50 Years of Thiazides: Should Thiazide Diuretics Be Considered Third-Line Hypertension Treatment?

2011 ◽  
Vol 18 (6) ◽  
pp. e244-e254 ◽  
Author(s):  
Angela Brown ◽  
Becky Captain
2017 ◽  
Vol 53 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Varsha Varakantham ◽  
Ashok Kumar Kurakula Sailoo ◽  
Dinesh Kumar Bharatraj

Background: The monitoring of hypertension treatment can provide insight into the rational drug use pattern. The objective of this study was to examine the antihypertensive medication use among South Indian adults with hypertension in compliance with the hypertension treatment guidelines (Seventh Joint National Committee [JNC 7] and JNC 8). Methods and Results: A total of 550 hypertensive people aged >25 years were included in this retrospective cross-sectional study. The order of drugs prescribed in the year 2012 was beta blockers (BB) > calcium channel blockers (CCB) > CCB + BB > angiotensin receptor blockers (ARB) > angiotensin-converting enzyme inhibitors (ACEI) > thiazide diuretics, whereas in the year 2014, the order has changed drastically, namely, ACEI > CCB > ARB > BB > thiazide diuretics ( P < .001). Most notably, there was a large increase in the use of monotherapy (from 56.9% to 82.5%, P < .001). The usage of BB has simply moved from the first position to the last position in concordance with JNC 8 guidelines, whereas use of thiazide diuretics was found to be the least preferred drug in the 2012 prescriptions, thus deviating from JNC 7 guidelines. The use of generic names (28.3% vs 11.3%) and National List of Essential Medicines (NLEM) compliance (79.3% vs 60.9%) were significantly more in the calendar year 2012 than in the calendar year 2014 ( P < .001). Conclusions: Antihypertensive medication use has gone through wide variations among south Indian adults with hypertension. Combination therapy regimens must be adopted as per the guidelines for achievement of blood pressure goals.


2020 ◽  
Author(s):  
Felipe Athayde Lins de Melo

This book deals with the emergence of prison management in Brazil, understanding it as an effect of forces between different orders of the penitentiary apparatus, in which the Justice and Security bundles are highlighted, based on disputes and accommodations between actors, institutions and perspectives that, within each order or in their external interactions, configure the dynamics of the Brazilian Penitentiary Administration, within which a penitentiary bureaucracy is produced, specialized in mediating the conflicts and the approximations between the orders. In recent times, these mediations also suffer the influence of a third line of force, represented by the criminal groups originating inside prisons. Traveling thousands of kilometers through prisons, suburbs, government palaces and courtroom hallways, the study describes the constant updating of the brazilian penitentiary apparatus, which operates with the goal of ensuring it's reproduction by different strategies of accomodation of Law resulting from the preponderance of Security in the correlation of forces, which manifests in the composition, the functioning, the characterization and the processes of professional formation of the penitentiarist bureaucracy, comprehended as a diffuse and fragmented body that, far from characterizing a rationalization of the prison system, manifests itself, above all, as a government mentality.


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