Treatment Of Primary Hypertension Research Articles

Economic evaluation of Annao Pills combined with antihypertensive drugs in treatment of primary hypertension: a study based on decision tree model

The purpose of this study was to evaluate the economics of Annao Pills combined with antihypertensive drugs in the treatment of primary hypertension in the Chinese medical setting. TreeAge pro 2018 was used for cost-effect analysis and sensitivity analysis of the two treatment regimens. The intervention time of the simulation model was 2 weeks. The cost parameters were derived from Yaozhi.com, and the effect parameters were based on Meta-analysis of randomized controlled trial(RCT) involving Annao Pills. The experimental group was treated with Annao Pills combined with anti-hypertensive drugs(nifedipine controlled-release tablets + losartan potassium tablets), and the control group was treated with anti-hypertensive drugs(nifedipine controlled-release tablets + losartan potassium tablets). The basic analysis showed that the incremental cost-effect ratio(ICER) of the two groups was 2 678.67 yuan, which was less than 7.26% of the per capita disposable income in 2022. That is, compared with anti-hypertensive drugs alone, Annao Pills combined with antihypertensive drugs cost 2 678.67 yuan more for each additional patient with primary hypertension. The results of sensitivity analysis verified the robustness of the basic analysis results. The probability sensitivity results showed that when the patient's personal willingness to pay the price was higher than 2 650 yuan, the probability of the regimen in the experimental group was higher, which was consistent with the results of the basic analysis. In conclusion, when the price was higher than 2 650 yuan, Annao Pills combined with anti-hypertensive drugs was more economical than anti-hypertensive drugs alone in terms of improving the response rate of the patients with primary hypertension.

Efficacy and safety of standard dose triple combination of telmisartan 80mg/amlodipine 5mg/chlorthalidone 25mg in primary hypertension: A randomized, double-blind, active-controlled, multicenter phase 3 trial.

The authors evaluated the efficacy, safety, and characteristics of patients who respond well to standard dose triple combination therapy including chlorthalidone 25mg with telmisartan 80mg plus amlodipine 5mg in hypertensive patients. This is a multicenter, double-blind, active-controlled, phase 3, randomized trial. Patients are randomized to triple combination (telmisartan 40mg/amlodipine 5mg/chlorthalidone 12.5mg, TEL/AML/CHTD group) or dual combination (telmisartan 40mg/amlodipine 5mg, TEL/AML group) treatment and then dose up titration to TEL 80/AML5/CHTD25mg and TEL80/AML5, respectively. The primary endpoint is the change of mean sitting systolic blood pressure (MSSBP) at week 8. A Target BP achievement rate, a response rate, and the safety endpoints are also evaluated. Total 374 patients (mean age=60.9±10.7years, male=78.3%) were randomized to the study. The baseline MSSBPs/diastolic BPs were 149.9±12.2/88.5±10.4mm Hg. After 8weeks treatment, the change of MSSBPs at week 8 are -19.1±14.9mm Hg (TEL/AML/CHTD) and -11.4±14.7mm Hg (TEL/AML) (p<.0001). The achievement rates of target BP (53.8% vs. 37.8%, p=.0017) and responder rate (54.8% vs. 35.6%, p=.0001) at week 8 were significantly higher in TEL/AML/CHTD. There are no serious adverse event and no one discontinued medication due to adverse event. Among the TEL 80/AML5/CHTD25mg treatment group, patients of female or age≥65years old showed higher rate of target BP achievement than relatively young male. (61.4 vs. 46.8%, p=.042) Our study showed standard dose triple combination of telmisartan 80mg/amlodipine 5mg/chlorthalidone 25mg is efficacious and safe in treatment of primary hypertension. Target BP achievement with triple therapy would be facilitated in female or old age.

Hipertenzija kod dece i adolescenata

Until recently, secondary hypertension used to be the most common form of hypertension in the paediatric population. Due to the increasing prevalence of obesity-related hypertension in children and adolescents, the share of secondary hypertension has decreased from 85% to 9%. Today, primary hypertension has become the dominant form of hypertension in the paediatric population. The purpose of this paper is to show the prevalence of various forms of hypertension and the prevalence of primary hypertension in children and adolescents relative to sex, age and body weight category in the General Hospital "Dr. Laza K. Lazarević" in Šabac. In children with secondary hypertension, the impact of body weight was not assessed since an organic cause of hypertension had been identified in these patients. All children from the age of a new-born to the age of 18 years with a diagnosis of hypertension (International Classification of Diseases, tenth revision (IDC-10), code I10-I15) in the period from 1 January 2013 to 31 December 2022 were selected from the medical digital database. This analysis included all children who showed blood pressure values above 95th percentile for age, sex and height in children under 13 and above 120/80 mmHg in children over 13, upon repeated measurements of blood pressure in the General Hospital, who were presumed to have hypertension. These children were referred to further evaluation at tertiary healthcare institutions, where a diagnosis of hypertension was made. Of the 134 children referred to the General Hospital due to elevated blood pressure levels measured in the primary care physician's office, hypertension was diagnosed in almost one in four subjects (24.6%). Primary hypertension was diagnosed in 18 (54.5%), secondary hypertension in 8 (24.2%) and white coat hypertension in 7 (21.2%) children. Primary hypertension was more common in boys (70.6%) than girls (37.5%). Among children with primary hypertension, overweight and obese children represented 66.7% of the group at the time of diagnosis. Statistical data analysis did not find a statistically significant difference in the prevalence of primary hypertension among the body weight or age categories. Since primary hypertension is the most significant and potentially reversible factor for the development of cardiovascular disease, early detection and treatment of primary hypertension in children is crucial in the prevention of cardiovascular disease in adults.

Efficacy of Amlodipine Combined with Telmisartan or Amiloride in Treating Primary Hypertension: A Meta-Analysis

Objective is to systematically analyze the efficacy of Amlodipine combined with Telmisartan or Amiloride in the treatment of primary hypertension. Methods about computer and manual retrieval, seven databases of CNKI, VIP, Wanfang, Baidu scholar, China biomedical literature database (CBM), PubMed and SinoMed, and supplemented by other ways, the randomized controlled trials of Amlodipine combined with Telmisartan or Amiloride were screened. With Review Manger 5. 3 software for Meta-analysis. Results: 9 needed literature were finally selected, with a total of 443 patients. Meta-analysis showed that Amlodipine combined with Telmisartan or Amiloride have a positive effect on primary hypertension, and there is no significant difference between the two medication methods under different medication periods (DBP 82. 7 ± 6. 5, 95% CI [- 0. 80, 0. 75], P > 0. 05, SBP 131. 1 ± 9. 1, 95% CI [- 0. 66, 1. 65], P > 0. 05). Conclusion there is no difference in the treatment of Amlodipine combined with Telmisartan or Amlodipine combined with Amiloride for 4-12 months, but different medication time of studies show significant heterogeneity (I2 > 50%). Considering the quality and quantity of the included literature, we believe that the research conclusions still need to be confirmed by more clinical reference studies.

Serum free fatty acid level in children with primary hypertension

To examine the serum level of free fatty acid (FFA) in children with primary hypertension and its value in the pathogenesis, prevention, and treatment of primary hypertension in children. In this retrospective study, 34 children with primary hypertension who were treated for the first time in Children's Hospital Affiliated to Capital Institute of Pediatrics from January to June, 2021, were enrolled as the hypertension group, and 32 children with normal blood pressure who underwent physical examination during the same period were enrolled as the control group. The two groups were compared in terms of the levels of fasting serum FFA, fasting serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C). The multivariate logistic regression model was used to analyze the influence of FFA on the development of primary hypertension. Compared with the control group, the hypertension group had significantly higher body mass index (BMI), systolic blood pressure, and diastolic blood pressure (P<0.05), as well as significantly higher serum levels of FFA, TG, LDL-C, and non-HDL-C and a significantly lower serum level of HDL-C (P<0.05). Compared with the control group, the hypertension group had significantly higher rates of elevated serum FFA (>0.45 mmol/L for girls and >0.60 mmol/L for boys) (P<0.05) and abnormal blood lipid levels (abnormality in at least one index among serum TG, TC, LDL-C, HDL-C, and non-HDL-C) (P<0.05). A multivariate logistic regression equation was established based on age, sex, BMI, elevated serum FFA, and abnormal blood lipid levels, and the results showed that elevated serum FFA was an independent risk factor for primary hypertension in children (OR=17.560, 95%CI: 1.964-157.003, P<0.05). There is a significant increase in serum FFA level in children with primary hypertension, and the increase in serum FFA can increase the risk of primary hypertension in children.

Network Pharmacology and Molecular Docking-Based Mechanism Study to Reveal Antihypertensive Effect of Gedan Jiangya Decoction

Primary hypertension is understood as a disease with diverse etiology, a complicated pathological mechanism, and progressive changes. Gedan Jiangya Decoction (GJD), with the patent publication number CN114246896A, was designed to treat primary hypertension. It contains six botanical drugs; however, the underlying mechanism is uncertain. We utilized network pharmacology to predict the active components, targets, and signaling pathways of GJD in the treatment of primary hypertension. We also investigated the potential molecular mechanism using molecular docking and animal experiments. The Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP), the Protein Database (UniProt), and a literature review were used to identify the active components and related targets of GJD's pharmacological effects. The GeneCards, Online Mendelian Inheritance in Man (OMIM), Therapeutic Target Database (TTD), and DrugBank databases were utilized to identify hypertension-related targets. Based on a Venn diagram of designed intersection targets, 214 intersection targets were obtained and 35 key targets for the treatment of hypertension were determined using the STRING data platform and Cytoscape software. The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of key targets revealed that the relevant molecular action pathways of GJD in the treatment of hypertension include the Toll-like receptor, MAPK, PI3K-Akt, and renin-angiotensin signaling pathways. A GJD active ingredient-key target-pathway connection diagram was created using Cytoscape software, and 11 essential active components were selected. Molecular docking was then used to verify the binding activity of key targets and key active ingredients in GJD to treat primary hypertension. The results of this study indicate that AGTR1, AKT1 with puerarin, EDNRA with tanshinone IIA, MAPK14 with daidzein, MAPK8 with ursolic acid, and CHRM2 with cryptotanshinone had high binding activity to the targets with active components, whereas AGTR1 was selected as target genes verified by our experiment. HPLC was utilized to identify the five active ingredients. Experiments in high-salt rats demonstrated that GJD might decrease the expression of AGTR1 in the kidney and thoracic aorta while increasing the expression of eNOS by preventing the activation of the renin-angiotensin pathway, thereby reducing lowering systolic and diastolic blood pressure.

Effect of Erbesartan and Eflodipine in the Treatment of Primary Hypertension

Effect of Erbesartan and Eflodipine in the Treatment of Primary Hypertension

Analysis of the experience of Chinese medicine doctor Li Shimao on the treatment of primary hypertension with Dihuang Yinzi and Zhenghan.

article: Analysis of the experience of Chinese medicine doctor Li Shimao on the treatment of primary hypertension with Dihuang Yinzi and Zhenghan - Minerva Surgery 2022 Mar 25 - Minerva Medica - Journals

Community-based heat-sensitive moxibustion for primary hypertension: study protocol for a randomized controlled trial with patient-preference arms

BackgroundLow- and middle-income countries have a high prevalence of primary hypertension, but its treatment and control are often low. Heat-sensitive moxibustion (HSM), an innovative acupoint stimulation technique, may be effective for treating hypertension and thus used appropriately in primary healthcare. The objective of this study is to investigate whether HSM is effective and safe for the treatment of primary hypertension in the community.MethodsThis study is a multicenter, pragmatic, randomized controlled trial (RCT) with patient-preference arms. Four hundred patients with primary hypertension from seven communities will be enrolled. Initially, the communities will be randomly assigned into two study clusters, one using compulsory randomization and the other allowing treatment selection by patient preferences. Then, patients in the compulsory randomization cluster will be randomized to receive HSM plus their original antihypertensive regimen (HSM group) or only their original antihypertensive regimen (control group) for 6 months. Patients in the patient preference cluster may choose to receive HSM or control if they have a preference; otherwise, patients will be randomly assigned. The primary outcome is the change in systolic blood pressure from baseline; secondary outcomes include change in diastolic blood pressure, dosage of antihypertensive drugs, quality of life (QoL), severity of hypertensive symptoms, and incidence of cardiovascular events. Patient compliance with the HSM regimen, the cost-effectiveness ratio, and safety outcomes will also be evaluated. Outcome data will be collected at 6 monthly visits.DiscussionThis trial will provide important evidence regarding HSM as a technique for primary hypertension in primary healthcare settings. Given the randomization with patient preferences considered, the trial will also allow analyzing patient-preference effects and the comparison of randomized and nonrandomized samples, to improve the robustness and extrapolation of study conclusions.Trial registrationClinicalTrials.govNCT04788563. Registered on March 9, 2021.

Revealing new therapeutic opportunities in hypertension through network-driven integrative genetic analysis and drug target prediction approach.

Epidemiological studies have established that untreated hypertension (HTN) is a major independent risk factor for developing cardiovascular diseases (CVD), stroke, renal failure, and other conditions. Several important studies have been published to prevent and manage HTN; however, antihypertensive agents' optimal choice remains controversial. Therefore, the present study is undertaken to update our knowledge in the primary treatment of HTN, specifically in the setting of other three important diseases. MicroRNAs (miRNAs) are remarkably stable short endogenous conserved non-coding RNAs that bind to the mRNA at its (3' UTR) to regulate its gene expression by causing translational repression or mRNA degradation. Through their coordinated activities on different pathways and networks, individual miRNAs control normal and pathological cellular processes. Therefore, to identify the critical miRNA-mRNA-TF interactions, we performed systematic bioinformatics analysis. We have also employed the molecular modelling and docking approach to identify the therapeutic target that delivers novel empathies into Food and Drug Administration approved and herbal drug response physiology. Gene Expression Omnibus (GEO) was employed to identify the differentially expressed genes (DEGs) and hub genes- KNG1, HLA-DPB1, CXCL8, IL1B, and BCL2. The HTN associated feed-forward loop (FFL) network included miR-9-5p, KNG1 and AR. We employed high throughput screening to get the best interacting compounds, telmisartan and limonin, that provided a significant docking score (-13.3 and -12.0kcal/mol) and a potential protective effect that may help to combat the impact of HTN. The present study provides novel insight into HTN etiology through the identification of mRNAs and miRNAs and associated pathways.

A Rare Case of Hydrochlorothiazide-Induced Hemolytic Anemia

Drug-induced immune hemolytic anemia is an exceedingly rare adverse drug event. Thiazide diuretics, commonly used in the treatment of primary hypertension, have been associated with this complication. In this case report, we present a 77-year-old male who developed acute hemolytic anemia two days after starting hydrochlorothiazide in the treatment of high blood pressure.

Clinical Observation on the Treatment of Hypertension by Combination of Modified Banxia Baizhu Tianma Decoction and Auricular Acupuncture

Objective: To observe the curative effect of Jiawei Banxia Baizhu Tianma Decoction (BBTD) in combination with auricular acupuncture in the treatment of primary hypertension with phlegm-dampness syndrome. Methods: 120 patients with hypertension were randomly divided into a pure Western medicine treatment control group (referred to as the control group) and an integrated traditional Chinese and Western medicine treatment group (referred to as the treatment group), with 60 cases in each group. The control group was given nifedipine sustained-release tablets orally; the treatment group: nifedipine sustained-release tablets were given on the basis of modified BBTD combined with auricular acupuncture. The treatment course duration of the two groups was 4 weeks. Before and after treatment, the two groups were evaluated for treatment efficacy and quality of life. Results: There is statistically significant difference in blood pressure lowering between the treatment group and the control group (P?0.05); the treatment group was better than the control group in symptoms improvement of the patients (P?0.05); in terms of the improvement in quality of life , the treatment group was significantly better than the control group (P?0.05, P?0.01). Conclusion: Modified BBTD combined with auricular acupuncture method can reduce blood pressure and improve clinical symptoms in patients with primary hypertension with phlegm-dampness syndrome, and significantly improve the quality of life of patients.

Systematic evaluation and trial sequential analysis of Tianma Gouteng Granules combined with anti-hypertensive drugs in treatment of essential hypertension

To systematically evaluate the efficacy and safety of Tianma Gouteng Granules combined with conventional anti-hypertensive drugs in the treatment of essential hypertension. The clinical randomized controlled trials(RCTs) on the treatment of essential hypertension with Tianma Gouteng Granules combined with conventional anti-hypertensive drugs were searched in PubMed, EMbase, Cochrane Library, VIP, CNKI, Wanfang, SinoMed since the establishment of the databases to April 2020 based on inclusion and exclusion criteria, and Meta-analysis was conducted by using RevMan 5.3 software. A total of 15 RCTs were included, involving a total of 1 508 patients. Meta-analysis results showed that Tianma Gouteng Granules combined with conventional Western medicine were supe-rior to the control group in reducing systolic blood pressure(MD=-10.24, 95%CI[-13.54,-6.95], P&lt;0.000 01), diastolic blood pressure(MD=-5.33, 95%CI[-7.21,-3.45], P&lt;0.000 01), improving the clinical efficacy of patients(RR=1.22, 95%CI[1.15, 1.28], P&lt;0.000 01) and curative effect of traditional Chinese medicine syndrome(RR=1.26, 95%CI[1.02, 1.57], P=0.04), increasing nitric oxide content(MD=9.59, 95%CI[7.23, 11.96], P&lt;0.000 01), reducing endothelin-1(MD=-10.74, 95%CI[-15.74,-5.75], P&lt;0.000 1), tumor necrosis factor(MD=-0.28, 95%CI[-0.36,-0.19], P&lt;0.000 01), and interleukin-6(MD=-39.71, 95%CI[-43.40,-36.03], P&lt;0.000 01). There was no statistically significant difference between the test group and the control group in the incidence of adverse reactions. No liver and kidney dysfunction occurred. The results of the subgroup analysis showed that the effect of Tianma Gouteng Granules combined with ARB drugs was more obvious in reducing the systolic and diastolic pressure. Trial sequential analysis showed that the studies accumulatively included for clinical efficacy crossed the traditional threshold and the TSA threshold, further affirming its clinical efficacy. The clinical application of Tianma Gouteng Granules combined with conventional Western medicine in the treatment of primary hypertension and accompanying symptoms has clear efficacy and certain safety, so it is recommended for clinical application.

The Role of Vitamin D Supplementation in the Treatment of Primary Hypertension: A Double-Blinded Randomized Placebo-Controlled Clinical Trial

Background: Hypertension is one of the most serious global concerns since it has affected over 1.2 billion people. Objectives: The present study aimed to determine the effect of vitamin D supplementation on blood pressure, fasting blood sugar, and lipid profile in hypertensive patients with vitamin D deficiency. Methods: In this double-blinded randomized placebo-controlled clinical trial study, 116 hypertensive patients (intervention and placebo groups, 58 each) with vitamin D deficiency (&lt; 30 ng/mL with ECL) for 14 weeks, started from the beginning of autumn 2019 in Seyed-al-Shohada Educational Hospital in Urmia City. Fifty-five patients (49%) were male with the mean vitamin D 15.89 ± 5.09 ng/mL and 57 females with 17.29 ± 6.31 ng/mL. In a stratified blocked randomization scheme, the patients were randomly allocated into similar sized intervention and control groups based on body mass index (BMI), then the randomization with four block size was performed in each of strata by random allocation software. The intervention group received six doses of 50,000 IU vitamin D supplements for 6 weeks, then two supplements for two following months (one capsule per month). Blood pressure (24/h blood pressure measured by an ambulatory blood pressure monitoring device), vitamin D, FBS, and lipid profile (HDL, LDL, CL, and TG) were all measured at baseline and end of the study. Physical activity (measured by short IPAQ questionnaire), sun exposure using a questionnaire, dietary intake of vitamin D using three 24-hour recalls during the intervention, and anthropometric indices were measured at baseline, middle, and end of the study. Fifty-six patients in each group completed the study. The study was approved by the Ethics Committee of the Urmia University of Medical Sciences (ethics code: IR.UMSU.REC.1398.192). Results: The office blood pressure, 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP), nighttime SBP and DBP were significantly reduced in the intervention group compared to the control group, whereas the reduction of daytime SBP and DBP was not statistically significant. Vitamin D supplementation significantly decreased serum triglyceride, cholesterol, and LDL levels. Conclusions: Vitamin D supplementation had positive effects on blood pressure, triglyceride, cholesterol, and LDL levels in patients with low serum vitamin D.

Tianma Gouteng Decoction combined with Qiju Dihuang Pill for the treatment of essential hypertension: A protocol for systematic review and meta-analysis.

Background:Essential hypertension is one of the risk factors of cardiovascular and cerebrovascular diseases, which can cause target organ damage such as heart, brain and kidney, and has extremely high disability rate and death rate. With the development of economy and society, the prevalence rate of hypertension in China has increased rapidly from 9.8% in the 1980s to over 30% in the 21st century. According to the data published in “China Cardiovascular Disease Report 2018,” China currently has 245 million hypertension patients. Comprehensive prevention and treatment of hypertension has become one of the major public health problems in China. The clinical practice and theoretical innovation of traditional Chinese medicine in the prevention and treatment of hypertension have been carried out for decades. Relevant literature points out that Tianma Gouteng Decoction combined with Qiju Dihuang Pill has ideal effect in the treatment of primary hypertension. However, most of the literatures are small sample studies, with uneven quality and clinical evidence, and lack of evidence-based medical evidence for clinical efficacy. Therefore, this study makes further meta-analysis of Tianma Gouteng Decoction combined with Qiju Dihuang Pill in the treatment of primary hypertension, with a view to providing evidence-based medical evidence for the treatment of primary hypertension.Methods:We will search 3 foreign electronic databases (Cochrane Library, Embase, PubMed) and 4 Chinese electronic databases (China National Knowledge Infrastructure, WangFang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journal Database) to collect potential systematic reviews from their inceptions to February 2020. The language of publication is limited to Chinese or English. First, the quality of randomized controlled trials documents included in this study was evaluated by using the improved Jadad scoring scale. Then, the 2 researchers conducted the evaluation independently according to Cochrane bias risk tools. The evidence level of the results will be evaluated by using the recommended evaluation, development and evaluation grading of recommendations assessment, development, and evaluation method. Statistical analysis will be conducted using Revman 5.3.Results:The results of this study will be published in a peer-reviewed journal.Conclusions:The conclusion of this study will provide evidence for the efficacy of Tianma Gouteng Decoction combined with Qiju Dihuang Pills in the treatment of primary hypertension due to the efficacy of western medicine alone in treating primary hypertension.Registration number PROSPERO:INPLASY202050088.

Randomized Controlled Trials of Tianma Gouteng Decoction Combined with Nifedipine in the Treatment of Primary Hypertension: A Systematic Review and Meta-Analysis.

Background Hypertension is a primary risk factor for cardiovascular disease (CVD). Tianma Gouteng decoction (TGD), originating from Zabingzhengzhixinyi, has been used for thousands of years in China to treat hypertension, giddiness, and migraine. This updated meta-analysis aimed at assessing the efficacy and safety of TGD combined with nifedipine in the treatment of primary hypertension. Methods Related research published prior to September 1, 2019, was found in electronic databases without language limitations. Fourteen studies were selected and analyzed for specified criteria, including the quality of the studies. All outcomes were recorded exhaustive. Data management and analysis were performed using RevMan 5.3 software. Results A total of 1,537 (769 cases in the experimental group and 768 cases in the control group) patients were enrolled. The total efficacy rate was improved significantly for the combination of nifedipine with TGD compared to nifedipine treatment alone (I2 = 22%, RR = 1.17, and 95% CI: 1.12 to 1.22). Traditional Chinese medicine (TCM) symptoms of patients were obviously improved in the experimental group than in the control group (I2 = 22%, RR = 1.17, and 95% CI: 1.12 to 1.22). Traditional Chinese medicine (TCM) symptoms of patients were obviously improved in the experimental group than in the control group (I2 = 22%, RR = 1.17, and 95% CI: 1.12 to 1.22). Traditional Chinese medicine (TCM) symptoms of patients were obviously improved in the experimental group than in the control group (I2 = 22%, RR = 1.17, and 95% CI: 1.12 to 1.22). Traditional Chinese medicine (TCM) symptoms of patients were obviously improved in the experimental group than in the control group (I2 = 22%, RR = 1.17, and 95% CI: 1.12 to 1.22). Traditional Chinese medicine (TCM) symptoms of patients were obviously improved in the experimental group than in the control group (P < 0.00001) when two studies (shicaihong 2017 and xiaoyugao 2017) were removed. And the results of DBP showed no heterogeneity (I2 = 22%, RR = 1.17, and 95% CI: 1.12 to 1.22). Traditional Chinese medicine (TCM) symptoms of patients were obviously improved in the experimental group than in the control group (P < 0.00001) when two studies (shicaihong 2017 and xiaoyugao 2017) were removed. And the results of DBP showed no heterogeneity (Conclusion The combination of TGD and nifedipine has a better effect in the treatment of hypertension, including blood pressure lowering and patients' TCMs improving. However, our findings must be handled with care because of the small sample size and low quality of clinic trials cited. Other rigorous and large-scale RCTs are in need to confirm these results.

How Physiotherapeutic and Yogic Interventions can be used for Treatment of Primary Hypertension?

How Physiotherapeutic and Yogic Interventions can be used for Treatment of Primary Hypertension?

Comparison of the curative effect of metoprolol combined with valsartan and nifedipine controlled release tablets in the treatment of primary hypertension complicated with coronary heart disease

Objective To compare the clinical effect of metoprolol combined with valsartan and nifedipine controlled release tablets in the treatment of primary hypertension complicated with coronary heart disease(CHD). Methods 200 primary hypertension patients with CHD were selected, and they were randomly divided into observation group and control group according to the digital table, 100 cases in each group.The observation group was treated with metoprolol combined with valsartan, the control group was treated with nifedipine controlled release tablets.The clinical effect of the two groups was compared. Results Before treatment, the diastolic and systolic blood pressure of the control group were (106.8±12.3)mmHg and (173.4±22.8)mmHg, respectively, which of the observation group were (104.3±11.4)mmHg, (177.6±24.2)mmHg, respectively, the differences were not statistically significant between the two groups(t=1.265, 0.337, all P>0.05). The diastolic and systolic blood pressure after treatmentin of the observation group were (131.6±17.4)mmHg, (85.3±7.1)mmHg, respectively, and the total effective rate of the observation group was 93.0%(93/100), the improvement rate of angina symptoms of the observation group was 86.0%(86/100), which were significantly better than those of the control group[(131.6±17.4)mmHg, (85.3±7.1) mmHg, 68.0%(68/100), 63.0%(63/100)], the differences were statistically significant (t=5.229, 6.122, χ2=9.148, 7.224, all P<0.05). Conclusion The combination of metoprolol and valsartan has better effect in the treatment of primary hypertension complicated with CHD compared with nifedipine controlled release tablets. Key words: Hypertension; Coronary heart disease; Metholol; Valsartan; Nifedipine controlled release tablets

Efficacy and safety of oral vitamin D (cholecalciferol) supplement therapy in Stage I primary hypertension; a prospective, randomized, double-blind, placebo controlled, clinical trial in a tertiary care hospital in central India.

Introduction : Hypertension is one of the most common cardiovascular disorders. Almost all targets in its therapy are exploited and there is a growing need to search for newer targets. Vitamin D is gaining increasing attention in treatment of primary hypertension. Objectives : To study the efficacy and safety of Vitamin D supplementation on systolic and diastolic BP in patients of primary hypertension (JNC 7 stage I) receiving conventional antihypertensive medications (namely Tab atenolol 50mg or Tab amlodipine 5mg). Methods : It was a prospective, randomized, double blind, parallel, placebo controlled clinical trial with 2 groups of 33 patients each. Both groups had patients receiving conventional antihypertensives (Tab atenolol50mg or Tab amlodipine 5mg). Group A patients were given placebo (lactose tablets) and Group B were given oral Vitamin D 3 (60,000 IU) once weekly at bedtime after meals, repeated every fortnightly for 12 weeks. Results : Patients belonging to Group B showed a statistically significant (p < 0.0001) decline in both systolic blood pressure after 12 weeks of receiving vitamin D supplementation. There was no significant change in the safety parameters. Conclusions : Thus, our study shows that Vitamin D supplementation has some role in safely reducing systolic blood pressure after 12 weeks of supplementation and hence it should be supplemented with antihypertensive drugs to the patients with hypertension.

OS 01-02 ENDOCAN LEVEL IN ESSENTIAL HYPERTENSION

Objective: Endocan, human endothelial cell-specific molecule, which is expressed by the vascular endothelium may play role in endothelium-dependent inflammatory process leading to the development of hypertension. The aim of the study was to estimate endocan concentration in 121 patients with primary hypertension and proper renal function as also in healthy individuals from the control group and to estimate endocan levels in subgroups with proper blood pressure control and without. Design and Method: The endocan concentration was estimated in 121 hypertensive patients (median age 56 min-19, max-85). The medical history, office blood pressure measurements, 24 hour ambulatory blood pressure measurement (ABPM), laboratory tests and the echocardiography were taken, the medical therapy was analysed. The correlation between endocan levels and catecholamine concentration in blood, blood pressure control, type of pharmacological therapy and medical history were analysed. Results: The median endocan concentration in the whole study group was 1.91 ng/ml. The median endocan level was significantly higher in hypertensive patients than in control group (Me = 2,02 ng/ml vs 1.09 ng/ml, p = 0.0001). The median office blood pressure in hypertensive patients was 145,5/86 mmHg and was significantly higher than the median home blood pressure measurements, which was 135/80 mmHg, p < 0,05. Endocan was higher in patients without proper blood pressure control in ambulatory measurements (Me = 2.28ng/ml vs Me = 1.91ng/ml). There were no statistically significant differences between endocan level and office blood pressure measurements. Negative correlation was observed between endocan level and BMI (r = −0.19, p = 0.046). Conclusions: Endocan, as indicator of the endothelium dysfunction could be a predictor of cardiovascular events. Higher endocan concentration in patients with primary hypertension than in control group as also higher endocan levels in subgroup with inadequate blood pressure control in ambulatory measurements need further studies to find out the exact role of endocan in pathogenesis and treatment of primary hypertension.