Effect of the Ca Antagonist Nilvadipine on Stroke Occurrence or Recurrence and Extension of Asymptomatic Cerebral Infarction in Hypertensive Patients with or without History of Stroke (PICA Study)

2007 ◽  
Vol 24 (2-3) ◽  
pp. 202-209 ◽  
Author(s):  
Yukito Shinohara ◽  
Hideo Tohgi ◽  
Shunsaku Hirai ◽  
Akiro Terashi ◽  
Yasuo Fukuuchi ◽  
...  
1995 ◽  
Vol 56 (7) ◽  
pp. 649-655 ◽  
Author(s):  
Hiroaki Naritomi ◽  
Takao Shimizu ◽  
Kotaro Miyashita ◽  
Hiroshi Oe ◽  
Tohru Sawada

2019 ◽  
Vol 14 (6) ◽  
pp. 840-845
Author(s):  
O. Yu. Korennova ◽  
S. P. Podolnaya ◽  
E. P. Prihodko ◽  
E. A. Turusheva ◽  
S. N. Starinskaya ◽  
...  

Aim. To evaluate the antihypertensive efficacy and tolerability of a fixed combination of amlodipine and ramipril in hypertensive patients with very high cardiovascular risk. Material and methods. A retrospective cohort study of real clinical practice of prescribing antihypertensive drugs according to 255 medical records of outpatient hypertensive patients with a history of acute coronary syndrome (ACS) and coronary artery stenting was performed in the first part. An open observational study was performed in the second part. 69 people older than 18 years with a history of ACS and coronary artery stenting, without reaching the target blood pressure (BP) level while using free combinations of antihypertensive drugs and with indications for a fixed combination of ramipril and amlodipine were included into the study. Analysis of self-monitoring of BP, office BP, daily BP monitoring (ABPM) and patients’ adherence to treatment (Morisky-Green test) initially, after 4 and after 12 weeks of taking the fixed combination of ramipril and amlodipine was performed to assess the clinical efficacy of the studied drug. Results. It was found that 42.0% of patients did not follow the recommendations for regular intake of antihypertensive drugs. So, hypertension of all patients regarded as false-refractory, which was the basis for the prescription of the fixed combination of ramipril and amlodipine in accordance with clinical guidelines for the diagnosis and treatment of hypertension. After 4 weeks of therapy, there was significant decrease in office BP with the achievement and preservation of the target level by the 12th week, normalization to the 12th week of day and night BP variability in 54.9% of patients. 78.0% of patients followed medical recommendations for regular administration of antihypertensive drugs, none of the patients had adverse events. Conclusion. The use of fixed combinations of drugs, in particular, amlodipine and ramipril as a part of multicomponent therapy in hypertensive patients with very high cardiovascular risk, led to the achievement of target BP by the 4th week of therapy and stable preservation of antihypertensive effect in 12 weeks of treatment as well as gradual normalization of day and night BP variability in more than half of patients. Fixed combination of ramipril and amlodipine allowed to improve adherence of patients to cardiovascular diseases.


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kang Yang ◽  
Xiaodong Zhu ◽  
Yulan Feng ◽  
Fanxia Shen ◽  
Jie Chen ◽  
...  

1981 ◽  
Vol 61 (s7) ◽  
pp. 367s-368s ◽  
Author(s):  
A. Fernandez-Cruz ◽  
M. Luque Otero ◽  
L. Llorente Perez ◽  
C. Fernandez Pinilla ◽  
N. Martell Claros

1. Human leucocyte AB antigens were determined by means of a lymphocyte toxicity test in 84 patients with essential hypertension and in 1000 blood donors. 2. The prevalence of HLA B8 was 16.4% in hypertensive patients and 8.9% in controls (P = 0.07). 3. The prevalence of HLA B12 was 34.5% in hypertensive patients and 26.9% in the control group (N.S.). In WHO stage III hypertension HLA B12 was found in six out of 10 patients. 4. The prevalence of HLA B15 was 1.2% in hypertensive patients and 6.4% in controls (P < 0.05). 5. In view of a previous report of HLA antigens in a Spanish diabetic population, this study does not support the suggestion of a genetic and possibly HLA-linked connection between essential hypertension and diabetes mellitus among the Spanish population. 6. A positive family history of hypertension tended to be more common in those patients with essential hypertension associated with HLA B8.


Author(s):  
Eka Prasetya Budi Mulia ◽  
Kevin Yuwono ◽  
Raden Mohammad Budiarto

Abstract Objectives We aimed to investigate the association between hypertension and asymptomatic lower extremity artery disease (LEAD) in outpatients with known history of coronary artery disease (CAD). Methods Patients with known history of CAD who have been undergone coronary angiography and have significant coronary artery stenosis (more than 60%) were included. LEAD was defined as ankle-brachial index (ABI) < 0.9 in either leg. The risk of LEAD in hypertensive group was analyzed using chi-square test, and correlation between blood pressure (BP) and ABI was analyzed using Pearson correlation test in SPSS v.25. Results One hundred and four patients were included. 82.7% of patients were male. Mean age was 57.05 ± 7.97. The prevalence of hypertension was 35.6%, and the prevalence of LEAD was 16.3%. A higher proportion of LEAD was found in hypertensive (18.9%) compared to non-hypertensive (14.9%), although not statistically significant (OR: 1.33; 95% CI: 0.46 to 3.85; p=0.598). There was an association between ABI and systolic BP (p=0.016), but not with diastolic BP (p=0.102). Conclusions Our study showed that the prevalence of LEAD in hypertension, especially in the CAD population, is relatively high. There was no association between hypertension and LEAD, but a higher prevalence of LEAD was found in hypertensive patients. Nevertheless, LEAD screening is still recommended in hypertensive patients, especially in the CAD population, given the fact that outcomes of health and mortality are worse for those with concomitants of these diseases.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryota Inokuchi ◽  
Xueying Jin ◽  
Masao Iwagami ◽  
Toshikazu Abe ◽  
Masatoshi Ishikawa ◽  
...  

Abstract Background Prehospital telephone triage stratifies patients into five categories, “need immediate hospital visit by ambulance,” “need to visit a hospital within 1 hour,” “need to visit a hospital within 6 hours,” “need to visit a hospital within 24 hours,” and “do not need a hospital visit” in Japan. However, studies on whether present and past histories cause undertriage are limited in patients triaged as need an early hospital visit. We investigated factors associated with undertriage by comparing patient assessed to be appropriately triaged with those assessed undertriaged. Methods We included all patients classified by telephone triage as need to visit a hospital within 1 h and 6 h who used a single after-hours house call (AHHC) medical service in Tokyo, Japan, between November 1, 2019, and November 31, 2020. After home consultation, AHHC doctors classified patients as grade 1 (treatable with over-the-counter medications), 2 (requires hospital or clinic visit), or 3 (requires ambulance transportation). Patients classified as grade 2 and 3 were defined as appropriately triaged and undertriaged, respectively. Results We identified 10,742 eligible patients triaged as need to visit a hospital within 1 h and 6 h, including 10,479 (97.6%) appropriately triaged and 263 (2.4%) undertriaged patients. Multivariable logistic regression analyses revealed patients aged 16–64, 65–74, and ≥ 75 years (adjusted odds ratio [OR], 2.40 [95% confidence interval {CI} 1.71–3.36], 8.57 [95% CI 4.83–15.2], and 14.9 [95% CI 9.65–23.0], respectively; reference patients aged < 15 years); those with diabetes mellitus (2.31 [95% CI 1.25–4.26]); those with dementia (2.32 [95% CI 1.05–5.10]); and those with a history of cerebral infarction (1.98 [95% CI 1.01–3.87]) as more likely to be undertriaged. Conclusions We found that older adults and patients with diabetes mellitus, dementia, or a history of cerebral infarction were at risk of undertriage in patients triaged as need to visit a hospital within 1 h and 6 h, but further studies are needed to validate these findings.


2012 ◽  
Vol 13 (1) ◽  
pp. 10-15
Author(s):  
Kazi Jahangir Hossain ◽  
Nazma Parvin ◽  
A Wazed ◽  
Md Shamsul Alam ◽  
Md Mustafa Kamal

The aim of the study was to investigate familial trend and socioeconomic status of the hypertensive patients attending at the Hypertension Clinic of Dhaka Medical College Hospital, Dhaka. The study period was from July 2009 to June 2010.  A total of 417 patients were recruited of which 245 were male and 172 female respectively, and selected consecutively on the basis of defined criteria.  The research instrument was an interviewer-administered questionnaire. For assessment of familial trend of hypertension, first and second degree relatives of the respondents were investigated.   Results showed that majority of the respondents were educated of which 22.1%(n=92), 18.2%(n=76), 19.9%(83) and 13.7%(n=57) were secondary, higher secondary, graduate and postgraduate educated respectively. In profession, 64.4%(n=111) female had household works, and 56.8%(n=139) male were in service and 41.2%(n=101) businessmen and had monthly income of  Tk. 10,000 to 80,000. The mean age of them was 47.4±6.9 years and BMI was 25.5±3.0 kg/m2. The nutritional status of them were normal in 40.5%(n=169) and rest had different degree of malnutrition.  In malnutrition, 53.1%(n=130) male were overweight, 2.9%(n=7) obese and 0.8%(n=2) undernourished; and 51.2%(n=88) female were overweight, 11.0(n=19) obese and 1.2%(n=2) undernourished respectively.   About 70.5%(n=294) of the studied hypertensive patients had positive history of hypertension in first and second degree relatives of which 17.3%(n=72) had single member positive history of hypertension, 18.2%(n=76) two, 16.8%(n=70) three, 14.1%(n=69) four and 4.1%(n=17) five members. In single member positive, most of them were in first degree relatives; in two members, 67.1%(n=51) were in first degree relatives and 27.6%(n=21) in both first and 2nd degree relatives; in three members, 64.3%(n=45) were in 1st degree and 31.4%(n=22) in both 1st and 2nd degree; in four members, 31.9%(n=22) were in 1st degree relationship, 17.4%(n=12) in 2nd degree and 50.7%(n=35) in both 1st and 2nd degree; and in five members, 17.6%(n=3) and 82.4%(n=14) in second degree, and both 1st and 2nd degree relatives respectively. Heath education and behavioral change intervention programs among the hypertensive population may be one of the most important applicable ways to control and/or prevention of hypertension and its complications in Bangladesh. DOI: http://dx.doi.org/10.3329/jom.v13i1.5941 JOM 2012; 13(1): 10-15


2019 ◽  
Vol 2 (1) ◽  
pp. 53-59
Author(s):  
Tirtha Man Shrestha ◽  
Laxman Bhusal ◽  
Shankar Raut ◽  
Rajan Ghimire ◽  
Poonam Shrestha

Objective: Hypertension is one of the common non-communicable health problems. While pharmacologic intervention is the most efficient way to control hypertension; non-adherence to medication is accounted as a significant cause for complications. This study was to address and to determine the magnitude of non-adherence among hypertensive patients by summarizing the associated risks factors among patients in community level. Method: This is a cross sectional study conducted on hypertensive patients who visited the community health clinic at Dhading, Nepal on 9th and 10th June 2018 using a pre structured questionnaire. Patients were sampled by nonprobability purposive sampling method. Effect of age, gender, marital status, employment, education level, presence of diabetes, cerebrovascular disease, current smoker, and family history of hypertension were analyzed by compliance of antihypertensive drugs using frequency distribution, chi-square test, and logistic regression. For all of the analysis p value <0.5 was considered as significance. Results: 150 patients were included in the study, out of whom 48 patients were found adherent and 102 patients non-adherent to antihypertensive medication. Out of total population 46% (n=69) were male and 54% (n=81) were female with no significant difference between compliant and noncompliant groups (OR= 1.512, p-=0.292). Mean age of patients in complaint group was 57 years and in non-compliant group was 52 years with odds ratio of 0.959 (p= 0.004, 95% C.I =0.933-0.987). However, there was no significant effect of marital status, employment status, and family history of hypertension on adherence to anti-hypertensive medication. Presence of diabetes had significant effect on adherence to medication (OR= 8.494, p= 0.014). The most common reason for non-adherence was the fear of getting stuck with medication for lifetime (n=31, 30.3%) followed by the use of ayurvedic/home remedy (n=27, 26.5%), unaware of complications (n=16, 15.7%), life style modification (n=14, 13.7%), and financial weakness (n=9, 8.8%). Pearson’s correlation of these reasons was between -1 to 0 with p value <0.5. Conclusion: Fear of taking medication lifelong was the major reason for non-adherence; however, age and comorbid health conditions like diabetes have a significant effect on adherence to medication. Health care awareness and counseling can help these patients to overcome the fear of taking medication for lifetime, which can increase the medication compliance rate.


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