scholarly journals Efficacy, Safety and Tolerability of High dose Valsartan Hydrochloride in Essential Hypertension

2013 ◽  
Vol 5 (2) ◽  
pp. 182-189
Author(s):  
MA Zaman

Background: Studies across the world have demonstrated the efficacy of valsartan in lowering blood pressure in a variety of patient populations, several of them investigated higher doses of the drug. This study focuses on revealing safety and efficacy of valsartan at higher doses in Bangladeshi population. Current study is planned to evaluate the efficacy, safety and tolerability of daily dose of Valsartan 160 or 320 mg in the treatment of essential hypertension. Method: This is a multi-center, open-label, observational, non-comparative, clinical decision based titration, involving about 31 centers in Bangladesh. A total of 334 newly diagnosed adult patients with essential hypertension received valsartan at a dose of 160 mg or 320 mg as deemed necessary by physician were included to allow for an assessment of efficacy, safety and tolerability. The total duration of treatment with valsartan was 16 weeks. Primary parameter for efficacy was percentage responders to valsartan at 16 weeks, reduction in Mean sitting systolic blood pressure (MSSBP) and Mean sitting Diastolic blood pressure MSDBP, control rate (% patients) achieving SBP <140 mmHg and DBP <90 mmHg at end point and Global assessment of efficacy and tolerability to valsartan treatment by the physician and patient. Result: Mean age of the patient was 53.31±8.8 years and 56.5% were male. A clearly evident decline is evident in mean Systolic BP and diastolic BP over the study duration. Average reduction of 30.4 ± 17.4 mmHg was seen in systolic BP, 18.4 ± 11.2 mmHg in diastolic BP and 3.5 ± 3.1/ minute in heart rate. The reduction was highly significant in both systolic BP and diastolic BP and heart rate as well (P<.001). At 16 weeks only 3.4% were found to be refractory to the treatment. Global assessment of safety and efficacy was assessed on four point scale, around 30.2% of the physician rated the efficacy as excellent, around 56% rated as very good and 13.8% rated as good. Tolerability of the treatment was also assessed based on the opinion of the patient and physician concerned on four point scale. Around 34.1% of the physician rated the tolerability as excellent, around 49.7% rated as very good and 16.2% rated as good. Conclusion: Sixteen week treatment with valsartan at 160mg daily or 320 mg daily is an effective treatment for patients with essential hypertension. The drug is found to be well tolerated with minimal adverse event during the course of treatment. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14323 Cardiovasc. j. 2013; 5(2): 182-189

Author(s):  
Rubina Yasmin ◽  
AKM Akhtaruzzaman ◽  
Paresh Chandra Sarker ◽  
Neaz Ahmed ◽  
Ranadhir Kumar Kundu ◽  
...  

This prospective clinical study was carried out in the Dept. of Anaesthesia, Analgesia and Intensive Care Medicine, BSMMU, Dhaka, during the period of May 2003 to July 2003. The study was done to emphasize the importance of giving analgesics preemptively instead of waiting for the child to complain of pain and to produce smooth recovery after surgery by decreasing immediate postoperative pain in children by a simple, safe acceptable drug. The children scheduled for tonsillectomy under general anaesthesia were recruited in this study. The analgesic efficiency of rectal paracetamol in two doses, 25 mg/kg bodywt.(Gr-P25) and 50 mg/kg. bodywt. (Gr-P50) were compared with Diclofenac Sodium suppository 1mg/ kg body weight (Gr-D) given half an hour before induction of anaesthesia. Pain scoring was done by TPPPS (Toddler Pre-schooler postoperative pain scale). Heart rate and blood pressure were stable in Gr-P50 and Gr-D. Time of first demand of analgesic was delayed in Gr-P50 and Gr-D. Total paracetamol consumption in 24 hours was less in Gr-P50(181±14.25) and Gr-D (212±25) than Gr-P25(318± 26.39). Total duration of analgesia in Gr- P50 (657±9.94) mins. and in Gr- D(502±10.63) mins. and in Gr-P25(288±23.17) mins. Pre-emptive high dose rectal paracetamol appears to be more effective than diclofenac sodium suppository for postoperative analgesia in children undergoing tonsillectomy. Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.9-16


1979 ◽  
Vol 7 (6) ◽  
pp. 524-527 ◽  
Author(s):  
A F Ebbutt ◽  
R W Elsdon Dew

A multicentre, open study of general practice patients with essential hypertension who were currently being treated with oxprenolol and cyclopenthiazide was undertaken in which the patients were transferred to Trasidrex for 12 weeks. Weight, blood pressure, heart rate and side-effects were assessed pre-trial and at 4-week intervals. A global assessment was also made at the same time intervals. The mean serum potassium remained virtually unchanged after 12 weeks treatment with Trasidrex. Blood pressure control was marginally improved during the study and it is thought possible that better patient compliance might explain this. Trasidrex was tolerated equally as well as the free combination.


Author(s):  
Tamoghna Maiti ◽  
Sonai Mandal ◽  
Ratul Banerjee ◽  
Sourav Chakrabarty ◽  
Amrita Panda

Background: High blood pressure (BP) is one of the significant non-communicable diseases that are of high prevalence in our country. Hypertension (HTN) is responsible cause of 57% of stroke and 24% of coronary heart disease deaths in India. Eight classes of medications are currently used in the treatment of hypertension. Azilsartan medoxomil is a newly added FDA approved drug to the ARB class of antihypertensive agents. azilsartan and chlorthalidone combination is also got the FDA approval. There is limited study in between these two groups regarding efficacy especially in rural Bengal.Methods: A prospective observational study was done in medicine OPD of Bankura Sammilani Medical College for twelve weeks with two groups that are azilsartan (80mg) and fixed dose combination of azilsartan (40mg) plus chlorthalidone (12.5mg) in the age group of 18 to 55years of moderate hypertensive patients. Change of heart rate was assessed as safety parameter.Results: It was found that both the group of drugs are very much effective in lowering blood pressure constantly in respect of both systolic and diastolic BP but azilsartan monotherapy in high dose reduce systolic blood pressure slightly high. Significant change of heart rate was not seen with both the groups.Conclusions: Both the group was effective as well as safe in hypertensive patients.


1973 ◽  
Vol 1 (2) ◽  
pp. 462-464
Author(s):  
Ann Dawson ◽  
Ian Smith ◽  
Brian F Johnson

In seven hypertensives receiving beta-blocker drugs, an additional reduction in standing blood pressure occurred between 60 and 90 minutes after 40 mg phentolamine by mouth. The occurrence of the postural hypotensive effect was delayed in relation to the reported time of peak plasma concentration of unchanged phentolamine. Supine blood pressure and heart rate were unaffected. Phentolamine has no clinically useful anti-hypertensive effect in conjunction with beta-blockers in patients with essential hypertension.


2019 ◽  
Vol 22 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Pablo Nejamkin ◽  
Verónica Cavilla ◽  
María Clausse ◽  
Florencia Landivar ◽  
Augusto M Lorenzutti ◽  
...  

Objectives The aim of this study was to describe the sedative and some physiological effects of tiletamine–zolazepam following buccal administration (BA) in cats. Methods Seven healthy spayed European shorthair cats (three males, four females) were studied twice in this randomized, blinded, crossover study. Each cat received two doses of tiletamine–zolazepam by BA: the low-dose (LD) group consisted of 5 mg/kg of each drug, and the high-dose (HD) group consisted of 7.5 mg/kg of each. Baseline systolic blood pressure (SAP), heart rate (HR), respiratory rate (RR) and a sedation score were recorded prior to administration of each treatment. The same variables plus the percentage of hemoglobin saturated with oxygen as measured by pulse oximetry (SpO2) were recorded at predefined intervals for the next 2 h. Results All cats completed the study. No retching or vomiting were observed. Hypersalivation was observed in 0/7 and 3/7 for LD and HD groups, respectively ( P = 0.2). There were significant changes in scores over time for posture, response to clippers and response to manual restraint for both groups, without differences between groups. RR, HR and SAP changed significantly over time. SAP and RR were significantly lower for the HD than for the LD group. No values for hemoglobin saturation <95% were observed. Conclusions and relevance BA of tiletamine–zolazepam at the doses studied here is a simple and effective method for chemical restraint in cats, where the LD group had a lower impact on SAP and RR than the HD group.


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