Interaction of antihypertensive drugs and rosuvastatin: focus on safety, efficiency and prospects

Arterial hypertension and dyslipidemia is a very frequent comorbid condition. Arterial hypertension and dyslipidemia are combined in 40-70% of patients. The statins is the basic drug in primary and secondary prevention of cardiovascular disease and in the reduction of cardiovascular complications. We`ve attempted to summarize some data about the statins and interaction of antihypertensive drugs. Rosuvastatin is a medicine that provides an intensive reduction of low-density lipoproteins, does not require dose adjustment when applied in conjunction with antihypertensive drugs. The absence of inhibition and activation of rosuvastatin cytochrome P450 provides a low risk of negative interactions in the clinical situations of induced polypharmacy. Every clinician is to remember that it`s crucial to take into account some adverse reactions combining the statins with drugs of other pharmacological groups.

Download Full-text

The hardness of the vessel wall in patients with arterial hypertension

Systemic Hypertension ◽

10.26442/sg29073 ◽

2015 ◽

Vol 12 (2) ◽

pp. 43-48

Author(s):

O D Ostroumova ◽

A I Kochetkov ◽

I I Kopchenov ◽

T F Guseva ◽

O V Bondarec

Keyword(s):

Arterial Hypertension ◽

Vessel Wall ◽

Antihypertensive Drugs ◽

Blood Pressure Level ◽

Vascular Wall ◽

Cardiovascular Complications ◽

Increased Risk ◽

The Status ◽

The Difference

The article deals with the role of the hardness of the vessel wall in the pathogenesis of arterial hypertension and its complications and cardiovascular mortality. We discussed the factors increasing the hardness of the vessel wall, such as age, blood pressure level, atherosclerosis, smoking and diabetes mellitus. We showed the indicators reflecting the status of the vascular wall and which could play a role of markers of increased risk of cardiovascular complications. We reviewed the data concerning the improvement of the parameters of the hardness of the vessel wall under the influence of antihypertensive therapy using the angiotensin II type 1 receptor blocker - candesartan. We discussed the possible mechanisms of the candesartan influence on the elastic properties of the vessels. We stressed that the effect on the hardness of the arteries on using antihypertensive drugs, even within the same class, was different, which, apparently, was associated with the difference in the pharmacokinetic properties.

Download Full-text

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

International Professional Journal Medicine ◽

10.31082/1728-452x-2020-211-212-1-2-31-39 ◽

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.

Download Full-text

Arterial hypertension in ophthalmic surgical patients

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-1-186-191 ◽

2021 ◽

pp. 186-191

Author(s):

L.V. Pavlyushchenko ◽

◽

E.E. Filimonova ◽

M.A. Esina ◽

◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Clinical Symptoms ◽

Antihypertensive Drugs ◽

High Stress ◽

Cardiovascular Complications ◽

Surgical Patients ◽

Uncontrolled Hypertension ◽

Standard Dosage

Purpose. Analysis of the frequency and structure of arterial hypertension (AH) among ophthalmic surgical patients, assessment of the adequacy of prescribed antihypertensive therapy. Material and methods. Clinical material is presented by 157 patients with hypertension. Its structure was assessed. Its structure was assessed according to the stage, the degree of increase in the level of blood pressure (BP) and the category of cardiovascular risk. We analyzed the proportion of cases of uncontrolled hypertension, including those with a sudden pronounced individually significant increase in blood pressure without affecting target organs. Results. The prevalence of patients was stage III hypertension (62.4%), grade 3 hypertension (53.5%), with a very high and high risk of cardiovascular complications (73.2 and 20.4%, respectively). 93.6% of patients received antihypertensive therapy, but only 57.1% of them, mostly women (69.1%), regularly took medications and monitored their blood pressure. With a sudden pronounced individually significant increase in blood pressure, we used oral antihypertensive drugs – captopril and nifedipine, which made it possible to achieve a decrease in blood pressure and relief of clinical symptoms in all cases. Conclusion. 33.1% of patients had no hypertension control at the time of hospitalization. The proportion of patients with a sudden pronounced individually significant increase in blood pressure was 12.7%. Typical reasons for loss of control over hypertension were interruptions in taking antihypertensive drugs and high stress levels before surgery. The use of standard dosage captopril and nifedipine was effective in all cases. Key words: arterial hypertension, sudden pronounced individually significant increase in blood pressure, antihypertensive therapy.

Download Full-text

The possibility of a new receptor blocker to angiotensin in improving control of hypertension. Non-intervention international multicenter observational prospective study of the use azilsartan medoxomil in patients with arterial hypertension and overweight or obesity in the Russian Federation and the Republic of Kazakhstan

Systemic Hypertension ◽

10.26442/sg29130 ◽

2016 ◽

Vol 13 (3) ◽

pp. 6-12

Author(s):

Yu V Zhernakova ◽

I E Chazova

Keyword(s):

Arterial Hypertension ◽

Russian Federation ◽

Antihypertensive Drugs ◽

Antihypertensive Agents ◽

Cardiovascular Complications ◽

Receptor Blocker ◽

The Russian Federation ◽

The Republic ◽

Azilsartan Medoxomil ◽

Overweight Or Obesity

Currently, there is evidence of a rather low efficacy of antihypertensive therapy, especially in patients with obesity and metabolic disorders that indicate the need for the search of new highly effective antihypertensive agents that have additional features to prevent destruction of target organs and cardiovascular complications. On the Russian pharmaceutical market antihypertensive drugs presents receptor blocker to angiotensin - azilsartan medoxomil (Edarbi®). The article is published design of study of the effectiveness of azilsartan medoxomil in patients with arterial hypertension and overweight or obesity in daily clinical practice of the Russian Federation and the Republic of Kazakhstan.

Download Full-text

Doctors’ Adherence to the Guidelines on the Diagnostics and Treatment of Arterial Hypertension

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-4-502-509 ◽

2019 ◽

Vol 15 (4) ◽

pp. 502-509

Author(s):

N. B. Perepech ◽

V. D. Shurygina ◽

A. V. Tregubov

Keyword(s):

Blood Pressure ◽

Risk Stratification ◽

Arterial Hypertension ◽

Antihypertensive Therapy ◽

Clinical Guidelines ◽

Antihypertensive Drugs ◽

Blood Pressure Level ◽

Cardiovascular Complications ◽

Target Blood Pressure ◽

Fixed Dose

Aim. Examination of knowledge of the basic provisions of clinical guidelines for the management of patients with arterial hypertension and finding out the readiness of doctors for the practical application of updated recommendationsMaterial and methods. Anonymous questionnaires of 306 doctors served as material for the study. The questionnaire consisted of two parts. The introductory part included questions that allow to find out the specialty, work experience, gender, age, and whether the respondent has cardiovascular risk factors. The main part of the questionnaire included 16 questions regarding provisions of the guidelines on the diagnosis and treatment of arterial hypertension in force at the time of the survey (2017/2018 academic year). Statistical processing of the results was carried out using the Microsoft Excel 2010 software package. Differences were regarded as significant at p<0.05.Results. The findings suggest that both therapists and cardiologists do not give due importance to the risk stratification of cardiovascular complications in patients with arterial hypertension and are not sufficiently aware of the possibilities and limitations of the use of combinations of antihypertensive drugs. Therapists worse than cardiologists know the main points of the clinical guidelines for the management of patients with arterial hypertension (target blood pressure levels during treatment [64.6% vs 87.7%, p<0.001], indications for combination antihypertensive therapy starting, the possibility of fixed dose combinations using [52.3% vs 83.9%, p<0.001]). A significant part of physicians (both cardiologists and therapists) adequately assess the antihypertensive treatment effectiveness, not enough frequent achievement of the target blood pressure level in their patients and is willing to provide more strict control of blood pressure.Conclusion. The results of the survey indicate the need of the active education of doctors in the management of patients with arterial hypertension. The most attention should be paid to the training of therapists and general practitioners on the cardiovascular complications risk stratification, the using of the antihypertensive drugs combinations use and methods to increase patient adherence to antihypertensive therapy.

Download Full-text

Multi-aspect approach to the optimization of pharmacotherapy of patients with arterial hypertension of high and very high risk

Research Results in Pharmacology ◽

10.3897/rrpharmacology.4.31952 ◽

2018 ◽

Vol 4 (4) ◽

pp. 53-64

Author(s):

Svetlana Gridina

Keyword(s):

High Risk ◽

Arterial Hypertension ◽

Fixed Combination ◽

Antihypertensive Drugs ◽

Treatment Options ◽

Hypotensive Effect ◽

Cardiovascular Complications ◽

Left Ventricular ◽

Hypotensive Action ◽

Very High

Introduction: Personalization of pharmacotherapy of cardiovascular diseases is one of the urgent problems of cardiology. Material and methods: The study includes 120 patients with grades 2-3 arterial hypertension with the criteria of high and very high risk of developing cardiovascular complications. The patients were randomized into three groups with differentstarting regimens of pharmacotherapy – fixed and free combinations of ACE inhibitors and dihydropyridine CCB. Evaluation of the efficacy, safety and individualization of a therapy was carried out by using pharmacokinetic, pharmacoeconomic, sonographic, and laboratory methods. Results and discussion: Antihypertensive treatment with the inclusion of Amlodipine and Lisinopril or Ramipril in patients with arterial hypertension, having a slow and very slow oxidative metabolism phenotype, is characterized by the development of a more pronounced hypotensive effect in this group of patients (p<0.05-0.001) (Δ% SBP from 12.7 to 24.6 and from 19.6 to 27.9, respectively; Δ% DBP from 10.6 to 19.1 and from 15.9 to 23.6, respectively) in comparison to the group of patients with a fast phenotype (Δ% SBP from 6.42 to 9.34; Δ% DBP from 1.04 to 5.66), which allows administering a personalized pharmacotherapy. For patients with arterial hypertension of high and very high risk, the use of a fixed combination of Amlodipine and Lisinopril as a basic variant of the two-four-component therapy compared with treatment options based on free combinations of the studied drugs provided a significantly more pronounced decrease in systolic blood pressure (24.9%, 17.8 %, 19.0%, respectively, p<0.01), a greater degree of regression of left ventricular myocardial hypertrophy (8.70%, 5.67%, 5.84%, respectively, p<0.05), significant (p<0.05-0.001) improvement in a number of parameters of the patients’ quality of life, and was characterized by the greatest economic efficiency according to various criteria of hypotensive action. Conclusion: The results obtained in the study demonstrate the advantages of a fixed combination over free combinations of antihypertensive drugs and demonstrate the possibility of a pharmacokinetic approach to individualization of pharmacotherapy.

Download Full-text

Fixed combination in patients with arterial hypertension: focus on antihypertensive and nephroprotective properties of fixed combination of lisinopril and amlodipine (clinical example)

Medical alphabet ◽

10.33667/2078-5631-2020-21-19-28 ◽

2020 ◽

pp. 19-28

Author(s):

E. Yu. Ebzeeva ◽

O. D. Ostroumova ◽

N. M. Doldo ◽

E. E. Pavleeva

Keyword(s):

Kidney Disease ◽

Arterial Hypertension ◽

Fixed Combination ◽

Enzyme Inhibitor ◽

Antihypertensive Drugs ◽

Adult Population ◽

Secondary Damage ◽

Dihydropyridine Calcium Channel Blocker ◽

Based Medicine ◽

Modern Population

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.

Download Full-text

Vascular endothelial growth factor as a potential marker of subclinical organ damage mediated by arterial hypertension

Siberian Medical Journal ◽

10.29001/2073-8552-2019-34-3-40-44 ◽

2019 ◽

Vol 34 (3) ◽

pp. 40-44

Author(s):

E. Yu. Gubareva ◽

I. V. Gubareva

Keyword(s):

Vascular Endothelial Growth Factor ◽

Essential Hypertension ◽

Growth Factor ◽

Arterial Hypertension ◽

Organ Damage ◽

Cardiovascular Complications ◽

Vascular Endothelial ◽

Potential Marker ◽

Endothelial Growth Factor

The authors’ report presents a brief review of the key studies, providing the reason for the use of vascular endothelial growth factor as a marker for stratification of the risk of cardiovascular complications in patients with essential hypertension.

Download Full-text

Baroreflex activation therapy for resistant hypertension: results from mid-term prospective ambulatory blood pressure registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.2784 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Sindt ◽

T Madej ◽

S Grimm ◽

M Knaut

Keyword(s):

Blood Pressure ◽

Side Effects ◽

Pressure Drop ◽

Arterial Hypertension ◽

Antihypertensive Drugs ◽

Drug Resistant ◽

Baroreflex Activation Therapy ◽

Activation Therapy ◽

Resistant Arterial Hypertension

Abstract Objectives First generation baroreflex activation therapy (BAT) devices showed clinical efficacy in patients with drug-resistant arterial hypertension (AHT), but the safety profile was insufficient. Data regarding efficacy of second-generation devices were generated mostly from office blood pressure (BP) measurements or short-term 24-hour ambulatory blood pressure measurements (ABPM). We present a mid-term prospective registry to evaluate the efficacy and safety of recent BAT devices. Purpose The purpose of our study was to find a method that helps patients with drug-resistant arterial hypertension to control their blood pressure. Further we sought to reduce the overall amount of antihypertensive drugs to lessen side effects, as well as the effects of polypharmacy. Methods All patients receiving Barostim neo between November 2013 and June 2019 for resistant AHT were prospectively included into this observational study. ABPM was performed at baseline, in 3-month intervals in the first year after BAT implantation and in 6-month intervals afterwards for up to 42 months. Patients were assigned into two groups of responders and non-responders. Non-responders had a mean blood pressure drop (BPD) below 5mmHg. Responders in turn were categorized into 3 sub-groups (low-BPD between 5–9 mmHg, medium-BPD between 10–19 mmHg and high-BPD ≥20 mmHg). The primary efficacy end-points were changes in systolic and diastolic BP and number of antihypertensive medications. The primary safety end point was BAT-related major adverse events (MAE). Results 64 patients (mean age 63 years, 67% males) were included. Only patients who completed a 24-hour ABPM during a follow up were counted in the statistical analysis. We had an overall responder rate of 67.8%. Out of those 15.4% had low-BPD, 38.4% medium-BPD and 46.2% had a high-BPD. Systolic BP decreased over the 3.5-years period from 168±17 mmHg to 149±19 mmHg (n=19, mean change −18.8 mmHg; 95% confidence interval [CI]: −29.32 to −8.36; p<0.0007). Diastolic BP decreased from 97±16 to 85±12 mmHg (n=19, mean change −11.7 mmHg; 95% CI: −19.2 to −4.2; p<0.0021). The mean number of antihypertensive drugs was reduced from 6.9±1.3 to 5.2±1.5 (n=19, mean change −1.7; 95% CI: −0.8 to −0.27; p<0.0009). The time course of primary end-points is shown in Fig.1. Freedom from BAT-related MAE was 93.5%. 4 perioperative complications (1 pocket bleeding, 1 pocket infection, 1 N. hypoglossus palsy, 1 hoarseness) resolved without residual side effects. There were five non BAT related deaths (7,8%) in the follow up period. Conclusion Systolic and diastolic ABP, as well as number and dosage of antihypertensive drugs decreased significantly during 3.5-years follow-up after Barostim neo implantation in 64 consecutive patients (of whom 62 completed at least one follow-up). No MAE associated with BAT were observed after the perioperative period. However, further controlled trials are needed to confirm the long-term efficacy of BAT. Figure 1. Mean blood pressure drop Funding Acknowledgement Type of funding source: None

Download Full-text

480 Cardiovascular and metabolic risk in patients with suspected comorbid insomnia and obstructive sleep apnea (COMISA)

SLEEP ◽

10.1093/sleep/zsab072.479 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A189-A190

Author(s):

Miguel Meira e Cruz ◽

Luana Seixas ◽

Augusto Santos ◽

João Garrido ◽

Yuri Lopes ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Arterial Hypertension ◽

Sleep Time ◽

Comorbid Condition ◽

Therapeutic Success ◽

Comorbid Insomnia ◽

Systemic Arterial Hypertension ◽

Obstructive Sleep

Abstract Introduction Only few studies looked for a possible association of cardiovascular disorders (CVD), in comorbid insomnia with obstructive sleep apnea (COMISA) even though this is a relevant topic in order to prevent one of the major causes of morbimortality. The present study aimed to investigate the association of insomnia symptoms in patients at risk for obstructive sleep apnea in terms of prevalence and clinical interactions and to evaluate the risk of CVD in patients with a risk for COMISA. Methods This is a cross-sectional study. All medical records with data such as age, sex, height, weight and BMI, time to sleep, time to wake up, total sleep time, the Epworth Sleepiness Scale (ESS), STOP-BANG Questionnaires were studied. Insomnia and comorbidities were also investigated, and the patientsanswered yes or no to systemic arterial hypertension, diabetes, CVD. Results 685 patients were enrolled on the present study. We observed that the mild, moderate, and high risk for COMISA presented progressively increasing levels for the frequency of hypertension, diabetes, and CVD. A binary logistic regression was performed to assess whether risk for COMISA could be a predictor for CVD, and it was found that the model containing risk for COMISA was statistically significant: [x2(1)=5.273;p<0.021, R2 Negelkerke=0.014]. Risk for COMISA presented itself as a significant predictor for CVD (OR=1.672; 95% CI=1.079–2.592). Conclusion There was an increased frequency of associated comorbidities such as CVD, systemic arterial hypertension, and diabetes, according to the mild, moderate, or high risk. These findings highlight the need for a cardiometabolic evaluation in patients with this comorbid condition which may impact prognosis and therapeutic success. Support (if any):

Download Full-text