scholarly journals Evaluation of Antihypertensive Treatment Inoutpatients at Batang Beruh Helath Centre Sidikalang

2021 ◽  
Vol 2 (2) ◽  
pp. 23-29
Author(s):  
Indra Ginting ◽  
Asriwati Asriwati ◽  
Mayang Sari
Keyword(s):  
Antihypertensive Drugs ◽  
Scientific Evidence ◽  
Health Centre ◽  
National Committee ◽  
National Formulary ◽  
Angiotensin Ii Receptor ◽  
Risk Of Death ◽  
Quantitative Descriptive ◽  
Antihypertensive Treatments ◽  
Antagonist Group

Hypertension is a cardiovascular disease with a high prevalence and risk of death in developed and developing countries with blood pressure reach ≥140/90 mmHg. Hypertension is the 3rd cause of death after stroke and tuberculosis, reached 6.7% of the population of deaths at all ages in Indonesia. Results of Basic Health Research (Riskesdas) Balitbangkes showed that the national prevalence of hypertension reached 31.7%. The National Formulary (Fornas) is a list of drugs compiled based on the latest scientific evidence by the National Committee for the Compilation of the Fornas. Evaluation of the appropriateness of antihypertensive treatments in outpatients at Batang Beruh Health Centre Sidikalang seen from the National Formulary was the aim of this study. This research is non-experimental, quantitative descriptive was conducted in May - July 2019 at Batang Beruh Health Centre Jl. Pahlawan Sidikalang, Sidikalang District of Dairi, North Sumatra. The population was 231 hypertensive patients using antihypertensive drugs, with sampling using the Slovin formula, amounted to 70 respondents. Based on the research conducted, in the Calcium Antagonist group, the names of the antihypertensive drugs used are Amlodipine and Nifedipine. Meanwhile, in the ACEIs group, the drug used is Captopril. Whereas in the Angiotensin II receptor antagonist group, the drugs used are Micardis, Valsartan and Candesartan. Whereas in the Diuretic group, the antibiotic used is Furosemide.

scholarly journals Hypertension after Kidney Transplantation: Clinical Significance and Therapeutical Aspects

2019 ◽  
Vol 7 (7) ◽  
pp. 1241-1245 ◽  
Author(s):  
Galina Severova-Andreevska ◽  
Ilina Danilovska ◽  
Aleksandar Sikole ◽  
Zivko Popov ◽  
Ninoslav Ivanovski
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Calcineurin Inhibitors ◽  
National Committee ◽  
Channel Blockers ◽  
Angiotensin Ii Receptor ◽  
Post Transplant ◽  
Cardiovascular Morbidity And Mortality ◽  
Receptor Blockers ◽  
Kdigo Guidelines

Most of the kidney transplanted patients develop arterial hypertension after renal transplantation. Together with very well-known and usual risk factors, post-transplant hypertension contributes to the whole cardiovascular morbidity and mortality in the kidney transplant population. The reasons of post-transplant hypertension are factors related to donors and recipients, immunosuppressive therapy like Calcineurin Inhibitors (CNI) and surgery procedures (stenosis and kinking of the renal artery and ureteral obstruction). According to Eighth National Committee (JNC 8) recommendations, blood pressure > 140/90 mmHg is considered as hypertension. The usual antihypertensive drugs used for the control of hypertension are Calcium channel blockers (CCB), Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin –II receptor blockers (ARB), B- blockers and diuretics. Follow the KDIGO guidelines the target blood pressure < 140/90 mmHg for patients without proteinuria and < 125/75 mmHg in patients with proteinuria is recommended. Better control of post-transplant hypertension improves the long-term graft and patient’s survival.

The Impact of Angiotensin-II Receptor Blockers on Cardiovascular Events in Hypertensive Patients – Evidence from Real-life Databases

2010 ◽  
Vol 6 (3) ◽  
pp. 33
Author(s):  
Robert J Petrella ◽  
Keyword(s):  
Angiotensin Ii ◽  
Antihypertensive Drugs ◽  
Real Life ◽  
Angiotensin Ii Receptor Blockers ◽  
Angiotensin Ii Receptor ◽  
Real World Setting ◽  
Actual Experience ◽  
Receptor Blockers ◽  
Randomised Controlled ◽  
The Impact

It is widely recognised that hypertension is a major risk factor for the development of future cardiovascular (CV) events, which in turn are a major cause of morbidity and mortality. Blood pressure (BP) control with antihypertensive drugs has been shown to reduce the risk of CV events. Angiotensin-II receptor blockers (ARBs) are one such class of antihypertensive drugs and randomised controlled trials (RCTs) have shown ARB-based therapies to have effective BP-lowering properties. However, data obtained under these tightly controlled settings do not necessarily reflect actual experience in clinical practice. Real-life databases may offer alternative information that reflects an uncontrolled real-world setting and complements and expands on the findings of clinical trials. Recent analyses of practice-based real-life databases have shown ARB-based therapies to be associated with better persistence and adherence rates and with superior BP control than non-ARB-based therapies. Analyses of real-life databases also suggest that ARB-based therapies may be associated with a lower risk of CV events than other antihypertensive-drug-based therapies.

scholarly journals Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 534
Author(s):  
Annina S. Vischer ◽  
Gabriela M. Kuster ◽  
Raphael Twerenbold ◽  
Otmar Pfister ◽  
Qian Zhou ◽  
...  
Keyword(s):  
Antihypertensive Treatment ◽  
Antihypertensive Drugs ◽  
Ang Ii ◽  
First Line ◽  
Open Label ◽  
Treatment Start ◽  
Equilibrium Concentrations ◽  
Open Label Trial ◽  
Anti Inflammatory ◽  
Antihypertensive Treatments

(1) Background: Recently, influences of antihypertensive treatment on the renin–angiotensin–aldosterone system (RAAS) has gained attention, regarding a possible influence on inflammatory and anti-inflammatory pathways. We aimed to study the effects of newly initiated antihypertensive drugs on angiotensin (Ang) II and Ang (1–7) as representers of two counter-regulatory axes. (2) Methods: In this randomized, open-label trial investigating RAAS peptides after the initiation of perindopril, olmesartan, amlodipine, or hydrochlorothiazide, Ang II and Ang (1–7) equilibrium concentrations were measured at 8 a.m. and 12 a.m. at baseline and after four weeks of treatment. Eighty patients were randomized (1:1:1:1 fashion). (3) Results: Between the four substances, we found significant differences regarding the concentrations of Ang II (p < 0.0005 for 8 a.m., 12 a.m.) and Ang (1–7) (p = 0.019 for 8 a.m., <0.0005 for 12 a.m.) four weeks after treatment start. Ang II was decreased by perindopril (p = 0.002), and increased by olmesartan (p < 0.0005), amlodipine (p = 0.012), and hydrochlorothiazide (p = 0.001). Ang (1–7) was increased by perindopril and olmesartan (p = 0.008/0.002), but not measurably altered by amlodipine and hydrochlorothiazide (p = 0.317/ 0.109). (4) Conclusion: The initiation of all first line antihypertensive treatments causes early and distinct alterations of equilibrium angiotensin levels. Given the additional AT1R blocking action of olmesartan, RAAS peptides shift upon initiation of perindopril and olmesartan appear to work in favor of the anti-inflammatory axis compared to amlodipine and hydrochlorothiazide.

scholarly journals Blood Pressure Control: Stroke and Stroke Prevention

2005 ◽  
Vol 6 (1_suppl) ◽  
pp. S8-S11
Author(s):  
Hans-Christoph Diener
Keyword(s):  
Blood Pressure ◽  
Stroke Prevention ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Antihypertensive Agents ◽  
Pressure Control ◽  
Angiotensin Receptor ◽  
Risk Of Death ◽  
Pressure Lowering ◽  
Receptor Blockers

Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention. All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention. Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP) increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences. The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

scholarly journals The effect of renin-angiotensin-aldosterone blockers on SARS-CoV-2 infection in adults: a systematic review of studies and meta-analyzes

2021 ◽  
pp. 26-33
Author(s):  
М. V. Leonova
Keyword(s):  
Cohort Studies ◽  
Randomized Clinical Trials ◽  
Ace Inhibitor ◽  
Scientific Evidence ◽  
Renin Angiotensin ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Duration Of Hospitalization ◽  
Severity Of The Disease

The article discusses the role of immune dysregulation of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of COVID-19 infection, the participation of ACE2 for the penetration of the SARS-CoV-2 coronavirus into cells and the possible role of RAAS blockers, which have a direct effect on the pathological activity of the RAAS, in the development of and the severity of the disease. It is noted that the beneficial organoprotective effects of ACE inhibitors and ARBs may protect against SARS-CoV-2 infection, and their withdrawal may lead to clinical decompensation in patients at high risk of cardiovascular risk. Since then, a number of observational cohort studies have been carried out to address the main questions: does the use of an ACE inhibitor or ARB increase the risk of contracting the novel SARS-CoV-2 coronavirus, and whether the use of RAAS blockers is associated with worse outcomes of COVID-19 disease. The article provides an overview of the scientific evidence on the relationship between the use of RASS blockers and COVID-19 infection. Several cohort studies and two meta-analyzes found no association between prior use of an ACE inhibitor/ARB and the risk of COVID-19 infection (RR 0.96–0.99). In studies on the study of clinical and laboratory features of the action of RAAS blockers in COVID-19, a significantly larger number of subpopulations of T-lymphocytes CD3+ and CD8+, lower concentrations of biomarkers (C-reactive protein, ferritin, IL-6, procalcitonin), as well as a lower viral load. In clinical outcomes, with the use of an ACE inhibitor/ARB, there was a lower incidence of severe/critical forms, and a shorter duration of hospitalization. In large cohort studies with >1000 patients, the use of an ACE inhibitor/ARB was not associated with an increase in the risk of death in patients with COVID-19 (RR < 1.0), and some studies showed a 37–67% decrease in RR. Meta-analyzes also confirmed the absence of the effect of RAAS blockers on the risk of mortality, and in the population of patients with hypertension, a significant reduction in the risk of mortality and severe course of COVID-19 was revealed. Most international associations of specialists, as well as the Russian Cardiological Society, are recommended to continue the use of RAAS blockers in patients with cardiovascular diseases and not to be canceled in case of COVID-19 disease. Further randomized clinical trials are needed to generate new evidence.

scholarly journals Effects of Antihypertensive Drugs Use on Risk and Prognosis of Colorectal Cancer: A Meta-Analysis of 37 Observational Studies

2022 ◽  
Vol 12 ◽  
Author(s):  
Yujiao Deng ◽  
Yuxiu Xie ◽  
Meng Wang ◽  
Peng Xu ◽  
Bajin Wei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Progression Free Survival ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Free Survival ◽  
Receptor Blockers

Background: Antihypertensive drugs might play a key role in the risk and poor prognosis of colorectal cancer. However, current epidemiologic evidence remains inconsistent. The aim of this study is to quantify the association between antihypertensive drugs and colorectal cancer.Methods: To identify available studies, we systematically searched electronic databases: PubMed, Web of Science, Embase, Cochrane Library. The risk estimates and their corresponding 95% confidence intervals (CIs) were collected and analyzed by using random-effects models. Heterogeneity test and sensitivity analysis were also performed.Results: Overall, 37 observational studies were included in this analysis (26 studies with cohort design, three studies with nested case-control design, and 8 studies with case-control design). Antihypertensive drugs did not present a significant effect on the risk or overall survival of patients with colorectal cancer [Risk ratio (RR) = 1.00, 95% CI: 0.95–1.04; Hazard ratio (HR) = 0.93, 95% CI: 0.84–1.02]. In the subgroup analysis, diuretics use was significantly associated with a worse overall survival of patients with colorectal cancer (HR = 1.27; 95% CI: 1.14–1.40). However, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers was associated with improved progression-free survival of patients who suffered from colorectal cancer (HR = 0.83; 95% CI: 0.72–0.95).Conclusion: Antihypertensive drug usage did not influence the risk and overall survival of patients with colorectal cancer in general. Further investigation reminded us that diuretics use might reduce the overall survival time in colorectal cancer patients, whereas those who took Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers had a longer progression-free survival.

scholarly journals The Impact of Antihypertensive Drugs on the Number and Risk of Death, Stroke and Myocardial Infarction in the United States

2006 ◽  
Author(s):  
Genia Long ◽  
David Cutler ◽  
Ernst Berndt ◽  
Jimmy Royer ◽  
Andrée-Anne Fournier ◽  
...  
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Antihypertensive Drugs ◽  
The United States ◽  
Risk Of Death ◽  
The Impact

scholarly journals Effects of combination drugs on antihypertensive medication adherence in a real-world setting: a Korean Nationwide Study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029862 ◽  
Author(s):  
Seung Jae Kim ◽  
Oh Deog Kwon ◽  
BeLong Cho ◽  
Seung-Won Oh ◽  
Cheol Min Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Real World ◽  
Antihypertensive Drugs ◽  
Medication Possession Ratio ◽  
The Elderly ◽  
Population Based ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Improve Medication Adherence ◽  
Real World Setting

ObjectivesWe tried to clarify, by using representative national data in a real-world setting, whether single-pill combinations (SPCs) of antihypertensives actually improve medication adherence.DesignA nationwide population-based study.SettingWe used a 2.2% cohort (n=1 048 061) of the total population (n=46 605 433) that was randomly extracted by National Health Insurance of Korea from 2008 to 2013.ParticipantsWe included patients (n=116 677) who were prescribed with the same antihypertensive drugs for at least 1 year and divided them into groups of angiotensin II receptor blocker (ARB)-only, calcium channel blocker (CCB)-only, multiple-pill combinations (MPCs) and SPCs of ARB/CCB.Primary outcome measuresMedication possession ratio (MPR), a frequently used indirect measurement method of medication adherence.ResultsAdjusted MPR was higher in combination therapy (89.7% in SPC, 87.2% in MPC) than monotherapy (81.6% in ARB, 79.7% in CCB), and MPR of SPC (89.7%, 95% CI 89.3 to 90.0) was higher than MPR of MPC (87.2%, 95% CI 86.7 to 87.7) (p<0.05). In subgroup analysis, adherence of SPC and MPC was 92.3% (95% CI 91.5 to 93.0) vs 88.1% (95% CI 87.1 to 89.0) in those aged 65–74 years and 89.3% (95% CI 88.0 to 90.7) vs 84.8% (95% CI 83.3 to 92.0) in those ≥75 years (p<0.05). According to total pill numbers, adherence of SPC and MPC was 90.9% (CI 89.8 to 92.0) vs 85.3% (95% CI 84.1 to 86.5) in seven to eight pills and 91.2% (95% CI 89.3 to 93.1) vs 82.5% (95% CI 80.6 to 84.4) in nine or more (p<0.05). The adherence difference between SPC and MPC started to increase at five to six pills and at age 50–64 years (p<0.05). When analysed according to elderly status, the adherence difference started to increase at three to four pills in the elderly (≥65 years) and at five to six in the non-elderly group (20–64 years) (p<0.05). These differences all widened further with increasing age and the total medications.ConclusionSPC regimens demonstrated higher adherence than MPC, and this tendency is more pronounced with increasing age and the total number of medications.

scholarly journals Effects of Recent Use of Renin-Angiotensin System Inhibitors on Mortality of Patients With Coronavirus Disease 2019

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Seongman Bae ◽  
Ju Hyeon Kim ◽  
Ye-Jee Kim ◽  
Joon Seo Lim ◽  
Sung-Cheol Yun ◽  
...  
Keyword(s):  
Propensity Score ◽  
South Korea ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Renin Angiotensin System ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Diagnostic Code ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Risk Of Death

Abstract Background There is growing concern about the potential harmful effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19) and cardiovascular diseases (CVDs). The aim of this study was to evaluate the association between recent exposure to ACEIs/ARBs and in-hospital mortality in patients with COVID-19. Methods We used data from a nationwide cohort of patients with COVID-19 from the health insurance claims data of South Korea, which were released for research purposes for public health by the Ministry of Health and Welfare of South Korea. Patients with COVID-19 were identified using the relevant diagnostic code. Propensity score matching (1:1) was carried out among patients with CVD according to the type of medication (ACEIs/ARBs vs other), and the risk of death was assessed. Results A total of 4936 patients with COVID-19 were analyzed, of whom 1048 (21.2%) had CVD. Of the 1048 patients with CVD, 864 (82.4%) received at least 1 antihypertensive medication before the diagnosis of COVID-19, including 359 (41.6%) who received ACEIs/ARBs and 505 (58.4%) who received drugs other than ACEIs/ARBs. Using the propensity scores for ACEI/ARB use, we matched 305 pairs of patients receiving ACEIs/ARBs and patients receiving other drugs. Recent use of ACEIs/ARBs was not significantly associated with in-hospital mortality in unadjusted analysis (odds ratio [OR], 0.62; 95% CI, 0.33–1.14) or propensity score matching analysis (OR, 1.00; 95% CI, 0.46–2.16). Conclusions In patients with COVID-19 and underlying CVDs, the recent use of ACEIs/ARBs was not significantly associated with in-hospital mortality. These findings do not support stopping or modifying ACEIs/ARBs in patients during the current COVID-19 pandemic.

scholarly journals The abilities of losartan in angioprotection in hypertensive patients with hyperuricemia

2012 ◽  
Vol 9 (4) ◽  
pp. 16-21
Author(s):  
S V Nedogoda ◽  
A A Ledyaeva ◽  
E V Chumachok ◽  
V V Tsoma ◽  
A S Salasyuk
Keyword(s):  
Uric Acid ◽  
Arterial Hypertension ◽  
Conventional Therapy ◽  
Antihypertensive Drugs ◽  
Vascular Wall ◽  
Antihypertensive Activity ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Open Label ◽  
Losartan Group

Aim: to evaluate the ability of the angiotensin II receptor blocker losartan (Lorista, KPKA) to reduce the level of uric acid and to correct the parameters of vascular wall elasticity in patients with arterial hypertension, hyperuricemia, and gout. Subjects and methods. An open-label, randomized, controlled, parallel group comparative (losartan versus conventional therapy with other antihypertensive drugs for 24 weeks) trial enrolled 40 patients with arterial hypertension, hyperuricemia, and gout. Results. No significant differences were found between the groups of losartan (Lorista) and conventional therapy with other antihypertensive drugs groups in their antihypertensive activity. At the same time the losartan group showed a considerably more decrease in uric acid levels than did the conventional group (34,7% versus 7,8% in the group of therapy with other antihypertensive drugs (p

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