scholarly journals Stress and arterial hypertension - from pathophysiology to pharmacology

2021 ◽  
pp. 66-66
Author(s):  
Nemanja Nenezic ◽  
Radomir Matunovic ◽  
Ognjen Gudelj ◽  
Ivica Djuric ◽  
Jasna Jancic ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Animal Studies ◽  
Strong Association ◽  
Antihypertensive Agents ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Hypertensive Retinopathy ◽  
Channel Blockers ◽  
Post Traumatic Stress ◽  
Converting Enzyme Inhibitors ◽  
Adrenergic Blockers

Arterial hypertension is the most massive chronic non-infectious disease of mankind nowadays. It may remain undiagnosed for years, provoking later complications, such as acute heart failure, cerebrovascular stroke, myocardial infarction, renal failure, hypertensive retinopathy, or sudden death. Primary arterial hypertension is more common, while secondary occurs in about 5-20% of cases. The recent studies have shown that stress may be a core factor in development of essential hypertension in some patients. For the patients suffering from post-traumatic stress disorder, stress is the dominant etiological factor that leads to the disease. It has been proven that chronic stress can affect blood pressure regulation and endocrine-metabolic functions through the limbic-hypothalamic centers, therefore it can affect the arterial hypertension development. The strong association between stress and arterial hypertension have been also confirmed in preclinical and animal studies. For the pharmacotherapy approach, the most important are beta-adrenergic blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors) and AT1-receptor blockers (sartans). As a second line treatment, calcium channel blockers, diuretics, alpha-adrenergic blockers, and central antihypertensive agents may be required. The anxiolytics, such as benzodiazepines, should be considered if chronic anxiety and psychosomatic disorders are present.

scholarly journals Primary stroke prevention and hypertension treatment: which is the first-line strategy?

2011 ◽  
Vol 3 (2) ◽  
pp. 12 ◽  
Author(s):  
Roberta Ravenni ◽  
Joe Jabre ◽  
Edoardo Casiglia ◽  
Alberto Mazza
Keyword(s):  
Stroke Prevention ◽  
Enzyme Inhibitors ◽  
Antihypertensive Agents ◽  
Clinical Intervention ◽  
Vascular Risk Factor ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Fixed Dose ◽  
Channel Blockers ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors

Hypertension (HT) iis considered the main classic vascular risk factor for stroke and the importance of lowering blood pressure (BP) is well established. However, not all the benefit of antihypertensive treatment is due to BP reduction <em>per se</em>, as the effect of reducing the risk of stroke differs among classes of antihypertensive agents. Extensive evidences support that angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), dihydropyridine calcium channel blockers (CCB) and thiazide diuretics each reduced risk of stroke compared with placebo or no treatment. Therefore, when combination therapy is required, a combination of these antihypertensive classes represents a logical approach. Despite the efficacy of antihypertensive therapy a large proportion of the population, still has undiagnosed or inadequately treated HT, and remain at high risk of stroke. In primary stroke prevention current guidelines recommend a systolic/diastolic BP goal of &lt;140/&lt;90 mmHg in the general population and &lt;130/80 mmHg in diabetics and in subjects with high cardiovascular risk and renal disease. The recent release in the market of the fixed-dose combination (FDC) of ACEI or ARB and CCB should provide a better control of BP. However to confirm the efficacy of the FDC in primary stroke prevention, clinical intervention trials are needed.

scholarly journals Arterial hypertension and metabolic syndrome: specifics of antihypertensive therapy

2011 ◽  
Vol 10 (4) ◽  
pp. 107-109
Author(s):  
L. I. Abasova ◽  
R. L. Dashdamirov ◽  
A. B. Bakhshaliev
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Hypertension ◽  
Metabolic Profile ◽  
Enzyme Inhibitors ◽  
Antihypertensive Agents ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Randomised Trials ◽  
Converting Enzyme Inhibitors ◽  
Literature Evidence

This review summarizes the literature evidence on humoral disturbances in arterial hypertension (AH), as well as on AH interrelationship with individual components of metabolic syndrome (MS). Based on the results of multi-centre randomised trials, the rationale for the use of antihypertensive agents with favourable metabolic profile is demonstrated, in particular, for antagonists of slow calcium channels, angiotensin-converting enzyme inhibitors, and selective imidazoline receptor agonists.

scholarly journals The Use of Antihypertensive Drugs as Coadjuvant Therapy in Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
José A. Carlos-Escalante ◽  
Marcela de Jesús-Sánchez ◽  
Alejandro Rivas-Castro ◽  
Pavel S. Pichardo-Rojas ◽  
Claudia Arce ◽  
...  
Keyword(s):  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Antihypertensive Agents ◽  
Drug Repurposing ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
New Drugs ◽  
Phase Iii ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Aldosterone Antagonists

Cancer is a complex group of diseases that constitute the second largest cause of mortality worldwide. The development of new drugs for treating this disease is a long and costly process, from the discovery of the molecule through testing in phase III clinical trials, a process during which most candidate molecules fail. The use of drugs currently employed for the management of other diseases (drug repurposing) represents an alternative for developing new medical treatments. Repurposing existing drugs is, in principle, cheaper and faster than developing new drugs. Antihypertensive drugs, primarily belonging to the pharmacological categories of angiotensin-converting enzyme inhibitors, angiotensin II receptors, direct aldosterone antagonists, β-blockers and calcium channel blockers, are commonly prescribed and have well-known safety profiles. Additionally, some of these drugs have exhibited pharmacological properties useful for the treatment of cancer, rendering them candidates for drug repurposing. In this review, we examine the preclinical and clinical evidence for utilizing antihypertensive agents in the treatment of cancer.

scholarly journals IS DOSE TITRATION REQUIRED FOR ANTIHYPERTENSIVE AGENTS IN GERIATRIC DIABETIC PATIENTS?

2018 ◽  
Vol 11 (12) ◽  
pp. 510
Author(s):  
Rajeshwari Shastry ◽  
Prabha M R Adhikari ◽  
Sheetal D Ullal ◽  
Mukta N. Chowta ◽  
Sahana D Acharya
Keyword(s):  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Antihypertensive Agents ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Dose Titration ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Objective: The objective of this study is to evaluate the antihypertensive drug usage and dosage differences between geriatric and non-geriatric diabetics with reference to the duration of hypertension and creatinine clearance (Crcl).Methods: In this observational study, patients with type 2 diabetes mellitus were grouped into geriatric (age ≥60 years) and non-geriatric (age <60 years). Patients’ demographic data, duration of hypertension, drugs prescribed, and serum creatinine were recorded after the patients had a stabilized antihypertensive dose for 6 months. Crcl was calculated using Cockcroft–Gault formula. The dosages of antihypertensives were converted into equivalent doses for easy comparison within a group. For angiotensin-converting enzyme inhibitors (ACEIs), enalapril was considered as prototype, and for angiotensin receptor blockers (ARBs) losartan, beta-blocker atenolol, and calcium channel blockers (CCBs), amlodipine was considered as prototype. Univariate analysis was done for comparison of drug doses between groups.Results: A total of 336 diabetics with hypertension were included, of which 252 were geriatric and 84 non-geriatric. Duration of hypertension was expectedly longer in the geriatric group (8.40±7.26 vs. 5.46±5.67; p=0.001). Systolic blood pressure was higher in geriatrics (137.14±13.51 vs. 133.38±12.49; p=0.01). When adjusted for the duration of hypertension and Crcl, there were no significant differences in the mean converted equivalent doses of beta-blockers, CCBs, ARBs, and hydrochlorothiazide between geriatrics and non-geriatrics. However, statistically significant lower converted equivalent doses of all ACEIs were needed in geriatrics compared to non-geriatrics, when adjusted for duration of hypertension and Crcl. Enalapril required 20.57% and ramipril required 18.36% dose reduction in geriatrics compared to non-geriatrics.Conclusion: A 20% dosage reduction is needed for ACEIs in the elderly.

scholarly journals Antihypertensive Drugs and the Risk of Cancer: A Nationwide Cohort Study

2021 ◽  
Vol 10 (4) ◽  
pp. 771
Author(s):  
In-Jeong Cho ◽  
Jeong-Hun Shin ◽  
Mi-Hyang Jung ◽  
Chae Young Kang ◽  
Jinseub Hwang ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors ◽  
Incident Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

We sought to assess the association between common antihypertensive drugs and the risk of incident cancer in treated hypertensive patients. Using the Korean National Health Insurance Service database, the risk of cancer incidence was analyzed in patients with hypertension who were initially free of cancer and used the following antihypertensive drug classes: Angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); beta blockers (BBs); calcium channel blockers (CCBs); and diuretics. During a median follow-up of 8.6 years, there were 4513 (6.4%) overall cancer incidences from an initial 70,549 individuals taking antihypertensive drugs. ARB use was associated with a decreased risk for overall cancer in a crude model (hazard ratio (HR): 0.744, 95% confidence interval (CI): 0.696–0.794) and a fully adjusted model (HR: 0.833, 95% CI: 0.775–0.896) compared with individuals not taking ARBs. Other antihypertensive drugs, including ACEIs, CCBs, BBs, and diuretics, did not show significant associations with incident cancer overall. The long-term use of ARBs was significantly associated with a reduced risk of incident cancer over time. The users of common antihypertensive medications were not associated with an increased risk of cancer overall compared to users of other classes of antihypertensive drugs. ARB use was independently associated with a decreased risk of cancer overall compared to other antihypertensive drugs.

scholarly journals Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-18 ◽  
Author(s):  
Jie Wang ◽  
Bo Feng ◽  
Xiaochen Yang ◽  
Wei Liu ◽  
Yongmei Liu ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Randomized Clinical Trials ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Data Extraction ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Deficiency Syndrome ◽  
Adjunctive Treatment ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Background. Tianma Gouteng Yin (TGY) is widely used for essential hypertension (EH) as adjunctive treatment. Many randomized clinical trials (RCTs) of TGY for EH have been published. However, it has not been evaluated to justify their clinical use and recommendation based on TCM zheng classification.Objectives. To assess the current clinical evidence of TGY as adjunctive treatment for EH with liver yang hyperactivity syndrome (LYHS) and liver-kidney yin deficiency syndrome (LKYDS).Search Strategy. 7 electronic databases were searched until November 20, 2012.Inclusion Criteria. RCTs testing TGY combined with antihypertensive drugs versus antihypertensive drugs were included.Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.Results. 22 RCTs were included. Methodological quality was generally low. Except diuretics treatment group, blood pressure was improved in the other 5 subgroups; zheng was improved in angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and “CCB + ACEI” treatment groups. The safety of TGY is still uncertain.Conclusions. No confirmed conclusion about the effectiveness and safety of TGY as adjunctive treatment for EH with LYHS and LKYDS could be made. More rigorous trials are needed to confirm the results.

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