Treatment of Hypertension in Middle-Aged Men: A Feasibility Study in a Community

1976 ◽  
Vol 51 (s3) ◽  
pp. 597s-599s
Author(s):  
H. Åberg ◽  
H. Hedstrand
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Feasibility Study ◽  
Blood Pressure Control ◽  
Blood Pressure Reduction ◽  
Pressure Control ◽  
Health Examination ◽  
Pressure Reduction ◽  
Hypertension Clinic ◽  
Treatment Of Hypertension

1. In a health examination survey of 2322 men, aged 49–50 years, the prevalence of hypertension was 7·5%. All men with a supine diastolic blood pressure ≥ 105 mmHg were invited to a hypertension clinic. 2. Two years' treatment in eighty-six men achieved a blood pressure reduction of 31/16 mmHg, which was maintained for a 4 years period and considered satisfactory in 80% of the subjects. Propranolol was used in more than 80% of the cases. 3. The study indicates that it is possible to obtain acceptable blood pressure control in the community.

Aliskiren for the Treatment of Hypertension: An Update

2009 ◽  
Vol 1 ◽  
pp. CMT.S1991
Author(s):  
S Lam ◽  
S Saxena ◽  
LO Macina ◽  
PE Lester
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Disease Risk ◽  
Angiotensin Receptor Blockers ◽  
Blood Pressure Reduction ◽  
Antihypertensive Agents ◽  
Pressure Control ◽  
Pressure Reduction ◽  
Efficacy And Safety ◽  
Treatment Of Hypertension

Hypertension can lead to significant morbidity and mortality, and requires lifestyle modifications with or without drug therapy to achieve target blood pressure control. Various classes of anti-hypertensive medications are available to healthcare providers. Choice of medications is based not only on efficacy but also tolerability and cost. Aliskiren is the first drug of a new class of agents known as renin inhibitors. It is approved by the U.S. Food and Drug Administration (FDA) as monotherapy or combination therapy with other antihypertensive agents to optimize blood pressure control. Its efficacy in blood pressure reduction is superior to placebo and comparable to angiotensin receptor blockers, hydrochlorothiazide, angiotensin-converting-enzyme inhibitors and atenolol. It also offers additional blood pressure reduction when used in combination of other agents. Recently, a study demonstrated its efficacy and safety in the elderly, and a study suggested its renoprotective effects in patient who were already taking losartan. More clinical studies are awaited to assess its potential for cardiovascular disease risk reduction. This paper reviews the pharmacology, efficacy and safety of aliskiren for the treatment of hypertension.

scholarly journals SGLT2 inhibitors and lower limb complications: an updated meta‐analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chu Lin ◽  
Xingyun Zhu ◽  
Xiaoling Cai ◽  
Wenjia Yang ◽  
Fang Lv ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Lower Limb ◽  
Blood Pressure Reduction ◽  
Random Effect Model ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Pressure Reduction ◽  
Effect Model ◽  
Meta Regression

Abstract Background To exam the associations between the use of sodium glucose co-transporter 2 inhibitor (SGLT2i) and the risk of lower limb complications, and to analyze the associated factors. Methods Pubmed, Medline, Embase, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from the inception to November 2020. Randomized controlled trials of SGLT2i conducted in population containing diabetic patients with reports of amputation, peripheral arterial disease (PAD) and diabetic foot (DF) events were included. Random-effect model, fixed-effect model and meta-regression analysis were accordingly used. Result The numbers of SGLT2i users versus non-SGLT2i users in the analyses of amputation, PAD and DF were 40,925/33,414, 36,446/28,685 and 31,907/25,570 respectively. Compared with non-SGLT2i users, the risks of amputation and PAD were slightly increased in patients with canagliflozin treatment (amputation: OR = 1.60, 95% CI 1.04 to 2.46; PAD: OR = 1.53, 95 % CI 1.14 to 2.05). Meta-regression analyses indicated that greater weight reduction in SGLT2i users was significantly associated with the increased risks of amputation (β = − 0.461, 95% CI − 0.726 to − 0.197), PAD (β = − 0.359, 95% CI − 0.545 to − 0.172) and DF (β = − 0.476, 95% CI − 0.836 to − 0.116). Lower baseline diastolic blood pressure (β = − 0.528, 95% CI − 0.852 to − 0.205), more systolic blood pressure reduction (β = − 0.207, 95% CI − 0.390 to − 0.023) and more diastolic blood pressure reduction (β = − 0.312, 95% CI − 0.610 to − 0.015) were significantly associated with the increased risks of amputation, PAD and DF respectively in patients with SGLT2i treatment. Conclusions The risks of amputation and PAD were slightly increased in patients with canagliflozin treatment. Reductions in body weight and blood pressure were associated with lower limb complications in patients with SGLT2i treatment.

scholarly journals Evening anti-hypertensive dosing improves blood pressure control and reduce cardiovascular events in hypertensive: a meta-analysis of 40 trials in 44,167 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.P Sunjaya ◽  
A.F Sunjaya
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Control ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Pressure Control ◽  
Controlled Trials ◽  
Night Time ◽  
Randomized Controlled

Abstract Introduction Nocturnal blood pressure (BP) and early morning BP surge have consistently been found to be a better prognostic marker of cardiovascular outcome than daytime BP. Most anti-hypertensive show greater blood pressure-lowering effect in the first 12 hours compared to the next 12 hours. Several prospective studies have shown better BP regulation and improved cardiovascular risk when anti-hypertensive are ingested at bedtime versus at awakening. Purpose In patients with hypertension does evening dosing of anti-hypertensive compared to morning dosing led to better reduction in pressure, blood pressure control and reduced cardiovascular morbidity. Methods A meta-analysis was performed based on randomized controlled trials obtained from Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline and Medline ahead of print published between 2000 and 2020. Main outcome measures include mean 24 hour systolic and diastolic blood pressure, cardiovascular events as well as prevalence of blood pressure in control. Data synthesis and analysis was done using RevMan 5.3 using a random effects model. Results A total of 40 randomized controlled trials, representing 44,167 patients were included in this meta-analysis. Most studies evaluate the administration of mixed anti-hypertensive with ≥1 medication ingested at bedtime, calcium channel blockers (CCBs) or angiotensin receptor blockers (ARBs) with sample sizes ranging from 30 to 19,084 patients. Evening administration of anti-hypertensive was found to significantly lower 24-hour systolic blood pressure (Mean difference = −1.05, 95% CI: −2.01 to −0.10, p=0.03) and 24-hour diastolic blood pressure (Mean difference = −1.09, 95% CI: −1.68 to −0.50, p=0.0003). Prevalence of controlled blood pressure was found to significantly increase with evening dosing (RR=1.15, 95% CI: 1.03 to 1.28, p=0.01). Significant reduction in cardiovascular events were found in the evening dosing group (RR=0.48, 95% CI: 0.03 to 0.68, p=<0.00001). Discussion Reduction in night-time blood pressure especially among non-dippers as reported in previous studies and higher prevalence of controlled blood pressure may explain the greater than 50% reduction in cardiovascular events in the evening dosing group. This marked benefit from a simple and inexpensive strategy certainly has great potential to benefit patients in practice. Even so, few studies have reported the prevalence of blood pressure in control (9 studies) and cardiovascular events (6 studies). Few has also studied this in geriatric populations where night-time hypotension and hypoperfusion may bring the most impact. Conclusion For patients with hypertension, evening dosing significantly improves blood pressure control and reduces the risk for cardiovascular events. Careful selection of anti-hypertensive administration time in patients is recommended given the possible benefits. Anti Hypertensive Dosing Forest Plot Funding Acknowledgement Type of funding source: None

Abstract TMP56: Prediction of Primary Stroke: A Secondary Analysis of the SPRINT Trial

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Eric Goldstein ◽  
Stephanie Lyden ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Blood Pressure Control ◽  
Primary Outcome ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Blood Pressure Reduction ◽  
Pressure Control ◽  
Significant Difference ◽  
History Of

Background: The Systolic Blood Pressure Intervention Trial enrolled patients aged 50 or older with at least one cardiovascular disease risk factor, but free of prior symptomatic stroke. Patients were assigned to two blood pressure reduction goals (<140 versus 120 mm Hg). There was not a significant difference in the rate of stroke, making this an ideal cohort to refine risk prediction of primary stroke, which is understudied in patients with adequate blood pressure control and a rigorously adjudicated outcome of stroke. Methods: The primary outcome is ischemic stroke. We fit Cox models to the primary outcome and evaluated all baseline demographic variables to determine which would be most predictive of stroke, which we then used to create a prediction score. Results: We included 9,361 patients with a mean (SD) age of 67.9 (9.4) years and 171 (1.8%) patients met the primary outcome of stroke. For our prediction model, we gave one point each for history of TIA, atrial fibrillation, congestive heart failure, or diabetes. Patients with 2 or more points were collapsed, making three possible scores of 0, 1, and 2, which had rates of stroke of 1.5% (117/8042), 3.2% (30/933), and 6.2% (24/386) (p<0.001). Compared to a score of 0, the hazard ratios for stroke of score 1 and 2 were 2.3 (95% CI, 1.6-3.5) and 4.6 (95% CI, 2.9-7.1) (both p<0.001) (Figure 1). Conclusion: A simple scoring system can improve prediction of ischemic stroke from 1.8% to 6.2% in patients with no prior history of stroke and excellent blood pressure control. This information could be used to improve patient selection for clinical trials or for identifying patients for more aggressive primary prevention strategies.

scholarly journals Electronic Monitoring of Adherence, Treatment of Hypertension, and Blood Pressure Control

2012 ◽  
Vol 25 (1) ◽  
pp. 54-59 ◽  
Author(s):  
H. A. W. v. Onzenoort ◽  
W. J. Verberk ◽  
A. A. Kroon ◽  
A. G. H. Kessels ◽  
C. Neef ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Electronic Monitoring ◽  
Pressure Control ◽  
Treatment Of Hypertension

scholarly journals Blood pressure reduction and RAAS inhibition in diabetic kidney disease: therapeutic potentials and limitations

2020 ◽  
Vol 33 (5) ◽  
pp. 949-963
Author(s):  
Giovanna Leoncini ◽  
Francesca Viazzi ◽  
Salvatore De Cosmo ◽  
Giuseppina Russo ◽  
Paola Fioretto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
Blood Pressure Control ◽  
Therapeutic Approach ◽  
Diabetic Kidney Disease ◽  
Blood Pressure Reduction ◽  
Pressure Control ◽  
Renal Outcome ◽  
Renal Protection ◽  
Diabetic Kidney

Abstract Diabetic kidney disease (DKD) affects approximately one-third of patients with diabetes and taking into consideration the high cardiovascular risk burden associated to this condition a multifactorial therapeutic approach is traditionally recommended, in which glucose and blood pressure control play a central role. The inhibition of renin–angiotensin–aldosterone RAAS system represent traditionally the cornerstone of DKD. Clinical outcome trials have demonstrated clinical significant benefit in slowing nephropathy progression mainly in the presence of albuminuria. Thus, international guidelines mandate their use in such patients. Given the central role of RAAS activity in the pathogenesis and progression of renal and cardiovascular damage, a more profound inhibition of the system by the use of multiple agents has been proposed in the past, especially in the presence of proteinuria, however clinical trials have failed to confirm the usefulness of this therapeutic approach. Furthermore, whether strict blood pressure control and pharmacologic RAAS inhibition entails a favorable renal outcome in non-albuminuric patients is at present unclear. This aspect is becoming an important issue in the management of DKD since nonalbuminuric DKD is currently the prevailing presenting phenotype. For these reasons it would be advisable that blood pressure management should be tailored in each subject on the basis of the renal phenotype as well as related comorbidities. This article reviews the current literature and discusses potentials and limitation of targeting the RAAS in order to provide the greatest renal protection in DKD.

Self-management of hypertension: Predictors of success in diastolic blood pressure reduction

1988 ◽  
Vol 11 (2) ◽  
pp. 105-115 ◽  
Author(s):  
Helen Nakagawa-Kogan ◽  
Annabaker Garber ◽  
Monica Jarrett ◽  
Kelly J. Egan ◽  
Susan Hendershot
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Reduction ◽  
Self Management ◽  
Pressure Reduction ◽  
Predictors Of Success
Sign in / Sign up

Export Citation Format

Share Document