Results of a National Therapeutic Trial Conducted in 10 000 Hypertensive Patients by 2000 General Practitioners

1978 ◽  
Vol 55 (s4) ◽  
pp. 353s-354s
Author(s):  
A. Jouve ◽  
L. Goldet ◽  
M. Mathieu
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Diastolic Blood Pressure ◽  
General Practitioners ◽  
Antihypertensive Drugs ◽  
Drop Out ◽  
Therapeutic Trial ◽  
Hypertensive Patients ◽  
Supine Diastolic Blood Pressure ◽  
Treatment Groups

1. 10 294 hypertensive patients were treated and followed by 2200 general practitioners under the supervision of 130 cardiologists and nephrologists. 2. The treatment groups, randomly allocated, were designated to use three distinct antihypertensive drugs, administered alone, and combined two-by-two. 3. Some 75% of patients had a supine diastolic blood pressure of less than 95 mmHg after 4 months treatment. 4. A total of 12% of patients had dropped out by 4 months from entry; no clear relationship was established between side effects and drop out.

Prazosin and Hydrallazine in the Treatment of Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 617s-619s ◽  
Author(s):  
Priscilla Kincaid-Smith ◽  
A. S. P. Hua ◽  
J. B. Myers ◽  
Ileene Macdonald ◽  
P. Fang
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Diastolic Blood Pressure ◽  
Blocking Agent ◽  
Base Line ◽  
Double Blind ◽  
Supine Diastolic Blood Pressure ◽  
Treatment Of Hypertension ◽  
Blood Pressures

1. Two vasodilators, prazosin and hydrallazine, have been compared in three double-blind cross-over studies designed to test their effect when used in combination with a β-adrenoceptor-blocking agent and a thiazide. 2. Single doses of 3 mg of prazosin or 75 mg of hydrallazine were administered to patients whose blood pressures remained uncontrolled on a thiazide and a β-adrenoceptor-blocking agent. Both agents produced significant falls in systolic and diastolic blood pressure apparent at 1 h. The effects of prazosin persisted for 6–7 h and those of hydrallazine for 4–6 h. Tachycardia was more marked and more prolonged after hydrallazine and continued after the blood pressure had risen to base-line levels or above. 3. In 6 week and 12 week double-blind cross-over studies, mean falls in blood pressure were similar with prazosin and hydrallazine. Similar falls in the supine diastolic blood pressure were achieved with 1 mg of prazosin and 20 mg of hydrallazine, but for a given fall in supine diastolic blood pressure, prazosin produced a significantly lower standing diastolic blood pressure. 4. Severe side effects were more pronounced after hydrallazine, which necessitated withdrawal of seven patients, whereas only one patient on prazosin withdrew from the trial because of side effects.

scholarly journals Effects of Polyherbal Tablet for Hypertensive Patients

2020 ◽  
Vol 25 (3) ◽  
Author(s):  
Woro Rukmi Pratiwi ◽  
Eti Nurwening Sholikhah ◽  
Dwi Aris Agung Nugrahaningsih ◽  
Mia Munawaroh Yuniyanti ◽  
Mustofa Mustofa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Reduce Blood Pressure ◽  
Comparison Study ◽  
Hypertensive Patients ◽  
Treatment Groups ◽  
The Third ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Hypertension is a degenerative disease whose prevalence is high and continues to increase over time. Polyherbal tablet have long been used by Indonesian people for hypertension drugs containing garlic (Alium sativum), jelawe (Belericae fructus), temu ireng rhizomes (Curcumae aeruginosae) and kapulaga (Amomi fructus) extracts. This study aims to determine the effect of polyherbal tablet on hypertensive patients. The subjects of 29 hypertensive patients participated in a open-randomized-without comparison-study for 6 weeks. Subjects were divided into 3 groups, each subject received polyherbal tablet with a dose of 2x600 mg (group 1), 2x1200 mg (group 2) and 2x2400 mg (group 3). Blood pressure was monitored on D-0, D-3, D-5, D-7, W-2, W-3, W-4, W-5 and W-6. There was a significant decrease in systolic and diastolic blood pressure at the sixth week in all three treatment groups. The highest decrease in systolic blood pressure was in group 1 while diastolic blood pressure was in group 2 (-22.94 ± 5.871 and 13.13 ± 4.324 respectively). The lowest reduction in systolic and diastolic blood pressure occurred in the third group (-15.07 ± 3,519 and 8.98 ± 3,394 respectively). This study suggests that polyherbal tablet contains garlic (Alii sativi), jelawe (Belericae Fructus), temu ireng rhizome (Curcumae aeruginosae) and cardamom (Amomi Fructus) can reduce blood pressure in patients with hypertension. 

scholarly journals Washed Microbiota Transplantation Lowers Blood Pressure in Patients With Hypertension

2021 ◽  
Vol 11 ◽  
Author(s):  
Hao-Jie Zhong ◽  
Hong-Lie Zeng ◽  
Ying-Li Cai ◽  
Yu-Pei Zhuang ◽  
Yu-Ligh Liou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gastrointestinal Tract ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Standard Error ◽  
Antihypertensive Effect ◽  
Antihypertensive Drugs ◽  
Lower Gastrointestinal Tract ◽  
Microbial Composition ◽  
Hypertensive Patients

BackgroundAlthough transplantation of the fecal microbiota from normotensive donors has been shown to have an antihypertensive effect in hypertensive animal models, its effect on blood pressure in patients with hypertension is unclear. This study aimed to assess the effect of washed microbiota transplantation (WMT) from normotensive donors on blood pressure regulation in hypertensive patients.MethodsThe clinical data of consecutive patients treated with washed microbiota transplantation (WMT) were collected retrospectively. The blood pressures of hypertensive patients before and after WMT were compared. The factors influencing the antihypertensive effect of WMT in hypertensive patients and fecal microbial composition of donors and hypertensive patients were also analyzed.ResultsWMT exhibited an antihypertensive effect on blood pressure: the blood pressure at hospital discharge was significantly lower than that at hospital admission (change in systolic blood pressure: −5.09 ± 15.51, P = 0.009; change in diastolic blood pressure: −7.74 ± 10.42, P < 0.001). Hypertensive patients who underwent WMT via the lower gastrointestinal tract (β = −8.308, standard error = 3.856, P = 0.036) and those not taking antihypertensive drugs (β = −8.969, standard error = 4.256, P = 0.040) had a greater decrease in systolic blood pressure, and hypertensive patients not taking antihypertensive drugs also had a greater decrease in diastolic blood pressure (β = −8.637, standard error = 2.861, P = 0.004). After WMT, the Shannon Diversity Index was higher in six of eight hypertensive patients and the microbial composition of post-WMT samples tended to be closer to that of donor samples.ConclusionWMT had a blood pressure-lowering effect in hypertensive patients, especially in those who underwent WMT via the lower gastrointestinal tract and in those not taking antihypertensive drugs. Therefore, modulation of the gut microbiota by WMT may offer a novel approach for hypertension treatment.

Blood Pressure Control and Associated Factors Among Hypertensive Patients Attending Shashemene Referral Hospital, Oromia, Ethiopia

2021 ◽  
pp. 001857872110613
Author(s):  
Aliyi Anota ◽  
Teshome Nedi
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Blood Pressure Control ◽  
Associated Factors ◽  
Antihypertensive Drugs ◽  
Pressure Control ◽  
Referral Hospital ◽  
Hypertensive Patients ◽  
The Mean ◽  
Study Participants

Background: Hypertension is public health challenge worldwide. It is defined as persistently elevated arterial blood pressure (BP), systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg or use of antihypertensive medication in adults older than 18 years. The aim of this study was to assess blood pressure control and associated factors among hypertensive patients attending the outpatient department of Shashemene Referral Hospital. Methods: Hospital based cross sectional study was conducted to determine level of blood pressure control and associated factors among hypertensive patients on medical follow-up. A medical chart review and interview was conducted from July 1 to October 31 2018. Result: A total of 325 participants were included in this study with response rate of 320 (98.5%). More than half of study participants were males 171 (53.4%). The mean age of the respondents was 55.10 (SD ± 12.7) years and majority of the respondents 191 (59.7%) were within age of less than 60 years old. The mean Systolic blood pressure (SBP) was 131.80 mmHg (SD ± 20.92) while the mean diastolic blood pressure (DBP) was 82.30 mmHg (SD ± 10.52). About 51.30% of study participants had a controlled SBP and 54.7% had a controlled DBP. The overall control of BP was achieved in 40.3% of the study participants. Multivariable logistic regression analysis showed that age, experience of side effects, frequency of BP measuring, number of antihypertensive drugs used, duration on antihypertensive, source of medication and physical exercise showed significant association with blood pressure control. Conclusion: Blood pressure control level among chronic hypertensive patients at outpatient department was low. Age of patients, educational level, experience of side effects, and number of antihypertensive drugs used were important determinant factors associated with blood pressure control among study participants.

scholarly journals Potential of Flavonoid in Mahkota Dewa to Reduce Sistolic and Diastolic Blood Pressure in Patient with Hypertension

2020 ◽  
Vol 1 (1) ◽  
pp. 26
Author(s):  
Abed Nego Okhtara
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Diastolic Blood Pressure ◽  
Alternative Treatment ◽  
Antihypertensive Drugs ◽  
The Elderly ◽  
Flavonoid Compounds

Treating hypertension by using antihypertensive drugs and diuretics has many harmful side effects. Mahkota Dewa fruit can be used as alternative treatment with minimal side effects. As generallly known that blood pressure increases slowly with age, which makes hypertension a critical disease to the elderly. This disease could be treated using flavonoid compounds that is contained in Mahkota Dewa fruit because it is effective in reducing blood pressure.

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

ASSESSING THE OUTCOMES OF TREATMENT AND MANAGEMENT, 400 HYPERTENSIVE PATIENTS IN BONG SON GENERAL HOSPITAL, BINH DINH PROVINCE

2016 ◽  
pp. 31-40
Author(s):  
Long Nhon Phan ◽  
Van Minh Huynh ◽  
Thi Kim Nhung Hoang ◽  
Van Nham Truong
Keyword(s):  
Blood Pressure ◽  
Risk Stratification ◽  
Hypertensive Patient ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Target ◽  
Average Risk ◽  
Hypertensive Patients ◽  
Average Systolic Blood Pressure ◽  
Complications Of Stroke

Objective: To evaluate the results of treatment achieved blood pressure goal (BP goal) and results of hypertensive patient management. Subjects and methods: A study of 400 hypertensive patient intervention, treatment and management after 2 year. To assess the results of BP target, monitor the use of medicines, the situation of hospitalization and complications of stroke. Results: Treatment: -100% of patients using diuretics and angiotensin-converting enzyme inhibitors (ACEIs), 33% of patients using angiotensin receptor blockers (ARBs), 46.25% of patients using calcium channel blockers (CCBs) and 19.5% of patients using beta-blocker. After 24 months of treatment: 50.5% of patients using 1 antihypertensive drug, 22% of patients using 2 drugs, 20.5% of patients using 3 drugs and 7% of patients taking more than 3 drugs. After 24 months of treatment: 91.75% achieved BP target and 8.25% fail. -Average risk stratification: 97.32% achieved BP target, hight risk stratification: 95.91% and very hight risk stratification: 73.03%. After 24 months of treatment. -Stage 1: 88.48% achieved BP target, stage 2: 92.85% achieved BP target and stage 3: 71.08% achieved BP target. After 24 months of treatment. -Hypertesive results before treatment were: 159.80 ± 20,22mmHg average systolic blood pressure and 82.97 ± 5,82mmHg average diastolic blood pressure. After treatment: average systolic blood pressure 125.38 ± 6,88mmHg and average diastolic blood pressure 79.83 ± 1,79mmHg. No adverse change in the index of tests about lipidemia, liver, kidney, glucomia and no recorded cases of drug side effects. Management of patients: -There were 89% non-medical examinational patients 1 month, 5.25% non-medical examinational patients 2 months, 4.25% non-medical examinational patients 3 months and 1.5% non-medical examinational patients 4 months. There were 93.5% drop pill 1 month, 3.25% drop pill 2 months, 4.25% drop pill 3 months and no patient drop pill over 3 months. In 24 months follow-up, 47% hospitalized inpatients <5 times, 44.5% hospitalized inpatients 5-10 times, 3% hospitalized inpatients 11-15 times, 4.75% hospitalized inpatients from 16-20 times and 0.75% hospitalized inpatients > 20 times. -There were 32.75% hospitalized inpatients for reasons of hypertension and 63.75% hospitalized inpatients for other common diseases. -There were a total of 11592 contacts directly by phone for medical advice, medical reminders and examinational reminders during 24 months of management. -There were 0.5% of patients stroked during 24 months of treatment and management. Conclusion: Treatment by protocol and management by phone directly for medical taking and re-examinational reminders is the best resulted method of achieving blood pressure target and reducing complications of stroke for hypertensive patients. Key word: : blood pressure target; risk stratification; treatment; management; stage; phone.

scholarly journals Baroreflex activation therapy for resistant hypertension: results from mid-term prospective ambulatory blood pressure registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Sindt ◽  
T Madej ◽  
S Grimm ◽  
M Knaut
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Pressure Drop ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Drug Resistant ◽  
Baroreflex Activation Therapy ◽  
Activation Therapy ◽  
Resistant Arterial Hypertension

Abstract Objectives First generation baroreflex activation therapy (BAT) devices showed clinical efficacy in patients with drug-resistant arterial hypertension (AHT), but the safety profile was insufficient. Data regarding efficacy of second-generation devices were generated mostly from office blood pressure (BP) measurements or short-term 24-hour ambulatory blood pressure measurements (ABPM). We present a mid-term prospective registry to evaluate the efficacy and safety of recent BAT devices. Purpose The purpose of our study was to find a method that helps patients with drug-resistant arterial hypertension to control their blood pressure. Further we sought to reduce the overall amount of antihypertensive drugs to lessen side effects, as well as the effects of polypharmacy. Methods All patients receiving Barostim neo between November 2013 and June 2019 for resistant AHT were prospectively included into this observational study. ABPM was performed at baseline, in 3-month intervals in the first year after BAT implantation and in 6-month intervals afterwards for up to 42 months. Patients were assigned into two groups of responders and non-responders. Non-responders had a mean blood pressure drop (BPD) below 5mmHg. Responders in turn were categorized into 3 sub-groups (low-BPD between 5–9 mmHg, medium-BPD between 10–19 mmHg and high-BPD ≥20 mmHg). The primary efficacy end-points were changes in systolic and diastolic BP and number of antihypertensive medications. The primary safety end point was BAT-related major adverse events (MAE). Results 64 patients (mean age 63 years, 67% males) were included. Only patients who completed a 24-hour ABPM during a follow up were counted in the statistical analysis. We had an overall responder rate of 67.8%. Out of those 15.4% had low-BPD, 38.4% medium-BPD and 46.2% had a high-BPD. Systolic BP decreased over the 3.5-years period from 168±17 mmHg to 149±19 mmHg (n=19, mean change −18.8 mmHg; 95% confidence interval [CI]: −29.32 to −8.36; p&lt;0.0007). Diastolic BP decreased from 97±16 to 85±12 mmHg (n=19, mean change −11.7 mmHg; 95% CI: −19.2 to −4.2; p&lt;0.0021). The mean number of antihypertensive drugs was reduced from 6.9±1.3 to 5.2±1.5 (n=19, mean change −1.7; 95% CI: −0.8 to −0.27; p&lt;0.0009). The time course of primary end-points is shown in Fig.1. Freedom from BAT-related MAE was 93.5%. 4 perioperative complications (1 pocket bleeding, 1 pocket infection, 1 N. hypoglossus palsy, 1 hoarseness) resolved without residual side effects. There were five non BAT related deaths (7,8%) in the follow up period. Conclusion Systolic and diastolic ABP, as well as number and dosage of antihypertensive drugs decreased significantly during 3.5-years follow-up after Barostim neo implantation in 64 consecutive patients (of whom 62 completed at least one follow-up). No MAE associated with BAT were observed after the perioperative period. However, further controlled trials are needed to confirm the long-term efficacy of BAT. Figure 1. Mean blood pressure drop Funding Acknowledgement Type of funding source: None

scholarly journals Perfluoroalkyl substances and blood pressure in exposed young population in the Veneto Region, Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Canova ◽  
M Jare Zeddi ◽  
G Barbieri ◽  
M Gion ◽  
F Daprà ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Sulfonic Acid ◽  
Antihypertensive Drugs ◽  
Adult Population ◽  
Additive Models ◽  
Perfluoroalkyl Substances ◽  
Surveillance Program ◽  
Veneto Region ◽  
Large Area

Abstract Background Residents in a large area of the Veneto Region (North-Eastern Italy) were exposed to perfluoroalkyl substances (PFASs) via drinking water. Studies on the association between PFASs and blood pressure (BP) levels are limited and results are inconsistent. Using cross-sectional data from the Regional health surveillance program, we aimed to quantify the associations between PFAS serum concentrations and blood pressure and hypertension prevalence. Methods The study included 16,224 individuals aged 20-39 years. Pregnant women (n = 327), participants with self-reported diagnosis or under treatment (n = 296) or with missing information on the selected covariates (n = 114) were excluded, leaving 15,487 subjects. Hypertension (HYP) was defined as any self-reported diagnosis, use of antihypertensive drugs, or raised systolic/diastolic blood pressure (SBP)≥140, DBP ≥90 mmHg). Serum PFASs were measured by HPLC-MS. Generalized additive models were used to investigate the relation between each PFAS (perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA)) ln transformed and by decile, and SBP, DBP, HYP, adjusted for potential confounders. Results Both SBP and DBP increased significantly with an increase in the ln-transformed serum PFASs concentration in a monotonic way. The predicted increase in SBP and DBP were 1.62 (95% CI = 0.69, 2.55), 1.64 mmHg (95% CI = 0.96, 2.31) from lowest to highest decile of PFOA. The associations were stronger for SBP in men and DBP in women. One unit increase in each ln-PFAS was positively associated with an increased odds of HYP in men: PFOA OR = 1.07 (1.01-1.14), PFOS OR = 1.18 (1.05-1.32), PFHxS OR = 1.11 (1.03-1.19), PFNA OR = 1.19 (1.01-1.41). Conclusions Our findings suggest that exposure to PFAS is associated with increased blood pressure and thus may contribute as a risk factor for the development of cardiovascular diseases. Key messages Serum PFASs were associated with raised systolic blood pressure in men and diastolic blood pressure in women in a large highly exposed young adult population. Serum PFASs were associated with raised prevalence of hypertension in men.

scholarly journals Obstructive sleep apnea syndrome and sleep quality in hypertensive patients

2017 ◽  
Vol 63 (12) ◽  
pp. 1055-1060 ◽  
Author(s):  
Marcelo Rodrigues Bacci ◽  
Jonathan Naim Mora Emboz ◽  
Beatriz da Costa Aguiar Alves ◽  
Glaucia Luciano da Veiga ◽  
Neif Murad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
High Blood Pressure ◽  
Antihypertensive Drugs ◽  
Poor Sleep ◽  
Hypertensive Patients ◽  
Group I ◽  
Obstructive Sleep

Summary Introduction: Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. Objective: To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. Method: A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Results: Group I (using up to two antihypertensive agents – 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs – 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Conclusion: Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).

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