Prognostic and diagnostic value of moderate intensity stress test with blood pressure control

In spite of age and blood pressure values at rest,hypertensive response to moderate intensity stress testingis characterized by increasing ofprobable beginning of cardiac infarction, stroke or coronary disease in 1.36 times. The hypertensive response to stress test in people with normal blood pressure values at rest (independent of other risk factors) is characterized by increasing risk of future hypertension more than in 2 times. Antihypertensive drugs affect blood pressure values differently during the stress testing. The prognosis of blood pressure values during daily physical activity is necessary for antihypertensive treatment. Low availability of convenient instruments and methodological tools for continuous measurement of blood pressure (similar to Spiroarteriocardiorhythmograph, Finapres) duringthe dosed physical loads constrain wide use of stress tests with controlled blood pressure in medical practice.

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Improvement of Blood Pressure Control by Adherence Check in Patients With Apparent Treatment-Resistant Hypertension: A Case Series

Clinical Medicine Insights Case Reports ◽

10.1177/1179547620904884 ◽

2020 ◽

Vol 13 ◽

pp. 117954762090488

Author(s):

Keiko Hosohata ◽

Ayaka Inada ◽

Saki Oyama ◽

Takashi Doi ◽

Iku Niinomi ◽

...

Keyword(s):

Blood Pressure ◽

Resistant Hypertension ◽

Antihypertensive Drugs ◽

Case Series ◽

Pressure Control ◽

Supporting Evidence ◽

Treatment Resistant ◽

Uncontrolled Blood Pressure ◽

Important Challenge ◽

Prescribed Medicines

Adherence to medications is an important challenge while treating chronic disease such as resistant hypertension, which is defined as uncontrolled blood pressure (BP) despite treatment with more than 3 antihypertensive drugs to achieve targets. It is possible that poor adherence is the most significant contributor to rates of pseudo-resistance among treated hypertensive patients. In this report, we describe 4 patients with apparent treatment-resistant hypertension, who received intervention to promote adherence by pharmacists who set the prescribed medicines in a weekly medication calendar and conducted a weekly pill count. The results showed that the intervention of pharmacists to medication adherence improved systolic BP in patients with apparent treatment-resistant hypertension; however, further controlled trials are required to strengthen supporting evidence.

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Blood Pressure Control: Stroke and Stroke Prevention

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/14703203050060010301 ◽

2005 ◽

Vol 6 (1_suppl) ◽

pp. S8-S11

Author(s):

Hans-Christoph Diener

Keyword(s):

Blood Pressure ◽

Stroke Prevention ◽

Antihypertensive Drugs ◽

Angiotensin Receptor Blockers ◽

Antihypertensive Agents ◽

Pressure Control ◽

Angiotensin Receptor ◽

Risk Of Death ◽

Pressure Lowering ◽

Receptor Blockers

Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention. All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention. Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP) increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences. The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

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Effect of strict blood pressure control on proteinuria in renal patients treated with different antihypertensive drugs

Nephrology Dialysis Transplantation ◽

10.1093/ndt/16.suppl_1.78 ◽

2001 ◽

Vol 16 (suppl_1) ◽

pp. 78-81 ◽

Cited By ~ 1

Author(s):

Soledad García de Vinuesa ◽

José Luño ◽

Francisco Gómez‐Campderá ◽

Natalia Ridao ◽

Mercedes Sánchez ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Antihypertensive Drugs ◽

Pressure Control

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Resistant Hypertension: A Real Entity Requiring Special Treatment?

European Cardiology Review ◽

10.15420/ecr.2016.11.1 ◽

2016 ◽

Vol 11 (1) ◽

pp. 8

Author(s):

Stefano Taddei ◽

Rosa Maria Bruno ◽

◽

Keyword(s):

Blood Pressure ◽

Resistant Hypertension ◽

Renal Denervation ◽

Antihypertensive Drugs ◽

Pressure Control ◽

Clinical Situation ◽

Special Treatment ◽

Separate Clinical Entity ◽

Real Entity ◽

Definition Of

Resistant hypertension (RH) was defined many years ago as a clinical situation in which blood pressure remains uncontrolled despite concomitant intake of at least three antihypertensive drugs (one of them preferably being a diuretic) at full doses. This operative definition was aimed at identifying a subset of hypertensive patients requiring a more extensive clinical workup in order to achieve an adequate blood pressure control. An oversimplification of this picture led to consider RH as a separate clinical entity requiring special, expensive treatments, such as renal denervation and baroreceptor activating therapy. In this review we will discuss the utility and the shortcomings of the definition of RH and the possible consequences for treatment.

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Drug utilization study of antihypertensive drugs and prevalence of blood pressure control in adult hypertensive patients based on JNC VIII guidelines in a tertiary care hospital: a cross sectional study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190142 ◽

2019 ◽

Vol 8 (2) ◽

pp. 245

Author(s):

Saumya Ramadas ◽

M. B. Sujatha ◽

M. A. Andrews ◽

Sanalkumar K. B.

Keyword(s):

Blood Pressure ◽

Combination Therapy ◽

Drug Utilization ◽

Antihypertensive Drug ◽

Blood Pressure Control ◽

Antihypertensive Drugs ◽

Pressure Control ◽

Antihypertensive Drug Therapy ◽

Care Hospital ◽

Drug Utilization Study

Background: Hypertension is a major independent risk factor for coronary artery disease, congestive heart failure, stroke, chronic kidney disease and peripheral vascular diseases if left untreated. Drug utilization study of antihypertensive drugs and the study on prevalence of blood pressure control would help in reducing the burden of the disease and health expenditure.Methods: The study was conducted in the Outpatient Department of Medicine in Government Medical College, Thrissur. Patients aged 18yrs or above diagnosed with hypertension, on antihypertensive drugs were enrolled in the study. Patients suffering from secondary hypertension and acutely ill were excluded. Patients were enrolled after taking an informed consent. Demographic data, present treatment for hypertension, associated co- morbid conditions if any, and treatment of the same were recorded. BP was recorded, and cost of treatment was calculated using CIMS.Results: A total of 250 patients were included in the study. Mono therapy was used in 64.8% patients and combination therapy in 35.2%. Overall drug utilization pattern showed that CCBs (42.8%) were most commonly prescribed, followed by ACEIs (32.4%) and ARBs (29.2%). Most commonly prescribed combination therapy was ACE I + BB (29.3%), followed by ARB + CCB (21.3%). Mean cost of antihypertensive drug therapy was 3057.8 Rs / yr. Recommended target BP was achieved in 49.6% of patients.Conclusions: The prescription pattern of antihypertensive drug was in accordance to the JNC-VIII guidelines. The blood pressure target was achieved only in less than 50% of patients.

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Scleroderma Renal Crisis

The Journal of Rheumatology ◽

10.3899/jrheum.131210 ◽

2014 ◽

Vol 41 (6) ◽

pp. 1040-1048 ◽

Cited By ~ 49

Author(s):

Luc Mouthon ◽

Guillaume Bussone ◽

Alice Berezné ◽

Laure-Hélène Noël ◽

Loïc Guillevin

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Antihypertensive Drugs ◽

Rna Polymerase Iii ◽

Pressure Control ◽

Hypertensive Encephalopathy ◽

Left Ventricular ◽

Scleroderma Renal Crisis ◽

Volume Depletion ◽

Renal Crisis

Scleroderma renal crisis (SRC) is characterized by malignant hypertension and oligo-anuric acute renal failure. It occurs in 5% of patients with systemic sclerosis (SSc), particularly in patients with diffuse disease during the first years. SRC is more common in patients receiving corticosteroids, the risk increasing with increasing dose. The disease is sometimes triggered by use of nephrotoxic drugs and/or intravascular volume depletion. Left ventricular insufficiency and hypertensive encephalopathy are typical clinical features. Thrombotic microangiopathy is detected in 43% of cases, and anti-RNA-polymerase III antibodies are present in one-third of patients. Renal biopsy is not necessary if SRC presents classical features. However, biopsy may help to define the prognosis and guide treatment in atypical forms. The prognosis of SRC has greatly improved with the introduction of angiotensin-converting enzyme (ACE) inhibitors. However, the 5-year survival for SSc patients with full SRC remains low (65%). The treatment of SRC relies on aggressive blood pressure control with an ACE inhibitor, combined with other antihypertensive drugs if needed. Dialysis is frequently indicated but can be stopped in about half of patients, mainly those with good blood pressure control. Patients who need dialysis for more than 2 years qualify for renal transplantation.

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