scholarly journals Effect of Different Blood-Pressure-Lowering Regimens on the Blood Pressure Control among Hypertensive Patients Treated in Hospital Conditions

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Anna Paczkowska ◽  
Karolina Hoffmann ◽  
Krzysztof Kus ◽  
Dorota Kopciuch ◽  
Tomasz Zaprutko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drug ◽  
Blood Pressure Control ◽  
Combined Treatment ◽  
Pressure Control ◽  
Antihypertensive Drug Therapy ◽  
Blood Pressure Lowering ◽  
Hypertensive Patients ◽  
Pressure Lowering ◽  
Β Blockers

Background. Scientific references lack sufficient amount of data on analyses of the reasons for hospital admissions or assessment of efficacy of arterial hypertension treatment at hospitals. Objectives. The aim of the study was to evaluate the efficacy of antihypertensive drug therapy on the blood pressure control among hospitalized hypertensive patients. Methodology. A cross-sectional retrospective study consisted of 204 patients aged 18–65 years admitted to the hospital due to hypertension between January 2018 and December 2018. The study was based on analysis of electronic records, obtained from the medical database of the selected healthcare facility. Results. As a result of the treatment applied at the hospital, 65.19% of the patients achieved the desired degree of blood pressure normalization (≤130/80 mmHg). Vast majority of the patients during their stay at the ward would receive three or more hypertensive drugs (63.73%). The most frequently prescribed antihypertensive drug combinations included bitherapies such as diuretics + ACEI and ACEI + β-blockers and tritherapy such as diuretics + β-blockers and calcium channel antagonists and diuretics + ACEI and ARBs. The highest blood-pressure lowering effects were observed among patients receiving combination therapy of a ACEI, a diuretic, and a ARBs. Tritherapy induced a significant mean reduction of inpatients`s SBP compared with bitherapy ( p = 0.0001 ). Conclusion. During their hospital stay, vast majority of patients (65.19%) achieved normal values of blood pressure, mostly owing to combined treatment with several hypertensive drugs. Efficacy of the most frequently used combinations of hypertensive drugs in normalizing arterial pressure varies.

scholarly journals 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

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.

scholarly journals MON-205 Effectiveness of Pre-Op α-Blockade on Intra-Op Blood Pressure Control in Patients with Pheochromocytoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Julia Caroline Wingate Lake ◽  
Richard J Comi
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Cumulative Dose ◽  
Hypertensive Crisis ◽  
Pressure Control ◽  
Volume Replacement ◽  
Perioperative Outcomes ◽  
Preoperative Treatment ◽  
Blood Pressure Lowering ◽  
Pressure Lowering

Abstract Pheochromocytoma are rare tumors arising from catecholamine producing chromaffin tissue. Surgical manipulation of pheochromocytoma inevitably leads to supraphysiologic levels of circulating catecholamines. Such manipulation has the potential to lead to an intra-operative hypertensive crisis, cardiac arrhythmia, myocardial infarction, or pulmonary edema. When inadequately primed pre-operatively, a patient exposed to such surges may experience life-threatening consequences. Phenoxybenzamine is a non-competitive, non-selective α 1 and α 2 receptor antagonist that prevents blood pressure liability during surgical resection of pheochromocytoma. Previous literature has suggested that phenoxybenzamine affords more pronounced peri-operative systolic blood pressure control as compared to selective alpha-blockers. This superior control potentially is at the cost of postoperative hypotension owing to the irreversible nature of phenoxybenzamine.1 Our study compares the effects of pre-operative phenoxybenzamine on perioperative outcomes at a single tertiary medical center from 2004 to 2019. The cumulative pre-operative phenoxybenzamine dose was compared to the maximum intra-operative blood pressure, need for IV blood pressure lowering medications, duration of vasopressor need, volume replacement need, duration of time in the OR, duration of hospital stay, and pre-operative catecholamine levels. We speculate that increased phenoxybenzamine exposure will result in reduced peak intra-operative blood pressure and need for IV blood pressure lowering medications but may increase the need for post-resection intra-operative vasopressors and post-resection volume replacement. After IRB approval, (ID #00031606), we performed a data warehouse query for the ICD 9 and 10 codes of “pheochromocytoma” and “paraganglioma”. Patients who did not have confirmed pheochromocytoma on pathology were excluded. Data was collected retrospectively on 30 patients who underwent adrenalectomy for pheochromocytoma. 14 charts were excluded due to incomplete intra-operative anesthetic documentation. Our results suggest that there is no significant correlation between peak intra-operative MAP and cumulative phenoxybenzamine exposure. The cumulative dose of pre-operative phenoxybenzamine did not correlate with the number of anti-hypertensive medications used intra-operatively. An increased cumulative dose of pre-operative phenoxybenzamine was not associated with an increased duration of intra-operative vasopressor medications. Intra-operative volume replacement needs were surprisingly reduced with increased cumulative pre-operative phenoxybenzamine exposure. 1 P.A. van der Zee, A. de Boer. Pheochromocytoma: A review on preoperative treatment with phenoxybenzamine or doxazosin. The Netherlands Journal of Medicine. May 2014; Vol. 72 No 4, 190-201.

Propylbutyldopamine. Mechanism of blood pressure lowering in hypertensive patients.

Hypertension ◽  
1984 ◽  
Vol 6 (2_pt_2) ◽  
Author(s):  
A A Taylor ◽  
W H Fennell ◽  
C O Ruud ◽  
J L Pool ◽  
E B Nelson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Lowering ◽  
Hypertensive Patients ◽  
Pressure Lowering

scholarly journals The importance of good blood pressure control in the prevention of stroke recurrence in hypertensive patients

1981 ◽  
Vol 57 (673) ◽  
pp. 690-693 ◽  
Author(s):  
J. H. Johnston ◽  
F. G. Dunn ◽  
D. G. Beevers ◽  
H. Larkin ◽  
D. M. Titterington
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Stroke Recurrence ◽  
Hypertensive Patients ◽  
Good Blood Pressure Control
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