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1.
JAMA ; 322(6): 524-534, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31408137

RESUMO

Importance: The effect of intensive blood pressure lowering on brain health remains uncertain. Objective: To evaluate the association of intensive blood pressure treatment with cerebral white matter lesion and brain volumes. Design, Setting, and Participants: A substudy of a multicenter randomized clinical trial of hypertensive adults 50 years or older without a history of diabetes or stroke at 27 sites in the United States. Randomization began on November 8, 2010. The overall trial was stopped early because of benefit for its primary outcome (a composite of cardiovascular events) and all-cause mortality on August 20, 2015. Brain magnetic resonance imaging (MRI) was performed on a subset of participants at baseline (n = 670) and at 4 years of follow-up (n = 449); final follow-up date was July 1, 2016. Interventions: Participants were randomized to a systolic blood pressure (SBP) goal of either less than 120 mm Hg (intensive treatment, n = 355) or less than 140 mm Hg (standard treatment, n = 315). Main Outcomes and Measures: The primary outcome was change in total white matter lesion volume from baseline. Change in total brain volume was a secondary outcome. Results: Among 670 recruited patients who had baseline MRI (mean age, 67.3 [SD, 8.2] years; 40.4% women), 449 (67.0%) completed the follow-up MRI at a median of 3.97 years after randomization, after a median intervention period of 3.40 years. In the intensive treatment group, based on a robust linear mixed model, mean white matter lesion volume increased from 4.57 to 5.49 cm3 (difference, 0.92 cm3 [95% CI, 0.69 to 1.14]) vs an increase from 4.40 to 5.85 cm3 (difference, 1.45 cm3 [95% CI, 1.21 to 1.70]) in the standard treatment group (between-group difference in change, -0.54 cm3 [95% CI, -0.87 to -0.20]). Mean total brain volume decreased from 1134.5 to 1104.0 cm3 (difference, -30.6 cm3 [95% CI, -32.3 to -28.8]) in the intensive treatment group vs a decrease from 1134.0 to 1107.1 cm3 (difference, -26.9 cm3 [95% CI, 24.8 to 28.8]) in the standard treatment group (between-group difference in change, -3.7 cm3 [95% CI, -6.3 to -1.1]). Conclusions and Relevance: Among hypertensive adults, targeting an SBP of less than 120 mm Hg, compared with less than 140 mm Hg, was significantly associated with a smaller increase in cerebral white matter lesion volume and a greater decrease in total brain volume, although the differences were small. Trial Registration: ClinicalTrials.gov Identifier: NCT01206062.


Assuntos
Anti-Hipertensivos/uso terapêutico , Encéfalo/fisiologia , Hipertensão/tratamento farmacológico , Substância Branca/patologia , Idoso , Pressão Sanguínea , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Fatores de Risco
3.
Pan Afr Med J ; 33: 27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384342

RESUMO

Introduction: In Nigeria, approximately 4.33 million adults suffer from hypertension and about a third of them do not adhere to prescribed medications. Depression has been reported to significantly predict poor medication adherence. The relationship between medication non-adherence and co-morbid depressive disorder in patients with hypertension has not been adequately explored in this environment. The study aimed to determine the prevalence of depression in patients with hypertension. The association between socio-demographic characteristics and presence of co-morbidity on medication adherence was also determined. Methods: A cross-sectional descriptive research design was adopted for the study. A socio-demographic questionnaire, the modified Morisky Medication Adherence Scale (MMAS), the Hamilton Rating Scale for Depression (HAM-D) and the Mini International Neuropsychiatric Interview (MINI), were administered to four hundred patients with hypertension attending medical out-patient clinic between August and September 2012. Results: About 43% (168) were aged 61 to 64 years the majority being females, with a female to male ratio of 1.63:1. The prevalence of comorbid depression was 22.8%, made up of mild (21.8%) and moderate (1.0%) depressive episodes only. Depression was commoner among females than males in a ratio of 3:1. A majority of the participants (96.8%) had high medication adherence; 2.8% and 0.4% had moderate and low adherence respectively. Depression was more among patients with good medication adherence. Conclusion: The occurrence of mild depressive disorder among hypertensives did not affect the level of medication adherence. Review of Antihypertensive drugs should also be done often to ensure patients are not likely to have depressive illness as a side effect of drugs used.


Assuntos
Anti-Hipertensivos/administração & dosagem , Depressão/epidemiologia , Hipertensão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Anti-Hipertensivos/efeitos adversos , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
4.
Zhonghua Yi Xue Za Zhi ; 99(30): 2367-2374, 2019 Aug 13.
Artigo em Chinês | MEDLINE | ID: mdl-31434418

RESUMO

Objective: To assess the effects of clinical medicine on salt sensitive hypertension. Methods: The PubMed, EMBASE, Cochrane Library, CBM, WanFang Data, VIP and CNKI databases were searched to collect randomized controlled trials (RCTs) on clinical medicine in treating salt sensitive hypertension from inception to December 2018. Two reviewers independently screened the literature, extracted data, and another investigator assessed the risk of bias included in the study. Then meta-analysis was performed using RevMan 5.3 software. Results: A total of 16 RCTs studies involving 1 355 patients were included. Meta-analysis showed that angiotensin-converting enzyme inhibitors (ACEIs) combined with diuretics could effectively reduce 24 h systolic blood pressure variability [mean difference (MD)=4.45, 95%CI: 3.47-5.43, P<0.001] and 24 h diastolic blood pressure variability (MD=3.71, 95%CI:2.83-4.59, P<0.001) in salt-sensitive hypertension patients. Angiotensin Ⅱ receptor antagonists (ARBs) combined with diuretics had no antihypertensive effect on salt-sensitive hypertension patients. Indapamide alone can reduce systolic blood pressure (MD=-14.70, 95%CI:-18.57--10.83, P<0.001) and diastolic blood pressure (MD=-8.73, 95%CI:-11.57--5.89, P<0.001). The use of ACEIs alone in salt-sensitive hypertension patients can not reduce systolic pressure (MD=2.20, 95%CI:-1.48-5.88, P=0.240) and diastolic pressure (MD=2.95, 95%CI: 1.37~4.54, P<0.001). Amlodipine combined with metformin had therapeutic effect on salt-sensitive hypertension (RR=1.23, 95%CI: 1.14~1.33, P<0.001). Conclusions: ACEIs combined with diuretics can effectively reduce blood pressure variability in salt-sensitive hypertensive patients. The use of amlodipine in combination with metformin and indapamide alone have antihypertensive effect in salt-sensitive hypertensive patients.


Assuntos
Hipertensão , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Anti-Hipertensivos , Pressão Sanguínea , Humanos
5.
Kardiologiia ; 59(7S): 47-52, 2019 Aug 23.
Artigo em Russo | MEDLINE | ID: mdl-31441741

RESUMO

AIM: To analyze the effect of introducing new treatment goals in hypertension stated in the 2018 European Society of Cardiology and European Society of Hypertension Guidelines on prevalence and treatment efficacy of arterial hypertension (AH) in a representative sample of patients in the European part of the Russian Federation. MATERIALS AND METHODS: A representative sample of population in the European part of Russia was evaluated in 1998, 2002, 2007, and 2017. The structure of patients with AH was compared in these samples according to the 2013 and 2018 European Guidelines. RESULTS: Introduction of new guidelines for the treatment of AH in 2018 resulted in increasing the prevalence of hypertension from 35.5% to 36.9% in 1998, from 39.1% to 39.9% in 2002, from 451.0% to 41.3% in 2007, and from 43.3% to 43.6% in 2017. Proportion of effectively managed patients decreased from 4.7% to 3.5% in 1998, from 7.5% to 6.2% in 2002, from 17.0 to 14.7% in 2007, and from 30.8% to 26.4%. Proportion of patients who required initiation of antihypertensive therapy increased from 59.6% to 61.1% in 1998, from 47.9% to 49.1% in 2002, from 27.9% to 28.2% in 2007, and from 17.5% to 18.2% in 2017. CONCLUSION: The new requirements to diagnostic and treatment of AH provided by the 2018 European Society of Cardiology Guidelines insignificantly influenced prevalence and treatment efficacy of AH. At the same time, the new guidelines appeared rather difficult for application due to different values of blood pressure used for diagnostics and treatment goals.


Assuntos
Hipertensão , Anti-Hipertensivos , Pressão Sanguínea , Determinação da Pressão Arterial , Humanos , Federação Russa
6.
Medicine (Baltimore) ; 98(26): e16264, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261595

RESUMO

BACKGROUND: Clinical researchers found that Amlodipine besylate and Valsartan (ABVS) can effectively treat mild to moderate hypertension (MMH). However, no study has systematically investigated its efficacy and safety for patients with MMH. Thus, present study will systematically assess the efficacy and safety of ABVS for patients with MMH. METHODS: MEDICINE, Cochrane Library, EMBASE, Ovid, PsycINFO, Web of Science, Allied and Complementary Medicine Database, and China National Knowledge Infrastructure will be searched for literatures related to the topic from inception to the present without language limitations. All randomized controlled trials that assess the efficacy and safety of ABVS for patients with MMH will be considered for inclusion. Two researchers will independently select study, extract data, and assess risk of bias for all eligible studies. RESULTS: The primary outcome includes the change of seated diastolic blood pressure. The secondary outcomes consist of the change of seated systolic blood pressure, health-related quality of life, and the tolerability. CONCLUSIONS: The results of this study will summarize the latest evidence on ABVS for the treatment of MMH. ETHICS AND DISSEMINATION: This study does not need ethical approval, because it will not use individual data. The results of this study are expected to be published at peer-reviewed journals. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019133123.


Assuntos
Combinação Anlodipino e Valsartana/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Índice de Gravidade de Doença , Revisão Sistemática como Assunto
9.
Acta Gastroenterol Belg ; 82(2): 319-321, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314195

RESUMO

Olmesartan, an angiotensin receptor blocker, is a widely spread antihypertensive drug. Seronegative villous atrophy of the small intestine due to olmesartan use was first described in 2012. We present a new case of olmesartan-induced enteropathy and compare it to recent literature. This case might suggest a use of budesonide for treatment.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Budesonida/uso terapêutico , Imidazóis/efeitos adversos , Enteropatias/induzido quimicamente , Enteropatias/tratamento farmacológico , Tetrazóis/efeitos adversos , Diarreia/induzido quimicamente , Diarreia/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico
10.
BMJ ; 366: l4064, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296584

RESUMO

OBJECTIVE: To estimate the causal impact of community based blood pressure screening on subsequent blood pressure levels among older adults in China. DESIGN: Regression discontinuity analysis using data from a national cohort study. SETTING: 2011-12 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, a national cohort of older adults in China. PARTICIPANTS: 3899 older adults who had previously undiagnosed hypertension. INTERVENTION: Community based hypertension screening among older adults in 2011-12. MAIN OUTCOME MEASURE: Blood pressure two years after initial screening. RESULTS: The intervention reduced systolic blood pressure: -6.3 mm Hg in the model without covariates (95% confidence interval -11.2 to -1.3) and -8.3 mm Hg (-13.6 to -3.1) in the model that adjusts additionally for demographic, social, and behavioural covariates. The impact on diastolic blood pressure was smaller and non-significant in all models. The results were similar when alternative functional forms were used to estimate the impact and the bandwidths around the intervention threshold were changed. The results did not vary by demographic and social subgroups. CONCLUSIONS: Community based hypertension screening and encouraging people with raised blood pressure to seek care and adopt blood pressure lowering behaviour changes could have important long term impact on systolic blood pressure at the population level. This approach could address the high burden of cardiovascular diseases in China and other countries with large unmet need for hypertension diagnosis and care.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Determinação da Pressão Arterial , China , Diagnóstico Precoce , Feminino , Humanos , Estudos Longitudinais , Masculino , Programas de Rastreamento , Análise de Regressão , Resultado do Tratamento
11.
Medicine (Baltimore) ; 98(29): e16526, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335731

RESUMO

BACKGROUND: This study will evaluate the efficacy of travoprost for patients with glaucoma systematically. METHODS: A comprehensive literature search will be carried from following literature sources from inception to the present: Cochrane Library, MEDLINE, EMBASE, Web of Science, Google scholar, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will only consider randomized controlled trials on assessing the efficacy and safety of travoprost for glaucoma for inclusion. We will use Cochrane risk of bias tool for the methodological quality assessment for each qualified study. If it is possible, we will pool the outcome data, and will perform meta-analysis. RESULTS: This study will systematically evaluate the efficacy and safety of travoprost for glaucoma. Primary outcomes include intraocular pressure (IOP), mean IOP, and mean reduction of IOP. Secondary outcomes consist of diastolic ocular perfusion pressure, central corneal thickness, and quality of life, as measured by 36-Item Short Form Health Survey, and treatment-related adverse events included hyperemia, eye pain, and eye pruritus. CONCLUSION: The findings of the present study will summarize the updated evidence of travoprost for patients with glaucoma.PROSPERO registration number: PROSPERO CRD42019126956.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma/tratamento farmacológico , Travoprost/uso terapêutico , Anti-Hipertensivos/efeitos adversos , Paquimetria Corneana , Dor Ocular/induzido quimicamente , Glaucoma/fisiopatologia , Humanos , Hiperemia/induzido quimicamente , Pressão Intraocular/efeitos dos fármacos , Prurido/induzido quimicamente , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Travoprost/efeitos adversos
12.
High Blood Press Cardiovasc Prev ; 26(4): 345-350, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31352663

RESUMO

INTRODUCION: Treatment strategies for patients with pre-hypertension and low-moderate cardiovascular (CV) risk may include nutraceutical compounds (NCs). AIM: To investigate the efficacy and safety of a new-generation of NC in lowering BP values and improving metabolic profile, in a group of hyper-cholesterolemic subjects with pre-hypertension. METHODS: 131 subjects with pre-hypertension (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg) without organ damage and history of CV diseases were enrolled. 66 subjects were treated with a once-daily oral formulation of a NC (red yeast rice, Berberine, Coenzyme Q10, folic acid and chrome) added to diet for 3 months, while 65 patients followed a diet only. Differences in serum total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDLC and HDLC), triglycerides (TG), glycemia, creatine phosphokinase (CPK), aspartate aminotransferase (AST) alanine aminotransferase (ALT) and body mass index (BMI) were evaluated. RESULTS: At the end of treatment, significant reductions of TC, LDLC, TG glucose levels were observed in both treatment groups, while HDLC values increased in the active treatment group only. A greater reduction of TC, LDLC and glycemia was observed in the treatment group. TG levels were not different within the two groups. BP and BMI levels remained unchanged, as well AST, ALT; CPK slightly increased in both groups, but it remained in the normal range. CONCLUSIONS: In patients with pre-hypertension, NC supplementation was safe, well tolerated and effective in improving lipid pattern and glucose levels and in preventing the progression to overt hypertension.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Suplementos Nutricionais , Hipercolesterolemia/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Hipolipemiantes/uso terapêutico , Lipídeos/sangue , Pré-Hipertensão/tratamento farmacológico , Idoso , Anti-Hipertensivos/efeitos adversos , Biomarcadores/sangue , Glicemia/metabolismo , Suplementos Nutricionais/efeitos adversos , Progressão da Doença , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/diagnóstico , Hipoglicemiantes/efeitos adversos , Hipolipemiantes/efeitos adversos , Itália , Masculino , Pessoa de Meia-Idade , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/fisiopatologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
14.
BMC Ophthalmol ; 19(1): 149, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300022

RESUMO

BACKGROUND: The effect of cataract surgery on IOP in patients with primary open-angle glaucoma (POAG) is a subject of debate. We investigated the effect of cataract surgery by phacoemulsification on intraocular pressure (IOP) in patients with medically POAG . METHODS: Seventy eyes of 40 POAG patients undergoing cataract surgery by phacoemulsification were retrospectively evaluated. All patients had their POAG medically controlled without prior glaucoma surgery. Baseline demographics and clinical characteristics were recorded. IOP and the number of glaucoma medications were evaluated before and for 1 year after cataract surgery. We analyzed IOP variations from baseline with a Student t-test for a paired sample. We used a Pearson correlation coefficient and linear regression to study the relation between IOP change from baseline and preoperative characteristics. RESULTS: One year after phacoemulsification, IOP decreased by a mean 1.15 ± 3 mmHg (6.8 ± 18.1%) (P = 0.01) and the number of glaucoma medications remained unchanged with a difference of - 0.1 ± 0.43 (P = 0.09). Higher preoperative IOP was associated with a greater IOP decrease after 1 year of follow-up (P < 0.001). One and 7 days after cataract surgery, 12.9 and 4.2% of the eyes had IOP spikes > 30 mmHg, respectively. One year after cataract surgery, 75.7% of the POAG eyes maintained the same number of glaucoma medications while 17.1% had a decrease and 7.2% of the eyes required adding glaucoma medications. CONCLUSION: Cataract surgery by phacoemulsification in eyes with medically controlled POAG resulted at 1 year in a very small IOP decrease without a change in the number of glaucoma medications. A drop in IOP should not be expected after performing phacoemulsification alone in POAG patients.


Assuntos
Catarata/complicações , Glaucoma de Ângulo Aberto/complicações , Pressão Intraocular/fisiologia , Facoemulsificação , Idoso , Anti-Hipertensivos/uso terapêutico , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/tratamento farmacológico , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Implante de Lente Intraocular/métodos , Masculino , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Tempo , Tonometria Ocular , Resultado do Tratamento
15.
J Agric Food Chem ; 67(28): 7810-7820, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31264418

RESUMO

Antihypertensive peptides were screened from thermolysin hydrolysate of Cassia obtusifolia seeds (Jue Ming Zi) using two independent bioassay-guided fractionations, reversed-phase high-performance liquid chromatography (RP-HPLC), and strong cation-exchange (SCX) liquid chromatography coupled with angiotensin I-converting enzyme (ACE) inhibitory assay. The identical peptide in the most active RP-HPLC and SCX fractions was simultaneously de novo sequenced as FHAPWK with high-resolution mass spectrometry. FHAPWK (IC50 = 16.83 ± 0.90 µM) was further identified as a competitive inhibitor and a true inhibitor on ACE by a Lineweaver-Burk plot and preincubation experiment, respectively. The molecular docking simulation indicated that FHAPWK could interact with several key residues of the ACE active site, which is consistent with the result of the inhibitory kinetics study. Moreover, its antihypertensive effect was demonstrated using the animal model of spontaneously hypertensive rats. It is concluded that FHAPWK is the first reported antihypertensive peptide derived from thermolysin hydrolysate of C. obtusifolia seeds.


Assuntos
Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/química , Cassia/química , Hipertensão/tratamento farmacológico , Peptídeos/administração & dosagem , Peptídeos/química , Proteínas de Plantas/química , Animais , Descoberta de Drogas , Humanos , Masculino , Espectrometria de Massas , Simulação de Acoplamento Molecular , Ratos , Ratos Endogâmicos SHR , Sementes/química
16.
Emerg Med Clin North Am ; 37(3): 529-544, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31262419

RESUMO

Central nervous system hemorrhage has multiple pathophysiologic etiologies, including intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI). Given the nuances intrinsic to each of these etiologies and pathophysiologic processes, optimal blood pressure varies significantly and depends on type of hemorrhage and individual characteristics. This article reviews the most current evidence regarding blood pressure targets and provides guidance on reversal of anticoagulation for TBI, ICH, and SAH. It also describes the assessment, optimal therapeutic targets, and interventions to treat intracranial hypertension that can result from TBI, ICH, or SAH.


Assuntos
Hemorragias Intracranianas/terapia , Hipertensão Intracraniana/terapia , Anti-Hipertensivos/uso terapêutico , Antitrombinas/uso terapêutico , Pressão Sanguínea , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/terapia , Medicina de Emergência , Hemostáticos/uso terapêutico , Humanos , Hemorragias Intracranianas/diagnóstico , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/etiologia , Transfusão de Plaquetas , Vasodilatadores/uso terapêutico
17.
Anticancer Res ; 39(7): 3543-3551, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31262878

RESUMO

BACKGROUND/AIM: Both bevacizumab (BEV) and soluble fms-like tyrosine kinase-1 (sFlt-1) have demonstrated anti-angiogenic effects, thereby causing hypertension and proteinuria. We hypothesized that anti-preeclamptic drugs that combat the action of sFlt-1 may reduce BEV's anti-tumor efficacy. MATERIALS AND METHODS: 3D co-cultured human mini-tumors consisting of endothelial cells, fibroblasts, and cancer cells were developed. The influence of anti-preeclamptic drugs and BEV on the invasion of mini-tumors embedded in collagen gel was evaluated. RESULTS: Mini-tumor spheroids that contained MDA-MB-231 cells showed higher invasion ability than spheroids with A549. Among the six anti-preeclamptic drugs investigated, only nicorandil enhanced the invasion of mini-tumors and inhibited the action of BEV. Glibenclamide, an ATP-sensitive potassium channel inhibitor, completely quenched the action of nicorandil on mini-tumors. CONCLUSION: In the human mini-tumor model, nicorandil aggravated the invasion of mini-tumors. These data raise the possibility that concomitant use of nicorandil counteracts the efficacy of BEV therapy.


Assuntos
Inibidores da Angiogênese/farmacologia , Anti-Hipertensivos/farmacologia , Bevacizumab/farmacologia , Esferoides Celulares/efeitos dos fármacos , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Técnicas de Cocultura , Feminino , Fibroblastos/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Nicorandil/farmacologia , Pré-Eclâmpsia , Gravidez , Esferoides Celulares/fisiologia , Fator A de Crescimento do Endotélio Vascular/farmacologia
18.
Medicine (Baltimore) ; 98(28): e16093, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305392

RESUMO

BACKGROUND: LCZ696 has been introduced in patients with hypertension in several trials. Here, we performed a meta-analysis to evaluate the effect and safety of LCZ696 in hypertensive patients. METHODS: PubMed, Embase, the Cochrane Library and ClinicalTrials.gov databases were searched to identify the available randomized controlled trials (RCTs) investigating the effect and safety of LCZ696 in hypertension patients. The last search date was October 31, 2018. RESULTS: Nine RCTs with 6765 subjects were finally included, in which 8 trials compared the effect and safety between LCZ696 and angiotensin receptor antagonists (ARBs). Evidences showed LCZ696, compared with ARBs, achieved a better blood pressure control rate (OR 1.24, 95% CI: 1.14-1.35), specifically, LCZ696 were better at reducing systolic blood pressure [WMD -4.11 mmHg, 95% CI: (-5.13, -3.08) mmHg], diastolic blood pressure [WMD -1.79 mmHg, 95% CI: (-2.22, -1.37) mmHg], mean 24-hour ambulatory systolic blood pressure [WMD -3.24 mmHg, 95% CI: (-4.48, -1.99) mmHg] and mean 24-hour ambulatory diastolic blood pressure [WMD -1.25 mmHg, 95% CI: (-1.81, -0.69) mmHg]. There was no difference in the events of adverse events (risk ratio [RR] 1.01, 95% CI: 0.39-1.09), serious adverse events (RR 0.80, 95% CI: 0.52-1.22) and discontinuation of treatment for any adverse events (RR 0.79, 95% CI: 0.56-1.11) between LCZ696 group and ARB/placebo group, except LCZ696 reduced the rate of headaches (RR 0.69, 95% CI: 0.48-0.99) while increased cough (RR 2.12, 95% CI: 1.11-4.04; P = .02; I = 25%). CONCLUSION: Our finding provides evidence that LCZ 696 was more effective than ARB on blood pressure control and was safe enough in patients with hypertension.


Assuntos
Aminobutiratos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Tetrazóis/uso terapêutico , Aminobutiratos/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Tetrazóis/efeitos adversos
19.
Semin Ophthalmol ; 34(5): 398-402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31284800

RESUMO

Purpose: To compare the success rates and safety of transscleral cyclophotocoagulation (TSCPC) for the treatment of refractory glaucoma using the slow coagulation technique and the conventional technique. Methods: A retrospective, interventional case series of 44 patients (44 eyes) who underwent TSCPC using the slow coagulation technique (22 eyes) and conventional technique (22 eyes) in a tertiary hospital was done. The main outcome measures were success and complications. Success was defined as a final intraocular pressure (IOP) between 6 and 21 mmHg with or without IOP lowering medications with the cessation of oral carbonic anhydrase inhibitor at 12 months. Results: Preoperative characteristics were statistically similar with regard to age, sex, laterality, diagnosis, IOP, and the number of glaucoma medications used. Both procedures had similar success rates of 40.9% and 36.3% in the conventional technique group and slow coagulation group, respectively (p = .757). The slow coagulation group had less prolonged anterior chamber inflammation (p = .048). Conclusions: Diode laser TSCPC using the slow coagulation technique is a safe and effective technique for lowering IOP in patients with refractory glaucoma in Chinese eyes.


Assuntos
Glaucoma/cirurgia , Fotocoagulação a Laser/métodos , Procedimentos Cirúrgicos Oftalmológicos , Esclera/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Inibidores da Anidrase Carbônica/uso terapêutico , Feminino , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Plant Foods Hum Nutr ; 74(3): 405-413, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31273642

RESUMO

The aim of this work was to evaluate the ability of broken rice, an underutilized industrial by-product, as a potential functional and health promoting ingredient. With this purpose, the ability to inhibit the angiotensin converting enzyme and renin of a rice protein hydrolyzate (RPH) obtained from a high-protein variety of broken rice (var. Nutriar FCAyF) was analyzed (IC50 = 0.87 and 2.7 mg/mL, respectively). RPH was separated by gel permeation chromatography and in a second purification step by RP-HPLC. The sequence of antihypertensive peptides presented in two RP-HPLC fractions was analyzed. Peptides capable of interacting with the active sites of both enzymes were identified. In this study, we demonstrate that the hydrolysis treatment improves functional and biological properties of rice proteins. Protein preparations obtained from a by-product of rice industry, such as broken rice, are a promising ingredient with potentially good biological properties.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/farmacologia , Anti-Hipertensivos/isolamento & purificação , Oryza/química , Peptídeos/isolamento & purificação , Renina/antagonistas & inibidores , Anti-Hipertensivos/farmacologia , Cromatografia Líquida de Alta Pressão , Promoção da Saúde , Hidrólise , Simulação de Acoplamento Molecular , Peptídeos/farmacologia , Peptidil Dipeptidase A/metabolismo , Proteínas de Plantas/antagonistas & inibidores , Proteínas de Plantas/metabolismo , Renina/metabolismo
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