scholarly journals 2289

2017 ◽  
Vol 1 (S1) ◽  
pp. 14-14
Author(s):  
David D. Maron ◽  
Marc Blackman ◽  
Richard Amdur ◽  
Thomas Mellman ◽  
Kathryn Sandberg
Keyword(s):  
Major Depression ◽  
Protective Effect ◽  
Large Scale ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Study Population ◽  
Age Range

OBJECTIVES/SPECIFIC AIMS: Angiotensin type 1 receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) are frequently prescribed for hypertension and associated cardiovascular and renal complications. In animal models, these drugs also reduce anxiety and depression. OBJECTIVE—to determine if Veteran Affairs (VA) clinical pharmacy data indicate a protective effect of ARBs and/or ACEIs for major depression. METHODS/STUDY POPULATION: Pharmacy records from nationwide VA electronic medical records (EMR) were extracted for patients prescribed ARBs, ACEIs, α-blockers, β-blockers, calcium channel blockers, or diuretics (n=4,081,359). Patients were excluded if: they had not received medications for 6 months with >70% coverage; were diagnosed with substance/alcohol abuse, dementia, psychosis, schizophrenia, or prescribed insulin. The study population was categorized as “ARB/ACEI” (A/A) or “Never ARB/ACEI” (NA/A). Using the Greedy Matching Algorithm, subjects were matched on a 1:1 ratio for sex and race over a 5 year age range resulting in 2 equal groups of n=1,350,236 each. Subjects were older (M=71.6, SD=12) and mostly men (97%). RESULTS/ANTICIPATED RESULTS: In the A/A Versus NA/A, respectively, the incidence of anti-depressant use was greater during (9.9% vs. 8.9%) but was lower after (11.8% vs. 12.2%) the study period. PHQ-2 scores (Mean±SD) were statistically lower, albeit similar, during (0.79±1.56 vs. 0.85±1.63) and after (1.00±1.73 vs. 1.07±1.79) the study period. DISCUSSION/SIGNIFICANCE OF IMPACT: These preliminary data suggest that inhibiting angiotensin II action does not provide a protective effect on major depression when compared with other classes of antihypertensive drugs. This study illustrates how “Big Data” may inform the design, or obviate the need, for large-scale randomized-controlled trials.

scholarly journals Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-18 ◽  
Author(s):  
Jie Wang ◽  
Bo Feng ◽  
Xiaochen Yang ◽  
Wei Liu ◽  
Yongmei Liu ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Randomized Clinical Trials ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Data Extraction ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Deficiency Syndrome ◽  
Adjunctive Treatment ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Background. Tianma Gouteng Yin (TGY) is widely used for essential hypertension (EH) as adjunctive treatment. Many randomized clinical trials (RCTs) of TGY for EH have been published. However, it has not been evaluated to justify their clinical use and recommendation based on TCM zheng classification.Objectives. To assess the current clinical evidence of TGY as adjunctive treatment for EH with liver yang hyperactivity syndrome (LYHS) and liver-kidney yin deficiency syndrome (LKYDS).Search Strategy. 7 electronic databases were searched until November 20, 2012.Inclusion Criteria. RCTs testing TGY combined with antihypertensive drugs versus antihypertensive drugs were included.Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.Results. 22 RCTs were included. Methodological quality was generally low. Except diuretics treatment group, blood pressure was improved in the other 5 subgroups; zheng was improved in angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and “CCB + ACEI” treatment groups. The safety of TGY is still uncertain.Conclusions. No confirmed conclusion about the effectiveness and safety of TGY as adjunctive treatment for EH with LYHS and LKYDS could be made. More rigorous trials are needed to confirm the results.

scholarly journals Renin-Angiotensin-Aldosterone-System inhibitor use in patients with COVID-19 infection and prevention of serious events: a cohort study in commercially insured patients in the US

2020 ◽  
Author(s):  
Maria C Schneeweiss ◽  
Sandra Leonard ◽  
Andrew Weckstein ◽  
Sebastian Schneeweiss ◽  
Jeremy Rassen
Keyword(s):  
Cohort Study ◽  
Protective Effect ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Pharmacy Claims ◽  
Level Data ◽  
Therapy Interventions

Objectives: There is a lack of clarity regarding the role of angiotensin receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEi) in interfering with the SARS-COV-2 binding on human cells and the resulting change in disease severity. We sought to assess the risk of hospitalization for COVID-19 and serious complications in current users of ARB or ACEi compared to users of dihydropyridine calcium channel blockers (dhpCCB). Design: Cohort study Setting: The analysis used de-identified, patient-level data from HealthVerity, linking longitudinal data from US medical and pharmacy claims, which contain information on inpatient or outpatient diagnoses, procedures and medication dispensing. Participants: We identified patients aged 40+ and free of chronic kidney disease (CKD) who were newly diagnosed COVID-19, between March 1, 2020 and May 30, 2020, and adherent to ACEi, ARB, or dhpCCB therapy. Interventions: Current use of an ACEi, ARB, or dhpCCB. Main outcome measures: We compared the 30-day risk of hospitalization for COVID-19 and serious complications. Results: Of 24,708 patients identified, 7,571 were current users of an ARB, 8,484 of an ACEi, and 8,653 of a dhpCCB. The unadjusted 30-day risk of hospitalization for COVID-19 was 2.66% among ARB users, and 2.90% among ACEi users and 3.68% in dhpCCB users. In the PS-matched cohort, the risk of hospitalization among ARB users was 17% lower as compared to dhpCCB (RR=0.83; 0.68-1.00), and the risk among ACE users was 10% lower as compared to dhpCCB (RR=0.90; 0.76-1.07). When including patients with pre-existing CKD, the protective effect of ARB (RR= 0.74; 0.62-0.88) and ACEi (RR=0.84; 0.71-0.99) was more pronounced. Conclusions: This cohort study showed that neither ARB nor ACEi use increase the risk of severe COVID-19 disease among those infected, and instead suggests that current use of ARB may offer a protective effect. This study found no evidence to support the discontinuation of ARB/ACEi therapy.

scholarly journals Antihypertensive Drugs and Risk of Cancer: Between Scylla and Charybdis

2020 ◽  
Author(s):  
Elias Sanidas ◽  
Maria Velliou ◽  
Dimitrios Papadopoulos ◽  
Anastasia Fotsali ◽  
Dimitrios Iliopoulos ◽  
...  
Keyword(s):  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Current Data ◽  
Channel Blockers ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Carcinogenic Potential ◽  
Risk Of Cancer

Abstract Antihypertensive drugs namely angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, beta blockers, and diuretics are among the most clearly documented regimens worldwide with an overall cardioprotective benefit. Given that malignancy is the second leading cause of mortality, numerous observational studies aimed to investigate the carcinogenic potential of these agents with conflicting results. The purpose of this review was to summarize current data in an effort to explore rare side effects and new mechanisms linking antihypertensive drugs with the risk of developing cancer.

scholarly journals The Use of Antihypertensive Drugs as Coadjuvant Therapy in Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
José A. Carlos-Escalante ◽  
Marcela de Jesús-Sánchez ◽  
Alejandro Rivas-Castro ◽  
Pavel S. Pichardo-Rojas ◽  
Claudia Arce ◽  
...  
Keyword(s):  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Antihypertensive Agents ◽  
Drug Repurposing ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
New Drugs ◽  
Phase Iii ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Aldosterone Antagonists

Cancer is a complex group of diseases that constitute the second largest cause of mortality worldwide. The development of new drugs for treating this disease is a long and costly process, from the discovery of the molecule through testing in phase III clinical trials, a process during which most candidate molecules fail. The use of drugs currently employed for the management of other diseases (drug repurposing) represents an alternative for developing new medical treatments. Repurposing existing drugs is, in principle, cheaper and faster than developing new drugs. Antihypertensive drugs, primarily belonging to the pharmacological categories of angiotensin-converting enzyme inhibitors, angiotensin II receptors, direct aldosterone antagonists, β-blockers and calcium channel blockers, are commonly prescribed and have well-known safety profiles. Additionally, some of these drugs have exhibited pharmacological properties useful for the treatment of cancer, rendering them candidates for drug repurposing. In this review, we examine the preclinical and clinical evidence for utilizing antihypertensive agents in the treatment of cancer.

Cardiovascular medication exposures and poisonings in Izmir, Turkey: A 14-year experience

2010 ◽  
Vol 30 (5) ◽  
pp. 347-353
Author(s):  
Sule Kalkan ◽  
Nil Hocaoglu ◽  
Kubilay Oransay ◽  
Pinar Unverir ◽  
Yesim Tuncok
Keyword(s):  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Clinical Manifestations ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
University Hospital ◽  
Channel Blockers ◽  
Clinical Effects ◽  
Age Group ◽  
Converting Enzyme Inhibitors

Cardiovascular medications (CVMs) are frequently prescribed for cardiovascular diseases. The unconscious use of cardiovascular drugs may lead to severe clinical manifestations, even to death, especially when in overdose. The objective of this study is to clarify the profile of CVM exposures admitted to Department of Emergency Medicine in Dokuz Eylul University Hospital (EMDEU) between 1993 and 2006. Case demographics, type of the medication, route and reason for exposure, clinical effects and outcome were recorded. Related to the CVM exposures, 105 poisoning cases were admitted. Mean age of children and adults were 12.8 ± 1.0 and 30.1 ± 1.8, respectively. Females were dominating (77.1%). Poisoning by accident occurred mainly among children in the 0—6 age group (64.3%) and suicide attempt was predominant in the 19—29 age group (47.8%). The most common ingested CVMs admitted to EMDEU were calcium channel blockers (19.7%), beta-blockers (17.3%), angiotensin converting enzyme inhibitors and diuretics (11.8%). Most of the patients were asymptomatic (59.1%). Frequently observed symptom was altered consciousness (18.6%). Antihypertensive drugs are responsible for the most of the CVM exposures. Prospectively designed multi-centered studies are needed to reflect the epidemiological properties of cardiovascular drug exposures throughout our country and would be very valuable for the determination of preventive measures.

scholarly journals Cost minimization analysis of generic and innovator formulations of antihypertensive drugs

2019 ◽  
Vol 8 (12) ◽  
pp. 2625
Author(s):  
Vishalkumar K. Vadgama ◽  
Vishal L. Gaekwad
Keyword(s):  
Cost Analysis ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Cost Minimization ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Medication Cost ◽  
National Committee ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Background: Hypertension, a chronic condition requiring lifelong care, affects approximately 25.3% Indian population. Average annual hypertension management cost which also includes medication cost varies from Rs. 4042 to 7621, amounting up to 40% of total household income of few families. Selection of a different brand or generic formulation may have an immense impact on total expenditure for treatment of hypertension. Present study aims at determining cost variability and cost analysis of various single drug antihypertensive formulations available in Indian market.Methods: One most prescribed drug, each from Joint National Committee recommended antihypertensive- thiazide diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin-receptor blockers and β blockers were selected for cost analysis. Cheapest, costliest and median priced formulations were searched for individual drugs and were compared to the price of their generic counterparts.Results: Generic formulations of hydrochlorothiazide, amlodipine, enalapril, losartan and atenolol were cheaper even than their respective cheapest innovator formulations. Costliest innovator formulation of amlodipine was 1750% expensive than generic one. Costliest counterparts of generic formulations were many folds overpriced. Similarly, innovator formulation of losartan was up to 953.89% costly than generic one. Innovator formulations of hydrochlorothiazide were the least costly than its generic counterpart, yet being at least 150% more expensive. Also, there exists considerable broad range of price among similar innovator formulations.Conclusions: By prescribing generic antihypertensive drug, we can reduce treatment expenditure by many folds. Same feat can be marginally achieved by using lower cost innovator formulations.

scholarly journals Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19

2020 ◽  
Vol 9 (10) ◽  
pp. 3136 ◽  
Author(s):  
Enrique Rodilla ◽  
Alberto Saura ◽  
Iratxe Jiménez ◽  
Andrea Mendizábal ◽  
Araceli Pineda-Cantero ◽  
...  
Keyword(s):  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Cross Sectional ◽  
All Cause Mortality ◽  
Study Population ◽  
Receptor Blockers ◽  
Comorbidity Index

It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization. ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.

scholarly journals Antihypertensive drug exposure in premature infants from 1997 to 2013

2016 ◽  
Vol 27 (5) ◽  
pp. 905-911 ◽  
Author(s):  
Srikanth Ravisankar ◽  
Devon Kuehn ◽  
Reese H. Clark ◽  
Rachel G. Greenberg ◽  
P. Brian Smith ◽  
...  
Keyword(s):  
Birth Weight ◽  
Antihypertensive Drug ◽  
Premature Infants ◽  
Drug Exposure ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Systemic Hypertension ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

AbstractBackgroundSystemic hypertension is increasingly recognised in premature infants. There is limited evidence regarding treatment, and most published treatment recommendations are based solely on expert opinions.MethodsWe identified all infants born ⩽32 weeks of gestation and ⩽1500 g birth weight discharged from one of 348 neonatal ICUs managed by the Pediatrix Medical Group between 1997 and 2013. We defined antihypertensive drugs as vasodilators, angiotensin-converting enzyme inhibitors, β receptor blockers, calcium channel blockers, and central α2 receptor agonists. We compared characteristics between infants who were treated with at least one antihypertensive drug during their initial hospitalisation and infants who were not prescribed antihypertensive drugs using Wilcoxon’s ranked sum test or Pearson’s χ2-test.ResultsWe identified 2504/119,360 (2.1%) infants who required at least one antihypertensive drug. The median postnatal age of first exposure was 48 days (25th, 75th percentile 15, 86), and the median length of therapy was 6 days (1, 16). Hydralazine was the most commonly prescribed antihypertensive with 1280/2504 (51.1%) treated infants exposed to the drug. More than two antihypertensive drugs were administered in 582/2504 (23.2%) infants, and 199/2097 (9.5%) of the treated infants were discharged home on antihypertensive therapy. Infants who received antihypertensive drugs were of lower gestational age (p<0.001) and birth weight (p<0.001) compared with infants not prescribed antihypertensive drugs.ConclusionsOur study is the largest to describe current antihypertensive drug exposure in a cohort of exclusively premature infants born ⩽32 weeks of gestation. We found wide variations in practice for treating hypertension in premature infants.

scholarly journals Profil Penggunaan Obat Antihipertensi di RSUD Mas Amsyar Kasongan Kabupaten Katingan

2018 ◽  
Vol 1 (1) ◽  
pp. 47-50
Author(s):  
Syahrida Dian Ardhany ◽  
Wahyu Pandaran ◽  
Mohammad Rizki Fadhil Pratama
Keyword(s):  
Prescription Drugs ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Angiotensin Ii Receptor ◽  
Converting Enzyme Inhibitors ◽  
Hypertension Patient ◽  
Receptor Blockers

Hypertension or high blood pressure is one of the lead causes of death. Hypertension can cause various complications with another disease, even the cause of heart disease, stroke, and kidney disorders. Hypertension is the second rank of the most diseases in Kabupaten Katingan. The purpose of this research is to know the profile of antihypertensive medicines in RSUD Mas Amsyar Kasongan. Method of this research was a descriptive method with saturation sampling used retrospective data on all prescription drugs in 2017. The results of this research based on the patient characteristic were found 43.3% men and 56.7% women, meanwhile 45.8% age < 45 years old and 54.2% for age > 45 years old. The antihypertensive drug items used are propranolol, telmisartan, amlodipine, lisinopril, furosemide, ramipril, valsartan, candesartan, irbesartan, and bisoprolol, meanwhile based on the classification of antihypertensive drugs. are angiotensin II receptor blockers (ARB), diuretics, angiotensin converting enzyme Inhibitors (ACEI), Calcium Channel Blockers (CCB) and alpha 2 adrenergic agonists. Based on the result, it can be concluded that hypertension patient in RSUD Mas Amsyar Kasongan is mostly female (56.7%) and age of hypertension patient is > 45 years old (54.2%). The most antihypertensive prescribed is monotherapy (72%) and the most item of the drug is amlodipine. (38%).

scholarly journals Antihypertensive Drugs and the Risk of Cancer: A Nationwide Cohort Study

2021 ◽  
Vol 10 (4) ◽  
pp. 771
Author(s):  
In-Jeong Cho ◽  
Jeong-Hun Shin ◽  
Mi-Hyang Jung ◽  
Chae Young Kang ◽  
Jinseub Hwang ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors ◽  
Incident Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

We sought to assess the association between common antihypertensive drugs and the risk of incident cancer in treated hypertensive patients. Using the Korean National Health Insurance Service database, the risk of cancer incidence was analyzed in patients with hypertension who were initially free of cancer and used the following antihypertensive drug classes: Angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); beta blockers (BBs); calcium channel blockers (CCBs); and diuretics. During a median follow-up of 8.6 years, there were 4513 (6.4%) overall cancer incidences from an initial 70,549 individuals taking antihypertensive drugs. ARB use was associated with a decreased risk for overall cancer in a crude model (hazard ratio (HR): 0.744, 95% confidence interval (CI): 0.696–0.794) and a fully adjusted model (HR: 0.833, 95% CI: 0.775–0.896) compared with individuals not taking ARBs. Other antihypertensive drugs, including ACEIs, CCBs, BBs, and diuretics, did not show significant associations with incident cancer overall. The long-term use of ARBs was significantly associated with a reduced risk of incident cancer over time. The users of common antihypertensive medications were not associated with an increased risk of cancer overall compared to users of other classes of antihypertensive drugs. ARB use was independently associated with a decreased risk of cancer overall compared to other antihypertensive drugs.

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