HYT-Hypertension in Turkey: A Cross-Sectional Survey on Blood Pressure Control with Calcium Channel Blockers Alone or Combined with Other Antihypertensive Drugs

Background and Objectives: Hypertension affects at least 80% of hemodialysis patients. Inappropriate control of blood pressure is mentioned as one of the essential cardiovascular risk factors associated with development of cardiovascular events in dialysis populations. The aim of the cross-sectional, retrospective study was the evaluation of the antihypertensive treatment schedule and control of blood pressure in relation to the guidelines in the group of hemodialysis patients. Additionally, we assessed the level of decrease in blood pressure by each group of hypotensive agents. Materials and Methods: 222 patients hemodialyzed in a single Dialysis Unit in three distinct periods of time—2006, 2011, and 2016—with a diagnosis of hypertension were enrolled in the study. The analysis of the antihypertensive treatment was based on the medical files and it consisted of a comparison of the mean blood pressure results reported during the six consecutive hemodialysis sessions. Results: The mean values of blood pressure before hemodialysis were as follows: 134/77, 130/74, and 140/76 mmHg, after hemodialysis 124/74, 126/73, and 139/77 mmHg in 2006, 2011, and 2016 respectively. The goal of predialysis blood pressure control (<140/90) was achieved by up to 64.3% of participants in 2006 as compared to 49.4% in 2016. Additionally, the postdialysis goal (<130/90) reached 57.1% of the study population in 2006 as compared to 27.1% of patients in 2016. The differences in percentage of patients using single, double, triple, and multidrug therapy during observation were not statistically significant. The most often used drugs were ß-blockers, diuretics, and calcium channel blockers in all points of the study. Blockades of the renin–angiotensin–aldosterone system in 2006 and calcium channel blockers in 2011 and 2016 were the drugs with highest impact on lowering blood pressure. Conclusions: The goal of predialysis or postdialysis blood pressure control was achieved in a lower percentage of patients during the period of the study. Blockade of renin–angiotensin–aldosterone system and calcium channel blockers decrease the blood pressure significantly. It is necessary to achieve better control of blood pressure in prevention of cardiovascular incidents.

Download Full-text

Aggressive blood pressure control and stroke prevention: role of calcium channel blockers

Journal of Hypertension ◽

10.1097/hjh.0b013e3282f4d1d5 ◽

2008 ◽

Vol 26 (5) ◽

pp. 844-852 ◽

Cited By ~ 14

Author(s):

Dimitris P Papadopoulos ◽

Vasilios Papademetriou

Keyword(s):

Blood Pressure ◽

Calcium Channel ◽

Blood Pressure Control ◽

Calcium Channel Blockers ◽

Stroke Prevention ◽

Pressure Control ◽

Channel Blockers

Download Full-text

Treating patients with hypertension in Indonesia’s primary health care centre: A challenging condition

Global Cardiology Science and Practice ◽

10.21542/gcsp.2019.14 ◽

2019 ◽

Vol 2019 (2) ◽

Author(s):

Lucky Aziza Abdullah Bawazir ◽

Wicensius Sianipar

Keyword(s):

Blood Pressure ◽

Health Care ◽

Primary Health Care ◽

Calcium Channel ◽

Blood Pressure Control ◽

Calcium Channel Blockers ◽

Antihypertensive Agents ◽

Pressure Control ◽

Channel Blockers ◽

Primary Health

Background: In Indonesia, hypertension treatment relies on primary health care services, and there are no current data on blood pressure control and hypertension treatment in Indonesia’s primary health care system.Methods: We conducted a cross-sectional study including all patients with hypertension (n = 273) who visited the Tegal Alur II Community Health Center in 2017. For all patients with hypertension, medical records containing the most recent blood pressure results and antihypertensive treatments were examined by the authors. The primary outcome in this study was optimal blood pressure control according to the Joint National Committee (JNC) VII guidelines.Results: The mean systolic and diastolic blood pressures were 143.7 mmHg (SD 18.5) and 87 mmHg (SD 11.4), respectively. Calcium channel blockers were the most frequently used antihypertensive agents (58.6%). Of all patients with hypertension, 27.1% achieved controlled blood pressure. Bivariate analysis revealed a significant association between antihypertensive agents and blood pressure control (p = 0.009). Multivariate analysis showed that calcium channel blockers were the strongest predictor of blood pressure control, with an adjusted odds ratio of 1.9 (95% confidence interval [CI] 1.1–3.5, p= 0.022).Conclusion: Controlled blood pressure was achieved by less than half of all patients with hypertension visiting the Tegal Alur II Community Health Center in 2017. The majority of patients with hypertension received single-drug therapy with calcium channel blockers, the most frequently used antihypertensive agents. There was a significant association between antihypertensive agents and blood pressure control.Funding: This study received no financial support from any specific funding agencies.

Download Full-text

Renoprotective effect of calcium channel blockers

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0912690d ◽

2009 ◽

Vol 137 (11-12) ◽

pp. 690-696

Author(s):

Nada Dimkovic ◽

Sinisa Dimkovic

Keyword(s):

Blood Pressure ◽

Renal Failure ◽

Calcium Channel ◽

Blood Pressure Control ◽

Calcium Channel Blockers ◽

Ace Inhibitors ◽

Clinical Studies ◽

Pressure Control ◽

Channel Blockers ◽

Glomerular Arterioles

The advancing chronic renal failure is at most the consequence of secondary haemodynamic and metabolic factors as intraglomerular hypertension and glomerular hypertrophy. Although tight blood pressure control is the major preventive mechanism for progressive renal failure, ACE inhibitors and angiotensin receptor blockers have some other renoprotective mechanisms beyond the blood pressure control. That is why these two groups of antihypertensive drugs traditionally have advantages in treating renal patients especially those with proteinuria over 400-1000 mg/day. Even if earlier experimental studies have shown renoprotective effect of calcium channel blockers, later clinical studies did not prove that calcium channel blockers have any advantages in renal protection over ACE inhibitors given as monotherapy or in combination with ACE inhibitors. It was explained by action of calcium channel blockers on afferent but not on efferent glomerular arterioles; a well known mechanism that leads to intraglomerular hypertension. New generations of dihydropiridine calcium channel blockers can dilate even efferent arterioles not causing unfavorable haemodynamic disturbances. This finding was confirmed in clinical studies which showed that renoprotection established by calcium channel blockers was not inferior to that of ACE inhibitors and that calcium channel blockers and ACE inhibitors have additive effect on renoprotection. Newer generation of dihydropiridine calcium channel blockers seem to offer more therapeutic possibilities in renoprotection by their dual action on afferent and efferent glomerular arterioles and, possibly by other effects beyond the blood pressure control.

Download Full-text

Patterns of use of drugs in hypertension in geriatric patients in the department of medicine at tertiary care hospital of Nepal.

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i3.33685 ◽

2020 ◽

Vol 5 (3) ◽

pp. 1155-1160

Author(s):

Binod Raut ◽

Anjan Khadka

Keyword(s):

Combination Therapy ◽

Calcium Channel ◽

Antihypertensive Drug ◽

Calcium Channel Blockers ◽

Geriatric Patients ◽

Antihypertensive Drugs ◽

Tertiary Care ◽

Channel Blockers ◽

Care Hospital ◽

Cross Sectional

Introduction: In Nepal, the prevalence of hypertensive in elderly population is 41.7% aged 65 years or more. Hypertension increases with age leading to arterial stiffness and endothelial dysfunction. The prevalence of hypertension is 20% of urban populations. Blood pressure control with the use of antihypertensive drugs reduces cardiovascular complications in geriatric patients. Objectives: The objective of our study is to know the various patterns of drugs used in geriatrics hypertensive patient along with their co-morbidities and to know the most commonly used antihypertensive drug in geriatric patient. Methodology: It was a hospital based cross sectional study involving 130 patients based on non-probability sampling. The study involved the hypertensive elderly patients of age > 65 years prescribed with antihypertensive drugs. Data were collected from patients attending outpatient department of medicine . Medical and nursing records were analyzed for patient’s characteristics (e.g. age, gender), systolic and diastolic BP readings, number of drugs, monotherapy, combination therapy, co morbidities. Data were analysed by using SPSS version 20. Results: The total 130 geriatric patients under treatment with antihypertensive drugs were included, in which 55.38% were male and 44.62% were female. The total numbers of antihypertensive drugs prescribed were 212 either as monotherapy or as a component of a combination therapy. The average number of drugs prescribed per patient was found to be 1.66. Among these drugs 56.92% were prescribed as monotherapy,26.92% were prescribed as two drugs combination therapy,12.30% were prescribed as three drugs combination and 3.84% were prescribed as four drugs combination therapy. calcium channel blockers (amlodipine )was the most commonly prescribed antihypertensive. Conclusion: The study showed male patient were more predominant hypertensive compare to female. calcium channel blockers group of drugs in which amlodipine was the most commonly prescribed antihypertensive drug and more than half of the patients were in monotherapy.

Download Full-text

Compliance to secondary prevention strategies for coronary artery disease: a hospital-based cross-sectional survey from Ernakulam, South India

BMJ Open ◽

10.1136/bmjopen-2020-037618 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037618

Author(s):

Remya Sudevan ◽

Damodaran Vasudevan ◽

Manu Raj ◽

Rajesh Thachathodiyl ◽

Maniyal Vijayakumar ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Smoking Cessation ◽

Secondary Prevention ◽

Blood Pressure Control ◽

Pressure Control ◽

Prevention Strategies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Resource Limited

ObjectivesThe primary objective of the study was to report the compliance to secondary prevention strategies for coronary artery disease (CAD), such as smoking cessation, weight management, low-density lipoprotein (LDL) cholesterol control, blood pressure control, glycaemic control, physical activity and cardiovascular drug therapy from a resource-limited setting.DesignAnalytical cross-sectional survey with data collection using questionnaire administered by study personnel.SettingInstitutional—two tertiary care hospitals and two cardiology clinics.ParticipantsPatients in the age group of 30–80 years with documented CAD with a minimum of 1 year and a maximum of 6 years of follow-up after diagnosis.Main outcome measuresThe main outcome measures were the prevalence of individual compliance to secondary prevention strategies for CAD such as smoking cessation, weight management, LDL cholesterol control, blood pressure control, glycaemic control, physical activity and cardiovascular drug therapy. The secondary outcomes were the association of secondary prevention strategies with age, sex, domicile, socioeconomic status, insurance and type of treatment.ResultsWe recruited a total of 1206 patients among whom 879 (72.9%) were males. The median age of patients was 62 (14) years. The compliance to smoking cessation was 93.86% (95% CI 91.66% to 96.06%), ideal body mass index was 63.76% (95% CI 61.05% to 66.47%), blood pressure control was 65.11% (95% CI 62.42% to 67.80%), LDL compliance was 36.50% (95% CI 33.18% to 39.82%), diabetes control was 51.23% (95% CI 46.10% to 56.36%) and adequate physical activity was 39.22% (95% CI 36.46% to 41.98%)respectively. Reported compliance for cardiovascular drugs therapy was 96% for antiplatelets, 89.4% for statins, 68.2% for beta blockers, 37.7% for renin angiotensin aldosterone system blockers, 81.28% for oral hypoglycaemic agents and 22% for insulin therapy.ConclusionCompliance to secondary prevention strategies for CAD in resource limited settings are moderate. This needs further improvement for better outcomes related to CAD in future.

Download Full-text

Abstract P140: Blood Pressure Control in Veterans Following Percutaneous Coronary Intervention (PCI)

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_1.ap140 ◽

2011 ◽

Vol 4 (suppl_1) ◽

Author(s):

Sloane A McGraw ◽

Michael Scholfield ◽

Ragu Murthy ◽

Burhan Mohamedali ◽

Anupama Shivaraju ◽

...

Keyword(s):

Blood Pressure ◽

Calcium Channel ◽

Calcium Channel Blockers ◽

Beta Blockers ◽

Coronary Intervention ◽

Pressure Control ◽

Joint National Committee ◽

National Committee ◽

Channel Blockers ◽

Drug Classes

Background: Control of blood pressure (BP) in patients with underlying coronary artery disease (CAD) provides a decreased risk in morbidity and mortality. According to the US Joint National Committee VII (JNC-7) recommendations, patients with underlying CAD should have goal blood pressures of systolic <130 and diastolic <80. These goals can be attained by using multiple classes of drugs including beta-blockers (BB), angiotensin agonists (ACE-I/ARB), calcium channel blockers (CCB), diuretics and nitrates. Methods: We conducted a retrospective cohort study focusing on attaining JNC-7 guidelines for BP in a diverse population of 772 patients undergoing PCI between September 2004 and September 2008 at the Jesse Brown Veterans Hospital in Chicago, IL. Data was collected which compared both BP measurements and antihypertensive regimens pre and post PCI. Results: For the 772 patients, the overall population mean systolic blood pressure (SBP) decreased from 134 to 128mmHg (p < 0.0001) and mean diastolic blood pressure (DBP) decreased from 73 to 70mmHg (p < 0.0001). With regards to JNC-7 guidelines, the percent of patients who reached SBP goals increased from 44 to 54% (340 to 417 of 772) (p < 0.0001) and with DBP goals rose from 72 to 78% (556 to 602 of 772) (p = 0.0031). At 6 months, there was a statistically significant (all p values <0.0001) change in the use of each drug class; the use of ACE-I/ARB increased from 64% (494 out of 772) to 76% (587 of 772) and BB from 73% (564 of 772) to 89% (687 of 772). There was also increased utilization of diuretics 41% (317 of 772) to 43% (332 of 772) and nitrates 23% (178 of 772) to 29% (224 of 772), however a decrease in the use of calcium channel blockers, 34% (262 of 772) to 31% (239 of 772). Conclusions: There was improvement in BP in the six months after PCI and although there were higher rates of attainment of JNC-7 goals for SBP and DBP at six months, overall percentage values are still suboptimal. Additionally, the medication usage improved in most drug classes with exception of calcium channel blockers; however these increases still leave some room for improvement.

Download Full-text