scholarly journals Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older from the American College of Physicians and the American Academy of Family Physicians

2019 ◽  
Vol 66 (2) ◽  
pp. 50-54
Author(s):  
Eric Pinashin ◽  
Craig Stern
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Normal Values ◽  
Family Physicians ◽  
Organ Damage ◽  
Secondary Hypertension ◽  
Endocrine Disorders ◽  
Low Blood Pressure ◽  
Treatment Of Hypertension ◽  
Untreated Hypertension

An elevation in systolic and diastolic blood pressure, known as hypertension, is characterized as a condition where blood pressure values are above the normal values, ranging around 120/80mmHg for most adults. There are two forms of hypertension, primary hypertension and secondary hypertension. Primary or essential hypertension accounts for 90–95% of patients with hypertension, with its etiology unknown, while secondary hypertension accounts for 5–10% of the population, due to chronic kidney disease, endocrine disorders, or usage of ibuprofen or venlafaxine.(1) If left untreated, hypertension can lead to heart attack, stroke, heart failure, vision problems, kidney damage, and a variety of other problems, depending on which vessels it affects. As seen in Figure 1, either having low or high systolic or diastolic blood pressure can be detrimental to one's health. Having low blood pressure can lead to hypoperfusion of vital organs, whereas elevated blood pressure can lead to end organ damage, stroke, and myriad related instances.

scholarly journals Causes of Resistant Hypertension Detected by a Standardized Algorithm

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Livia Beatriz Santos Limonta ◽  
Letícia dos Santos Valandro ◽  
Flávio Gobis Shiraishi ◽  
Pasqual Barretti ◽  
Roberto Jorge da Silva Franco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Secondary Hypertension ◽  
Control Blood Pressure ◽  
Primary Level ◽  
Standardized Protocol ◽  
Frequent Use ◽  
Drug Classes ◽  
Treatment Of Hypertension ◽  
Secondary Causes

Resistant hypertension (RH) is characterized by blood pressure above 140 × 90 mm Hg, despite the use, in appropriate doses, of three antihypertensive drug classes, including a diuretic, or the need of four classes to control blood pressure. Resistant hypertension patients are under a greater risk of presenting secondary causes of hypertension and may be benefited by therapeutical approach for this diagnosis. However, the RH is currently little studied, and more knowledge of this clinical condition is necessary. In addition, few studies had evaluated this issue in emergent countries. Therefore, we proposed the analysis of specific causes of RH by using a standardized protocol in Brazilian patients diagnosed in a center for the evaluation and treatment of hypertension. The management of these patients was conducted with the application of a preformulated protocol which aimed at the identification of the causes of resistant hypertension in each patient through management standardization. The data obtained suggest that among patients with resistant hypertension there is a higher prevalence of secondary hypertension, than that observed in general hypertensive ones and a higher prevalence of sleep apnea as well. But there are a predominance of obesity, noncompliance with diet, and frequent use of hypertensive drugs. These latter factors are likely approachable at primary level health care, since that detailed anamneses directed to the causes of resistant hypertension are applied.

scholarly journals Enalapril Combined with Hydrochlorothiazide and Indapamide in the Treatment of Hypertension with Heart Failure

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Xueting Sun
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ventricular Remodeling ◽  
Effective Rate ◽  
Control Group ◽  
Observation Group ◽  
Research Subjects ◽  
Treatment Regimens ◽  
Treatment Of Hypertension

Objective: To explore the effect of enalapril combined with hydrochlorothiazide and indapamide on hypertension and heart failure. Methods: 80 patients with hypertension and heart failure admitted to our hospital from January 2019 to January 2020 were selected as the research subjects, and they were divided into two groups with random number table method, 40 cases each. The control group was given conventional treatment regimens, including enalapril and hydrochlorothiazide; the observation group replaced hydrochlorothiazide with indapamide based on the above therapies. The efficacy and systolic blood pressure, diastolic blood pressure and left heart ejection fraction (LVEF) of the two groups were compared. Results: After treatment, the effective rate of the observation group was 92.50% (37/40) higher than that of the control group 75.00% (30/40). The systolic and diastolic blood pressure were lower than those of the control group, and the LVEF was higher than that of the control group. The difference was statistically significant (P<0.05). Conclusion: Enalapril combined with indapamide is effective in the treatment of hypertension with heart failure, which can help lower blood pressure, reduce heart load, increase cardiac output, reverse ventricular remodeling, and delay disease progression.

scholarly journals Application of lercanidipine in the treatment of hypertension

2014 ◽  
Vol 5 (2) ◽  
pp. 46-50
Author(s):  
G. G Shehyan ◽  
A. A Yalymov ◽  
V. S Zadionchenko ◽  
S. I Varentsov
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Clinical Trials ◽  
Calcium Antagonist ◽  
Diastolic Blood Pressure ◽  
Marked Reduction ◽  
Efficacy And Safety ◽  
Good Tolerability ◽  
High Adherence ◽  
Treatment Of Hypertension

The article presents data from clinical trials that have examined the efficacy and safety of modern calcium antagonist (CA) III generation of lercanidipine. The results of studies show that treatment with lercanidipine leads to a marked reduction in systolic and diastolic blood pressure without significant effect on heart rate. Unique pharmacokinetic characteristics of the drug provide its excellent efficacy and safety, good tolerability, convenience, acceptance and high adherence CA data in patients with hypertension. Additional properties of lercanidipine allow us to recommend the use of the CA in comorbidity.

scholarly journals A Meta-Analysis on the Effect and Safety of LCZ696 in the Treatment of Hypertension

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Li Zheng ◽  
Binbin Xia ◽  
Xuqian Zhang ◽  
Yan Zhao
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Angiotensin Receptor Blockers ◽  
Meta Analysis ◽  
Blood Pressure Level ◽  
Evaluation Standard ◽  
Treatment Of Hypertension ◽  
Patient Will ◽  
Receptor Blockers

Objectives. To systematically evaluate the differences in effect and safety of LCZ696 and angiotensin receptor blockers (ARBs) in the treatment of hypertension. Methods. We searched PubMed, Cochrane, Web of Science, and Ovid, collected randomized controlled trials (RCTs) about the effect and safety of LCZ696 and ARBs in hypertensive patients, extracted relevant data and evaluated the quality of the included literature according to the RCT quality evaluation standard recommended by Cochrane Reviewer’s Handbook, using RevMan 5.3, and performed meta-analysis. Results. Eight RCTs studies were included, with a total of 4313 patients. Compared with ARBs, LCZ696 can better reduce systolic blood pressure (msSBP) (WMD −4.29 mmHg; 95% CI: −5.37 to −3.21; P  < 0.001), diastolic blood pressure (msDBP) (WMD −1.87 mmHg; 95% CI:−2.38 to −1.36; P  < 0.01), ambulatory systolic blood pressure (maSBP) (WMD −3.37 mmHg; 95% CI:−4.26 to −2.47; P  < 0.01), and ambulatory diastolic blood pressure (maDBP) (WMD −1.47 mmHg; 95% CI: −1.97 to −0.97; P  < 0.01). In terms of safety, LCZ696 is basically the same as ARBs, but LCZ696 is more likely to cause cough than ARBs (OR = 2.38; 95% CI: 1.27 to 4.47; P  < 0.01). Conclusion. LCZ696 can significantly reduce the blood pressure level of patients with hypertension, but it is necessary to pay attention to whether the patient will experience coughing after taking the drug.

scholarly journals Effect of Relaxation Therapy: Slow Deep Breathing on Decreasing Blood Pressure in Patients with 1st Degree Hypertension

2016 ◽  
Vol 1 (3) ◽  
pp. 95
Author(s):  
Toting Ardhiansyah ◽  
Sukadiono Sukadiono ◽  
Suyatno H S ◽  
Muhammad Anas
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Deep Breathing ◽  
Relaxation Therapy ◽  
Pharmacological Management ◽  
Hypertensive Patients ◽  
Breathing Exercises ◽  
Treatment Of Hypertension ◽  
Post Test ◽  
Level 1

Background: Hypertension is linearly associated with cardiovascular disease morbidity and mortality. Therefore, hypertension must be prevented and treated, and controlled adequately. Early treatment of hypertension is crucial because it can prevent complications in several organs such as the heart, kidneys, and brain. The treatment of hypertension has shifted from pharmacology to non-pharmacology because of the side effects it causes. One of the non-pharmacological management for hypertensive patients is slow deep breathing exercises. The mechanism of slow deep breathing relaxation (slow deep breathing) in the respiratory system is in the form of a state of inspiration and exhalation with a frequency of breaths of 6-10 times per minute, resulting in an increase in a cardiopulmonary stretch.Objective: To determine the effect of relaxation therapy: slow deep breathing on lowering blood pressure in patients with grade 1 hypertension.Method: Pre-experimental Design One Group Pre-Post Test Design.Results: Before being given slow deep breathing relaxation therapy, patients with grade 1 hypertension had an average (mean) systolic and diastolic blood pressure of 152.16 and 93.68 mmHg. After being given slow deep breathing relaxation therapy, patients with grade 1 hypertension have an average (mean) systolic and diastolic blood pressure of 140.42 and 92.74 mmHg.Conclusion: There is a significant effect between Relaxation Therapy: Slow Deep Breathing on Decreasing Blood Pressure in Level 1 Hypertension Patients.

scholarly journals Internal Bleaching of a Non vital Anterior Tooth in Patient with Postural Hypotension

2020 ◽  
Vol 23 (2) ◽  
pp. 45-50
Author(s):  
Ramadhani Putri Salicha ◽  
Kun Ismiyatin ◽  
Pramita Tanjung Sari ◽  
Olivia Vivian Widjaja ◽  
Ria Puspita Sari
Keyword(s):  
Blood Pressure ◽  
Hydrogen Peroxide ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Postural Hypotension ◽  
Clinical Case ◽  
Anterior Tooth ◽  
Central Incisor ◽  
Low Blood Pressure

Postural hypotension is a form of low blood pressure, characterized a 20 mmHg decrease in systolic blood pressure or a 10 mmHg drop in diastolic blood pressure when rising from a sitting or lying position. This can cause syncope. A patient who comes to a dentist with postural hypotension may be a tough case. A 48-year-old woman arrived with postural hypotension and felt dissatisfied with the discolored and unsightly condition of her upper central incisor. This clinical case shows a management of postural hypotension patient in internal bleaching technique on non-vital teeth using 35% hydrogen peroxide. This therapy is simple, safety and adequate for patients who has postural hypotension with satisfactory results.

Timolol and Bendroflumethiazide in the Treatment of Hypertension

1979 ◽  
Vol 7 (3) ◽  
pp. 215-220 ◽  
Author(s):  
N B Karatzas ◽  
G Papazachos ◽  
P Clouva ◽  
T Tsaknakis
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Moderate Essential Hypertension ◽  
Double Blind ◽  
Combination Tablet ◽  
Treatment Regimens ◽  
Treatment Of Hypertension ◽  
Pre Treatment ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

The effects on mild to moderate essential hypertension of 20 mg timolol and 5 mg bendroflumethiazide daily were compared in a randomized double-blind, crossover study in twenty-seven out-patients with pre-treatment diastolic blood pressure ranging from 100 to 130 mm Hg. After a four-week placebo period, a six-week treatment period for each drug followed, with one week on placebo before the crossover. All the patients then received a combination tablet containing the two drugs for another six weeks, using the same doses, except in those patients whose diastolic blood pressure had fallen to 90 mm Hg or below with either timolol or bendroflumethiazide alone, in whom the daily doses were halved. The lying diastolic blood pressure in the group of patients receiving timolol before bendroflumethiazide was 108 mm Hg on placebo, 90 mm Hg on timolol, 94 mm Hg on bendroflumethiazide and 86 mm Hg on the combination tablet. In the group of patients receiving bendroflumethiazide before timolol, it was 109 mm Hg on placebo, 95.5 mm Hg on bendroflumethiazide, 94 mm Hg on timolol and 84 mm Hg on the combination tablet. Of the twenty-seven patients, eleven achieved a diastolic blood pressure of 90 mm Hg or below with timolol, ten with bendroflumethiazide and twenty-three with the combination tablet. Two patients could not tolerate timolol, one because of bradycardia and the other because of bronchospasm, but in the rest, tolerance of all treatment regimens was excellent.

scholarly journals A case of primary aldosteronism with a negative aldosterone-to-renin ratio

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fengyi Liu ◽  
Liang Wang ◽  
Yanchun Ding
Keyword(s):  
Blood Pressure ◽  
Primary Aldosteronism ◽  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Screening Method ◽  
Organ Damage ◽  
Secondary Hypertension ◽  
Cardiovascular Damage ◽  
Aldosterone To Renin Ratio ◽  
Clinical Conditions

Abstract Background Primary aldosteronism (PA), as a cause of secondary hypertension, can cause more serious cardiovascular damage than essential hypertension. The aldosterone-to-renin ratio (ARR) is recommended as the most reliable screening method for PA, but ARR screening is often influenced by many factors. PA cannot be easily excluded when negative ARR. Case presentation We report the case of a 45-year-old Chinese man with resistant hypertension. Three years ago, he underwent a comprehensive screening for secondary hypertension, including the ARR, and the result was negative. After that, the patient's blood pressure was still poorly controlled with four kinds of antihypertensive drugs, the target organ damage of hypertension progressed, and hypokalaemia was difficult to correct. When the patient was hospitalized again for comprehensive examination, we found that aldosterone levels had significantly increased, although the ARR was negative. An inhibitory test with saline was further carried out, and the results suggested that aldosterone was not inhibited; therefore, PA was diagnosed. We performed a unilateral adenoma resection for this patient, and spironolactone was continued to control blood pressure. After the operation, blood pressure is well controlled, and hypokalaemia is corrected. Conclusion When the ARR is negative, PA cannot be easily excluded. Comprehensive analysis and diagnosis should be based on the medication and clinical conditions of patients.

Sign in / Sign up

Export Citation Format

Share Document