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Academic literature on the topic 'HYPERTENSIVE DRUGS'

Author: Grafiati

Published: 11 September 2023

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Journal articles on the topic "HYPERTENSIVE DRUGS"

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Wilson, J., M. A. Orchard, A. A. Spencer, J. A. Davies, and C. R. M. Prentice. "Anti-Hypertensive Drugs Non-Specifically Reduce “Spontaneous” Activation of Blood Platelets." Thrombosis and Haemostasis 62, no. 02 (1989): 776–80. http://dx.doi.org/10.1055/s-0038-1646901.

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SummaryAbnormal activation of blood platelets may be a contributory factor in the accelerated vascular disease which occurs in hypertension. We investigated the effects of lowering blood pressure in 12 patients with mild hypertension on several aspects of platelet function, initially in a placebo-controlled, double-blind, crossover study with nisoldipine, and subsequently in the same patients comparing nisoldipine with the patients’ usual anti-hypertensive therapy. Values were compared with those from an age, sex-matched control population. Seven hypertensive patients with renal failure were also studied. Administration of nisoldipine reduced ex vivo “spontaneous” aggregation of blood platelets significantly, and a similar significant effect was seen when blood pressure was lowered by the patients usual anti-hypertensive therapy. “Spontaneous” aggregation occurring in the control population was similar to that in the treated hypertensives. Blood platelet count, and aggregation in response to ADP and adrenalin were unaffected by treatment. Median plasma beta thromboglobulin levels were significantly higher in the untreated hypertensive patients (43 ng ml-1) than in the controls (30 ng ml-1), and there was a trend to reduced values for beta thromboglobulin on treatment of the hypertension. These results indicate that blood platelet activity is enhanced in hypertension and that function returns towards normal when blood pressure is lowered by treatment.

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O'Collins, Victoria E., Geoffrey A. Donnan, Malcolm R. Macleod, and David W. Howells. "Hypertension and Experimental Stroke Therapies." Journal of Cerebral Blood Flow & Metabolism 33, no. 8 (June 5, 2013): 1141–47. http://dx.doi.org/10.1038/jcbfm.2013.88.

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Hypertension is an established target for long-term stroke prevention but procedures for management of hypertension in acute stroke are less certain. Here, we analyze basic science data to examine the impact of hypertension on candidate stroke therapies and of anti-hypertensive treatments on stroke outcome. Methods: Data were pooled from 3,288 acute ischemic stroke experiments (47,899 animals) testing the effect of therapies on infarct size (published 1978-2010). Data were combined using meta-analysis and meta-regression, partitioned on the basis of hypertension, stroke model, and therapy. Results: Hypertensive animals were used in 10% of experiments testing 502 therapies. Hypertension was associated with lower treatment efficacy, especially in larger infarcts. Overall, anti-hypertensives did not provide greater benefit than other drugs, although benefits were evident in hypertensive animals even when given after stroke onset. Fifty-eight therapies were tested in both normotensive and hypertensive animals: some demonstrated superior efficacy in hypertensive animals (hypothermia) while others worked better in normotensive animals (tissue plasminogen activator, anesthetic agents). Discussion: Hypertension has a significant effect on the efficacy of candidate stroke drugs: standard basic science testing may overestimate the efficacy which could be reasonably expected from certain therapies and for hypertensive patients with large or temporary occlusions.

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Bhandary, Apeksha, and Prasan R. Bhandari. "Drug usage pattern of anti-hypertensive drugs in elderly diabetic, hypertensive in-patients with or without impaired renal function in a tertiary care hospital." International Journal of Basic & Clinical Pharmacology 7, no. 4 (March 23, 2018): 696. http://dx.doi.org/10.18203/2319-2003.ijbcp20181172.

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Background: Hypertension (HTN) and Diabetes mellitus (DM) are the leading contributors to the cardiovascular mortality and morbidity. Drug utilisation studies (DUS) are potential tools in the evaluation in health care systems. Objectives was to analyse the drug usage pattern of anti-hypertensives in elderly hypertensive diabetic in-patients in a tertiary hospital. To analyse drug usage pattern of anti-hypertensives in elderly hypertensive, diabetic in-patients with renal impairment in a tertiary hospital.Methods: The study population consisted of 165 hypertensive diabetic in-patients at Shri Dharmasthala Manjunatheshwara (SDM) Hospital. Questionnaire based study was conducted and prescriptions of patient with HTN and DM at and above the age of 60 years irrespective of gender were included.Results: Our study revealed that angiotensin receptor blockers (ARBs) were the most commonly prescribed (42.4%) class of anti-hypertensive drugs. In patients with impaired renal function also ARBs were the most common class prescribed (22.0%). Out of 35 anti-hypertensive fixed drug combinations (FDCs) prescribed the most frequent combination was combination with an ARBs (85.7%). There was a significant increase in the number of anti-hypertensive drugs prescribed in patients with impaired renal function when compared to patients without impaired renal function (p <0.05). The cost index was high, and the percentage cost variation was more than 100% in most of the anti-hypertensive drugs prescribed.Conclusions: This study shows that the most commonly prescribed anti-hypertensive drug class was ARBs in patients with and in patients without impaired renal function.

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Risna, Amalia, Jauhar Latifah, Linda Permata Sari, Ronalisa Ronalisa, Henny Maryani, and Difa Intannia. "PROFIL PERESEPAN PENGGUNAAN ANTIHIPERTENSI PADA PASIEN RAWAT JALAN DI PUSKESMAS SUNGAI ULIN PERIODE OKTOBER 2020." Jurnal Insan Farmasi Indonesia 5, no. 1 (May 29, 2022): 8–15. http://dx.doi.org/10.36387/jifi.v5i1.913.

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Hypertension is a disease that often causes death because many people do not realize it. People have hypertension if the blood pressure above 140/90 mmHg after regular checking. In Sungai Ulin Public health center, hypertension is the second-highest disease. The study aimed to determine the characteristics of hypertensive patients and the profile of prescribing the use of anti-hypertensive drugs in outpatients in the period October 2020 at Sungai Ulin Public health center. This research is an observational descriptive study using retrospective data with the inclusion criteria. A population of all prescription anti-hypertensive drugs given to outpatients in the period October 2020 in Sungai Ulin Public health center (87 prescriptions). The results showed the percentage of prescription use of anti-hypertensive drugs, namely women who received more anti-hypertensive prescriptions as many as 59 (65,02%) prescriptions, while the age criteria from > 65 years was (26,43%). The majority of drugs were given in Puskesmas Sungai Ulin was amlodipine with a percentage of 72,41%.

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Cífková, Renata. "Antiplatelet and Lipid-lowering Drugs in Hypertension." European Cardiology Review 9, no. 1 (2014): 16. http://dx.doi.org/10.15420/ecr.2014.9.1.16.

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Antiplatelet therapy, and low-dose acetylsalicylic acid (ASA) in particular, is recommended in hypertensive patients with previous cardiovascular events and is considered in hypertensive patients with reduced renal function or a high cardiovascular (CV) risk, provided blood pressure is well-controlled. Acetylsalicylic acid is not recommended in low-to-moderate risk hypertensive patients in whom absolute benefit and harm are equivalent. Further trials evaluating antithrombotic therapy including newer agents in hypertension are needed. Women at high and moderate risk of pre-eclampsia are advised to take a low dose of ASA daily from 12 weeks of gestation until delivery. In addition to their lipid-lowering effects, statins induce a small blood pressure reduction. The 2013 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines recommend using statin therapy in hypertensive patients at moderate-to-high CV risk to achieve the target low-density lipoprotein (LDL) cholesterol value <3 mmol/l (115 mg/dl). For individuals with manifest CV disease or at very high CV risk, a more aggressive LDL target of <1.8 mmol/l (70 mg/dl) is recommended.

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Rajak, Devraj, Deepali Sahu, Anushree Jain, Rubeena Khan, Basant Khare, Prateek Kumar Jain, and Bhupendra Singh Thakur. "Review on Toxicity of Antihypertensive Drugs." Asian Journal of Dental and Health Sciences 2, no. 4 (December 15, 2022): 64–68. http://dx.doi.org/10.22270/ajdhs.v2i4.28.

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Adverse drug reactions are common and pose a serious health problem, limiting treatment options, causing compliance issues, and even leading to therapy discontinuation. Hypertension is a chronic disease that is regarded as a major risk factor for cardiovascular disease. To achieve a target blood pressure in an individual patient, a wide range of anti-hypertensive agents are available as single or combination therapy, whereas combination therapy increases the risk of developing Adverse Drug Reaction. Hypertensive patients frequently have coexisting disease conditions such as hyperlipidemia, impaired glucose metabolism, and renal impairment, which increase the risk of Cardio Vascular morbidity and mortality. When treating hypertensive patients, comprehensive management of both hypertension and concomitant Cardio Vascular Disease risk factors is essential. Some of the rare and serious Adverse Drug Reactions that occurred in patients treated with these drugs included beta-blockers causing psoriasis, calcium channel blockers causing gingival hyperplasia, peripheral oedema, Angiotensin Converting Enzyme inhibitors causing ankle oedema, and thiazide diuretics causing hyponatremia and hyperglycemia. Asymptomatic hypertension is more common and necessitates lifelong treatment with antihypertensive agents, predisposing to Adverse Drug Events.In order to improve treatment outcomes and reduce morbidity and mortality associated with adverse drug reactions, healthcare professionals must monitor adverse drug reactions in patients taking antihypertensive drugs. Keywords: Adverse drug reactions, Hypertension, hyperlipidemia, glucose metabolism

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Ullah, Mohammad, Suman Kumar Saha, Md Toufiqur Rahman, Md Abdul Karim, and Rashid Ahmed. "Nonadherence to Drugs among the Hypertensive Patients in Outpatient Department of a Secondary Hospital of Bangladesh." Cardiovascular Journal 11, no. 2 (February 27, 2019): 105–13. http://dx.doi.org/10.3329/cardio.v11i2.40409.

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Background: One fifth Bangladeshi adults are hypertensive. Forty percent of them know that they are hypertensive. 53% to 75% hypertensive people have got uncontrolled hypertension. One of the most important causes of uncontrolled hypertension is nonadherence to drugs. We tried to find the causes of non adherence of drugs among the patients with HTN in a secondary care hospital of Bangladesh. Methods: The study was conducted from March 2018 to June 2018. Total 144 patients with HTN were included in the study. Taking drugs in less than 80% of the days of previous six months was defined as nonadherence. We used Hill Bone compliance scale to find out the causes of nonadherence to drugs. Results: Out of 144 patients 79 patients (55%) were non adherent to drugs. 36.8% patients forget to take their drugs, 34.02% patients run out of drugs, 29.86% patients miss taking drugs when they feel better, 15.27% patients skip their drugs before going to the doctor and 14.58% patients decide not to take drugs anymore without any specific reason. In most of the patients there are more than one causes of nonadherence. 85.9% patients with nonadherence had uncontrolled hypertension and 66.6 % of the nonadherent patients had target organ damage. Nonadherence is more in elderly patients and with increased duration of hypertension. Conclusion: Fifty five percent of the diagnosed hypertensive population is nonadherent to their drugs. We must take measures to diagnose HTN among our population and find the ways to make them adherent to their treatment. Cardiovasc. j. 2019; 11(2): 105-113

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Riungu, Dianah Kathambi, and Patrick Mbataru. "Determinants of Accessibility of Hypertensive Drugs by Adult Patients Under Sustainable Development Goal Three in Nairobi City County, Kenya." International Journal of Current Aspects 5, no. 4 (November 22, 2021): 108–19. http://dx.doi.org/10.35942/ijcab.v5i4.214.

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Hypertension is noted to be the easiest non-communicable disease to diagnose treat and monitor if proper health systems are put in place to ensure hypertensive drugs are accessible to hypertensive patients who need them daily. It is estimated that prevalence rate of hypertension in Kenya range from 13 % to 50 % and only 1 in 5 of the diagnosed are on hypertensive medicines. Lack of medication intake leads to uncontrolled hypertension resulting to more serious health complications which result to premature deaths. Previous studies have provided little information on the determinants of hypertensive drugs accessibility to patients. An enquiry on the availability of hypertensive drugs in public hospitals is worthwhile because hypertension has become an important social problem. This study has investigated the determinants of accessibility of hypertensive drugs by adult patients who are supposed to have uninterrupted medication intake for a healthy living. The concept of essential drugs was adopted for this study. This concept of essential drugs contained essential medicines list (EML) and the eight elements of primary health care of 1978 with a goal to ensure equal access to medicines. Descriptive design has been adopted for the study. The targeted population of 6329 hypertensive patients in public health facilities within Nairobi County. Yamane formula was used to get the sample size, which will be a total of 394 patients. Systemic random sampling procedure was employed for the study. A questionnaire tool of data collection was used for data collection. The collected data was there after coded and analyzed using Statistical Package for Social Sciences (SPSS) both for descriptive statistics (frequencies and percentages) and inferential statistics (correlation analysis). Data is presented using pie charts tables and figures. The study revealed that accessibility of medication in Nairobi city county health facilities is contributed by lack of medication in the facilities.

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Walker, James Johnston. "Hypertensive Drugs in Pregnancy." Clinics in Perinatology 18, no. 4 (December 1991): 845–73. http://dx.doi.org/10.1016/s0095-5108(18)30499-8.

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Brubaker, R. F. "Ocular hypertensive drugs—Overview." Experimental Eye Research 55 (September 1992): 185. http://dx.doi.org/10.1016/0014-4835(92)90845-j.

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Dissertations / Theses on the topic "HYPERTENSIVE DRUGS"

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Nievelstein, Hubert Nicolas Maria Willem. "Hemodynamic effects of antihypertensive drugs in conscious spontaneously hypertensive rats." Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1987. http://arno.unimaas.nl/show.cgi?fid=5367.

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Beaubien, Eliot R. "Non-steroidal anti-inflammatory drugs and the risk of end stage renal disease in hypertensive individuals." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81593.

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Objective. To examine the association between non-steroidal anti-inflammatory drug (NSAID) use and end stage renal disease (ESRD) among hypertensive subjects.
Study design. We conducted a nested case-control study within a cohort of 77,887 hypertensive adult subjects within the province of Saskatchewan, Canada.
Outcome. The primary outcome was ESRD, defined by chronic dialysis or renal transplantation.
Exposure. NSAID exposure was determined using prescription records, for various time windows up to 10 years preceding the onset of end stage renal disease.
Statistical analysis. Rate ratios (RR) were estimated with 95% confidence intervals using conditional logistic regression, adjusting for potential confounding variables and stratified for effect modifiers.
Results. We identified 397 cases and 7,399 controls. In subjects followed for at least 10 years continuous NSAID use was observed in 20.8% of cases and 17.9% of controls (RR = 1.18, 95% CI 0.68--2.05). Additionally, neither early (RR = 1.10, 95% CI 0.50--2.41) nor late (RR = 0.81, 95% CI 0.32--2.04) NSAID exposure was associated with ESRD during this time period. Evaluation of other time windows (0--2 years, 2--5 years and 5--10 years) and NSAID dosing provided similar results. Results were not modified by loop diuretic and angiotensin converting enzyme inhibitor use.
Conclusion. Up to 10 years of non-steroidal anti-inflammatory drug use does not appear to influence the development of end stage renal disease. These results however may be influenced by unmeasured co-morbidities and confounding by "contra-indication".

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Komulainen, S. (Silja). "Effect of antihypertensive drugs on blood pressure during exposure to cold:experimental study in normotensive and hypertensive subjects." Doctoral thesis, University of Oulu, 2007. http://urn.fi/urn:isbn:9789514286131.

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Abstract The aim of the present study was to describe the effects of different types of cold exposures on blood pressure (BP) and heart rate (HR) and to test how these cold-induced effects are modulated by antihypertensive drugs representing different kind of mechanisms of action. The tested drugs represented the following antihypertensive drug subgroups: metoprolol from beta-blocking agents, carvedilol from alfa- and beta-blocking agents, lisinopril from angiotensin converting enzyme inhibitors, eprosartan from angiotensin II antagonists, amlodipine from calcium channel blockers and hydrochlorothiazide from diuretics. The main outcome measures were the levels and changes in systolic (SBP) and diastolic blood pressure (DBP) and HR before, during and after cold exposure. The normotensive and mildly hypertensive subjects were exposed either to –15°C for 15 minutes (with winter clothing), 5°C for 45 minutes (minimal clothing) or to a cold pressor test (CPT). Before measurements at –15°C, metoprolol, carvedilol, lisinopril, eprosartan, hydrochlorothiazide or placebo were given for a week in a double-blind and crossover manner. In one test procedure (5°C and CPT) the test subjects ingested amlodipine for three days or were without drug ingestion before the tests in a crossover manner. Both SBP and DBP were markedly increased by all types of cold exposure. Cold-induced rises of SBP/DBP were higher during the exposure to 5°C and –15°C (19–35/20–24 mmHg) than during CPT (13/16 mmHg). Metoprolol, carvedilol, lisinopril, eprosartan and amlodipine decreased the level of BP during the exposure to 5°C and –15°C compared to placebo or no drug. The antihypertensive drugs, with dosages used in this study, did not affect the cold-induced rise of BP compared to no drug or placebo. HR increased during CPT, but decreased during exposure to 5°C and –15°C. Metoprolol and carvedilol decreased HR during exposure to –15°C compared to placebo. The present study demonstrates for the first time the effects of antihypertensive drugs on BP in hypertensive subjects exposed to cold similar to normal outdoor exposure in winter. Although the magnitude of the cold-induced rise in BP was not affected by the drugs, the drug-induced decrease in the level of BP kept the peak values in the cold closer to the recommended threshold limit values
Tiivistelmä Tutkimuksen tarkoituksena oli selvittää eri mekanismeilla vaikuttavien verenpainelääkkeiden vaikutusta verenpainevasteisiin ja sydämen lyöntitiheyteen kylmässä sekä verrata erilaisten kylmäaltistusten vaikutusta verenpaineeseen ja sydämen lyöntitiheyteen. Tutkitut lääkkeet edustivat seuraavia verenpainelääkeryhmiä: metoprololi beetasalpaajia, karvediloli yhdistettyjä alfa- ja beetasalpaajia, lisinopriili ACE-estäjiä, eprosartaani angiotensiini II antagonisteja, amlodipiini kalsiumestäjiä ja hydroklooritiatsidi diureetteja. Tärkeimmät mitatut vasteet olivat systolisen ja diastolisen verenpaineen ja sydämen lyöntitiheyden tasot ja muutokset ennen kylmäaltistusta, kylmäaltistuksen aikana ja sen jälkeen. Lisäksi mitattiin lämpötilavasteita ja tuntemuksia. Normo- ja hypertensiiviset koehenkilöt altistettiin joko –15°C:seen 15 minuutin ajaksi (talvivaatetuksessa), 5°C:seen 45 minuutin ajaksi (minimaalisella vaatetuksella) tai tehtiin ns. käden kylmävesitesti (CPT). Testisarjoissa (–15°C) metoprololi, karvediloli, lisinopriili, eprosartaani ja hydroklooritiatsidi tai plasebo annettiin viikon ajan kaksoissokko- ja vaihtovuoromenetelmällä. Yhdessä testisarjassa (5°C ja CPT) koehenkilöt ottivat amlodipiinia 3 päivän ajan tai olivat ilman lääkettä ennen testikertoja vaihtovuoroisessa järjestyksessä. Kaikki kylmäaltistustyypit nostivat merkittävästi sekä systolista että diastolista verenpainetta. Systolisen ja diastolisen verenpaineen nousu oli korkeampi koko kehon kylmäaltistuksissa (5°C tai –15°C) (19–35/20–24 mmHg) kuin ns. kylmävesitestissä (13/16 mmHg). Metoprololi, karvediloli, lisinopriili, eprosartaani ja amlodipiini laskivat verenpaineen tasoja koko kehon kylmäaltistuksessa verrattuna plaseboon. Yksikään verenpainelääkkeistä ei vaikuttanut merkittävästi kylmän aiheuttamaan verenpaineen nousuun verrattuna tutkimuskertaan ilman lääkettä tai plaseboon. Sydämen lyöntitiheys nousi ns. kylmävesitestin aikana, mutta laski koko kehon kylmäaltistuksissa (5°C ja –15°C). Metoprololi ja karvediloli laskivat sydämen lyöntiheyttä kylmäaltistuksessa (–15°C) verrattuna plaseboon. Tämä tutkimus kuvaa ensimmäistä kertaa, kuinka verenpainelääkkeet vaikuttavat verenpainetasoihin ja -vasteisiin kylmäaltistuksessa, joka simuloi tyypillisiä ulko-olosuhteita talvella. Vaikka lääkkeet eivät estäneet kylmän aiheuttamaa verenpaineen nousua, ne laskivat verenpaineen tasoa, jolloin verenpaine pysyi kylmässäkin lähempänä suositusrajoja

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Filho, Gilberto Senechal de Goffredo. "Incapacidade temporária para atividades habituais: relação com a pressão arterial e o uso de terapia farmacológica antihipertensiva no Estudo Pró-Saúde." Universidade do Estado do Rio de Janeiro, 2008. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=5021.

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A hipertensão arterial (HA) desempenha papel determinante na ocorrência de eventos clínicos graves, havendo entretanto controvérsia quanto ao seu impacto no cotidiano do portador. A incapacidade temporária para a realização de atividades habituais, definida como uma restrição temporária na capacidade funcional habitual do indivíduo, é um indicador de saúde recomendado pela Organização Mundial da Saúde para uso em estudos populacionais. A partir do objetivo geral de investigar a associação entre hipertensão arterial e incapacidade temporária para atividades habituais, delineamos os seguintes objetivos específicos: A) Investigar se a elevação dos níveis pressóricos determina a freqüência e o período acumulado de incapacidade temporária para atividades habituais; B) Investigar se o uso de medicações anti-hipertensivas associa-se a alterações na freqüência e no período acumulado de incapacidade temporária para atividades habituais. O estudo seccional com dados de 2953 participantes obtidos através de questionário auto-administrado no Estudo Pró-Saúde, uma coorte de funcionários técnico-administrativos de universidade localizada no estado do Rio de Janeiro. A exposição foi avaliada a partir do valor aferido da PA e do uso de drogas anti-hipertensivas. Conduzimos a análise separando os participantes em 4 grupos, combinando as informações quanto à PA aferida (< ou 140/90 mmHg), e o relato de uso ou não de medicação anti-hipertensiva. O desfecho foi avaliado com a utilização de uma variável composta com informação referente à ocorrência e ao período de incapacidade. Realizamos análise multivariada através de regressão logística multinomial. Temos como resultado 690 (23,4 %) participantes foram classificados como hipertensos, e 704 (23,8 %) relataram incapacidade temporária. O relato do uso de medicação anti-hipertensiva mostrou, entre os indivíduos com PA < 140/90 mmHg, associação direta com a prevalência de incapacidade temporária de longa duração, com OR=2,25 (IC 95 %: 1,31 3,87). A presença de PA 140/90 mmHg mostrou relação inversa com a chance de incapacidade temporária de curta duração entre os indivíduos que não usavam medicação anti-hipertensiva, a qual porém não foi estatisticamente significativa (OR=0,64; IC 95 %: 0,40 1,03). Encontramos uma associação direta entre o uso de drogas anti-hipertensivas e incapacidade temporária de longa duração, a qual pode relacionar-se a efeitos adversos da medicação; os resultados sugerem também uma relação inversa entre os valores da PA e a prevalência de incapacidade de curta duração, a qual não alcançou significância estatística, e que pode estar relacionada a um fenômeno conhecido como hipoalgesia associada à HA.
Arterial hypertension (AH) plays a determinant role in the occurrence of severe clinical events; however, there are controversies about its impact on daily life. The temporary disability for daily activities, which is defined as a temporary restriction in an individuals usual level of functioning, is a health indicator proposed by the World Health Organization for utilization in population studies. To investigate the association between arterial hypertension and temporary disability for daily activities, we proposed the following specific objectives: A) To investigate whether elevated blood pressure (BP) determine the frequency or accumulated period of temporary disability for daily activities; 2) To investigate whether the use of anti-hypertensive drugs are associated with changes in the frequency or accumulated period of temporary disability for daily activities. We have a cross-sectional study with data obtained from 2953 participants who answered a self administered questionnaire in the Pro-Saude Study, a cohort of university employees in Rio de Janeiro state. The exposure was evaluated using the measured value of BP and the report of the use of anti-hypertensive drugs. We conducted the analysis classifying the participants in 4 groups, combining the information about measured BP (< or 140/90 mmHg) and the report of the use of anti-hypertensive drugs or not. The outcome was evaluated with a composite variable with information about the report and period of disability. Multivariate analyses were conducted using multinomial logistic regression. The results are 690 (23.4 %) were classified as hypertensives, and 704 (23.8 %) reported temporary disability. The use of antihypertensive drugs, among the participants with BP < 140/90 mmHg, was directly associated with the prevalence of temporary disability for daily activities for a longer period (OR=2.25, CI 95 %: 1.31 - 3.87). The presence of BP 140/90 mmHg showed an inverse relationship with the chance of temporary disability for a short period among the participants that did not use ntihypertensive drugs, not reaching statistical significance (OR=0.64; CI 95 %: 0.40 - 1.03). We found a direct association between the use of anti-hypertensive drugs and temporary disability for daily activities for a long period, which may be related to adverse effects of the drugs; the results also suggest an inverse relationship between BP values and the prevalence of temporary disability for a short period, which did not reach statistical significance, and can be related to a phenomenon known as AH-asociated hypalgesia.

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Forino, Andrew Stephen. "Determining Effects of the PAF-R and Anti-Hypertensive Drugs Mediated Microvesicle Particle Release in Modulating Anti-Tumor Response of Lung Cancer." Wright State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=wright1590691151424173.

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Merlo, Juan. "Pharmacoepidemiologic studies on cardiovascular drugs with special reference to the effectiveness and safety of blood pressure lowering drugs /." Lund : Dept. of Community Medicine, Lund University, and the NEPI Foundation, 1998. http://books.google.com/books?id=c_BsAAAAMAAJ.

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Moore, Suzanne P. "Adherence to randomised drug regimens of patients enrolled in the Second Australian National Blood Pressure Study : a description of the patterns of adherence and of factors influencing non-adherence /." [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16251.pdf.

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Yates, John. "Haemodynamic effects of vasoactive drugs in experimental portal hypertension." Thesis, Liverpool John Moores University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337787.

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Yu, Zhen. "Altered drug responses in diabetic and hypertensive-diabetic cardiomyopathy." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/29406.

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Diabetes mellitus has been associated with both clinical and experimental cardiac dysfunction. Diabetic cardiomyopathy which is characterized by depressed cardiac contractility is accompanied by a variety of biochemical changes in Ca⁺⁺ metabolism. This cardiomyopathy may occur in the presence of normal coronary arteries and normal blood pressure. However, some studies have shown that hypertension is more prevalent among diabetics and can aggravate the cardiovascular abnormalities associated with diabetes. To understand the mechanisms of diabetic cardiomyopathy and consequences of combined hypertension and diabetes, experiments were designed to measure cardiac tissue responses to various inotropic agents in experimental diabetes. Six weeks following streptozotocin (STZ) administration, Wistar, spontaneously hypertensive (SHR) and Wistar Kyoto (WKY) rats exhibited the 'classical signs' of diabetes which included: hyperglycemia, hypoinsulinemia, hyperlipidemia (except in WKY), and hypothyroidism. Decreased basal atrial rate and increased basal developed force (BDF) suggest a depressed SA node function and an alteration of Ca⁺⁺ utilization by diabetic ventricles. Decreased post quiescent potentiation (PQP) values (except in WKY) in ventricular tissues suggest a diminished amount of releasable Ca⁺⁺ from sarcoplasmic reticulum (SR). Decreased post stimulation potentiation (PSP) values in SHR papillary muscles (PM) are probably suggestive of a depressed sarcolemmal Na⁺-Ca⁺⁺ exchange function in this tissue. Diabetic rats show subsensitivity to β-adrenergic stimulation in ventricular tissues, supersensitivity and hyperresponsiveness to Ca⁺⁺ and α-adrenergic stimulation (except in WKY) in ventricular tissues and left atria (LA) and supersensitivity to BAY K 8644 in SHR LA and hyperresponsiveness to verapamil in ventricular strips. These alterations may be attributed to a change in receptor number and/or a post receptor alteration. Ryanodine decreased the PQP of Wistar and SHR PM and SHR LA in both controls and diabetics. It especially abolished PQP in SHR diabetic tissues, but had no effect on WKY tissues, which may suggest a difference in the SR function in these tissues. SR with impaired Ca⁺⁺ uptake may contribute to these phenomena in diabetic rats. Ryanodine also diminished (PQP + BDF) of SHR LA and (PQP/BDF) of Wistar and SHR PM, ˙but had no effects on control and other diabetic tissues. It appears that ryanodine has some influence on the Na⁺-Ca⁺⁺ exchange generated by sarcolemma (SL) of certain diabetic tissues. Further experiments are required to clarify this. SHR diabetic rats had greater changes in most of the measurements such as hyperlipidemia, depressed PQP and PSP values, and altered drug responses. This model exhibited very high mortality as compared to Wistar and WKY diabetic rats. As has been shown previously, the combination of hypertension and diabetes exerts a synergistic effect on the cardiac dysfunction in this model, and that altered lipid metabolism, SL and SR function are all involved in the development of cardiomyopathy. WKY diabetic rats, on the other hand, exhibited no significant changes in blood lipids, or in response to phenylephrine or to Ca⁺⁺ (LA) stimulation. Lack of change in these factors may explain the relatively normal cardiac function of this model as measured previously.
Pharmaceutical Sciences, Faculty of
Graduate

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Greer, I. A. "The effect of anti-hypertensive agents on platelets, prostacylin and thromboxane and observations on prostacyclin and thromboxane in normal and hypertensive pregnancy." Thesis, University of Glasgow, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380334.

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Books on the topic "HYPERTENSIVE DRUGS"

1

Heart attacks, hypertension, and heart drugs. Emmaus, Pa: Rodale Press, 1987.

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M, Drayer Jan I., Lowenthal David T, and Weber Michael A, eds. Drug therapy in hypertension. New York: Dekker, 1987.

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Switzerland) International Symposium Clonidine in Hypertension (1984 Geneva. Low dose oral and transdermal therapy of hypertension: International Symposium Clonidine in Hypertension, Geneva, 14th-16th June, 1984. Darmstadt: Steinkopff, 1985.

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1947-, Martin John E., and Dubbert Patricia M, eds. Non-drug treatments for essential hypertension. New York: Pergamon Press, 1988.

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H, Messerli Franz, and Opie Lionel H, eds. Combination drug therapy for hypertension. New York: Author's Pub. House, 1997.

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Mann, Samuel J. Hypertension and you: Old drugs, new drugs, and the right drugs for your high blood pressure. Lanham: Rowman & Littlefield Publishers, 2012.

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van, Zwieten P. A., and Greenlee William J, eds. Antihypertensive drugs. Amsterdam, the Netherlands: Harwood Academic Publishers, 1997.

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H, Messerli Franz, ed. The Heart and hypertension. New York, N.Y: Yorke Medical Books, 1987.

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Bönner, Gerd. Prostacyclin and hypertension. Berlin: Springer-Verlag, 1990.

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Lower blood pressure without drugs: Curing your hypertension naturally. 2nd ed. Garden City Park, NY: Square One Publishers, 2012.

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Book chapters on the topic "HYPERTENSIVE DRUGS"

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Iturrioz, Xavier, Annabelle Reaux, Le Goazigo, and Catherine Llorens-Cortes. "Aminopeptidase Inhibitors as Anti-Hypertensive Drugs." In Aminopeptidases in Biology and Disease, 229–50. Boston, MA: Springer US, 2004. http://dx.doi.org/10.1007/978-1-4419-8869-0_11.

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Kuriyama, Yoshihiro, Tohru Sawada, and Teruo Omae. "Antihypertensive Drugs and Cerebral Circulation." In How Should Elderly Hypertensive Patients Be Treated?, 69–83. Tokyo: Springer Japan, 1989. http://dx.doi.org/10.1007/978-4-431-68340-7_5.

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Cockcroft, John R., and David J. Webb. "Phase I Trials on Anti-hypertensive Drugs." In Early Phase Drug Evaluation in Man, 302–12. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-10705-6_24.

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Voicu, Victor, and Maria Dorobantu. "New Drugs for the Hypertensive Failing Heart." In Updates in Hypertension and Cardiovascular Protection, 313–34. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-93320-7_20.

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Nakamaru, Mitsuaki, Toshio Ogihara, Hiroshi Mikami, Fuminori Masugi, Jitsuo Higaki, Atsuhiro Otsuka, Takeshi Hata, and Yuichi Kumahara. "Complications and the Choice of Antihypertensive Drugs in the Elderly." In How Should Elderly Hypertensive Patients Be Treated?, 213–18. Tokyo: Springer Japan, 1989. http://dx.doi.org/10.1007/978-4-431-68340-7_21.

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Sarros, G., H. Nastou, A. Nastos, V. Sarrou, N. Fotopoulos, and J. Anastassopoulou. "Molecular Design and FT-IR Spectra of Hypertensive Drugs." In Spectroscopy of Biological Molecules, 565–66. Dordrecht: Springer Netherlands, 1995. http://dx.doi.org/10.1007/978-94-011-0371-8_261.

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Kirpizidis, H. G. "Quality of Life, Drugs and Diet in Hypertensive Patients." In Handbook of Disease Burdens and Quality of Life Measures, 2965–86. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_173.

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Agrawal, S. S. "Development of Transdermal and Transbuccal Drug Delivery Systems for Cardioactive Drugs with Special Reference to Anti- Hypertensive Agents." In Atherosclerosis, Hypertension and Diabetes, 229–46. Boston, MA: Springer US, 2003. http://dx.doi.org/10.1007/978-1-4419-9232-1_19.

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Escher, Emanuel. "Angiotensin II Antagonists with Prolonged Duration of Action Possible Anti-Hypertensive Drugs." In Molecular Biology of Brain and Endocrine Peptidergic Systems, 29–45. Boston, MA: Springer US, 1988. http://dx.doi.org/10.1007/978-1-4684-8801-2_3.

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Bernstein, Donald P. "How Should You Manage Anti-Hypertensive Drugs in Morbidly Obese Surgical Patients?" In Controversies in the Anesthetic Management of the Obese Surgical Patient, 91–101. Milano: Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-2634-6_8.

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Conference papers on the topic "HYPERTENSIVE DRUGS"

1

Wilson, J., M. A. Orchard, A. A. Spencer, J. A. Davies, and C. R. M. Prentice. "TREATMENT OF RAISED BLOOD PRESSURE WITH NISOLDIPINE REDUCES "SPONTANEOUS" PLATELET AGGREGATION IN WHOLE BLOOD." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644260.

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Hypertensive patients are at risk of premature vascular disease, and abnormalplatelet function in hypertensive subjects may contribute to vascular damage. Ina placebo controlled, double blind, cross over study, we have investigated theeffect of treatment of moderate hypertension with nisoldipine (a 1,4, dihydropyridine calcium antagonist) on several aspects of platelet function. In 12 hypertensive subjects, venous blood samples were taken for platelet count, PCV, βTG, PF4, and aggregation to standard doses of ADP and adrenaline in whole blood. Platelet aggregation in whole blood which occurred during processing (spontaneous aggregation) was also recorded. Samples were collected on four occasions: after 4 weeks treatment with placebo (A), after 6 weeks and 12 weeks of the crossover phase with either nisoldipine (B) or placebo (C), and finally after re-establishment of blood pressure control on routine therapy (D). Nisoldipine was effective in lowering blood pressure, with mean values during the 4 treatment phases of: A 119 mmHg, B 104 mmHg (p < 0.01), C 114 mnHg, D 103 mmHg. Neither nisoldipine nor routine treatment significantly affected platelet count, PCV, βTG, PF4 or aggregation in whole blood to adrenalin or ADP. "Spontaneous aggregation" in whole blood however, was significantly inhibited by reduction in blood pressure during treatment both with nisoldipine and routine drugs. Treatment of hypertension appears to raise the threshold of blood platelets for aggregation regardless of the pharmacological agent used.

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Martins, A. V. V., J. G. A. L. Junior, L. A. Bortolotto, G. Lorenzi-Filho, and L. F. Drager. "Insomnia is Common in Patients with Hypertension and Associated with Higher Need of Anti-hypertensive Drugs." In XIX Congresso Brasileiro do Sono. Thieme Revinter Publicações Ltda., 2023. http://dx.doi.org/10.1055/s-0043-1770250.

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Suryantara, A. A., I. Suyasa, Ni Kamaryati, and Ida Diyu. "Determinant Factors Affecting Adherence of Hypertensive Patients to Taking Antihypertensive Drugs." In The Bali Biennial International Conference on Health Sciences. SCITEPRESS - Science and Technology Publications, 2022. http://dx.doi.org/10.5220/0011940700003576.

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Yalcin, Huseyin C., Mohamed A. Elrayess, Hadeel T. Al-Jighefee, Mahmoud Khatib A. A. Al-Ruweidi, Shamma Almuraikhy, and Hadi M. Yassine. "Soluble ACE2 and Angiotensin II levels Modulated in Hypertensive COVID-19 Patients treated with different Antihypertension Drugs." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2021. http://dx.doi.org/10.29117/quarfe.2021.0085.

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Hypertension is a major risk factor and common comorbidity among severe Coronavirus Disease 2019 (COVID-19) patients. Prominent antihypertensive drugs, such as angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) can modulate the expression of angiotensin-converting enzyme 2 (ACE2) and may influence COVID-19 prognosis. Other classes of antihypertensive drugs, such as beta-blockers (BB) and calcium channel blockers (CCB) are associated with reduced mortality. Still, their effect on the circulating levels of ACE2 and angiotensin II, as well as the severity of COVID-19, are less characterized. Two hundred hypertensive COVID-19 patients on four different classes of antihypertensive medication (ACEi, ARB, BB, and CCB), with different COVID-19 severities (mild, moderate, and severe) were recruited, and clinical data were assessed. Sera-circulating ACE2 and angiotensin II levels were measured using standard ELISA kits. Linear regression models were used to assess the effect of antihypertensive medications on circulating levels of ACE2 and angiotensin II in relation to disease severity and other clinical indices. Included patients were on ACEi (n=57), ARB (n=68), BB (n=15), or CCB (n=30), with mild (n=76), moderate (n=76), or severe (n=52) COVID-19. ACE2 levels were higher in patients with severe COVID-19 than those with mild (p=0.04) and moderate (p=0.007) disease. ACE2 levels correlated positively with the length of hospital stay (r=0.3, p=0.003), while angiotensin II levels decreased with disease severity (p=0.04). Higher ACE2 levels were associated with elevated CRP and D-dimer, while higher angiotensin II levels were associated with lower levels of CRP, D-dimer, and troponin. Among the four treated groups, patients on ARB exhibited elevation in ACE2 levels with increased disease severity (p=0.01), whereas patients on ACEi showed lower angiotensin II levels with increased disease severity. Patients on BB showed the lowest disease severity compared to other treated groups. Our data show increased COVID-19 severity with elevated levels of circulating ACE2 and lower levels of angiotensin II and suggest a protective effect of BB treatment against disease severity in hypertensive patients, independently of ACE2 and angiotensin II levels.

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Prihayati, Apriliya, and Pujiyanto Pujiyanto. "Drug Utilization Pattern and Cost Estimates of Anti-Hypertensive Drugs in Pharmacies under the National Health Insurance Program." In The 6th International Conference on Public Health 2019. Masters Program in Public Health, Graduate School, Universitas Sebelas Maret, 2019. http://dx.doi.org/10.26911/the6thicph-fp.04.06.

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Prihayati, Apriliya, and Pujiyanto Pujiyanto. "Drug Utilization Pattern and Cost Estimates of Anti-Hypertensive Drugs in Pharmacies Under the National Health Insurance Program." In The 6th International Conference on Public Health 2019. Masters Program in Public Health, Graduate School, Universitas Sebelas Maret, 2019. http://dx.doi.org/10.26911/the6thicph.04.60.

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Rajendran, Rasvini, and Zaitul Marlizawati Zainuddin. "The Determining Factors in Prescribing Anti-Hypertensive Drugs to First-Ever Ischemic Stroke Patients." In 2016 International Conference on Industrial Engineering, Management Science and Application (ICIMSA). IEEE, 2016. http://dx.doi.org/10.1109/icimsa.2016.7504041.

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Daudt, Pedro Eugênio Deboni, Alexandre Grunfeld Starling Jardim, and Felipe Ibiapina dos Reis. "Arterial hypertension and cerebrovascular accidents. epidemiological profile of patients attended between 2013 and 2019 in Joinville, Santa Catarina, Brazil." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.344.

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Introduction: Cerebrovascular accident (CVA) is the second cause of death in the world, and arterial hypertension (AH) is the main risk factor. Objetives: To evaluate the prevalence of AH and the epidemiological profile of patients who suffered CVA, first and recurrent events, registered at JOINVASC, between 2013 and 2019. Methodology: An observational, descriptive, retrospective study, analyzing demographic data and risk factors, in patients that suffered CVA, first or recurrent event, was done. Results: In the study period, 6057 CVA events were registered, 4402(72.6%) patients were classified as hypertensive, (122 were excluded due to incomplete data), 4387 registers were analyzed. In this group, 2149 (51.2%) were male, mean age was 68.4±14.7(18 a 102 years), BMI was 27.5±5.1(14 a 59), 4330(39.9%) with Diabetes, 2559(58.8%) were smokers or ex-smokers, 3174(7.42%) were sedentary, and 504(11.5%) had controlled AH. In the group with recurrent event (1392-31.7%) (52.3%, p<0.001) were females, mean age was (69.4± 11.5) (p<0.002); BMI was lower (p=0.02). There was more cardiopathy (47.6%) (p<0,001) ,smokers or ex-smokers (66.2)(p<.005), diabetes (46.7%) (p<0.001) and deaths (32.3%)(p<0.001), less physical activity (22.0%)(p<0.001), use of antihypertensive drugs was greater (1.52±0,93)(p<0.001),. Logistic regression showed that female sex, BMI, DM, cardiopathy, physical activity, and more anti- hypertension drugs, were significant predictors for recurrence of neurologic event. Discussion: Despite advances in primary health care and prevention campaigns, the prevalence of AH in patients with CVA is high, and still has low levels of control, even in patients with recurrent CVA.

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Daudt, Pedro Eugênio Deboni, Alexandre Grunfeld Starling Jardim, and Felipe Ibiapina dos Reis. "Arterial hypertension and cerebrovascular accidents. epidemiological profile of patients attended between 2013 and 2019 in Joinville, Santa Catarina, Brazil." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.475.

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Introduction: Cerebrovascular accident (CVA) is the second cause of death in the world, and arterial hypertension (AH) is the main risk factor. Objectives: To evaluate the prevalence of AH and the epidemiological profile of patients who suffered CVA, first and recurrent events, registered at JOINVASC, between 2013 and 2019. Methodology: An observational, descriptive, retrospective study, analyzing demographic data and risk factors, in patients that suffered CVA, first or recurrent event, was done. Results: In the study period, 6057 CVA events were registered, 4402(72.6%) patients were classified as hypertensive, (122 were excluded due to incomplete data), 4387 registers were analyzed. In this group, 2149 (51.2%) were male, mean age was 68.4±14.7(18 a 102 years), BMI was 27.5±5.1(14 a 59), 4330(39.9%) with Diabetes, 2559(58.8%) were smokers or ex-smokers, 3174(7.42%) were sedentary, and 504(11.5%) had controlled AH. In the group with recurrent event (1392-31.7%) (52.3%, p<0.001) were females, mean age was (69.4± 11.5) (p<0.002); BMI was lower (p=0.02). There was more cardiopathy (47.6%) (p<0,001) ,smokers or ex-smokers (66.2)(p<.005), diabetes (46.7%) (p<0.001) and deaths (32.3%)(p<0.001), less physical activity (22.0%)(p<0.001), use of antihypertensive drugs was greater (1.52±0,93)(p<0.001),. Logistic regression showed that female sex, BMI, DM, cardiopathy, physical activity, and more anti- hypertension drugs, were significant predictors for recurrence of neurologic event. Discussion: Despite advances in primary health care and prevention campaigns, the prevalence of AH in patients with CVA is high, and still has lowlevels of control, even in patients with recurrent CVA.

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Vaibavi, S. R., Rahul Vaippully, Basudev Roy, and Saumendra K. Bajpai. "Anti-hypertensive Calcium-Blocking Drugs Induce a Change in Viscoelasticity of Mcf-7 Cancer Cells." In ICBET 2020: 2020 10th International Conference on Biomedical Engineering and Technology. New York, NY, USA: ACM, 2020. http://dx.doi.org/10.1145/3397391.3397420.

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Reports on the topic "HYPERTENSIVE DRUGS"

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Fillipin, Federico, Pamela Seron, and Ruvistay Gutierrez-Arias. Effectiveness of antihypertensive drugs to prevent cognitive decline, mild cognitive impairment, and dementia. An overview of systematic reviews. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2022. http://dx.doi.org/10.37766/inplasy2022.12.0057.

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Review question / Objective: To determine effectiveness of antihypertensive drugs to prevent different dementia subtypes such as Alzheimer’s disease and vascular dementia. Condition being studied: Dementia is a global health burden, with the number of affected individuals increasing. A recent meta-analysis reported that the prevalence of all-type dementia was 697 per 10,000 people and the prevalence of Alzheimer’s disease was 324 per 10,000 people. The SHEP and SYST-EUR were the two first randomized controlled trials to show that hypertension treatment reduces dementia risk.

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Xin, Yuning, Hongyu Li, Gungyu Cheng, Junfeng Cui, Yinghui Liu, Aidong Liu, Xiaolin Xu, Pengfei Li, and Huize Han. Evaluation of the Effectiveness and Safety of Acupuncture in the Treatment of Cervicogenic Hypertension A Protocol for Systematic Review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2022. http://dx.doi.org/10.37766/inplasy2022.12.0036.

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Review question / Objective: The purpose of this study is to explore the efficacy and safety of acupuncture in the treatment of patients with cervicogenic hypertension，Through scientific verification, it provides clinicians with application reference and provides more choices for patients to solve pain. Patients included should have a clear diagnosis of cervicogenic hypertension(In the absence of antihypertensive drugs, blood pressure was measured 3 times a day, systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg; or a clear history of hypertension and Diagnosis of cervical spondylosis using computed tomography, magnetic resonance imaging, and other imaging methods)；The intervention group received acupuncture treatment alone or acupuncture combined with treatment by Chinese herbal medicine or conventional Western medicine; The control group was a blank control group, a placebo group, a fake acupuncture group or received treatment only through conventional Western medicine； The Inclusion criteria of study type was an RCT; The outcomes of the main analyses were efficacy of clinical symptoms，systolic blood pressure value，Diastolic blood pressure value；Secondary outcome indicators were Traditional Chinese Medicine syndrome curative effects, Traditional Chinese Medicine syndrome scores,and adverse reactions.

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Li, YueXin, YangXiao Chen, Lin Fu, YangHang Chen, Ni Ren, Qian Jiang, Ran Ma, et al. A Bayesian Network Meta-analysis on the Efficacy and Safety of Novel Targeted Drugs for Type Ⅰ Pulmonary Hypertension. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2020. http://dx.doi.org/10.37766/inplasy2020.12.0023.

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Zhao, Jing, Yuanyuan Zeng, Jieqiong Weng, Jingfang Zhang, Tingting Yao, Mengfei Yuan, and Xiaoxu Shen. Evening dosing versus morning regimen drug therapy for hypertension: a meta-analysis of randomized controlled trial. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2021. http://dx.doi.org/10.37766/inplasy2021.8.0005.

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Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel, and Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb38.

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Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.

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Lifestyle changes may be more important than drugs for mild hypertension. National Institute for Health Research, January 2019. http://dx.doi.org/10.3310/signal-000713.

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Introducing magnesium sulphate for the management of pregnancy induced hypertension. Population Council, 2005. http://dx.doi.org/10.31899/rh16.1012.

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Global studies have demonstrated that using magnesium sulphate (MgSO4) to manage hypertensive disease in pregnancy reduces morbidity and mortality due to severe pre-eclampsia/eclampsia, one of the five direct causes of maternal death. Many countries have been slow to introduce MgSO4 to the detriment of women’s health. There are also critical gaps in health-care provider knowledge, skills, and practice in management of eclampsia. Although the use of MgSO4 was introduced successfully to the Maternity Unit at Kenyatta National Hospital, Nairobi, in 2001, there has been no systematic introduction of the drug across the country. Generally, the only facilities utilizing MgSO4 are those supported by development partners and some mission hospitals. In response to requests from health-care managers and providers in Western Province to be trained in the use of MgSO4, a two-day practical training program was developed. As noted in this brief, the main objective of the training was to ensure that participants had specific skills for preventing and managing severe pre-eclampsia and eclampsia.

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