Drugs In Hypertensive Patients Research Articles

Single nucleotide polymorphism (SNP) rs4291 of the angiotensin-converting enzyme (ACE) gene is associated with the response to losartan treatment in hypertensive patients.

Arterial hypertension is characterized by systolic pressure ≥ 140 mmHg and/or diastolic pressure ≥ 90 mmHg and its treatment consists of the use of antihypertensive drugs, as losartan and hydrochlorothiazide. Blood pressure is regulated by angiotensin-converting enzyme (ACE) and polymorphisms in the ACE gene are associated to a greater predisposition to hypertension and response to treatment. The aim of this study was to evaluate the association of genetic polymorphisms of ACE rs4363, rs4291 and rs4335 and the response to antihypertensive drugs in hypertensive patients from Ouro Preto/MG, Brazil. A case-control study was carried out with 87 hypertensive patients being treated with losartan and 75 with hydrochlorothiazide, who answered a questionnaire and had blood samples collected. Biochemical analyzes were performed on serum using UV/Vis spectrophotometry and identification of ACE variants rs4363, rs4291 and rs4335 was performed by real-time PCR using the TaqMan® system. Univariate logistic regression test was performed to compare categorical data in STATA 13.0 software. The results showed that there was an influence of ACE polymorphisms on the response to losartan, demonstrating that AT or TT genotypes of rs4291 were more frequent in the group of controlled AH (54.9%), indicating that these individuals are 2.8 times more likely to of being controlled AH (95% CI 1.12-6.80, p. =0.026) compared to those with AA genotype. In contrast, no influence of ACE polymorphisms on the response to hydrochlorothiazide was observed. In conclusion, the presence of the T allele of the rs4291 variant was associated to controled blood pressure when losartan was used as an antihypertensive agent. These results show the importance of pharmacogenetic studies to detect genetic characteristics, enabling therapeutic individuality and reducing costs for the healthcare system.

Correlation of Knowledge and Family Support with Treatment Compliance of Tuberculosis Sufferers

Introduction: The Hypertension is a cardiovascular disease characterized by increased blood pressure. Pharmacological and non-pharmacological therapies are one of the factors that can control hypertension. Pharmacological therapy involves the use of drugs which is the basis of a person's compliance with treatment. Adherence in taking medication also has factors that can influence such as knowledge, family support, access to health services. Knowing the relationship between knowledge and family support with adherence to taking anti-hypertensive drugs in hypertensive patients at the Matraman District Health Center. Methods: This study is a quantitative study with an analytical descriptive design and uses a cross-sectional approach. The population in this study were all patients aged 40-73 years who sought treatment at the PTM Poly of the Matraman District Health Center. The sample taken was 96 respondents using purposive sampling technique. Data collection using a questionnaire and then analyzed using the Chi square test. Results: The results of research conducted on 96 respondents obtained on the characteristics of respondents most of the respondents were 52-73 years old, female gender, and secondary education level. The results of the chi square test showed that there was a relationship between knowledge and adherence to taking anti-hypertensive drugs (p-value 0.03) and family support with adherence to taking anti-hypertensive drugs (p-value 0.01). Conclusions: The There is a significant relationship between knowledge and family support with adherence to taking anti-hypertensive drugs in patients with hypertension at the Matraman District Health Center.

Profile of Antihypertensive Drugs in Hypertensive Patients with Chronic Kidney Disease

Profile of Antihypertensive Drugs in Hypertensive Patients with Chronic Kidney Disease

Study of the Cost Effectiveness of Therapy in Hypertention Patients in Hospital

Hypertension is where the blood pressure is > 140 mmHg and > 90 mmHg. Combination therapy is needed if a single antihypertensive has not been able to control the desired blood pressure target while the cost of treatment is increasing from time to time. The purpose of this study was to determine the cost-effective combination therapy for antihypertensive drugs in hypertensive patients in an inpatient setting. This study is a descriptive study with a pharmacoeconomic analysis approach using the Cost Effectiveness Analysis (CEA) method which was carried out retrospectively. Data were collected using the Total Sampling technique with 93 patients which were then analyzed to determine the cost-effective therapy based on ACER and ICER. The results showed that hypertension was mostly experienced by patients aged 50-60 years, male sex was more than female. HT stage 2 is often experienced by patients. Type II DM is the most common comorbidity. The lowest ACER value is Rp. 65.195.77. The lowest ICER value is Rp. 7.047.2551 when compared with standard therapy, namely CCB + ACEI. The combinations used in the inpatient unit include two combinations of 42 patients (45.16%) three combinations of 37 patients (39.78%), four combinations 6 (6.45%) five combinations of 8 patients (8.6%). The lowest average direct medical cost is the combination of ACEI antihypertensive + Diuretic + -Blocker Rp. 2.765.262. The cost effective therapy based on ACER and ICER values is a combination of Diuretics + CCB + ACEI + Blockers with an ACER value of Rp. 65,195.77 and also dominant.            Â

The Vanilloid (Capsaicin) Receptor TRPV1 in Blood Pressure Regulation: A Novel Therapeutic Target in Hypertension?

Today's sedentary lifestyle with excess food and little exercise increases the number of people with hypertension, a major risk factor for stroke. New knowledge of treatments in this field is of utmost importance. In animal experiments, the activation by capsaicin of TRPV1-expressing sensory afferents evokes a drop in blood pressure by triggering the Bezold-Jarisch reflex. In hypertensive rats, capsaicin reduces blood pressure. Conversely, genetic ablation of the TRPV1 receptor results in elevated nocturnal (but not diurnal) blood pressure. These observations imply a therapeutic potential for TRPV1 activation in hypertensive patients. Indeed, in a major epidemiological study involving 9273 volunteers, dietary capsaicin was found to lower the risk for hypertension. New research indicates that the mechanism of action of capsaicin on blood pressure regulation is far more complex than previously thought. In addition to the well-recognized role of capsaicin-sensitive afferents in blood pressure regulation, TRPV1 seems to be expressed both in endothelial cells and vascular smooth muscle. This review aims to evaluate the therapeutic potential of TRPV1-targeting drugs in hypertensive patients.

EVALUASI RASIONALITAS PENGGUNAAN OBAT ANTIHIPERTENSI TERHADAP PASIEN HIPERTENSI DI RSUD KARAWANG

Hypertension is a disease characterized by an increase in systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg on two measurements, with an interval of five minutes in a state of sufficient rest/calm. This study aims to determine the relationship between hypertension and the patient's gender and age on the incidence of hypertension and the rationality of using antihypertensive drugs in hypertensive patients at the Karawang Hospital Outpatient Installation in 2019. This research is an observational study with a cross-sectional descriptive analysis design. Data collection was carried out retrospectively using secondary data from medical records taken from Karawang Hospital in 2019 at Karawang Hospital. Next, calculate the use of antihypertensive drugs and evaluate the rationale for using antihypertensive drugs in hypertensive patients based on the right patient, right indication, right drug, and the right dose. Data were obtained for 60 patients compared to Dipiro and JNC VIII guidelines. The results showed that the most widely used antihypertensive drugs were amlodipine 15% and a combination of 2 drugs (amlodipine and candesartan) 85%. Evaluation of the rationality of using hypertension drugs in hypertensive patients as follows: right drug 91.7%, right indication 100%, right patient 100%, right dose 91.7% and there is no relationship between gender and age of the patient to the incidence of hypertension in Karawang Hospital.

Assessment of Oxidative Stress Markers in Hypertensive Patients under the Use of Renin-Angiotensin-Aldosterone Blockers.

As in other fields, chronotherapy applied to arterial hypertension (AHT) may have implications on oxidative stress. We compared the levels of some redox markers between hypertensive patients with morning and bedtime use of renin-angiotensin-aldosterone system (RAAS) blockers. This was an observational study that included patients older than 18 years with a diagnosis of essential AHT. Blood pressure (BP) figures were measured using twenty-four-hour ambulatory BP monitoring (24-h ABPM). Lipid peroxidation and protein oxidation were assessed using the thiobarbituric acid reactive substances (TBARS) and reduced thiols assays. We recruited 70 patients with a median age of 54 years, of whom 38 (54%) were women. In hypertensive patients with bedtime use of RAAS blockers, reduced thiol levels showed a positive correlation with nocturnal diastolic BP decrease. TBARS levels were associated with bedtime use of RAAS blockers in dipper and non-dipper hypertensive patients. In non-dipper patients, bedtime use of RAAS blockers was also associated with a decrease in nocturnal diastolic BP. Chronotherapy applied to bedtime use of some BP-lowering drugs in hypertensive patients may be linked to a better redox profile.

Analysis of Hemodynamic Changes after Administration of Mepivacaine HCL 3% with Prilocaine 3% Solution + Felypressin

Introduction: With regards to the usage of local anesthetic drugs in hypertensive patients, this study is designed for comparing the effects of mepivacaine 3% and prilocaine 3% + felypressin in hemodynamic changes after inferior alveolar nerve block to help dental practitioner select anesthetic solutions for hypertensive patients considering their hemodynamic effects in order to provide patient safety.Materials & Methods: In this double blind clinical trial 32 patients were referred to oral and maxillofacial surgery department of Shiraz dentistry school in 2021 were divided into 2 groups with 16 patients in each group. In first group, inferior alveolar nerve block was accomplished by mepivacaine 3% and in the other group, prilocaine 3% and felypressin. Then systolic and diastolic blood pressure, heart rate and oxygen saturation were measured at 4 different time points consisting of before injection, immediately after injection, 10 minutes after injection and 30 minutes after tooth extraction. The data were analyzed by ANOVA and T-test (p value < 0.05).Results: There were no statistically significant differences in systolic blood pressure, diastolic blood pressure, heart rate and oxygen saturation changes between mepivacaine and prilocaine groups during all four sampling time points. But in each group, individually there were significant differences in systolic and diastolic blood pressure, heart rate and oxygen saturation in different times. In addition mepivacaine causes a significant increase in systolic blood pressure immediately after injection but in contrast prilocaine + felypressin didn’t do so.Conclusion: We recommend prilocaine + felypressin in comparison with mepivacaine for local anesthesia in hypertensive patients.

Relationship of Knowledge Level on Medicine Use in Hypertension Patients in the Puskesmas Sungai Tabuk Area

Hypertension or high blood pressure is a condition in which a person experiences an increase in blood pressure if the systolic blood pressure is more than or equal to 140 mmHg and the diastolic pressure is more than or equal to 90 mmHg. In 2018 the Province of South Kalimantan was ranked first at 44.1% at the age of >18 years, which means that there was a significant increase in the number of people with hypertension in the Province of South Kalimantan. The purpose of this study was to determine the relationship between the level of knowledge and the use of drugs in hypertensive patients in the Sungai Tabuk 3 Community Health Center. The method used was a csoss-sectional or cross-sectional design. The sample is the people who live in the Sungai Tabuk Health Center area with a sample of 60 people with the Consecutive Sampling sampling technique. Using a questionnaire as a measuring tool. Data were analyzed by Spearman rho test with 95% confidence level. The result of the level of knowledge of respondents in the good category is 41 people (68.33%) with rational use of antihypertensive drugs as many as 33 people (50.00%). The results of the Spearman rho test on the relationship between the level of knowledge and the use of antihypertensive drugs obtained a significance value of 0.000 (<0.05), the correlation coefficient was 0.532 with a positive correlation direction. There is a relationship between the level of knowledge and the use of antihypertensive drugs in the community living in the Sungai Tabuk 3 Community Health Center.

Patterns of Use of Antihypertensive Drugs in Hypertensive Patients in the Outpatient Unit of the Kowel Health Center, Pamekasan Regency

Penggunaan obat yang tidak tepat akan memberikan dampak negatif yang besar dan merugikan bagi unit atau instansi pelayanan kesehatan pasien maupun masyarakat. Oleh karena itu diperlukan pemilihan dan penggunaan obat secara tepat, sehingga intervensi obat dapat mencapai sasarannya (penyembuhan penderita) dengan efek samping obat seminimal mungkin. Penelitian Ini bertujuan Untuk mengetahui pola penggunaan obat anti hipertensi pada pasien dengan hipertensi di unit rawat jalan Puskesmas Kowel Kabupaten Pamekasan. Sampel diambil dari data rekam medik pasien hipertensi dari periode Januari-Mei 2022 dengan total sampel 75 pasien. Variabel penelitian antara lain, jenis obat, dosis, frekuensi, lama pemakaian,efek samping, interaksi obat, dan rutinitas kontrol pasien. Obat dosis tunggal paling banyak digunakan adalah golongan antagonis kalsium yaitu amlodipin sebanyak 46 pasien (61,33%). Dan Dosis kombinasi paling banyak terdapat pada Antagonis kalsium + Ace Inhibitor yaitu amlodipin dan captopril sebanyak 3 pasien (4%).
 

PDE5 inhibitor prescribing in hypertension

ABSTRACT Purpose We will analyze the PDE5 inhibitor prescription at Kobe-Sannomiya EAST Ekimae Clinic(predecessor). Methods To analyze the type of antihypertensive drug in hypertensive patients receiving pharmacotherapy among male re-examination patients who prescribed PDE5 inhibitors more than 6 months after the initial consultation. Results The target 445 age groups were 5 in their 30s, 35 in their 40s, 144 in their 50s, 177 in their 60s, 79 in their 70s, and 5 in their 80s. The elapsed time from initial consultation to re-examination was 96 for 6 months or more and less than 1 year, 214 for 1 year or more and less than 2 years, and 135 for 2 years or more. The antihypertensive drugs were Ca antagonist 133 (24 other drugs other than ARB), angiotensin Ⅱ receptor antagonist (ARB) 112 (19 other drugs other than Ca antagonist), Ca antagonist and there were 186 patients with ARB (43 with other drugs) and 14 with other drugs. The breakdown of other concomitant drugs and other drugs was β-blockers, α-blockers, αβ-blockers, ACE inhibitors, and diuretics. Very few patients voluntarily complained of ED symptoms associated with taking antihypertensive drugs, and various types of antihypertensive drugs were taken. Discussion Even if a PDE5 inhibitor is more effective, it is necessary to consult with your GP about taking antihypertensive drugs. Disclosure Work supported by industry: no.

Identifikasi Penggolongan Obat Berdasarkan Peresepan Obat Hipertensi di Instalasi Rawat Jalan Rumah Sakit

The cause of hypertension is not clearly known, but risk factors that cause hypertension are found, namely the elderly or the elderly, in the form of a family history of hypertension, excess body weight and excessive salt levels. Hypertension is the third leading cause of death in Indonesia with a CFR (Case Fetality Rate) of 4.81%. Causes of the elderly suffer from hypertension due to reduced work functions in the human body. This study aims to determine the characteristics (gender and age) and classes of drugs prescribed to outpatient hypertension patients at RSUD Dr. Achmad Diponegoro Putussibau. This research is an observational study with a retrospective descriptive research design. From the results of the study, it was found that there were 55 hypertension patients with medical record data, based on gender the number of women was 62% and based on the age of 60-74 years by 80%. The class of drugs that are widely used are ACE-Inhibitors by 31%. Comorbidities that often accompany hypertension patients are diabetes mellitus by 40%. The dosage form is tablets by 90%, with the route of using the drug orally by 100%. The conclusion is that the use of drugs in hypertensive patients in the outpatient installation of RSUD Dr. Achmad Diponegoro Putussibau is mostly women. The majority occur at the age of 60-74 years, the most widely used drug class is the ACE-Inhibitor group with tablet dosage form and the oral route of use is the most widely used.

The role of tadalafil in treated hypertensive patients with erectile dysfunction.

In this issue, Kloner and colleagues showed in a pooled safety analysis that tadalafil—a phosphodiesterase type 5 (PDE-5) inhibitor—is safe in treated hypertensive patients and is not associated with increased hypotension-related treatment adverse events and major cardiovascular (CV) events.1 The safety data were extracted from 72 Phase II–IV clinical studies of tadalafil used for erectile dysfunction (ED) or benign prostate hypertrophy. PDE-5 inhibitors are vasodilating drugs that work by blocking the degradation of cyclic GMP by PDE-5 in the smooth muscle cells lining the blood vessels supplying various tissues. The increase of the intracellular cyclic GMP prolongs its duration of action resulting in increase in nitric oxide bioavailability, smooth muscle relaxation, vasodilation and increased blood flow in the corpora cavernosa, and penile erection. The main PDE-5 inhibitors are sildenafil, vardenafil, avanafil, and tadalafil. They differ in their pharmacodynamic and pharmacokinetic properties allowing targeting the treatment to the patients' needs. Avanafil has the fastest onset of action and tadalafil has the longest duration of action (half-life of 17.5 h and duration of action up to 36 h).2 ED impairs the quality of life of affected individuals and may be a prognostic marker for the development of CV disease.3 The prevalence of ED in the general population is around 15–20% and it is significantly higher in patients with hypertension,2, 4 probably due to vascular changes. Hypertension is a major modifiable risk factor for CV disease and lowering blood pressure is beneficial. Lowering blood pressure may cause or aggravate ED and it is not clear whether it is a side effect of the antihypertensive treatment or a result of the blood pressure decrease. The development of ED is one of the major reasons to withdraw antihypertensive treatment leading to inadequate blood pressure control. PDE-5 inhibitors improve ED and improve adherence to antihypertensive therapy, improve blood pressure control, and thereby may reduce CV risk in hypertensive patients with ED. The effect of PDE-5 inhibitors is not limited to the corpora cavernosa and they also vasodilate other vascular beds thereby reducing blood pressure. There was a concern that blood pressure decrease may cause CV side effects particularly in patients with CV risk factors. Kloner and colleagues in this issue showed that in subjects not receiving antihypertensive medications the incidence of hypotension related treatment emergent adverse events was low, but it was significantly higher in the tadalafil group than in the placebo group.1 Most subjects (>90%) not receiving antihypertensive medications were normotensives, and in this group, lowering blood pressure by tadalafil may increase the incidence of hypotension-related events. However, in hypertensive patients on antihypertensive medications tadalafil does not increase the hypotension related events. The co-administration of tadalafil with doxazosin, a blood pressure lowering alpha blocker is associated with a remarkable blood pressure decrease that maybe deleterious.5 However, with other antihypertensive agents tadalafil is not associated with hypotensive related side effects. The co-administration of PDE-5 inhibitors with various antihypertensive drugs, except alpha blockers, is safe. This was observed even in those who used several antihypertensive agents.1 It has been shown that all PDE-5 inhibitors are safe in treated hypertensive patients.2 The hypotensive effect of PDE-5 inhibitors should be exploit to treat resistant hypertension, particularly in those with ED. Since tadalafil has the longest duration of action it will probably be the best PDE-5 inhibitor to use for lowering blood pressure. Low dose tadalafil (5 mg daily) can improve blood pressure control and erectile function. The fact that PDE-5 inhibitors can lower blood pressure and improve erectile function suggests that lowering blood pressure by itself does not cause ED and it is probably related to the antihypertensive medications. The safety profile of tadalafil presented by Kloner in this issue may justify wider use of the drug in hypertensive patients. Wide use of tadalafil in hypertensive patients may improve erectile function and blood pressure control leading to a decrease in CV events. Further long term studies should be done to prove this concept. The author has no competing interests.

Therapeutic Effects of a Selective Mineralocorticoid Receptor Blocker as an Additional Combination Antihypertensive Drug in Hypertensive Patients

Therapeutic Effects of a Selective Mineralocorticoid Receptor Blocker as an Additional Combination Antihypertensive Drug in Hypertensive Patients

Prescribing Pattern of Antihypertensive Drugs in Hypertensive Patients with Non-Insulin Dependent Diabetes Mellitus at Tertiary Care Hospitals in Karachi Pakistan

Introduction: Hypertension (HTN) is one of the most serious public health issues in the world, affecting around 1.4 billion people worldwide. HTN is becoming highly prevalent in Pakistan, about more than 33% of people over the age of 40 years suffering from the HTN. The illness burden is continuously growing due to the incorrect medicine prescriptions, a lack of education, and a lack of patient compliance. The existence of comorbidities such as Diabetes Mellitus (DM) should be properly considered while choosing an Antihypertensive medication. Similarly, the prescriptions of Oral Hypoglycemic agent’s appropriate consideration are essential. Oral hypoglycemic medications are divided into several categories. Physicians face a challenge in rationally selecting a regimen from a variety of classes, and the situation becomes more complicated when the patients have additional non-communicable illnesses, such as HTN. The combination therapy of ailments not only effects the patient`s economic status but also effects the quality of life.
 Objective: To study the prescribing pattern of Antihypertensive drugs in Hypertensive patients with Type 2 Diabetes Mellitus at Tertiary care hospitals in Karachi, Pakistan.
 Methods: A cross sectional study was undertaken for six months in medicine outpatient department at tertiary care hospitals of Karachi. The study population was observed for the prescribed pattern of Antihypertensive medicines by assessing the 300 prescriptions of Hypertensive patients with Type 2 Diabetes Mellitus. Statistical analysis was performed using SPSS version 20. Data was presented as frequencies and percentages.
 Results: The result revealed that the most commonly prescribed single antihypertensive drug was Enalapril 66 (22%) followed by Amlodipine 63(21%), Ramipril 57(19%), Diltiazem 33(11%), Lisinopril 21(7%) losartan k 6(2%), Nebivolol 6(2%), Bisoprolol 3(1%). Dual therapy included Ramipril and Nebivolol 1(0.33%) and Amlodipine+Valsartan 35 (11.67%), Amlodipine+Valsartan+HCTZ 9 (3%) were the antihypertensive drugs prescribed as fixed dose combinations.
 Conclusion: The present study shows Enalapril belonging to Angiotensin Converting Enzyme Inhibitor (ACEI) class was frequently used as single Antihypertensive agent and Amlodipine+Valsartan belonging Calcium Channel Blockers (CCBs) and Angiotensin Receptor Blockers (ARBs) was the most frequently prescribed fixed dose combination while managing Hypertension of Hypertensive patients with Type 2 Diabetes Mellitus.

Effect of Home Based Yoga on Blood Pressure and Quality of Life in Patients with Hypertension

Background and Aim: Hypertension is one of the major growing global problems. Management of hypertension by medicine, diet and exercise is not enough and alternative therapy is need of time. Yoga is one such substitute healthcare practice assumed to improve blood pressure control and quality of life in hypertensive. A prospective intervention was designed to check the effect of home based yoga exercise on blood pressure and quality of life in hypertensives. Methods: A total 74 hypertensive participants were recruited for the present study after following inclusion and exclusion criteria. Participants were divided into two groups, study group (n=39) who have done home based yoga and control group (n=35) who have not done home based yoga. Detailed methodology of home based yoga; their advantage and disadvantage were explained to the study group very well. Study group have done their home based yoga for three months and control group did not have done the home based yoga. Cardiovascular parameters like systolic blood pressure, diastolic blood pressure and pulse rate were recorded after following all standard precautions at the time of initiation of study and at end of every month till completion of study. Participants were also assessed for their quality of life, health and other areas of life by World Health Organization Quality of Life questionnaire at the time of beginning of the study and at every month till completion of study. Results: Significant decrease in systolic blood pressure from 130.60 ± 4.06 to 124.20 ± 0.60 mm of Hg and diastolic blood pressure from 85.62 ± 5.55 to 79.21 ± 0.73 mm of Hg were seen in study group. In control group, blood pressure reduction was not seen. Self rated score of quality of life was improved in study group as compared to control group. Conclusion: A short term home-based yoga program in hypertensive patients have shown to reduce blood pressure as well as positive effect on self-rated quality of life compared to controls. A simple 12-weeks duration home based yoga exercise program may be useful as supplementary therapy in addition to antihypertensive drugs in hypertensive patients.

O papel dos inibidores da enzima conversora de angiotensina e dos antagonistas dos receptores de angiotensina em pacientes com Covid-19: uma revisão narrativa

O objetivo deste trabalho é reunir e discutir os principais achados científicos, opiniões de especialistas e considerações de comunidades médicas a respeito da continuação do tratamento de pacientes hipertensos diagnosticados com Covid-19 em uso de anti-hipertensivos. Trata-se de uma revisão narrativa de literatura, restringida a publicações até abril de 2020, utilizando as bases de dados Medline e Embase e consulta a quatro sociedades científicas de Cardiologia. Um total de 93 publicações foram encontradas nas bases de dados consultadas, e, destas, nove publicações foram elegíveis para análise, sendo que seis publicações se mostraram favoráveis à continuação do tratamento com inibidores da enzima conversora de angiotensina e antagonistas dos receptores de angiotensina, o que foi ao encontro das recomendações das sociedades de Cardiologia; outras três publicações sugeriram que essas classes de anti-hipertensivos podem aumentar a gravidade da infecção. A continuação do tratamento com anti-hipertensivos durante a pandemia de coronavírus ou após o diagnóstico da infecção apresenta um paradoxo entre o potencial aumento da patogenicidade viral e a proteção pulmonar conferida pelo equilíbrio do sistema renina-angiotensina.

EVALUASI RASIONALITAS PENGGUNAAN DAN PEMBERIAN OBAT PADA PASIEN HIPERTENSI GERIATRI DI PUSKESMAS TAJINAN PERIODE JANUARI – DESEMBER 2019

Increasing the number of elderly causes an increase in health problems one of which is associated with hypertension which can cause complications and death. The purpose of this study was to determine the description and accuracy of the use of antihypertensive drugs in geriatric patients who were diagnosed with hypertension at the Tajinan Primary Health in Malang in the period January-December 2019. This study was an observational or non-experimental study conducted using retrospective medical record data. The measuring instrument used was the data collection sheet from the medical record, the Consensus for Hypertension Management 2019 to see the accuracy of indications, patient accuracy, drug accuracy, and dose accuracy. Data analysis using Correlation Test. The results of the correlation analysis showed that the resulting Standardize estimates were 0.002 (p <0.05) which showed that there was a significant relationship between sexes with the occurrence of hypertension. The results of the correlation analysis showed that the resulting Standardize estimates were 0.001 (p <0.05) which means that there was a significant relationship between the accuracy of the types of antihypertensive drugs used in hypertensive patients. The conclusion is that the rationality evaluation of the use and administration of drugs in hypertensive patients at the Tajinan Primary Health in Malang based on the 2019 Hypertension Management Consensus guidelines shows the accuracy both in terms of indication, drug, patient and dose.

Sarcopenia and COVID-19: A Manifold Insight on Hypertension and the Renin Angiotensin System.

Sarcopenia and COVID-19: A Manifold Insight on Hypertension and the Renin Angiotensin System.

Relationship between 25(OH) vitamin D and the number of antihypertensive drugs in hypertensive patients in the area of Blida (Algeria)

The purpose of the study was to evaluate the relationship between 25(OH) vitamin D and the number of antihypertensive drugs (AHTs) used in hypertensive patients. A total of 1145 patients were enrolled in the study between January 2017 and June 2018 in specialized consultation at the department of internal medicine at the Blida university hospital (65.8% female, 34.2% male, age: 52 ± 13 years old). The initial serum 25 (OH) vitamin D level was determined by the enzyme immunoassay for all patients. Antihypertensive therapy was supplemented with 200000 IU/month cholecalciferol for all the patients. A follow-up visit was performed 12 months later. In total, 22.4% of patients received 1 antihypertensive drug, 47.7% of patients 2 drugs, 19.7% of patients 3 drugs, 8.8% of patients 4 drugs, and 1.4% were treated with 5 antihypertensive drugs. The mean number of antihypertensive drugs was 2.5. Glomerular filtration measured by CKD-EPI was 49.3 ± 7.2 ml/min. The mean level of baseline plasma vitamin D was 10.6 ± 5.4 ng/ml. One year later, the mean plasma level of vitamin D increased to 28.3 ± 10.8. Sixty seven percent of the patients were still under vitamin D supplementation at follow-up whereas 32.8% had stopped the treatment. In the former, plasma vitamin D increased to 29.0 ng/ml versus 15.3 ng/ml in the latter group. There was a significant relationship between the 25(OH) vitamin D plasma level and blood pressure ( P = 0.05) and the number of antihypertensive drugs used ( P = 0.013). The difference between those patients who kept the treatment and those who stopped was highly significant ( P < 0.05). The action of diuretics on BP is more synergistic in combination with vitamin D (95.5% vs. 76.4% without vitamin D), followed respectively by calcium channel blockers (67.8% vs. 57.4%), beta-blockers (66.2% vs. 46.5%), converting enzyme inhibitors (50.3% vs. 34.4%) and finally angiotensin II receptor blockers (45.1% vs. 36.2%). The number of antihypertensive drugs have a less significant effect on PA in compared to groups with vitamin D ( P < 0.001). Supplementation with vitamin D improved the control of BP in our studied population. It seems desirable to encourage the prescription of a dual therapy containing a diuretic in hypertensive patients with supplementation in vitamin D. Further studies are necessary to better explore the plasma level of vitamin D and the efficiency of different classes of antihypertensive treatment.