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

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.

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.

P6365Contrasting the impact of the European (ESC/ESH 2018) versus American (ACC/AHA 2017) high blood pressure clinical practice guidelines in Poland

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Wyszomirski ◽  
M J Pencina ◽  
P K Whelton ◽  
B Wojtyniak ◽  
Z Gaciong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Treatment ◽  
High Blood Pressure ◽  
Antihypertensive Drug ◽  
European Society ◽  
Disease Risk ◽  
Assessment Tools ◽  
Antihypertensive Drug Treatment ◽  
Recommended Treatment ◽  
The Impact

Abstract Background The 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for the management of arterial hypertension and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline for the prevention, detection, evaluation, and management of high blood pressure in adults differ in approach to defining stages of hypertension and recommendations for treatment of high blood pressure. Purpose To contrast the implications of the ESC/ESH versus ACC/AHA hypertension guidelines among the general population in Poland – a country representing a high CVD risk region in Europe. Methods We used data from a representative random sample of 1439 Polish adults aged 40 to 79 from the research program NATPOL 2011. The analysis was weighted in order to reflect the structure of the population in Poland and was stratified by age and gender. We applied the ESC/ESH 10-year SCORE (Systematic COronary Risk Evaluation) and the ACC/AHA ASCVD (atherosclerotic CV disease) risk assessment tools and followed guideline-specific algorithms to detect hypertension and follow recommendations for treatment. Results The overall prevalence of hypertension among Polish adults according to the ACC/AHA guideline was 76.9% (95% CI, 74.7–79.0%) versus 51.8% (95% CI, 49.2–54.4%) according to the ESC/ESH guidelines. Application of the ACC/AHA guideline recommendations would result in antihypertensive drug treatment for 63.0% (95% CI, 60.5–65.5%) of Polish adults compared with 46.2% (95% CI, 43.6–48.7%) based on application of the ESC/ESH guidelines (difference 16.8% (95% CI, 14.9–18.8%), table 1). Table 1 2017 ACC/AHA guideline 2018 ESC/ESH guideline Δ (difference) Hypertension Recommended treatment Hypertension Recommended treatment Hypertension Recommended treatment % (95% CI) % (95% CI) % (95% CI) % (95% CI) % (95% CI) % (95% CI) Age   40–49 (n=391) 63.2 (58.4–68.0) 37.3 (32.6–42.1) 32.0 (27.4–36.6) 21.2 (17.2–25.3) 31.2 (26.6–35.8) 16.1 (12.5–19.8)   50–59 (n=452) 77.7 (73.8–81.5) 61.7 (57.2–66.2) 49.1 (44.5–53.7) 40.0 (35.5–44.6) 28.5 (24.4–32.7) 21.7 (17.9–25.5)   60–69 (n=356) 82.3 (78.3–86.3) 75.3 (70.8–79.8) 62.4 (57.3–67.4) 61.5 (56.5–66.6) 19.9 (15.8–24.1) 13.8 (10.2–17.3)   70–79 (n=231) 90.0 (86.2–93.9) 90.0 (86.2–93.9) 74.5 (68.8–80.1) 76.6 (71.2–82.1) 15.6 (10.9–20.3) 13.4 (9.0–17.8) Gender   Male (n=689) 80.4 (77.4–83.4) 67.5 (64.0–71.0) 52.5 (48.8–56.3) 47.2 (43.4–50.9) 27.9 (24.5–31.2) 20.3 (17.3–23.3)   Female (n=741) 73.6 (70.4–76.7) 58.8 (55.3–62.4) 51.2 (47.6–54.8) 45.2 (41.6–48.8) 22.4 (19.4–25.4) 13.6 (11.2–16.1) Conclusions Application of the ACC/AHA guideline would result in a considerable increase in the prevalence and antihypertensive drug treatment of hypertension in Polish adults compared with application of the ESC/ESH guidelines.

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