scholarly journals Drug-induced arterial hypertension

2019 ◽  
Vol 16 (2) ◽  
pp. 32-41
Author(s):  
Olga D Ostroumova ◽  
Mariia I Kulikova
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Antihypertensive Drugs ◽  
Smooth Muscles ◽  
Home Monitoring ◽  
New Drugs ◽  
Uncontrolled Hypertension ◽  
Drug Induced ◽  
Subsequent Increase ◽  
Induced Hypertension

This review is devoted to the problem of drug-induced hypertension (H). It summarizes the literature data on drugs and substances that can increase blood pressure, discusses the mechanisms of their hypertensive action. Many classes of drugs such as steroids, nonsteroidal anti-inflammatory drugs, sympathomimetics, immunosuppressants, oral contraceptives, antidepressants, erythropoietin, etc. can cause episodic or persistent increase in blood pressure, cause uncontrolled hypertension, reduce the effectiveness of antihypertensive drugs. The development of drug-induced hypertension is realized through a number of pathophysiological mechanisms: sodium retention with subsequent increase in the volume of circulating blood, activation of the sympathetic nervous system, direct effect on the smooth muscles of arterioles, there are other, not fully studied mechanisms. Drug-induced H may also be the result of pharmacokinetic or pharmacodynamic drug interactions. To suspect the presence of drug-induced hypertension, in the first place, should be in persons with newly diagnosed hypertension, as well as in patients who previously had a well-controlled hypertension (stable target blood pressure - BP levels) when they have episodes of unexplained increase in BP without a clear relationship with physical or psycho-emotional stress. It is very important to have a properly collected history with a focus on a thorough assessment of the medicines taken by the patient, especially newly prescribed, as well as those purchased at the pharmacy independently, including over-the-counter, this will avoid unnecessary and/or expensive studies and unnecessary prescriptions of additional antihypertensive drugs. The article presents these measures for the prevention and correction of drug-induced H. The appointment of new drugs by a doctor to patients receiving antihypertensive therapy should necessarily take into account their impact on the risk of drug-induced hypertension. Prescribing drugs that cause an increase in BP levels should either be avoided or, if alternative treatment regimens are not possible, strict control of the patient's BP level (including the method of home monitoring of BP) and, if necessary, the correction of antihypertensive therapy. When canceling a drug that causes drug-induced hypertension, BP returns to its original level, which is proof of the iatrogenic cause of hypertension.

Arterial hypertension in ophthalmic surgical patients

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.

Influence of melatonin on blood pressure indicators with different severity of desynchronosis

2020 ◽  
pp. 30-40
Author(s):  
M. G. Melnik
Keyword(s):  
Blood Pressure ◽  
Circadian Rhythms ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Home Monitoring ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Pronounced Decrease ◽  
The Third ◽  
Pressure Indicators

Purpose. To study the dynamics of blood pressure (BP) indicators under the influence of exogenously administered melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) with various manifestations of desynchronosis of circadian BP rhythms (arterial hypertension – AH, high normal blood pressure) to determine the scheme of their effective compensation. Material and methods. The study included 101 patients with desynchronosis of circadian rhythms of blood pressure – 52 patients with hypertension, constituting the first and second groups, and 49 individuals with high normal blood pressure, representing the third and fourth groups. Patients of the second and fourth groups received conservative therapy, patients of the first and third groups combined it with melatonin. All patients underwent measurements of office blood pressure, home monitoring of blood pressure (ABPM), electrocardiography, 24-hour blood pressure monitoring (ABPM). Results and discussion. In patients of the first and third groups, compared with the traditional treatment groups, by the end of the observation period, a significantly (p < 0.05) decrease in office systolic blood pressure (SBP) / diastolic blood pressure (DBP) was established: in the first group compared with the second – 1.11 / 1.13 times, in the third group compared to the fourth – 1.43 / 1.58 times; significantly more (p < 0.05) pronounced decrease in SBP / DBP during DMAD – by 1.08 / 1.17 and 1.58 / 1.62 times, respectively, Significantly (p < 0.05) more pronounced decrease in average daily, average daily and average nighttime SBP / DBP during ABPM – by 1.13 / 1.20, 1.11 / 1.20, 1.23 / 1.25 and 1.47 / 1.31, 1.42 / 1.19, 1.54 / 1.41 times, respectively; reliably (p < 0.05) more frequent registration of the dipper rhythm type SBP / DBP – 1.6 / 1.4 and 1.6 / 1.4 times, respectively. In addition, the dynamics of patients in the first and third groups showed a significant (p < 0.05) decrease in the mean daily and mean nighttime SBP / DBP variability (SBP in the first group by 27.3 and 41.3 %, respectively; DBP in the first group by 20.1 and 26.3 %, respectively; SBP in the third group by 13.5 and 25.2 %, respectively; DBP in the third group by 12.2 and 28.2 %, respectively). Conclusions. With various manifestations of desynchronosis of circadian rhythms of blood pressure (AH, high normal blood pressure), the prescription of melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) at a dose of 3 mg per day 30–40 minutes before bedtime for a month against the background of non-drug therapy and antihypertensive drugs led to a significantly more effective decrease in blood pressure at its office measurement, DMAD, ABPM with an improvement in the circadian rhythm of blood pressure and normalization of blood pressure variability.

scholarly journals A Blood Pressure Lowering Effect Only through Complex Korean Medical Treatment, without Antihypertensive Drugs, for Patients with Stress Induced Hypertension - A Case Report

2021 ◽  
Vol 42 (5) ◽  
pp. 808-819
Author(s):  
Ji-hyun Lee ◽  
Min-yeong Roh ◽  
Seok-yeong Yoon ◽  
Hyung-sun Jun ◽  
Yang-hee Han ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Antihypertensive Drugs ◽  
Blood Pressure Lowering Effect ◽  
Hypertensive Patients ◽  
Pittsburg Sleep Quality Index ◽  
Induced Hypertension ◽  
Pressure Lowering ◽  
Pressure Symptom

Objectives: This study considered the effectiveness of integrative Korean medical treatment for stress-induced hypertensive patients without the use of conventional medication.Methods: A 62-year-old female with stress-induced hypertension (HTN) was hospitalized for 33 days. Her pattern identification was ascendant hyperactivity of liver yang (Ganyangsanghang)-type HTN. Herbal medicine and acupuncture were used for the treatment: Cheonggansoyo-san for 33 days and Chunwangbosim-dan for 15 days, together with acupuncture for 20 minutes twice a day. Blood pressure was checked daily during hospitalization with a digital sphygmomanometer in the brachial artery.Results: After 33 days of treatment, blood pressure decreased. The Handicap Inventory (DHI) scale and Pittsburg Sleep Quality Index (PSQI) scores both decreased. The patient also reported fewer complaints. A five-month follow-up after discharge, with no further treatment, confirmed stable blood pressure. Symptom improvements continued with no significant side effects.Conclusions: This study indicates that Korean medical treatment is effective for stress-induced hypertensive patients.

scholarly journals Emerging Drug Classes and Their Potential Use in Hypertension

Hypertension ◽  
2019 ◽  
Vol 74 (5) ◽  
pp. 1075-1083 ◽  
Author(s):  
Michel Azizi ◽  
Patrick Rossignol ◽  
Jean-Sébastien Hulot
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Generic Drugs ◽  
Antihypertensive Agents ◽  
Uncontrolled Hypertension ◽  
Blood Pressure Lowering ◽  
Receptor Antagonists ◽  
Drug Classes ◽  
Pressure Lowering ◽  
Potential Use

Despite the availability of multiple antihypertensive drugs targeting the different pathways implicated in its pathophysiology, hypertension remains poorly controlled worldwide, and its prevalence is increasing because of the aging of the population and the obesity epidemic. Although nonadherence to treatment contributes to uncontrolled hypertension, it is likely that not all the pathophysiological mechanisms are neutralized by the various classes of antihypertensive treatment currently available, and, the counter-regulatory mechanisms triggered by these treatments may decrease their blood pressure–lowering effect. The development of new antihypertensive drugs acting on new targets, with different modes of action, therefore, remains essential, to improve blood pressure control and reduce the residual burden of cardiovascular risks further. However, the difficulties encountered in the conception, development, costs, and delivery to the market of new classes of antihypertensive agents highlights the hurdles that must be overcome to release and to evaluate their long-term safety and efficacy for hypertension only, especially because of the market pressure of cheap generic drugs. New chemical entities with blood pressure–lowering efficacy are thus being developed more for heart failure or diabetic kidney disease, 2 diseases pathophysiologically associated with hypertension. These include dual angiotensin II receptor-neprilysin inhibitors, soluble guanylate cyclase stimulators, nonsteroidal dihydropyridine-based mineralocorticoid receptor antagonists, as well as sodium-glucose cotransporter 2 inhibitors. However, centrally acting aminopeptidase A inhibitors and endothelin receptor antagonists have a dedicated program of development for hypertension. All these emergent drug classes and their potential use in hypertension are reviewed here.

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 Rational pharmacotherapy of hypertension. Urapidil potential

2013 ◽  
Vol 10 (4) ◽  
pp. 38-43
Author(s):  
T E Morozova ◽  
T B Andruschishina ◽  
D G Shmarova
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Effect ◽  
Antihypertensive Drugs ◽  
Combined Therapy ◽  
Evidence Base ◽  
Uncontrolled Hypertension ◽  
5Ht1a Receptor ◽  
Reflex Tachycardia ◽  
The Central Nervous System ◽  
Selection Of

Optimizing pharmacotherapy of arterial hypertension (AH) and varied selection of medicines remains an urgent problem for practitioners. However, despite the large variety of effective antihypertensive drugs, the control of blood pressure levels remains inadequate. Most patients require combined therapy with two or more agents to achieve target blood pressure levels, so the choice of second-line therapy is of particular importance. As adjunctive therapy in patients with uncontrolled hypertension a-blockerscan be used, which, in addition to the antihypertensive effect, have a number of other benefits including improved lipid profile and glucose metabolism, as well as reducing the symptoms of benign prostatic hyperplasia. Urapidil provides a-blocking effect and additionally exhibits the central sympatholytic effect which is mediated by stimulation of serotonin 5HT1A-receptor in the central nervous system. The evidence base suggests that the drug has antihypertensive effect in combination with a favorable metabolic profile, and has a good safety profile as well, and has no disadvantages inherent to a-blockers, in particular, the development of reflex tachycardia.

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 Primary care doctors’ views on self-monitoring of blood pressure and self-titration among patients with uncontrolled hypertension in Spain. The ADAMPA trial focus group study.

BJGP Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. bjgpopen20X101062
Author(s):  
Irene Marco-Moreno ◽  
Patricia Martínez-Ibañez ◽  
Eugenia Avelino-Hidalgo ◽  
Laura Bellot-Pujalte ◽  
Ignacio Barreira-Franch ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Focus Group ◽  
Home Monitoring ◽  
Self Management ◽  
Uncontrolled Hypertension ◽  
Focus Group Study ◽  
Self Monitoring ◽  
Primary Care Doctors ◽  
Role Of Nursing

BackgroundDespite the increased use of blood pressure (BP) monitoring devices at home, the hypertension of more than 50% of European patients remains uncontrolled. Nevertheless, the self-management of BP, through the combination of home monitoring of BP with self-titration, could be anaccessible and effective tool for improving hypertension control in the primary care setting. The ADAMPA study is a trial with participants randomised to BP self-management (BPSM) with self-titration of antihypertensive medication or to usual care, in a population of patients with poorly controlled hypertension.AimTo explore the views and attitudes of primary care doctors participating in the ADAMPA trial regarding BPSM with self-titration.Design & settingA focus group study took place with primary care doctors participating in the ADAMPA trial, which was carried out in one health district of the Valencia Health System in Spain.MethodNine primary care doctors participating in the ADAMPA trial were included in the focus group. Three researchers (two using manual methods and one using NVivo software) independently conducted a content analysis, reading the transcripts, identifying, classifying, and coding the contents, and developing a conceptual scheme based on these topics.ResultsParticipating doctors clearly support home BP monitoring (HBPM), the setting of individual BP targets, and incorporating patient readings into decision-making. They consider it an investment to educate patients for medication self-adjustment and estimate that an important proportion of their patients are potential candidates for hypertension self-management with medication self-titration. However, they show important divergences regarding the role of nursing in BP control.ConclusionPrimary care doctors participating in the ADAMPA trial feel comfortable with BPSM with self-titration, and would consider extending its use (or the use of some components, such as BP target setting) to other patients with hypertension outside the trial.

scholarly journals Renal arteries denervation: from the treatment of resistant hypertension to the treatment of atrial fibrillation

2021 ◽  
Vol 23 (Supplement_E) ◽  
pp. E177-E183
Author(s):  
Francesco Versaci ◽  
Sebastiano Sciarretta ◽  
Massimiliano Scappaticci ◽  
Riccardo Di Pietro ◽  
Simone Calcagno ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Antihypertensive Drugs ◽  
Reduce Blood Pressure ◽  
Antiarrhythmic Effect ◽  
Uncontrolled Hypertension ◽  
Study Results ◽  
Opening Up

Abstract Renal denervation (RDN) is a therapeutic strategy for patients with uncontrolled arterial hypertension characterized by considerable fluctuations during its progression. After initial strong enthusiasm, the procedure came to an abrupt halt following the publication of the Symplicity HTN-3 study results. The results of recently published studies highlight the reduction in blood pressure values after RDN and justify the inclusion in the Guidelines of new recommendations for the use of RDN in clinical practice, in selected patients. Additionally, RDN findings are summarized in view of other potential indications such as atrial fibrillation. Six prospective, randomized studies are presented that evaluated RDN as an adjunct therapy to pulmonary vein isolation for the treatment of atrial fibrillation. In five studies, patients had uncontrolled hypertension despite therapy with three antihypertensive drugs. The analysis of these studies showed that RDN reduced the recurrence of atrial fibrillation (AF) by 57% compared to patients with pulmonary vein isolation (PVI) only. Modulation of the autonomic nervous system by RDN has been shown not only to reduce blood pressure but also to have an antiarrhythmic effect in symptomatic AF patients when the strategy is combined with PVI, thus opening up new therapeutic scenarios.

Sign in / Sign up

Export Citation Format

Share Document