A Japan nationwide web-based survey of patient preference for renal denervation for hypertension treatment

AbstractRenal denervation is a potential alternative to antihypertensive drug therapy. However, data on patient preference for this treatment option are limited and there are no data specifically from Asian patients. This study evaluated patient preference for renal denervation in patients with hypertension from Japan. Patients were a subset of those who participated in a March 2020 online electronic survey of patients with hypertension who had regularly visited medical institutions for treatment, were receiving antihypertensive drug therapy and had home blood pressure recordings available. The survey included a question about patient preference for treatment with renal denervation. A total of 2,392 patients were included (66% male, mean age 59.8 ± 11.6 years, mean duration of hypertension 11.4 ± 9.5 years). Preference for renal denervation was expressed by 755 patients (31.6%), and was higher in males than in females, in younger compared with older patients, in those with higher versus lower blood pressure, in patients who were less adherent versus more adherent to antihypertensive drug therapy, and in those who did rather than did not have antihypertensive drug-related side effects. Significant predictors of preference for renal denervation on logistic regression analysis were younger patient age, male sex, higher home or office systolic blood pressure, poor antihypertensive drug adherence, the presence of heart failure, and the presence of side effects during treatment with antihypertensive drugs. Overall, a relevant proportion of Japanese patients with hypertension expressed a preference for renal denervation. This should be taken into account when making shared decisions about antihypertensive drug therapy.

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Blood pressure in hemodialysis patients during amelioration of anemia with erythropoietin.

Journal of the American Society of Nephrology ◽

10.1681/asn.v24927 ◽

1991 ◽

Vol 2 (4) ◽

pp. 927-936

Author(s):

P A Abraham ◽

M G Macres

Keyword(s):

Blood Pressure ◽

Drug Therapy ◽

Diastolic Blood Pressure ◽

Antihypertensive Drug ◽

Antihypertensive Drugs ◽

Pressure Control ◽

Hemodialysis Patients ◽

Uncontrolled Hypertension ◽

Antihypertensive Drug Therapy ◽

Dose Dependent

This study analyzed blood pressure in hemodialysis patients treated with epoetin beta in multicenter trials. Antihypertensive drugs were prescribed as usual. Placebo-controlled trials compared epoetin (100 to 150 U/kg; N = 151) with placebo (N = 78) for 82 days. Hemoglobin (108 +/- 18 versus 75 +/- 14 g/L) (mean +/- SD) and diastolic blood pressure (84 +/- 14 versus 78 +/- 15 mm Hg) were greater (P less than 0.05) after epoetin. Clinically important increases in blood pressure (increases in diastolic blood pressure greater than or equal to 10 mm Hg and/or drug therapy) were more frequent with epoetin (58 versus 37%; P = 0.005). A dose-response trial compared epoetin, 25 U/kg (N = 42), 100 U/kg (N = 40), and 200 U/kg (N = 39) for 138 days. Increases in hemoglobin were dose dependent, but clinically important increases in blood pressure were not. In analyses of all patients treated with epoetin (N = 272), no baseline or final level of hemoglobin, or rate of hemoglobin rise, was a threshold for a rise in blood pressure. Patients requiring antihypertensive drugs or having uncontrolled hypertension (diastolic blood pressure greater than 90 mm Hg) at baseline had decreases in blood pressure (P less than 0.05) with antihypertensive therapy. Thus, compared with placebo, 21% of patients had clinically important increases in blood pressure during amelioration of anemia. The baseline or final levels of hemoglobin, the extent or rate of hemoglobin rise, or uncontrolled hypertension or antihypertensive drug use at baseline were not confirmed as risks. Antihypertensive drug therapy was important for blood pressure control.

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Home blood pressure and cardiovascular outcomes in very elderly patients receiving antihypertensive drug therapy: a subgroup analysis of Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure (HONEST) study

Clinical and Experimental Hypertension ◽

10.1080/10641963.2016.1267194 ◽

2018 ◽

Vol 40 (5) ◽

pp. 407-413 ◽

Cited By ~ 1

Author(s):

Ikuo Saito ◽

Kazuomi Kario ◽

Toshio Kushiro ◽

Satoshi Teramukai ◽

Mai Yaginuma ◽

...

Keyword(s):

Blood Pressure ◽

Drug Therapy ◽

Elderly Patients ◽

Antihypertensive Drug ◽

Subgroup Analysis ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Antihypertensive Drug Therapy ◽

Very Elderly

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The Prevalence of Arterial Hypertension in Romanian Adult Population: Results from the Predatorr Study

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2018-0036 ◽

2018 ◽

Vol 25 (3) ◽

pp. 303-312 ◽

Cited By ~ 1

Author(s):

Maria-Magdalena Roșu ◽

Maria Moța

Keyword(s):

Blood Pressure ◽

Drug Therapy ◽

Antihypertensive Drug ◽

Antihypertensive Drugs ◽

Adult Population ◽

Antihypertensive Drug Therapy ◽

National Study ◽

Age Group ◽

Unhealthy Lifestyle ◽

And Control

Abstract Background and aims: PREDATORR is a national study designed to estimate the prevalence of diabetes mellitus, prediabetes, overweight, obesity, dyslipidemia, hyperuricemia and chronic kidney disease in Romanian adult population. The aim of present study was to estimate the prevalence, incidence, treatment and control in subjects from PREDATORR study. Material and methods: This study included 2727 adults aged 20 – 79 years. Subjects were examined, and three measurements were performed at a time of at least one minute and the mean of blood pressure readings was recorded. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or antihypertensive drug therapy. Results: The prevalence of hypertension in Romanian adult population aged 20 – 79 years was 47.38% and was higher in men: 48.62% than women: 46.23%. The incidence of hypertension was: 10.7% in 20 – 39 years age group, 43.1% in 40 – 59 years age group and 75.1% in subjects aged ≥ 60 years. Among subjects with hypertension, 18.7% did not receive antihypertensive drug therapy, 27.7% received antihypertensive treatment in monotherapy, 34.7% were under double antihypertensive drugs and most of them (37.6%) received three or more antihypertensive drugs. Conclusions: The prevalence of hypertension in Romania is high, possible explanations of this might be the unhealthy lifestyle and diet.

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Drug utilization study of antihypertensive drugs and prevalence of blood pressure control in adult hypertensive patients based on JNC VIII guidelines in a tertiary care hospital: a cross sectional study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190142 ◽

2019 ◽

Vol 8 (2) ◽

pp. 245

Author(s):

Saumya Ramadas ◽

M. B. Sujatha ◽

M. A. Andrews ◽

Sanalkumar K. B.

Keyword(s):

Blood Pressure ◽

Combination Therapy ◽

Drug Utilization ◽

Antihypertensive Drug ◽

Blood Pressure Control ◽

Antihypertensive Drugs ◽

Pressure Control ◽

Antihypertensive Drug Therapy ◽

Care Hospital ◽

Drug Utilization Study

Background: Hypertension is a major independent risk factor for coronary artery disease, congestive heart failure, stroke, chronic kidney disease and peripheral vascular diseases if left untreated. Drug utilization study of antihypertensive drugs and the study on prevalence of blood pressure control would help in reducing the burden of the disease and health expenditure.Methods: The study was conducted in the Outpatient Department of Medicine in Government Medical College, Thrissur. Patients aged 18yrs or above diagnosed with hypertension, on antihypertensive drugs were enrolled in the study. Patients suffering from secondary hypertension and acutely ill were excluded. Patients were enrolled after taking an informed consent. Demographic data, present treatment for hypertension, associated co- morbid conditions if any, and treatment of the same were recorded. BP was recorded, and cost of treatment was calculated using CIMS.Results: A total of 250 patients were included in the study. Mono therapy was used in 64.8% patients and combination therapy in 35.2%. Overall drug utilization pattern showed that CCBs (42.8%) were most commonly prescribed, followed by ACEIs (32.4%) and ARBs (29.2%). Most commonly prescribed combination therapy was ACE I + BB (29.3%), followed by ARB + CCB (21.3%). Mean cost of antihypertensive drug therapy was 3057.8 Rs / yr. Recommended target BP was achieved in 49.6% of patients.Conclusions: The prescription pattern of antihypertensive drug was in accordance to the JNC-VIII guidelines. The blood pressure target was achieved only in less than 50% of patients.

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Interactions between five candidate genes and antihypertensive drug therapy on blood pressure

The Pharmacogenomics Journal ◽

10.1038/sj.tpj.6500339 ◽

2005 ◽

Vol 6 (1) ◽

pp. 22-26 ◽

Cited By ~ 34

Author(s):

H Schelleman ◽

B H Ch Stricker ◽

W M M Verschuren ◽

A de Boer ◽

A A Kroon ◽

...

Keyword(s):

Blood Pressure ◽

Drug Therapy ◽

Candidate Genes ◽

Antihypertensive Drug ◽

Antihypertensive Drug Therapy

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Blood Pressure Response Under Chronic Antihypertensive Drug Therapy

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2008.09.046 ◽

2009 ◽

Vol 53 (5) ◽

pp. 445-451 ◽

Cited By ~ 72

Author(s):

Athanase Protogerou ◽

Jacques Blacher ◽

George S. Stergiou ◽

Apostolos Achimastos ◽

Michel E. Safar

Keyword(s):

Blood Pressure ◽

Drug Therapy ◽

Antihypertensive Drug ◽

Blood Pressure Response ◽

Pressure Response ◽

Antihypertensive Drug Therapy

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Some aspects of the modern antihypertensive drug therapy and most common side effects

Scripta Scientifica Pharmaceutica ◽

10.14748/ssp.v1i1.1045 ◽

2015 ◽

Vol 2 (1) ◽

pp. 7 ◽

Cited By ~ 1

Author(s):

Petko Marinov ◽

Kaloyan Georgiev ◽

Marieta Georgieva

Keyword(s):

Drug Therapy ◽

Side Effects ◽

Antihypertensive Drug ◽

Antihypertensive Drug Therapy

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The chaos of hypertension guidelines for chronic kidney disease patients

Clinical Kidney Journal ◽

10.1093/ckj/sfz126 ◽

2019 ◽

Vol 12 (6) ◽

pp. 771-777 ◽

Cited By ~ 3

Author(s):

Esmeralda Castillo-Rodriguez ◽

Beatriz Fernandez-Fernandez ◽

Raquel Alegre-Bellassai ◽

Mehmet Kanbay ◽

Alberto Ortiz

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Drug Therapy ◽

Kidney Disease ◽

Antihypertensive Drug ◽

Secondary Hypertension ◽

Antihypertensive Drug Therapy ◽

Hypertensive Drug ◽

Definition Of ◽

Current Guidelines

Abstract Three major guidelines deal with blood pressure thresholds and targets for antihypertensive drug therapy in chronic kidney disease (CKD) patients: the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease; the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults; and the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. However, a careful reading of the three guidelines leaves the practicing physician confused about the definition of CKD, how hypertension and secondary hypertension should be diagnosed in CKD patients and what the blood pressure thresholds, targets and compelling indications of antihypertensive drug therapy should be for this population. Current guidelines refer to different CKD populations and propose different definitions of hypertension, different thresholds to initiate antihypertensive therapy in CKD patients and different BP targets compelling antihypertensive drug use. The different bodies producing guidelines should work together towards a unified definition of CKD, a unified concept of hypertension and unified BP thresholds and targets for hypertensive drug therapy for CKD patients. Otherwise they risk promoting confusion and therapeutic nihilism among physicians and patients.

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