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Thakkar B, Dadhaniya H, Dudhat K. Exploring hypertension-linked diseases: a comprehensive review of innovative drug combinations with enhanced therapeutic potential. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2025:10.1007/s00210-025-03819-3. [PMID: 39888363 DOI: 10.1007/s00210-025-03819-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Accepted: 01/14/2025] [Indexed: 02/01/2025]
Abstract
Hypertension, a prevalent cardiovascular condition affecting a substantial portion of the global population, remains a formidable health challenge associated with a multitude of complications. This review article provides a comprehensive examination of hypertension, its various complications, and the emergence of a novel management technique that shows promising potential in transforming the therapeutic landscape. Over the years, conventional treatment approaches, encompassing lifestyle modifications, dietary interventions, and pharmacotherapy, have been the mainstay in managing hypertension. However, these strategies fall short in achieving optimal blood pressure control and preventing complications in a significant number of patients. Consequently, the medical community has ventured into exploring innovative management techniques to tackle this unmet medical need. The focal point of this review centers on the emergence of a new management technique for hypertension that exhibits promise in preclinical and clinical studies. The latest research findings shed light on the efficacy and safety of this innovative approach, which encompasses pharmaceutical agents, medical devices, and non-invasive interventions. Through critical analysis and discussion, we explore the potential impact of these novel strategies on hypertension management and patient outcomes. In conclusion, this review article provides a comprehensive overview of hypertension, its complications, and the promising emergence of innovative management techniques. By acknowledging the complexity of hypertension and the potential of new therapeutic avenues, we aspire to pave the way for improved patient care, enhanced quality of life, and ultimately, the mitigation of hypertension-related morbidity and mortality.
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Affiliation(s)
- Bhavesh Thakkar
- School of Pharmacy, RK University, Kasturbadham, Rajkot, Gujarat, 360020, India
| | - Hetvi Dadhaniya
- School of Pharmacy, RK University, Kasturbadham, Rajkot, Gujarat, 360020, India
| | - Kiran Dudhat
- School of Pharmacy, RK University, Kasturbadham, Rajkot, Gujarat, 360020, India.
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Baneu P, Prelipcean A, Buda VO, Jianu N, Tudor A, Andor M, Merlan C, Romanescu M, Suciu M, Buda S, Mateoc T, Gurgus D, Dehelean L. Under-Prescription of Drugs in the Elderly Population of Western Romania: An Analysis Based on STOPP/START Version 2 Criteria. J Clin Med 2024; 13:5970. [PMID: 39408034 PMCID: PMC11477657 DOI: 10.3390/jcm13195970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 09/30/2024] [Accepted: 10/02/2024] [Indexed: 10/20/2024] Open
Abstract
Background/Objectives: Numerous European countries, including Romania, are facing the concern of rapid ageing of their populations. Moreover, Romania's life expectancy ranks among the lowest in the European Union. In light of this, it is imperative that the assessment of medication-related harm be given national priority in order to secure and enhance pharmacotherapy and the medical act. In this study, we sought to describe and evaluate the under-prescribing practices among the Romanian elderly population. Methods: We conducted a cross-sectional study in urban areas of two counties in Western Romania (Timis and Arad) from November 2017 to February 2019. We collected chronic electronic prescriptions issued for elderly patients (>65 years old) with chronic conditions. The medication was prescribed by generalist or specialist physicians for periods ranging between 30 and 90 days. To assess inappropriate prescribing behaviours, a multidisciplinary team of specialists applied the Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) v.2 criteria to the collected prescriptions. Results: Within the 1498 prescriptions included in the study, 57% were issued to females, the mean age was 74.1 ± 6.95, and the average number of medicines per prescription was 4.7 ± 1.51. The STOPP criteria most commonly identified were the (1) long treatment duration (23.6%) and (2) prescription of neuroleptics (14.6%) or zopiclone (14.0%) as medications that increase the risk of falls. According to START criteria, the following medicines were under-prescribed: (1) statins (47.4%), (2) beta-blockers (24.5%), (3) antiresorptive therapy (10.0%), and (4) β2-agonists and muscarinic antagonists for chronic obstructive pulmonary disease (COPD) (4.5%). Within our study group, the prevalence of potentially inappropriate medications was 18.58%, whereas the prevalence of potential prescribing omissions was 49.2%. Conclusions: To decrease medication-related harm and morbid-mortality, and to increase the quality of life for elderly people in Romania, immediate actions are needed from national authorities. These actions include reinforcing primary care services, providing periodic training for physicians, implementing medication review services by pharmacists, and utilising electronic health records at their full capacity.
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Affiliation(s)
- Petru Baneu
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Andreea Prelipcean
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania
| | - Valentina Oana Buda
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania
- Gina Farm Community Pharmacy, Decebal Street no. 2A, 315300 Ineu, Romania
| | - Narcisa Jianu
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania
| | - Anca Tudor
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
| | - Minodora Andor
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
| | - Cristina Merlan
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania
| | - Mirabela Romanescu
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
| | - Maria Suciu
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania
| | - Simona Buda
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania
| | - Teodora Mateoc
- Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (P.B.); (N.J.); (C.M.); (M.R.); (T.M.)
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
| | - Daniela Gurgus
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
- Department of Balneology, Medical Recovery and Rheumatology, Family Discipline, Center for Preventive Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Liana Dehelean
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (A.T.); (M.A.); (D.G.); (L.D.)
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Lee JD, Kuo YW, Lee CP, Huang YC, Lee M, Lee TH. Initial in-hospital heart rate is associated with long-term survival in patients with acute ischemic stroke. Clin Res Cardiol 2021; 111:651-662. [PMID: 34687320 PMCID: PMC9151537 DOI: 10.1007/s00392-021-01953-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/13/2021] [Indexed: 11/24/2022]
Abstract
Aims Increased heart rate has been associated with stroke risk and outcomes. The purpose of this study was to explore the long-term prognostic value of initial in-hospital heart rate in patients with acute ischemic stroke (AIS). Methods We analyzed data from 21,655 patients with AIS enrolled (January 2010–September 2018) in the Chang Gung Research Database. Mean initial in-hospital heart rates were averaged and categorized into 10-beat-per-minute (bpm) increments. The primary and secondary outcomes were all-cause mortality and cardiovascular death. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable adjusted Cox proportional hazard models, using the heart rate < 60 bpm subgroup as the reference. Results The adjusted HRs for all-cause mortality were 1.23 (95% CI 1.08–1.41) for heart rate 60–69 bpm, 1.74 (95% CI 1.53–1.97) for heart rate 70–79 bpm, 2.16 (95% CI 1.89–2.46) for heart rate 80–89 bpm, and 2.83 (95% CI 2.46–3.25) for heart rate ≥ 90 bpm compared with the reference group. Likewise, heart rate ≥ 60 bpm was also associated with an increased risk of cardiovascular death (adjusted HR 1.18 [95% CI 0.95–1.46] for heart rate 60–69 bpm, 1.57 [95% CI 1.28–1.93] for heart rate 70–79 bpm, 1.98 [95% CI 1.60–2.45] for heart rate 80–89 bpm, and 2.36 [95% CI 1.89–2.95] for heart rate ≥ 90 bpm). Conclusions High initial in-hospital heart rate is an independent predictor of all-cause mortality and cardiovascular death in patients with AIS. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00392-021-01953-5.
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Affiliation(s)
- Jiann-Der Lee
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Wen Kuo
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yen-Chu Huang
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Meng Lee
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsong-Hai Lee
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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