Combination pharmacotherapy in hypertension

Stergiou, George S.

doi:10.1007/s11255-006-0036-z

Cited by 3 publications

(3 citation statements)

References 69 publications

(108 reference statements)

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“…However, despite recent improvements in BP control rates, hypertension remains inadequately managed in approximately 50% of all patients 5 . About two thirds of the diagnosed hypertensive population will require combination therapy in order to achieve BP goals 6–8 . Therapy using multiple antihypertensive agents from different therapeutic classes treats the disease through multiple physiologic pathways 7,9 .…”

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confidence: 99%

Comparative Effectiveness Analysis of Amlodipine/Renin‐Angiotensin System Blocker Combinations

Ram

Vasey²,

Panjabi

et al. 2012

J of Clinical Hypertension

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A comparative effectiveness analysis of antihypertensive therapy amlodipine (AML) and angiotensin receptor blocker (ARB) fixed-and loose-dose combinations (FDCs and LDCs) in achieving blood pressure (BP) reduction and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) goal attainment was made using retrospective electronic medical record (EMR) data. Treatment goal rates ranged from 35.0% for LDC AML ⁄ losartan to 45.7% for FDC AML ⁄ olmesartan (OM). FDC AML ⁄ OM achieved significantly greater reductions in systolic BP than FDC AML ⁄ benazepril (BEN), FDC AML ⁄ valsartan (VAL), and LDC AML ⁄ ARBs, respectively, and significantly greater reductions in diastolic BP than FDC AML ⁄ VAL and LDC therapy, respectively. Compared with patients treated with AML ⁄ OM, patients prescribed AML ⁄ VAL and LDC AML ⁄ ARB were significantly less likely to attain JNC 7 BP goal. Among subpopulations, AML ⁄ OM yielded higher rates of goal attainment among both African Americans and obese ⁄ overweight patients relative to AML ⁄ VAL and combined LDCs. Switchers from monotherapy with AML, OM, or VAL to AML ⁄ OM were significantly more likely to attain JNC 7 goals than those switching to AML ⁄ VAL or AML ⁄ BEN. J Clin Hypertens (Greenwich). 2012;14:601-610. Ó2012 Wiley Periodicals, Inc.Nearly 33.5% of US adults have high blood pressure (BP), 1 and the prevalence is expected to increase by 9.9% over the next 2 decades, reaching 37.3% by the year 2030.2 Untreated or undertreated hypertension is associated with significant cardiovascular morbidity and mortality 1,3 and is a precursor to first stroke, first heart attack, or heart failure (HF) in approximately 75% of individuals.

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confidence: 99%

Comparative Effectiveness Analysis of Amlodipine/Renin‐Angiotensin System Blocker Combinations

Ram

Vasey²,

Panjabi

et al. 2012

J of Clinical Hypertension

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“…16 As a result, HT self-management, awareness, and interventions are important treatment routes and have substantial roles in managing HT complications. [17][18][19] Studies comprising knowledge, attitude, and practice (KAP) can measure HT self-management 20 as KAP levels may reflect current self-management status. Though there are various global studies on HT KAP, [20][21][22][23][24] rare studies were published in SA, such as the studies performed by Siddiqua et al in Asir region 25 and the study by Bakhsh et al, 2017 in King Abdulaziz University Hospital in Jeddah city.…”

Section: Introductionmentioning

confidence: 99%

Hypertension self-management and antihypertensive prevalence amid patients in Saudi Arabia via knowledge, attitude, and practice assessment

Sharaf¹,

Alharbi²,

Alsharif³

et al. 2021

IJFCM

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Background: Diagnosed cases with hypertension (HT) are elevating worldwide and in Saudi Arabia (SA). HT self-management amid patients is important for controlling the disease and its complications. The aim of this study is to perform an HT KAP evaluation amid patients with HT in SA. Subjects and methods: This Cross-sectional study was performed between January and April 2021. An administered validated online survey was presented to the patients via the Survey Monkey website-link. Data collectors contacted possible patients in several sites comprising; hospitals, shopping malls, and leisure-centers. The associations amid categorical variables were assessed via the chi-square test application. The Pearson correlation coefficient (r) measured potential correlations between the patients’ KAP and outcome variables. Results: This study surveyed 410 patients with HT with mean systolic blood pressure (SBP) of 144.1 mmHg ± 15.4 and diastolic blood pressure (DBP) 90.2 mmHg ± 10.2, mean age 56 ± 11 years, range 18–80 years. Generally, 73% of patients showed good HT knowledge and 78% showed good HT attitude, whereas 77% revealed poor HT practice. Significant positive linear correlations were found amid attitude versus (with) knowledge (r= 0.40, P <0.001), practice with knowledge (r= 0.26, P <0.001), practice with attitude (r= 0.26, P <0.001), SBP with DBP (r= 0.57, P <0.001), whereas significant negative linear correlations were found amid SBP with knowledge (r= −0.13, P <0.05), SBP with attitude (r= −0.11, P <0.05), SBP with practice (r= −0.10, P <0.05), DBP with knowledge (r= −0.10, P <0.05), DBP with attitude (r= −0.14, P <0.05), and DBP with practice (r= −0.10, P <0.05). Surprisingly, 59% of patients didn’t administer any prescribed anti-hypertensives. Conclusion: The patients showed a very good attitude and knowledge regarding HT; however, these were not mirrored in their practice towards HT. Unproper administration of prescribed anti-hypertensive medicines without a proper healthy diet and exercise caused a direct contribution resulted in poor HT practice despite increased HT knowledge and awareness. Consequently, patients are advised to participate in the free HT health education programs provided by the ministry of health (MOH) to increase their knowledge of the importance of drug compliance and applications for improving HT self-management to better manage HT and its complications.

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“…Alternative therapies are being pursued, especially for populations that cannot tolerate HMG-CoA reductase inhibitors. Owing to the risk of adverse drug interactions, combination therapy is less frequently used in the treatment of hypercholesterolaemia, a strategy that differs from the treatment regimens in hypertension, for example [11,12] . Natural bioactives from dietary sources may allow the targeting of complementary mechanisms to overcome such situations.…”

Section: Introductionmentioning

confidence: 99%

Bioactives for cholesterol lowering: targeting of cholesterol absorption pathways

Leifert

Abeywardena²

2007

Expert Opinion on Drug Discovery

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The relationship between serum cholesterol and coronary heart disease is well established. Inhibitors of endogenous cholesterol synthesis (statins) have been shown to reduce cardiovascular events. Similarly, strategies directed towards the gastrointestinal tract may also be effective, as cholesterol absorption via the intestinal lumen is known to contribute to the total amount of cholesterol in the body. Although the exact mechanism(s) remain elusive, several naturally occurring compounds (bioactives), such as plant sterols, have been shown to influence the cholesterol absorption process. Accordingly, new targets, such as cholesterol esterase and cholesterol transport protein (Niemann-Pick C1-like 1 protein), may serve as worthy candidates for biologically active targets. This article discusses some of the potential benefits of targeting key proteins involved in cholesterol absorption and biosynthesis.

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Combination pharmacotherapy in hypertension

Cited by 3 publications

References 69 publications

Comparative Effectiveness Analysis of Amlodipine/Renin‐Angiotensin System Blocker Combinations

Comparative Effectiveness Analysis of Amlodipine/Renin‐Angiotensin System Blocker Combinations

Hypertension self-management and antihypertensive prevalence amid patients in Saudi Arabia via knowledge, attitude, and practice assessment

Bioactives for cholesterol lowering: targeting of cholesterol absorption pathways

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