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Yang R, Tang J, Kuang M, Liu H. Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study. Ann Med 2023; 55:276-284. [PMID: 36594446 PMCID: PMC9815216 DOI: 10.1080/07853890.2022.2162113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Globally, the prevalence of hypertension and the accompanying burden of cardiovascular disease are increasing. Through drug utilization research, we can understand the prescription status of hypertension patients and promote rational drug use. The purpose of this retrospective study was to describe the current prescription pattern of antihypertensive drugs in Chinese patients and determine the compliance level of treatment guidelines. MATERIALS AND METHODS Around 11.1 million patients who received a prescription for antihypertensive therapy between January 2021 to December 2021 were obtained from a database of Hangzhou Kang Sheng Health Consulting CO., Ltd. RESULTS The mean age of hypertensive patients was 54.75 ± 12.98 years. About 6.7 million (60.30%) were males. About 46.07% of patients had comorbidities. The most common classes of antihypertensive medications used were calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). Around 78.33% of participants were on monotherapy. Diuretics + ARBs and Diuretics + CCBs + ARBs were the most commonly prescribed pattern in two-drug combination therapy and three-drug combination therapy, respectively. CONCLUSIONS CCBs and ARBs were the two most frequently prescribed for patients with hypertension. The prescription pattern of antihypertensive medications in the study largely complied with recommended Chinese hypertension guidelines.Key messagesCardiovascular disease is the most common complication of hypertension.Calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs) are the two most commonly used drugs for hypertension patients in China.The proportion of combination prescription pattern in Chinese hypertensive patients is low.
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Affiliation(s)
- Renren Yang
- Medical Affairs, Hangzhou Kang Sheng Health Consulting CO., Ltd, Hangzhou, China
| | - Jia Tang
- Medical Affairs, Hangzhou Kang Sheng Health Consulting CO., Ltd, Hangzhou, China
| | - Ming Kuang
- Medical Affairs, Hangzhou Kang Sheng Health Consulting CO., Ltd, Hangzhou, China
| | - Hongying Liu
- Medical Affairs, Hangzhou Kang Sheng Health Consulting CO., Ltd, Hangzhou, China
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Zheng D, Li X, Fu Y. Risk factors of acute cerebral infarction in patients with primary hypertension. Ir J Med Sci 2023; 192:2441-2445. [PMID: 36401085 DOI: 10.1007/s11845-022-03206-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/25/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To explore the risk factors of acute cerebral infarction (ACI) in patients with primary hypertension. METHODS Patients diagnosed with primary hypertension and ACI and confirmed by MRI, who were admitted to Honghuagang District people's Hospital, Zunyi City, from January 2020 to December 2020, were selected. Concurrent patients with primary hypertension were selected as the control group. The risk factor including sex, age, smoking, drinking, laboratory examination, and other complications was analyzed. RESULTS Three hundred patients with hypertensive ACI and 117 cases with hypertension were included. The laboratory examination comparison between the two groups showed that patients in the ACI group had higher glycosylated hemoglobin, D-dimer and FDPs then patients of the control group (P < 0.05). There was significant association between diabetes mellitus and acute cerebral infarction in patients with primary hypertension (OR = 1.452, P = 0.004). CONCLUSION Poor control of blood glucose in pre-morbid diabetes mellitus may be related to the occurrence of ACI. Diabetes mellitus is an independent risk factor in ACI patients with primary hypertension.
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Affiliation(s)
- Deliang Zheng
- Department of Laboratory, People's Hospital of Honghuagang District, 134 Linjiapo Road, Zunyi City, 563000, Guizhou Province, China.
| | - Xinmiao Li
- Department of Laboratory, People's Hospital of Honghuagang District, 134 Linjiapo Road, Zunyi City, 563000, Guizhou Province, China
| | - Yongping Fu
- Department of Laboratory, People's Hospital of Honghuagang District, 134 Linjiapo Road, Zunyi City, 563000, Guizhou Province, China
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Compliance to Multidisciplinary Lifestyle Intervention Decreases Blood Pressure in Patients with Resistant Hypertension: A Cross-Sectional Pilot Study. J Clin Med 2023; 12:jcm12020679. [PMID: 36675608 PMCID: PMC9867179 DOI: 10.3390/jcm12020679] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Hypertension is a common chronic medical condition. Treatment is not satisfactory in a significant proportion of patients with primary hypertension, despite the concurrent use of three or more medications with different mechanisms of action. Such treatment-resistant hypertension is a clinical challenge associated with poor prognosis and needs further investigation. The efficacy of lifestyle changes has not been established yet in patients with resistant hypertension, and educational efforts appear clinically irrelevant in patients who must achieve behavioral changes without supervision. A 6-month multidisciplinary pilot intervention enrolled 50 patients with established resistant hypertension. The aims were: (1) to examine whether intensive and supervised lifestyle changes contribute to decreasing blood pressure in this condition, and (2) to identify which components affect compliance and feasibility. The program provided intensive changes in nutrition, physical exercise, and control of sleep disturbances supervised by nutritionists, physiotherapists, and psychologists. Nurses and pharmacists followed up on adherence to the antihypertensive medication. The primary outcome was 24 h blood pressure control. Data in patients with full compliance (n = 30) indicate that lifestyle modifications in resistant hypertension significantly reduced 24 h both systolic and diastolic blood pressure (p < 0.01), body mass index (p < 0.01), medication burden (p = 0.04), improving physical fitness, and cardiovascular risk markers such as heart rate (p = 0.01) and augmentation index (p = 0.02). The adherence to the intervention was moderate, with an attrition rate of 12%. A modified version reducing visits and explorations will likely improve compliance and can be used to assess the long-term maintenance of these benefits in managing resistant hypertension by diverse healthcare providers.
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Stavropoulos K, Imprialos KP, Patoulias D, Katsimardou A, Doumas M. Impact of Primary Aldosteronism in Resistant Hypertension. Curr Hypertens Rep 2022; 24:285-294. [PMID: 35445928 DOI: 10.1007/s11906-022-01190-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW In this narrative review, we aim to summarize the latest data on the association between primary aldosteronism and resistant hypertension, as well as to emphasize the necessity for screening for primary aldosteronism all patients with resistant hypertension. RECENT FINDINGS Epidemiological data suggests that up to one out of five patients with resistant hypertension suffer from primary aldosteronism. Patients with primary aldosteronism have increased incidence of renal disease, diabetes mellitus, atrial fibrillation, and obstructive sleep apnea, as well as they are characterized by an extended target organ damage and increased cardiovascular morbidity and mortality. Specific treatments for primary hyperaldosteronism (adrenalectomy and mineralocorticoid receptor antagonists) have significant impact on blood pressure, can reverse target organ damage, and mitigate cardiovascular risk. All patients with resistant hypertension should be evaluated for primary aldosteronism. Patients diagnosed with the disease may further undergo lateralization with adrenal vein sampling in order to receive the optimal therapeutic option which results in significant improvements in quality of life and cardiovascular profile.
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Affiliation(s)
| | | | - Dimitrios Patoulias
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | - Alexandra Katsimardou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | - Michael Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
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Kario K, Nomura A, Harada N, Okura A, Nakagawa K, Tanigawa T, Hida E. Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial. Eur Heart J 2021; 42:4111-4122. [PMID: 34455443 PMCID: PMC8530534 DOI: 10.1093/eurheartj/ehab559] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 12/16/2022] Open
Abstract
Aims Digital therapeutics is a new approach to facilitate the non-pharmacological treatment of hypertension using software programmes such as smartphone applications and/or device algorithms. Based on promising findings from a small pilot trial, the HERB Digital Hypertension 1 (HERB-DH1) pivotal trial investigated the efficacy of digital therapeutics in patients with hypertension not receiving antihypertensive medication. Methods and results This prospective, open-label, randomized controlled study was performed at 12 sites in Japan. Patients with hypertension [office systolic blood pressure (SBP) 140 to <180 mmHg and 24 h SBP ≥130 mmHg] were randomly assigned 1:1 to the digital therapeutics group (HERB system + standard lifestyle modification) or control group (standard lifestyle modification alone). The primary efficacy endpoint was the mean change in 24 h ambulatory SBP from baseline to 12 weeks; key secondary efficacy endpoints were mean changes in office and home blood pressure (BP) from baseline to 12 weeks. All analyses were conducted in the full analysis set population. Between December 2019 and June 2020, 390 patients were randomly assigned to the digital therapeutics group (n = 199) or control (n = 191) group. Between-group differences in 24-h ambulatory, home, and office SBPs at 12 weeks were −2.4 (95% confidence interval −4.5 to −0.3), −4.3 (−6.7 to −1.9), and −3.6 (−6.2 to −1.0) mmHg, respectively. No major programme-related safety events occurred up to 24 weeks. Conclusion The HERB-DH1 pivotal study showed the superiority of digital therapeutics compared with standard lifestyle modification alone to reduce 24-h ambulatory, home, and office BPs in the absence of antihypertensive medications.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Akihiro Nomura
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.,Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.,Department of Biomedical Informatics, CureApp Institute, 4136-1 Azayakozawa, Nagakutra, Kitasaku-Gun, Karuizawa, Nagano 389-0111, Japan
| | - Noriko Harada
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Ayako Okura
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Kiyose Nakagawa
- CureApp, Inc., . Kodenma-Cho YS building 4th floor, 12-5 Nihonbashi kodenma-Cho, Chuo-ku, Tokyo 103-0001, Japan
| | - Tomoyuki Tanigawa
- CureApp, Inc., . Kodenma-Cho YS building 4th floor, 12-5 Nihonbashi kodenma-Cho, Chuo-ku, Tokyo 103-0001, Japan
| | - Eisuke Hida
- Department of Biostatistics and Data Science, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita-Shi, Osaka 565-0871, Japan
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Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker. Cardiovasc Ther 2021; 2021:5935149. [PMID: 33747123 PMCID: PMC7943268 DOI: 10.1155/2021/5935149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 01/01/2021] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction In spite of the established importance of detecting angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker- (ARB-) induced hyperkalemia, there have not been many studies on the time of its occurrence. Methods We retrospectively analyzed electronic medical records to determine the onset time and incidence rate of hyperkalemia (serum potassium > 5.5 mEq/L or 6.0 mEq/L) among hospitalized patients newly started on a 15-day ACEI or ARB therapy. Results Among 3101 hospitalized patients, hyperkalemia incidence was 0.5%–0.9% and 0.8%–2.1% in the ACEI and ARB groups, respectively. However, it was not significantly different among different ARB types. Hyperkalemia's onset was distributed throughout 15 days, without any trend. Hyperkalemia incidence was 7.3 and 35.1 times higher at 5.5 mEq/L (hazard ratio (HR) = 7.31, 95%confidence interval (CI) = 4.19–12.76, p < 0.001) and 6.0 mEq/L (HR = 35.11, 95%CI = 8.25–149.52, p < 0.001), respectively, than the baseline creatinine level. Hyperkalemia incidence in patients with chronic renal failure was 5.7 and 9.2 times higher at 5.5 mEq/L (HR = 5.72, 95%CI = 3.24–10.12, p < 0.001) and 6.0 mEq/L (HR = 9.16, 95%CI = 4.02–20.88, p < 0.001), respectively. Conclusions It is unlikely that it is necessary to monitor hyperkalemia immediately after administration of ACEI or ARB. However, when prescribed for patients with abnormal kidney function, clinicians should always consider the possibility of developing hyperkalemia.
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Wang C, Jing H, Sun Z, Yao J, Zhang X, Liu T, Wu Y. A Bibliometric Analysis of Primary Aldosteronism Research From 2000 to 2020. Front Endocrinol (Lausanne) 2021; 12:665912. [PMID: 33986730 PMCID: PMC8111213 DOI: 10.3389/fendo.2021.665912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 11/18/2022] Open
Abstract
Thousands of papers on primary aldosteronism (PA) have been published in the last two decades. This study aimed to evaluate the research hotspots and future trends in PA research using bibliometric analysis. A total of 2,365 PA research papers between 2000 and 2020 were included. The dominant position of the United States in global PA research throughout this 20-year period was evident, and it was also the country most frequently involved in international cooperation. The University of Padua was the most productive institution and a leader in research collaboration. The Journal of Clinical Endocrinology & Metabolism was the most productive journal in terms of the number of publications on PA. Further, Mulatero P, Reincke M, Beuschlein F and Wu VC all made significant contributions to PA research. Five hotspots have been identified: (1) metabolic syndrome associated with PA; (2) molecular mechanisms of PA; (3) adrenal adenoma and adrenal cortex; (4) hypertension associated with PA; and (5) clinical monitoring parameters and diagnosis in patients with PA. Our results suggest that the molecular mechanisms of PA will remain research hotspots in the future. International collaboration is also expected to widen and deepen in the field of PA research.
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Affiliation(s)
- Chengyuan Wang
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Hongwei Jing
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Zuyu Sun
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Jiaxi Yao
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Xinyu Zhang
- Department of Pulmonary Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Tao Liu
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Ying Wu, ; Tao Liu,
| | - Ying Wu
- Phase I Clinical Trails Center, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Ying Wu, ; Tao Liu,
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Jafari F, Jafari M, Moghadam AT, Emami SA, Jamialahmadi T, Mohammadpour AH, Sahebkar A. A Review of Glycyrrhiza glabra (Licorice) Effects on Metabolic Syndrome. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1328:385-400. [DOI: 10.1007/978-3-030-73234-9_25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tadic M, Cuspidi C. Obesity and resistant hypertension: Never ending story. J Clin Hypertens (Greenwich) 2019; 21:1516-1518. [PMID: 31448857 DOI: 10.1111/jch.13669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 08/03/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Marijana Tadic
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Cesare Cuspidi
- Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy
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