scholarly journals Management of renin-angiotensin-aldosterone inhibitors and other antihypertensives and their clinical effects on pre-anesthesia blood pressure

2022 ◽  
Author(s):  
Eda Balcı ◽  
Zeliha Aslı Demir ◽  
Melike Bahçecitapar
Keyword(s):  
Blood Pressure ◽  
Drug Treatment ◽  
Systolic Blood Pressure ◽  
Antihypertensive Drug ◽  
Antihypertensive Drugs ◽  
Treatment Strategies ◽  
Clinical Effects ◽  
Renin Angiotensin ◽  
Perioperative Morbidity ◽  
Antihypertensive Drug Treatment

Background: Blood pressure fluctuations appear more significant in patients with poorly controlled hypertension and are known to be associated with adverse perioperative morbidity. In the present study, we aimed to determine the effects of antihypertensive drug treatment strategies on preanesthetic operating room blood pressure measurements.Methods: A total of 717 patients participated in our study; 383 patients who were normotensive based on baseline measurements and not under antihypertensive therapy were excluded from the analysis. The remaining 334 patients were divided into six groups according to the antihypertensive drug treatment. These six groups were examined in terms of preoperative baseline and pre-anesthesia blood pressure measurements. Results: As a result of the study, it was observed that 24% of patients had high blood pressure precluding surgery, and patients using renin-angiotensin-aldosterone system inhibitors (RAASI) had higher pre-anesthesia systolic blood pressure than patients using other antihypertensive drugs. Patients who received beta-blockers were also observed to have the lowest pre-anesthesia systolic blood pressure, diastolic blood pressure, and mean blood pressure, compared to others. Conclusions: Recently, whether RAASI should be continued preoperatively remains controversial. Our study shows that RAASI cannot provide optimal pre-anesthesia blood pressure and lead to an increase in the number of postponed surgeries, probably due to withdrawal of medication before the operation. Therefore, the preoperative discontinuation of RAASI should be reevaluated in future studies.

Antihypertensive Drug Treatment and Circadian Blood Pressure Rhythm: A Review of the Role of Chronotherapy in Hypertension

2014 ◽  
Vol 21 (6) ◽  
pp. 756-772 ◽  
Author(s):  
Giuseppe Schillaci ◽  
Francesca Battista ◽  
Laura Settimi ◽  
Luca Schillaci ◽  
Giacomo Pucci
Keyword(s):  
Blood Pressure ◽  
Drug Treatment ◽  
Antihypertensive Drug ◽  
Circadian Blood Pressure ◽  
Antihypertensive Drug Treatment

Abstract P139: Healthy Lifestyle Status, Antihypertensive Treatment and the Risk of Heart Failure among Finnish Men and Women

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Yujie Wang ◽  
Jaakko Tuomilehto ◽  
Pekka Jousilahti ◽  
Riitta Antikainen ◽  
Markku Mähönen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Drug Treatment ◽  
Lifestyle Intervention ◽  
Antihypertensive Drug ◽  
Antihypertensive Treatment ◽  
Healthy Lifestyle ◽  
Antihypertensive Drugs ◽  
Untreated Group ◽  
Hypertensive Patients ◽  
Antihypertensive Drug Treatment

Background: It is unclear which is more effective in preventing heart failure (HF) in hypertensive people: lifestyle intervention or antihypertensive drug treatment. Aim: To investigate whether there are differences in HF risk among hypertensive patients using antihypertensive drug treatment versus those engaging in a healthy lifestyle at baseline. Methods: Study cohorts included 38075 Finnish participants who were 25 to 74 years of age and free of HF at baseline. The study population was classified into five groups according to their blood pressure status at baseline. A healthy lifestyle was defined as having two or more healthy lifestyle factors including moderate or high level of physical activity, never smoking, body mass index <25 kg/m 2 , and vegetable consumption ≥3 times/week. Results: During a median follow-up of 14.1 years, 638 men and 445 women developed HF. Compared with normotensive people, hypertensive patients with and without antihypertensive treatment had a higher risk of HF. Engaging in a healthy lifestyle was associated with a decreased risk of HF. The multivariable-adjusted hazard ratios (HRs) of HF in the ten subgroups (normotensive group with a healthy lifestyle; hypertensive, unaware, untreated group with a healthy lifestyle; hypertensive, aware, untreated group with a healthy lifestyle; hypertensive, treated, controlled group with a healthy lifestyle; hypertensive, treated, uncontrolled group with a healthy lifestyle; normotensive group without a healthy lifestyle; hypertensive, unaware, untreated group without a healthy lifestyle; hypertensive, aware, untreated group without a healthy lifestyle; hypertensive, treated, controlled group without a healthy lifestyle; and hypertensive, treated, uncontrolled group without a healthy lifestyle) were 1.00, 1.50, 1.54, 2.24, 1.91, 2.12, 2.68, 3.05, 2.27, and 3.21 (Ptrend <0.001), respectively. Hypertensive subjects who used antihypertensive drugs but did not engage in a healthy lifestyle had a significantly higher risk of HF (HR 2.10; 95% CI 1.68–2.63) than hypertensive subjects who did not use antihypertensive drug but engaged in a healthy lifestyle. Hypertensive subjects who did not use antihypertensive drugs and did not engage in a healthy lifestyle had a significant higher risk of HF (HR 1.44; 95% CI 1.16–1.80) compared with hypertensive subjects who used antihypertensive drug and engaged in a healthy lifestyle. Conclusions: The present study demonstrates that the risk of HF was lower in hypertensive patients who engaged in a healthy lifestyle but higher in hypertensive people despite of antihypertensive drug treatment and adequate control of hypertension. Lifestyle intervention may be more effective in preventing HF than antihypertensive treatment in hypertensive subjects.

P1949Changes in prevalence patients with arterial hypertension in Russia

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Badin ◽  
I V Fomin ◽  
D S Polyakov ◽  
S S Yakushin ◽  
E A Smirnova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Treatment ◽  
Arterial Hypertension ◽  
Antihypertensive Drug ◽  
P Value ◽  
Antihypertensive Drug Treatment ◽  
European Guidelines ◽  
The Mean ◽  
Grade 3

Abstract Aim The present study shows the dynamics of the prevalence different grades of AH and treatment coverage over15 years of observation. Methods 8740 apartments were randomized in 2002 year in eight regions of Russia and 19449 individuals were included. Re-examination was carried out in 2017 year. The representative sample was separated in four groups: Grade 0 – individuals with systolic blood pressure (BP) <140 mm Hg and diastolic blood pressure <90 mm Hg; and three Grades of arterial hypertension (AH) in accordance with European guidelines. Also, we select patient with and without antihypertensive drug treatment (AHDT). Results The mean age individuals was 44.4±19.3 years in 2002 year. Grade 0 had 63.3% participants (mean age 36.5±17.1 y.), Grade 1 – 19.5% (mean age 55.2±15.4 y.), Grade 2 – 11.7% (mean age 60.6±13.5 y.) and Grade 3 – 5.6% (mean age 62.4±12.8 y.). 3.0% participants had AHDT and blood pressure meets Grade 0. Patients with AH Grade 1 used drugs in 25.5% cases, with Grade 2 – 49.4% and with Grade 3 – 60.8% patients respectively. The mean age of participants with AHTD was significantly higher than mean age group without AHTD in Grade 0, 1 and 2 (p<0.001). In group Grade 3 mean age was not difference (p=0.16). The mean age individuals (51.3±16.9 y.) in 2017 year was significantly higher on 6.9 years than mean age in 2002 year (p<0.001). The proportion of patients with AHDT in all grades groups in sample 2017 year were significantly higher than in sample 2002 year (Table). The prevalence of AH in 2002 y. amounted to 38.6%. In 2017 y. prevalence of AH was significantly higher – 41.4% (p<0.001). Structure of samples Grade 2002 2017 AHDT Mean age AHDT P value Mean age 0 63,3% No 35,8±16,8 70,1% 42,6±13,9 Yes 3,0% 57,4±14,5 16,3% <0,001 63,6±12,0 1 19,5% No 53,3±15,7 23,6% 57,3±13,3 Yes 25,5% 60,9±13,0 68,4% <0,001 66,3±11,3 2 11,7% No 58,5±14,2 5,4% 58,0±14,9 Yes 49,4% 62,7±12,3 80,6% <0,001 66,5±11,5 3 5,6% No 61,7±13,9 1,0% 63,6±17,6 Yes 60,8% 62,8±12,0 71,1% 0,03 66,0±12,8 ALL 100% 44,4±19,3 100% 51,3±16,9 AHDT: antihypertensive drug treatment. Conclusion Over 15 years follow up period the prevalence of hypertension in Russia increased to 41.4%, but the effectiveness of therapy remains low.

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