The Effects of Antihypertensive Agents on Serum Lipids and Lipoproteins

Lardinois, Claude K.; Neuman, Sherry L.

doi:10.1001/archinte.1988.00380060044012

Cited by 150 publications

(15 citation statements)

References 154 publications

(10 reference statements)

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“…amounts of drug in plasma is associated with adverse effects [38]. So, a continuous release was preferred.…”

Section: Formulation F25mentioning

confidence: 99%

Computer Aided Formulation and Characterization of Propranolol Hcl Buccal Tablet Using Polymeric Blend

Hanif¹,

Irfan²,

Danish³

et al. 2017

TOPROCJ

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Abstract:The current study was aimed to formulate a continuous release mucoadhesive buccal tablet containing propranolol HCl. The type and quantities of polymers as well as method of compression were set in a preliminary study (F1-F13). Direct compression method was employed in the main study (F14-F24) using Carbopol ® 934P (CP), ethylcellulose (EC), sodium alginate (SA), hydroxypropyl methylcellulose (HPMC k4M) and carboxymethylcellulose (CMC) as mucoadhesive polymers and were tested for physicochemical tests i.e. swellability, surface pH, mucoadhesive time, mucoadhesive strength, in vitro release etc. Results obtained from the study were optimized using NeuralPower ® 3.1, an artificial intelligence approach. Against the desirability of physicochemical parameters, the software optimized the ingredients as HPMC (150mg), CMC (25mg), CP (20mg) and EC (20mg). Outcome revealed that HPMC primarily contributed to the physicochemical properties of mucoadhesive formulation. To compare prediction, optimized ingredients were formulated (F25) and tested. The swellability index of confirmation formulation (F25) was 102% at 6 h. As predicted, similar release pattern was of F25 was obtained as 26% (0.5h), 34% (1h), 40% (2h), 45% (3h), 50% (4h), 62% (5h), 76% (6h), 85% (7h) and 97% (8h) respectively. For release kinetics, DD solver ® suggested the release of the drug to be non-Fickian.

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“…amounts of drug in plasma is associated with adverse effects [38]. So, a continuous release was preferred.…”

Section: Formulation F25mentioning

confidence: 99%

Computer Aided Formulation and Characterization of Propranolol Hcl Buccal Tablet Using Polymeric Blend

Hanif¹,

Irfan²,

Danish³

et al. 2017

TOPROCJ

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“…Thiazide diuretics are preferred first-line medications for the treatment of essential hypertension unless there are compelling indications for another drug class. Diuretics, however, may worsen dyslipidemia and glucose tolerance [5][6][7][8]. In a large metaanalysis of 474 clinical trials from 1960 to 1993 with approximately 65,000 patients, diuretics were shown to increase total and low-density lipoprotein (LDL) cholesterol levels [9].…”

Section: Diureticsmentioning

confidence: 99%

Lipid Effects of Antihypertensive Medications

Deaño

Sorrentino

2011

Curr Atheroscler Rep

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Thiazide diuretics and beta-blockers are first-line therapies for hypertension unless there are compelling indications for other drug classes. Diuretics and beta-blockers, however, may worsen dyslipidemia and glucose tolerance whereas antihypertensive agents in other drug classes may have neutral or beneficial effects. Initial clinical trials of antihypertensive regimens suggested that blood pressure lowering was the most important aspect of therapy and that the adverse effects on lipids and glucose tolerance did not impact clinical outcomes. Newer trials, however, question this finding and implicate these pleotropic effects as contributing to the results of the trials. Patients with cardiometabolic risk factors may have compelling indications for agents that inhibit the renin-angiotensin-aldosterone system, relegating diuretics and beta-blockers to third-line therapy.

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“…In view of the fact that hypertension is often associated with metabolic abnormalities, there is increasing concern regarding the metabolic effects of antihypertensive drug therapy and its impact on cardiovascular risk reduction resulting from the treatment of hypertension [9][10][11][12][13][14][15][16][17][18]. These concerns have been highlighted by the recent JNC V Guidelines that have recommended diuretic and beta-blocker agents for first-line treatment for hypertension [19].…”

Section: Metabolic Effectsmentioning

confidence: 99%

“…The preliminary report of the British Medical Research Council (MRC) trial disclosed a 12% incidence of glucose intolerance in young people followed up for 5 years of diuretic therapy. Diuretics, at least in high doses, have been associated with potassium and magnesium depletion [20], lipid abnormalities [10,13,15,16], and glucose intolerance [9,15,16,21]. Beta-blocker therapy is associated with impaired insulin sensitivity and release, glucose intolerance, and dyslipidemia [13][14][15][16][21][22][23].…”

Section: Metabolic Effectsmentioning

confidence: 99%

Calcium channel blockers and hypertension: Evolving perspectives?1996

Epstein

1997

Cardiovasc Drug Ther

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In recent years, calcium channel blockers (CCBs) have been used extensively in the United States and elsewhere as antihypertensive agents, and their availability has been an important advance in the management of hypertension. As antihypertensive agents, the CCBs thus appear considerably more versatile than most previous vasodilators. The available studies indicate that CCBs are metabolically neutral and do not exacerbate dyslipidemia or impair glucose tolerance. In contrast to diuretics and beta-blockers, CCBs do not appear to alter insulin sensitivity. The CCBs also differ from previous vasodilators because of their favorable accompanying effects on the heart and kidney. Despite the attributes of CCBs enumerated earlier, a number of recent retrospective analyses by Psaty et al. (JAMA 1995;274:620-625) have suggested that CCBs may be detrimental and may promote adverse cardiovascular events. I have recently reviewed the results of Psaty's meta-analysis and report (Arch Intern Med 1995;155: 2150-2156). I have emphasized that it is the rate of drug delivery into the systemic circulation that produces profound effects on the hemodynamic and neurohumoral responses to a dihydropyridine CCB drug. During chronic treatment with dihydropyridines, major fluctuations in blood pressure (rapid onset and offset of antihypertensive effects) during the dosing interval may persist for drugs and formulations that are short acting. In contrast, slow-release formulations of otherwise rapidly absorbed dihydropyridines achieve a more gradual and sustained antihypertensive effect. It is probable that newer CCB formulations that do not provoke intermittent sympathetic activation and do not evoke a cardioacceleratory response would not be expected to promote adverse cardiovascular events.

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The Effects of Antihypertensive Agents on Serum Lipids and Lipoproteins

Cited by 150 publications

References 154 publications

Computer Aided Formulation and Characterization of Propranolol Hcl Buccal Tablet Using Polymeric Blend

Computer Aided Formulation and Characterization of Propranolol Hcl Buccal Tablet Using Polymeric Blend

Lipid Effects of Antihypertensive Medications

Calcium channel blockers and hypertension: Evolving perspectives?1996

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