender. However, during Ramadan, those who took their treatment after dinner had significant higher values of 24 hour systolic BP, awake systolic and diastolic BP, asleep systolic and diastolic BP than those who took their treatment with the shour (p < 0.05). Conclusion In this study, there were no significant changes in systolic and diastolic blood pressures as well as heart rate during the 2 periods. However, during Ramadan, a slight superiority of taking the treatment with the shour is observed. Average values of BP and heart rate Group 1 Group 2 p 24 hour SBP (mmHg) 134 ± 23 122 ± 6 0.017 24 hour DBP (mmHg) 76 ± 12 70 ± 5 0.052 Awake SBP (mmHg) 138 ± 23 125 ± 6 0.012 Awake DBP (mmHg) 79 ± 12 73 ± 5 0.044 Asleep SBP (mmHg) 127 ± 26 114 ± 12 0.030 Asleep DBP (mmHg) 71 ± 13 65 ± 7 0.045 24 hour average heart rate (bpm) 71 ± 7 70 ± 6 0.524 Awake average heart rate (bpm) 76 ± 7 74 ± 7 0.322 Asleep average heart rate (bpm) 65 ± 7 65 ± 7 0.931 Average values of blood pressure and heart rate in both groups Abstract Figure. 24hour course of blood pressure


Author(s):  
Tamoghna Maiti ◽  
Sonai Mandal ◽  
Ratul Banerjee ◽  
Sourav Chakrabarty ◽  
Amrita Panda

Background: High blood pressure (BP) is one of the significant non-communicable diseases that are of high prevalence in our country. Hypertension (HTN) is responsible cause of 57% of stroke and 24% of coronary heart disease deaths in India. Eight classes of medications are currently used in the treatment of hypertension. Azilsartan medoxomil is a newly added FDA approved drug to the ARB class of antihypertensive agents. azilsartan and chlorthalidone combination is also got the FDA approval. There is limited study in between these two groups regarding efficacy especially in rural Bengal.Methods: A prospective observational study was done in medicine OPD of Bankura Sammilani Medical College for twelve weeks with two groups that are azilsartan (80mg) and fixed dose combination of azilsartan (40mg) plus chlorthalidone (12.5mg) in the age group of 18 to 55years of moderate hypertensive patients. Change of heart rate was assessed as safety parameter.Results: It was found that both the group of drugs are very much effective in lowering blood pressure constantly in respect of both systolic and diastolic BP but azilsartan monotherapy in high dose reduce systolic blood pressure slightly high. Significant change of heart rate was not seen with both the groups.Conclusions: Both the group was effective as well as safe in hypertensive patients.


2018 ◽  
Vol 1 (4) ◽  
Author(s):  
Xianfeng Hua

Objective To investigate the effects of Shaolin Ba Duan Jin on patients with hypertension. Methods In the hypertensive patients detected in the national physical fitness test of public officials in Guiyang City, 40 patients with hypertension were selected. The experiment was started after Shaolin Ba Duan Jin has been practiced for seven days and the subjects had learned it. Experimental method: Frequency of subjects practicing Ba Duan Jin is 7 days a week, subjects practice once a day, practicing time is 6:00-7:30 am or 18:00 -19:30 pm, practicing lasts 1.5 hours each time (practicing has 3 groups, 14 minutes in each group;subjects rest 2 minutes between groups,;preparing part is 8 minutes;ending part is 5 minutes), record the blood pressure of the subjects before and after each experiment, and fill in the quality of life scale (WHOQOL-BREF scale) regularly for a period of 12 weeks. Questionnaire method: Fill in the quality of life scale every three weeks and measure heart rate and blood pressure before and after each exercise. Mathematical statistics: The paired sample t test was used to analyze the changes in blood pressure before and after the 12-week experiment. Results 1) The systolic and diastolic blood pressures of the subjects were significantly lower than before the experiment (P <0.01). 2) The WHOQOL-BREF scale after 12 weeks has improved significantly in all areas than before the experiment. Conclusions 1) Martial arts Ba Duan Jin has a good influence on the circulatory system of hypertensive patients. The performance is that the heart rate is slow and the systolic and diastolic blood pressures have a downward trend. 2) Martial arts Ba Duan Jin has significant improvement in the physiology, psychology, social relations, environment and other fields .


2000 ◽  
Vol 5 (3) ◽  
pp. 23-30 ◽  
Author(s):  
Raúl Fernández-González ◽  
Casimiro Gómez-Pajuelo ◽  
Rafael Gabriel ◽  
Mariano de la Figuera ◽  
Emilio Moreno

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marcello Chinali ◽  
Rakesh K Mishra ◽  
Giovanni de Simone ◽  
Gerard P Aurigemma ◽  
Eva Gerdts ◽  
...  

Background: Early mitral flow deceleration time (DTE) is a prognostically validated marker of LV chamber stiffness. However, for any given LV stiffness, a higher E peak velocity (E) is associated with longer DTE, suggesting that the prognostic relevance of DTE might be influenced by variations in cardiac preload (e.g. during anti-hypertensive treatment). It is not known whether normalization of deceleration time for E-velocity (DTE/E) might be a more stable diastolic index for prediction of incident cardiovascular (CV) events in hypertensive patients during treatment, as compared to DTE. Methods: We evaluated 770 hypertensive patients (66±7 years; 42% women) with ECG-LV hypertrophy enrolled in the LIFE echo-substudy. Echocardiographic exams were performed annually for 5 years during anti-hypertensive treatment. Prognostic value of basal DTE/E was preliminary evaluated. Variation over time of both DTE/E and DTE were therefore analyzed in relation to incident combined fatal and non-fatal CV events. Results: During follow-up, 69 CV events occurred (9% of study population). Mean basal DTE/pE was 3.55±1.55 sec 2 /cm*10 −3. In univariate analysis baseline DTE/E was associated positively with age (r=0.10; p<0.01), relative wall thickness (r=0.13; p<0.01) and isovolumic relaxation time (r=0.26; p<0.001) and negatively with heart rate (r=−0.20; p<0.001); no association was found with systolic blood pressure, diastolic blood pressure, LV mass or ejection fraction. Unadjusted Cox regression showed a positive association between baseline DTE/E and CV events [(HR=1.21 (95%CI= 1.07–1.37); p=0.002]. In time-varying Cox model, independently of age, gender, type of anti-hypertensive treatment and in-treatment heart rate, higher in-treatment DTE/E was associated with higher rate of CV events [(HR=1.26 (95%CI= 1.04 –1.80); p<0.026], whereas no association was found for in-treatment DTE (p=NS). Conclusions: In a population of treated hypertensive patients with ECG-LV hypertrophy, the ratio of in-treatment DTE/E, but not DTE alone, independently predicts incident CV events. In high-risk hypertensive patients, normalization of DTE for E peak velocity might be preferred to DTE in evaluating diastolic function during anti-hypertensive treatment.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M A Losi ◽  
C Mancusi ◽  
E Gerdts ◽  
K Wachtell ◽  
S E Kjeldsen ◽  
...  

Abstract Background Myocardial energetic efficiency (MEE) per unit of left ventricular (LV) mass significantly predicts composite of cardiovascular (CV) events in treated hypertensive patients and specifically heart failure in an event-free population-based cohort with normal ejection fraction, independently of LV hypertrophy (LVH). Purpose To investigate whether MEEi changes over time in treated hypertensive patients, and whether different treatments have different effects. Methods From the Losartan Intervention For Endpoint study (LIFE Echo Sub-study) we selected 744 hypertensive patients (age 66±7 years; 45% women) with LVH at ECG, without atrial fibrillation, previous or incident myocardial infarction and with normal echocardiographic ejection fraction (>50%). MEE was estimated as the ratio of stroke work to the “double” product of heart rate times systolic blood pressure (BP), simplified as the ratio of stroke volume to heart rate, as previously reported. MEE was normalized for LVM (MEEi) and analyzed in quartiles at baseline and at the end treatment, according to an “intention-to-treat” protocol. Results Age and proportion of women were not significantly different from the highest to the lowest quartiles (from 65±7 to 66±7 years, p for trend=0.352; from 45% to 42%, p=0.946, respectively), whereas diastolic blood pressure (from 97±8 to 100±9 mmHg, p=0.006), prevalence of obesity (from 14 to 31%, p=0.001) and diabetes (from 4 to 14%, 0.004) progressively increased. Prevalence of concentric LV geometry and echocardiographic LVH also progressively increased from the highest to the lowest quartile (from 14 to 70%, and 61 to 90%, both p<0.0001). MEEi increased over time (p<0.007), independently of initial diastolic BP, diabetes and obesity, significantly more in patients treated with atenolol than with losartan (p<0.0001) (Figure), due to both increased stroke volume and decreased heart rate (both p<0.0001). Figure 1 Conclusions In a randomized clinical study, MEEi improves with anti-hypertensive therapy. Improvement is more evident in patients with atenolol than with losartan-based treatment, possibly providing pathophysiologic explanation of the comparable performance in prevention of ischemic heart disease previously reported in the LIFE study.


1980 ◽  
Vol 58 (1) ◽  
pp. 115-117 ◽  
Author(s):  
D. B. Rowlands ◽  
T. J. Stallard ◽  
R. D. S. Watson ◽  
W. A. Littler

1. Ambulatory blood pressure recordings were made over a 48 h period on six hypertensive patients. The conditions of study were standardized, particularly with regard to physical activity, and during one period of each day the patients were randomly allocated to be active or inactive. 2. Results show that blood pressure was highest during physical activity and lowest during sleep. There was no significant difference between the arterial pressures measured during the same physical activities carried out at the same time each day. However, during the same time on consecutive days when activity was randomized, there was a significant difference between the pressure recordings during physical activity compared with those during inactivity. Heart rate changes showed a similar trend during the randomized period. 3. Physical activity and sleep have a profound effect on continuous arterial blood pressure recordings and these are independent of time alone. These observations should be taken into account when using this ambulatory system to assess hypotensive therapy.


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