scholarly journals Efficacy and safety of azilsartan medoxomil in various doses in patients with metabolic disorders

2021 ◽  
Vol 18 (3) ◽  
pp. 130-139
Author(s):  
Nikita B. Perepech ◽  
Irina E. Chazova ◽  
Juliya V. Zhernakova
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Metabolic Disorders ◽  
Antihypertensive Drugs ◽  
Response To Therapy ◽  
Moderate Intensity ◽  
Angiotensin Ii Receptor Blocker ◽  
Efficacy And Safety ◽  
Azilsartan Medoxomil ◽  
Overweight Or Obesity

Background. Obesity is an independent risk factor of the cardiovascular complications in patients with arterial hypertension (HTN). It can directly contribute to an increase in blood pressure (BP). Thus, the treatment of patients with HTN and obesity becomes a complex clinical problem, which requires new highly effective antihypertensive drugs. Aim. To assess the effectiveness and safety of novel angiotensin II receptor blocker azilsartan medoxomil (AZL-M) as monotherapy and in free combinations with diuretics and/or calcium antagonists in obese or overweight patients with HTN in real clinical practice. Materials and methods. An international multicenter observational non-interventional prospective study of the efficacy and safety of AZL-M in patients with hypertension and overweight or obesity was performed in the Russian Federation and the Republic of Kazakhstan. Patients took the drug for 6 months in accordance with the approved local instructions for use. All examinations were performed in accordance with routine clinical practice on the basis of a physicians decision. Results. In patients prescribed AZL-M as monotherapy (without dosage changes during the study) a significant decrease in systolic and diastolic blood pressure (systolic BP and diastolic BP, respectively) was observed (p0.001, compared to baseline); the average decrease in systolic BP and diastolic BP was 30.5012.67 and 14.478.65 mmHg, respectively (n=865). Target BP (140/90 mmHg or 140/85 mmHg in patients with diabetes mellitus) was achieved in 112 (94.12%), 547 (92.24%) and 135 (88.24%) of patients who were prescribed AZL-M at doses of 20, 40, or 80 mg/day, correspondingly. In patients receiving AZL-M in combination with a diuretic or calcium antagonist, the rate of achievement of ad blood pressure targets was 78.887.5% and 81.385.5%, respectively, and the frequency of response to therapy was 68.892.9% and 81.393.9%, respectively. During the entire observation period, 43 adverse events (AEs) were recorded, the most common of which were arterial hypotension (14 cases). All AEs associated with the study drug were of mild or moderate intensity. Conclusion. AEs administered as monotherapy and as part of combination therapy provided a statistically and clinically significant decrease in BP and a high frequency of target BP achievement in patients with HTN and metabolic disorders associated with overweight or obesity. Given the high efficacy and good tolerance of the drug, AEs can be considered as the drug of choice for the treatment of HTN in patients with overweight or obesity.

scholarly journals Clinical Practice Patterns of Hypertensive Disease in Pregnancy among Korean Obstetricians

2021 ◽  
Vol 25 (3) ◽  
pp. 221-229
Author(s):  
Tae Gyu Ahn ◽  
Yeon Hee Kim ◽  
Yun Sook Kim ◽  
Jae Eun Shin ◽  
Young-Lim Oh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Practice Patterns ◽  
Antihypertensive Drugs ◽  
Antihypertensive Agents ◽  
Delivery Method ◽  
Hypertensive Disease ◽  
Clinical Practice Patterns ◽  
Elevated Liver Enzymes ◽  
Prophylactic Aspirin

Purpose: The purpose of this study was to investigate the clinical practice patterns of Korean obstetricians and gynecologists the diagnosis and management of hypertensive disease in pregnant women. Methods: From April 2015 to October 2015, questionnaire was distributed via email to obstetricians who were members of the Society for Maternal and Fetal Medicine. The survey consisted of 37 questions in 6 categories. Responses to the questions on the management of hypertensive disorders of pregnancy, from diagnosis to treatment, were evaluated. Results: A total of 93 obstetricians and gynecologists responded to the survey. High blood pressure was allocated the highest priority as an index mainly used when deciding to hospitalize patients with hypertensive disease during pregnancy, followed by pregnancy symptoms, proteinuria, and blood test results. Calcium channel blocker (CCB) for oral administration and hydralazine for injection were preferred as antihypertensive drugs mainly used to control severe hypertension. Regarding the delivery method for hypertensive disease during pregnancy, in cases of preeclampsia, 63% of the respondents chose the delivery method according to the cervical status, and in cases of hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome and eclampsia, which increased in severity, 52% and 31% responded that the delivery method was determined according to the cervical status, respectively. In cases of mild preeclampsia, the 70% of respondents preferred 37–38 weeks of gestation for the delivery time. Regarding the use of aspirin in patient with hypertension during pregnancy, 52% of the respondents occasionally administered aspirin, and in patients with a history of hypertensive disease during pregnancy, only 43% were administered prophylactic aspirin. Conclusion: Domestic obstetricians regarded blood pressure as the most meaningful factor when treating women with hypertension during pregnancy and considered blood pressure control as important. The preferred antihypertensive agents were oral CCB and hydralazine injections, and the choice of delivery method was determined according to the condition of the cervix and severity of the disease. Even in women with high risk factors for preeclampsia, prophylactic aspirin was administered in as low as 50%, of patients, possibly may due to the absence of domestic guidelines for aspirin use during pregnancy. Korean guidelines for prophylactic aspirin administration during pregnancy is needed based on additional research on the efficacy of aspirin for domestic women in the future.

scholarly journals Fixed-Dose Triple Combination of Antihypertensive Drugs Improves Blood Pressure Control: From Clinical Trials to Clinical Practice

2017 ◽  
Vol 34 (4) ◽  
pp. 975-985 ◽  
Author(s):  
Alberto Mazza ◽  
Salvatore Lenti ◽  
Laura Schiavon ◽  
Antonella Paola Sacco ◽  
Fabio Dell’Avvocata ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Blood Pressure Control ◽  
Antihypertensive Drugs ◽  
Pressure Control ◽  
Fixed Dose ◽  
Triple Combination

scholarly journals Evaluation of the efficacy and safety of injectable glycosaminoglycan-peptide complex (GPC) in patients with osteoarthritis: a multicenter observational study GLADIOLUS (GPC in the treatment of osteoarthritis: a follow-up study of pain relief and local symptom reduction)

2020 ◽  
Vol 14 (2) ◽  
pp. 76-83
Author(s):  
L. I. Alekseeva ◽  
A. E. Karateev ◽  
E. Yu. Pogozheva ◽  
V. N. Amirdzanova ◽  
E. S. Filatova ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Rating Scale ◽  
Response To Therapy ◽  
Efficacy And Safety ◽  
Functional Disorders ◽  
Peptide Complex ◽  
Number Of Patients ◽  
Pain At Rest ◽  
Real Clinical Practice

Glycosaminoglycan-peptide complex (GPC) is a popular injectable extended-release symptomatic agent (ERSA) in Russia for the treatment of osteoarthritis (OA). To date, no large-scale studies of GPC used in real clinical practice have been conducted in our country.Objective: to evaluate the efficacy and safety of GPC in the treatment of OA in real clinical practice.Patients and methods. A multicenter observational non-interventional study was performed to evaluate the efficacy of GPC (Rumalon® , a cycle of intramuscular injections thrice weekly; a total of 25 injections). A study group consisted of 2,955 patients (75.4% female) aged 61.4±11.8 years) with knee and hip OA, and generalized OA (GOA) with the previous inefficacy of oral ERSAs, moderate/severe pain, and the need for regular use of nonsteroidal anti-inflammatory drugs (NSAIDs). 414 (14%) patients received a GPC and diacerein combination 100 mg/day. The investigators assessed the dynamics of pain during movement and at rest, functional disorders (on a numeric rating scale (NRS) of 0–10), as well as the need for NSAIDs at 12 weeks after starting the GPC cycle.Results and discussion. 98.5% of the patients completed their GPC treatment cycle. The therapy decreased the intensity of pain at rest from 4 [3; 5] to 1 [0; 2] and during movement from 6 [5; 7] to 2 [1; 3] and reduced the severity of functional disorders from 5 [4; 6] to 1 [0; 3]. The number of patients with a good response to therapy (a≥50% decrease in symptom severity) for pain at rest and during movement was 55.6 and 53.5%, respectively; and for functional disorders was 50.8%. 68.1% of patients stopped taking NSAIDs. The GPC and diacerein combination was more effective than GPC monotherapy: the number of patients with a ≥50% decrease in movement pain was 62.8 and 54.3%, respectively (p <0.001). GPC was well tolerated. During treatment, there were skin allergic reactions (0.3%), moderate injection-site pain (0.37%), and adverse reactions (ARs) related to the gastrointestinal tract (8%) and cardiovascular system (6%) (which were likely to be caused by NSAIDs). There were no serious ARs that were life-threatening and required hospitalization.Conclusion. GPC allows successful control of the main symptoms of knee and hip OA and GOA, by reducing pain, and those of functional disorders, and the need for NSAIDs. The GPC and diacerein combination is more effective than GPC monotherapy. GPC therapy is well tolerated and very rarely causes ARs.

scholarly journals SAFETY OF THE COMBINED EMERGENCY ANTIHYPERTENSIVE THERAPY

2021 ◽  
Vol 22 (1) ◽  
pp. 32-39
Author(s):  
О. V. Grishsin
Keyword(s):  
Blood Pressure ◽  
Medical Care ◽  
Therapeutic Effect ◽  
Antihypertensive Therapy ◽  
Antihypertensive Drugs ◽  
Efficacy And Safety ◽  
Emergency Medical Care ◽  
Emergency Therapy ◽  
Emergency Medical ◽  
Objective Control

In 91 patients with increased blood pressure, the efficacy and safety of three combinations of antihypertensive drugs was clarified. It was proved that the use of hourly monitoring of changes in blood pressure immediately after the provision of emergency therapy with the help of sublingual use of combinations of antihypertensive drugs allows for objective control of the time of onset and duration of the preservation of the therapeutic effect and to assess the likelihood and severity of repeated increase and excessive decrease in blood pressure. It has been shown that combinations of antihypertensive drugs: captopril with furosemide, moxonidine with furosemide and moxonidine with nifedipine are not only highly effective, but also safe, and therefore can be used by a doctor or paramedic of emergency medical care to provide emergency therapy, even in elderly and senile patients with comorbid pathology. 

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

2014 ◽  
Vol 21 (4) ◽  
pp. 18-21
Author(s):  
V. N. Marchenko ◽  
L. A. Noskin ◽  
V. V. Pivovarov ◽  
G. K. Zaytsev
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Stress Test ◽  
Pressure Control ◽  
Diagnostic Value ◽  
Moderate Intensity ◽  
Stress Tests ◽  
Response To Stress ◽  
Increasing Risk ◽  
Intensity Stress

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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