Intensive monitoring of adherence in patients with uncontrolled hypertension was evaluated over a 6-month period. After that period, only patients well characterized as having resistant hypertension were followed for 12 months. The goal of this study was to evaluate whether adherence to a drug regimen helps to identify patients with resistant hypertension. Forty-four hypertensive patients resistant to a 3-drug regimen (average blood pressure [BP] mm Hg, mean AE standard deviation) were studied prospectively. Each patient was followed for a 12-month period. Adherence to treatment was evaluated through self-report, applying Morisky's questionnaire and the pill count method. Ambulatory BP monitoring and office BP measures were performed. By pill count, 63.6% of the patients were adherent to treatment at the start of the survey and 94% at the end, although 59% of the patients still did not reach normal BP levels. We found that non-adherence was not associated with resistance to antihypertensive treatment. Therefore, after investigation, we concluded that patients who presented with uncontrolled arterial BP may be truly resistant hypertensive to treatment.
BackgroundArtemisia annua L. has been used for many centuries in Chinese traditional medicine. Artemisinin, the active principle was first isolated and identified in the 1970s becoming the global back bone to the fight against malaria. Our research group previously developed an economic and ecological friendly process to obtain this compound. In the pursuit to also exploit the residue generated throughout the process we further evaluated the pharmacological potential of that extract.MethodsThe alcoholic crude extract after artemisinin precipitation maintained an enriched sesquiterpene lactones content with residue artemisinin (1.72%) and deoxyartemisinin (0.31%), used as chemical markers for this sample. This study evaluated the pharmacological potential of the enriched sesquiterpene lactone fraction (Lac-FR) on different nociceptive and inflammatory experimental animal models. Previous findings on the biological properties of lactones obtained from natural products permitted us to explore the antinociceptive activities of these compounds based on in vivo chemical-induced behavioral assays.ResultsThe enriched sesquiterpene lactone fraction (Lac-FR) was administrated by intraperitoneal injection producing a relevant reduction in the reaction time of the animals in both phases of the formalin test, significantly reduced the sensitivity to mechanical allodynia stimulus, reduced the paw edema caused by carrageenan injection and promoted high antinociceptive activity in tail flick model suggesting relationship with the opioid system. Further studies are being undertaken to elucidate the active components involved with the antinociceptive activity as well as evaluation of synergy effect that is seen by combination of substances that is greater than would be expected from consideration of individual contributions.ConclusionFor the first time, results presented herein provided consistent data to support the potential use of these lactones for pain relief as revealed by chemical-induced nociception assays in mice.
AGRADECIMENTOSÀ Deus por me dar a oportunidade de aprender cada dia mais sobre a vida.À minha família por me ouvir e respeitar minhas vontades e escolhas.Ao meu pai Edison, que me mostra sempre com muita sabedoria, paciência, respeito e amor, como um verdadeiro mestre faz, os caminhos pelos quais eu devo seguir e como fazer para superar as dificuldades.À minha mãe Solange, por me defender sempre com todas as suas forças, como uma leoa faz por sua cria, mas também por me apoiar com toda a sua fé, com todo seu amor e sempre reforçar de que há alguém muito superior que cuida de nós.À minha avó Glades, por todo o apoio, pelo carinho e por sempre acreditar no meu sucesso.Ao meu avô Dionísio (in memória) que deixou uma lição de simplicidade ao viver, que ainda estou aprendendo.Ao meu sobrinho Luiz Fernando, que retribui com o amor sincero de uma criança o amor intenso que eu sinto por ele.À minha co-orientadora e grande amiga Profa. Dra. Maricene Sabha, por todo o apoio, pela amizade sincera, pelo respeito para com o meu trabalho em todos os momentos, por me ensinar lições preciosas durante o meu aprendizado e por abrir a minha mente para o futuro.Ao meu orientador Prof. Dr. Heitor Moreno Júnior, por me dar a oportunidade de realizar essa pós-graduação numa área que eu sempre quis conhecer. À amiga Walnéia A. de Souza pela boa vontade de sempre em me ajudar e por me fornecer informações fundamentais para esse trabalho, sem pretensões de reconhecimento.Ao amigo Luiz Cláudio Martins pelo seu grande trabalho no ambulatório, pelo incentivo e pela grande figura humana e exemplo que mostrou ser, a mim, aos colegas de trabalho e a todos os pacientes. vi À minha grande amiga Wanessa C. Souto que sempre me apoiou para que eu me qualificasse e acreditou no meu sucesso, dando muito incentivo, atenção, mandando boas energias e me proporciona uma amizade linda, sincera e de coração aberto.
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