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1.
J Assoc Physicians India ; 69(6): 11-12, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34472787

RESUMO

BACKGROUND: The present study intended to estimate the comorbidities and risk factors among patients with hypertension in India. Further, the current practice of hypertension management was evaluated and the choice of therapy was assessed based on hypertension grade, risk factors, and comorbidities. METHODS: Electronic medical record data (June 2017-June 2019) of Indian adult hypertensive patients (≥140/90 mmHg) who had two blood pressure (BP) readings were retrospectively analyzed. Demographic characteristics, BP readings, comorbidities, medications and co-medications, and laboratory data were collected at baseline. Grids based on hypertension grade (I, II, and III), demographic factors, risk factors, and comorbidities were created and prescribed antihypertensive drugs (AHDs) in each grid were evaluated. RESULTS: Among 100,075 patients, the proportion of patients in 18-40 year, 40-65 year, and >65 year age groups were 11.4%, 65.1%, and 23.4%, respectively. Proportion of men and women was similar (52.0% vs 47.9%). Proportion of patients with BMI <25 Kg/m2 was 8.1%, 25-29.9 Kg/m2 was 11.9%, and >30 Kg/m2 was 8.8%. Mean BP of patients with hypertension was: grade I (145.05/90.73 mmHg), grade II (160.07/95.64 mmHg), and grade III (180.82/102.76 mmHg). Mean low density lipoprotein (113.26 mg/dL), serum creatinine (2.28 mg/dL), mean HbA1c (8.7%) levels were highest among patients with grade III hypertension. Commonly observed comorbidities were type 2 diabetes mellitus (T2DM: 51.5%), dyslipidemia (36.4%), and chronic kidney disease (CKD: 4.4%). Top concomitant medications included anti-diabetic therapies (34.6%), drugs for dyslipidemia (30.0%), and anti-platelet therapies (6.9%). CONCLUSION: Most prescribed AHD monotherapies were angiotensin receptor II blockers (ARBs) and calcium channel blockers (CCBs) and most prescribed combination therapies were ARBs + diuretics and ARBs + CCBs. Telmisartan and amlodipine+telmisartan for patients with comorbid T2DM or dyslipidemia and metoprolol for those with coronary artery disease were the commonly prescribed AHDs.


Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Adolescente , Adulto , Idoso , Antagonistas de Receptores de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Morbidade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
2.
Cad Saude Publica ; 37(8): e00061120, 2021.
Artigo em Português | MEDLINE | ID: mdl-34495089

RESUMO

The study analyzes interactions between drug treatment adherence, blood pressure targets, and depression in a probabilistic sample of hypertensive individuals treated in the Family Health Strategy in Governador Valadares, Minas Gerais State, Brazil. This is a cross-sectional study with 641 hypertensive individuals 40 years or older, residing in the urban area of Governador Valadares. Structured scripts were used to collect data in home interviews, with a focus on the following indicators: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI), and blood pressure measurement. Due to the simultaneity of the target events (depression, blood pressure target, and adherence), we applied a system of recursive and simultaneous nonlinear equations. The results suggest that the odds of meeting the blood pressure target increase significantly with adherence to treatment; they also suggest that individuals that meet the blood pressure target show 2.6 higher odds of treatment adherence. Adherence has a protective effect against depression: individuals with minimal adherence show 8.4 higher odds of developing depressive symptoms when compared to those with maximum adherence. Drug treatment adherence is related simultaneously to blood pressure control and lower levels of depression. Promoting drug treatment adherence is essential for ensuring that individuals remain normotensive, with the potential for reducing levels of depression. These positive externalities can reduce pressure on the health system, with simultaneous gains in quality of life for hypertensive individuals.


Assuntos
Hipertensão , Preparações Farmacêuticas , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Brasil , Estudos Transversais , Depressão , Saúde da Família , Humanos , Hipertensão/tratamento farmacológico , Adesão à Medicação , Qualidade de Vida
3.
BMC Public Health ; 21(1): 1648, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503467

RESUMO

BACKGROUND: Hypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke. METHODS: Our cross-sectional study included 18,796 adults aged ≥40 years and residing in northeast China. Ischemic stroke was diagnosed according to the World Health Organization's criteria, which requires the clinical record, computed tomography (CT) and/or magnetic resonance imaging (MRI) during the hospital stay. Hypertension was defined according to the Chinese hypertension guidelines (mean SBP ≥140 mmHg and/or mean DBP ≥90 mmHg, and/or self-reported use of anti-hypertensive medication in the past 2 weeks). RESULTS: Of the 986 survivors of ischemic stroke, 819 (83.1%) were identified with hypertension (535 were pre-stroke hypertension and 284 were post-stroke hypertension). Among hypertensive patients, the awareness and treatment rates were 76.8 and 66.7% respectively. Only 11.0% achieved an appropriate blood pressure (< 140 mmHg and < 90 mmHg) among those who took hypertensive medications. 16.8% of treated hypertensive patients received combination therapy, and calcium channel blockers were the most frequently used anti-hypertensive medication as monotherapy. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the stroke population was 155.3 ± 22.9 mmHg and 89.2 ± 12.3 mmHg. Both SBP and DBP were higher in rural patients than in urban patients (158.5 ± 23.8 mmHg vs. 146.4 ± 17.5 mmHg and 90.3 ± 12.9 mmHg vs. 85.9 ± 10.1 mmHg, respectively; p < 0.001). The rates of stage 2 and above hypertension in the ischemic stroke population were 32.5 and 18.7%, and was significantly higher in rural areas than in urban areas. CONCLUSIONS: The prevalence of poorly-controlled hypertension and the high rates of blood pressures at stages 2 and above in patients with prior ischemic stroke demonstrated an alarming situation in northeast China.


Assuntos
Hipertensão , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , China/epidemiologia , Estudos Transversais , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Sobreviventes
4.
Rev Med Suisse ; 17(750): 1549-1555, 2021 Sep 15.
Artigo em Francês | MEDLINE | ID: mdl-34528417

RESUMO

High blood pressure levels are frequently encountered in medical practice, whether in an outpatient or inpatient setting. It is imperative to quickly differentiate severe hypertension associated with target organ damage, from severe hypertension without acute organ damage. In the latter situation, the management can be done on an outpatient basis by prescribing oral antihypertensive treatment with a close follow-up. On the other hand, in severe hypertension with acute target organ damage, patients should be admitted in an intensive care unit for close monitoring and, in most cases, treated with intravenous antihypertensive treatment. This article reviews the new definitions and management of these two entities and is addressed to both general practitioner and emergency doctor.


Assuntos
Hipertensão Maligna , Hipertensão , Assistência Ambulatorial , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Serviço Hospitalar de Emergência , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão Maligna/tratamento farmacológico
5.
Rev Med Suisse ; 17(750): 1562-1566, 2021 Sep 15.
Artigo em Francês | MEDLINE | ID: mdl-34528419

RESUMO

Blood pressure (BP) variability appears to be a cardiovascular risk factor in its own right. Seasonal and temperature changes contribute to BP variations in the medium term with increased BP values in winter and lowered values in summer, and in the short term by influencing the circadian rhythm of BP. International societies have not issued specific recommendations on the detection of patients at risk of significant seasonal variations in BP, nor on the possible adaptation of antihypertensive treatments. This is a topical issue in the context of global warming, which will make these seasonal differences more significant in the future. Measuring BP outside the medical setting can be of great help in screening and monitoring these patients.


Assuntos
Monitorização Ambulatorial da Pressão Arterial , Hipertensão , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Ritmo Circadiano , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Estações do Ano
6.
Rev Med Suisse ; 17(750): 1567-1570, 2021 Sep 15.
Artigo em Francês | MEDLINE | ID: mdl-34528420

RESUMO

High blood pressure and dementia are both frequent age-related diseases. The purpose of this article is to review the treatment of hypertension and his effects on cognition, and to propose key points to improve hypertension's treatment in dementia suffering patients. The management of hypertension in middle-life patients seems to be very important to avoid or decrease the progression of cognitive impairment or dementia. Nevertheless, there is no guidelines regarding blood pressure in patients concerned by dementia. To personalize the treatment, to take other comorbidities into account, and the frequent reevaluation of the medication are keys of an optimal management of hypertension in general and becomes crucial more specific in this population.


Assuntos
Disfunção Cognitiva , Demência , Hipertensão , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Cognição , Disfunção Cognitiva/etiologia , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia
7.
Ann Palliat Med ; 10(7): 7486-7513, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34353038

RESUMO

BACKGROUND: JiaWeiSiWu granule (JWSWG) has been applied clinically for more than a decade, and the preliminary results show that blood pressure can be reduced while protecting the target organ at the same time. The purpose of this research is to study the pharmacological mechanism of JWSWG in treating hypertension using network pharmacology. METHODS: The chief active components, relevant targets, and the target genes of JWSWG were retrieved by the databases TCMSP and UniProt. The GeneCards database was used to obtain target genes of hypertension. Then, the target genes of hypertension and active components were intersected to discover the potential targets by which JWSWG acts on hypertension. Cytoscape software was employed to construct the "medicine-compound-target-disease" network. The STRING database was used to construct the protein-protein interaction network in order to screen the key target genes. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were analyzed by RGUI and org.Hs.eg.db. RESULTS: By intersecting 102 compound target genes with 6,732 target genes of hypertension, 88 action target genes were obtained, thereby screening out the key compounds and key targets. The results of GO enrichment showed the main molecular functions, biological processes, and cellular components. The main pathways of JWSWG in treating hypertension were revealed by KEGG pathway enrichment. CONCLUSIONS: This research clarified the mechanism of JWSWG in the treatment of hypertension systematically, providing new potential ideas and a theoretical foundation for further experimental and clinical research.


Assuntos
Medicamentos de Ervas Chinesas , Hipertensão , Anti-Hipertensivos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/genética , Medicina Tradicional Chinesa
8.
BMC Health Serv Res ; 21(1): 834, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407820

RESUMO

BACKGROUND: Poor medication adherence is an extraordinarily common problem worldwide that contributes to inadequate control of many chronic diseases, including Hypertension (HT). Globally, less than 14% of the estimated 1.4 billion patients with HT achieve optimal control. A myriad of barriers, across patient, healthcare provider, and system levels, contributes to poor medication adherence. Few studies have explored the reasons for poor medication adherence in Tanzania and other African countries. METHODS: A qualitative study applying grounded theory principles was conducted in the catchment area of two semi-urban clinics in Dar es Salaam, Tanzania, to determine the perceived barriers to HT medication adherence. Ten key informant interviews were conducted with healthcare providers who manage HT patients. Patients diagnosed with HT (SBP ≥ 140 and DBP ≥ 90), were randomly selected from patient registers, and nine focus group discussions were conducted with a total 34 patients. Inductive codes were developed separately for the two groups, prior to analyzing key thematic ideas with smaller sub-categories. RESULTS: Affordability of antihypertensive medication and access to care emerged as the most important barriers. Fee subsidies for treatment and medication, along with health insurance, were mentioned as potential solutions to enhance access and adherence. Patient education and quality of physician counseling were mentioned by both providers and patients as major barriers to medication adherence, as most patients were unaware of their HT and often took medications only when symptomatic. Use of local herbal medicines was mentioned as an alternative to medications, as they were inexpensive, available, and culturally acceptable. Patient recommendations for improving adherence included community-based distribution of refills, SMS text reminders, and family support. Reliance on religious leaders over healthcare providers emerged as a potential means to promote adherence in some discussions. CONCLUSIONS: Effective management of hypertensive patients for medication adherence will require several context-specific measures. These include policy measures addressing financial access, with medication subsidies for the poor and accessible distribution systems for medication refill; physician measures to improve health provider counseling for patient centric care; and patient-level strategies with reminders for medication adherence in low resource settings.


Assuntos
Anti-Hipertensivos , Hipertensão , Anti-Hipertensivos/uso terapêutico , Pessoal de Saúde , Humanos , Hipertensão/tratamento farmacológico , Adesão à Medicação , Pesquisa Qualitativa , Tanzânia
9.
Indian J Ophthalmol ; 69(9): 2475-2480, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34427247

RESUMO

Purpose: To compare the efficacy and the tolerability of preservative-free Tafluprost 0.0015% (TP) vs Latanoprost 0.005% (LP) in patients with primary open-angle glaucoma (POAG). Methods: Prospective, randomized, crossover study included patients with early POAG attending the outpatient clinic from July 2019 to February 2020. Patients were divided into 2 groups: group A included patients receiving TP and group B receiving LP. After 2 months, treatment was stopped for 1 month (washout period) then drops were switched between the groups for further 2 months. Intraocular pressure (IOP) was recorded at baseline and monthly until 5 months. Efficacy was measured by the IOP reduction at the end of each treatment period. Tolerability was assessed both subjectively (questionnaire on ocular comfort) and objectively (ocular findings) at the end of each period. Results: A total of 30 patients were allocated into two groups (15 patients each). There was no statistically significant difference between the 2 groups in baseline clinical examinations. All the eyes in both groups achieved IOP reduction >20% compared to baseline values, with no statistically significant difference in between. Corneal erosions and conjunctival hyperemia were significantly higher in LP-treated eyes throughout the study, regardless of the sequence. Tear break-up time scores significantly worsened after LP at the 2nd and 5th month (P < 0.001and P = 0.026 respectively) but not after TP treatment (P = 0.719 and P = 0.164). Significant exacerbation in all patients' symptoms was noticed on switching from TP to LP. Conclusion: : Tafluprost was proved to exhibit a comparable effect on IOP control in POAG patients, as Latanoprost drops resulted in marked alleviation in both subjective and objective ocular discomfort manifestations.


Assuntos
Glaucoma de Ângulo Aberto , Hipertensão Ocular , Prostaglandinas F Sintéticas , Anti-Hipertensivos/uso terapêutico , Estudos Cross-Over , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Humanos , Latanoprosta , Hipertensão Ocular/tratamento farmacológico , Estudos Prospectivos , Prostaglandinas F , Resultado do Tratamento
11.
Artigo em Inglês | MEDLINE | ID: mdl-34444005

RESUMO

Falls are prominent health issues among older adults. Among hypertensive older adults, falls may have a detrimental effect on their health and wellbeing. The purpose of this study is to determine the prevalence of falls among hypertensive older adults and to identify the associated factors that contribute to their falls. This was a cross-sectional study conducted among two hundred and sixty-nine hypertensive older adults who were selected via systematic random sampling in two primary health clinics in Kuala Terengganu, Malaysia. Data on their socio-demographic details, their history of falls, medication history and clinical characteristics were collected. Balance and gait were assessed using the Performance Oriented Mobility Assessment (POMA). It was found that 32.2% of participants reported falls within a year. Polypharmacy (adjusted OR 2.513, 95% CI 1.339, 4.718) and diuretics (adjusted OR 2.803, 95% CI 1.418, 5.544) were associated with an increased risk of falls. Meanwhile, a higher POMA score (adjusted OR 0.940, 95% CI 0.886, 0.996) and the number of antihypertensives (adjusted OR 0.473, 95% CI 0.319, 0.700) were associated with a low incidence of falling among hypertensive older adults. Falls are common among hypertensive older adults. Older adults who are taking diuretics and have a polypharmacy treatment plan have a higher incidence of falls. However, older adults taking a higher number of anti-hypertensive medications specifically were not associated with an increased prevalence of falls.


Assuntos
Acidentes por Quedas , Hipertensão , Idoso , Anti-Hipertensivos/uso terapêutico , Estudos Transversais , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Prevalência , Fatores de Risco
12.
Front Cell Infect Microbiol ; 11: 679624, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34458158

RESUMO

Background: Although transplantation of the fecal microbiota from normotensive donors has been shown to have an antihypertensive effect in hypertensive animal models, its effect on blood pressure in patients with hypertension is unclear. This study aimed to assess the effect of washed microbiota transplantation (WMT) from normotensive donors on blood pressure regulation in hypertensive patients. Methods: The clinical data of consecutive patients treated with washed microbiota transplantation (WMT) were collected retrospectively. The blood pressures of hypertensive patients before and after WMT were compared. The factors influencing the antihypertensive effect of WMT in hypertensive patients and fecal microbial composition of donors and hypertensive patients were also analyzed. Results: WMT exhibited an antihypertensive effect on blood pressure: the blood pressure at hospital discharge was significantly lower than that at hospital admission (change in systolic blood pressure: -5.09 ± 15.51, P = 0.009; change in diastolic blood pressure: -7.74 ± 10.42, P < 0.001). Hypertensive patients who underwent WMT via the lower gastrointestinal tract (ß = -8.308, standard error = 3.856, P = 0.036) and those not taking antihypertensive drugs (ß = -8.969, standard error = 4.256, P = 0.040) had a greater decrease in systolic blood pressure, and hypertensive patients not taking antihypertensive drugs also had a greater decrease in diastolic blood pressure (ß = -8.637, standard error = 2.861, P = 0.004). After WMT, the Shannon Diversity Index was higher in six of eight hypertensive patients and the microbial composition of post-WMT samples tended to be closer to that of donor samples. Conclusion: WMT had a blood pressure-lowering effect in hypertensive patients, especially in those who underwent WMT via the lower gastrointestinal tract and in those not taking antihypertensive drugs. Therefore, modulation of the gut microbiota by WMT may offer a novel approach for hypertension treatment.


Assuntos
Hipertensão , Microbiota , Animais , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Humanos , Hipertensão/terapia , Estudos Retrospectivos
13.
Medicine (Baltimore) ; 100(31): e26818, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397841

RESUMO

ABSTRACT: Hypertension is the leading cause of increased morbidity and mortality rates worldwide. Despite adherence to therapies is the important determinant of treatment success to reduce apparent resistant hypertension, maintaining good adherence to antihypertensive medications remained the most serious challenge. Thus, this study aimed to assess adherence to antihypertensive medications among adult hypertensive patients in Dessie Referral Hospital.A cross-sectional study design was conducted among hypertensive patients during May and June 2020. The study participants were selected using a systematic random sampling technique. The collected data were entered into EpiData version 4.4 and exported to SPSS version 25.0 software for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression at a 95% confidence interval (CI). A variable that has a P-value < .05 was declared as statistically significant. Hosmer-Lemeshow test was used to test goodness-of-fit and multicollinearity was tested.The overall good adherence to antihypertensive medications was 51.9%; 95% CI: (46.8-58.3%) and poor adherence was 48.1%. Factors associated with good adherence were: sex-female adjusted odd ratio (AOR) = 1.31; 95% CI (1.06-2.52), occupational status-employed AOR = 2.24; 95% CI (1.33-3.72), good knowledge of the disease AOR = 2.20; 95% CI (1.34-3.72) and good self-efficacy AOR = 1.38; 95% CI (1.20-2.13).This study revealed that almost half of the hypertensive patients in Dessie Referral Hospital had good antihypertensive medication adherence. Sex, occupational status, knowledge, and self-efficacy were factors associated with good adherence. Therefore, health education should be given to patients on the importance of complying with medication and patients should be monitored by health extension workers.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão , Adesão à Medicação , Adulto , Causalidade , Indicadores de Doenças Crônicas , Estudos Transversais , Emprego , Etiópia/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/psicologia , Masculino , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Centros de Cuidados de Saúde Secundários/estatística & dados numéricos , Autoeficácia , Fatores Sexuais
14.
Zool Res ; 42(5): 633-636, 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34423606

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent responsible for the global coronavirus disease 2019 (COVID-19) pandemic. Numerous studies have demonstrated that cardiovascular disease may affect COVID-19 progression. In the present study, we investigated the effect of hypertension on viral replication and COVID-19 progression using a hypertensive mouse model infected with SARS-CoV-2. Results revealed that SARS-CoV-2 replication was delayed in hypertensive mouse lungs. In contrast, SARS-CoV-2 replication in hypertensive mice treated with the antihypertensive drug captopril demonstrated similar virus replication as SARS-CoV-2-infected normotensive mice. Furthermore, antihypertensive treatment alleviated lung inflammation induced by SARS-CoV-2 replication (interleukin (IL)-1ß up-regulation and increased immune cell infiltration). No differences in lung inflammation were observed between the SARS-CoV-2-infected normotensive mice and hypertensive mice. Our findings suggest that captopril treatment may alleviate COVID-19 progression but not affect viral replication.


Assuntos
Anti-Hipertensivos/uso terapêutico , COVID-19/complicações , Captopril/uso terapêutico , Hipertensão/complicações , Pneumopatias/tratamento farmacológico , SARS-CoV-2 , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Animais , Anti-Hipertensivos/farmacologia , Captopril/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Inflamação/complicações , Inflamação/tratamento farmacológico , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Pneumopatias/etiologia , Pneumopatias/virologia , Camundongos , Replicação Viral/efeitos dos fármacos
15.
J Fam Pract ; 70(5): 220-228, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34410912

RESUMO

After confirmation of the diagnosis, follow up with recommendations for lifestyle adjustment and, in certain clinical situations, pursue medical therapy.


Assuntos
Hipertensão/diagnóstico , Pediatria/métodos , Anti-Hipertensivos/uso terapêutico , Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/métodos , Humanos , Hipertensão/tratamento farmacológico , Pediatria/tendências
16.
Nutrients ; 13(8)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34444905

RESUMO

Gamma-amino butyric acid (GABA) is marketed in the U.S. as a dietary supplement. USP conducted a comprehensive safety evaluation of GABA by assessing clinical studies, adverse event information, and toxicology data. Clinical studies investigated the effect of pure GABA as a dietary supplement or as a natural constituent of fermented milk or soy matrices. Data showed no serious adverse events associated with GABA at intakes up to 18 g/d for 4 days and in longer studies at intakes of 120 mg/d for 12 weeks. Some studies showed that GABA was associated with a transient and moderate drop in blood pressure (<10% change). No studies were available on effects of GABA during pregnancy and lactation, and no case reports or spontaneous adverse events associated with GABA were found. Chronic administration of GABA to rats and dogs at doses up to 1 g/kg/day showed no signs of toxicity. Because some studies showed that GABA was associated with decreases in blood pressure, it is conceivable that concurrent use of GABA with anti-hypertensive medications could increase risk of hypotension. Caution is advised for pregnant and lactating women since GABA can affect neurotransmitters and the endocrine system, i.e., increases in growth hormone and prolactin levels.


Assuntos
Anti-Hipertensivos/uso terapêutico , Suplementos Nutricionais , Substâncias para Melhoria do Desempenho/uso terapêutico , Vigilância de Produtos Comercializados , Ácido gama-Aminobutírico/uso terapêutico , Animais , Pressão Sanguínea/efeitos dos fármacos , Cães , Feminino , Fermentação , Humanos , Masculino , Leite/química , Gravidez , Ratos , Alimentos de Soja/análise , Estados Unidos
17.
Molecules ; 26(16)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34443434

RESUMO

The aerial part of Biebersteinia heterostemon Maxim. (Geraniaceae Biebersteiniaceae) known as ming jian na bao in Chinese, has been traditionally used in Tibetan folk medicine for treatment of diabetes and hypertension. The aim of the present study was to evaluate the effects of galegine obtained from an ethanol extract of the entire Biebersteinia heterostemon plant on the rat's cardiovascular system in order to characterize its contributions as an antihypertensive agent. The antihypertensive effect of galegine was investigated in pentobarbital-anesthetized hypertensive rats at three dose levels based on the LD50 of galegine. Meanwhile a positive control group received dimaprit with the same procedure. Dimaprit infusion induced a significant hypotension which declined by an average margin of 20%. Simultaneously, single administration of galegine at the doses of 2.5, 5, and 10 mg/kg by intraperitoneal injection induced an immediate and dose-dependent decrease in mean arterial blood pressure (MABP) by an average margin of 40% with a rapid increase in heart rate (HR). We demonstrated that galegine is effective in reducing blood pressure in anesthetized hypertensive rats with rapid onset and a dose-related duration of the effects. The results indicate that galegine was the bioactive compound which can be used as a pharmacophore to design new hypertensive agents.


Assuntos
Anti-Hipertensivos/farmacologia , Guanidinas/farmacologia , Magnoliopsida/química , Animais , Anti-Hipertensivos/química , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Dimaprit/farmacologia , Feminino , Guanidinas/química , Guanidinas/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Masculino , Camundongos , Ratos Sprague-Dawley
18.
Pol Merkur Lekarski ; 49(292): 306-310, 2021 Aug 16.
Artigo em Polonês | MEDLINE | ID: mdl-34464374

RESUMO

Hypertensive crisis is a sudden rise in blood pressure that is significantly above normal values. Depending on the severity of symptoms, hypertensive crisis can be classified as hypertensive urgency, i.e. severe arterial hypertension (AH) without organ failure and damage with nonspecific symptoms (pain, dizziness, nosebleeds, nausea, vomiting), and hypertensive emergency, i.e. severe AH with organ failure and/or acute organ damage. The most common causes of hypertensive crisis in neonates and infants are vascular diseases (thrombus or stenosis of the renal artery, coarctation of the aorta) or renal parenchymal diseases, in older children kidney diseases and renal artery stenosis, in adolescents also intoxications or pregnancy. In neonates and infants, nonspecific symptoms caused by acute heart failure predominate, and in older children, symptoms from the central nervous system are most typical. Fast- and short-acting medications are used in the treatment of hypertensive urgencies and emergencies; a gradual normalization of blood pressure within 36-48 hours is recommended. Hypertensive emergencies are treated with intravenous drugs (e.g., labetalol, hydralazine), and hypertensive urgencies with intravenous or oral drugs such as nifedipine, clonidine, and minoxidil. Hypertensive emergencies are treated with intravenous drugs (e.g., labetalol, hydralazine), and hypertensive urgencies with intravenous or oral drugs such as nifedipine, clonidine, and minoxidil. Emergency conditions are treated with intravenous drugs (e.g., labetalol, hydralazine), urgent conditions with intravenous or oral drugs such as nifedipine, clonidine, and minoxidil. Some causes of hypertensive crisis require different management, e.g. alpha-blockers in pheochromocytoma. In all patients, evaluation of target organ damage and extensive diagnostics for secondary forms of hypertension is necessary.


Assuntos
Insuficiência Cardíaca , Hipertensão , Adolescente , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Criança , Emergências , Feminino , Humanos , Hipertensão/tratamento farmacológico , Lactente , Recém-Nascido , Gravidez
19.
Kardiologiia ; 61(7): 68-78, 2021 Jul 31.
Artigo em Russo | MEDLINE | ID: mdl-34397344

RESUMO

Arterial hypertension (AH) is one of the most important risk factors for development of myocardial infarction, chronic heart failure, stroke, cognitive disorders and dementia, and chronic kidney disease. Currently, special attention is paid to increased blood pressure variability (BPV) as a new risk factor for development of cardiovascular and cerebrovascular complications. The available evidence-based body of clinical studies demonstrates the importance of reducing not only the blood pressure itself but also the increased BPV to provide significant improvement of the prognosis and limits the risk of complications. This notion has been validated in consensus documents on the management of patients with AH. Among antihypertensive drugs, the fixed-dose combination (FC) amlodipine/perindopril has demonstrated a unique capability for reducing all types of BPV (visit-to-visit, day-to-day, during 24 h). According to current clinical guidelines, this combination belongs to first-line FCs indicated for most patients with AH. A distinctive feature of the FC amlodipine/perindopril is numerous data from real-life clinical practice, which support both its high antihypertensive efficacy and the ability to decrease high BPV. Therefore, the FC amlodipine/perindopril can be recommended for a broad range of AH patients to achieve BP control and to improve the prognosis.


Assuntos
Insuficiência Cardíaca , Hipertensão , Infarto do Miocárdio , Anlodipino/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Combinação de Medicamentos , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Infarto do Miocárdio/tratamento farmacológico , Perindopril
20.
Rev Bras Enferm ; 74(suppl 6): e20200173, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34431928

RESUMO

OBJECTIVES: to evaluate the factors associated to the adherence to the non-pharmacological treatment of hypertension in primary health care. METHODS: cross-sectional study with 421 participants. The adherence was evaluated using the components: weight control, abdominal circumference, physical activity, and alcohol consumption. The chi-squared and Mann-Whitney's tests were used for analysis. RESULTS: the adherence to the control of the abdominal circumference was associated to smoking, sex, and stress. Smoking, age, and profession were associated to weight control. The adherence to a physical activity varied between the sexes and between people who used beta blockers and those who did not. Moderate alcohol consumption was associated to sex, age, profession, income, comorbidities, time using antihypertensive drugs, and using other medication. CONCLUSIONS: socioeconomic and clinical factors were associated to the adherence to the anti-hypertensive treatment. Innovative techniques, such as the transtheoretical model of change, motivational interviews, and supported self-care can help in behavioral changes.


Assuntos
Anti-Hipertensivos , Hipertensão , Anti-Hipertensivos/uso terapêutico , Estudos Transversais , Humanos , Hipertensão/tratamento farmacológico , Adesão à Medicação , Atenção Primária à Saúde
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