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1.
Medicine (Baltimore) ; 99(6): e19047, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028419

RESUMEN

BACKGROUND: Although evidence from animal and observational studies has supported the beneficial effects of green tea intake for lowering blood pressure (BP), randomized placebo-controlled trials (RCTs) have yielded conflicting results. In this meta-analysis of RCTs, we aimed to assess the effects of green tea supplementation on measures of BP control. METHODS: The PubMed, Embase, and Cochrane Library databases were electronically searched from inception to August 2019 for all relevant studies. The results were pooled using the generic inverse-variance method with random-effects weighting and expressed as mean differences (MDs) with 95% confidence intervals (CIs). The quality of studies was assessed using the Jadad score. Publication bias was evaluated using funnel plots, Egger test, and Begg test. RESULTS: Twenty-four trials with 1697 subjects were included in the meta-analysis. The pooled results showed that green tea significantly lowered systolic BP (SBP; MD: -1.17 mm Hg; 95%CI: -2.18 to -0.16mm Hg; P = .02) and diastolic BP (DBP; MD: -1.24 mm Hg; 95%CI:-2.07 to -0.40mm Hg; P = .004). Significant heterogeneity was found for both SBP (I = 43%) and DBP (I = 57%). In addition, no evidence of significant publication bias was found from funnel plots or Egger test (P = .674 and P = .270 for SBP and DBP, respectively). CONCLUSION: Overall, green tea significantly reduced SBP and DBP over the duration of the short-term trials. Larger and longer-term trials are needed to further investigate the effects of green tea supplementation on BP control and clinical events.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , , Suplementos Dietéticos , Humanos , Hipertensión/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto
2.
J Zoo Wildl Med ; 50(4): 988-992, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926533

RESUMEN

Five free-ranging male (subadults, n = 3; adults, n = 2) plains zebras (Equus quagga) were immobilized using a combination of etorphine (0.017 mg/kg), medetomidine (0.017 mg/kg), and azaperone (0.24 mg/kg) by means of a blank cartridge-fired projector. Time to recumbency was recorded and a descriptive score used to assess the quality of immobilization, manipulation, maintenance, and recovery. Physiological parameters were recorded at 5-min intervals for 20 min. At the end of the procedure, naltrexone (0.23 mg/kg) was administered intramuscularly and time to standing documented. The combination evaluated in this study allowed for successful immobilization and safe recovery of all animals, including during the subsequent 15 days. Despite the good outcome in this pilot study, as a result of the periodic apneic events and hypercapnia documented in the zebras, the authors suggest that physiological parameters be thoroughly monitored when using this protocol. Further studies are needed to improve upon chemical immobilization protocols in free-ranging plains zebras.


Asunto(s)
Azaperona/farmacología , Equidae , Etorfina/farmacología , Inmovilización/veterinaria , Medetomidina/farmacología , Animales , Animales Salvajes , Azaperona/administración & dosificación , Presión Sanguínea/efectos de los fármacos , Combinación de Medicamentos , Etorfina/administración & dosificación , Frecuencia Cardíaca/efectos de los fármacos , Hipnóticos y Sedantes/administración & dosificación , Hipnóticos y Sedantes/farmacología , Masculino , Medetomidina/administración & dosificación , Proyectos Piloto , Frecuencia Respiratoria/efectos de los fármacos
3.
Clin Sci (Lond) ; 134(2): 289-302, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-31961431

RESUMEN

Preeclampsia (PE) is regarded as a pregnancy-associated hypertension disorder that is related to excessive inflammatory responses. Although the gut microbiota (GM) and short-chain fatty acids (SCFAs) have been related to hypertension, their effects on PE remain unknown. We determined the GM abundance and faecal SCFA levels by 16S ribosomal RNA (rRNA) sequencing and gas chromatography, respectively, using faecal samples from 27 patients with severe PE and 36 healthy, pregnant control subjects. We found that patients with PE had significantly decreased GM diversity and altered GM abundance. At the phylum level, patients with PE exhibited decreased abundance of Firmicutes albeit increased abundance of Proteobacteria; at the genus level, patients with PE had lower abundance of Blautia, Eubacterium_rectale, Eubacterium_hallii, Streptococcus, Bifidobacterium, Collinsella, Alistipes, and Subdoligranulum, albeit higher abundance of Enterobacter and Escherichia_Shigella. The faecal levels of butyric and valeric acids were significantly decreased in patients with PE and significantly correlated with the above-mentioned differential GM abundance. We predicted significantly increased abundance of the lipopolysaccharide (LPS)-synthesis pathway and significantly decreased abundance of the G protein-coupled receptor (GPCR) pathway in patients with PE, based on phylogenetic reconstruction of unobserved states (PICRUSt). Finally, we evaluated the effects of oral butyrate on LPS-induced hypertension in pregnant rats. We found that butyrate significantly reduced the blood pressure (BP) in these rats. In summary, we provide the first evidence linking GM dysbiosis and reduced faecal SCFA to PE and demonstrate that butyrate can directly regulate BP in vivo, suggesting its potential as a therapeutic agent for PE.


Asunto(s)
Ácidos Grasos Volátiles/análisis , Microbioma Gastrointestinal/fisiología , Hipertensión/fisiopatología , Preeclampsia/fisiopatología , Adulto , Animales , Bacterias/clasificación , Bacterias/genética , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Butiratos/administración & dosificación , Butiratos/análisis , Butiratos/metabolismo , Ácidos Grasos Volátiles/metabolismo , Heces/química , Heces/microbiología , Femenino , Microbioma Gastrointestinal/efectos de los fármacos , Microbioma Gastrointestinal/genética , Humanos , Hipertensión/metabolismo , Hipertensión/microbiología , Ácidos Pentanoicos/análisis , Ácidos Pentanoicos/metabolismo , Dinámica Poblacional , Preeclampsia/metabolismo , Preeclampsia/microbiología , Embarazo , ARN Ribosómico 16S/genética , Ratas Sprague-Dawley
4.
Medicine (Baltimore) ; 99(1): e18541, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895792

RESUMEN

Perioperative hypertension is a common occurrence in the neurosurgical population, where 60% to 90% of the patients require treatment for blood pressure (BP) control. Nicardipine and clevidipine have been commonly used in neurocritical settings. This retrospective, observational study assessed the effectivity of the administration of clevidipine after nicardipine treatment failure in neurosurgical patients.We retrospectively reviewed the medical charts of adult patients who were admitted to our neurosurgical department and received clevidipine after nicardipine treatment failure for the control of BP. The primary effectivity outcome was the comparison of the percentage of time spent at targeted SBP goals during nicardipine and clevidipine administration, respectively.A total of 12 adult patients treated with clevidipine after nicardipine treatment failure and were included for data analysis. The median number of events that required dose-titration was 20.5 vs 17 during the administration of nicardipine and clevidipine, respectively (P = .534). The median percentage of time spent at targeted SBP goal was 76.2% during the administration of nicardipine and 93.4% during the administration of clevidipine (P = .123).Our study suggests that clevidipine could be an alternative effective drug with an acceptable benefit/risk ratio in the neurosurgical population that fails to achieve BP control with nicardipine treatment.


Asunto(s)
Bloqueadores de los Canales de Calcio/administración & dosificación , Hipertensión/tratamiento farmacológico , Complicaciones Intraoperatorias/tratamiento farmacológico , Procedimientos Neuroquirúrgicos/efectos adversos , Piridinas/administración & dosificación , Presión Sanguínea/efectos de los fármacos , Femenino , Humanos , Hipertensión/etiología , Complicaciones Intraoperatorias/etiología , Masculino , Persona de Mediana Edad , Nicardipino/uso terapéutico , Estudios Retrospectivos , Insuficiencia del Tratamiento , Resultado del Tratamiento
5.
Expert Opin Drug Saf ; 19(1): 59-67, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31795777

RESUMEN

Introduction: The objective of this study was to review the current status of drug-induced hypomagnesemia and its adverse effects on cardiovascular disease (CVD) and hypertension. Since magnesium is a potent vasodilator, which modulates vasomotor tone, peripheral blood flow, and hypertension, its deficiency could have significant cardiovascular and blood pressure (BP) effects.Areas covered: Studies have shown that several factors can contribute to magnesium deficiency including age, diet, disease, and certain drugs such as diuretics and proton-pump inhibitors (PPIs). For an updated perspective of drug-induced hypomagnesemia, a Medline search of the English language literature was conducted between 2010 and 2019 using the terms diuretics, proton-pump inhibitors, hypomagnesemia, cardiovascular disease, hypertension, and 35 pertinent papers were retrieved.Expert opinion: The data showed that magnesium deficiency is difficult to occur since it is plentiful in green leafy vegetables, cereals, nuts, and the drinking water. However, magnesium deficiency can occur with the use of diuretics for the treatment of hypertension and heart failure, or the use of PPIs for the treatment of gastroesophageal reflux disease. Therefore, magnesium deficiency should be detected and treated to prevent the aggravation of hypertension and the onset of CVD and serious cardiac arrhythmias including torsades de points.


Asunto(s)
Diuréticos/efectos adversos , Deficiencia de Magnesio/inducido químicamente , Inhibidores de la Bomba de Protones/efectos adversos , Animales , Arritmias Cardíacas/inducido químicamente , Presión Sanguínea/efectos de los fármacos , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/fisiopatología , Diuréticos/administración & dosificación , Humanos , Hipertensión/etiología , Deficiencia de Magnesio/complicaciones , Deficiencia de Magnesio/diagnóstico , Inhibidores de la Bomba de Protones/administración & dosificación
6.
J Agric Food Chem ; 68(3): 759-768, 2020 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-31841328

RESUMEN

In this study, we investigated the antihypertensive effects in vitro and in vivo of novel angiotensin-converting enzyme inhibitory (ACEI) peptides purified and identified from bovine bone gelatin hydrolysate (BGH). Thirteen ACEI peptides were identified from BGH, and among which, RGL-(Hyp)-GL and RGM-(Hyp)-GF exhibited high ACE inhibition with IC50 values of 1.44 and 10.23 µM. Molecular docking predicted that RGM-(Hyp)-GF and ACE residues of Glu384, His513, and Lys511 formed hydrogen-bonding interactions at distances of 2.57, 2.99, and 2.42 + 3.0 Å. RGL-(Hyp)-GL formed hydrogen bonds with Lys511 and Tyr523 and generated hydrogen-bonding interactions with His387 and Glu411 in the zinc(II) complexation motif at distances of 2.74 and 3.03 + 1.93 Å. The maximal decrements in systolic blood pressure in spontaneously hypertensive rats induced by one-time gavage of RGL-(Hyp)-GL and RGM-(Hyp)-GF at 30 mg/kg were 31.3 and 38.6 mmHg. RGL-(Hyp)-GL had higher enzyme degradation resistance than that of RGM-(Hyp)-GF in vitro incubation in rat plasma, and they were sequentially degraded into pentapeptides and tetrapeptides within 2 h. Our results indicate that BGH can serve as a nutritional candidate to control blood pressure.


Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/química , Antihipertensivos/química , Huesos/química , Gelatina/química , Péptidos/química , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/aislamiento & purificación , Animales , Antihipertensivos/administración & dosificación , Antihipertensivos/aislamiento & purificación , Presión Sanguínea/efectos de los fármacos , Bovinos , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Masculino , Simulación del Acoplamiento Molecular , Péptidos/administración & dosificación , Péptidos/aislamiento & purificación , Peptidil-Dipeptidasa A/química , Hidrolisados de Proteína/química , Ratas , Ratas Endogámicas SHR
8.
J Sci Food Agric ; 100(1): 315-324, 2020 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-31525262

RESUMEN

BACKGROUND: In order to utilize tilapia skin gelatin hydrolysate protein, which is normally discarded as industrial waste in the process of fish manufacture, we study the in vivo and in vitro angiotensin-I-converting enzyme (ACE) inhibitory activity of the peptide Leu-Ser-Gly-Tyr-Gly-Pro (LSGYGP). The aim was to provide a pharmacological basis of the development of minimal side effects of ACE inhibitors by comparative analysis with captopril in molecular docking. RESULTS: This peptide from protein-rich wastes showed excellent ACE inhibitory activity (IC50  = 2.577 µmol L-1 ) and exhibited a mixed noncompetitive inhibitory pattern with Lineweaver-Burk plots. Furthermore, LSGYGP and captopril groups both showed significant decreases in blood pressure after 6 h and maintained good digestive stability over 4 h. Molecular bond interactions differentiate competitive captopril upon hydrogen bond interactions and Zn(II) interaction. The C-terminal Pro generates three interactions (hydrogen bonds, hydrophilic interactions and Van der Waals interactions) in the peptide and effectively interacts with the S1 and S2 pockets of ACE. CONCLUSION: LSGYGP, with an IC50 value of 2.577 µmol L-1 , has an antihypertensive effect in spontaneously hypertensive rats. Through comparison with captopril, this study revealed that LSGYGP may be a potential food-derived ACE inhibitory peptide and could act as a functional food ingredient to prevent hypertension. © 2019 Society of Chemical Industry.


Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/química , Antihipertensivos/química , Captopril/química , Hipertensión/tratamiento farmacológico , Péptidos/química , Secuencia de Aminoácidos , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/metabolismo , Animales , Antihipertensivos/administración & dosificación , Antihipertensivos/metabolismo , Presión Sanguínea/efectos de los fármacos , Captopril/administración & dosificación , Cíclidos , Digestión , Proteínas de Peces/química , Tracto Gastrointestinal/metabolismo , Humanos , Enlaces de Hidrógeno , Interacciones Hidrofóbicas e Hidrofílicas , Hipertensión/metabolismo , Hipertensión/fisiopatología , Cinética , Masculino , Simulación del Acoplamiento Molecular , Péptidos/metabolismo , Péptidos/farmacología , Peptidil-Dipeptidasa A/química , Peptidil-Dipeptidasa A/metabolismo , Hidrolisados de Proteína/química , Hidrolisados de Proteína/metabolismo , Ratas , Ratas Endogámicas SHR
9.
Food Chem ; 308: 125601, 2020 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-31670190

RESUMEN

The aim of this work was to analyse the hypotensive effect of amaranth protein/peptides on spontaneously hypertensive rats (SHR). The mechanism of action of these peptides was studied in vivo and ex vivo. We also tested the effect of protection against gastrointestinal digestion (GID) exerted by an O:W emulsion on the integrity of the antihypertensive peptides. All samples tested produced a decrease in blood pressure (SBP). The animals treated with emulsion (GE) and emulsion + peptide (GE+VIKP) showed the most significant reduction in the SBP (42 ±â€¯2 mmHg and 35 ±â€¯2 mmHg, respectively). The results presented suggest that after GID, a variety of peptides with biological activities were released or were resistant to this process. These peptides play a role in the regulation of the SBP by acting on plasma ACE, plasma renin and the vascular system. These results support the use of amaranth protein/peptides in the elaboration of functional foods for hypertensive individuals.


Asunto(s)
Amaranthus/química , Antihipertensivos/farmacología , Hipertensión/tratamiento farmacológico , Péptidos/farmacología , Sistema Renina-Angiotensina/efectos de los fármacos , Animales , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Masculino , Péptidos/uso terapéutico , Proteínas de Plantas/farmacología , Proteínas de Plantas/uso terapéutico , Ratas , Ratas Endogámicas SHR
10.
Braz J Med Biol Res ; 53(1): e8645, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31859910

RESUMEN

Data about the feasibility and safety of thoracoscopic surgery under non-intubated anesthesia and regional block are limited. In this prospective study, 57 consecutive patients scheduled for thoracoscopic surgery were enrolled. Patients were sedated with dexmedetomidine and anesthetized with propofol and remifentanil. Ropivacaine was used for intercostal nerve and paravertebral block. Lidocaine was used for vagal block. The primary outcomes were mean arterial pressure (MAP), heart rate (HR), oxygen saturation, and end-tidal carbon dioxide partial pressure (ETCO2) at T0 (pre-anesthesia), T1 (immediately after laryngeal mask/nasopharyngeal airway placement), T2 (immediately after skin incision), T3 (10 min after opening the chest), T4 (end of surgery), and T5 (immediately after laryngeal mask/nasopharyngeal airway removal). One patient required conversion to intubation, 15 developed intraoperative hypotension, and two had hypoxemia. MAP at T0 and T5 was higher than at T1-T4; MAP at T3 was lower (P<0.05 vs other time points). HR at T0 and T5 was higher (P<0.05 vs other time points). ETCO2 at T2 and T3 was higher (P<0.05 vs other time points). Arterial pH, PCO2, and lactic acid at T1 differed from values at T0 and T2 (P<0.05). The Quality of Recovery-15 (QoR-15) score at 24 h was lower (P<0.05). One patient experienced dysphoria during recovery. Thoracoscopic surgery with regional block under direct thoracoscopic vision is a feasible and safe alternative to conventional surgery under general anesthesia, intubation, and one-lung ventilation.


Asunto(s)
Anestesia General/métodos , Máscaras Laríngeas , Bloqueo Nervioso/métodos , Toracoscopía/métodos , Adolescente , Adulto , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Dexmedetomidina/administración & dosificación , Estudios de Factibilidad , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Propofol/administración & dosificación , Estudios Prospectivos , Remifentanilo/administración & dosificación , Adulto Joven
11.
Vasc Health Risk Manag ; 15: 551-558, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31853180

RESUMEN

Introduction: As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective: The objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable. Results: A total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3-56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts. Conclusion: In this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Conocimientos, Actitudes y Práctica en Salud , Estilo de Vida Saludable , Hospitales Universitarios , Hipertensión/terapia , Servicio Ambulatorio en Hospital , Conducta de Reducción del Riesgo , Adulto , Anciano , Estudios Transversales , Escolaridad , Etiopía , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Ocupaciones , Factores de Riesgo , Factores Sexuales
12.
Medicine (Baltimore) ; 98(51): e18311, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31860981

RESUMEN

BACKGROUND: Studies have shown the efficacy of norepinephrine in the treatment of maternal hypotension during cesarean section by comparing it to treatment with phenylephrine. However, few studies have compared the efficacy of norepinephrine to ephedrine. METHODS: Ninety-seven women undergoing elective cesarean section were administered norepinephrine at 4 µg/minute (group N; n = 48) or ephedrine at 4 mg/minute (group E; n = 49) immediately postspinal anesthesia, with an on-off titration to maintain systolic blood pressure (SBP) at 80% to 120% of baseline. A rescue bolus of 8 µg norepinephrine was given whenever SBP reached the predefined lower limit. Our primary outcome was the incidence of tachycardia. Secondary outcomes included the incidence of bradycardia, hypertension, hypotension, severe hypotension, hypotensive episodes, number of rescue top-ups, hemodynamic performance error including median performance error (MDPE), and median absolute performance error (MDAPE). Neonatal Apgar scores and umbilical arterial (UA) blood gas data were also collected. RESULTS: Women in group N experienced fewer cases of tachycardia (4.2% vs 30.6%, P = .002, odds ratio: 0.11 [95% confidence interval, CI: 0.02-0.47]), a lower standardized heart rate (HR) (70.3 ±â€Š11 vs 75 ±â€Š11, P = .04, difference: 4.7 ±â€Š2.2 [95% CI: 0.24-9.1]), and a lower MDPE for HR (1.3 ±â€Š9.6 vs 8.4 ±â€Š13.5 bpm, P = .003, difference: 3.1 ±â€Š1.8 [95% CI: -0.6-6.7]). In addition, the lowest or the highest HR was lower in group N compared to group E (both P < .05). Meanwhile, the standardized SBP in group N was lower than that in group E (P = .04). For neonates, the UA blood gas showed a higher base excess (BE) and a lower lactate level in group N compared to E (both P < .001). Other hemodynamic variables, maternal, and neonatal outcomes were similar. CONCLUSION: Infusion of 4 µg/minute norepinephrine presented fewer cases of tachycardia, less fluctuation and a lower HR compared to baseline values, as well as a less stressed fetal status compared to ephedrine infusion at 4 mg/minute. In addition, norepinephrine infusion presented a lower standardized SBP compared to ephedrine.


Asunto(s)
Anestesia Raquidea/métodos , Cesárea/efectos adversos , Efedrina/uso terapéutico , Hipotensión/prevención & control , Norepinefrina/uso terapéutico , Adulto , Anestesia Raquidea/efectos adversos , Presión Sanguínea/efectos de los fármacos , Cesárea/métodos , Método Doble Ciego , Efedrina/efectos adversos , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Hipotensión/etiología , Infusiones Intravenosas , Norepinefrina/administración & dosificación , Embarazo
13.
Medicine (Baltimore) ; 98(51): e18471, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31861026

RESUMEN

This study aimed to compare the Hamilton anxiety rating/Hamilton depression rating (HAMA/HAMD) scale scores and blood pressure (BP) goal achievement associated with the use of valsartan-amlodipine single-pill combinations (SPCs) versus valsartan and amlodipine combination in adult hypertensive patients.A total of 476 hypertensive patients were randomly assigned into the SPC (valsartan-amlodipine) and control (valsartan and amlodipine combination) groups. All patients had an uncontrolled BP (160-179/100-109 mm Hg). BP goal was <140/90 mm Hg. Cox proportional hazards regression analysis was used to analyze the likelihood of HAMA/HAMD scales, SPCs, control group, and daily dosage number. Kaplan-Meier analysis was used to estimate the rates of BP goal achievement over time among the 2 groups.A total of 476 patients were included in the study, and 439 patients completed the follow-up and received the index drug therapy. There was a significant difference in BP between the 2 groups on days 28, 42, and 56. Patients who received SPCs had a significantly higher rate of BP goal achievement over time (P = .000). The average HAMD scores in the SPC and control groups were 5.54 and 5.49 and 6.06 and 6.21 on days 28 and 56, respectively. The average HAMA scores in the SPC and control groups were 7.41 and 7.13 and 7.90 and 8.01 on days 28 and 56, respectively. The means of HAMD and HAMA scores were 5.826 and 7.614, respectively. The higher the HAMA/HAMD scores, the lower was the BP goal achievement. The number of drugs taken by the patients was associated with the HAMA and HAMD scores. There was no significant difference between HAMA scores of patients taking 1 tablet daily (7.22 ±â€Š1.885) and those taking two-tablets daily (7.38 ±â€Š1.953) (P = .408). However, when these scores were compared to those of patients taking 4 tablets daily (8.08 ±â€Š2.285), a significant difference was observed (P = .000, P = .000).Hypertensive patients treated with valsartan-amlodipine SPCs were significantly more likely to achieve BP goal and have lesser HAMA/HAMD scores compared to patients treated with valsartan and amlodipine combination.


Asunto(s)
Combinación Amlodipino y Valsartán/uso terapéutico , Antihipertensivos/administración & dosificación , Ansiedad/prevención & control , Depresión/prevención & control , Hipertensión/tratamiento farmacológico , Combinación Amlodipino y Valsartán/farmacología , Presión Sanguínea/efectos de los fármacos , Femenino , Humanos , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
14.
Zhongguo Zhong Yao Za Zhi ; 44(18): 3861-3868, 2019 Sep.
Artículo en Chino | MEDLINE | ID: mdl-31872716

RESUMEN

Baihu Jia Renshen Decoction recorded in Treatise on Febrile Diseases by Zhang Zhongjing in the Han Dynasty could be used to clear heat,invigorate Qi,and promote fluid production. The indications of Baihu Jia Renshen Decoction include infectious diseases,such as lung infection,influenza,encephalitis,enteric typhoid and hospital infection; thermoplegia; acute cerebrovascular disease,diabetes mellitus,severe hyperosmolarity,hypernatremia,intractable hypotension,shock and other internal diseases; sweating,irritation,thirst,want to drink several liters of water,dry mouth,dry tongue,and big pulse. This prescription has been widely used to treat acute and severe cases in the cardiovascular intensive care ward. The prescription can be used to treat exogenous and internal injury diseases,which are characterized by excessive heat,fluid injury,thirst for water,dry mouth,dry tongue and other symptoms; refractory hypotension and hypovolemic shock that need large dose of supplemental fluid to maintain blood pressure and may also belong to the extension of the Baihu Jia Renshen Decoction formula syndrome; severe hyperosmolarity and hypernatremia needing nasal feeding with large quantities of sterile water or cool boiled water that may also belong to the extension of the Baihu Jia Renshen Decoction formula syndrome; the four major symptoms,namely severe heat,excessive perspiration,great thirst,and large-bounding pulse,are actually the indications of Baihu Jia Renshen Decoction,rather than Baihu Decoction. Severe irritability should also be added into the indications of Baihu Jia Renshen Decoction; severe heat refers to pathogenesis,rather than a symptom.


Asunto(s)
Glucemia/efectos de los fármacos , Presión Sanguínea/efectos de los fármacos , Medicamentos Herbarios Chinos/farmacología , Panax/química , Cuidados Críticos , Calor , Humanos , Medicina Integral , Fitoterapia , Síndrome , Resultado del Tratamiento
15.
Presse Med ; 48(11 Pt 1): 1269-1283, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31757732

RESUMEN

Hypertension is a major risk factor for cardiovascular diseases. Because of the high frequency of hormonal contraceptives use, assessing their side effects is an important public health issue. In this perspective, we conducted a review of the risk of hypertension associated with the use of hormonal contraceptives, either combined estrogen-progestin or only progestin. The use of combined hormonal contraceptives, regardless of its type and route of administration, is associated with a slight increase in blood pressure, both systolic and diastolic blood pressures. The frequency of onset of hypertension in women who use combined hormonal contraception is between 0.6% and 8.5%. Progestin-only contraception seems safe with respect to the risk of hypertension. It is therefore important to remember that the use of combined hormonal contraception is contra-indicated in hypertensive women, even well controlled. Finally, we propose a prescription assistance algorithm according to the recommendations of an expert panel. It should be remembered that taking blood pressure at each contraceptive consultation (initial and follow-up) is essential.


Asunto(s)
Anticoncepción/efectos adversos , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/efectos adversos , Hipertensión/inducido químicamente , Progestinas/efectos adversos , Adolescente , Adulto , Presión Sanguínea/efectos de los fármacos , Determinación de la Presión Sanguínea , Femenino , Humanos , Persona de Mediana Edad , Progestinas/administración & dosificación , Factores de Riesgo , Adulto Joven
16.
Presse Med ; 48(12): 1520-1526, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31761608

RESUMEN

Non-adherence to antihypertensive treatment is one of the critical contributors to sub-optimal blood pressure control. The French Society of Hypertension remembered that urine and serum biochemical detection of antihypertensive drugs could be useful in a patient with resistant hypertension. Talking to a patient with biochemically confirmed non-adherence to blood pressure-lowering therapy and repeating them improved adherence to drugs. Despite its usefulness, biochemical detection of antihypertensive drugs is not routinely effective in France as they are not reimbursed by French Medical Care, except in patients attending hospitals. The list of blood pressure-lowering drugs able to be biochemically detected in France and their modalities are recorded here.


Asunto(s)
Antihipertensivos/uso terapéutico , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Cumplimiento de la Medicación/estadística & datos numéricos , Antihipertensivos/economía , Presión Sanguínea/efectos de los fármacos , Formas de Dosificación , Costos de los Medicamentos , Francia/epidemiología , Humanos , Hipertensión/economía
17.
J Med Life ; 12(3): 260-265, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31666828

RESUMEN

Lower back pain is one of the leading causes of disability in the world. The aim of this study was to evaluate the effect of supplementation of dexmedetomidine and neostigmine with lidocaine 1.5% and triamcinolone for epidural block in increasing the duration of analgesia among patients suffering from chronic low back pain. In this double-blind, randomized clinical trial, 33 patients with chronic low back pain were included in three groups of 11 patients for epidural blockage. Triamcinolone (40 mg/ml) was added to lidocaine 1.5% solution (2 cc/segment) for all three groups. In group N, neostigmine was used at a dose of 1 mg (mg), followed by group D (dexmedetomidine 35 µg [0.5 µg/kg]), and grou [ND (neostigmine 0.5 mg, and 35 µg dexmedetomidine, all of which were added to the triamcinolone and lidocaine solution in each group. Medications were injected into the epidural space using an interlaminar approach. Subsequently, scores of pain and duration of analgesia were recorded in questionnaires and analysed using SPSS version 23. One month after the injections, pain scores recorded in the N group were 7.6±1.4, followed by 5.88±1.2 in group D and 5.42 ±1.1 in group ND. Therefore, the pain scores were significantly higher in the neostigmine group than the other two groups (p = 0.02), but no significant difference was found between the two groups that received dexmedetomidine and a combination of dexmedetomidine + neostigmine. Three months after the injections, there was a significant difference in pain scores between the two groups (P = 0.01). Both neostigmine and dexmedetomidine were capable of reducing the pain of patients with chronic low back pain after epidural block. However, neostigmine's impact is lower compared to dexmedetomidine. The combination of the two drugs also reduced the pain scores of the patients after the intervention.


Asunto(s)
Analgesia Epidural , Dolor Crónico/tratamiento farmacológico , Dexmedetomidina/uso terapéutico , Lidocaína/uso terapéutico , Dolor de la Región Lumbar/tratamiento farmacológico , Neostigmina/uso terapéutico , Triamcinolona/uso terapéutico , Adulto , Presión Sanguínea/efectos de los fármacos , Dolor Crónico/fisiopatología , Dexmedetomidina/farmacología , Método Doble Ciego , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Lidocaína/farmacología , Dolor de la Región Lumbar/fisiopatología , Masculino , Neostigmina/farmacología , Oxígeno/metabolismo , Manejo del Dolor , Triamcinolona/farmacología
19.
Presse Med ; 48(11 Pt 1): 1244-1248, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31732361

RESUMEN

Before menopause, women are protected from the risk of hypertension and atherosclerosis by endogenous estrogens. Estrogens have a vasoprotective role, while progesterone seems to have a neutral effect. Exogenous estrogens used in menopausal treatment have vascular effects. These effects depend of type, dose and administration type, and with age and atherosclerosis stages. Synthetic progestins have varying clinical effects. Each drug must be evaluated separately.


Asunto(s)
Aterosclerosis/prevención & control , Estrógenos/farmacología , Estrógenos/fisiología , Hipertensión/prevención & control , Premenopausia , Progestinas/farmacología , Arterias/efectos de los fármacos , Arterias/fisiología , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Terapia de Reemplazo de Estrógeno , Etinilestradiol/farmacocinética , Etinilestradiol/farmacología , Femenino , Humanos , Menopausia/fisiología , Premenopausia/fisiología , Progesterona/fisiología , Moduladores Selectivos de los Receptores de Estrógeno/farmacología
20.
Presse Med ; 48(11 Pt 1): 1295-1300, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31735524

RESUMEN

Can menopausal hormone therapy (HT) be used in hypertensive women? The group of experts of the French Society of Hypertension has carried out a review of the recent literature in order to answer this question, based on the most recent scientific publications. If use of oral HT is associated with a discreet increase in blood pressure, the transdermal route seems to be safer. The first results of major randomized trials of HT had alerted to an increase in cardiovascular events and breast cancer with the use of oral HT, generally, tipping the benefit-risk balance of the deleterious side. Complementary analyzes have shown the importance of the window of intervention (less than 10 years after the menopause) and the age of the woman to start the HT. On the contrary, they have shown a significant decrease of the coronary events. For woman suffering from hypertension and important climacteric symptoms, it is important to evaluate the whole cardiovascular risk in order to decide the possibility of prescribing a HT. Thus, the group of experts proposes a prescription assistance algorithm based on the stratification of cardiovascular risk, always favoring, when it is authorized, HT by transdermal route of administration.


Asunto(s)
Neoplasias de la Mama/inducido químicamente , Enfermedades Cardiovasculares/inducido químicamente , Terapia de Reemplazo de Estrógeno/métodos , Hipertensión , Menopausia , Administración Cutánea , Administración Oral , Factores de Edad , Algoritmos , Presión Sanguínea/efectos de los fármacos , Contraindicaciones de los Medicamentos , Terapia de Reemplazo de Estrógeno/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo
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