Efficacy of Low-Dose Captopril Given Twice Daily to Patients with Essential Hypertension Uncontrolled by a Beta Blocker plus Thiazide Diuretic

1984 ◽  
Vol 12 (4) ◽  
pp. 221-228 ◽  
Author(s):  
G Muiesan ◽  
C Alicandri ◽  
E Agabiti-Rosei ◽  
R Fariello ◽  
E Montini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Antihypertensive Agent ◽  
Thiazide Diuretic ◽  
Low Dose ◽  
Optimal Dosage ◽  
Supine Diastolic Blood Pressure

Thirty-two patients with moderate to severe essential hypertension whose supine diastolic blood pressure (SDBP) was ⩾95 mm Hg following 2 weeks' treatment with the optimal dosage of beta blocker-diuretic combination were randomly assigned to the addition of either Captopril 25 mg or 50 mg b.i.d. After 6 weeks' treatment, if patients were not normalized (SDBP <95 mm Hg), the dose of Captopril was doubled for a further 6 weeks. The addition of Captopril led to a significant fall in standing and supine diastolic and systolic blood pressure at the end of the sixth and twelfth week of treatment. There was no difference in the change in blood pressure between the two groups. At the end of the study SDBP was normalized in 66% of patients and a further 12·5% had their SDBP reduced by >10%. Captopril 25 or 50 mg administered twice daily proved to be a very effective antihypertensive agent when added to a beta blocker-diuretic combination in patients resistant to optimal doses of these drugs.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

A STUDY OF SERUM URIC ACID LEVELS IN NEWLY DIAGNOSED CASES OF ESSENTIAL HYPERTENSION

2021 ◽  
pp. 72-74
Author(s):  
Deepak Jain ◽  
Ajith Thomas ◽  
Rajinder Singh Gupta
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Essential Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Serum Uric Acid ◽  
Control Group ◽  
Newly Diagnosed ◽  
The Mean ◽  
And Control

Background: The association of raised serum uric acid levels with various cardiovascular risk factors has often led to the debate of whether raised serum uric acid levels could be an independent risk factor in essential hypertension. Hence, the present study was conducted for assessing the serum uric acid levels in cases of essential hypertension and comparing them with normal healthy, non-hypertensive controls. Materials & Methods: Sixty patients visiting in the department of general medicine, MMIMSR with newly diagnosed cases of essential hypertension [according to the Indian guidelines on Hypertension(IGH) III-2013] , fullling the inclusion criteria and after verifying the exclusion criteria were nally taken up for the study. Sixty controls of age and sex matched were taken from the same catchment area. Results: The mean age of the subjects of the essential hypertension group and control group was found to be 45.75 years and 47.8 years respectively. Mean systolic blood pressure and diastolic blood pressure among the subjects of the essential hypertension group was 161.3 and 102.3 mm of Hg. Mean systolic blood pressure and diastolic blood pressure among the subjects of the control group was 116.8 and 77.4 mm of Hg. Mean serum uric acid levels among the subjects of the essential hypertension group and control group was found to be 6.45 mg/dL and 5.57 mg/dLrespectively. Signicant results were obtained while comparing the mean serum uric acid levels among the subjects of the essential hypertension group and the control group. Hyperuricemia was present in 38.33 percent of the patients (23 patients) of the essential hypertension group and 13.33 percent of the patients (8 patients) of the control group. Signicant results were obtained while comparing the prevalence of hyperuricemia in between the two study groups.Conclusion: An independent relationship of elevated serum uric acid levels with hypertension and indicates the signicance of maintaining normal serum uric acid concentration to prevent hypertension.

scholarly journals Peculiarities of 24 hour ambulatory blood pressure monitoring indices in patients with essential hypertension, stage II of different age groups

2018 ◽  
Vol 1 (4) ◽  
pp. 63-70
Author(s):  
V. S. Pasko
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Age Groups ◽  
Pressure Monitoring

The aim of the study was to determine peculiarities of 24 hour ambulatory blood pressure monitoring indices of patients with essential hypertension, stage II of different age groups. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. The control group consisted of 15 patients for every of the surveyed categories (group III - middle-aged and group IV – elderly respectively) matched with basic by age and gender. Results. We have shown that one of the factors that determines the change in hemodynamics in patients with essential hypertension is age, with the age patients experience the decrease in diastolic blood pressure with steadily increased systolic blood pressure, that should be considered in the prescription of antihypertensive treatment. With age, a gradual increase in systolic blood pressure is associated with the increased aortic stiffness, partially with the increase in collagen and the decrease in elastic fibrils and the formation of isolated systolic hypertension. Thus, it is proved that in the formation of isolated hypertension the growth of pulse blood pressure for more than 60 mm Hg is unfavorable in a development of cerebrovascular events. Pulse arterial blood pressure was stronger risk factor than systolic blood pressure and diastolic blood pressure or average arterial pressure in the elderly. Recently, taking into account age characteristics, all three indices were recognized as comparable predictors at the age of 50-59 years as the transitional period, and at the age of 60-79 years diastolic blood pressure adversely affecting the cardiovascular risk, increased pulse blood pressure prognostically above the level of systolic arterial pressure.

scholarly journals ALTERATION IN SERUM MAGNESIUM LEVELS IN PATIENTS WITH ESSENTIAL HYPERTENSION

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Asha G ◽  
Jyothi A Natikar ◽  
Shrabani Mohanty ◽  
Alapaty Shailaja
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Healthy Subjects ◽  
Serum Magnesium ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Age Group ◽  
Hypertensive Patients

Introduction: Essential hypertension (EHTN) accounts for 95% of all cases of hypertension affecting approximately one billion individuals worldwide. Alteration in trace elements like magnesium can be helpful in knowing the elemental involvement in the pathophysiology of EHTN and its associated complications. Aims and Objectives: 1. To estimate serum levels of magnesium in patients of EHTN and compare it with normotensive healthy subjects. 2. To find the correlation of serum levels of magnesium with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients of EHTN. Materials and Methods: The study was conducted in 100 subjects, out of which 50 were essential hypertensive patients (cases) and 50 were normotensive healthy subjects (controls), within the age group of 25-65 years. Serum magnesium were measured by using the auto analyzer Beckman Coulter DXC 600. The results were analysed by using students ‘t’ test and pearson’s correlation. Results: Our study found a significantly (p<0.001**) decreased levels of serum magnesium in cases as compared to controls. Our study also revealed a significant negative correlation between serum magnesium with SBP (r= -0.805, p<0.001**) and DBP (r= -0.395, p=0.005**) among essential hypertensives. Keywords: EHTN- Essential hypertension, HTN – Hypertension, SBP – Systolic blood pressure, DBP – Diastolic blood pressure

scholarly journals Protocol of an Observational Study Based on the Prevalence of Essential Hypertension in Different Types of Prakruti in Wardha City, India

2021 ◽  
pp. 161-166
Author(s):  
Disha Bhatero ◽  
Punam Sawarkar ◽  
Vaishnavi Paraskar ◽  
Gaurav Sawarkar
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Essential Hypertension ◽  
Adverse Effects ◽  
Observational Study ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Hypertensive Patients ◽  
Different Types

Background: In 2000, 26.4% people of the society were suffering hypertension in the globe and around 29.2% are considered to have hypertension till 2025. Coronary Heart Disease, Stroke and other vascular disorders are the adverse effects of hypertension. Hypertension is taxonomically adjacent to UchchaRakta Tapa in Ayurveda. Prakrutiis the morphological, physiological, and psychological basic traits, manifested in the intrauterine life and is said to be unchangeable throughout life. Objectives: The present study aims to observe the Prevalence of Essential Hypertension in different types of Prakruti to differentiate Systolic blood pressure and Diastolic blood pressure according to various Prakruti in the population of Wardha city and contribute to knowledge in this population regarding Essential Hypertension and its relation with Prakruti. Materials and Methods: Wardha. Data collected in from the hypertensive patients in Wardha district by personal interviews based on the Prakruti Questionnaires. Results: The results will be concluded on the basis of observations drawn from the collected information.

scholarly journals A CLINICAL STUDY TO EVALUATE THE ANTIHYPERTENSIVE EFFECT OF TRINPANCHMOOL KWATH IN MANAGEMENT OF ESSENTIAL HYPERTENSION

AYUSHDHARA ◽  
2020 ◽  
pp. 1-10
Author(s):  
Prerna ◽  
Vijay Chaudhary ◽  
B.L. Mehra
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Antihypertensive Effect ◽  
Diastolic Pressure ◽  
Group Iii ◽  
Group I ◽  
Days Of Therapy ◽  
Group Ii

The present study was conducted to evaluate the antihypertensive effect of an Ayurvedic formulation Trinpanchmool Kwath in the management of essential hypertension. The study was conducted in 30 patients selected from OPD and IPD of R.G.G. P.G.A.C. and Hospital, Paprola. Patients were randomly divided into three groups. Group- I patients were managed with Trinpanchmool Kwath , Group- II patients were managed with Tab Chlorthalidone and Group– III patients were managed with both Trinpanchmool Kwath and Tab. Chlorthalidone. The results obtained were analysed on the basis of various objective and subjective parameters. However change in blood pressure was the main criteria for assessing the effect of the therapy. Statistically highly significant reduction was observed in systolic and diastolic blood pressure after 45 days of therapy. In Group-I systolic blood pressure reduced by 9.374%, in Group-II systolic blood pressure decreased by 15.46% and in Group-III systolic blood pressure decreased by 16.86%. Similarly in Group-I diastolic blood pressure decreased by 8.195% , in Group-II showed 11.250% reduction and in Group-III diastolic blood pressure decreased by 12.17% after completion of therapy. Results revealed that therapy given in Group-III i.e. the combination of Trinpanchmool Kwath and Tab. Chlorthalidone showed best results as compared to other groups. Group-II, in which patients were managed with Tab Chlorthalidone showed better results over Group-I where only Trinpanchmool Kwath was given to the patients. However statistically highly significant reduction in both systolic and diastolic pressure was observed in all three groups.

Timolol Maleate (MK 950) in the Treatment of Essential Hypertension

1973 ◽  
Vol 1 (6) ◽  
pp. 580-583 ◽  
Author(s):  
Philip A Poole-Wilson
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Timolol Maleate ◽  
Blind Trial ◽  
The Mean ◽  
Single Blind ◽  
Single Blind Trial

To thirteen patients with essential hypertension timolol was given in a single-blind trial. A dosage of 15 mg three times a day produced a fall in diastolic blood pressure in all patients. The mean diastolic blood pressure was reduced by 15 and 14 mm Hg in the lying and standing positions respectively. Changes in the systolic blood pressure were variable but a significant mean reduction occurred.

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.

RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASES AND ANATOMOSIS OF ARTERIOVENOUS FISTULAR IN PATIENTS WITH REGULARLY HEMODIALYSIS

2017 ◽  
pp. 88-92
Author(s):  
Van Hien Pham ◽  
Huu Vu Quang Nguyen ◽  
Tam Vo
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Cardiovascular Diseases ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Negative Correlation ◽  
Mean Value ◽  
The Mean

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.

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