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1
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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Paudel, Gita, Sirisa Karki, Karma Murti Bhurtyal, and Lokeshwar Chaurasia. "Prescription pattern of anti-hypertensive drugs in Chitwan Medical College Hospital." Janaki Medical College Journal of Medical Science 9, no. 1 (July 8, 2021): 41–46. http://dx.doi.org/10.3126/jmcjms.v9i1.38325.
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Background and Objectives: Hypertension is a crucial health issue globally. Cardiovascular and kidney disease is one of the results of hypertension which remarkably confer to overall mortality. Thus, the aim of this study is to investigate the prescribing pattern of anti-hypertensive drugs to hypertensive patients and also to establish the current trend of prescribing pattern of anti-hypertensive drugs at Chitwan Medical College (CMC).
Material and Methods: A descriptive cross-sectional study was conducted among 290 patients to assess the prescribing pattern of anti-hypertensive drugs from hypertensive patients visiting medicine OPD of CMC during study period and fulfilling the inclusion criteria. A standard proforma was used to collect information about patient’s socio-demographic details and anti-hypertensive drugs used for them. Data was collected, compiled and analyzed by using Statistical Package of Social Science (SPSS) version 16.
Results: Out of 290 prescriptions, 201 (69.3%) patients received monotherapy while only 89 (30.7%) patients received combination therapy. In monotherapy, calcium channel blockers (CCBs) and Angiotensin receptor blockers (ARBs) were most commonly prescribed, while angiotensin receptor blockers (ARBs) + diuretics were the most commonly prescribed combination therapy.
Conclusion: In the present study, it was found that CCBs and ARBs were the most commonly prescribed anti-hypertensive drug in monotherapy.
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Makó, Katalin, Corina Ureche, and Zsuzsanna Jeremiás. "An Updated Review of Hypertensive Emergencies and Urgencies." Journal Of Cardiovascular Emergencies 4, no. 2 (June 1, 2018): 73–83. http://dx.doi.org/10.2478/jce-2018-0013.
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Abstract A hypertensive crisis is an abrupt and severe rise in the arterial blood pressure (BP) occurring either in patients with known essential or secondary hypertension, or it may develop spontaneously. The most frequent cause for the severe and sudden increase in BP is inadequate dosing or stopping antihypertensive treatment in hypertensive patients. Severe hypertension can be defined as either a hypertensive emergency or an urgency, depending on the existence of organ damage. In hypertensive urgencies, there are no signs of acute end-organ damage, and orally administered drugs might be sufficient. In hypertensive emergencies, signs of acute end-organ damage are present, and in these cases, quickly-acting parenteral drugs must be used. The prompt recognition, assessment, and treatment of hypertensive urgencies and emergencies can decrease target organ damage and mortality. In this review, the definitions and therapeutic recommendations in a hypertensive crisis are presented in the light of the 2017 ACC/AHA Hypertension Guidelines.
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Gupta, Rohini, Apoorva Malhotra, and Pavan Malhotra. "Study of prescribing pattern of drugs used in the treatment of hypertension in a tertiary care teaching hospital in North India: an observational study." International Journal of Research in Medical Sciences 6, no. 7 (June 25, 2018): 2380. http://dx.doi.org/10.18203/2320-6012.ijrms20182821.
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Background: Hypertension is one of the most common chronic diseases leading to high mortality and morbidity. In order to prevent complications and to improve the patient survival, the early and efficient management of essential hypertension is very much needed. In this context, the use of established anti-hypertensives assumes paramount importance. Objective was to study the prescribing pattern of anti-hypertensive drugs in a tertiary care teaching hospital in north India.Methods: It was a cross-sectional observational study involving 205 prescriptions for patients suffering from primary essential hypertension in the Medicine Outpatient Department of Acharaya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu, J and K. All hypertensive patients irrespective of age and sex visiting OPD and treated with at least one hypertensive drugs were included in the study. Data was obtained from the patients by scrutinizing the out patients regarding the demographic profile and details pertaining to the prescribing pattern of antihypertensive drugs used for the treatment of hypertension.Results: A total of 205 prescriptions were analysed during the study period. Out of which 131 (63.9%) were males and 74 (36.1%) were females. Maximum numbers of patients were in the age group of 50-59 years 60 (29.3%) patients. 145 (70.7%) of the patients had a family history of hypertension, (61.5%) of the patients were in stage-I hypertension and (56.1%) were of normal BMI. The results revealed that, the maximum number of 86 (41.9%) patients underwent dual therapy in 86 (41.9%) followed by monotherapy in 59 (28.7%) of patients.Conclusions: From the present study, it can be concluded that in hypertension calcium channel blockers are the most frequently prescribed classes of drugs alone and diuretics are the most commonly used class of drugs in combination. However, further studies are necessary to set up a rationale or pattern for the choice of medication; taking into consideration the demographic factors involved in the prevalence of hypertension.
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Dole, Radhika, Daniel Kothapally, Sampoorna Chukkala, and Ravi Chander Thatipelli. "Approaches to Improve Oral Bioavailability of Antihypertensive Drugs: A Mini-Review." Journal of Drug Delivery and Therapeutics 13, no. 5 (May 15, 2023): 73–77. http://dx.doi.org/10.22270/jddt.v13i5.5814.
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Hypertension elevates the risk of heart disease and stroke which are one of the most frequent causes of death. Fortunately, hypertension is manageable with the use of anti-hypertensives and a healthy lifestyle. However, patient non-adherence to the prescribed dosing regimen is the primary reason for uncontrolled blood pressure levels. Daily multiple doses of medication are one of the major reasons for patient non-compliance to the dosing regimen. Multiple doses of medication are a result of low solubility and high first-pass metabolism of anti-hypertensives. There are several approaches to improve the bioavailability of anti-hypertensives like polymeric and non-polymeric approaches to enhance solubility, avoiding first-pass metabolism through alternate routes of drug delivery and others. The objective of this review is to discuss different approaches to enhance the oral bioavailability of anti-hypertensive drugs.
Keywords: Solubility enhancements, solid lipid nanoparticles, hot melt extrusion, drug delivery, pharmacokinetics, poorly soluble, oral bioavailability.
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Hatamipour Dehno, Safura, Simin Taghavi, and Nayyereh Ayati. "Correlation Between Divided Doses of Chronic Antihypertensive Drugs and Pregnancy Outcomes." International Journal of Women's Health and Reproduction Sciences 8, no. 3 (November 4, 2017): 328–32. http://dx.doi.org/10.15296/ijwhr.2020.52.
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Objectives: Hypertension, as a common problem during pregnancy, is a major cause of maternal and fetal morbidity and mortality. Anti-hypertensive drugs are used to prolong the pregnancy or modify perinatal outcomes in pregnant women with hypertensive disorders. Severe monitoring of blood pressure is subsequently essential in these mothers. The aim of this study was to evaluate the correlation between divided doses of chronic hypertensive drugs and the end of pregnancy in mothers with gestational hypertension. Materials and Methods: In this prospective research, 99 pregnant women with chronic hypertension, who were treated with antihypertensive medicines, were studied during pregnancy. During routine follow-up of these mothers, the number of the drug and the divided doses were recorded. The incidence of maternal and fetal outcomes were evaluated according to the number of less or more than 5 divided doses. Results: Maternal and fetal-baby complications were observed in 5.50 and 5.53% cases, respectively. The incidence of maternal and fetal complications were significantly enhanced by increasing the number of up-taken anti-hypertensive drugs. The maternal and fetal-baby complications were higher in mothers who received more than five divided doses compared to those who received less than five doses. Conclusion: Based on our results, chronic hypertension was associated with maternal and fetal-baby complications in half of the cases. It is clarified that precise blood pressure monitoring and regularly taking of anti-hypertensive medicine may decrease the hypertension side effects. The awareness about this field in the pre-pregnancy consulting is considered as the patients’ rights and should be respected.
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Chelo, Herman Ngadjole, Théophile Kabesha Barhwamire, Patricia Lukusa Mishika, Zacharie Kibendelwa Tsongo, and Stanis Okitotsho Wembonyama. "Prevalence and associated factors of uncontrolled hypertension in hypertensive patients in the city of Goma, DRC." Advances in General Practice of Medicine 5, no. 1 (March 2, 2023): 74–80. http://dx.doi.org/10.25082/agpm.2023.01.001.
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Background: The objectives of this study were to determine the proportion of uncontrolled hypertension in hypertensive patients followed up on an outpatient basis and to investigate the factors associated with this poor control. Methods: This was a cross-sectional analytical study of 167 hypertensive patients followed in eight health facilities in Goma city. Uncontrolled hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg. Results: The proportion of uncontrolled hypertension was 95.2%. In bivariate analysis, no factor was associated with uncontrolled hypertension. Conclusion: Almost all hypertensive patients in our study were poorly controlled by antihypertensive treatment. These results highlight the need for a cohort study to determine the factors associated with this excessively high prevalence of uncontrolled hypertension in hypertensive patients on antihypertensive drugs, in order to allow targeted actions to try to control hypertension by antihypertensive drugs.
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Xalilov, Nizomiddin, Temur Jurakulov, Gyosiddin Xursandov, Xumoyun Nematov, and Jonibek Safarov. "MODERN EMERGENCY CARE STRATEGY FOR HYPERTONIC CRISIS." UZBEK MEDICAL JOURNAL Special issue, no. 2 (May 30, 2021): 9–18. http://dx.doi.org/10.26739/2181-0664-2021-si-2-2.
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The article is devoted to discussing modern approaches todiagnosis andtreatment in complicated anduncomplicated hypertensive crises.The options for antihypertensive drugs are considereddepending on thenature of target organ damage ina hypertensive crisis.The data on themost frequently prescribed drugs for complicated anduncomplicated hypertensive crisis increases the volumetric velocity of coronary andcerebral blood flowand reduces the pressure inthe pulmonary artery system.It is usually used to relieve the mild uncomplicated hypertensive crisis. Still, a wide range of side effects, including reflex tachycardia, periorbital andperipheral edema, skin redness, pruritus,limits its use.Keywords: cerebral blood flow, routine clinical, hypertension, medical associations, hypertensive crisis
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Xalilov, Nizomiddin, Temur Jurakulov, Gyosiddin Xursandov, Xumoyun Nematov, and Jonibek Safarov. "MODERN EMERGENCY CARE STRATEGY FOR HYPERTONIC CRISIS." UZBEK MEDICAL JOURNAL Special issue, no. 2 (May 30, 2021): 9–18. http://dx.doi.org/10.26739/2181-0664-2021-si-2-2.
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The article is devoted to discussing modern approaches todiagnosis andtreatment in complicated anduncomplicated hypertensive crises.The options for antihypertensive drugs are considereddepending on thenature of target organ damage ina hypertensive crisis.The data on themost frequently prescribed drugs for complicated anduncomplicated hypertensive crisis increases the volumetric velocity of coronary andcerebral blood flowand reduces the pressure inthe pulmonary artery system.It is usually used to relieve the mild uncomplicated hypertensive crisis. Still, a wide range of side effects, including reflex tachycardia, periorbital andperipheral edema, skin redness, pruritus,limits its use.Keywords: cerebral blood flow, routine clinical, hypertension, medical associations, hypertensive crisis
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Hidayah, Himyatul. "EVALUASI RASIONALITAS PENGGUNAAN OBAT ANTIHIPERTENSI TERHADAP PASIEN HIPERTENSI DI RSUD KARAWANG." Jurnal Buana Farma 3, no. 1 (March 31, 2023): 7–13. http://dx.doi.org/10.36805/jbf.v3i1.775.
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Hypertension is a disease characterized by an increase in systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg on two measurements, with an interval of five minutes in a state of sufficient rest/calm. This study aims to determine the relationship between hypertension and the patient's gender and age on the incidence of hypertension and the rationality of using antihypertensive drugs in hypertensive patients at the Karawang Hospital Outpatient Installation in 2019. This research is an observational study with a cross-sectional descriptive analysis design. Data collection was carried out retrospectively using secondary data from medical records taken from Karawang Hospital in 2019 at Karawang Hospital. Next, calculate the use of antihypertensive drugs and evaluate the rationale for using antihypertensive drugs in hypertensive patients based on the right patient, right indication, right drug, and the right dose. Data were obtained for 60 patients compared to Dipiro and JNC VIII guidelines. The results showed that the most widely used antihypertensive drugs were amlodipine 15% and a combination of 2 drugs (amlodipine and candesartan) 85%. Evaluation of the rationality of using hypertension drugs in hypertensive patients as follows: right drug 91.7%, right indication 100%, right patient 100%, right dose 91.7% and there is no relationship between gender and age of the patient to the incidence of hypertension in Karawang Hospital.
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Purnawinadi, I. Gede, and Irene Jessica Lintang. "RELATIONSHIP OF FAMILY SUPPORT WITH ADHERENCE TO TAKING MEDICATION AMONG HYPERTENSIVE PATIENTS." Jurnal Skolastik Keperawatan 6, no. 1 (July 14, 2020): 35–41. http://dx.doi.org/10.35974/jsk.v6i1.2248.
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ABSTRACT
Introduction: Hypertension requires lifelong treatment. One influence of the successful treatment of hypertensive patients is adherence to taking drugs through family support roles. Purpose: This study identified the relationship between family support and adherence to taking medication for hypertensive patients at the Airmadidi Health Center in North Minahasa Regency. Method: This study was an observational analytic with cross-sectional approach. The sampling technique used was purposive sampling with a sample of 127 respondents diagnosed with hypertension. Results: Dominant family support (84.3%) was included in the low category, and dominant medication adherence (65.4%) was included in the low category. There is a significant relationship between family support and medication adherence to hypertensive patients (p value 0.016), but the correlation coefficient is weak (r = -0.213) with a negative relationship direction. Discussion: Communities including families of hypertensive patients are expected to take part in improving compliance with taking medication for hypertensive patients, and for hypertensive patients must be more obedient in taking drugs.
Keywords: Family Support, Hypertension, Adherence, Taking Medication.
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Usman, Umar, Bello Magaji Arkilla, Abduljalil Alfa Ismail, and Usman Dauda. "TIME-TO-OPTIMAL CONTROL OF HYPERTENSION USING KAPLAN-MEIER ESTIMATOR, COX PROPORTIONAL HAZARD AND WEIBULL MODEL." FUDMA JOURNAL OF SCIENCES 6, no. 5 (November 2, 2022): 71–75. http://dx.doi.org/10.33003/fjs-2022-0605-1096.
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Hypertension is a worldwide public health challenge. The study investigated the time it takes to attain an optimal control of hypertension and the major factors that influence the control in Specialist Hospital, Sokoto.
A retrospective cohort study was conducted involving 300 patient records. The population consisted all hypertensive patients on follow-ups at Specialist Hospital Sokoto from1st February, 2015 to 1st February, 2021.Statistical Package for the Social Sciences version 20 and R software were used for descriptive, Kaplan-Meier estimator, Cox Proportional Regression (CPH) Model and Weibull Regression Model analyses.
Hypertensive patients attain an optimal control after a median survival time of 40.43 (at 95% CI: 33.67- 47.19) months (3.37 years) and mean survival time of 44.18 (CI: 37.24-51.12) months (3.68 years). The CPH analysis revealed that the factors that influenced an optimal control of hypertension were body mass index (BMI) (P <0.001), number of anti-hypertensive drugs (P <0.001), place of residence (P = 0.030). similarly, the Weibull model revealed that the factors that affected an optimal control of hypertension were BMI (P <0.01), number of anti-hypertensive drugs (P <0.001), place of residence (P = 0.042) and educational status (P = 0.036).
In conclusion, BMI, number of anti-hypertensive drugs, Place of residence, Educational status. should be watched out during management of hypertensive patients. This also call for an extension of this study through a prospective design to be able to measure the effect of other factors in the achievement of optimal control of hypertension
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Radhika, A. R. "Drug utilization study of antihypertensive drugs in a tertiary care hospital." International Journal of Basic & Clinical Pharmacology 7, no. 12 (November 24, 2018): 2309. http://dx.doi.org/10.18203/2319-2003.ijbcp20184680.
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Background: Hypertension is a major common disease and effects a million of people worldwide. And is risk factor for other diseases like cardiovascular diseases, stroke etc. The aim of our study was undertaken to study the utilization pattern of anti hypertensive drugs at a tertiary care hospital. The guidelines for the treatment of hypertension are put forward by the Joint National Committee (JNC) on detection, evaluation and treatment of blood pressure. The Indian guidelines endorsed by the cardiology society of India, the hypertension society of India, and Indian college of physicians closely follow the JNC guidelines.Methods: A prospective cross-sectional observational study was conducted on 100 patients in outpatient Department of General medicine of Government General Hospital, Mahabubnagar district, Telangana. The data collected was analysed from the prescription pattern of anti hypertensive drugs. The data collected were statistically analysed and presented as counts and percentages.Results: Out of 100 study subjects, males were 55% and females were 45% and maximum number of patients in age group are (51 to 60 years.). Among antihypertensive drugs commonly used in present study are Losartan (ARB’s)-64% and for two drug therapy are enalapril and amlodipine 22% and for three drug therapy are enalapril +atenolol+furosemide-14%. Average number of drugs prescribed is 6.15% per prescription. Percentages of medicines prescribed by generic drugs are85% and from the essential drug list are 95%.Conclusions: In this study usage of anti hypertensive drugs were prescribed rationally in tertiary care hospital. The study emphasizes that need for effective continuing medical education and also preventive measures in hypertensive individuals.
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Murty, MSN, Rajesh Pandey, Sibeka Behera, J. Jayakrishnan, Vivek Hande, and Vineet Behera. "Plasma Renin-guided Therapy in Patients of Primary Hypertension on Antihypertensives: A Prospective Cohort Study." Journal of the Association of Physicians of India 70, no. 8 (August 1, 2022): 31–36. http://dx.doi.org/10.5005/japi-11001-0061.
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Background: Most guidelines for hypertension overlook the underlying pathophysiologic basis in deciding antihypertensives. Based on renin levels, hypertension may be classified as high-renin hypertension (HRH), low-renin hypertension (LRH), and normal-renin hypertension (NRH). The study examined the renin levels in a hypertensive population and assessed the effect of renin-guided antihypertensive management on blood pressure (BP) control. Materials and methods: This study was a single-center prospective cohort study. Subjects with primary hypertension (aged 20–60 years) on antihypertensives were included in the study. Initial BP was recorded and subsequently, all antihypertensives were discontinued. After 2 weeks, second BP was recorded and plasma renin assay (PRA) sample was collected. All patients were restarted on the previous antihypertensives and further modification of medication was performed based on their PRA. Anti V drugs, such as diuretics and calcium channel blockers (CCBs) were used in LRH while beta-blockers and antirenin drugs (Anti R drugs) were used in HRH. Results: The study included 918 patients with hypertension and 896 cases were finally analyzed. Of these patients, 287 (32.03%) had LRH (<0.51 ng/mL/hr), 412 (45.98%) had HRH (>2.64 ng/mL/hr), while 197 (21.99%) had NRH (0.51–2.64 ng/mL/hr). Renin-guided management caused significant BP reduction. In controlled BP group, the systolic BP (SBP)/diastolic BP (DBP) before and after modification were 133.83 ± 3.36/84.77 ± 3.12 and 123.87 ± 10.59/84.05 ± 1.84, respectively (p-value < 0.05). In uncontrolled BP group, the corresponding SBP/DBP were 152.17 ± 2.95/90.36 ± 5.02 and 138 ± 1.23/87.78 ± 0.84, respectively (p-value < 0.05). The number of hypertensives used in patients also reduced with reduction in patients on two, three, or four drugs. Conclusions: Renin-guided therapy is useful for improving BP control in both controlled and uncontrolled hypertensive patients and in reducing the number of antihypertensive drugs.
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Raut, Binod, and Anjan Khadka. "Patterns of use of drugs in hypertension in geriatric patients in the department of medicine at tertiary care hospital of Nepal." Birat Journal of Health Sciences 5, no. 3 (December 30, 2020): 1155–60. http://dx.doi.org/10.3126/bjhs.v5i3.33685.
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Introduction: In Nepal, the prevalence of hypertensive in elderly population is 41.7% aged 65 years or more. Hypertension increases with age leading to arterial stiffness and endothelial dysfunction. The prevalence of hypertension is 20% of urban populations. Blood pressure control with the use of antihypertensive drugs reduces cardiovascular complications in geriatric patients.
Objectives: The objective of our study is to know the various patterns of drugs used in geriatrics hypertensive patient along with their co-morbidities and to know the most commonly used antihypertensive drug in geriatric patient.
Methodology: It was a hospital based cross sectional study involving 130 patients based on non-probability sampling. The study involved the hypertensive elderly patients of age > 65 years prescribed with antihypertensive drugs. Data were collected from patients attending outpatient department of medicine . Medical and nursing records were analyzed for patient’s characteristics (e.g. age, gender), systolic and diastolic BP readings, number of drugs, monotherapy, combination therapy, co morbidities. Data were analysed by using SPSS version 20.
Results: The total 130 geriatric patients under treatment with antihypertensive drugs were included, in which 55.38% were male and 44.62% were female. The total numbers of antihypertensive drugs prescribed were 212 either as monotherapy or as a component of a combination therapy. The average number of drugs prescribed per patient was found to be 1.66. Among these drugs 56.92% were prescribed as monotherapy,26.92% were prescribed as two drugs combination therapy,12.30% were prescribed as three drugs combination and 3.84% were prescribed as four drugs combination therapy. calcium channel blockers (amlodipine )was the most commonly prescribed antihypertensive.
Conclusion: The study showed male patient were more predominant hypertensive compare to female. calcium channel blockers group of drugs in which amlodipine was the most commonly prescribed antihypertensive drug and more than half of the patients were in monotherapy.
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K. Deepak Maharshi, T. Vani, M. Navaneetha, G. Jyothi, Shantveer Halcher, and Gururaj V Wadageri. "Prescription pattern of anti-hypertensive drugs among hypertensive patients at district hospital." International Journal of Research in Hospital and Clinical Pharmacy 1, no. 2 (May 30, 2019): 57–61. http://dx.doi.org/10.33974/ijrhcp.v1i2.86.
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Background: To conduct a prospective observational study on prescribing pattern of anti-hypertensive drug in the department of general medicine in Government District hospital, Gulbarga. In this study it was aimed to evaluate the current practice of anti-hypertensive drug by comparing with JNC-8 guidelines in population. Objectives: The objective of our study is to determine the prescription pattern of antihypertensive drugs and adherence to JNC8 guidelines and to find out the most prescribed anti-hypertensive drugs. Methods: A Prospective Observational Study of 06 months was conducted. Undertaken 174 patients data collection form of all the patients of inpatient department of age 18 ≥ years of hypertensive with or without co-morbidities. Result: The results of this analysis suggests that out of the total 174 hypertensive patients included in the study, 92 patients were males while 82 patients were females, indicating the higher prevalence of hypertension in male population than in female population, that is 10% higher prevalence in males than in females. Out of the total study subjects, 169 hypertensive patients were found to have other co morbid conditions. Considering out of the total 174 patients, majority of the patients received monotherapy (129) while remaining patients receiving the Combinational therapy are 45. However in the case of overall utilization pattern of antihypertensive agents, CCBs are the most frequently prescribed class of drugs, followed by ARBs , BBs and finally ACEIs.
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Kušljugić, Zumreta, Katarina Divković, Fahir Baraković, Elnur Smajić, Amila Arslanagić, Mustafa Hadžiomerović, Emir Fazlibegović, et al. "Effects of nebivolol on artery hypertension--multicentre study Bosnia and Herzegovina." Bosnian Journal of Basic Medical Sciences 5, no. 1 (February 20, 2005): 42–51. http://dx.doi.org/10.17305/bjbms.2005.3334.
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Hypertension is a major risk factor for cardiovascular diseases; drugs that reduce blood pressure and simultaneously improve or reverse endothelian dysfunction, as nebivolol, may be advantageous in terms of cardiovascular protection. The objective of this study is to show the anti-hypertensive efficacy and safety of nebivolol (5 mg once a day) given to patients with arterial hypertension for 3 months. It should also provide information about drug's influence on laboratory tests--fasting blood glucose and serum cholesterol, triglyceride and creatinine concentrations. Six centers--Tuzla, Sarajevo, Mostar, Bihac, Zenica and Banja Luka participated in this prospective study with follow-up period of 3 months that included 3 visits. The study group consisted of 328 hypertensic patients. Results showed a significant decrease in both systolic and diastolic blood pressure and heart rate at the end of the study. Fasting blood glucose level and serum cholesterol, triglyceride and creatinine changed significantly during the study, with lower levels of all the tests. Nebivolol seems to be free from some of the problems that generally accompany not only the classical beta- blockers but sometimes also newer classes of antihypertensive drugs. With its high anti-hypertensive efficiency and safety, and presence of statically significant difference in laboratory tests and beneficial effects, absence of adverse interaction with glucose and lipid metabolism, patients treated with Nebivolol may show an optimal adherence to therapy.
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Tanase, Daniela Maria, Evelina Maria Gosav, Smaranda Radu, Anca Ouatu, Ciprian Rezus, Manuela Ciocoiu, Claudia Florida Costea, and Mariana Floria. "Arterial Hypertension and Interleukins: Potential Therapeutic Target or Future Diagnostic Marker?" International Journal of Hypertension 2019 (May 2, 2019): 1–17. http://dx.doi.org/10.1155/2019/3159283.
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Hypertension as a multifactorial pathology is one of the most important cardiovascular risk factors, affecting up to 30-40% of the general population. Complex immune responses are involved in the inflammatory mechanism of hypertension, with evidence pointing to increased inflammatory mediators even in prehypertensive patients. Increased vascular permeability, thrombogenesis, and fibrosis, effects that are associated with sustained hypertension, could be attributed to chronic inflammation. Chronic inflammation triggers endothelial dysfunction via increased production of ROS through proinflammatory cytokines. Increased serum level of proinflammatory cytokines such as IL-1β, IL-6, IL-8, IL-17, IL-23, TGFβ, and TNFα in hypertensive patients has been associated with either increased blood pressure values and/or end-organ damage. Moreover, some cytokines (i.e., IL-6) seem to determine a hypertensive response to angiotensin II, regardless of blood pressure values. Understanding hypertension as an inflammatory-based pathology gives way to new therapeutic targets. As such, conventional cardiovascular drugs (statins, calcium channels blockers, and ACEIs/ARBs) have shown additional anti-inflammatory effects that could be linked to their blood pressure lowering properties. Moreover, anti-inflammatory drugs (mycophenolate mofetil) have been shown to decrease blood pressure in hypertensive patients or prevent its development in normotensive individuals. Further research is needed to evaluate whether drugs targeting hypertensive-linked proinflammatory cytokines, such as monoclonal antibodies, could become a new therapeutic option in treating arterial hypertension.
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Sumino, H., M. Nara, K. Seki, T. Takahashi, T. Kanda, S. Ichikawa, K. Goto-Onozato, S. Koya, M. Murakami, and M. Kurabayashi. "Effect of Antihypertensive Therapy on Blood Rheology in Patients with Essential Hypertension." Journal of International Medical Research 33, no. 2 (March 2005): 170–77. http://dx.doi.org/10.1177/147323000503300204.
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Hypertension is an important risk factor for cardiovascular disease, and antihypertensive drugs can decrease the occurrence of such events in hypertensive patients. This study compared the rheological properties of blood in 22 untreated hypertensive patients, 42 patients taking antihypertensive drugs and 74 normotensive subjects. Using a microchannel method, the whole blood passage time was measured and blood movement was observed with a microscope connected to an image display unit. The blood passage time in untreated hypertensive patients was significantly higher than in treated hypertensive patients or normotensive subjects, but was similar in the latter two groups. Microscopic observations showed that platelet aggregation and leucocyte adhesion were increased in untreated hypertensive patients, resulting in poor flow, while blood samples from treated hypertensive patients and normotensive subjects passed smoothly through the microchannels. These rheological differences could contribute to the decrease in cardiovascular disease seen when hypertensive patients are treated effectively.
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Islam, T., MN Huda, S. Hossain, MN Islam, E. Huq, PM Bhattachariya, SM Alam, and PM Basak. "Study on Stroke among Hypertensive Patients in a Teaching Hospital." TAJ: Journal of Teachers Association 27, no. 2 (November 28, 2018): 30–32. http://dx.doi.org/10.3329/taj.v27i2.37636.
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Stroke is one of the commonest causes of death and disability in the world. Hypertension is the greatest treatable risk factor for both ischernic and hemorrhagic stroke. This study was carried out in Rajshahi Medical College Hospital to observe the incidence of stroke among hypertensive patients and to compare the occurrence of stroke among patients who were taking anti-hypertensive drugs regularly and those who were taking irregularly. Hundred stroke patients with hypertension were selected randomly. Ischemic stroke 66% and hemorrhagic stroke 34% was observed. Majority (64%) of hypertensive patient was treated irregularly and only 36% patients were treated regularly with drugs. Incidence of ischemic (66.6%) and hemorrhagic (58.8%) stroke was increased in irregularly antihypertensive treatment patients.TAJ 2014; 27(2): 30-32
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Harun, Harnavi. "Tingkat Kepatuhan Minum Obat Pasien Hipertensi Dinilai dengan Morisky Medication Adherence Scale - 8 (MMAS-8) di RSUP M Djamil Padang." Seminar Nasional ADPI Mengabdi Untuk Negeri 1, no. 1 (September 20, 2020): 137–41. http://dx.doi.org/10.47841/adpi.v1i1.40.
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Introduction : Hypertension is a disease that is commonly found and one of the causes of death allover the world. Riset Kesehatan Dasar in 2013 shows that the prevalence of hypertension in Indonesiais 26.5%. The lack of medication adherence of hypertensive patients is a major cause of hypertensiontherapy failure. Non-adherence to antihypertensive drugs is a potential factor that can cause variouscomplications such as heart failure, stroke, kidney failure and blindness. The purpose of this study wasto determine the level of medication adherence for hypertensive patients in M. Djamil HospitalPadang.Method: This is a descriptive research with cross sectional design. The study population was patientswith hypertension with sampling based on counsecutive sampling. Inclusion criteria were essentialhypertension patients and willing to join the study. Exclusion criteria were hypertension emergency,hypertension urgency, and hypertension with complications. Data obtained directly from respondentsthrough the Morisky Medication Adherence Scale-8 questionnaire and direct blood pressuremeasurement.Results: Based on the characteristics of hypertensive patients, found that male 62% and female 38%,ages 20-39 (19%) and ≤ 40 (81%), duration of hypertension < 5 years (62%) and ≥ 5 years (38 %),anti-hypertensive drugs > 1 (60%) and 1 (40%), uncontrolled blood pressure (65%) and controlled(35%). Low compliance rates (60%), moderate (31%) and high (9%).Conclusion: The level of medication adherence for hypertensive patients in M. Djamil HospitalPadang is low (60%), while moderate compliance (31%) and high compliance (9%).
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., Shalini, and Manish Kumar Goel. "Non-Adherence to Anti-Hypertensive Treatment." Indian Journal of Community Health 32, no. 1 (March 31, 2020): 126–29. http://dx.doi.org/10.47203/ijch.2020.v32i01.025.
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Background: In developed countries, adherence among patients suffering from chronic diseases averages only 50%; in developing countries it is assumed to be much lower. Aims & objectives: To find out the prevalence of non-adherence to antihypertensive treatment among individuals seeking anti-hypertensive treatment from tertiary care hospital in New Delhi & to find out the factors related to non-adherence to the anti-hypertensive treatment among study subjects. Material and Methods: A cross-sectional hospital-based study was conducted from June to October 2018 among 150 diagnosed cases of hypertension. The drug adherence was assessed by using standard Brief Medication Questionnaire I (BMQ I) and to know the determinants of non-adherence a semi-structured (self-designed and pre tested) questionnaire was used. The association of different factors with adherence was analyzed by applying chi square (χ2) test. Results: Among total of 150 participants 44% were males and 56% were females. The magnitude of non-adherence to anti-hypertensive drugs was 35.3%. Side effects of anti-hypertensive drugs was significant risk factor for non-adherence to anti-hypertensive drugs and common reasons for non-adherence were unwanted side effects (64.2%) followed by worry about long term side effects (62.3%). Conclusion: Prevalence of non-adherence to anti-hypertensive drugs was quite high, most common reason for non-adherence to anti-hypertensive medication was unwanted side effects and worry about long term side effects.
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Lahamate, Shrikant B., Syed U. Razvi, Mirza S. Baig, and Sudhakar M. Doifode. "Drug utilization study of antihypertensive drugs used in the treatment of second and third trimester of pregnancy in tertiary care hospital." International Journal of Basic & Clinical Pharmacology 7, no. 9 (August 23, 2018): 1733. http://dx.doi.org/10.18203/2319-2003.ijbcp20183480.
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Background: Hypertensive disorders are major cause of the perinatal and maternal mortality and morbidity worldwide. Aim of study was to evaluate current trend of antihypertensive drugs and to assess frequency and distribution of antihypertensive drugs in pregnancy.Methods: A retrospective observational study was conducted in a tertiary care hospital for period of six months in collaboration with department of obstetrics and gynaecology. Patients data recorded in case report form and analysed to study prescription pattern and related information.Results: Total of 104 cases were enrolled in this study. Prescribed antihypertensive drugs in pregnancy were Labetalol, Nifedipine, MgSO4 and furosemide. Most commonly prescribed drug was labetalol. In this study, Gestational hypertension was most common diagnosis in hypertensive disorder. Majority of drug prescribed from category C and A. In present study, Single drug therapy was most commonly prescribed for hypertension in pregnancy was 64.42% whereas multiple drug therapy was 35.57%. Most common maternal complication was anaemia i.e. 54.05% followed by placental abruption in 24.3%. Neonatal outcome was low birth weight i.e.36% followed by preterm birth i.e.24%.Conclusions: Labetalol found to be most common prescribed drug. Single drug therapy prescription was high as compared to multiple drug therapy prescription in hypertensive disorders in pregnancy. Gestational hypertension was most common cause of hypertensive disorder. Anaemia was found to be most common maternal complication encountered in hypertensive disorders in pregnancy. Most common adverse neonatal outcome was low birth weight.
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Sharma, Vishal, Beena Sharma, Rajveer Singh Rathore, and Lokendra Sharma. "A prospective observational study of prescription pattern of antihypertensive drugs in general medicine outpatient department of associated hospital RUHS CMS, Jaipur." International Journal of Basic & Clinical Pharmacology 12, no. 5 (August 25, 2023): 682–87. http://dx.doi.org/10.18203/2319-2003.ijbcp20232564.
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Background: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The aim of study is the prescribing pattern and the consumption of antihypertensive drugs in isolated hypertensive patients and in hypertensive patients with different co-existing morbidities. Methods: The present study is a Prospective observational study. The study was conducted at Medicine Department of associated hospital of RUHS College of Medical Sciences, Jaipur. Results: A total of 965 patients having hypertension were analyzed, in that 556 patients were male and 409 patients were female. In hypertension patients, angiotensin receptor blockers ARB, diuretics and β- blockers (29.90%) were mostly used classes in three drug therapy. Whereas telmisartan, hydrochlorothiazide and metoprolol (35.05%) were mostly prescribed. Drugs. In hypertension patients, angiotensin receptor blockers ARB, diuretics, β- blockers and calcium channel blockers (56.67%) and calcium channel blockers, angiotensin converting enzyme inhibitors, β-blockers and diuretics (43.33%) were used classes in four drug therapy. Whereas Telmisartan, Hydrochlorothiazide, Nebivolol and Amlodipine (62.5%) were mostly prescribed drugs. Hypertensive Patients with Comorbidity were found in higher prevalence with 276 hypertensive patients (28.60%) along with Diabetes Mellitus most commonly found and 389 hypertensive patients (40.31%) were found to be with No Comorbidity. Conclusions: Present results reveal that antihypertensive medication adherence to JNC-8 recommendations is suboptimal. Therefore, physicians should follow JNC-8 guidelines to improve the patients care because suboptimal adherence leads to adverse clinical outcomes. The present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with co-morbid conditions.
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Santos, Zélia Maria de Sousa Araújo, Helder de Pádua Lima, Flávia Braga de Oliveira, Jamilly Silva Vieira, Natasha Marques Frota, and Jennara Candido do Nascimento. "User's adherence to hypertensive drug therapy." Rev Rene 14, no. 1 (2013): 11–22. http://dx.doi.org/10.15253/2175-6783.2013000100003.
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The low treatment adherence is one of the major factors for the lack of blood pressure control and risk for cardiovascular diseases. We aimed to analyze the hypertensive user's adherence to drug therapy. A descriptive study carried out with 400 hypertensive users, from May to August 2010, through interviews. Most interviewees were female (67.2%), aged over 60 (54.3%) and with brown skin (57.4%). 326 (81.5%) users were making regular use of medicine with a predominance of those with over 10 years of diagnosis (33.5%), those with up to 5 years of treatment (31.0%), and those who received the complete medication provided by SUS (39.2%). The knowledge on the types of antihypertensive drugs and the daily frequency of medication prevailed regardless the regularity of medication, the same happened regarding the lack of knowledge on side effects, to the discomforts caused and the complexity of drug therapy. We concluded that the treatment adherence prevailed in most users.
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Ahluwalia, Pritpal Singh, Mirza Shiraz Baig, and Meenakshi Bhattacharya. "Drug utilization study of anti-hypertensive drugs at a tertiary care hospital." International Journal of Basic & Clinical Pharmacology 9, no. 8 (July 21, 2020): 1241. http://dx.doi.org/10.18203/2319-2003.ijbcp20203142.
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Background: The increasing prevalence of hypertension influence the prescribing patterns of antihypertensive drug. Prescribing against evidence-based guidelines in hypertension treatment leads to the increase cost of medications and problems in providing affordable prescriptions to population. The aim of present study was to analyse anti-hypertensive prescribing pattern in Government Medical College and Hospital, Aurangabad, Maharashtra, India.Methods: Study was prospective, observational, open label and descriptive clinical study. It included 336 patients admitted in MICU during January 2018 to June 2019 fulfilling inclusion criteria.Results: 54.46% patients were between 51-70 years of age, followed by 33.63% in 31 to 50 age group. Of total enrolled hypertensive patients 69% patients had various comorbidities. Drug prescribed was 28.27% ARBs, 26.84% CCBs, 17.62% beta blockers, 6.14% high ceiling diuretics, 4.50% ACE inhibitors, 2.45% thiazide diuretics and 2.04% received alpha blocker. As monotherapy, 31.82% patients received telmisartan as most commonly prescribed drug followed by 27.31% patients received Amlodipine followed by other drugs. In combination therapy telmisartan and hydrochlorothiazide was prescribed most commonly followed by beta blocker and CCB and ARB and CCB. 33.60% of drugs were prescribed in generic names while 66.39% of drugs prescribed in brand names. Average number of drugs prescribed per prescription was 1.45 of which 33.60% of drugs were prescribed by generic names.Conclusions: With average number of drugs per prescription in hypertension 1.45, the study showed that poly pharmacy is unavoidable in hypertension due to associated comorbid conditions.
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Saragih, Glory Grifith B., and Jeanny Rantung. "STUDY OF PHENOMENOLOGY OF DRUG CONSUMPTION PATTERNS OF INDIVIDUALS WITH HYPERTENSION IN WORKING AREAS OF PARONGPONG HEALTH CENTER WEST BANDUNG." Abstract Proceedings International Scholars Conference 7, no. 1 (December 18, 2019): 636–41. http://dx.doi.org/10.35974/isc.v7i1.1983.
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Introduction: In 2016 West Java was the fourth ranked province as the region with the highest prevalence of hypertension, which was 29.4% in Indonesia. Failure to treat hypertension was found due to low compliance in the use of hypertension drugs. Non-compliance with the consumption of antihypertensive drugs will have an impact on the incidence of uncontrolled blood pressure. Long term Uncontrolled blood pressure can cause complications of disease and even death. The purpose of this study is to identify the overview of hypertensive patients in consuming hypertension drugs.
Method: This study uses a qualitative method with a phenomenological approach.
Result: From this study it was found that taking medication for a long period of time caused a feeling of laziness and boredom in taking medicine, resulting in patients with hypertension stopped consuming medication. Fear of side effects from taking medication for a long period of time makes hypertensive patients decided to stop the consumption of hypertension medicine.
Discussion is hoped that this research can be an input to improve health promotion to reduce the failure of hypertension treatment.
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Fadillah, Aris, Juwita Ramadhani, Karina Erlianti, and Hasniah Hasniah. "ANALISIS COST OF ILLNESS PENYAKIT HIPERTENSI DI RUMAH SAKIT UMUM DAERAH PRAYA, NTB." AL ULUM JURNAL SAINS DAN TEKNOLOGI 6, no. 2 (May 1, 2021): 104. http://dx.doi.org/10.31602/ajst.v6i2.5226.
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The high prevalence of hypertension and the long-term of antihypertensive treatments required are the main reasons for the need of economic analysis on the costs of hypertensive treatment. This study aims to quantify direct medical cost of hypertension. This study uses retrospective cost of illness analysis in descriptive observational design with heath care perspective. Data were collected from the hospital’s management information system, patient's prescriptions and patient's medical records. Fifty-eight patient’s data were analyzed. Direct medical cost of the patient without comorbidities in stage 1 hypertension was Rp 535,660 ± 100,681, stage 2 hypertension was Rp 381,940 ± 126,423 and hypertensive crises was Rp 456,241 ± 197,959. Direct medical cost of the patients with comorbidities in stage 1 hypertension was Rp 398,750 ± 240,542, stage 2 hypertension was Rp 486,227 ± 241,136 and hypertensive crises was Rp 425,816 ± 140,898. Direct medical costs for patients with compelling indications in stage 1 hypertension was Rp 512,810 ± 152,661, stage 2 hypertension was Rp 444,183 ± 109,162 and hypertensive crises was Rp 410,364 ± 80,388. Cost for drugs was represented as the largest component of direct medical cost (37.49%) followes by cost for ward (26.54%), medical treatment fee (15.88%), medical support fee (9.05%), doctor visit fee (8.12%) and service fee (2.91%). The hypertension's stage, comorbidities and compelling indications are not affecting the cost of therapy. The rational use of drugs will decrease the cost of hypertension treatment.
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Hinokuma, Nodoka, Shunsuke Sakurai, Atsutoshi Shiratori, Keiko Nagahara, Yoshifusa Abe, Takeshi Shimizu, Takanari Fujii, Katsumi Mizuno, and Hideshi Tomita. "A pediatric patient with hyponatremic hypertensive syndrome without persistent hypertension in acute phase: A case report and review of literature." SAGE Open Medical Case Reports 8 (January 2020): 2050313X2096955. http://dx.doi.org/10.1177/2050313x20969559.
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Hyponatremic hypertensive syndrome is characterized by hypertension, hyponatremia, and hypokalemia due to unilateral renal artery stenosis. We herein report a 1-year-old hyponatremic hypertensive syndrome infant without persistent hypertension in the acute phase. On the ninth hospital day, his systolic and diastolic blood pressure increased up to 154–160 and 70–84 mmHg, respectively. Acute gastroenteritis and dehydration might transiently mask his hypertension. By percutaneous transluminal balloon angioplasty for right renal artery, his blood pressure finally normalized without antihypertensive drugs. We reviewed 23 previously reported pediatric patients with hyponatremic hypertensive syndrome under the age of 15 years. Including our patient, there are only three reports on hyponatremic hypertensive syndrome without persistent hypertension in the acute phase. Hyponatremic hypertensive syndrome is curable with proper diagnosis and timely intervention. Therefore, pediatricians should pay attention to the signs and symptoms associated with hyponatremic hypertensive syndrome, even if persistent hypertension was absent in the acute phase.
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&NA;. "Drugs of choice for hypertensive emergencies." Inpharma Weekly &NA;, no. 824 (February 1992): 13. http://dx.doi.org/10.2165/00128413-199208240-00027.
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Siegemund, Martin. "Oral anti-hypertensive drugs and anaesthesia." Baillière's Clinical Anaesthesiology 11, no. 4 (December 1997): 731–57. http://dx.doi.org/10.1016/s0950-3501(97)80050-5.
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Tkacheva, O. N., Yu V. Kotovskaya, and K. A. Eruslanova. "Hypertensive Crisis in the Elderly Patients." Kardiologiia 60, no. 5 (May 4, 2020): 128–35. http://dx.doi.org/10.18087/cardio.2020.5.n1121.
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A hypertensive crisis is a sudden increase in blood pressure (BP) to an individually high level associated with clinical symptoms and target organ damage, in which BP must be reduced immediately. Since 2018 in Europe and since 2020 in Russia, an uncomplicated hypertensive crisis is recommended to be considered as a part of malignant (uncontrolled) arterial hypertension. The clinical picture of increased BP in elderly patients is characterized by nonspecific symptoms even in target organ damage. Management of this group of patients requires a physician to know the patient’s comorbidities and the drugs taken on a regular basis to minimize development of side effects of the administered drugs and their undesirable interaction with the chronic therapy.
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Festa, Marco, Clementina Sansone, Christophe Brunet, Fabio Crocetta, Luisa Di Paola, Michele Lombardo, Antonino Bruno, Douglas M. Noonan, and Adriana Albini. "Cardiovascular Active Peptides of Marine Origin with ACE Inhibitory Activities: Potential Role as Anti-Hypertensive Drugs and in Prevention of SARS-CoV-2 Infection." International Journal of Molecular Sciences 21, no. 21 (November 7, 2020): 8364. http://dx.doi.org/10.3390/ijms21218364.
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Growing interest in hypertension—one of the main factors characterizing the cardiometabolic syndrome (CMS)—and anti-hypertensive drugs raised from the emergence of a new coronavirus, SARS-CoV-2, responsible for the COVID19 pandemic. The virus SARS-CoV-2 employs the Angiotensin-converting enzyme 2 (ACE2), a component of the RAAS (Renin-Angiotensin-Aldosterone System) system, as a receptor for entry into the cells. Several classes of synthetic drugs are available for hypertension, rarely associated with severe or mild adverse effects. New natural compounds, such as peptides, might be useful to treat some hypertensive patients. The main feature of ACE inhibitory peptides is the location of the hydrophobic residue, usually Proline, at the C-terminus. Some already known bioactive peptides derived from marine resources have potential ACE inhibitory activity and can be considered therapeutic agents to treat hypertension. Peptides isolated from marine vertebrates, invertebrates, seaweeds, or sea microorganisms displayed important biological activities to treat hypertensive patients. Here, we reviewed the anti-hypertensive activities of bioactive molecules isolated/extracted from marine organisms and discussed the associated molecular mechanisms involved. We also examined ACE2 modulation in sight of SARS2-Cov infection prevention.
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Ergün Barış, Kaya, and Şener Yusuf Ziya. "Hypertensive toxicity of thyrosine kinase inhibitors; Friend or Foe?" Annals of Clinical Hypertension 5, no. 1 (January 12, 2021): 001–2. http://dx.doi.org/10.29328/journal.ach.1001025.
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Tyrosine kinase inhibitors (TKIs) are widely used in Oncology practice. Hypertension may develop during cancer treatment and TKIs are well known drugs that are associated with drug related hypertensive toxicity. TKI related hypertensive toxicity is not always the indicator of worse clinical outcomes and it may be the sign of treatment efficacy.
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Cífková, Renata, Mark R. Johnson, Thomas Kahan, Jana Brguljan, Bryan Williams, Antonio Coca, Athanasios Manolis, et al. "Peripartum management of hypertension: a position paper of the ESC Council on Hypertension and the European Society of Hypertension." European Heart Journal - Cardiovascular Pharmacotherapy 6, no. 6 (December 16, 2019): 384–93. http://dx.doi.org/10.1093/ehjcvp/pvz082.
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Abstract Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life-threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks’ gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus.
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Ahola, Teemu L., Ilkka M. Kantola, Juhani Mäki, Antti Reunanen, and Antti M. Jula. "Adding a low-dose antihypertensive regimen would substantially improve the control of hypertension and reduce cardiovascular morbidity among uncomplicated hypertensive patients." European Journal of Preventive Cardiology 19, no. 4 (May 24, 2011): 712–22. http://dx.doi.org/10.1177/1741826711410835.
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Aims: To assess the utilization of antihypertensive drugs among uncomplicated hypertensive patients in Finland between 2000 and 2006 and to calculate the achievable reduction in cardiovascular morbidity, with intensified antihypertensive treatment. Methods: From the databases of the Social Insurance Institution of Finland, 428,986 treated hypertensives without diabetes or cardiac disease (further named uncomplicated hypertensives) in 2000 and 591,206 in 2006, respectively, were identified. In addition, from the Health 2000 survey representing the whole Finnish adult population, 729 uncomplicated hypertensives were determined to assess their characteristics and control of hypertension. Applying Law′s meta-analyses we calculated the reduction of blood pressure (BP) by intensifying the treatment with low-dose antihypertensive regimens for those with a BP ≥140/90 mmHg. Results: The nationwide data suggests a relative overuse of beta-blockers. Combination antihypertensive treatment increased relatively 8%, while at least three drug combinations increased from 19.8% to 21.6% between 2000 and 2006. However, calculated prevalence of controlled BP (<140/90 mmHg) increased only from 30.3% to 33.9%. Addition of one half standard dose or one to two half standard doses for the treatment of the patients with a BP ≥140/90 mmHg would improve the control of hypertension from 33.9% to 47.8% and 67.3%, respectively. The intensified treatment would reduce strokes by 18% and 28%, and ischaemic heart disease events by 13% and 21%, respectively. Conclusions: Underutilization of preferred drugs and poor control of BP continues. Surprisingly small addition of the number of low-dose antihypertensive regimen is needed in order to substantially improve the control of hypertension and to decrease cardiovascular morbidity among uncomplicated hypertensive patients.
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Picon, Rafael V., Juvenal S. Dias-da-Costa, Flavio D. Fuchs, Maria Teresa A. Olinto, Niteesh K. Choudhry, and Sandra C. Fuchs. "Hypertension Management in Brazil: Usual Practice in Primary Care—A Meta-Analysis." International Journal of Hypertension 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/1274168.
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Knowing the usual clinical practice is relevant for evaluations in health care and economic policies of management of hypertension. This study aimed to describe the usual management of hypertension in the Brazilian primary healthcare system through a systematic review and meta-analysis. The search of population-based studies conducted in Brazil was undertaken using PubMed, EMBASE, and Brazilian databases. Eligible studies were those conducted in adults with hypertension (blood pressure (BP) ≥ 140/90 mmHg or using BP lowering drugs). Three datasets’ data were analyzed: SESI study (in Brazilian workers); HIPERDIA (Brazilian Registration and Monitoring of Hypertensive and Diabetic Patients Program); and a population-based study. Meta-analysis has been performed using the fixed and random effect models. A total of 11 studies or data sets were included in the systematic review. Hypertensive individuals had, on average, 2.6 medical visits annually and 18.2% were on diuretics (n=811 hypertensive patients) and 16.2% on ACE inhibitors (n=1768 hypertensive patients). BP control rate ranged from 43.7 to 67.5%; 35.5% had measured total cholesterol and 36.5% determined fasting plasma glucose in the previous 12 months. Thiazide diuretics and ACE inhibitors were the most used BP lowering medications as single drugs, but the control rate of hypertension is insufficient.
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Gaidhankar, Smita L., Jaiprakash B. Ramanand, Parashram G. Kadam, Ajitkumar M. Zende, Rama R. Bhosale, and Nitin N. Puram. "A Study of drug utilization and clinical outcomes in indoor patients of hypertensive disorders of pregnancy." International Journal of Basic & Clinical Pharmacology 6, no. 10 (September 23, 2017): 2401. http://dx.doi.org/10.18203/2319-2003.ijbcp20174367.
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Background: Hypertensive disorders of pregnancy are an important determinant of drug use during pregnancy. The aim of study was to assess the clinical outcome and evaluate drug utilization according to WHO core drug prescribing indicators in hypertensive disorders of pregnancy.Methods: This prospective, observational study in a tertiary care hospital was conducted in 150 pregnant women with hypertensive disorders of pregnancy from January 2014 and December 2014 who fulfilled the inclusion criteria. Antepartum and intrapartum care and the maternal and perinatal outcome were noted. The data was analyzed to evaluate clinical outcome and drug utilization according to WHO core drug use indicators.Results: Gestational hypertension was most common among hypertensive disorders of pregnancy seen in 62/150 (41.3%) women. The most common symptom was headache (48%) while sign noted was edema (69%). A total of 66% women had preterm delivery and 42% babies weighed less than 2.5 kg. Average number of drugs per encounter was 9.7. Percentage of drugs prescribed by generic name and from essential drug list was 64% and 79% respectively. The most commonly used drugs were vitamins and minerals prescribed in 100% patients followed by antihypertensive drugs (92%). The most common antihypertensive used were calcium channel blockers and anticonvulsant was magnesium sulphate.Conclusions: There was increased maternal and perinatal morbidity and operative intervention among pregnant women with hypertensive disorders of pregnancy. Most of the drugs were used appropriately and were in accordance with standard guidelines. The important problems identified were inappropriate use of antimicrobials, use of sublingual nifedipine and use of brand names in 1/4th of prescriptions.
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Fadhilla, Salma Nara, and Dharma Permana. "The use of antihypertensive drugs in the treatment of essential hypertension at outpatient installations, Puskesmas Karang Rejo, Tarakan." Yarsi Journal of Pharmacology 1, no. 1 (February 9, 2020): 7–14. http://dx.doi.org/10.33476/yjp.v1i1.1209.
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Background: Essential hypertension is the most common type of hypertension, affecting 95% of hypertensive patients. Essential hypertension can be managed through a combination lifestyle changes and antihypertensive drugs. The aim of this study was to know the use of antihypertensive drugs in the treatment of essential hypertensive at outpatient installations, Puskesmas Karang Rejo, Tarakan.Methods: The research method is descriptive by using secondary data from complete patient medical records of the essential hypertension patients undergoing outpatient treatment at Puskesmas Karang Rejo, Tarakan in the period of January-April 2017.Results: A total of 557 medical records were selected, there were 72.53% (n = 404) female and 27.47 % (n = 153) male; age ranged from 20-80 years (mean = 50.32 years). The most common of essensial hypertension were 47.22 % (n = 263) grade II hypertension and 45.42 % (n = 253) grade I hypertension. The antihypertensive drugs were used single or in combination in the following order: Amlodipine (Calcium channel blockers), Captopril (ACE inhibitors), Hydrochlorothiazide/HCT (Diuretic), Methyldopa (alpha-2 adrenergic receptor agonist) and Isosorbid dinitrate (Vasodilator). Four hundred fifty four (81.51%) patients were treated with a single drug (monotherapy) and 103 (18.49%) patients were given combination therapy. Monotherapy and the combination of two antihypertensive drugs were used for prehypertension, grade I hypertension and grade II hypertension, with the most widely used drugs as monotherapy was amlodipine (67.86%, n =378 ) and the mostly used combination therapy of two antihypertensive drugs was Amlodipine-Hydrochlorothiazide (15.80%, n = 88). The combination of antihypertensive Amlodipin-Hydrochlorothiazide-Captopril (0.35%, n=2) was used for hypertension grade II.Conclusion: Amlodipine was the most widely used drug as monotherapy or combination drugs therapy in the treatment of essensial hypertension at outpatient installations, Puskesmas Karang Rejo.
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Sapkota, Biswash, Heamant Shrestha, Nischal Khatri, and Krishna Shrestha. "Prescribing Pattern of Anti-Hypertensive Drugs and Adherence to JNC VII Guideline." Proceedings 6, no. 1 (November 14, 2018): 11. http://dx.doi.org/10.3390/iecehs-1-05708.
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Introduction: Hypertension is an important public health concern because of its associated morbidity, mortality and economic impact on society. It is a significant risk factor for cardiovascular, cerebrovascular and renal complications. A number of national and international guidelines for the management of hypertension have been published. The Joint National Committee (JNC) in 2003 published a series of guidelines to recommend the appropriate antihypertensive therapy based on the best available evidence. Objectives: This drug utilization study was intended to find out the preferred drug group prescribed either alone or in combinations and their adherence to the JNC 7 guidelines. Materials and Methods: This was a prospective cross-sectional study. Drug utilization data on 100 hypertensive patients were collected from various hospitals in Nepal. The patients who received antihypertensive drugs during their treatment period in SPSS V. 16.0. The prescribed drugs were compared with JNC 7 guidelines. Results: It was found that 40% of patients were male and 60% were female. The largest subset of female hypertensive patients (45.0%) were in the age group of >60 years and a plurality of male hypertensive patients (45.0%) were in the age group of 40–60 years. It was found that 45% of the patients had Stage 1 hypertension, 32% of the patients were in prehypertension, 17% of the patients had Stage 2 hypertension. The most frequently prescribed antihypertensive drug regimens were angiotensin receptor blockers (ARBs) (32.44%), ARB + thiazide (15.94%), diuretics (11.59%), calcium channel blockers (CCBs) + beta blockers (9.42%) and CCBs (8.7%). Thirty-nine percent received monotherapy while the remaining 61% received combination therapy. Seventy-four percent of the total prescriptions followed JNC 7 guidelines. Conclusion: There is a need to follow official guidelines in managing hypertension as a chronic disease, since these guidelines are based on various clinical trials, and the successful attainment of a target BP in patients will be made much easier by implementing them. National health policymakers should consider the evaluation and treatment of hypertension as a right in the public health system for better outcomes in terms of morbidity and mortality from hypertension.
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Gultom, Agustina Boru, and Arbani Batubara. "The use of progressive muscle relaxation with classical music in hypertension women." Journal of Nursing Education and Practice 11, no. 9 (May 18, 2021): 44. http://dx.doi.org/10.5430/jnep.v11n9p44.
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Background/Objective: Hypertension is still a public health problem both in the world and in Indonesia. Even though women with hypertension are already taking antihypertensive drugs, often blood pressure remains high. Women are more likely to be stressed, and stress increases hypertension. The study aimed to analyze the use of progressive muscle relaxation with classical music on stress and blood pressure in hypertensive women.Methods: This study used a quasi-experimental design with a control group. There were three groups of hypertensive women who took anti-hypertensive drugs, consisting of those who received progressive muscle relaxation with classical music, accepted progressive muscle relaxation without classical music, and did not get treatment, each of which totaled 36 participants. The activity was carried out from July to October 2020. The stress instrument used was the Cohen’s Perceived Stress Scale, while blood pressure was measured with the OMRON digital tensimeter.Results: The group that received progressive muscle relaxation with classical music from Bach described high significance for stress (p = .0001), systolic (p = .0001), diastolic (p = .0001). The group that received progressive muscle relaxation alone also showed high significance for stress (p = .010), systolic (p = .003), diastolic (p = .006). While the untreated group showed significance for systolic (p = .013), but did not show significance for stress (p = .758), diastolic (p = .123). The use of ANOVA showed a significant difference in the effect of the three intervention on stress (p = .005), systolic blood pressure (p = .009), but did not have a significant effect on diastolic blood pressure (p = .500).Conclusions: Progressive muscle relaxation with classical music and antihypertensive drugs provides a greater chance of controlling stress, lowering systolic and diastolic blood pressure than just progressive muscle relaxation and antihypertensive drugs or antihypertensive drugs alone in women with hypertension.