scholarly journals Single pill combinations present a proven fast track in practice to reach the target blood pressure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Brguljan ◽  
I E Chazova ◽  
Z Gaciong ◽  
D Simic ◽  
P Vajer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Initial Dose ◽  
Drug Efficacy ◽  
Dual Therapy ◽  
Open Label ◽  
Measuring Device ◽  
Funding Sources ◽  
Trial Treatment ◽  
The Mean ◽  
Long Acting

Abstract Objective To assess the efficacy of ambulatory blood pressure (BP) lowering with perindopril/amlodipine (dual SPC arm) and perindopril/amlodipine/indapamide (triple SPC arm) in newly diagnosed and uncontrolled hypertensive patients. Design and method: 450 adults with essential hypertension were assessed in the interventional, open-label, prospective, international, multicentre PRECIOUS trial. Treatment duration was 16 weeks, divided into four treatment periods. ABPM was performed at the baseline and end of the study (prior to the visit 1 and 5), with a validated automated portable BP-measuring device (Mobil-O-Graph PWA) worn on the non-dominant arm for a 24-hour period, measuring BP in 20 minutes interval during the day and 30 minutes interval during the night. At inclusion, naïve or patients uncontrolled on previous mono or dual therapy (other than perindopril/amlodipine (P/A)) were assigned to dual SPC arm with initial dose of 4/5 mg P/A. Those uncontrolled on previous dual or triple therapy were assigned to triple SPC arm with initial dose of 4/5/1.25 mg perindopril/amlodipine/indapamide (P/A/I). If office BP control was not reached, the initial dose was up titrated in 4-week intervals to 8/5 mg, 8/10 mg P/A or 8/10/2.5 mg P/A/I in dual SPC arm and to 8/5/2.5 mg, or 8/10/2.5 mg P/A/I in triple SPC arm. Results After 16 weeks of treatment the decrease in average ambulatory BP was −16.1/−10.8 mmHg (from 142.8/92.6 mmHg to 125.1/80.8 mmHg) in dual SPC arm and −21.8/−13.5 mmHg (from 147.3/93.3 mmHg to 124.2/79.0 mmHg) in triple SPC arm. The relative reductions in ambulatory BP were −11.1%/−11.3% in dual and −14.5%/−14.2% in triple SPC arm. The absolute as well as relative ABPM reductions were higher for the awake-time BP. All ambulatory BP reductions were statistically significant in both arms (p<0.001). 71% of patients reached the normal 24h SBP levels and 45.6% the normal 24h DBP levels. At the end of the trial, the mean dose of perindopril was 6.4±2.0 mg and of amlodipine 6.5±2.3 mg in dual SPC arm. In triple SPC arm, the mean dose of perindopril was 6.66±1.89 mg, of amlodipine 6.51±2.30 mg, and of indapamide 2.08±0.59 mg. Treatment tolerability was good. 85% of patients experienced no adverse events; the recorded ones were clinically irrelevant. Conclusions Applying dual (perindopril/amlodipine) and triple (perindopril/amlodipine/indapamide) SPC treatment strategy resulted in a significant and fast BP reduction, measured by ABPM, in naïve and in patients uncontrolled on previous therapy. In even 71% of patients normal 24h SBP was reached. It seems that adding long acting diuretic in triple SPC enhanced drug efficacy even though the patients in the triple SPC arm had a more resistant hypertension. FUNDunding Acknowledgement Type of funding sources: None.

Ramadan and blood pressure: importance of chronotherapy

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
MA Bejar ◽  
I Zairi ◽  
I Ben Mrad ◽  
B Besbes ◽  
K Mzoughi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Dual Therapy ◽  
Average Heart Rate ◽  
Hypertensive Patients ◽  
Mean Values ◽  
Funding Sources ◽  
Cardiology Department ◽  
Group 2 ◽  
And Gender

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

Carteolol Treatment of Essential Hypertension: A Long-Term Study of Safety and Efficacy

1986 ◽  
Vol 14 (4) ◽  
pp. 175-184 ◽  
Author(s):  
Robert R Luther ◽  
Clemeth J Maurath ◽  
Michael J Klepper ◽  
Robert O Peckinpaugh ◽  
Gary L Ringham ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Multicenter Trial ◽  
Open Label ◽  
Once Daily ◽  
Long Term Study ◽  
Daily Dose ◽  
Baseline Values ◽  
The Mean ◽  
Oral Doses

The long-term safety and antihypertensive efficacy of carteolol were evaluated in an open-label, multicenter trial of 245 hypertensive patients. For those patients maintained on carteolol monotherapy, three months of treatment with once-daily oral doses of carteolol ranging from 2.5 to 60 mg reduced the mean recumbent blood pressure by 12/14 mm Hg from baseline values of 151/100. Blood pressure reductions observed at three months were maintained throughout the study. The final daily dose of carteolol for most patients was 10 mg or less. Carteolol was shown to be safe and well tolerated by most patients.

scholarly journals Associations Between the DASH Diet and Nocturnal Blood Pressure in a Sample of Chinese Elderly Subjects

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 550-550
Author(s):  
Muzi Na ◽  
Yanxiu Wang ◽  
Ming Gao ◽  
Aijun Xing ◽  
Shouling Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Elderly Subjects ◽  
Linear Regression Models ◽  
Hypertension Status ◽  
Cross Sectional ◽  
Dash Diet ◽  
Funding Sources ◽  
Sleep Parameters ◽  
The Mean ◽  
Diet Score

Abstract Objectives The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce daytime blood pressure (BP). This study aims to examine the relationship between DASH diet and BP monitored during sleep in a sample of Chinese old adults. Methods A cross-sectional sample of 324 participants aged ≥ 60 years who did not take BP-lowering drugs were included (68.8% men; 70.1% with hypertension). Usual dietary intake was assessed using a validated food frequency questionnaire. The DSAH diet score was calculated based on the intake ranking of 9 dietary components. 24-hour ambulatory BP was measured and the mean and variability independent of the mean (VIM) for nocturnal systolic (SBP) and diastolic BP (DBP) were calculated. Multivariable linear regression models were constructed of each BP outcome as a function of the DASH diet score adjusting for socio-demographic characteristics (age, sex, and education), body mass index, hypertension, lifestyle factors (smoking, alcohol intake, and physical activity). The interaction between DASH diet and hypertension status was also tested in the above models. We further adjusted for three self-reported sleep parameters (duration, insomnia, snoring) to explore the potential impact of sleep on the diet-nocturnal BP relationship. Results Mean (SD) age of subjects was 66.3 (6.0) years. There was no significant relationship between the DASH diet score and mean nocturnal SBP or DBP. However, per one unit increase of DASH diet score, nocturnal VIM-SBP and VIM-DBP were significantly reduced by −0.16 SD (95%CI: −0.30, −0.01) and −0.16 SD (95%CI: −0.28, −0.05) in the adjusted model. No significant interaction was detected between DASH diet and hypertension status. The significant associations persisted after further adjustment for the sleep parameters. Conclusions Adherence to the DASH diet may contribute to lower nocturnal systolic and diastolic blood pressure variability in elderly people. Future studies are warrant to explore the effect of modifiable diet on blood pressure during sleep, which has significant predictive value of heart health and mortality in high-risk populations. Funding Sources Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention, College of Health and Human Development, Pennsylvania State University.

scholarly journals Validation of the wrist blood pressure measuring device Omron RS6 (HEM-6221-E) among obese Sudanese patients according to the European Society of Hypertension International Protocol Revision 2010

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1284
Author(s):  
Elrazi A. Ali ◽  
Saeed M. Omar ◽  
Yassin Ibrahim ◽  
Osama Al-Wutayd ◽  
Ishag Adam
Keyword(s):  
Blood Pressure ◽  
European Society ◽  
Measuring Device ◽  
Average Systolic Blood Pressure ◽  
The Mean ◽  
Suitable Measure ◽  
Pressure Measuring Device ◽  
Blood Pressure Measuring Device ◽  
Good Agreement ◽  
Mercury Sphygmomanometer

Background: Electronic devices for measuring blood pressure (BP) need to go through independent clinical validation as recommended by different authorities, both in general and specific populations. The aim of this study was to assess the validity of the Omron RS6 (HEM-6221-E) wrist oscillometric devices in obese Sudanese patients. Methods: Of 90 obese individuals invited for recruitment, 33 were included in the study, and had their BP at the level of the wrist measured using Omron RS6 and standard mercury sphygmomanometer. Two observations were made and the mean was taken. BP differences between the two methods for the 33 participants were classified into three categories (≤5, ≤10, and ≤15 mmHg), according to the European Society of Hypertension-International Protocol revision 2010 (ESH-IP2) criteria. This was then used to assess the validity of the tested Omron RS6 device. Results: Participants had a mean age of 56.97 years (standard deviation (SD), 8.75; range, 36-79). Average systolic blood pressure (SBP) was 146.21 mmHg (SD, 23.07; range, 107-182), and average diastolic blood pressure (DBP) was 93.82 mmHg (SD, 16.06; range, 67-128). There was a good agreement between the two observations using the OMRON RS6 and the standard sphygmomanometer: −4 to + 3 mmHg for SBP and −4 to +4 mmHg for DBP, with the mean difference of 1.73±1.11 mmHg for SBP and 1.49±1.02 mmHg for DBP. Conclusion: Thus, the Omron RS6 (HEM-6221-E) is a valid and suitable measure of BP according to ESH-IP2.

Abstract 14317: Kidney Function Deterioration is Dependent on Blood Pressure Levels: 11.2-year Follow-up in Diabetic Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hirofumi SOEJIMA ◽  
Takeshi Morimoto ◽  
Sadanori Okada ◽  
Chisa Matsumoto ◽  
Masafumi Nakayama ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Diabetic Patients ◽  
Open Label ◽  
History Of ◽  
The Mean

Introduction: Blood pressure (BP) is a significant predictor for chronic kidney disease (CKD). Hypothesis: We sought to evaluate whether the progression of CKD in diabetic patients, without a history of atherosclerotic events, is dependent on BP control. Methods: The Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial was a multicenter, prospective, randomized, open label, blinded, end-point study done from 2002 to 2008. After completion of the JPAD trial, we followed up the patients until 2019. We defined late-stage kidney disease (LSKD) as estimated glomerular filtration rate (eGFR) <30 ml/min/1.73m 2 or hemodialysis. Among 2,536 JPAD patients, 27 patients were excluded for eGFR <30ml/min/1.73m 2 on registration. BP of the JPAD patients was recorded on average 8 times. Based on the mean value of systolic BP (SBP), we divided the patients into three groups: a High BP Group (n=607, SBP≥140 mm Hg); a Moderate BP Group (n=989, 140>SBP≥130 mm Hg); or a Low BP Group (n=913, SBP<130 mm Hg). We compared the incidence of LSKD among the three groups. Results: The mean eGFR (ml/min/1.73m 2 ) was 75.1 in the High BP Group, 72.6 in the Moderate BP Group, and 75.7 in the Low BP Group on registration. During a 11.2-year follow-up, the incidence of LSKD was significantly higher in the High BP and Moderate BP Groups than in the Low BP Group (P<0.0018, Figure). Cox proportional hazards model analysis revealed that the High BP (HR, 1.57, P=0.049) and Moderate BP (HR, 1.52, P=0.037) were independent factors after adjustment for proteinuria≥±, age≥65 years, men, body mass index≥24 kg/m 2 , duration of diabetes ≥7.0 years, statin usage, aspirin usage, eGFR≥60 ml/min/1.73m 2 , and hemoglobin A1c ≥7.2 % (Figure). Conclusions: Our study demonstrated that SBP was independently associated with the progression to LSKD in diabetic patients, without a history of atherosclerotic events. SBP less than 130 mm Hg is recommended for diabetic patients to prevent progression to LSKD.

scholarly journals Prospective Randomized Open-label Trial to evaluate risk faCTor management in patients with Unruptured intracranial aneurysms: Study protocol

2018 ◽  
Vol 13 (9) ◽  
pp. 992-998 ◽  
Author(s):  
Mervyn DI Vergouwen ◽  
Gabriel JE Rinkel ◽  
Ale Algra ◽  
Jens Fiehler ◽  
Helmuth Steinmetz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracranial Aneurysms ◽  
Aneurysm Rupture ◽  
Home Blood Pressure ◽  
Open Label ◽  
Measuring Device ◽  
Risk Factor Management ◽  
Unruptured Intracranial Aneurysms ◽  
Risk Of Rupture ◽  
Open Label Trial

Rationale Unruptured intracranial aneurysms are currently left untreated if the presumed complication risk of preventive endovascular or neurosurgical intervention is higher than the risk of rupture. Aneurysm wall inflammation and blood pressure are attractive modifiable risk factors of aneurysm rupture and growth. Aim To investigate in patients with an unruptured intracranial aneurysm who do not qualify for preventive endovascular or neurosurgical intervention whether a treatment strategy of acetylsalicylic acid 100 mg/day plus intensive blood pressure treatment (targeted systolic blood pressure < 120 mmHg, monitored with a home blood pressure measuring device) reduces the risk of aneurysm rupture or growth compared with care as usual (no acetylsalicylic acid, targeted office systolic blood pressure < 140 mmHg, no home blood pressure measuring device). Sample size We aim to randomize 776 patients 1:1 to the intervention arm or care as usual. Design Bi-national (Germany and the Netherlands) multicenter, prospective, randomized, open-label phase III trial with blinded outcome assessment. Outcomes The primary outcome is aneurysm rupture or growth (increase in any aneurysm diameter by ≥ 1 mm) on repeated MR or CT angiography within 36 ± 6 months after randomization. Discussion The Prospective Randomized Open-label Trial to Evaluate risk faCTor management in patients with Unruptured intracranial aneurysms (PROTECT-U) is the first randomized trial to investigate if a medical strategy reduces the risk of rupture or growth of intracranial aneurysms in patients not undergoing preventive endovascular or neurosurgical aneurysm treatment. Clinical trial Registration: NCT03063541.

Local Anesthetic -Bupiv Acaine Increases the Peritoneal Transport of Solutes. Part I: In Vivo Study

1984 ◽  
Vol 4 (4) ◽  
pp. 221-223 ◽  
Author(s):  
Andrzej Breborowicz ◽  
Jan Knapowski
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Local Anesthetic ◽  
Vascular System ◽  
Dialysis Fluid ◽  
The Past ◽  
The Mean ◽  
Long Acting ◽  
Solute Clearance

A local anesthetic -bupivacaine was used in concentration 0.25 mmol/l in the dialysis fluid during peritoneal dialysis in rabbits. Bupivacaine increased the mean peritoneal clearance of urea by 33% and of inulin by 53%. The effect of the anesthetic persisted during next exchanges, performed without the drug. Bupivacaine given intraperitoneally, did not decrease blood pressure. Peritoneal dialysis is used widely for treatment of renal failure (1). During the last few years, many attempts have been made to find a substance, which would increase the efficiency of peritoneal dialysis (2, 4). In the past we observed that procaine added to the fluid augments peritoneal solute clearance (5). Local anesthetics in the peritoneal cavity influence both the mesothelium and the vascular system. In the present study we used bupivacaine a long-acting, tissue-bound local anesthetic as the adjunct during peritoneal dialysis in rabbits.

scholarly journals A Smartphone Intervention to Promote Time Restricted Eating Reduces Body Weight and Blood Pressure in Adults with Overweight and Obesity: A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2148
Author(s):  
Malini Prasad ◽  
Keenan Fine ◽  
Allen Gee ◽  
Nandini Nair ◽  
Collin J. Popp ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Smartphone Application ◽  
Overweight And Obesity ◽  
Open Label ◽  
Dietary Counseling ◽  
Wilcoxon Rank Sum Test ◽  
The Mean ◽  
Eating Occasions ◽  
Smartphone Intervention

The goal of this study was to test the feasibility of time restricted eating (TRE) in adults with overweight and obesity. Participants (n = 50) logged all eating occasions (>0 kcal) for a 2-week run-in period using a smartphone application. Participants with eating duration ≥14 h enrolled in an open label, non-randomized, prospective 90-day TRE intervention, with a self-selected reduced eating window of 10 h. No dietary counseling was provided. Changes in anthropometrics, eating patterns and adherence after TRE were analyzed using t-tests or Wilcoxon Rank-Sum Test. The mean duration of the baseline eating window was 14 h 32 m ± 2 h 36 m (n = 50) with 56% of participants with duration ≥14 h. TRE participants (n = 16) successfully decreased their eating window from 16 h 04 m ± 1 h 24 m to 11 h 54 m ± 2 h 06 m (p < 0.001), and reduced the number of daily eating occasions by half (p < 0.001). Adherence to logging and to the reduced eating window was 64% ± 22% and 47% ± 19%, respectively. TRE resulted in decreases in body weight (−2.1 ± 3.0 kg, p = 0.017), waist circumference (−2.2 ± 4.6 cm, p = 0.002) and systolic blood pressure (−12 ± 11 mmHg, p = 0.002). This study demonstrates the feasibility and efficacy of TRE administered via a smartphone, in adults with overweight and obesity.

scholarly journals A Protocol for a Randomised Controlled Trial to improve Hypertension outcomes using Wireless Home Blood Pressure Monitoring with Automatic Outcome-based feedback and Financial Incentives (Preprint)

2021 ◽  
Author(s):  
Marcel Bilger ◽  
Agnes Ying Leng Koong ◽  
Ian Kwong Yun Phoon ◽  
Ngiap Chuan Tan ◽  
Juliana Bahadin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Usual Care ◽  
Financial Incentives ◽  
Blood Pressure Monitoring ◽  
Controlled Trial ◽  
Uncontrolled Hypertension ◽  
Lifestyle Modifications ◽  
Open Label ◽  
Cardiovascular Morbidity And Mortality ◽  
The Mean

BACKGROUND Hypertension is prevalent in Singapore and is a major risk factor for cardiovascular morbidity and mortality and increased healthcare costs. A strategy is to lower blood pressure (BP) through lifestyle modifications and home BP monitoring (HBPM). Nonetheless, adherence to HBPM remains low. OBJECTIVE The objective of the Wireless monitoring and Financial incentives for uncontrolled Hypertension (WiFHy) study is to determine whether a Wireless HBPM System with and without financial incentives is effective at reducing systolic BP (SBP) compared to a non-wireless HBPM (usual care). METHODS WiFHy is a randomized, controlled, open-label, superiority study. The sample size of 224 was computed to detect differences of 10 mmHg in average SBP. Participants were to be randomized into one of three parallel study arms: (1) Usual care, (2) Wireless HBPM System and (3) Wireless HBPM System with financial incentives, in the ratio of 2:3:3. The primary outcome was the mean change in SBP at Month 6. The secondary outcomes were the mean reduction in DBP, cost of financial incentives, time taken for the intervention and adherence to HBPM, effectiveness of the framing of financial incentives in decreasing non-adherence to BP self-monitoring and the adherence to most-frequently used anti-hypertensive at month 6. RESULTS Due to unforeseen events the study was stopped prematurely. Therefore, no results are available. CONCLUSIONS This protocol details an algorithm for remote management of primary care patients with hypertension. Depending on the BP information received from the patients, the algorithm can trigger immediate BP advice (e.g. Accident and Emergency department visit advice for extremely high BP), weekly feedback on BP monitoring, medication titration or skipping of routine follow-ups. The inclusion of financial incentives framed as health capital provides a novel idea on how to promote adherence to remote monitoring, and ultimately, improve chronic disease management. CLINICALTRIAL ClinicalTrials.gov registry, ID: NCT 03368417. Registered on 11th December 2017. (https://clinicaltrials.gov/ct2/show/NCT03368417).

A Post-Marketing Acceptability Study in 11685 Patients of the Efficacy of Timolol/Bendrofluazide in the Management of Hypertension in General Practice

1987 ◽  
Vol 15 (2) ◽  
pp. 106-114 ◽  
Author(s):  
B. T. Marsh ◽  
M. J. Atkins ◽  
D. J. Talbot ◽  
I. T. Fairey
Keyword(s):  
Blood Pressure ◽  
General Practice ◽  
Adverse Event ◽  
Initial Dose ◽  
Moderate Hypertension ◽  
Once Daily ◽  
Continuous Therapy ◽  
Post Marketing ◽  
Blood Pressures ◽  
The Mean

A post-marketing acceptability study was performed in 11 685 patients to assess the efficacy and acceptability of 10 mg timolol/2.5 mg bendrofluazide in patients with mild to moderate hypertension in general practice. The initial dose was 1 tablet/day. This was adjusted at weekly intervals up to a maximum of 4 tablets/day or until blood pressures of ≤95 mmHg diastolic or, in patients of ≥60 years, ≤100 mmHg plus the patient's age (in years) systolic, were achieved. Stabilized patients were followed-up after 12, 24 and 48 weeks. Of the patients enrolled, 69% (8039) were successfully treated for at least 8 weeks, 26% (3033) were withdrawn and 5% (613) defaulted. One tablet/day was required by 61% of patients and 29% required 2 tablets/day to achieve stabilization. The mean reductions in systolic and diastolic blood pressures and pulse rate were 31 and 19 mmHg, and 11 beats/min, respectively. Over 60% of the patients enrolled were still taking timolol/bendrofluazide after 12 months' continuous therapy. The most frequently reported reason for withdrawal was an ‘adverse event’ which occurred in 15.4% (1805) of patients. Only 1.9% (217) failed to achieve target blood pressure on 4 tablets/day. This large study has shown timolol/bendrofluazide to be a highly effective and acceptable once daily therapy for mild to moderate hypertension in general practice.

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