Blood pressure. Supplement最新文献

{"title":"The effects of high-dose amlodipine/benazepril combination therapies on blood pressure reduction in patients not adequately controlled with amlodipine monotherapy.","authors":"Steven G Chrysant,&nbsp;Daniel H Sugimoto,&nbsp;Marty Lefkowitz,&nbsp;Thomas Salko,&nbsp;Mahmudul Khan,&nbsp;Vipin Arora,&nbsp;Victor Shi","doi":"10.1080/08038020701189828","DOIUrl":"https://doi.org/10.1080/08038020701189828","url":null,"abstract":"Background. This study compared the efficacy and safety of amlodipine/benazepril (10/40 mg/day and 10/20 mg/day) with amlodipine 10 mg/day in patients whose blood pressure (BP) was not adequately controlled with amlodipine monotherapy. Methods. After a lead‐in period with amlodipine monotherapy, 812 non‐responder patients (mean sitting diastolic BP⩾95 mmHg) were randomized to one of three treatment groups. Ambulatory BP monitoring was conducted in 276 patients. Results. Treatment with amlodipine/benazepril 10/40 mg/day and 10/20 mg/day resulted in a decrease of mean sitting systolic and mean sitting diastolic BP by 13.3/12.7 mmHg and 12.1/11.6 mmHg, respectively, compared with monotherapy (6.6/8.5 mmHg) (p<0.0001). Both combinations resulted in more responders than monotherapy (74% and 65% vs. 54%; p<0.0001 and p<0.0085, respectively). Amlodipine/benazepril 10/40 mg/day and 10/20 mg/day decreased ambulatory systolic and diastolic BP by 9.9/6.7 mmHg and 7.4/5.2 mmHg compared with monotherapy (p<0.0001). The incidence of pedal edema was lower in the amlodipine/benazepril combinations compared with monotherapy (4.5%, 5.5% vs. 9.2%, respectively, p = NS). No significant metabolic side‐effects were noted among the combination groups. Conclusion. Amlodipine/benazepril combinations were well tolerated and resulted in significant BP reductions and better BP responder rates than amlodipine monotherapy.","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"1 ","pages":"10-7"},"PeriodicalIF":0.0,"publicationDate":"2007-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020701189828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26774680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There is a need for more aggressive implementation of combination strategies to control hypertensive risk.","authors":"Thomas Hedner,&nbsp;Krzysztof Narkiewicz,&nbsp;Sverre E Kjeldsen","doi":"10.1080/08038020701244037","DOIUrl":"https://doi.org/10.1080/08038020701244037","url":null,"abstract":"Despite major efforts to improve detection, treatment and follow-up, inadequate management of risk patients remains one of the leading causes of excess cardiovascular morbidity and mortality worldwide (1). In order to come to grips with this situation, there is clearly an urgent need to improve identification, quantification and management of cardiovascular risk in the hypertensive population. Inadequate risk assessment leads to serious underestimation of the risk level in many patients and poor quantification of total cardiovascular risk will have serious consequences for the choice of appropriate treatment. Hypertension remains an area of medicine where major improvements can be made, since in spite of intense clinical and research, goal blood pressure levels are rarely achieved (2). The decision to initiate antihypertensive treatment is based on clinical, ambulatory or home assessment of systolic and diastolic blood pressure as well as additional risk factors in order to calculate the level of total cardiovascular risk. The evident goal is to achieve maximum reduction in the long-term total risk of cardiovascular morbidity and mortality at the expense of minimal adverse effects and costs. This requires a focused and optimized management of all the reversible risk factors identified, including smoking, dyslipidemia, abdominal obesity or diabetes, as well as appropriate management of associated clinical conditions. Recent randomized trials demonstrate that irrespective of what mode of blood pressure lowering, reduction of blood pressure to v140 and v90 mmHg, markedly and costeffectively reduces cardiovascular morbid and fatal events as compared to those remaining even moderately above these values (3). However, in spite of overwhelming evidence of the benefits of treatment, primary hypertension still remains underdiagnosed and under-treated, resulting in an excess of strokes and heart attacks that are potentially preventable (2). Several evidence-based guidelines offer guidance on appropriate blood pressure targets. Current evidence based on analyses of randomized trials, provide evidence that a value of at least v140/ 90 mmHg should be the blood pressure target in the whole hypertensive population. Still, however, the level to which blood pressure should be reduced to achieve maximum benefit remains to be settled. It is obvious that in diabetic patients as well as in patients at increased risk, the target systolic as well as diastolic blood pressures should be even lower, although this remains poorly implemented in the everyday clinical setting (4). Thus, it is increasingly evident, that reality does not match ambition, theory and guidelines (2). Despite widespread use of multidrug combination treatments, even in the setting of clinical outcome trials, the achieved average systolic blood pressure has remained above 140 mmHg (5), with control rates of most 60–70% of the recruited and treated patient population. More importantly, in diabetic pati","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"1 ","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2007-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020701244037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26774678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antihypertensive properties of a high-dose combination of trandolapril and verapamil-SR.","authors":"Franz Messerli,&nbsp;William H Frishman,&nbsp;William J Elliott,&nbsp;Peter H Bacher,&nbsp;Carl J Pepine","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The superior diastolic blood pressure reduction (BP) of high-dose combination therapy with trandolapril (Tr) and verapamil-SR (Ve) compared with monotherapy has previously been reported. Guideline changes, placing greater emphasis on systolic BP, prompted a re-evaluation of TV-51 and an assessment of a subset of patients from the INternational VErapamil-SR Trandolapril STudy (INVEST). The objective of this analysis was to determine if the short-term antihypertensive effects of high-dose Tr+Ve (Tr/Ve study) could be confirmed in a sample of higher-risk INVEST patients with longer follow-up. The Tr/Ve study was a double-blind, randomized, parallel-group, placebo-controlled trial to evaluate the antihypertensive effects of trandolapril and verapamil-SR alone or in combination in 631 patients randomized to placebo, 4 mg trandolapril, 240 mg verapamil-SR or 4 mg/240 mg Tr+Ve combination for 6 weeks; 581 INVEST patients were selected for comparison with 24-month BP data, 90% use of trandolapril and verapamil-SR combination therapy and no triple therapy. Tr+Ve combination treatment achieved significantly greater systolic and diastolic BP reduction versus monotherapy. The BP-lowering effects of high-dose Tr+Ve achieved during short-term treatment were confirmed in INVEST during longer follow-up. Despite differences in the risk profiles of previously studied patients and INVEST patients, the antihypertensive effects of Ve+Tr were similar.</p>","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"1 ","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2007-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26774679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure control with valsartan and hydrochlorothiazide in clinical practice: the MACHT Observational Study.","authors":"Markus Abts,&nbsp;Volker Claus,&nbsp;Marcos Lataster","doi":"10.1080/08038020510046698","DOIUrl":"https://doi.org/10.1080/08038020510046698","url":null,"abstract":"<p><p>Reduction of blood pressure (BP) in hypertensive patients reduces cardiovascular risk, with substantial reductions in death from cardiovascular disease and all-cause mortality. This observational study assessed BP reduction in 17,242 patients with uncontrolled hypertension (mean baseline BP 165.4/95.8 mmHg) treated in clinical practice with a combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 12.5 mg by non-hospital specialists and general practitioners. BP was recorded at baseline and at 1 and 3 months with efficacy assessed as BP change from baseline at last timepoint. Mean systolic and diastolic BP reductions of -27.0 mmHg and -13.7 mmHg were achieved overall, with greater reductions in previously untreated patients or in those with a higher baseline BP. Response rates were high overall (78%), and in both formerly antihypertensive naive patients (87%) and in pre-treated patients (76%). The combination of valsartan and HCTZ was well tolerated with a discontinuation rate due to adverse events of <0.4%. In routine clinical practice, valsartan plus HCTZ is effective at reducing BP with high response rates despite patients having previously uncontrolled hypertension, and regardless of individual risk status. The low adverse event rates confirm the good tolerability profile and suitability for chronic use of antihypertensive regimens containing valsartan.</p>","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"1 ","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020510046698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25885034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RAAS inhibition--a practice of medical progress.","authors":"Thomas Hedner,&nbsp;Sverre E Kjeldsen,&nbsp;Krzysztof Narkiewicz","doi":"10.1080/08038020600613480","DOIUrl":"https://doi.org/10.1080/08038020600613480","url":null,"abstract":"The therapeutic utility of inhibiting the RAAS remains one of the major therapeutic successes in cardiovascular medicine over the past decades (1). The angiotensin-converting enzyme (ACE) inhibitors, when first introduced in 1980ies, were indicated only for treatment of refractory hypertension. Since then, they have been shown to reduce morbidity or mortality in hypertension, congestive heart failure, myocardial infarction, diabetes mellitus, chronic renal insufficiency, and atherosclerotic cardiovascular disease (1). These conditions were also targeted by the angiotensin receptor blockers (ARBs), and this class of drugs proved to be beneficial in cardiovascular, renal and metabolic disease as well. As a result of extensive research over the years, it was demonstrated that the pathologies underlying the target organ damage in these conditions were at least partly linked to the reninangiotensin-aldosterone system (RAAS). The end product, angiotensin II is involved in development of structural damage causing endothelial dysfunction, altered renal hemodynamics, as well as vascular and cardiac hypertrophy. Initially the ACE inhibitors and later the ARBs were shown to attenuate or prevent such expressions of target organ damage, an effect that could be translated into improved patient outcomes to the benefit of the individual. The beneficial clinical effects of ACE inhibitors or ARBs which were demonstrated in a number of classical outcome trials, include prevention of myocardial infarction (fatal and nonfatal), re-infarction, angina, stroke, end-stage renal disease, as well as reduction of morbidity and mortality associated with heart failure. In addition to this, these classes of drugs were shown to be generally well tolerated and have few contraindications (2,3). A large number of landmark trials during the past decades have clearly confirmed the benefits of ACE inhibitor or ARB therapy in patients’ cardiovascular and renal disease. Despite the strongly favourable clinical evidence and recent guideline recommendations, RAAS inhibition remains underused in the everyday clinic. When using an ACE inhibitor or an AT1 antagonist, combination with a low dose diuretic is often very attractive when choosing combination therapy. There is increasing evidence that such combination therapies should be utilized more for the initial treatment of hypertensive patients. The collective evidence from major clinical trials in the elderly, diabetics, stroke patients, and other multiple risk patient groups all indicate that combination therapy is necessary to control blood pressure in a reasonable proportion of patients. Although most recent guidelines acknowledge the value of combination therapy, this remains a difficult issue to implement in practice. Several combination therapies such as an ACE inhibitor or an ARB and a diuretic, or an ACE inhibitor or ARB with a calcium antagonist have been shown to be effective in patients who do not respond to monotherapy alone (","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"1 ","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2006-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020600613480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25885033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of arterial hypertension. Introduction.","authors":"Kalina Kawecka-Jaszcz,&nbsp;Renata Cífkova","doi":"10.1080/08038020500429698","DOIUrl":"https://doi.org/10.1080/08038020500429698","url":null,"abstract":"Root rot and wilt caused by Rhizoctonia solani, Fusarium solani and F. oxysporum is the most destructive diseases of tomato plants. Effect of some chemical inducers viz. ethephon, hydrogen peroxide (H2O2), mannitol, salicylic acid (SA) at three different concentrations (50,100, 200 ppm) on root rot and wilt diseases incidence as well as their influence on growth, quantity and quality parameters of tomato plants (cv. Super Strain B) when used as seedling soaking under greenhouse and field conditions were studied. All the tested chemical inducers significantly reduced root rot and wilt diseases severity either under greenhouse or field conditions. The efficiency of these compounds increased by increasing concentrations. Mannitol was the most effective inducer for decreasing area under disease progress carve (AUDPC) followed by salicylic acid, while ethephon recoded the lowest reduction ones. Also, under laboratory conditions, all tested chemical inducers were significantly reduced mycelial linear growth of all tomato root rot and wilt tested fungi compared with control. The highest decrease in linear growth was noticed with ethephon at concentration 200 followed by SA at 200 ppm. On the other hand, F. solani more affected with chemical inducers than F. oxysporum or R. solani. Under field conditions, the treatments were accompanied with significant increase in tomato growth, yield quantity and quality parameters. Application of mannitol at 200 ppm followed by SA at 200 was the most potent in all growth, quantity and some quality parameters compared with check treatment.","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"2 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020500429698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25813510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can we improve the effectiveness of treatment in elderly hypertensives?","authors":"Barbara Gryglewska","doi":"10.1080/08038020500428740","DOIUrl":"https://doi.org/10.1080/08038020500428740","url":null,"abstract":"<p><p>Despite evidence for the benefits of treating hypertension in old age, only a small number of elderly patients have adequate blood pressure control. The reasons are complex and include a combination of factors related to physician, patient adherence to therapy and properties of the antihypertensive drugs. Substantial gaps have been documented between the development and dissemination of recommendations and their implementation in practice. Older patients are more likely to have difficulty with medication adherence. Better compliance achievement among the elderly patients should include a complex strategy. Moreover, physician information strategies must be improved.</p>","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"2 ","pages":"46-9"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020500428740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25814844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient's education in arterial hypertension.","authors":"Marzena Dubiel,&nbsp;Marcin Cwynar,&nbsp;Andrzej Januszewicz,&nbsp;Tomasz Grodzicki","doi":"10.1080/08038020500424731","DOIUrl":"https://doi.org/10.1080/08038020500424731","url":null,"abstract":"<p><p>Non-compliance is an important factor in lack of appropriate control of blood pressure. Education of hypertensive patients on about consequences of hypertension and benefits of antihypertensive therapy has been reported to improve the results of the management of hypertension. The aim of this article is to present main factors influencing patients' compliance with antihypertensive treatment and the role of educational interventions in the process of therapy.</p>","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"2 ","pages":"53-6"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020500424731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25814189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial hypertension as a public health issue in Slovenia.","authors":"Rok Accetto","doi":"10.1080/08038020500424632","DOIUrl":"https://doi.org/10.1080/08038020500424632","url":null,"abstract":"<p><p>Hypertension is an important risk factor for cardiovascular diseases. An epidemiological survey in 1985 found that the prevalence of hypertension in Slovenia was comparable to rates reported from western European countries. Awareness of hypertension was poor and only a small fraction of patients had their blood pressure under satisfactory control. Since 1985, few population studies have been completed; the results suggest that little progress has been made in the field of hypertension control. The responsibility for the situation lies partly with family physicians, who often fail to react properly to uncontrolled blood pressure. Data from the last CINDI survey conducted in 2004 are more encouraging. Apparently, physicians now provide their patients with more information on how to attain their target blood pressure, and the percentage of hypertensive patients with controlled blood pressure seems to have increased. However, these are only assumptions, which should be verified by a nationwide epidemiological study. A pilot survey involving a random sample of the Slovenian adult population (about 11,000 subjects) is in progress and will be completed by the end of the year 2005.</p>","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"2 ","pages":"22-4"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020500424632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25814839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension in Latvia--epidemiology and management.","authors":"Vilnis Dzerve,&nbsp;Aivars Lejnieks","doi":"10.1080/08038020500428690","DOIUrl":"https://doi.org/10.1080/08038020500428690","url":null,"abstract":"<p><p>The aims of investigations were to assess the prevalence of arterial hypertension (AH) among Latvian population aged > or = 45 years and to evaluate the current AH management situation in Latvia. Four epidemiological databases (Dbases) for analyses were selected: Dbases of a randomized urban population of Riga city (in 1997) and Kuldiga region (in 2000), a Dbase of the DIASCREEN population selected by high risk to diabetes from those visiting family doctors (in 2003) and a Dbase of a Latvian population selected from those visiting family doctors during 3 days in 2005. The prevalence of AH in the urban population was 41.8 +/- 1.4% (with 61.2% for persons over age 45), in rural population 40.5 +/- 1.6% (with 63.7% for those aged above 45). Therapeutic control of AH for patients over 45 years with regular medicine intake differed significantly in three samples of the population analysed: Riga 7.2 +/- 2.7%, Kuldiga 9.9 +/- 1.6% and DIASCREEN 6.4 +/- 0.8%. The addition of another risk factor decreases the control rate, especially in a combination of AH and overweight. The most widely prescribed drugs are angiotensin-converting enzyme inhibitors (ACEI) 31%, diuretics 21% and beta-blockers 20% of patients. AH control rate in the case of monotherapy with ACEI was 6.9 +/- 0.9%, calcium antagonists 5.6+1.2%, beta-blockers 12.5+2.0% and diuretics 3.8+1.4%. The current status of management of hypertension in Latvia is discussed.</p>","PeriodicalId":8974,"journal":{"name":"Blood pressure. Supplement","volume":"2 ","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08038020500428690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25814841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}