Treatment of Hypertension: Favourable Effect of the Twice-Daily Compared to the Once-Daily (Evening) Administration of Perindopril and Losartan

Ipoly, Szauder; Csajági, Eszter; Major, Zsuzsanna; Pavlik, G.; Ujhelyi, Gabriella

doi:10.1159/000368513

Cited by 12 publications

(14 citation statements)

References 57 publications

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“…Therefore, a twice daily administration of 50–70 mg might improve the coverage of the therapeutic window (see Figure 3B ). Consistently, a recent study also reported that twice daily administration of the same daily dose of losartan is more effective in comparison to once daily administration of a single dose ( 31 ). Additional use cases can be found in Section 5 of supplementary information (S2) .…”

Section: Use Casesupporting

confidence: 59%

SuperDRUG2: a one stop resource for approved/marketed drugs

Siramshetty

Eckert

Gohlke

et al. 2017

Nucleic Acids Research

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Regular monitoring of drug regulatory agency web sites and similar resources for information on new drug approvals and changes to legal status of marketed drugs is impractical. It requires navigation through several resources to find complete information about a drug as none of the publicly accessible drug databases provide all features essential to complement in silico drug discovery. Here, we propose SuperDRUG2 (http://cheminfo.charite.de/superdrug2) as a comprehensive knowledge-base of approved and marketed drugs. We provide the largest collection of drugs (containing 4587 active pharmaceutical ingredients) which include small molecules, biological products and other drugs. The database is intended to serve as a one-stop resource providing data on: chemical structures, regulatory details, indications, drug targets, side-effects, physicochemical properties, pharmacokinetics and drug–drug interactions. We provide a 3D-superposition feature that facilitates estimation of the fit of a drug in the active site of a target with a known ligand bound to it. Apart from multiple other search options, we introduced pharmacokinetics simulation as a unique feature that allows users to visualise the ‘plasma concentration versus time’ profile for a given dose of drug with few other adjustable parameters to simulate the kinetics in a healthy individual and poor or extensive metabolisers.

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Section: Use Casesupporting

confidence: 59%

SuperDRUG2: a one stop resource for approved/marketed drugs

Siramshetty

Eckert

Gohlke

et al. 2017

Nucleic Acids Research

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“…Alteration of the dosing times (eg, to include a nocturnal dose) or using divided doses of drugs with half-lives of <12 to 15 hours may also improve BP control even when the drug theoretically has a pharmacodynamic effect of up to 24 hours in duration. 387,388 Dosing at night of certain agents, for example, guanfacine, also helps reduce adverse effects such as drowsiness and may aid in sleeping.…”

Section: Pharmacological Treatment Of Rhmentioning

confidence: 99%

Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association

Carey¹,

Calhoun²,

Bakris³

et al. 2018

Hypertension

740

751

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Resistant hypertension (RH) is defined as above-goal elevated blood pressure (BP) in a patient despite the concurrent use of 3 antihypertensive drug classes, commonly including a long-acting calcium channel blocker, a blocker of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a diuretic. The antihypertensive drugs should be administered at maximum or maximally tolerated daily doses. RH also includes patients whose BP achieves target values on ≥4 antihypertensive medications. The diagnosis of RH requires assurance of antihypertensive medication adherence and exclusion of the “white-coat effect” (office BP above goal but out-of-office BP at or below target). The importance of RH is underscored by the associated risk of adverse outcomes compared with non-RH. This article is an updated American Heart Association scientific statement on the detection, evaluation, and management of RH. Once antihypertensive medication adherence is confirmed and out-of-office BP recordings exclude a white-coat effect, evaluation includes identification of contributing lifestyle issues, detection of drugs interfering with antihypertensive medication effectiveness, screening for secondary hypertension, and assessment of target organ damage. Management of RH includes maximization of lifestyle interventions, use of long-acting thiazide-like diuretics (chlorthalidone or indapamide), addition of a mineralocorticoid receptor antagonist (spironolactone or eplerenone), and, if BP remains elevated, stepwise addition of antihypertensive drugs with complementary mechanisms of action to lower BP. If BP remains uncontrolled, referral to a hypertension specialist is advised.

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“…Thus, it is surprising that Zappe et al conclude that once daily administration of valsartan resulted in similar 24-h BP control regardless of dosing time and when compared to administration of a long-acting ACEI taken in the morning (102). In contrast, Szauder et al report that twice daily administration of an ACEI or an ARB, was more effective in converting non-dippers to dippers compared to once daily dosing of either medication in the evening (103). The latter study suggests that for some drug classes in order to obtain ideal pharmacological profiles twice-daily dosing may be required.…”

Section: Resultsmentioning

confidence: 98%

Chronotherapy for Hypertension

et al. 2018

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Given the emerging knowledge that circadian rhythmicity exists in every cell and all organ systems, there is increasing interest in the possible benefits of chronotherapy for many diseases. There is a well-documented 24-h pattern of blood pressure with a morning surge that may contribute to the observed morning increase in adverse cardiovascular events. Historically, antihypertensive therapy involves morning doses, usually aimed at reducing daytime blood pressure surges, but an absence of nocturnal dipping blood pressure is also associated with increased cardiovascular risk. To more effectively reduce nocturnal blood pressure and still counteract the morning surge in blood pressure, a number of studies have examined moving one or more antihypertensives from morning to bedtime dosing. More recently, such studies of chronotherapy have studied comorbid populations including obstructive sleep apnea, chronic kidney disease, or diabetes. Here, we summarize major findings from recent research in this area (2013-2017). In general, nighttime administration of antihypertensives improved overall 24-h blood pressure profiles regardless of disease comorbidity. However, inconsistencies between studies suggest a need for more prospective randomized controlled trials with sufficient statistical power. In addition, experimental studies to ascertain mechanisms by which chronotherapy is beneficial could aid drug design and guidelines for timed administration.

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Treatment of Hypertension: Favourable Effect of the Twice-Daily Compared to the Once-Daily (Evening) Administration of Perindopril and Losartan

Cited by 12 publications

References 57 publications

SuperDRUG2: a one stop resource for approved/marketed drugs

SuperDRUG2: a one stop resource for approved/marketed drugs

Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association

Chronotherapy for Hypertension

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