Efficacy and Duration of Action of the Four Selective Angiotensin II Subtype 1 Receptor Blockers, Losartan, Candesartan, Valsartan and Telmisartan, in Patients with Essential Hypertension Determined by Home Blood Pressure Measurements

2005 ◽  
Vol 27 (6) ◽  
pp. 477-489 ◽  
Author(s):  
Takuya Nishimura ◽  
Junichiro Hashimoto ◽  
Takayoshi Ohkubo ◽  
Masahiro Kikuya ◽  
Hirohito Metoki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Angiotensin Ii ◽  
Home Blood Pressure ◽  
Pressure Measurements ◽  
Duration Of Action ◽  
Receptor Blockers

Assessment of the Antihypertensive Effect of Atenolol with 24 H Ambulatory Monitoring of Blood Pressure

1979 ◽  
Vol 57 (s5) ◽  
pp. 387s-389s ◽  
Author(s):  
J. S. Floras ◽  
P. Fox ◽  
M. O. Hassan ◽  
J. V. Jones ◽  
P. Sleight ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Arterial Blood Pressure ◽  
Antihypertensive Effect ◽  
Ambulatory Monitoring ◽  
Single Daily Dose ◽  
Pressure Measurements ◽  
Arterial Blood ◽  
Blood Pressure Study ◽  
Daily Dose

1. Twenty-four hour intra-arterial blood pressure measurements and electrocardiograms were obtained from 12 subjects with untreated essential hypertension. 2. The patients kept records of their activity, paying particular attention to times of retiring to bed, and times of waking in the morning. 3. All subjects were treated with a single daily dose of atenolol (50 to 200 mg) for between 2 and 9 months, and then underwent a second 24 h blood pressure study. 4. Arterial blood pressure was lowered significantly throughout the 24 h period with a single daily dose of atenolol.

scholarly journals Use of angiotensin II receptor blockers alone and in combination with other drugs: a large clinical experience trial

2001 ◽  
Vol 2 (1_suppl) ◽  
pp. S217-S222
Author(s):  
Matthew R Weir ◽  
Rebecca Y Wang
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Systolic Hypertension ◽  
Large Scale ◽  
Candesartan Cilexetil ◽  
Antihypertensive Drugs ◽  
Isolated Systolic Hypertension ◽  
Open Label ◽  
Background Therapy ◽  
Receptor Blockers

Angiotensin II (Ang II) receptor blockers are the newest class of antihypertensive drugs to be developed. No large-scale clinical trials have been performed to evaluate their efficacy alone, or in combination with other drugs. A large-scale, eight week, open-label, non-placebo-controlled, single-arm trial evaluated the efficacy, tolerability and dose-response of candesartan cilexetil, 16—32 mg once-daily, either as monotherapy or as part of combination therapy, in a diverse hypertensive population in actual practice settings. 6465 patients with high blood pressure, of whom 52% were female and 16% African American, with a mean age of 58 years, were included. 5446 patients had essential hypertension and 1014 patients had isolated systolic hypertension. In order to be included in this study, patients had either untreated or uncontrolled hypertension (systolic blood pressure (SBP) 140—179 mmHg and/or diastolic blood pressure (DBP) 90—109 mmHg inclusive at baseline), despite a variety of other antihypertensive drugs. Of the 5156 patients with essential hypertension and at least one post baseline efficacy measurement, the mean pretreatment blood pressure (BP) was 156/97 mmHg. Candesartan cilexetil monotherapy reduced mean SBP/DBP by 18.0/12.2 mmHg. Similarly, in the 964 patients with isolated systolic hypertension and at least one post baseline efficacy measurement, candesartan cilexetil monotherapy reduced SBP/DBP from 158/81 by 16.5/4.5 mmHg. Candesartan cilexetil was similarly effective when employed as add-on therapy. When added to baseline antihypertensive medication in 51% of the patients with essential hypertension not achieving BP control, additional reduction in BP was achieved regardless of the background therapy, including diuretics (17.8/11.7 mmHg) calcium antagonists (16.6/11.2 mmHg), beta-blockers (16.5/10.4 mmHg), angiotensin-converting enzyme inhibitors (ACE-I) (15.3/10.0 mmHg), and alpha blockers (16.4/10.4 mmHg). Likewise, when candesartan cilexetil was used as add-on therapy in patients with isolated systolic hypertension, there was a consistent further reduction of mean SBP/DBP, regardless of the background therapy. Moreover, these monotherapeutic or add-on efficacy benefits were seen regardless of age (<65 or >65 years), gender, or race. Despite the open-label design of the study which enhances efficacy owing to the placebo effect, the Ang II receptor blocker, candesartan cilexetil either alone, or as an add-on therapy, is highly effective for assisting in the control of systolic and diastolic hypertension.

Screening for orthostatic hypotension using home blood pressure measurements

2019 ◽  
Vol 37 (5) ◽  
pp. 923-927 ◽  
Author(s):  
Antoine Cremer ◽  
Anne-laure Rousseau ◽  
Romain Boulestreau ◽  
Sophie Kuntz ◽  
Christophe Tzourio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Orthostatic Hypotension ◽  
Home Blood Pressure ◽  
Pressure Measurements

scholarly journals PERAN KOMPLEKS JUKSTAGLOMERULUS TERHADAP RESISTENSI PEMBULUH DARAH

2013 ◽  
Vol 4 (3) ◽  
Author(s):  
Renny M. Toreh ◽  
Sonny J.R. Kalangi ◽  
Sunny Wangko
Keyword(s):  
Blood Pressure ◽  
Angiotensin Ii ◽  
Vascular Resistance ◽  
Sodium Intake ◽  
Angiotensin Receptor Blockers ◽  
Antihypertensive Agents ◽  
Angiotensin I ◽  
Renin Angiotensin ◽  
Renin Synthesis ◽  
Receptor Blockers

Abstract: As the main structural component of the renin-angiotensin-aldosterone system (RAAS), the juxtaglomerular complex plays a very important role in the regulation of vascular resistance. The synthesis and release of renin into the circulation occurs due to the decrease of blood pressure, loss of body fluid, and a decrease of sodium intake. Renin converts angiotensinogen into angiotensin I, which is further converted by the angiotensin converting enzyme (ACE) into angiotensin II. This angiotensin II causes vasoconstriction of blood vessels, resulting in an increase of vascular resistance and blood pressure. The ACE inhibitors and the angiotensin receptor blockers (ARBs) do not inhibit the RAAS completely since they cause an increase of renin activity. The renin blockers are more effective in inhibiting RAAS activity; therefore, these renin blockers can be applied as antihypertensive agents with fewer side effects. The RAAS activity can be inhibited by a decrease of renin synthesis in the juxtaglomerular complex by blocking the signals in the juxtaglomerular complex that stimulate renin synthesis, and by blocking the gap junctions in the juxtaglomerular complex. Keywords: juxtaglomerular complex, vascular resistance, RAAS.   Abstrak: Kompleks jukstaglomerulus sebagai komponen struktural utama sistem renin angiotensin berperan penting dalam pengaturan resistensi pembuluh darah. Sintesis dan pelepasan renin ke sirkulasi terjadi karena tekanan darah yang rendah, kehilangan cairan tubuh, dan kurangnya intake natrium. Renin akan memecah angiotensinogen menjadi angiotesin I yang kemudian secara cepat dikonversi oleh enzim pengonversi angiotensin  menjadi angiotensin II. Angiotensin II menyebabkan vasokontriksi pembuluh darah sehingga meningkatkan resistensi pembuluh darah yang pada akhirnya akan meningkatkan tekanan darah. ACEinhibitor dan ARB kurang sempurna dalam menghambat kerja SRAA oleh karena keduanya memutuskan rantai mekanisme timbal balik sehingga meningkatkan aktifitas renin. Penghambat renin lebih efektif digunakan untuk menghambat aktifitas SRAA sehingga penghambat renin dapat digunakan sebagai obat anti-hipertensi dan memiliki efek samping yang rendah. Metode penghambatan SRAA yang juga dapat dikembangkan ialah penghambatan sintesis renin dalam kompleks jukstaglomerulus dengan cara menekan sinyal-sinyal dalam kompleks jukstaglomerulus yang merangsang sintesis renin dan menghambat fungsi taut kedap yang terdapat dalam kompleks jukstaglomerulus. Kata kunci: kompleks juksta glomerulus, resistensi vaskular, SRAA.

Two-day home blood pressure monitoring may offer an alternative to costlier methods

2018 ◽  
Vol 4 (2) ◽  
pp. 84-90
Author(s):  
Gavin Devereux ◽  
Daniel Gibney ◽  
Fiqry Fadhlillah ◽  
Paul Brown ◽  
Neil Macey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
White Coat Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Measurements ◽  
Pressure Monitoring ◽  
Time Saving ◽  
Home Based

BackgroundKey benefits of home-based blood pressure measurements are the potential to reduce the risk of ‘white coat hypertension’, encouraging patients to take ownership of their condition and be more actively involved in their long-term condition care, and to move work out of the doctor’s office.AimTo assess whether performing 20 resting blood pressure measurements over a 2-day period would provide a reliable, stable representation of patients’ resting systolic and diastolic blood pressure. Following clinician recommendation, each participant completed the Stowhealth home blood pressure monitoring procedure.MethodOne thousand and forty-five participants (mean age 66±13 years, 531 women and 514 men) completed the procedure, of 10 resting measurements per day, for 2 days (20 resting systolic and diastolic blood pressure readings in total). All measurements were made using automated oscillometric monitors.ResultsWithin-patient coefficient of variation for the entire participant cohort was 8% for systolic blood pressure (cohort mean 141±11 mm Hg), and 8% for diastolic blood pressure (cohort mean 79±6 mm Hg). There were no significant differences between the first and second day, for either systolic (142±1vs 141±1 mm Hg, respectively, p>0.05) or diastolic blood pressures (79±1vs 78±1 mm Hg, respectively, p>0.05 in both cases).ConclusionThe overall duration of home blood pressure monitoring may be able to be reduced to just 48 hours. This method would offer meaningful time saving for patients, and financial and time benefits for doctors and their surgery administration.

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