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Drugs 2006Hypertension affects 65 million people in the US, and is a major cause of morbidity and mortality, but less than one-third of patients with hypertension are treated to... (Review)
Review
Hypertension affects 65 million people in the US, and is a major cause of morbidity and mortality, but less than one-third of patients with hypertension are treated to goal blood pressure. Multiple factors have been cited, and include suboptimal adherence to treatment and lifestyle modifications, limited access to healthcare services, and the failure of health professionals to treat hypertension aggressively. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends a goal blood pressure of <140/90mm Hg for most patients and <130/80mm Hg for those with diabetes mellitus or chronic kidney disease. The 'ideal' antihypertensive agent would have a number of characteristics: (i) effective in lowering blood pressure to recommended goals; (ii) high efficacy as monotherapy; (iii) rapid onset of effect; (iv) convenient once-daily dose administration to maximise compliance; (v) sustained efficacy over 24 hours; (vi) response increases with higher doses (clear dose-response effect); and (vii) optimum tolerability profile. Although the ideal agent does not yet exist and will vary from patient to patient, drug development and new formulations have provided more options for clinicians and patients and certain drug classes appear to show promise because they possess many beneficial characteristics. Hypertension treatment needs to be tailored to individual patients' age, race, socioeconomic situation, concomitant conditions and family history. Physicians and other clinical providers have an important role to play in hypertension management, particularly by combining culturally sensitive patient care with aggressive treatment. Regular follow-up that is directed at achieving goal blood pressure, while monitoring the patient for possible drug-related adverse effects, will help ensure and support adherence to treatment regimens. By supporting the integration of lifestyle changes into this plan, the clinician can further influence and have a positive impact on a patient's overall cardiovascular profile.
Topics: Animals; Antihypertensive Agents; Humans; Hypertension
PubMed: 16827600
DOI: 10.2165/00003495-200666090-00006 -
The British Journal of Clinical Practice 1996Losartan is an orally active angiotensin II antangonist that selectively blocks effects mediated by the stimulation of the AT1 subtype of the angiotensin II receptor.... (Review)
Review
Losartan is an orally active angiotensin II antangonist that selectively blocks effects mediated by the stimulation of the AT1 subtype of the angiotensin II receptor. This agent, at doses of 50-150mg/day, is as effective at lowering blood pressure as chronic angiotensin converting enzyme (ACE) inhibitors. Losartan is generally well tolerated and has an incidence of adverse effects very similar, in double-blind controlled trials, to that of placebo. It does not cause coughing, the most common side-effect of the ACE inhibitors, most probably because angiotensin II antagonism has no impact on ACE, an enzyme known to process bradykinin and other cough-inducing peptides. Losartan is a promising antihypertensive agent with the potential to become a first-line option for the treatment of patients with high blood pressure.
Topics: Angiotensin Receptor Antagonists; Antihypertensive Agents; Biphenyl Compounds; Humans; Imidazoles; Losartan; Tetrazoles
PubMed: 8794603
DOI: No ID Found -
Current Hypertension Reports Dec 2012There has been an evolution in the understanding of the treatment of hypertension in children and adolescents over the past decade. This has been fueled in part by the... (Review)
Review
There has been an evolution in the understanding of the treatment of hypertension in children and adolescents over the past decade. This has been fueled in part by the increased attention paid to the clinical problem, given the increasing numbers of children and adolescents being diagnosed with this condition. There has also been a growing number of clinical trials performed and completed that demonstrate the blood pressure (BP)-lowering effects of antihypertensives and the side effect profiles of these medications, and that has led to FDA-labeling of many antihypertensive medications for use in children and adolescents. However, none of these trials has provided definitive data on the optimal first line agent for this patient population. Clinical experience and other approaches discussed in this review are still necessary to guide treatment of hypertension in the young. The quest for the optimal antihypertensive agent is just beginning, and it is going to take some extraordinary effort to reach that goal.
Topics: Adolescent; Antihypertensive Agents; Child; Humans; Hypertension; Practice Guidelines as Topic
PubMed: 22986908
DOI: 10.1007/s11906-012-0302-7 -
American Heart Journal Feb 1991The factors to be considered in selecting antihypertensive agents have traditionally centered around balancing efficacy against adverse side effects. The former can be... (Review)
Review
The factors to be considered in selecting antihypertensive agents have traditionally centered around balancing efficacy against adverse side effects. The former can be achieved by a variety of agents alone or in combination. The latter not only involves safety but is also concerned with whether an otherwise safe agent is tolerated by the patient so compliance with the treatment regimen can be achieved. A relatively new consideration is how antihypertensive agents affect other disease states that may or may not be associated with hypertension. For example, how a drug may affect diabetes, gout, myocardial hypertrophy, atherosclerosis, and coronary events must be evaluated. These concerns taken together answer the question of why yet another antihypertensive agent may be needed in the pharmacologic armamentarium.
Topics: Adrenergic beta-Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Arteriosclerosis; Blood Pressure; Calcium Channel Blockers; Diuretics; Humans; Hyperlipidemias; Myocardial Infarction; Patient Compliance
PubMed: 1671186
DOI: 10.1016/0002-8703(91)90444-m -
JACC. Heart Failure Feb 2021
Topics: Antihypertensive Agents; Friends; Heart Failure; Humans; Hypertension; Kidney
PubMed: 33309577
DOI: 10.1016/j.jchf.2020.10.007 -
Advances in Chronic Kidney Disease Sep 2021Cancer is one of the leading causes of death worldwide. With the introduction of newer chemotherapeutic agents, targeted therapies, and immunotherapy, the prognosis and... (Review)
Review
Cancer is one of the leading causes of death worldwide. With the introduction of newer chemotherapeutic agents, targeted therapies, and immunotherapy, the prognosis and survival of patients with cancer has remarkably improved. As a result, patients are living longer and experiencing long-term cardiovascular complications. Hypertension is an important risk factor for cardiovascular diseases. Patients with malignancy have multiple etiologies of hypertension development, worsening, or association. This is because of the complex interplay between cancer type, chemotherapeutic agent, patient age, antihypertensive agent, and preexisting comorbidities in the etiology and pathogenesis of hypertension. Management of hypertension in patients with cancer requires accurate blood pressure measurement and considering factors such as adjuvant therapy and cancer-related pain. There are no set guidelines for management of hypertension in this unique cohort, and the therapy should be individualized based on the treatment guidelines for the general population. Onco-hypertension is an emerging subspeciality and entails a multidisciplinary approach between oncology, primary care physicians, nephrology, and cardiology.
Topics: Antihypertensive Agents; Antineoplastic Agents; Cardiology; Humans; Hypertension; Medical Oncology; Neoplasms
PubMed: 35190114
DOI: 10.1053/j.ackd.2021.09.011 -
Anti-cancer Drugs Jul 2024Repurposing existing drugs for cancer therapy has become an important strategy because of its advantages, such as cost reduction, effect and safety. The present study...
Repurposing existing drugs for cancer therapy has become an important strategy because of its advantages, such as cost reduction, effect and safety. The present study was designed to investigate the antimelanoma effect and possible mechanisms of action of nebivolol, which is an approved and widely prescribed antihypertensive agent. In this study, we explored the effect of nebivolol on cell proliferation and cell activity in melanoma in vitro and the potential antimelanoma mechanism of nebivolol through a series of experiments, including the analysis of the effects with regard to cell apoptosis and metastasis. Furthermore, we evaluated the antimelanoma effect on xenograft tumor models and inspected the antimelanoma mechanism of nebivolol in vivo using immunohistochemical and immunofluorescence staining assays. As results in this work, in vitro , nebivolol possessed a strong activity for suppression proliferation and cell cycle arrest on melanoma. Moreover, nebivolol significantly induced cell apoptosis in melanoma through a mitochondrial-mediated endogenous apoptosis pathway. Additionally, nebivolol inhibited melanoma cell metastasis. More importantly, nebivolol exhibited significantly effective melanoma xenograft models in vivo , which related to the mechanism of apoptosis induction, proliferation inhibition, metastasis blocking and angiogenesis arrest. Overall, the data of the present study recommend that nebivolol holds great potential in application as a novel agent for the treatment of melanoma.
Topics: Nebivolol; Animals; Humans; Melanoma; Apoptosis; Cell Proliferation; Mice; Antihypertensive Agents; Xenograft Model Antitumor Assays; Cell Line, Tumor; Mice, Nude; Cell Cycle Checkpoints; Antineoplastic Agents; Skin Neoplasms; Cell Movement
PubMed: 38602174
DOI: 10.1097/CAD.0000000000001597 -
JPMA. the Journal of the Pakistan... Sep 2018
Topics: Antihypertensive Agents; Humans; Hypertension; Osteoporosis; Osteoporotic Fractures; Sodium Chloride Symporter Inhibitors; Treatment Outcome
PubMed: 30317281
DOI: No ID Found -
Acts as an Antihypertensive and Vasorelaxant Agent Through sGC and Prostaglandin Synthesis Pathways.Cardiovascular & Hematological Agents... 2023is a medicinal plant used in traditional medicine to treat various ailments, including hypertension.
BACKGROUND
is a medicinal plant used in traditional medicine to treat various ailments, including hypertension.
AIMS
The study aimed to determine the antihypertensive activity of .
OBJECTIVE
The study aimed to investigate the antihypertensive and vasorelaxant activities of the aqueous extract of fruits (ALAE) in rats.
METHODS
ALAE was prepared to study its antihypertensive effect in L-NAME (Nω-L-arginine methyl ester)-induced hypertensive rats and its vasorelaxant activity in isolated thoracic aortas of rats. The acute and subchronic effects of ALAE on systolic, diastolic, mean arterial pressure, and heart rate (HR) were evaluated after oral administration of ALAE (60 and 100 mg/kg body weight) for 6 h for the acute experiment and over 7 days for the subchronic test. Isolated thoracic aortic rings were prepared to examine the vasorelaxant action of ALAE. Several common pharmacological agents were used to test potential pathways implicated in vasorelaxant action.
RESULTS
The results showed that ALAE reduced blood pressure parameters (systolic, mean, and diastolic blood pressure) in L-NAME-induced hypertension rats after repeated oral treatment over seven days without affecting normotensive rats. Furthermore, in thoracic aortic rings pre-contracted with epinephrine (EP) (10 μM) or KCl (80 mM), ALAE (0.250-1.625 mg/ml) showed a vasorelaxant effect. In isolated rat thoracic aortas, blockage of soluble guanylyl cyslase with blue methylene (P < 0.01) partially decreased this vasorelaxant effect. In addition, blockage of the prostaglandin synthesis pathway with indomethacin (P<0.05) also reduced the vasorelaxant activity of ALAE. Pretreatment of aortic rings with glibenclamide, propanolol, L-NAME, MLN-4760, or nifedipine did not affect ALAE-induced vasorelaxation.
CONCLUSION
is a prescient medicinal plant, able to act as an antihypertensive agent. Moreover, the results suggest that the extract increased cGMP in NO-independent manner.
Topics: Rats; Animals; Antihypertensive Agents; Vasodilator Agents; NG-Nitroarginine Methyl Ester; Plant Extracts; Rats, Wistar; Hypertension; Plants, Medicinal
PubMed: 36503395
DOI: 10.2174/1871525721666221209161605 -
Current Hypertension Reports Oct 2005Proteinuria is a known risk factor for both cardiovascular disease and progression of established kidney disease. Observational studies and intervention trials have... (Review)
Review
Proteinuria is a known risk factor for both cardiovascular disease and progression of established kidney disease. Observational studies and intervention trials have established that even low levels of albuminuria (microalbuminuria) are associated with increased risk for cardiovascular morbidity and mortality in general, and especially in high-risk populations such as those with diabetes mellitus. People with hypertension are at increased risk for proteinuria and arguably should be treated with regimens that not only lower blood pressure but also reduce proteinuria. Clinical trials indicate that lowering proteinuria in those with chronic kidney disease is associated with reduced risk for progression to end-stage kidney disease and cardiovascular outcomes. Many of these trials employ antihypertensive agents that block the renin-angiotensin-aldosterone system (RAAS), and indicate that these drugs are, in general, more effective than other antihypertensive regimens for reducing proteinuria. In addition, several small studies suggest that nondihydropyridine calcium channel blockers are comparable with angiotensin-converting enzyme inhibitors and more effective than dihydropyridine calcium channel blockers for reducing proteinuria in type 2 diabetics with advanced kidney disease. Based on the combined evidence from epidemiologic and intervention studies, it seems prudent to make proteinuria reduction a mandatory consideration in the selection of antihypertensive regimens.
Topics: Antihypertensive Agents; Cardiovascular Diseases; Clinical Trials as Topic; Disease Progression; Glomerular Filtration Rate; Humans; Kidney Failure, Chronic; Proteinuria
PubMed: 16157082
DOI: 10.1007/s11906-005-0074-4