scholarly journals Choosing the optimal antihypertensive therapy

2021 ◽  
pp. 15-18
Author(s):  
O. V. Karpenko
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
European Society ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers ◽  
European Society Of Cardiology ◽  
Selection Of

The article considers approaches to the selection of optimal antihypertensive therapy in order to achieve the target blood pressure in patients with hypertension in accordance with the latest Recommendations on hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology; ESC), as well as the circadian rhythm of blood pressure. Fixed combinations of renin-angiotensin-aldosterone system blockers, which include angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors, with calcium antagonists should be preferred. Taking such a fixed combination at night can prevent the morning rise in blood pressure, when patients with hypertension usually have cardiovascular accidents.

Efficacy and Safety of Angiotensin-Converting Enzyme Inhibitors in Combination with Angiotensin II Receptor Blockers in Non-diabetic Chronic Kidney Disease: a Systematic Review and Meta-Analysis

2021 ◽  
Vol 28 ◽  
Author(s):  
Mingming Zhao ◽  
Hanwen Zhang ◽  
Yi Yu ◽  
Rumeng Wang ◽  
Meiying Chang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Enzyme Inhibitors ◽  
Meta Analysis ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Efficacy And Safety ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Background: It is unclear whether angiotensin-converting enzyme inhibitors (ACEIs) in combination with angiotensin II receptor blockers (ARBs) are superior to ACEIs or ARBs alone in the treatment of nondiabetic chronic kidney disease (CKD). The present meta-analysis was designed to assess the efficacy and safety of ACEIs in combination with ARBs in nondiabetic CKD. Methods: The PubMed, Embase, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) published prior to March 2020. A random-effects model was used to calculate the effect sizes of eligible studies. Results: The present meta-analysis of 20 RCTs encompassing 1,398 patients with nondiabetic CKD demonstrated that ACEIs in combination with ARBs were superior to ACEIs or ARBs alone in reducing urine albumin excretion (SMD, -0.69; 95% CI, -1.13 to -0.25; P=0.002), urine protein excretion (SMD, -0.34; 95% CI, -0.46 to -0.23; P<0.001) and blood pressure (systolic blood pressure: WMD, -1.43; 95% CI, -2.42 to -0.44; P=0.005; diastolic blood pressure: WMD, -1.85; 95% CI, -2.67 to -1.04; P<0.001) without decreased glomerular filtration rate (SMD, -0.07; 95% CI, -0.20 to 0.06; P=0.30) or increased incidences of hyperkalaemia (RR, 1.25; 95% CI, 0.47 to RR=0.80; P=0.20 to 0.06; P=0.30). Conclusion: Compared with ACEIs or ARBs alone, ACEIs in combination with ARBs are effective and safe in the treatment of nondiabetic CKD. ACEIs combined with ARBs may be a better choice to reduce proteinuria as long as it can be tolerated. (PROSPERO number: CRD42020179398).

scholarly journals The vicious cycle: a history of obesity and COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacek Bil ◽  
Olga Możeńska
Keyword(s):  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Obesity Paradox ◽  
Lifestyle Changes ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
History Of ◽  
Receptor Blockers ◽  
History Of Obesity

AbstractRecently, we face a surge in the fast-forward Coronavirus Disease 2019 (COVID-19) pandemic with nearly 170 million confirmed cases and almost 3.5 million confirmed deaths at the end of May 2021. Obesity, also known as the pandemic of the 21st century, has been evolving as an adverse prognostic marker. Obesity is associated with a higher risk of being SARS-CoV-2-positive (46%), as well as hospitalization (113%) and death (48%) due to COVID-19. It is especially true for subjects with morbid obesity. Also, observational studies suggest that in the case of COVID-19, no favorable “obesity paradox” is observed. Therefore, it is postulated to introduce a new entity, i.e., coronavirus disease-related cardiometabolic syndrome (CIRCS). In theory, it applies to all stages of COVID-19, i.e., prevention, acute proceedings (from COVID-19 diagnosis to resolution or three months), and long-term outcomes. Consequently, lifestyle changes, glycemic control, and regulation of the renin-angiotensin-aldosterone pathway have crucial implications for preventing and managing subjects with COVID-19. Finally, it is crucial to use cardioprotective drugs such as angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers and statins. Nevertheless, there is the need to conduct prospective studies and registries better to evaluate the issue of obesity in COVID-19 patients.

Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on pulmonary function in hypertensive patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Azza S. Jabbar ◽  
Nadheera F. Neamah ◽  
Ahmed H. Al-Darraji
Keyword(s):  
Angiotensin Ii ◽  
Adverse Effects ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Hypertensive Patients ◽  
Receptor Blockers

Abstract Objectives Hypertension is a very common cardiovascular disease. Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are widely used to treat hypertension. Many patients with hypertension are vulnerable to the antihypertensive adverse effects, which potentially reduces the adherence rate. Therefore, we conducted this study in order to evaluate the safety profile of both classes (ACEi and ARBs) on respiratory functions. Methods Two main groups of subjects were studied: first group is healthy control subjects and the second group is hypertensive patients, which was subdivided into subgroups in order to investigate the effect of all tested medications (captopril, enalapril, lisinopril, losartan, and valsartan). Respiratory efficiency was evaluated by measuring pulmonary function tests: FEV1, FVC, and FEV1%. Measurements were done using micromedical spirometer. Results We found that ARBs do not impair normal respiratory functions as measured by FEV1, FEV1%, and FVC in hypertensive patients. While ACEi treatments significantly reduced FEV1, FEV1%, and FVC compared to the other groups. Conclusions ARBs are not associated with any harmful effects on respiratory functions in hypertensive patients, unlike ACEi. As such, they could represent a first-choice treatment for hypertensive patients who are at high risk to the respiratory adverse effects.

Sign in / Sign up

Export Citation Format

Share Document