scholarly journals ECHOs of Medication Non-Adherence in Hypertensive Patients: A Systematic Review

2021 ◽  
Vol 8 (7) ◽  
pp. 446-452
Author(s):  
Satish S ◽  
Agnes Jain Rose
Keyword(s):  
Systematic Review ◽  
Antihypertensive Drugs ◽  
Pressure Control ◽  
Left Ventricular ◽  
Economic Outcomes ◽  
Health Crisis ◽  
Productivity Costs ◽  
Humanistic Outcomes ◽  
Clinical Consequences ◽  
Ischemic Attack

Globally, hypertension has been one of the most common diseases. Although there has been improvement in the blood pressure control with the use of antihypertensive drugs, poor adherence to medications is still a problem. This has caused economic, clinical and humanistic outcomes (ECHOs) resulting in severe health crisis. This includes worsening of present disease condition, increase in co morbid diseases, increase in health care costs and ultimately death. This systematic review has broadened the scope of knowledge by providing valuable input into the development of clinical, economic and humanistic framework to standardize the consequences of medication non-adherence with the ECHOs. Literature documents the multiple adverse clinical consequences of medication non-adherence. It is also associated with a greater risk of cardiovascular events including vascular stiffness, left ventricular hypertrophy, micro albuminuria, acute coronary syndromes, stroke and transient ischemic attack and chronic heart failure ultimately leading to death. Humanistic outcomes were evaluated by measuring the symptomatic and functional status and quality of life. Economic outcomes were mainly affected by hospital related costs, productivity costs, social welfare costs, personal costs, cost to the family and friends and other associated costs. Keywords: Hypertension, Medication non-adherence, Clinical outcomes, Economic outcomes, Humanistic outcomes.

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.

scholarly journals Hemodynamic monitoring using thoracic bioimpedance – an optimal solution for the treatment of hypertension

2018 ◽  
Vol 91 (4) ◽  
pp. 474-478
Author(s):  
Anca Daniela Farcas ◽  
Florin Petru Anton ◽  
Mihaela Mocan ◽  
Luminita Animarie Vida-Simiti
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Hemodynamic Monitoring ◽  
Antihypertensive Drugs ◽  
Optimal Solution ◽  
Pressure Control ◽  
Left Ventricular ◽  
Uncontrolled Hypertension ◽  
Tailored Therapy ◽  
Electrical Bioimpedance

Hypertension is a major issue of public health because of its increasing prevalence and multiple complications caused by failing to achieve an efficient blood pressure control. Considering hypertension as a hemodynamic disorder allows to prescribe a tailored therapy guided by individual hemodynamic parameters, therefore leading to an increased rate of control. We present the case of a 59 years old diabetic, dyslipidemic and obese male who, although treated with 5 classes of antihypertensive drugs had uncontrolled hypertension that caused left ventricular failure. Using the HOTMAN system of hemodynamic monitoring using thoracic electrical bioimpedance allowed a quick identification of the cause and guided the therapy, achieving blood pressure control after 5 days of treatment. Treating hypertension by identifying the underlying hemodynamic imbalance allows prescribing a tailored therapy and shortens the initiation and stabilization phases of treatment.

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.

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