scholarly journals Medical Management in Moyamoya Disease

2021 ◽  
Author(s):  
Nattaphol Uransilp ◽  
Sirinat Puengcharoen ◽  
Sombat Muengtaweepongsa
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Moyamoya Disease ◽  
Antihypertensive Drugs ◽  
Hemorrhagic Complication ◽  
Elevated Blood ◽  
Ischemic Event ◽  
Antithrombotic Drug ◽  
Pathologic Condition ◽  
Hemorrhagic Event

Medical treatment seems to be not entirely helpful in the treatment of Moyamoya disease. No evidence supports the benefits of any drug treatment in Moyamoya disease. The ischemic or hemorrhagic event in Moyamoya disease is not preventable with any medical treatment. However, most of the physicians still prescribe the antithrombotic drug for Moyamoya patients with an ischemic event. Moreover, the standard guidelines recommend administering antithrombotic medications to treat Moyamoya with the ischemic event, even the risk of hemorrhagic complication. Antihypertensive drugs are routinely prescribed in Moyamoya patients with or without elevated blood pressure. A literature review about medical treatment in Moyamoya disease should help determine its use in this pathologic condition.

scholarly journals A Blood Pressure Lowering Effect Only through Complex Korean Medical Treatment, without Antihypertensive Drugs, for Patients with Stress Induced Hypertension - A Case Report

2021 ◽  
Vol 42 (5) ◽  
pp. 808-819
Author(s):  
Ji-hyun Lee ◽  
Min-yeong Roh ◽  
Seok-yeong Yoon ◽  
Hyung-sun Jun ◽  
Yang-hee Han ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Antihypertensive Drugs ◽  
Blood Pressure Lowering Effect ◽  
Hypertensive Patients ◽  
Pittsburg Sleep Quality Index ◽  
Induced Hypertension ◽  
Pressure Lowering ◽  
Pressure Symptom

Objectives: This study considered the effectiveness of integrative Korean medical treatment for stress-induced hypertensive patients without the use of conventional medication.Methods: A 62-year-old female with stress-induced hypertension (HTN) was hospitalized for 33 days. Her pattern identification was ascendant hyperactivity of liver yang (Ganyangsanghang)-type HTN. Herbal medicine and acupuncture were used for the treatment: Cheonggansoyo-san for 33 days and Chunwangbosim-dan for 15 days, together with acupuncture for 20 minutes twice a day. Blood pressure was checked daily during hospitalization with a digital sphygmomanometer in the brachial artery.Results: After 33 days of treatment, blood pressure decreased. The Handicap Inventory (DHI) scale and Pittsburg Sleep Quality Index (PSQI) scores both decreased. The patient also reported fewer complaints. A five-month follow-up after discharge, with no further treatment, confirmed stable blood pressure. Symptom improvements continued with no significant side effects.Conclusions: This study indicates that Korean medical treatment is effective for stress-induced hypertensive patients.

Abstract 16061: Antihypertensive Therapy Prescribing Pattern Among Patients With Markedly Elevated Blood Pressure in a Real-world Setting

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuan Lu ◽  
Chenxi Huang ◽  
Shiwani Mahajan ◽  
Cesar Caraballo ◽  
Erica S Spatz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Combination Therapy ◽  
Antihypertensive Drug ◽  
Guideline Adherence ◽  
Real World ◽  
Ace Inhibitor ◽  
Antihypertensive Drugs ◽  
Drug Prescription ◽  
Elevated Blood ◽  
Outpatient Visits

Introduction: Combination therapy with two or more antihypertensive agents is recommended for management of patients with markedly elevated blood pressure (systolic blood pressure [SBP] ≥160 mmHg or diastolic blood pressure [DBP] ≥100 mmHg) by the 2017 AHA/ACC hypertension guideline. Using electronic health records (EHR) data from a large health system, we characterized real-world antihypertensive drug prescribing patterns and assessed guideline adherence among ambulatory patients with markedly elevated BP. Methods: Our cohort included patients aged 18-85 years with at least 2 outpatient visits in the Yale New Haven Hospital System between January 1 st , 2013 and December 31 st , 2018, resulting in a total of 665,691 patients. We defined the phenotype of markedly elevated BP as two consecutive outpatient visits with SBP ≥160 mmHg or DBP ≥100 mmHg. We described the number and class of antihypertensive drugs (previously taken and newly prescribed) at the second visit with BP ≥160/100 mmHg. Results: We identified 38,098 patients with markedly elevated BP with a mean age of 62.4 (SD: 13.7) years; 47.9% were male; and 67.8%, 20.9%, and 9.3% were White, Black and Hispanic. Among them, 49.3% were not on any antihypertensive drugs at the end of the second visit, 26.2% had one active antihypertensive drug prescription, and 24.5% had two or more agents prescribed (Figure). Among patients with two or more antihypertensive drug prescriptions, the most common drug class combination prescribed was diuretic/ACE inhibitor (10.2%), followed by diuretic/ARB (9.3%), and ACE inhibitor/calcium channel blocker (6.5%). The low prescription of combination therapy was consistent across age, gender, and race subgroups. Conclusions: Prescribing of guideline-recommended combination antihypertensive drugs for patients with markedly elevated BP is suboptimal. Major opportunities exist for improving the guideline adherence of antihypertensive drug prescription in this population.

Abstract 4889: Long-term Changes Of Left Ventricular (lv) Structure And Function After Adrenalectomy Or Medical Treatment For Primary Aldosteronism

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Gian Paolo Rossi ◽  
Maurizio Cesari ◽  
Maria Teresa Seccia ◽  
Gisella Pitter ◽  
Achille Cesare Pessina
Keyword(s):  
Blood Pressure ◽  
Medical Treatment ◽  
Wall Thickness ◽  
Primary Aldosteronism ◽  
Antihypertensive Drugs ◽  
Statistical Significance ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Lv Mass

Objectives: to evaluate the structural and functional LV outcome of surgically or medically treated patients with documented primary aldosteronism (PA). Methods: after a cross-sectional Doppler echocardiography assessment of LV wall thickness and dimensions and transmitral LV filling flow velocity indexes, 55 PA patients entered a prospective follow-up study lasting 6.4 years (range: 4.5 to 8 years) after adrenalectomy (n=41) or medical treatment (n=14). The diagnosis of aldosterone producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) was based on adrenal vein sampling, pathology, and on follow-up data. Results: by the PAPY Study criteria 47 patients had APA and 8 IHA. Excess LV hypertrophy (LVH) and concentric remodelling rate was observed at baseline in both groups; atrial contribution to LF filling (ACLVF) was higher in the 14 (6 APA and 8 IHA) medically treated than in the 41 adrenalectomized patients. At follow-up blood pressure (p<0.001) and the rate of LVH decreased (p<0.001): LV mass index (MI) fell (from 115±22 to 106±18 in adrenalectomized patients and from, 118±26 to 103±21 in medically treated patients). This LVMI reduction and an increase of relative wall thickness (from 0.43±0.07 to 0.46±0.06 in adrenalectomized patients and from 0.41±0.06 to 0.45±0.05 in medically treated patients) attained statistical significance only in the former. By contrast, the reduction of ACLVF was significant only in the latter (p=0.002), thus indicating a normalization of the LV diastolic filling indexes (but only in the medically-treated patients which showed an impaired diastolic function at baseline). Conclusion: 1) Both treatments reduce BP, LV mass index and the prevalence of LVH; 2) With a similar fall of blood pressure and despite a greater reduction of antihypertensive drugs, these changes were more prominent in adrenalectomized patients; 3) An improvement of LV diastolic filling occurs also in the medically-treated PA patients when it is altered at baseline.

Influence of melatonin on blood pressure indicators with different severity of desynchronosis

2020 ◽  
pp. 30-40
Author(s):  
M. G. Melnik
Keyword(s):  
Blood Pressure ◽  
Circadian Rhythms ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Home Monitoring ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Pronounced Decrease ◽  
The Third ◽  
Pressure Indicators

Purpose. To study the dynamics of blood pressure (BP) indicators under the influence of exogenously administered melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) with various manifestations of desynchronosis of circadian BP rhythms (arterial hypertension – AH, high normal blood pressure) to determine the scheme of their effective compensation. Material and methods. The study included 101 patients with desynchronosis of circadian rhythms of blood pressure – 52 patients with hypertension, constituting the first and second groups, and 49 individuals with high normal blood pressure, representing the third and fourth groups. Patients of the second and fourth groups received conservative therapy, patients of the first and third groups combined it with melatonin. All patients underwent measurements of office blood pressure, home monitoring of blood pressure (ABPM), electrocardiography, 24-hour blood pressure monitoring (ABPM). Results and discussion. In patients of the first and third groups, compared with the traditional treatment groups, by the end of the observation period, a significantly (p < 0.05) decrease in office systolic blood pressure (SBP) / diastolic blood pressure (DBP) was established: in the first group compared with the second – 1.11 / 1.13 times, in the third group compared to the fourth – 1.43 / 1.58 times; significantly more (p < 0.05) pronounced decrease in SBP / DBP during DMAD – by 1.08 / 1.17 and 1.58 / 1.62 times, respectively, Significantly (p < 0.05) more pronounced decrease in average daily, average daily and average nighttime SBP / DBP during ABPM – by 1.13 / 1.20, 1.11 / 1.20, 1.23 / 1.25 and 1.47 / 1.31, 1.42 / 1.19, 1.54 / 1.41 times, respectively; reliably (p < 0.05) more frequent registration of the dipper rhythm type SBP / DBP – 1.6 / 1.4 and 1.6 / 1.4 times, respectively. In addition, the dynamics of patients in the first and third groups showed a significant (p < 0.05) decrease in the mean daily and mean nighttime SBP / DBP variability (SBP in the first group by 27.3 and 41.3 %, respectively; DBP in the first group by 20.1 and 26.3 %, respectively; SBP in the third group by 13.5 and 25.2 %, respectively; DBP in the third group by 12.2 and 28.2 %, respectively). Conclusions. With various manifestations of desynchronosis of circadian rhythms of blood pressure (AH, high normal blood pressure), the prescription of melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) at a dose of 3 mg per day 30–40 minutes before bedtime for a month against the background of non-drug therapy and antihypertensive drugs led to a significantly more effective decrease in blood pressure at its office measurement, DMAD, ABPM with an improvement in the circadian rhythm of blood pressure and normalization of blood pressure variability.

ROLE OF THE THYROID GLAND IN DEVELOPMENT AND MAINTENANCE OF RENAL HYPERTENSION IN RATS

1960 ◽  
Vol XXXIV (III) ◽  
pp. 411-429 ◽  
Author(s):  
Melvin J. Fregly ◽  
Kenneth M. Cook
Keyword(s):  
Blood Pressure ◽  
Rate Increase ◽  
Renal Hypertension ◽  
The Other ◽  
Elevated Blood Pressure ◽  
Unit Weight ◽  
Elevated Blood ◽  
Inhibition Of Growth ◽  
Testicular Size

ABSTRACT The anti-thyroid drugs, thiouracil, propylthiouracil, and methimazole, prevented both development of elevated blood pressure and cardiac hypertrophy usually accompanying kidney encapsulation with latex envelopes. These drugs also reduced elevated blood pressure of rats with hypertension of 13 to 40 weeks' duration prior to drug administration. Addition of desiccated thyroid powder to diet containing an anti-thyroid drug overcame the anti-hypertensive effect of the latter. Withdrawal of thyroid powder only was followed by return of blood pressure to previous low level within 3 weeks. The results suggest that the anti-hypertensive effect of these drugs is related directly to the hypothyroidism produced rather than to extrathyroidal effects of the drugs. Comparison of potencies of the 3 drugs in terms of anti-hypertensive effect, inhibition of growth rate, increase in testicular size, and increase in thyroid size suggests that propylthiouracil and methimazole are equally potent per unit weight of drug. Thiouracil has approximately half the potency of the other two.

THE USE OF MEDICINES IN TREATING HYPERTENSION IN HUE UNIVERSITY HOSPITAL

2016 ◽  
pp. 76-84
Author(s):  
Khoa Bao Chau Thai ◽  
Thi Hong Phuong Vo
Keyword(s):  
Blood Pressure ◽  
Channel Blocker ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Good Prognosis ◽  
Target Blood Pressure ◽  
University Hospital ◽  
Key Words Hypertension ◽  
Cross Sectional ◽  
Positive Effects

Background: Hypertension is a common condition in the world as well as in Viet Nam. If hypertension isn’t treated well, it can cause many serious complications. Controlling target blood pressure will bring positive effects on reducing mortality rate and also disabilities caused by diseases related to hypertension. Objectives: (1) Analyzing the use of medicines in treating hypertension. (2) Evaluating the effects of medicine usage in treating hypertension at the hospital of Hue University of Medicine and Pharmacy. Materials and methods: 388 patients were diagnosed as having hypertension with inpatient care at the Cardiovascular Department of Hue University of Medicine and Pharmacy’s hospital, using cross-sectional descriptive study methods. Results: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. Angiotensin converting enzyme inhibitor and calcium channel blocker were the two most popular drug groups (96.6% and 71.4%, respectively). The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens in both initial therapies (64.7%>35.3%) and final therapies (61.9%>38.1%). The rate of patients having interactions between antihypertensive drugs and the other kinds of drugs was 7.5%. The rate of patients having reasonable prescriptions was 84.3%. Evaluating the effects of medicine usage in treatments showed that the rate of patients reaching target blood pressure before leaving the hospital was 67.3%. Most patients were evaluated as having good prognosis after treatment, up to 81.7%. Conclusions: All antihypertensive drugs in the research were contained in the antihypertensive list recommended by Vietnamese Society of Cardiology. The rate of using multi-therapy regimens was higher than the rate of using uni-therapy regimens. The rate of drug interactions was quite low; most patients were evaluated as having good prognosis after treatment. Key words: hypertension, antihypertensive drugs.

Sign in / Sign up

Export Citation Format

Share Document