scholarly journals The telmisartan and amlodipine combination in the treatment of hypertension

2014 ◽  
Vol 11 (1) ◽  
pp. 64-72
Author(s):  
G G Shehyan ◽  
A A Yalymov ◽  
A M Schikota ◽  
V S Zadionchenko ◽  
S I Varentsov
Keyword(s):  
Ventricular Hypertrophy ◽  
Antihypertensive Drugs ◽  
Pressure Control ◽  
Drug Manufacturer ◽  
Left Ventricular ◽  
Efficacy And Safety ◽  
Carbohydrate And Lipid Metabolism ◽  
Target Organs ◽  
Treatment Of Hypertension ◽  
Significant Disease

The following review assesses socially significant disease - hypertension (AH) - and the problem of finding an effective antihypertensive therapy. Twynsta® drug (manufacturer Boehringer Ingelheim Pharma) - modern combined antihypertensive drug, which not only provides effective blood pressure control, but also due to the protective effect has been proved for all target organs improves the life expectancy of patients with hypertension. The clinical studies show that combination of telmisartan and amlodipine provides additional benefits in the treatment of patients with metabolic syndrome (by improving the carbohydrate and lipid metabolism), patients with impaired renal function (by inducing the regression of proteinuria), as well as left ventricular hypertrophy (by causing regression of the latter). The recently completed studies have shown that telmisartan acts as a selective PPAR-receptor modulator.In the present review it is shown that Twynsta® represents modern combined antihypertensive drugs and has a clinically proven favorable efficacy and safety profile.

scholarly journals Novel stratified medicines approach to manage uncontrolled hypertension due to multiple drug intolerances

2018 ◽  
Vol 11 (1) ◽  
pp. e226045
Author(s):  
Catherine Schuster Bruce ◽  
Gurvinder Rull ◽  
Antoniou Sotiris ◽  
Melvin D Lobo
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Antihypertensive Drugs ◽  
Pressure Control ◽  
Left Ventricular ◽  
Home Blood Pressure ◽  
Uncontrolled Hypertension ◽  
Multiple Drug ◽  
Antihypertensive Medications

A 61-year-old man with a 30-year history of uncontrolled hypertension was unable to tolerate conventional antihypertensive medications from all classes. At the time of referral to our centre he had discontinued all antihypertensive drugs and felt well. However, his average home blood pressure (HBP) reading was 179/125 mm Hg and echocardiography demonstrated moderate concentric left ventricular hypertrophy. A novel stratified medicines algorithm was used to guide treatment entailing transdermal clonidine patch therapy instead of tablet formulations. Sixteen months later, his average HBP was 147/106 mm Hg with no side effects and the left ventricular hypertrophy had completely regressed. Our experience has taught us that multiple drug intolerance is a common, often overlooked, cause of non-adherence to antihypertensive medication. This case demonstrates the benefit of a novel approach to optimise blood pressure control and emphasises the important role of hypertension specialists in managing complex, high-risk patients unable to tolerate guideline-based therapy.

scholarly journals Effect of Intensive Blood Pressure Control on Cardiovascular Remodeling in Hypertensive Patients with Nephrosclerosis

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Otelio Randall ◽  
John Kwagyan ◽  
Tamrat Retta ◽  
Kenneth Jamerson ◽  
Velvie Pogue ◽  
...  
Keyword(s):  
Ventricular Hypertrophy ◽  
Enzyme Inhibitor ◽  
Pressure Control ◽  
Left Ventricular ◽  
Rate Of Change ◽  
Arterial System ◽  
Cardiovascular Remodeling ◽  
Increased Risk ◽  
System Properties ◽  
Intensive Blood Pressure

Pulse pressure (PP), a marker of arterial system properties, has been linked to cardiovascular (CV) complications. We examined (a) association between unit changes of PP and (i) composite CV outcomes and (ii) development of left-ventricular hypertrophy (LVH) and (b) effect of mean arterial pressure (MAP) control on rate of change in PP. We studied 1094 nondiabetics with nephrosclerosis in the African American Study of Kidney Disease and Hypertension. Subjects were randomly assigned to usual MAP goal (102–107 mmHg) or a lower MAP goal (≤92 mmHg) and randomized to beta-blocker, angiotensin converting enzyme inhibitor, or calcium channel blocker. After covariate adjustment, a higher PP was associated with increased risk of CV outcome (RR = 1.28, CI = 1.11–1.47,P<0.01) and new LVH (RR = 1.26, CI = 1.04–1.54,P=0.02). PP increased at a greater rate in the usual than in lower MAP groups (slope ± SE: 1.08 ± 0.15 versus 0.42 ± 0.15 mmHg/year,P=0.002), but not by the antihypertensive treatment assignment. Observations indicate that control to a lower MAP slows the progression of PP, a correlate of cardiovascular remodeling and complications, and may be beneficial to CV health.

Scleroderma Renal Crisis

2014 ◽  
Vol 41 (6) ◽  
pp. 1040-1048 ◽  
Author(s):  
Luc Mouthon ◽  
Guillaume Bussone ◽  
Alice Berezné ◽  
Laure-Hélène Noël ◽  
Loïc Guillevin
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Antihypertensive Drugs ◽  
Rna Polymerase Iii ◽  
Pressure Control ◽  
Hypertensive Encephalopathy ◽  
Left Ventricular ◽  
Scleroderma Renal Crisis ◽  
Volume Depletion ◽  
Renal Crisis

Scleroderma renal crisis (SRC) is characterized by malignant hypertension and oligo-anuric acute renal failure. It occurs in 5% of patients with systemic sclerosis (SSc), particularly in patients with diffuse disease during the first years. SRC is more common in patients receiving corticosteroids, the risk increasing with increasing dose. The disease is sometimes triggered by use of nephrotoxic drugs and/or intravascular volume depletion. Left ventricular insufficiency and hypertensive encephalopathy are typical clinical features. Thrombotic microangiopathy is detected in 43% of cases, and anti-RNA-polymerase III antibodies are present in one-third of patients. Renal biopsy is not necessary if SRC presents classical features. However, biopsy may help to define the prognosis and guide treatment in atypical forms. The prognosis of SRC has greatly improved with the introduction of angiotensin-converting enzyme (ACE) inhibitors. However, the 5-year survival for SSc patients with full SRC remains low (65%). The treatment of SRC relies on aggressive blood pressure control with an ACE inhibitor, combined with other antihypertensive drugs if needed. Dialysis is frequently indicated but can be stopped in about half of patients, mainly those with good blood pressure control. Patients who need dialysis for more than 2 years qualify for renal transplantation.

Impact of Blood Pressure Control on Prevalence of Left Ventricular Hypertrophy in Treated Hypertensive Patients

Cardiology ◽  
2000 ◽  
Vol 93 (3) ◽  
pp. 149-154 ◽  
Author(s):  
C. Cuspidi ◽  
L. Lonati ◽  
L. Sampieri ◽  
G. Macca ◽  
I. Michev ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Blood Pressure Control ◽  
Ventricular Hypertrophy ◽  
Pressure Control ◽  
Left Ventricular ◽  
Hypertensive Patients

Regression of Left Ventricular Hypertrophy in the Short-Term Treatment of Hypertension With Isradipine

1991 ◽  
Vol 4 (2_Pt_2) ◽  
pp. 188S-190S ◽  
Author(s):  
Manoel A. Saragoça ◽  
Jorge E. Portela ◽  
Patricia Abreu ◽  
Frida Plavnik ◽  
Adália Vanneta ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Term Treatment ◽  
Left Ventricular ◽  
Short Term ◽  
Short Term Treatment ◽  
Treatment Of Hypertension
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