scholarly journals Effects of hypertension and antihypertensive drugs on cardiovascular complications in the elderly.

1988 ◽  
Vol 52 (1) ◽  
pp. 1-8 ◽  
Author(s):  
KIZUKU KURAMOTO ◽  
SATORU MATSUSHITA ◽  
HIROSHI SHIBATA
Keyword(s):  
Antihypertensive Drugs ◽  
The Elderly ◽  
Cardiovascular Complications

scholarly journals ROLE OF TRIVIDHA ROGAYATANA IN THE MANIFESTATION OF ESSENTIAL HYPERTENSION W.S.R. TO PRAGYAPARADA - A CONCEPTUAL STUDY

2021 ◽  
Vol 9 (8) ◽  
pp. 1733-1736
Author(s):  
Ajay Kumar Nigwal ◽  
Lajwanti Keswani ◽  
Rajesh Kumar Malviya ◽  
Arvind Kumar Yadav
Keyword(s):  
Elderly Population ◽  
Antihypertensive Drugs ◽  
Adult Population ◽  
The Elderly ◽  
Elevated Blood ◽  
The World ◽  
Causes Of Disease ◽  
Conceptual Study ◽  
Day By Day

Cardiovascular disease such as hypertension will be the largest cause of death and disability in India by 2020. The prevalence of hypertension is increasing globally and currently, more than 1 billion people have hypertension. About 26.4% of the world adult population in 2000 had hypertension and 29.2% were projected to have this con- dition by 2025. Elevated blood pressure affects 1 billion individuals and causes an estimated 10.4 million deaths per year. Thus, hypertension is needed to be studied. Though a lot of potent antihypertensive drugs are available today none of them is free from untoward adverse effects. Especially the elderly population poorly tolerates these drugs. The global incidence of hypertension is increasing day by day and is a very common problem nowadays. Ayurveda has classified the causes of disease into three main categories: - 1. Asatmendriyartha Samyoga 2. Pragyaparada and 3. Parinama (Kaala), these three main causes of disease enable different kinds of diseases to manifest. Firstly, they lead to the imbalance of body /or mind by vitiation the Tridosha. The consequence of the imbalance is a disturbance of the basic biological principles. Hypertension is a lifestyle disorder. Ayurveda causes of lifestyle disorders are mainly Pragyaparada. Pragyaparadha is the main cause of all noncommunicable dis- eases (NCDs) such as diabetes, cancer, hypertension etc. Keywords: Asatmendriyartha, Pragyaparada, Parinama, Trividha Rogaayatanas, Hypertension.

OBESITY: CLINICAL AND PATHOGENETIC JUSTIFICATION OF PREVENTION AND TREATMENT

2020 ◽  
pp. 5-10
Author(s):  
O. M. Korzh
Keyword(s):  
Metabolic Syndrome ◽  
Antihypertensive Drugs ◽  
Critical Role ◽  
Cardiovascular Complications ◽  
Excess Body Weight ◽  
Treatment And Prevention ◽  
Prevalence Of Obesity ◽  
Tissue Sensitivity ◽  
Genetic And Environmental Factors ◽  
Weight Correction

Obesity is one of the most common chronic diseases worldwide. Numerous studies in recent years have identified obesity as a key cause of type 2 diabetes, metabolic syndrome, and cardiovascular disease. Comprehensive medical and non−medical treatment of metabolic disorders, obesity and correction of excess body weight are the urgent tasks for both the patient and doctor. When defining the obesity as a chronic psychosomatic disease caused by the interaction of numerous genetic and environmental factors there is emphasized the complexity of the problem, including psychological, medical, social, physical and economic aspects. The widespread prevalence of obesity, which determines its comorbid nature, dictates the need to clarify the principles and options for treatment and prevention. In the process of active study, the multicomponent pathogenesis of obesity with the important role of different parts of the brain determines the relevance of a combination of pharmacotherapy and lifestyle intervention. In pharmacotherapy, the weight correction is an important component and reduces the risk of cardiovascular complications, improves quality of life and prognosis. The basis of weight correction measures is a change in lifestyle, increased physical activity and alteration in diet in order to achieve a balance between energy consumption and expenditure. Weight loss is accompanied with an increased tissue sensitivity to insulin, improved lipid metabolism, elimination of latent inflammation, lowering blood pressure and, accordingly, plays a critical role in prevention of the associated diseases and reducing the risk of complications. The fight against obesity is not only an improvement in the patient general condition, but also a great economic benefit, as the doses of drugs are reduced or the need for hypolipidemic, antidiabetic and antihypertensive drugs disappears. Key words: obesity, metabolic syndrome, diabetes mellitus, cardiometabolic risk, microbiota, insulin resistance, treatment, prevention.

Abstract 512: Drugs in the Elderly: Threats and Opportunities

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Martin Wehling
Keyword(s):  
Elderly People ◽  
Antihypertensive Drugs ◽  
Rank Order ◽  
Renin Angiotensin System ◽  
The Elderly ◽  
The United States ◽  
Channel Blockers ◽  
Aged Population ◽  
Type D ◽  
Long Acting

Taking 10 and more drugs is unpredictable and may cause more harm than good, given that up to 100,000 medication-related deaths in the United States annually. An early attempt to improve drug safety in the aged population was the establishment of criteria for drugs to avoid by Beers in 1997. The evidence for the effectiveness of the Beers list is not compelling.. There should also be a positive labelling of drugs that are indispensable in elderly people as data on morbidity, mortality, and safety are available or emerging for this particular group. There is increasing clinical evidence for beneficial action of, for example, antihypertensive drugs (e.g., Hypertension in the Very Elderly Trial) in elderly people. Drugs should be labelled taking into consideration their usefulness for elderly people (Table 1) This classification would be an extension of the Beers approach into the positive listing of valuable drugs. This seems necessary as overtreatment and undertreatment are both typical problems of the aged population. Undertreatment, for example, relates to the poor control of arterial hypertension elderly people and may leave more than half of the patients un- or undertreated. The FORTA classification for antihypertensive drugs as an example is as follows: diuretics B, betablockers B, renin-angiotensin-system blockers A, long acting dihydropyridine calcium channel blockers (CCB) A, CCBs, verapamil type D, spironolactone C, alphablockers C, clonidine D, minoxidil D. The typical use of the scheme would address general practitioners struggling with polypharmacy. They would then synthesize the recommendations into a rank order of drugs that they could use to cut the list short.

Hypertension

2019 ◽  
pp. 3-32
Author(s):  
Robert Zweiker ◽  
Sabine Perl
Keyword(s):  
Health Care Providers ◽  
Antihypertensive Drugs ◽  
Renin Angiotensin System ◽  
The Elderly ◽  
Pharmacological Therapy ◽  
Lifestyle Changes ◽  
Channel Blockers ◽  
Choice Of Treatment ◽  
Risk Treatment ◽  
Hereditary Nature

Hypertension has a major impact on cardiovascular and overall morbidity and mortality of patients. In most cases, the condition is caused by polygenetic predisposition and environmental lifestyle factors. General practitioners and other health-care providers should seek to screen for high blood pressure (BP) in all adults. Public knowledge about the disease can also help to detect previously unknown hypertension. First-degree family members of hypertensive patients deserve special attention because of the hereditary nature of the disease. Most measurements are made as in-office BP readings (>140/>90mmHg), which should be confirmed by out-of-office BP measurements in order to uncover white-coat effects. The basis for treatment decisions is ideally a calculation of the overall cardiovascular risk. Treatment of hypertension consists of both non-pharmacological lifestyle changes and pharmacological therapy. Several classes of antihypertensive drugs are available. The choice of medication is mainly dependent on compelling indications, as their main effect is BP lowering per se. From a hypertensiologist’s view, renin–angiotensin system inhibition seems an appropriate first choice of treatment for younger patients, whereas the elderly benefit more from calcium channel blockers and diuretics. Nevertheless, therapy based on the combination of 2–3 drugs is preferable in most cases.

scholarly journals Effects of combination drugs on antihypertensive medication adherence in a real-world setting: a Korean Nationwide Study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029862 ◽  
Author(s):  
Seung Jae Kim ◽  
Oh Deog Kwon ◽  
BeLong Cho ◽  
Seung-Won Oh ◽  
Cheol Min Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Real World ◽  
Antihypertensive Drugs ◽  
Medication Possession Ratio ◽  
The Elderly ◽  
Population Based ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Improve Medication Adherence ◽  
Real World Setting

ObjectivesWe tried to clarify, by using representative national data in a real-world setting, whether single-pill combinations (SPCs) of antihypertensives actually improve medication adherence.DesignA nationwide population-based study.SettingWe used a 2.2% cohort (n=1 048 061) of the total population (n=46 605 433) that was randomly extracted by National Health Insurance of Korea from 2008 to 2013.ParticipantsWe included patients (n=116 677) who were prescribed with the same antihypertensive drugs for at least 1 year and divided them into groups of angiotensin II receptor blocker (ARB)-only, calcium channel blocker (CCB)-only, multiple-pill combinations (MPCs) and SPCs of ARB/CCB.Primary outcome measuresMedication possession ratio (MPR), a frequently used indirect measurement method of medication adherence.ResultsAdjusted MPR was higher in combination therapy (89.7% in SPC, 87.2% in MPC) than monotherapy (81.6% in ARB, 79.7% in CCB), and MPR of SPC (89.7%, 95% CI 89.3 to 90.0) was higher than MPR of MPC (87.2%, 95% CI 86.7 to 87.7) (p<0.05). In subgroup analysis, adherence of SPC and MPC was 92.3% (95% CI 91.5 to 93.0) vs 88.1% (95% CI 87.1 to 89.0) in those aged 65–74 years and 89.3% (95% CI 88.0 to 90.7) vs 84.8% (95% CI 83.3 to 92.0) in those ≥75 years (p<0.05). According to total pill numbers, adherence of SPC and MPC was 90.9% (CI 89.8 to 92.0) vs 85.3% (95% CI 84.1 to 86.5) in seven to eight pills and 91.2% (95% CI 89.3 to 93.1) vs 82.5% (95% CI 80.6 to 84.4) in nine or more (p<0.05). The adherence difference between SPC and MPC started to increase at five to six pills and at age 50–64 years (p<0.05). When analysed according to elderly status, the adherence difference started to increase at three to four pills in the elderly (≥65 years) and at five to six in the non-elderly group (20–64 years) (p<0.05). These differences all widened further with increasing age and the total medications.ConclusionSPC regimens demonstrated higher adherence than MPC, and this tendency is more pronounced with increasing age and the total number of medications.

Hypolipidemic and antihypertensive drugs for prevention of cardiovascular complications in patients with rheumatoid arthritis

2008 ◽  
Author(s):  
Barbora de Courten ◽  
Melissa N Barber ◽  
Renea V Johnston ◽  
Danny Liew ◽  
Maximilian de Courten ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Antihypertensive Drugs ◽  
Cardiovascular Complications

scholarly journals Association of Hypertension and Lipid Profile with Osteoporosis

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mohammed Al-Hariri ◽  
Bander Aldhafery
Keyword(s):  
Saudi Arabia ◽  
Antihypertensive Drugs ◽  
The Elderly ◽  
Significant Negative Correlation ◽  
High Risk Group ◽  
Mineral Density ◽  
Record System ◽  
The Status ◽  
Related Quality ◽  
Health Related

Background. Hypertension (HTN) and osteoporosis (OP) are common diseases that adversely affect the health-related quality of life among the elderly. However, there is a scarcity of literature on the association between HTN and OP. Objective. The aims of this study were to investigate the association between HTN and antihypertensive drugs (AHT), with bone mineral density (BMD) T-scores, as well as to determine the status of bone quality in Saudi Arabia. Method. A retrospective study was conducted at King Fahd Hospital of the University, Khobar, Saudi Arabia, during 2016 to 2018. BMD was measured using dual-energy X-ray absorptiometry (DEXA). T-score values were used for the diagnosis of osteoporosis. HTN diagnosis and medications, laboratory, and radiology results were collected from the hospital record system. Results. Out of 1332 extracted profiles, 1103 (82.8%) were females. Based on the T-score, the majority of patients either had osteopenia (41.1%) or was osteoporotic (27.8%). The present study found that there is a significant increase in serum lipids and alkaline phosphatase (ALP) in the osteoporotic group when compared with normal and osteopenia groups. Furthermore, it was found that ALP and Ca levels were significant predictors for OP. Pearson’s correlation test revealed a significant negative correlation between HTN and BMD T-score. However, the study reported a nonsignificant association between AHT and BMD T-score. Conclusion. We conclude that controlling both HTN and dyslipidemia might improve bone health. Every osteoporotic patient should be screened for dyslipidemia. Early detection and appropriate management for OP are highly recommended in Saudi Arabia, especially amongst the high-risk group.

scholarly journals Deprescribing Antihypertensive Drugs in Patients of Older Age Groups

2020 ◽  
Vol 16 (1) ◽  
pp. 82-93
Author(s):  
O. D. Ostroumova ◽  
M. S. Cherniaeva ◽  
D. A. Sychev
Keyword(s):  
Elderly Patients ◽  
Dose Reduction ◽  
Randomized Clinical Trials ◽  
Drug Withdrawal ◽  
Antihypertensive Drugs ◽  
Age Groups ◽  
Economic Cost ◽  
The Elderly ◽  
Older Age ◽  
Additional Tool

Arterial hypertension (AH) is one of the most common diseases in the elderly. It has been proven that lowering blood pressure (BP) is effective in preventing stroke and cardiovascular complications in patients even at the age of ≥80 years. On the other hand, there is evidence that a significant decrease in BP can be harmful to older people and may lead to a higher risk of overall mortality. Therefore, existing guidelines for the treatment of AH determine specific approaches for managing patients of older age groups, where the target BP levels are determined not only by age and concomitant diseases, but also by the presence of frailty. Moreover, there is a need to monitor the dynamics of frailty indicators (social, functional, cognitive and mental status of the patient), since their deterioration may require changes in the tactics of antihypertensive therapy (dose reduction, drug withdrawal or replacement) and changes in target BP levels. In this regard, in recent years, the possibility/necessity of a planned and controlled process of dose reduction, drug withdrawal or replacement, if this drug can be harmful and/or does not bring benefits (deprescribing), has attracted attention. This article is a review of current literature, which presents the design and main characteristics of randomized clinical trials (RCTs) and systematic reviews on the deprescribing of antihypertensive drugs in elderly patients with AH and frailty. An analysis of these studies showed the benefits of deprescribing of antihypertensive drugs for elderly patients with frailty, which avoids potential harm to their health, improves the quality of life and reduces the economic cost of treatment. Therefore, deprescribing of antihypertensive drugs can be used as an additional tool to achieve the necessary target BP values in patients of an older age group. However, for the development of deprescribing of antihypertensive drugs schemes and its introduction into clinical practice, the results of large specially planned RCTs are needed to study this issue.

scholarly journals Risk Factors Related to Low Ankle-Brachial Index Measured by Traditional and Modified Definition in Hypertensive Elderly Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Raphael Monteiro ◽  
Renata Marto ◽  
Mario Fritsch Neves
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Antihypertensive Drugs ◽  
Ankle Brachial Index ◽  
The Elderly ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Simple Modification ◽  
Modified Method

Peripheral arterial disease (PAD) increases with age and ankle-brachial index (ABI) ≤ 0.9 is a noninvasive marker of PAD. The purpose of this study was to identify risk factors related to a low ABI in the elderly using two different methods of ABI calculation (traditional and modified definition using lower instead of higher ankle pressure). A cross-sectional study was carried out with 65 hypertensive patients aged 65 years or older. PAD was present in 18% of individuals by current ABI definition and in 32% by modified method. Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions. Smoking and LDL-cholesterol were associated with low ABI only by the modified definition. Low ABI by the modified definition detected 9 new cases of PAD but cardiovascular risk had not been considered high in 3 patients when calculated by FRS. In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.

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