scholarly journals Dihydropyridine calcium channel blockers, angiotensin receptor blockers, and ace inhibitors in combination with diuretics or beta blockers: real world effectiveness in blood pressure change and control among patients with diabetes and hypertension

2004 ◽  
Vol 17 (5) ◽  
pp. S101
Author(s):  
J BISOGNANO
2015 ◽  
Vol 156 (5) ◽  
pp. 179-185 ◽  
Author(s):  
Gergely Fehér ◽  
Gabriella Pusch

The treatment of migraine depends on the frequency, severity and concomitant diseases. There are several specific drugs developed for migraine prevention in addition to the additive antimigraine effects of some other non-specific drugs. The aim of this literature-based review is to summarize the possible antimigraine properties of different antihypertensive agents (beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, etc.) focusing on the possible side effects (avoidance of beta blockers in the absence of heart disease, possible antiparkinson effect of calcium channel blockers, additive effect of drugs modifying the renin-angiotensin system activity, etc.). Current evidence supports the use of angiotensin converting enzyme inhibitors (mainly lisinopril) and angiotensin receptor blockers (mainly candesartan) for long-term migraine prevention and blood pressure control. Long-term beta-blocker treatment should be avoided in the absence of ischemic heart disease due to possible unfavourable cardiovascular effects. Orv. Hetil., 2015, 156(5), 179–185.


2005 ◽  
Vol 6 (1_suppl) ◽  
pp. S4-S7 ◽  
Author(s):  
Franz H Messerli ◽  
Simbo M Chiadika

Reductions in blood pressure (BP) through intervention can significantly reduce the risk of cardiovascular events in hypertensive patients. However, a number of trials indicate that beta-blockers, despite lowering BP, do not reduce the risk of stroke. A recent meta-analysis suggested that, over and beyond BP reduction, angiotensin-converting enzyme (ACE) inhibitors appear superior to calcium channel blockers for prevention of coronary heart disease whereas calcium channel blockers appear superior to ACE inhibitors for prevention of stroke. Indeed, in the Syst-EUR study a 42% reduction in strokes was achieved in the calcium antagonist arm when compared to the placebo arm.It is hypothesised that antihypertensive agents that stimulate the AT2-receptor (thiazide diuretics, dihydropyridine calcium antagonists and angiotensin receptor blockers) are more cerebroprotective than drug classes that do not stimulate the AT2-receptor (beta-blockers and ACE inhibitors).The angiotensin receptor blockers are the only drug class that have a dual mechanism of action that could be helpful in preventing strokes in that they not only inhibit the AT1-receptor but also allow stimulation of the AT2-receptor. Not surprisingly therefore, in trials such as LIFE, VALUE and MOSES, angiotensin receptor blockers showed excellent cerebroprotection.


2021 ◽  
Vol 11 (1) ◽  
pp. e13-e13
Author(s):  
Ahmadreza Maghsoudi ◽  
Maryam Dehghani Mobarakeh ◽  
Ali Momeni ◽  
Alireza Nematollahi ◽  
Shahin Asgari ◽  
...  

Introduction: Hypertension is one of the most leading causes of death worldwide. It is an important risk factor for ischemic heart disease (IHD), chronic kidney disease (CKD) and cerebrovascular diseases. Objectives: The aim of the study was evaluation of the status of blood pressure control and trends in prescribed antihypertensive medication usage among hypertensive patients in Shahrekord, Iran. Patients and Methods: In a cross-sectional descriptive study 250 hypertensive patients were enrolled. The patients were evaluated based on the status of blood pressure (BP) control and the prescription trends and efficacy of antihypertensive drugs. The data were also evaluated in subgroups of diabetics or non-diabetics, smokers or non-smokers, patients with or without CKD, patients with or without IHD. Results: A total of 250 patients (149 women and 101 men) were enrolled in this study. The mean age of participants was 66.22±13.58 years. Mean systolic and diastolic BP were 143.4±29.4 mm Hg and 85.8±12.5 mm Hg respectively. Poor controlled BP was seen in 106 patients. The more common prescribed antihypertensive drugs were angiotensin receptor blockers (46%), diuretics (33.6%) and beta-blockers (32.8%). Conclusion: The study showed that most of the patients had poor controlled BP and physicians increasingly prescribe angiotensin receptor blockers.


2019 ◽  
Vol 27 (3) ◽  
pp. 247-255 ◽  
Author(s):  
Chris Noone ◽  
Joy Leahy ◽  
Eimear C Morrissey ◽  
John Newell ◽  
Micheál Newell ◽  
...  

Aims This analysis aims to estimate the comparative efficacy of anti-hypertensive medications and exercise interventions on systolic and diastolic blood pressure reduction in people with hypertension. Methods A systematic review was conducted focusing on randomised controlled trials (RCTs) of exercise interventions and first-line anti-hypertensives where blood pressure reduction was the primary outcome in those with hypertension. Network meta-analyses were conducted to generate estimates of comparative efficacy. Results We identified 93 RCTs ( N = 32,404, mean age in RCTs: 39–70 years) which compared placebo or usual care with first-line antihypertensives including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers and thiazide-like diuretics and exercise interventions including aerobic training and dynamic resistance training. Of these, there were 81 (87%) trials related to medications ( n = 31,347, 97%) and 12 (13%) trials related to exercise ( n = 1057, 3%). The point estimates suggested that antihypertensive medications were more effective than exercise but there was insufficient evidence to suggest that first-line medications significantly reduced blood pressure to a greater extent than did the exercise interventions. Of the first-line treatments, angiotensin receptor blockers and calcium channel blockers had the highest treatment ranking, while exercise had the second lowest treatment ranking, followed by control conditions. Conclusion The current evidence base with a bias towards medication research may partly explain the circumspection around the efficacy of exercise in guidelines and practice. Clinicians may justifiably consider exercise for low risk hypertension patients who confirm a preference for such an approach.


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