Novel Compounds in Targeting the α1-adrenoceptor for Antihypertensive Therapy.
Hypertension, a prevalent cardiovascular condition, increases the risk of strokes and myocardial infarctions by inducing elevated blood pressure. Its prevalence has risen, particularly in low- and middle-income nations. The incidence of hypertension in adults is higher in low- and middle-income countries compared to high-income nations. One significant class of antihypertensive drugs is α1-adrenoceptor antagonists, which inhibit α1-adrenergic receptors and promote vasodilation. Terazosin, doxazosin, tamsulosin, and alfuzosin are examples of α1-adrenoceptor antagonists that have antihypertensive properties; however, they are linked to considerable side effects, including headaches, dizziness, reproductive problems, and postural hypotension. In the last several years, a number of novel α1-adrenergic antagonists have been synthesised by modifications of various pharmacophores such as Isochroman-4-one, Quinazolines, Piperazine, and Quinazoline-triazole, etc. The present review highlights recently synthesized α1-adrenoceptor antagonists for the management of hypertension, and emphasizes their structure-activity relationship and subtype selectivity.
- Research Article
- 10.4081/jphr.2020.1846
- Jul 3, 2020
- Journal of Public Health Research
Background: Hypertension is one of the main causes of morbidity and mortality in the Indonesian population, characterized by an increasing number of sufferers each year. Curtailing saltwater fish consumption pattern is an optional effort to prevent hypertension, as most users tend to attribute little or no attention to this possibility.Design and Methods: The purpose of this study, therefore, was to analyze the correlation between saltwater fish consumption pattern and the incidence of hypertension in adults, using analytic research design with cross sectional approach.Results: The analysis showed the dominance of female respondents (63%), aged 36-45 years (60%), graduated from senior high school (33.8%), working as housewives (32.5%), monthly income above the average (63.6%), absence of hypertension history (80.5%), eat sea fish often as a side dish (59.7%), and pre hypertension (59.1%). Furthermore, data analysis showed a Pvalue of 0.000, indicating the presence of a significant relationship between the consumption pattern of sea fish and the incidence of hypertension.Conclusions: The results of this study show the high consumption of saltwater fish by most people living in Kebungson, Gresik Village. This correlates with the incidence of hypertension in indigenous adults, as the majority was classified with prehypertension levels.Significance for public healthHypertension is a serious health challenge in Indonesia, characterized by an increase in prevalence among patients. This disease features difficulty in regulating blood pressure, as well as other comorbidities and complications, which consequently increases morbidity and mortality. This study shows the correlation between saltwater fish consumption pattern and the incidence of hypertension in adults.
- Research Article
- 10.26911/jepublichealth.2022.07.01.01
- Jan 16, 2022
- Journal of Epidemiology and Public Health
Background: Hypertension is a disease that causes damage to body systems. Risk factors for hypertension are changes in socioeconomic, environmental, and unhealthy lifestyle such as smoking, lack of physical activity, high-fat and high-calorie foods, and alcohol consumption. This study aims to analyze the relationship between physical activity, sleep duration, and alcohol consumption on the incidence of hypertension in adults with a meta-analysis study. Subjects and Method: This study is a systematic review and meta-analysis with the population: adults (>18 years old). Intervention: low physical activity, short sleep duration and frequent alcohol consumption. Comparison: moderate physical activity, normal sleep duration, and no alcohol consumption. Outcome: the incidence of hypertension. The articles used were obtained from several databases: PubMed, SpringerLink, ScienceDirect, and Google Scholar. The keywords are: “physical activity” OR exercise” AND “sleep duration” AND “alcohol consumption” AND "hypertension" OR “high blood pressure”. The article used was a full-text article with a cross-sectional study design and the results were reported in aOR. Articles were analyzed using the Review Manager 5.3 application. Results: A total of 27 articles in this study came from 4 continents, namely Asia (South Korea, China, Lebanon, Thailand), Africa (Cameroon, Uganda, Ethiopia, Sudan), Europe (Poland, France, Portugal, Spain) and America (United States of America). The forest plot results showed that adults with low physical activity had 1.41 times higher risk to experience hypertension compared to people who did moderate physical activity (aOR = 1.41; 95% CI = 1.22 to 1.62; p < 0.001). Short sleep duration increased the incidence of hypertension by 1.19 times higher compared to normal sleep duration (aOR = 1.19; 95% CI = 1.06 to 1.32; p = 0.002). Frequent alcohol consumption increased the incidence of hypertension by 1.29 times higher compared to no alcohol consumption (aOR=1.29; 95% CI = 1.12 to 1.49; p=0.0006). Conclusion: Physical activity, sleep duration, and alcohol consumption increase the incidence of hypertension in the adult population. Keywords: Physical activity, sleep duration, alcohol consumption, hypertension, meta-analysis Correspondence: Niken Putri Eka Saraspuri. Vocational School, Universitas Gadjah Mada. Email: nikenputri54-@gmail.com. Mobile: 081327372766.
- Research Article
- 10.62354/therapy.v3i1.53
- Aug 19, 2024
- Therapy : Journal of Health Science
High blood pressure or hypertension is a state of increased blood pressure, both systolic and diastolic, which is more than 140/90 mmHg. Lifestyle is the most important factor that greatly affects society. An unhealthy lifestyle can cause hypertension / high blood pressure. Many risk factors that can increase the occurrence of hypertension include diet, physical activity, rest habits, smoking habits. In this study, there were 115 respondents aged 21-40 years and dominated by women who found that their blood pressure was above normal. Research Objectives : This study aims to determine the relationship between the relationship between lifestyle with the incidence of hypertension in adults in RT 03 RW 01 Dukuh Karya Village. Research Methods : The research method used is quantitative with cross-sectional analytic research. The populatin in this study is the community of RT 03 RW 01 Dukuh Karya Village totaling 142 respondents. The data collection technique was using purposive sampling. Research Results : It was found that there was a significant relationship between diet (a value = 0,008), physical activity (a value = 0,016), rest habits (a value = 0,020), smoking habit (a value = 0,041) with the incidence of hypertension in adults in RT 03 RW 01 Dukuh Karya Village. Conclusion : There is a relationship between lifestyle and the incidence of hypertension in RT 03 RW 01 Dukuh Karya Village.
- Research Article
7
- 10.3889/oamjms.2019.447
- Oct 14, 2019
- Open Access Macedonian Journal of Medical Sciences
BACKGROUND:The incidence rate of hypertension is increasing in Indonesia concerning unhealthy behaviours such as unhealthy physical activity and eating pattern which trigger obesity. In Indonesia, the prevalence of hypertension in > 18-year-old people was 34.1% in 2018.AIM:The objective of the research was to find out the relationship between physical activity and obesity with the incidence of hypertension in adults (26-45 years old) in Medan.METHODS:The research was done in Medan, using a case-control study design. The samples were 150 hypertension patients, taken by using proportional allocation: 75 of them were in the case group and the other 75 of them were in the control group. The data were gathered by conducting interviews, measurement, and questionnaires and analysed by using simple logistic regression test.RESULTS:The result of the research showed that there was significant relationship of physical activity (p = 0.000; OR = 3.6; 95% CI, 1.802-7.270) and obesity (p = 0.000; OR = 4; 95% CI, 2.030-7.900) with the incidence of hypertension in 26-45-year-old respondents.CONCLUSION:Make a habit of a healthy lifestyle in their daily life by doing physical activity regularly and good eating pattern to forestall hypertension.
- Research Article
3
- 10.4040/jkan.23067
- Feb 1, 2024
- Journal of Korean Academy of Nursing
This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.
- Research Article
2
- 10.35308/jns.v3i1.5450
- May 28, 2022
- Journal of Nutrition Science
Hypertension is one of the most non-communicable diseases in Indonesia. The prevalence of hypertension in Indonesia is 25.8% based on measurements at age ≥ 18 years. One of the factors that influence the occurrence of hypertension is sodium intake and several studies have shown that there is a relationship between hypertension and salt taste threshold. This study aimed to analyse the relationship between salt taste threshold and sodium intake with the incidence of hypertension at the age of 18-60 years in the Cimanggis District Health Center, Depok City in 2019. This study used a case control design of outpatients in the Cimanggis District Health Center, Depok City. Subjects were selected by purposive sampling technique. Data characteristics were collected using administered questionnaire. Sodium intake was measured using the SQ-FFQ, and salt taste threshold was measured using the Khobragade method, with 5 variation of sodium concentration. Sodium intake in the case group was higher than the control group, with an average sodium intake in the case group of 2,620 mg and in the control group of 2,100 mg. The taste threshold in the case group increased by 20% while in the control group as much as 12%. There was no significant relationship between salted taste threshold and the incidence of hypertension, but there was significant relationship between sodium intake and hypertension.
- Research Article
48
- 10.1161/hypertensionaha.119.13212
- Jul 15, 2019
- Hypertension
Many countries dedicated in mitigation of air pollution in the past several decades. However, little is known about how air quality improvement affects health. Therefore, we conducted current study to investigate dynamic changes in long-term exposure to ambient particulate matter (PM2.5) and incidence of hypertension in a large longitudinal cohort. We recruited 134 978 adults aged 18 years or above between 2001 and 2014. All the participants received a series of standard medical examinations, including measurements of blood pressure. The PM2.5 concentration was estimated using a satellite-based spatiotemporal model at a high resolution (1×1 km2). The change in long-term exposure to PM2.5 (ΔPM2.5) was defined as the difference between the values measured during follow-up and during the immediately preceding visit, and a negative value indicated an improvement in PM2.5 air quality. Time-varying Cox model was used to examine the associations between ΔPM2.5 and the development of hypertension. The results show that PM2.5 concentrations increased in 2002, 2003, and 2004, but began to decrease in 2005. Every 5 µg/m3 change in exposure to PM2.5 (ie, a ΔPM2.5 of 5 µg/m3) was associated with a 16% change in the incidence of hypertension (hazard ratio, 0.84; 95% CI, 0.82-0.86). Both stratified and sensitivity analyses generally yielded similar results. We found that an improvement in PM2.5 exposure is associated with a decreased incidence of hypertension. Our findings demonstrate that air pollution mitigation is an effective strategy to reduce the risk of cardiovascular disease.
- Research Article
7
- 10.1016/j.clnu.2020.01.020
- Jan 31, 2020
- Clinical Nutrition
Positive association of alcohol consumption with incidence of hypertension in adults aged 40 years and over: Use of repeated alcohol consumption measurements.
- Research Article
1
- 10.1093/gerona/glae087
- Mar 26, 2024
- The journals of gerontology. Series A, Biological sciences and medical sciences
The associations of age at orthostatic hypotension onset with incident myocardial infarction (MI), stroke, and dementia remain unknown. This study aimed to examine whether younger onset age of orthostatic hypotension was associated with higher risks of incident MI, stroke, and dementia. Data were obtained from the UK Biobank. Information on the diagnosis of orthostatic hypotension, MI, stroke, and dementia was collected at baseline (2006-2010) and follow-ups (median = 13 years). The propensity score matching method and the Cox proportional hazard models were employed. A total of 448 374 adults (mean age: 56.8 ± 8.1 years), of whom 3795 had orthostatic hypotension, were included. orthostatic hypotension patients exhibited higher risks of developing MI, stroke, and dementia than non-orthostatic hypotension participants. Importantly, among orthostatic hypotension patients, younger onset age (per 10-year decrement) was significantly associated with high risks of MI (HR = 3.15, 95% CI: 2.54-3.90, p < .001), stroke (HR = 1.72, 95% CI: 1.33-2.23, p < .001), and dementia (HR = 1.26, 95% CI: 1.02-1.57, p = .034). After propensity score matching, orthostatic hypotension patients had significantly higher risks of MI, stroke, and dementia than matched controls among all onset age groups, and the HRs gradually increased with descending onset age. Younger onset age of orthostatic hypotension was associated with higher risks of incident MI, stroke, and dementia, underscoring the necessity to pay additional attention to the cardiovascular health and neurocognitive status of individuals diagnosed with orthostatic hypotension at younger ages to attenuate subsequent risks of incident cardiovascular diseases and dementia.
- Research Article
- 10.3389/fpubh.2025.1509898
- Feb 12, 2025
- Frontiers in Public Health
PurposeChinese Visceral Adiposity Index (CVAI) has been found significantly associated with hypertension in general and type-2 diabetes adults. However, the predictive value of CVAI for the incidence of hypertension in adults with prediabetes is unclear. This study aimed to assess the predictive utility of the CVAI for the new onset of hypertension in middle-aged and older adult Chinese individuals with prediabetes.MethodsA prospective cohort study was conducted involving participants aged 45 years and above with prediabetes from the 2011–2012 cohort of the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression models were utilized to investigate the association between CVAI levels and the risk of new-onset hypertension.ResultsThe study included 2,186 participants, among whom 444 (20.31%) developed hypertension. Significantly higher incidence rates of hypertension were observed in individuals belonging to the highest quartile group (Q4) compared to those in the lowest quartile group (Q1) of CVAI (29.41% vs. 14.69%, p < 0.001). Multivariate logistic regression analysis indicated that participants in Q4 had a 1.91-fold greater risk of hypertension development compared to those in Q1 (odds ratio (OR): 1.91, 95% confidence interval (CI): 1.49–2.45, p < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) demonstrated that CVAI exhibited superior performance in discriminating individuals at heightened risk of hypertension compared to other obesity-related indices (p < 0.001). A subgroup analysis revealed that age may modulate the relationship between CVAI and new-onset hypertension, with a more pronounced interaction observed among participants below 60 years of age (P for interaction: 0.026).ConclusionElevated CVAI levels were significantly associated with an increased risk of developing hypertension. CVAI proves to be a reliable and effective tool for risk stratification in middle-aged and older adult Chinese individuals with prediabetes, underscoring its substantial implications for primary prevention of hypertension and public health strategies.
- Research Article
- 10.1039/d4fo03110e
- Jan 1, 2024
- Food & function
The incidence of hypertension (HTN) and consumption of ultra-processed foods are increasing worldwide. However, only a limited amount of research has assessed the causality between ultra-processed foods and the risk of HTN. Therefore, the present study aimed to determine the association between ultra-processed foods and the risk of HTN in a prospective cohort study. In the present study, we included 2399 individuals, aged approximately 19 years, who participated in the Tehran Lipid and Glucose Study (TLGS). The participants had complete dietary data and were free from HTN at baseline. We used the Cox proportional hazards model to determine the association between ultra-processed food intake and the risk of HTN occurrence, reporting the results as the hazard ratio (HR) and 95% confidence interval (95% CI). The mean age of participants was 37.6 years, and we followed them up for an average of 9.21 years. Our results indicated that participants in the highest tertile of ultra-processed foods had a 48% higher risk of HTN development (HR: 1.48; 95% CI: 1.23, 1.79) than those in the lowest tertile. We found a significant association between age and ultra-processed food intake in relation to the risk of HTN. The HR for developing HTN in participants aged <47 years was 1.99 (95% CI: 1.53, 2.58) and in participants aged ≥47 years was 1.26 (95% CI: 0.95, 1.68). Among the ultra-processed food components, consumption of industrial fat products had a positive correlation with the risk of HTN (HR: 1.04; 95% CI: 1.02 to 1.06). Our results suggest that consuming ultra-processed foods is associated with an increased incidence of HTN in adults. This association varied by age and was significant for adults younger than 47 years.
- Research Article
64
- 10.1503/cmaj.191012
- Mar 22, 2020
- CMAJ : Canadian Medical Association Journal
BACKGROUND:Only a few population-based studies have examined the association between glucocorticoids and hypertension, with inconsistent results. We aimed to investigate the effect of oral glucocorticoids on incidence of hypertension in adults with chronic inflammatory diseases.METHODS:We analyzed electronic health records from 389 practices in England during 1998–2017 of adults diagnosed with any of 6 chronic inflammatory diseases but with no previous diagnosis of hypertension. We used glucocorticoid prescription data to construct time-variant daily and cumulative variables of prednisolone-equivalent dose (cumulated from 1 year before the start of follow-up) and estimated incidence rates and adjusted hazard ratios (HRs) for hypertension using Cox regression analysis.RESULTS:Among 71 642 patients in the cohort, 24 896 (34.8%) developed hypertension during a median follow-up of 6.6 years. The incidence rate of hypertension was 46.7 (95% confidence interval [CI] 46.0–47.3) per 1000 person-years. Incidence rates increased with higher cumulative glucocorticoid prednisolone-equivalent dose, from 44.4 per 1000 person-years in periods of nonuse to 45.3 per 1000 person-years for periods with between > 0.0 and 959.9 mg (HR 1.14, 95% CI 1.09–1.19), to 49.3 per 1000 person-years for periods with 960–3054.9 mg (HR 1.20, 95% CI 1.14–1.27), and to 55.6 per 1000 person-years for periods with ≥ 3055 mg (HR 1.30, 95% CI 1.25–1.35). Cumulative effects were seen for the 6 diseases studied, but dose–response effects were not found for daily dose.INTERPRETATION:Cumulative dose of oral glucocorticoids was associated with increased incidence of hypertension, suggesting that blood pressure should be monitored closely in patients routinely treated with these drugs. Given that glucocorticoids are widely prescribed, the associated health burden could be high. Trial registration: ClinicalTrials. gov, no. NCT03760562.
- Research Article
30
- 10.1161/circulationaha.109.921072
- May 10, 2010
- Circulation
Current guideline statements for primary and secondary prevention of cardiovascular disease (CVD) rely on estimates of absolute risk of coronary events. For example, the American Heart Association guidelines on primary prevention state that persons with ≥10% risk over 10 years of myocardial infarction (MI) or coronary death should be considered for antiplatelet therapy with aspirin.1 Similarly, the National Cholesterol Education Program Adult Treatment Panel III (ATP III) guidelines2 state that target low-density lipoprotein level should be based on projected absolute risk of future coronary events rather than on presence or absence of specific risk factors. These guidelines state that patients at high risk of MI and coronary death, defined as an absolute 10-year risk of ≥20%, should have a target low-density lipoprotein level <100 mg/dL and should receive statin therapy if needed to achieve this goal. Stroke, however, is not included as one of the outcomes contributing to these absolute risk levels. Included in the group of patients with elevated risk, moreover, are those who already have ischemic heart disease, as well as patients deemed to be “coronary heart disease (CHD) risk equivalents,” indicating those at the same elevated risk as patients with ischemic heart disease. CHD risk equivalents include patients with diabetes mellitus, those with multiple risk factors that put them at elevated risk based on calculation of their Framingham Score, and patients with “other forms of symptomatic atherosclerotic disease.” The latter group is further defined to include those with peripheral arterial disease (PAD), abdominal aortic aneurysm (AAA), and carotid artery disease. The category of “risk equivalents” in the ATP III guidelines, however, does not include the vast majority (≈80%3) of ischemic stroke patients without carotid artery disease as cause of their stroke. Ischemic stroke is therefore notably excluded from the list of outcomes contributing to …
- Research Article
22
- 10.1097/00004872-199917100-00003
- Oct 1, 1999
- Journal of Hypertension
To study the association between blood pressure and risk of myocardial infarction in elderly subjects. Prospective cohort study. The Rotterdam Study, a Dutch population-based study. 6004 men and women aged > or = 55 years. Fatal or non-fatal myocardial infarction (n = 190) during a 4-year follow-up. After excluding participants using blood pressure-lowering medication and participants with a history of myocardial infarction, increasing levels of systolic blood pressure (SBP) were associated with increasing risk of first myocardial infarction (P for trend < 0.0001). The relative risk (RR) for an SBP of 160 mmHg or higher was 5.7 (95% confidence interval (CI) 1.9-17.1) compared with an SBP below 120 mmHg. Increasing diastolic blood pressure (DBP) was also associated with increasing risk of first myocardial infarction, with the RR reaching 2.5 (95% CI 1.4-4.5) in subjects with values of 80-90 mmHg compared with values below 70 mmHg (P for trend < 0.05). Analyses in subjects aged 70 years and over showed that the positive associations between SBP and DBP and risk of first myocardial infarction remained at older age. These findings in a relatively healthy cohort of elderly subjects do not provide evidence for a J- or U-shaped relation between SBP and DBP and risk of first myocardial infarction. They suggest that the risk of first myocardial infarction increases with increasing level of systolic and diastolic blood pressure and that this relationship persists into older age.
- Research Article
97
- 10.1111/j.1365-2796.2004.01313.x
- Mar 22, 2004
- Journal of Internal Medicine
We investigated the prognostic significance of orthostatic hypotension on the risk of myocardial infarction (MI) amongst the elderly. Prospective population-based study. Home-dwelling population. Orthostatic testing was performed between 8 a.m. and 2 p.m., irrespective of having had meals, on 792 persons, representing 82% of all home-dwelling persons aged > or =70 years living in five municipalities around the city of Oulu. Occurrence of cases of MI were recorded during mean 3.58 (SD 1.09) years follow-up period, from national mortality statistics and local hospital discharge registers. Ninety cases of MI, of which 40 were fatal after initial hospitalization, occurred during the follow-up period. Orthostatic diastolic blood pressure (BP) drop 1 min after standing up was associated with subsequent MI, but systolic BP reactions had no predictive value. According to the Cox regression model, the strongest predictor of the occurrence of subsequent MI was found in regard to > or =8 mmHg drop in diastolic BP 1 min after standing up; adjusted for history of MI, diabetes mellitus, chest pain, use of calcium antagonist, beta-blocker, nitrate and diuretic medication, hazard ratio of MI being 2.00 (1.11-3.59). Orthostatic testing offers a novel means to assess the risk of MI amongst elderly persons. Diastolic BP drop immediately after standing up identifies elderly subjects at a high risk of subsequent MI.
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