scholarly journals PRESCRIPTION PATTERN OF CARDIOVASCULAR AND/OR ANTIDIABETIC DRUGS IN ABUJA DISTRICT HOSPITALS

2019 ◽  
pp. 21-27
Author(s):  
NKEIRUKA GRACE OSUAFOR ◽  
CHINWE VERONICA UKWE ◽  
MATTEW JEGBEFUME OKONTA
Keyword(s):  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Age Groups ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
World Health ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Prescribing Indicators ◽  
Prescription Pattern ◽  
District Hospitals

Objective: The study aimed to describe the prescription pattern of cardiovascular and/or anti-diabetic drugs and adherence to the World Health Organization (WHO) prescribing indicators in Abuja District Hospitals. Methods: This descriptive retrospective study was carried out in Asokoro and Maitama District Hospitals Abuja. One thousand and nine prescriptions that contained a cardiovascular drug (CVD) and/or anti-diabetic drug issued between June 2017 and May 2018 from the Medical Outpatient Department were analyzed. Data were collected from the pharmacy electronic database, prescription pattern and adherence to WHO prescribing indicators were assessed. The analysis was done using descriptive statistics. Results were presented as percentages, means, and standard deviations. Results: The frequency of treatment was higher among women (58.8%) and the age group of 41–60 (54.8%). The average number of drugs prescribed was 3.3±1.6: the percentage of drugs prescribed in generic was (64%) and (78.8%) were from the Essential Drug List (EDL). Calcium Channel Blockers (CCB, 71.7%) and Biguanides (B, 92.4%) were the most prescribed CVD and anti-diabetic drug. The majority of the CVD (74.5%) and diabetes (63.6%) patients were on combination therapy. The most frequent CVD combination was CCB plus Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers (29.7%). Compared to men, the proportion of females taking one or more CVD (61.3%) or antidiabetic (56.4%) was higher. Conclusion: The prescribing indicators are not optimal in Abuja district hospitals. Women received more treatment for cardiovascular and diabetes diseases than men while the age range of 41-60 was more treated than other age groups.

Pharmacology of vasodilators

ESC CardioMed ◽  
2018 ◽  
pp. 180-184
Author(s):  
Stéphane Laurent
Keyword(s):  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Organic Nitrates ◽  
Channel Blockers ◽  
Resistance Arteries ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers ◽  
Small Resistance ◽  
Direct Acting

Antihypertensive and antianginal agents are differentially able to vasodilate small resistance arteries, large conducting arteries, and epicardial coronary arteries. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and alpha-adrenergic antagonists are not addressed here, since they are discussed in specific chapters. This chapter discusses the pharmacology of calcium channel blockers, nitrovasodilators, and direct-acting vasodilators. Dihydropyridines, such as nifedipine and amlodipine, are compared to the non-dihydropyridine agents verapamil and diltiazem. Organic nitrates, such as nitroglycerine and isosorbide dinitrate, are compared to inorganic nitrates, such as sodium nitroprusside. Molsidomine and nicorandil are also discussed. Finally, the pharmacology of direct-acting vasodilators focuses on minoxidil and hydralazine. Pharmacology of mechanisms of action is detailed to better understand therapeutic indications and side effects.

scholarly journals Role of antihypertensive drugs in the treatment of migraine

2015 ◽  
Vol 156 (5) ◽  
pp. 179-185 ◽  
Author(s):  
Gergely Fehér ◽  
Gabriella Pusch
Keyword(s):  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Migraine Prevention ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

The treatment of migraine depends on the frequency, severity and concomitant diseases. There are several specific drugs developed for migraine prevention in addition to the additive antimigraine effects of some other non-specific drugs. The aim of this literature-based review is to summarize the possible antimigraine properties of different antihypertensive agents (beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, etc.) focusing on the possible side effects (avoidance of beta blockers in the absence of heart disease, possible antiparkinson effect of calcium channel blockers, additive effect of drugs modifying the renin-angiotensin system activity, etc.). Current evidence supports the use of angiotensin converting enzyme inhibitors (mainly lisinopril) and angiotensin receptor blockers (mainly candesartan) for long-term migraine prevention and blood pressure control. Long-term beta-blocker treatment should be avoided in the absence of ischemic heart disease due to possible unfavourable cardiovascular effects. Orv. Hetil., 2015, 156(5), 179–185.

scholarly journals Renin-Angiotensin-Aldosterone-System inhibitor use in patients with COVID-19 infection and prevention of serious events: a cohort study in commercially insured patients in the US

2020 ◽  
Author(s):  
Maria C Schneeweiss ◽  
Sandra Leonard ◽  
Andrew Weckstein ◽  
Sebastian Schneeweiss ◽  
Jeremy Rassen
Keyword(s):  
Cohort Study ◽  
Protective Effect ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Pharmacy Claims ◽  
Level Data ◽  
Therapy Interventions

Objectives: There is a lack of clarity regarding the role of angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEi) in interfering with the SARS-COV-2 binding on human cells and the resulting change in disease severity. We sought to assess the risk of hospitalization for COVID-19 and serious complications in current users of ARB or ACEi compared to users of dihydropyridine calcium channel blockers (dhpCCB). Design: Cohort study Setting: The analysis used de-identified, patient-level data from HealthVerity, linking longitudinal data from US medical and pharmacy claims, which contain information on inpatient or outpatient diagnoses, procedures and medication dispensing. Participants: We identified patients aged 40+ and free of chronic kidney disease (CKD) who were newly diagnosed COVID-19, between March 1, 2020 and May 30, 2020, and adherent to ACEi, ARB, or dhpCCB therapy. Interventions: Current use of an ACEi, ARB, or dhpCCB. Main outcome measures: We compared the 30-day risk of hospitalization for COVID-19 and serious complications. Results: Of 24,708 patients identified, 7,571 were current users of an ARB, 8,484 of an ACEi, and 8,653 of a dhpCCB. The unadjusted 30-day risk of hospitalization for COVID-19 was 2.66% among ARB users, and 2.90% among ACEi users and 3.68% in dhpCCB users. In the PS-matched cohort, the risk of hospitalization among ARB users was 17% lower as compared to dhpCCB (RR=0.83; 0.68-1.00), and the risk among ACE users was 10% lower as compared to dhpCCB (RR=0.90; 0.76-1.07). When including patients with pre-existing CKD, the protective effect of ARB (RR= 0.74; 0.62-0.88) and ACEi (RR=0.84; 0.71-0.99) was more pronounced. Conclusions: This cohort study showed that neither ARB nor ACEi use increase the risk of severe COVID-19 disease among those infected, and instead suggests that current use of ARB may offer a protective effect. This study found no evidence to support the discontinuation of ARB/ACEi therapy.

Abstract 15213: Association of Angiotensin-converting Enzyme Inhibitors or Angiotensin Receptor Blockers Use and Covid-19 Infection Among Patients With Hypertension

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jaejin An ◽  
Rong Wei ◽  
hui zhou ◽  
Tiffany Luong ◽  
Ran Liu ◽  
...  
Keyword(s):  
Antihypertensive Medication ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Age Groups ◽  
Medication Use ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Increased Risk ◽  
Receptor Blockers

Introduction: Given the limited evidence, we investigated the association between use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and risk of Covid-19 infection within a large diverse hypertension population. Methods: We identified patients with hypertension as of March 1, 2020 (index date) from Kaiser Permanente Southern California, a large US integrated healthcare system. Patient demographics, antihypertensive medication use, neighborhood income and education, and comorbidities were identified from electronic health records within 1-year pre-index date. The study outcome was a positive RT-PCR test for Covid-19 between March 1 - May 6, 2020. We used multivariable logistic regression models to examine the association between ACEI/ARB use and Covid-19 infection. Results: Among 824,650 patients with hypertension, 16,898 (2.0%) were tested for Covid-19. Of those tested, 1,794 (10.6%) had a positive result and 547 (30.5% of positive cases) were hospitalized within 14-days of testing positive. Of those tested, 4,878 (28.9%) were on ACEIs, 3,473 (20.6%) were on ARBs, and 4,177 (24.7%) were on other antihypertensive medication classes. Risk of covid-19 infection associated with ACEI use decreased with increasing age (P-interaction = 0.01). In age-stratified analyses, ACEI use was not statistically associated with increased risk of Covid-19 infection among the age groups of 18-39, 40-64, and 65-84 years but was associated with lower risk of Covid-19 among those aged ≥85 years ( Table ). Across all age groups, ARB use was not associated with increased risk of Covid-19, but non-white race, lower neighborhood income and education, and no antihypertensive medication use were associated with increased risk of Covid-19. Conclusions: ACEI nor ARB use was not associated with increased risk of Covid-19 infection. The decreased risk of Covid-19 infection among older adults using ACEIs warrants further investigation.

Abstract 3783: Antihypertensive Medications in the Department of Veterans Affairs (VA) 1999–2006

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Julio R Lopez ◽  
Sonya Wong ◽  
Joy L Meier ◽  
Fran Cunningham ◽  
David Siegel
Keyword(s):  
Antihypertensive Medication ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Medication Use ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Steady Increase ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors

Objective: To evaluate national antihypertensive medication use we collected data from 2003–2006 and compared it to previously collected data from 1999 –2002. We examine the cost implications of shifts in antihypertensive medications prescribed. Methods: National VA pharmacy data were used to determine the use of beta blockers (BB), calcium channel blockers (CCB), thiazide diuretics (TD) alone or with K sparing diuretics, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and combinations of the aforementioned classes for 2003–2006. Total number of treatment days, determined from days supply of the prescription, was used to determine patterns of use over time. Results: Antihypertensive medication use in the VA represented more than 1.5 billion days in 2006 and increased 2.5 fold from the 577 million estimated for 1999. ACEI were most commonly used, representing 31.8% and 31.7% of treatment days in 1999 and 2006, respectively. In the ACEI class lisinopril is the most commonly used drug. Increases in use from 1999 to 2006 were 21.2% to 25.2% for BB, 14.4% to 17.8% for TD, and 1.2% to 5.2% for ARB. Decreases in use from 1999 to 2006 were 26.7% to 17.6% for CCB. The decline in CCB was inversely correlated to the increase in BB or TD (p<0.001). Shifts in medication use are estimated to save the VA $33 million annually. Conclusions: ACEI remain the most prescribed antihypertensive drug class in the VA, followed by BB, TD, CCB, and ARBs. TD use shows a slow steady increase while CCB use continues to decline. These findings suggest that VA has increasing adherence to JNC7 and VA HTN guidelines.

scholarly journals Effects of Different Anti-hypertensive Drugs on Hospitalized Patients With COVID-19 and Hypertension in China

2020 ◽  
Author(s):  
Xia Shi ◽  
Mengli Cao ◽  
Shourong Liu ◽  
Peifen Chen ◽  
Feng Hu ◽  
...  
Keyword(s):  
Enzyme Inhibitors ◽  
Clinical Laboratory ◽  
Angiotensin Receptor Blockers ◽  
Combined Therapy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Drug Regimen ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Clinical Prognosis ◽  
Receptor Blockers

Abstract Background and aims: Calcium channel blockers (CCBs) and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) are commonly used in the treatment of hypertension. However, it is still not clear whether there are differences among different anti-hypertensive drugs in the treatment of patients with coronavirus disease 2019 (COVID-19) and hypertension. Herein, we aimed to assess the relation between different anti-hypertensive medications and COVID-19 outcomes. Materials and methods: We conducted a retrospective analysis of 58 hypertensive patients with COVID-19 who were treated with different anti-hypertensive drugs and reviewed the clinical data obtained from electronic medical records, including epidemiological, clinical, laboratory, and the treatment and progression of the disease. Results: There was no obvious difference in clinical prognosis after using any anti-hypertensive drugs in patients with COVID-19 and hypertension, but the different anti-hypertensive drugs were associated with the use of non-invasive ventilator treatment at admission comparing two groups between ACEIs/ARBs and CCBs+ACEIs/ARBs. Conclusion: there is no evidence showing that the different use of anti-hypertensive drugs is related to outcomes of patients with COVID-19 and hypertension, even between single drug regimen and combined therapy (with at least two anti-hypertensive drugs as combined therapy).

Cardioprotective drugs

2017 ◽  
Author(s):  
Johan De Sutter ◽  
Miguel Mendes ◽  
Oscar H. Franco
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Black People ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Stable Coronary Artery Disease ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Cardioprotective drugs are important in the treatment of patients at risk for or with documented cardiovascular disease. Beta-blockers are indicated after acute coronary syndromes, stable coronary artery disease, heart failure, and arrhythmias. Angiotensin-converting enzyme inhibitors (ACEi) are important in congestive heart failure, stable angina, post-acute myocardial infarction, and secondary prevention after any event or revascularization. Angiotensin receptor blockers are mainly alternative drugs for the same indications in case of intolerance to ACEi. Calcium channel blockers are first line medication for patients with isolated systolic hypertension, black people, and during pregnancy, in the presence of intermittent claudication, asymptomatic atherosclerosis, or metabolic syndrome. A polypill is a combination pill in which multiple medications effective in the prevention of cardiovascular disease (for example statins, antihypertensives, and aspirin) are put together in a single pill.

scholarly journals Effect of Anti-Hypertensive Medication History on Arteriovenous Fistula Maturation Outcomes

2018 ◽  
Vol 48 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Ke Wang ◽  
Leila R. Zelnick ◽  
Peter B. Imrey ◽  
Ian H. deBoer ◽  
Jonathan Himmelfarb ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Lower Risk ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Medication History ◽  
Converting Enzyme Inhibitors ◽  
Fistula Maturation

Background: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. However, approximately half of AVFs fail to mature. The use of angiotensin converting enzyme inhibitors (ACE-Is), angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs) exerts favorable endothelial effects and may promote AVF maturation. We tested associations of ACE-I and ARBs, CCBs, beta-blockers, and diuretics with the maturation of newly created AVFs. Methods: We evaluated 602 participants from the Hemodialysis Fistula Maturation Study, a multi-center, prospective cohort study of AVF maturation. We ascertained the use of each medication class within 45 days of AVF creation surgery. We defined maturation outcomes by clinical use within 9 months of surgery or 4 weeks of initiating hemodialysis. Results: Unassisted AVF maturation failure without intervention occurred in 54.0% of participants, and overall AVF maturation failure (with or without intervention) occurred in 30.1%. After covariate adjustment, CCB use was associated with a 25% lower risk of overall AVF maturation failure (95% CI 3%–41% lower) but a non-significant 10% lower risk of unassisted maturation failure (95% CI 23% lower to 5% higher). ACE-I/ARB, beta-blocker, and diuretic use was not significantly associated with AVF maturation outcomes. None of the antihypertensive medication classes were associated with changes in AVF diameter or blood flow over 6 weeks following surgery. Conclusions: CCB use may be associated with a lower risk of overall AVF maturation failure. Further studies are needed to determine whether CCBs might play a causal role in improving AVF maturation outcomes.

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