scholarly journals Changes in Blood Pressure During Induction of Anesthesia and Oral and Maxillofacial Surgery by Type and Timing of Discontinuation of Antihypertensive Drugs

2010 ◽  
Vol 57 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Yoshihiro Momota ◽  
Kazuhiro Kaneda ◽  
Kumiko Arishiro ◽  
Naotaka Kishimoto ◽  
Seiji Kanou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Drug Class ◽  
Antihypertensive Drugs ◽  
Perioperative Complications ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Anesthetic Agents ◽  
Frequency Of Use ◽  
Blood Pressures

Abstract The purpose of this study was to evaluate the effects of an antihypertensive drug class and the timing of discontinuation of antihypertensive therapy on blood pressure during oral and maxillofacial surgery for 129 patients on antihypertensive therapy receiving general anesthesia. Blood pressures at loss of response to stimulation and 5–15 minutes after intubation were significantly lower than those before induction, although the type of antihypertensive therapy did not affect changes in blood pressure. No significant correlation was observed between systolic blood pressure (SBP) on the ward and change in SBP during surgery, though patients with higher blood pressure on the ward tended to exhibit larger differences between SBP on the ward and the lowest SBP during surgery. Frequency of use of vasopressors during surgery was significantly higher in patients who discontinued antihypertensive therapy on the day before surgery than in those who continued antihypertensive therapy on the day of surgery. These findings suggest that appropriate preoperative antihypertensive therapy is important for minimizing change in blood pressure during surgery and preventing perioperative complications. Patients undergoing antihypertensive therapy should be carefully monitored perioperatively by observation for interactions between antihypertensive and anesthetic agents and minimizing interruption schedules for antihypertensive therapy.

scholarly journals Tactical approaches to the treatment of arterial hypertension in the European part of the Russian Federation. EPOHA study 2017

Kardiologiia ◽  
2019 ◽  
Vol 59 (11S) ◽  
pp. 77-84
Author(s):  
Yu. V. Badin
Keyword(s):  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Russian Federation ◽  
Antihypertensive Treatment ◽  
Antihypertensive Drugs ◽  
European Part ◽  
Frequency Of Use ◽  
Two Component ◽  
The Russian Federation ◽  
Real Clinical Practice

Aim. Analysis of antihypertensive treatment among different groups of patients with arterial hypertension from “EPOCHA” study 2017. Materials and methods. EPOCHA study is a representative sample of the European part of the Russian Federation was created in 2002 and re-examined in 2017. Results. 34.6% of the effectively treated (ET) patients had one antihypertensive drug and 32,2% of the ineffective treatment (IT) patients, p=0.16. Two-component antihypertensive therapy was 45.9% and 44.9%, respectively, p=0.56. Three antihypertensive drugs had 17.9% of the ET patients and 20.7% of the IT patients, p=0.05. Four antihypertensive drugs had 1.6% of the ET patients and 2.2% of the IT patients. The frequency of use of renin-angiotensin-aldosterone system blockers in the group of ET patients was 85.0%, which was significantly lower than 91.6% in the group of IT patients, р<0.0001. Conclusion. EPOCHA study shows that structure of antihypertensive therapy does not differ between ET and IT patients what is caused lack of medical supervision for patients with hypertension in real clinical practice.

The Value of Portably Recorded Blood Pressures in the Initiation of Treatment of Moderate Hypertension

1973 ◽  
Vol 45 (s1) ◽  
pp. 195s-198s ◽  
Author(s):  
Maurice Sokolow ◽  
Dorothee Perloff ◽  
Ronald Cowan
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Arterial Pressure ◽  
Antihypertensive Therapy ◽  
Moderate Hypertension ◽  
Vascular Involvement ◽  
Pressure Elevation ◽  
Blood Pressures ◽  
Hypotensive Therapy ◽  
Reduce Risk

1. The value of making portable-recorder measurements of blood pressure has been studied. 2. The danger associated with mild arterial pressure elevation is not immediate, but almost any reduction in pressure is likely to reduce risk. 3. Patient and doctor together must decide what burden of side effects of hypotensive therapy is tolerable. 4. Such decisions will become rational only when the probability of vascular involvement can be accurately assessed in a given patient. 5. The likelihood of arresting the disease through antihypertensive therapy must similarly be assessed.

scholarly journals Assessing the impact of antihypertensive therapy on ambulatory blood pressure monitoring in patients with isolated systolic hypertension

2014 ◽  
Vol 5 (1) ◽  
pp. 5-9
Author(s):  
V. A Aydarova ◽  
Z. T Astahova ◽  
F. U Kanukova ◽  
M. M Besaeva
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Systolic Hypertension ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Isolated Systolic Hypertension ◽  
Pressure Monitoring ◽  
Group 2 ◽  
The Impact

The study examined the effectiveness of drug correction of high numbers of blood pressure (BP) by means of modern groups of antihypertensive drugs, the effect of a fixed combination of perindopril and indapamide on circadian blood pressure monitoring, and a commitment to patients of antihypertensive therapy, based on the opened simple randomization three groupswere formed: 1st comprised of 21 patients with isolated systolic hypertension (ISAH) and 22 patients with systolic-diastolic hypertension (SDAH) - they all received monotherapy with calcium antagonists (amlodipine 10 mg/day); Group 2 - of 16 ISAH patients and 24 SDAH patients - who received monotherapy with perindopril (2 mg/day) and the third group - of 17 patients with ISAH and 14 patients with SDAH - who received combination therapy with the drug noliprel (Servier) with a fixed combination of perindopril (2 mg) and indapamide of 0,625 mg. Treatment efficacy was assessed primarily to reduce the absolute numbers of blood pressure, and taken into account as a reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP), uncontrolled drop of which, according to the literature, in elderly patients can have fatal consequences

scholarly journals THE FREQUENCY OF USE OF COMBINATIONS OF ANTIHYPERTENSIVE DRUGS IN PATIENTS WITH DIFFICULT-TO-CONTROL HYPERTENSION ON THE BACKGROUND OF BIOFEEDBACK AND PACED BREATHING AND HEART RATE VARIABILITY

2018 ◽  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Drug Therapy ◽  
Arterial Hypertension ◽  
Antihypertensive Effect ◽  
Antihypertensive Drugs ◽  
Basic Subgroup ◽  
Paced Breathing ◽  
Frequency Of Use

The frequency of administration of combinations of antihypertensive drugs and its changes at different stages of observation was studied in 60 patients with difficult-to-control arterial hypertension (DTCAH) (32 men and 28 women) aged 59.0 ± 9.4. All patients were randomly divided into two subgroups: biofeedback (BFB) in the loop of paced breathing (PB) and heart rate variability (HRV) (33 patients) – basic subgroup, subgroup of comparisons (27 patients). Determined that patients with DTCAH in the subgroup of patients with the BFB in the loop of PB there has been a reduction of four-component antihypertensive therapy to three-component and in the subgroup of comparisons the frequency of the appointment of a four-component therapy was increased. At the same time, it was found that the addition of drug therapy with regular BFB sessions in the loop of PB contributed to the potentiation of the antihypertensive effect in patients with DTCAH. It is concluded that the BFB in the loop of PB and HRV can be used as a technology to improve the efficiency of control of blood pressure in patients with DTCAH.

scholarly journals Combination Antihypertensive Therapy Prescribing and Blood Pressure Control in a Real-World Setting

2019 ◽  
Vol 33 (4) ◽  
pp. 316-324
Author(s):  
Oyunbileg Magvanjav ◽  
Rhonda M Cooper-Dehoff ◽  
Caitrin W McDonough ◽  
Yan Gong ◽  
William R Hogan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Drug Class ◽  
Clinical Decision ◽  
Pressure Control ◽  
Prescribing Patterns ◽  
Concomitant Disease ◽  
Prescribing Practices ◽  
Uncomplicated Hypertension ◽  
Drug Classes

Abstract BACKGROUND Specific combinations of two drug classes are recommended in a variety of clinical situations in the management of hypertension. These preferred combinations are based on complimentary blood pressure (BP) lowering mechanisms or benefit for a concomitant disease. METHODS Using electronic health records (EHRs) data from 27,579 ambulatory hypertensive patients, we investigated antihypertensive therapy prescribing patterns and associations of preferred two drug classes with BP control. RESULTS Overall, BP control, defined as BP &lt;140/90 mm Hg, was 65% among treated patients. Preferred dual antihypertensive therapy was prescribed in 55% of patients with uncomplicated hypertension, 49% of patients with diabetes, and 47% of patients with a history of myocardial infarction (MI); these prescribing frequencies of preferred combinations were not explained by worse BP control on those combinations. In fact, we found suggestive evidence of association between prescribing of preferred two drug classes and improved BP control among post-MI (OR: 1.21, 95% CI: 0.99–1.48, P = 0.061) and uncomplicated hypertensive (OR: 1.11, 95% CI: 0.98–1.26, P = 0.089) patients. CONCLUSIONS Prescribing of guideline-recommended antihypertensive drug classes for concomitant diseases is suboptimal and prescribing of preferred/optimized drug class combinations was moderate. We did not find a clear association between the use of optimized drug class combinations and greater BP control. Overall, using EHR data, we identified potential opportunities for re-examining prescribing practices with implications for clinical decision support and healthcare improvement at the community and health system-wide levels.

The optimal combination of Lysinopril and Amlodipine for the treatment of patients with hypertension

2020 ◽  
Vol 1-2 (211-212) ◽  
pp. 31-39
Author(s):  
Gulnara Junusbekova ◽  
◽  
Meiramgul Tundybayeva ◽  
Tatyana Leonovich ◽  
Manshuk Yeshniyazova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Cardiovascular Complications ◽  
Antihypertensive Activity ◽  
Daily Monitoring ◽  
Very High

Arterial hypertension (AH) remains one of the most common diseases in the world. Reducing cardiovascular risk of mortality from cardiovascular complications is a priority in the treatment of hypertension. Targets of hypertension therapy is to achieve SBP/DBP <140/80 mm Hg. article, regardless of cardiovascular risk and comorbidity. The choice of antihypertensive therapy depends on blood pressure levels, the presence or absence of concomitant diseases, lesion of target organs. Effective and long-lasting control of AH proved by the use of combinations of antihypertensive drugs, including antagonists and ACE inhibitors. The purpose of the study. Evaluation of clinical efficacy and safety of fixed combination antihypertensive therapy using lisinopril combined with amlodipine in patients with hypertension. Material and methods. The study included 30 respondents from essential hypertension II-III degree (ESH/ESC, 2018) aged 35 to 75 years. Patients were treated with the schema a (lisinopril 10 mg, amlodipine 5 mg) and scheme b (lisinopril 20 mg, amlodipine 10 mg) fixed combination therapy with the drug VivaCor® once in the morning. The period of observation was 3 months. At the time of inclusion and at the end of the study all respondents was performed echocardiography, daily monitoring of blood pressure, evaluation of laboratory and instrumental methods of research. Results and discussion. The combination of lisinopril with amlodipine has a fairly high antihypertensive activity, provides a significant cardioprotective effect and is an integral part of antihypertensive therapy in the long-term strategy of administering patients with high hypertensive / very high total cardiovascular risk. Conclusions: 1. The use of a fixed combination of lisinopril and amlodipine in patients with hypertension instead of free or other two-component combinations leads to its target level within 3 months of therapy. 2. Taking a fixed combination of lisinopril and amlodipine is effective and safe. 3. Therapy using the combined drug VivaCor® in patients with high / very high risk of hypertension prevents further pathological remodeling of the heart. 4. The combination of amlodipine and lisinopril is metabolically neutral and well tolerated by patients. Keywords: arterial hypertension, lisinopril, amlodipine, VivaCor.

A novel therapeutic approach for reversal of left ventricular hypertrophy and blood pressure control in hypertensive patients treated with alpha-methyldopa or propranolol

1985 ◽  
Vol 63 (4) ◽  
pp. 304-308
Author(s):  
P. G. Fernandez ◽  
W. Snedden ◽  
B. K. Kim ◽  
C. C. Lee
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Antihypertensive Drugs ◽  
Left Ventricular ◽  
Stepwise Discriminant Analysis ◽  
Therapeutic Effects ◽  
Long Term Effects ◽  
Hypertensive Patients ◽  
Blood Pressures

A recently added goal in the control of primary hypertension is the reversal of left ventricular hypertrophy which may occur early in the disease and which can have serious consequences. We have attempted to define the hemodynamic parameters which distinguish most sensitively between the long-term effects of two antihypertensive drugs, alpha-methyldopa and propranolol, with a view to determining the optimal conditions under which each of the drugs may be used therapeutically. Twenty matched hypertensive patients, all with established left ventricular hypertrophy, were divided at random into two groups who received either alpha-methyldopa or propranolol as monotherapy. Dosage was titrated until blood pressures were normalized (diastolic blood pressure (DBP) ≤ 95 mmHg) (1 mmHg = 133.322 Pa); then therapy was maintained for 48–52 weeks. Supine and erect blood pressures, heart rates, and eight echocardiographic indices were recorded before commencement of therapy and at the 48- to 52-week period. Stepwise discriminant analysis identified erect DBP, erect heart rate, and posterior wall thickness of the left ventricle as being the parameters which distinguished most clearly the therapeutic effects of the chosen drugs. Using these three parameters, all 20 patients were correctly classified into their respective drug groups. We propose that these results may form the basis of a more rational choice of antihypertensive therapy with alpha-methyldopa or propranolol for hypertensive patients based on the initial determination of these three parameters.

scholarly journals Controlling resistant hypertension

2018 ◽  
Vol 3 (2) ◽  
pp. 69-75 ◽  
Author(s):  
J David Spence
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Resistant Hypertension ◽  
Antihypertensive Drugs ◽  
Renal Hypertension ◽  
Pressure Control ◽  
Uncontrolled Hypertension ◽  
Aldosterone Antagonists ◽  
Improve Blood Pressure Control ◽  
Blood Pressures

Resistant hypertension (failure to achieve target blood pressures with three or more antihypertensive drugs including a diuretic) is an important and preventable cause of stroke. Hypertension is highly prevalent in China (>60% of persons above age 65), and only ~6% of hypertensives in China are controlled to target levels. Most strokes occur among persons with resistant hypertension; approximately half of strokes could be prevented by blood pressure control. Reasons for uncontrolled hypertension include (1) non-compliance; (2) consumption of substances that aggravated hypertension, such as excess salt, alcohol, licorice, decongestants and oral contraceptives; (3) therapeutic inertia (failure to intensify therapy when target blood pressures are not achieved); and (4) diagnostic inertia (failure to investigate the cause of resistant hypertension). In China, an additional factor is lack of availability of appropriate antihypertensive therapy in many healthcare settings. Sodium restriction in combination with a diet similar to the Cretan Mediterranean or the DASH (Dietary Approaches to Stop Hypertension) diet can lower blood pressure in proportion to the severity of hypertension. Physiologically individualised therapy for hypertension based on phenotyping by plasma renin activity and aldosterone can markedly improve blood pressure control. Renal hypertension (high renin/high aldosterone) is best treated with angiotensin receptor antagonists; primary aldosteronism (low renin/high aldosterone) is best treated with aldosterone antagonists (spironolactone or eplerenone); and hypertension due to overactivity of the renal epithelial sodium channel (low renin/low aldosterone; Liddle phenotype) is best treated with amiloride. The latter is far more common than most physicians suppose.

scholarly journals Elderly Patient with Hypertension in General Practice: Clinical Features and Antihypertensive Therapy

2021 ◽  
pp. 61-66
Author(s):  
Viacheslav Zhdan ◽  
Yevdokiia Kitura ◽  
Maryna Babanina ◽  
Oksana Kitura ◽  
Maksym Tkachenko
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
High Frequency ◽  
Antihypertensive Drugs ◽  
White Coat Hypertension ◽  
Aged Patients ◽  
Increased Risk ◽  
Treatment Of Hypertension

The prevalence of arterial hypertension (AH) increases with age: among people over 60 years old this index is more than 2 times higher in the general population, 2/3 of people over 65 years old suffer from hypertension. Among patients 65–89 years old with hypertension, 2/3 patients have isolated systolic hypertension (ISAG). Features of hypertension in the elderly patients are: lability of blood pressure (BP), increasing frequency of pseudohypertension, high frequency of «white coat hypertension», decreased sensitivity of pressor factors for antihypertensive drugs, high frequency of resistant to treatment of hypertension. The new recommendations of the European Society of Cardiology for the diagnosis and treatment of hypertension emphasize 2 groups of elderly patients: 65–79 years old and ≥80 years old, which described the epidemiological features, the prevalence of risk factors for cardiovascular events, blood pressure levels for antihypertensive therapy and target blood pressure, and the recommended principles of drug therapy that are different from young and middle-aged patients. For most patients, fixed combinations are indicated as starting AGT, but monotherapy is recommended for the treatment of hypertension in very elderly patients (over 80 years old) and elderly patients over 65 years old with senile asthenia. The decreasing of blood pressure should be gradual, taking into consideration the increased risk of orthostatic reactions at this age. European and American experts recommend os first-line drugs low doses of thiazide diuretics and calcium channel antagonists (mainly dihydropyridine), which are especially indicated in isolated systolic arterial hypertension to effectively reduce the frequency of cardiovascular complications in the treatment of elderly patients with hypertension.

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