scholarly journals Use of Kv1.3 channel blockers for the prevention of restenosis in human vessels: Mechanisms and outcomes in diabetic patients

2020 ◽  
Author(s):  
Marycarmen Arévalo Martínez
Keyword(s):  
Diabetic Patients ◽  
Channel Blockers ◽  
Kv1.3 Channel

Antihypertensive Drugs and Diabetic Retinopathy in Patients with Type 2 Diabetes

2015 ◽  
Vol 235 (2) ◽  
pp. 87-96
Author(s):  
Jen-Chieh Lin ◽  
Mei-Shu Lai
Keyword(s):  
Diabetic Retinopathy ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Incidence Rates ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Type 2 Diabetic Patients ◽  
Converting Enzyme Inhibitors ◽  
Type 2 Diabetic

Objective: To evaluate the association between the development of sight-threatening diabetic retinopathy (STDR) and antihypertensive drugs (AHDs) use among type 2 diabetic patients with concomitant hypertension. Methods: Type 2 diabetic patients aged 20-100 years who had at least one prescription for AHDs between 2000 and 2011 were identified from the Longitudinal Health Insurance Database (LHID) 2005. The incidence rates of STDR were followed and Cox proportional hazard models were used to analyze the risk associated with AHDs. Results: Users of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) were associated with a significantly higher risk than users of calcium channel blockers (CCBs), independent of baseline characteristics. After adjusting for time-varying use of concomitant medications for propensity score-matched or -unmatched cohorts, the results showed that patients receiving ACEIs/ARBs and CCBs were associated with a significantly greater risk compared with β-blocker users. Conclusions: Our study did not support a superiority of ACEIs/ARBs and CCBs over β-blockers for lowering the progression of diabetic retinopathy.

scholarly journals Control of blood pressure and cardiovascular outcomes in type 2 diabetes

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 304-323 ◽  
Author(s):  
Hernando Vargas-Uricoechea ◽  
Manuel Felipe Cáceres-Acosta
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Angiotensin Receptor Blockers ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Patients With Diabetes ◽  
The Impact

AbstractHigh blood pressure in patients with diabetes mellitus results in a significant increase in the risk of cardiovascular events and mortality. The current evidence regarding the impact of intervention on blood pressure levels (in accordance with a specific threshold) is not particularly robust. Blood pressure control is more difficult to achieve in patients with diabetes than in non-diabetic patients, and requires using combination therapy in most patients. Different management guidelines recommend initiating pharmacological therapy with values >140/90 mm/Hg; however, an optimal cut point for this population has not been established. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90mmHg, and that values approaching 130/80mmHg should be recommended. Initial treatment of hypertension in diabetes should include drug classes demonstrated to reduce cardiovascular events; i.e., angiotensin converting-enzyme inhibitors, angiotensin receptor blockers, diuretics, or dihydropyridine calcium channel blockers. The start of therapy must be individualized in accordance with the patient's baseline characteristics, and factors such as associated comorbidities, race, and age, inter alia.

Abstract P297: Comparing Blood Pressure Control in Diabetic verses Non-Diabetic Veterans following Percutaneous Coronary Intervention (PCI)

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Sloane A McGraw ◽  
Michael Scholfield ◽  
Ragu Murthy ◽  
Anupama Shivaraju ◽  
Burhan Mohamedali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Beta Blockers ◽  
Coronary Intervention ◽  
Pressure Control ◽  
Joint National Committee ◽  
National Committee ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
The Mean ◽  
Artery Disease

Background: Blood pressure (BP) control in patients with coronary artery disease (CAD) is beneficial on morbidity and mortality, however the US Joint National Committee VII (JNC-7) also recommends systolic BP (SBP) <130 and diastolic BP (DBP) <80 for diabetic patients because diabetes itself is an additional risk for a cardiac event. This can be attained using beta-blockers (BB), angiotensin agonists (ACE-I/ARB), calcium channel blockers, diuretics and nitrates. Methods: We conducted a retrospective cohort study focusing on attaining JNC-7 guidelines, comparing outcomes between 302 diabetic to the 469 non-diabetic patients; all underwent PCI between September 2004 and September 2008 at the Jesse Brown Veterans Hospital in Chicago, IL. We collected data of BP values and antihypertensive regimens on admission and at six month follow up, and correlated these into percentages of which have attained goals. Results: Among diabetics, mean SBP decreased from 134 to 130mmHg (p = 0.002) and mean DBP decreased from 72 to 70mmHg (p= 0.004); in the non-diabetics, the mean SBP decreased from 133 to 127mmHg (p<0.0001) and the mean DBP decreased from 73 to 71mmHg (p<0.0012). With regards to guidelines, the percent of diabetics at SBP goal increased from 41% to 51% (124 to 154 of 302) (p= 0.006), however the percent at DBP goal was not significant. In non-diabetics, percent at goal for SBP increased 46% to 57% (216 to 267 of 469) (p=0.0002) and for DBP increased 69% to 76% (324 to 356 of 469) (p=0.0131). At 6 months, among diabetics the medication usage increased with BB, 80% to 92% (241 to 278 of 302) (p<0.0001) and nitrates 30% to 36% (91 to 109 of 302) (p=0.035). Similarly, among non-diabetics, use of BB, 68% to 87% (319 to 408 of 469) (p<0.0001) and nitrates 19% to 24% (89 to 113 of 469) (p=0.006) increased, as well as ACE-I/ARB 52% to 71% (244 to 333 if 469) (p<0.0001). Conclusions: There were improvements in BP among both populations at six months post-PCI; both attained JNC-7 SBP goal, but only non-diabetics achieved DBP goal. Medication use increased for both groups with BB and nitrates, but also with ACE-I/ARB for non-diabetics only. This analysis suggests that tighter control needs to be obtained among diabetics, especially because they are a higher risk population than those solely with CAD.

scholarly journals A study on management of hypertension in patients with type 2 diabetes mellitus in tertiary care teaching rural hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 2196
Author(s):  
Shruti Vihang Brahmbhatt ◽  
Bhagya M. Sattigeri
Keyword(s):  
Antihypertensive Agent ◽  
Angiotensin Receptor Blockers ◽  
Tertiary Care ◽  
Antihypertensive Agents ◽  
Blood Pressure Target ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Informed Consent Form ◽  
First Choice ◽  
Hospital Patients

Background: This study was aimed to analyze the drug utilization pattern in the management of hypertension in diabetic patients.Methods: A prospective, observational and non interventional study was conducted in 100 diabetic hypertensive patients admitted in medicine wards at Dhiraj Hospital. Patients who signed informed consent form were only included in the study. All the data were recorded from patients’ case files and analyzed.Results: Of enrolled 100 patients, 69 (69%) were male and 31 (31%) were female and maximum number of the patients (42%) were found in the age group of 51-60 years. Out of 100 admitted patients, 75% patients were treated with single antihypertensive agent, 20% were treated with combination of two antihypertensive agents while only 5% were administered more than two antihypertensive agents. As a single antihypertensive agent, most commonly prescribed was ACE inhibitors (32%), Calcium Channel Blockers (23%), Angiotensin Receptor Blockers (12%) and β1 blockers (8%).Conclusions: There was poor awareness among the patients regarding control of hypertension, regular follow up, medication adherence etc. However, two third of diabetic patients had achieved blood pressure target control and ACE inhibitor remained first choice of drug for hypertension in diabetes in this study.

Abstract P049: Race/Ethnic Differences in Patterns of Antihypertensive Medication Uptake and Clinical Outcomes among Hospitalized Diabetic Patients with Hypertension

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Heidi Mochari-Greenberger ◽  
Lori Mosca
Keyword(s):  
Calcium Channel ◽  
Clinical Outcomes ◽  
Ethnic Differences ◽  
Beta Blocker ◽  
Antihypertensive Medication ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Lower Odds ◽  
Race Ethnicity

Background: Hypertension increases the risk of complications in patients with diabetes. Race/ethnic differences in the uptake of antihypertensive medications may contribute to disparities in clinical outcomes, but this has not been formally evaluated. We aimed to assess patterns of antihypertensive medication prescription by race/ethnic group and the association with clinical outcomes among hospitalized diabetic patients with hypertension. Methods: This was a 1 year prospective study of individuals with existing diabetes and hypertension (N=1126, 42% black/Hispanic [minority]; 39% female) that participated in an NHLBI clinical outcomes study of patients admitted to a cardiovascular service. Baseline clinical/medication data and outcomes (rehospitalization/death) were documented by electronic medical record, National Death Index, and standardized mail survey. Logistic regression was used to evaluate associations between race/ethnicity, antihypertensive prescription, and outcomes adjusted for demographics/comorbidities. Results: Overall utilization of antihypertensive medication prior to admission did not differ between minority (92%) vs. white/other (93%) patients; minorities were more likely to report taking calcium channel blockers (OR=1.40;95%CI=1.08-1.81) and less likely to use beta blockers (OR=0.65;95%CI=0.50-0.84) vs. whites/others. Race/ethnic differences in prescription type did not persist at discharge after adjustment for demographics/comorbidities (96% prescribed any antihypertensive medication: 62% ACE inhibitor/ARB, 81% beta blocker, 29% calcium channel blocker, 48% diuretic). A total of 676 (60%) of participants were rehospitalized/dead at 1 year; predictors of rehospitalization/death included minority race/ethnicity, lack of health insurance, renal failure/dialysis, peripheral vascular disease, and heart failure (p<0.05). Prescription of beta blocker (OR=0.60;95%CI=0.43-0.82) was associated with lower odds of rehospitalization/death at 1 year. Race/ethnic minority status remained a significant predictor of death/rehospitalization at 1 year after adjustment demographics, comorbidities and beta blocker prescription at discharge (OR=1.31;95%CI=1.01-1.71). Conclusion: In this study of hospitalized diabetic patients with hypertension, antihypertensive prescription at discharge did not vary by race/ethnicity; beta blocker prescription at discharge was associated with lower odds of rehospitalization/death at 1 year. Higher odds of rehospitalization/death among minorities was not explained by measured covariates including type of antihypertension medication.

Abstract 159: Comparing Blood Pressure Control in Diabetic vs Non-Diabetic Veterans following Percutaneous Coronary Intervention

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Dmitry Blumenkrants ◽  
Saifullah M Siddiqui ◽  
Karthik Challa ◽  
Amit Ladani ◽  
Adhir Shroff
Keyword(s):  
Blood Pressure ◽  
Lifestyle Modification ◽  
Beta Blockers ◽  
Coronary Intervention ◽  
Pressure Control ◽  
National Committee ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
The Mean

Background As per the US Joint National Committee VII (JNC-7) recommendations, patients with known underlying coronary artery disease and diabetes should have goal blood pressures (BP) of systolic (SBP) <130 and diastolic (DBP) <80 to decrease morbidity and mortality associated with cardiovascular disease. In addition to lifestyle modification, these goals can be attained by use of multiple classes of drugs including beta-blockers (BB), angiotensin agonists (ACE-I/ARB), calcium channel blockers (CCB), diuretics and nitrates. Methods We conducted a retrospective cohort study focusing on the attainment of the JNC-7 guidelines, comparing outcomes between 415 diabetic to 637 non-diabetic patients undergoing PCI between September 2004 and December 2012 at the Jesse Brown Veterans Administration Hospital in Chicago, IL. Blood pressure (BP) measurements and antihypertensive medications pre and post PCI at 6-month follow-up were documented. Results Among the diabetic population, the mean SBP decreased from 136 to 131 mmHg (p < 0.0001) and mean DBP decreased from 73 to 70 mmHg (p < 0.0001). In the non-diabetics, the mean SBP decreased from 133 to 127 mmHg (p < 0.0001) and the mean DBP decreased from 74 to 71 mmHg (p < 0.0001). With regards to JNC-7 guidelines, the percent of diabetics at SBP goal increased from 42% to 49% (p = 0.047) and percent at DBP goal increased from 74% to 82% (p = 0.008). In non-diabetics, percent at goal for SBP increased from 46% to 57% (p < 0.0001) and percent at DBP goal increased from 68% to 76% (p = 0.003). Among diabetics, there was a statistically significant (p <0.0001) increase in use of BB from 77% to 90%. In non-diabetics, there was a statistically significant (p <0.0001) increase in use of BB from 64% to 86% and ACE-I/ARB from 51% to 70%. Conclusions In both groups (diabetics and non-diabetics) undergoing PCI, both systolic and diastolic blood pressure improved with more patients achieving JNC-7 targets. Among diabetics, there was a significant increase in utilization of BB. Among non-diabetics, there was a significant increase in utilization of BB and ACE-I/ARB.

Abstract 137: Comparing Blood Pressure Control in Diabetic Versis Nondiabetic Veterans Following Percutaneous Coronary Intervention

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Karthik Challa ◽  
Amit Ladani ◽  
Sloane McGraw ◽  
Anupama Shivaraju ◽  
Adhir Shroff
Keyword(s):  
Lifestyle Modification ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Coronary Intervention ◽  
National Committee ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors ◽  
The Mean

Background: As per the US Joint National Committee VII (JNC-7) recommendations, patients with known underlying coronary artery disease and diabetes should have goal blood pressures (BP) of systolic (SBP) <130 and diastolic (DBP) <80 to decrease morbidity and mortality associated with cardiovascular disease. In addition to lifestyle modification, these goals can be attained by use of multiple classes of drugs including beta-blockers (BB), angiotensin-converting-enzyme inhibitors/angiotensin receptor blockers (ACE-I/ARB), calcium channel blockers (CCB), diuretics and nitrates. Methods: We conducted a retrospective cohort study focusing on the attainment of the JNC-7 guidelines, comparing outcomes between 355 diabetic to 580 non-diabetic patients undergoing PCI between September 2004 and January 2011 at the Jesse Brown Veterans Affairs Hospital in Chicago, IL. BP measurements and antihypertensive medications pre and post PCI at 6-month follow-up were documented. Results: Among the diabetic population, the mean SBP decreased from 136 to 131 mmHg (p = 0.0007) and mean DBP decreased from 73 to 70 mmHg (p = 0.0005). In the non-diabetics, the mean SBP decreased from 133 to 127 mmHg (p < 0.0001) and the mean DBP decreased from 73 to 70 mmHg (p < 0.0001). With regards to JNC-7 guidelines, the percent of diabetics at SBP goal increased from 39% to 49% (p = 0.0053) and percent at DBP goal increased from 73% to 82% (p = 0.0098). In non-diabetics, percent at goal for SBP increased from 45% to 57% (p < 0.0001) and percent at DBP goal increased from 68% to 76% (p = 0.0009). Among diabetics, there was a statistically significant (p <0.0001) increase in use of BB from 79% to 92%. In non-diabetics, there was a statistically significant (p <0.0001) increase in use of BB from 66% to 87% and ACE-I/ARB from 51% to 70%. Conclusions: In both groups undergoing PCI, SBP and DBP improved with more patients achieving JNC-7 targets. Among diabetics, there was a significant increase in utilization of BB. Among non-diabetics, there was a significant increase in utilization of BB and ACE-I/ARB.

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