scholarly journals Pressure Natriuresis in Nitric Oxide-Deficient Hypertensive Rats

1999 ◽  
Vol 10 (1) ◽  
pp. 21-27
Author(s):  
LOURDES A. FORTEPIANI ◽  
ELENA RODRIGO ◽  
M. CLARA ORTÍZ ◽  
VICTORIA CACHOFEIRO ◽  
NOEMÍ M. ATUCHA ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Arterial Hypertension ◽  
Calcium Channel ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Renal Hemodynamics ◽  
High Dose ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Synthesis Inhibitor

Abstract. Chronic inhibition of nitric oxide (NO) synthesis has been shown to result in arterial hypertension and an important blunting of the pressure diuresis and natriuresis response (PDN). The mechanisms mediating these abnormalities are not completely understood. In the present study, the role of several antihypertensive drugs to ameliorate these alterations was evaluated. The PDN relationships have been evaluated in rats chronically (8 wk) treated with the NO synthesis inhibitor NG-nitro-L-arginine methyl ester (L-NAME; 40 mg/kg per d in the drinking water). Appropriate groups of rats were simultaneously treated with the angiotensin II receptor blocker candesartan at a low (1.5 mg/kg per d) and high (2.5 mg/kg per d) dose, with the converting enzyme inhibitor captopril (60 mg/kg per d) and with the calcium channel blocker verapamil (100 mg/kg per d). Chronic treatment with L-NAME significantly elevated mean BP (163.6 ± 6.5 mmHg versus 105.1 ± 3.6 in controls), reduced GFR and renal blood flow (RBF), and shifted to the right the PDN responses. Chronic administration of low-dose candesartan, captopril, or verapamil prevented the arterial hypertension and improved renal hemodynamics, but these levels were not completely normalized. High-dose administration also improved renal hemodynamics but induced reduced BP below the levels of control animals. Despite the normalization of the elevated BP, the PDN responses of these hypertensive treated groups were not normalized, and the slopes of the respective diuretic or natriuretic responses were very similar to those of the hypertensive untreated rats. The results indicate that interruption or blockade of the reninangiotensin system and calcium channel blockade are effective treatments for the NO-deficient arterial hypertension and renal vasoconstriction. However, the PDN responses are not normalized, and this finding suggests that the antihypertensive treatment is not enough to overcome the renal alterations associated with the chronic deficiency of NO.

scholarly journals The abilities of losartan in angioprotection in hypertensive patients with hyperuricemia

2012 ◽  
Vol 9 (4) ◽  
pp. 16-21
Author(s):  
S V Nedogoda ◽  
A A Ledyaeva ◽  
E V Chumachok ◽  
V V Tsoma ◽  
A S Salasyuk
Keyword(s):  
Uric Acid ◽  
Arterial Hypertension ◽  
Conventional Therapy ◽  
Antihypertensive Drugs ◽  
Vascular Wall ◽  
Antihypertensive Activity ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Open Label ◽  
Losartan Group

Aim: to evaluate the ability of the angiotensin II receptor blocker losartan (Lorista, KPKA) to reduce the level of uric acid and to correct the parameters of vascular wall elasticity in patients with arterial hypertension, hyperuricemia, and gout. Subjects and methods. An open-label, randomized, controlled, parallel group comparative (losartan versus conventional therapy with other antihypertensive drugs for 24 weeks) trial enrolled 40 patients with arterial hypertension, hyperuricemia, and gout. Results. No significant differences were found between the groups of losartan (Lorista) and conventional therapy with other antihypertensive drugs groups in their antihypertensive activity. At the same time the losartan group showed a considerably more decrease in uric acid levels than did the conventional group (34,7% versus 7,8% in the group of therapy with other antihypertensive drugs (p

scholarly journals The place of fixed antihypertensive drugs in modern therapy of arterial hypertension

2021 ◽  
Vol 17 (4) ◽  
pp. 44-48
Author(s):  
Tatiana V. Pinchuk ◽  
Natalia V. Orlova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Calcium Channel ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Dual Therapy ◽  
Evidence Base ◽  
Target Blood Pressure ◽  
High Dose ◽  
Channel Blockers

The article provides information on modern approaches to the treatment of arterial hypertension. The historical information about therapy with combined antihypertensive drugs is given. Based on data from multicenter clinical trials, the article provides evidence of the benefits of dual and triple fixed drug combinations. Combinations of 1-adrenoreceptor antagonist bisoprolol and the dihydropyridine-type calcium channel blocker amlodipine are considered. The article highlights the advantages of each of the drugs, as well as their combination. It shows the benefits of a fixed combination of low and medium doses compared to high-dose monotherapy, such as efficacy in achieving target blood pressure, preventing cardiovascular events, increasing adherence to treatment, safety and development of side effects. It provides the evidence base for the effectiveness of a triple fixed combination of renin-angiotensin-aldosterone system blockers with calcium channel blockers and diuretics in achieving target blood pressure compared to a double fixed combination of members of these drug classes, which is due to additive effects. The safety and tolerability profiles were found to be more effective with triple therapy compared with dual therapy, which is also supported by studies.

scholarly journals Optimization of Outpatient Drug Care for Patients with Arterial Hypertension in Healthcare Conditions of the Republic of Kazakhstan based on Pharmacoeconomic Analysis

2020 ◽  
Vol 2 (37) ◽  
pp. 20-30
Author(s):  
Dinara Begesheva ◽  
Keyword(s):  
Arterial Hypertension ◽  
Calcium Channel ◽  
Fixed Combination ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Pharmacoeconomic Analysis ◽  
Channel Blockers ◽  
First Line Therapy ◽  
The Republic ◽  
European Society Of Cardiology

Abstract In the Republic of Kazakhstan, as in the whole world, cardiovascular diseases make the first place in terms of the “contribution” to the morbidity and mortality of the population. Arterial hypertension is the leading modifiable cause of cardiovascular and overall mortality in the world. Purpose of the study: To assess the pharmacoeconomic feasibility of using fixed combinations in the treatment of patients with arterial hypertension in the Republic of Kazakhstan. Methods. Review of domestic and foreign literature on the state of the management of patients with arterial hypertension, ABC / VEN- and frequency analyzes of the consumption of antihypertensive drugs, questioning patients for adherence to therapy and identifying their opinions about convenient therapy regimens, pharmacoeconomic analysis of the use of amlodipine in combination with lisinopril and their fixed combination. Results. In the updated version of the 2018 European Society of Cardiology guidelines, fixed combinations of two drugs in the form of one tablet strengthened their position as first-line therapy. Preferred dual combinations are those of the renin-angiotensin-aldosterone system blockers with calcium channel blockers or diuretics. Analysis of financing and coverage of the population with drugs at the outpatient level within the guaranteed volume of free medical care showed that arterial hypertension is the most costly nosology, while a tendency to inadequate provision of patients with antihypertensive drugs was revealed. The highest costs were associated with fixed combinations, despite the fact that they ranked only 5th in frequency of prescriptions, the most popular was the combination of an angiotensin-converting enzyme inhibitor with a calcium channel blocker (amlodipine / lisinopril). The results of the pharmacoeconomic analysis showed the feasibility of using a fixed combination of amlodipine / lisinopril, which makes it possible to assume the same trend in relation to other fixed combinations. Conclusions. The results obtained indicate the need to provide access for patients with arterial hypertension to fixed combination drugs. At the same time, the inclusion of these drugs in state drug supply programs may be accompanied by an increase in the burden on the health care system budget due to their high cost. The results of pharmacoeconomic studies should be the basis for making managerial decisions in the field of drug circulation. Key words: arterial hypertension, combined antihypertensive therapy, fixed combinations, pharmacoeconomic analysis

Fixed combination in patients with arterial hypertension: focus on antihypertensive and nephroprotective properties of fixed combination of lisinopril and amlodipine (clinical example)

2020 ◽  
pp. 19-28
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
N. M. Doldo ◽  
E. E. Pavleeva
Keyword(s):  
Kidney Disease ◽  
Arterial Hypertension ◽  
Fixed Combination ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Adult Population ◽  
Secondary Damage ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Based Medicine ◽  
Modern Population

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.

Landscape of Combination Therapy – Which Way Forward? Proceedings of the Satellite Symposium Held at the ESH European Meeting on Hypertension and Cardiovascular Protection, 27 April 2012, London

2012 ◽  
Vol 8 (3) ◽  
pp. 192
Author(s):  
Patricia Fonseca ◽  
Anna F Dominiczak ◽  
Stephen Harrap ◽  
◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Combination Therapy ◽  
Enzyme Inhibitor ◽  
Synergistic Effects ◽  
Term Treatment ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Hypertensive Patients ◽  
Long Term Treatment

Early combination therapy is more effective for hypertension control in high-risk patients than monotherapy, and current guidelines recommend the use of either an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) for first-line therapy in patients younger than 55 years. Recent evidence shows that ACEIs reduce mortality, whereas ARBs show no apparent benefit despite their blood pressure lowering action. However, it is important to consider which blood pressure parameters should be targeted given that different drugs have distinct effects on key parameters. Remarkably, a high percentage of hypertensive patients whose treatment has brought these parameters within target ranges still remain at high risk of cardiovascular disease due to additional risk factors. Combination therapy with synergistic effects on blood pressure and metabolic control should thus be considered for the long-term treatment of hypertensive patients with co-morbid conditions.

scholarly journals Gender differences efficiency of various dosage regimes of antihypertensive agents by patients with arterial hypertension and coronary heart disease

2018 ◽  
Vol 15 (3) ◽  
pp. 21-26
Author(s):  
V V Skibitsky ◽  
E V Gorodetskaya ◽  
E A Kudryashov ◽  
A V Fendrikova ◽  
A V Skibitsky
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Antihypertensive Agents ◽  
Functional Class ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Men And Women ◽  
Stable Coronary Heart Disease

Aim - to assess the effect of different dosing regimens for combined antihypertensive therapy with the use of ACE inhibitor zofenopril or angiotensin II receptor blocker valsartan on the blood pressure (BP) profile in men and women with arterial hypertension (AH) and stable coronary heart disease (CHD). Materials and methods. 198 patients (98 men and 100 women) with AH and stable CHD (stable angina of II functional class) were examined. In men and women, the effectiveness of 3 variants of antihypertensive therapy was evaluated: a combination of metoprolol succinate/hydrochlorothiazide + zofenopril or valsartan 160 mg once or valsartan 80 mg 2 times/day. Initially and 24 weeks later, 24-hour BP monitoring was performed. Results. Among men, BP

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