scholarly journals Fixed combination of bisoprolol and a low-dose hydrochlorothiazide in arterial hypertension

2018 ◽  
Vol 146 (5-6) ◽  
pp. 330-337
Author(s):  
Branislava Ivanovic ◽  
Milan Pavlovic ◽  
Arsen Ristic ◽  
Dragan Kovacevic
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Hypertension ◽  
Thiazide Diuretic ◽  
Beta Blockers ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Thiazide Diuretics ◽  
Cardiovascular Morbidity And Mortality ◽  
Dose Dependent

Beta-blockers showed better results in lowering elevated blood pressure in the younger age group of patients with higher renin plasma levels. Actual recommendations from the European Society of Cardiology for treatment of arterial hypertension from 2013 insist that heart rate should always be measured along with blood pressure. These recommendations point out the significance of resting heart rate as an independent predictor of cardiovascular morbidity and mortality in patients with arterial hypertension. Beta-blockers have a compelling indication for treatment of arterial hypertension in patients with coexistence of coronary artery disease, especially post myocardial infarction, as well as in patients with systolic heart failure. Bisoprolol, a highly selective beta-blocker with a long half-life and a prolonged antihypertensive effect, has shown consistent blood pressure control over a period of 24 hours. It has been demonstrated in placebo-controlled studies that administration of thiazide diuretics, in addition to lowering blood pressure levels, had also been associated with a reduction of cardiovascular morbidity and mortality rates. It is evident that effectiveness of thiazide diuretics is dose-dependent; however, undesirable effects of drugs are also dose-dependent. Depending on the dose, they aggravate glucose intolerance, increase lipid levels, cause hypokalemia, hyponatremia, and hypomagnesemia, and increase levels of uric acid. Administration of very low doses of a thiazide diuretic is acceptable in combination with other antihypertensive drugs, because it potentiates the action of other drugs without causing undesirable metabolic effects. The effectiveness and safety of the combination of bisoprolol (in various doses) and a thiazide diuretic in a small dose has been proven in clinical trials.

scholarly journals Estrogen therapy for arterial hypertension in menopansal females

2003 ◽  
Vol 49 (4) ◽  
pp. 51-54
Author(s):  
A. N. Karachentsev ◽  
I. V. Kuznetsova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
High Blood Pressure ◽  
Estrogen Therapy ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Rational Pharmacotherapy ◽  
Cardiovascular Morbidity And Mortality ◽  
History Of ◽  
Practical Recommendations

The epidemiology of arterial hypertension in women with menopause Arterial hypertension, according to many experts, "is the greatest non-infectious pandemic in the history of mankind that determines the structure of cardiovascular morbidity and mortality"; Thus, only in Russia AG about 40% of the population suffers. Due to the wide prevalence of hypertension, it has become an interdisciplinary problem, and today doctors of different specialties need practical recommendations for rational pharmacotherapy of high blood pressure in specialized patients.

scholarly journals Short-term secondhand smoke exposure decreases heart rate variability and increases arrhythmia susceptibility in mice

2008 ◽  
Vol 295 (2) ◽  
pp. H632-H639 ◽  
Author(s):  
Chao-Yin Chen ◽  
Drin Chow ◽  
Nipavan Chiamvimonvat ◽  
Kathryn A. Glatter ◽  
Ning Li ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Secondhand Smoke ◽  
Suspended Particle ◽  
Air Pollutant ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Short Term ◽  
Cardiovascular Morbidity And Mortality ◽  
Shs Exposure

Exposure to secondhand smoke (SHS), a major indoor air pollutant, is linked to increased cardiovascular morbidity and mortality, including cardiac arrhythmias. However, the mechanisms underlying the epidemiological findings are not well understood. Impaired cardiac autonomic function, indexed by reduced heart rate variability (HRV), may represent an underlying cause. The present study takes advantage of well-defined short-term SHS exposure (3 days, 6 h/day) on HRV and the susceptibility to arrhythmia in mice. With the use of electrocardiograph telemetry recordings in conscious mice, HRV parameters in the time domain were measured during the night after each day of exposure and 24 h after 3 days of exposure to either SHS or filtered air. The susceptibility to arrhythmia was determined after 3 days of exposure. Exposure to a low concentration of SHS [total suspended particle (TSP), 2.4 ± 3.2; and nicotine, 0.3 ± 0.1 mg/m3] had no significant effect on HRV parameters. In contrast, the exposure to a higher but still environmentally relevant concentration of SHS (TSP, 30 ± 1; and nicotine, 5 ± 1 mg/m3) significantly reduced HRV starting after the first day of exposure and continuing 24 h after the last day of exposure. Moreover, the exposed mice showed a significant increase in ventricular arrhythmia susceptibility and atrioventricular block. The data suggest that SHS exposure decreased HRV beyond the exposure period and was associated with an increase in arrhythmia susceptibility. The data provide insights into possible mechanisms underlying documented increases in cardiovascular morbidity and mortality in humans exposed to SHS.

Vascular inflammation in hypertension and diabetes: molecular mechanisms and therapeutic interventions

2007 ◽  
Vol 112 (7) ◽  
pp. 375-384 ◽  
Author(s):  
Carmine Savoia ◽  
Ernesto L. Schiffrin
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Metabolic Disorders ◽  
Molecular Mechanisms ◽  
Vascular Inflammation ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Low Grade ◽  
Cardiovascular Morbidity And Mortality

More than 80% of patients with type 2 diabetes mellitus develop hypertension, and approx. 20% of patients with hypertension develop diabetes. This combination of cardiovascular risk factors will account for a large proportion of cardiovascular morbidity and mortality. Lowering elevated blood pressure in diabetic hypertensive individuals decreases cardiovascular events. In patients with hypertension and diabetes, the pathophysiology of cardiovascular disease is multifactorial, but recent evidence points toward the presence of an important component dependent on a low-grade inflammatory process. Angiotensin II may be to a large degree responsible for triggering vascular inflammation by inducing oxidative stress, resulting in up-regulation of pro-inflammatory transcription factors such as NF-κB (nuclear factor κB). These, in turn, regulate the generation of inflammatory mediators that lead to endothelial dysfunction and vascular injury. Inflammatory markers (e.g. C-reactive protein, chemokines and adhesion molecules) are increased in patients with hypertension and metabolic disorders, and predict the development of cardiovascular disease. Lifestyle modification and pharmacological approaches (such as drugs that target the renin–angiotensin system) may reduce blood pressure and inflammation in patients with hypertension and metabolic disorders, which will reduce cardiovascular risk, development of diabetes and cardiovascular morbidity and mortality.

Blood Pressure and Cardiovascular Morbidity and Mortality in a Dutch Population: The Nijmegen Cohort Study

2001 ◽  
Vol 32 (2) ◽  
pp. 142-147 ◽  
Author(s):  
J.C Bakx ◽  
M.I Veldstra ◽  
H.J.M van den Hoogen ◽  
G.A Zielhuis ◽  
Th Thien ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Dutch Population ◽  
Cardiovascular Morbidity And Mortality

scholarly journals Sex differences in the efficacy of antihypertensive treatment in preventing cardiovascular outcomes and reducing blood pressure: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e036128
Author(s):  
Karina Gasbarrino ◽  
Christopher Labos ◽  
Victoria Mastropietro ◽  
Lindsay Hales ◽  
Nadia Khan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Sex Differences ◽  
Antihypertensive Treatment ◽  
Meta Analysis ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Men And Women ◽  
Cardiovascular Morbidity And Mortality

IntroductionHypertension is a leading cause of mortality worldwide and its prevalence is expected to rise over the next decade. Sex differences exist in the epidemiology and pathophysiology of hypertension. It is well established that antihypertensive treatment can significantly reduce the risk for stroke and other cardiovascular disease events. However, it remains unclear whether this effect is dependent on sex. In this protocol, we outlined a systematic review and meta-analysis to evaluate the effects of antihypertensive therapy in (1) reducing blood pressure and (2) preventing cardiovascular morbidity and mortality outcomes for each sex separately.Methods and analysisThe following electronic databases will be searched: Medline, Embase, The Cochrane Library, PubMed, Cumulative Index of Nursing and Allied Health Literature Plus, Web of Science, grey literature (Google Scholar) and several trial registries. Search strategies will be designed to identify human adult (≥18) randomised (and non-randomised) controlled trials, prospective and retrospective cohort studies, and case–control studies concerning ‘sex-specific differences associated with the efficacy of antihypertensive treatment’. A preliminary search strategy was developed for Medline (1946—16 September 2019). Two investigators will independently review each article included in the final analysis. Primary outcomes investigated are cardiovascular morbidity and mortality and systolic and diastolic blood pressure. Pooled analyses will be conducted using the random-effects model. Publication bias will be assessed by visual inspection of funnel plots and by Begg’s and Egger’s statistical tests. Between-studies heterogeneity will be measured using the I2test (p<0.10). Sources of heterogeneity will be explored by sensitivity, subgroup and metaregression analyses.Ethics and disseminationThis is the first meta-analysis that will comprehensively compare the efficacy of antihypertensive treatment regimens between men and women. Findings will be shared through scientific conferences and societies, social media and consumer advocacy groups. Results will be used to inform the current guidelines for management of hypertension in men and women by demonstrating the importance of implementing sex-specific recommendations. Ethical considerations are not applicable for this protocol.

Novel device therapies for resistant hypertension

2018 ◽  
pp. 717-730
Author(s):  
Kenneth Chan ◽  
Manish Saxena ◽  
Melvin D. Lobo
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Antihypertensive Agents ◽  
Cardiovascular Morbidity ◽  
Office Blood Pressure ◽  
Morbidity And Mortality ◽  
Hypertensive Patients ◽  
Novel Device ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk

Resistant hypertension (RHTN) is defined as uncontrolled office blood pressure (>140/90 mmHg) despite treatment with maximum tolerated doses of three or more antihypertensive agents from at least three different classes, including a diuretic. The prevalence of RHTN is about 8–18% in hypertensive patients and confers greatly increased risk of cardiovascular morbidity and mortality.

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