Efficacy and safety of combination therapy of high-dose losartan and hydrochlorothiazide in patients with hypertension
|
|
- Rachel Cannon
- 6 years ago
- Views:
Transcription
1 529358JRA / Journal of the Renin Angiotensin Aldosterone SystemShiga et al. research-article2014 Original Article Efficacy and safety of combination therapy of high-dose losartan and hydrochlorothiazide in patients with hypertension Journal of the Renin-Angiotensin- Aldosterone System 2015, Vol. 16(4) The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalspermissions.nav DOI: / jra.sagepub.com Yuhei Shiga 1,2,3,4, Shin-ichiro Miura 1,6, Kenji Norimatsu 1, Yuka Hitaka 1,2, Itsuki Nagata 1,5, Rie Koyoshi 1, Joji Morii 1,5, Takashi Kuwano 1, Yoshinari Uehara 1,6, Asao Inoue 2, Tetsuro Shirotani 3, Kazuaki Fujisawa 4, Eiyu Matsunaga 5 and Keijiro Saku 1,6 Abstract Objective: We analyzed the efficacy and safety of combination therapy of high-dose losartan (100 mg/day) and hydrochlorothiazide (HCTZ, 12.5 mg/day) compared with those of the combination of high-dose telmisartan (80 mg/ day) and HCTZ (12.5 mg/day). Methods: Forty hypertensive patients who received a combination of high-dose telmisartan and HCTZ were enrolled. We applied a changeover strategy with switching from a combination of high-dose telmisartan and HCTZ to highdose losartan and HCTZ. We divided the patients into two groups; those who achieved the target blood pressure (controlled group) and those who did not reach the target blood pressure (uncontrolled group) before the changeover and performed further analysis. Results: The uncontrolled group showed a significant decrease in systolic blood pressure (SBP) (143±12 mmhg to 126±11 mmhg at three months). In addition, serum uric acid significantly decreased in all subjects, and in each of the controlled and uncontrolled groups. There were no significant changes in other biochemical parameters, such as potassium and hemoglobin A1c, at three months after the changeover in all subjects. Conclusion: Combination therapy with high-dose losartan and HCTZ was superior to the combination of telmisartan and HCTZ with respect to significant decreases in systolic blood pressure and serum uric acid in hypertensive patients. Keywords Blood pressure, angiotensin II type 1 receptor blocker, losartan, hydrochlorothiazide, uric acid Introduction Combinations of angiotensin II type 1 receptor blockers (ARBs) and thiazide diuretics are recommended by various guidelines for the treatment of high blood pressure. 1,2 Most patients with hypertension require two or more drugs to achieve their target blood pressure (BP). 3 In fact, largescale clinical trials have shown that thiazide diuretics and/ or calcium channel blockers are frequently added to ARBs to achieve adequate BP control. 4 Nine kinds of single-pill fixed-dose combinations of ARBs and diuretics are available for clinical use in Japan (Table 1). The combination of high-dose telmisartan (80 mg/day) and hydrochlorothiazide (HCTZ, 12.5 mg/day) (Micombi BP) has the strongest BP-lowering effect. 5 We previously used a changeover design in which the patients were switched from high-dose ARBs or a combination of medium-dose losartan (50 mg/ day) and HCTZ to high-dose telmisartan and HCTZ. 6 Although we found that high-dose telmisartan and HCTZ induced a significant reduction of BP at three months after changeover, the combination therapy resulted in a 1 Department of Cardiology, Fukuoka University School of Medicine, Japan 2 Inoue Hospital, Fukuoka, Japan 3 Shirotani Hospital, Fukuoka, Japan 4 Fujisawa Clinic, Fukuoka, Japan 5 Matsunaga Hospital, Fukuoka, Japan 6 Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Japan Corresponding author: Shin-ichiro Miura, Department of Cardiology, Fukuoka University School of Medicine, Nanakuma, Jonan-ku, Fukuoka, , Japan. miuras@cis.fukuoka-u.ac.jp Creative Commons CC-BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (
2 Shiga et al Table 1. Nine kinds of single-pill, fixed-dose combination of angiotensin II receptor blockers (ARBs) and diuretics in Japan. ARBs Diuretics Hydrochlorothiazide 6.25 mg 12.5 mg Losartan 50mg Preminent Valsartan 80mg Codio MD Codio EX Candesartan 8mg Ecard HD 4mg Ecard LD Telmisartan 80mg Micombi BP 40mg Micombi AP Trichlormethiazide 1mg Irbesartan 200mg Irtra HD 100mg Irtra LD significant increase in serum uric acid (UA). In particular, an elevation of serum UA was observed in patients who were switched from a combination of medium-dose losartan and HCTZ to high-dose telmisartan and HCTZ. It is still controversial whether a higher level of serum UA is a risk factor for arteriosclerosis and coronary artery disease. Although a relationship between serum UA and cardiovascular events was not observed in the Framingham study, 7 such relationships have been demonstrated in some studies. 8,9 Moreover, in a subanalysis of data from the Japanese Coronary Artery Disease Study, a high level of UA was shown to be an independent predictor of all events, including cardiovascular events and all-cause mortality. 10 In a prospective, randomized trial, allopurinol was shown to decrease C-reactive protein and reduce cardiovascular and hospitalization risk in patients with estimated GFR (egfr) <60 ml/min. 11 Among ARBs, although both losartan and telmisartan significantly blocked urate transporter 1 (URAT1) in in vitro experiments, 12,13 only losartan showed uricosuric action through the inhibition of URAT1 in humans. 14 We hypothesized that a combination of high-dose losartan and HCTZ could produce similar reduction in BP and significant decrease in serum UA compared with a combination of high-dose telmisartan and HCTZ. Therefore, we analyzed whether a changeover with switching from a combination of high-dose telmisartan and HCTZ to highdose losartan (100 mg/day) and HCTZ would be more efficacious and safe for hypertensive patients. Methods Study design Forty hypertensive patients who received a combination of high-dose telmisartan and HCTZ were enrolled. We applied a changeover strategy with switching from Micombi BP (a single-pill fixed-dose combination of telmisartan (80 mg/day) and HCTZ (12.5 mg/day)) to Preminent (a single-pill fixed-dose combination of losartan (50 mg/day) and HCTZ (12.5 mg/day)) + losartan (50 mg/day). Twenty-four patients (60%) received Micombi BP in the morning and the rest of patients (40%) received it in the evening. After changeover, we did not change the administration time in all patients. We divided the patients into two groups: those who achieved the target BP (controlled group) and those who did not reach the target BP (uncontrolled group) before the changeover, and performed further analysis according to the Japanese Society of Hypertension Guidelines We excluded patients with secondary hypertension, heart failure of NYHA grade III or IV, moderate to severe liver dysfunction (defined as aspartate aminotransferase and alanine aminotransferase levels of more than three-fold the normal ranges), renal dysfunction (defined as a serum creatinine (Cr) level of more than 2.0 mg/dl), pregnancy, or a history of allergy to losartan. The protocol in this study was approved by the ethics committee of Fukuoka University Hospital, and all subjects gave their informed consent to participate. Evaluation of clinical parameters We analyzed seated office systolic BP (SBP), diastolic BP (DBP) and pulse rate (PR), body weight (BW), and blood and urinary levels of biochemical parameters at baseline and at three months after changeover. BP was determined as the mean of two measurements obtained in an office setting by the conventional cuff method using a mercury sphygmomanometer after at least 5 min of rest. All of the blood and urinary samples were collected in the morning after the patients had fasted overnight. Data regarding serum levels of biochemical parameters, such as highdensity lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), UA, Cr, egfr, brain natriuretic peptide (BNP), fasting blood glucose (FBS), hemoglobin A1c (HbA1c), sodium (Na), potassium (K), albumin (Alb), urinary (U)-UA, U-Cr, the ratio of U-UA to U-Cr (U-UA/U-Cr), and the fractional excretion of UA (FEUA, U-UA serum Cr/serum UA U-Cr) were collected in all patients. Body mass index (BMI) was calculated as weight (kg)/height (m) 2. The characteristics of the patients, with regard to history of dyslipidemia (DL), diabetes mellitus (DM), hyperuricemia (HU), smoking status and medication use, were obtained from medical records. Patients who had a current SBP/DBP 140/90mmHg or who were receiving antihypertensive therapy were considered to have hypertension. Patients with LDL-C 140 mg/dl, TG 150 mg/dl and/or HDL-C < 40 mg/dl, or who were receiving lipid-lowering therapy were considered to have DL. DM was defined using the American Diabetes Association criteria or the use of a glucose-lowering drug. HU was defined as a
3 1080 Journal of the Renin-Angiotensin-Aldosterone System 16(4) Table 2. Baseline patient characteristics. All subjects (n=40) Controlled group (n=27) Uncontrolled group (n=13) Age, years 71±13 73±12 68±14 Sex (male), % BMI, kg/m 2 24±4 24±4 25±4 Smoking, % WC, cm 86±9 86±10 85±8 DL, % DM, % HU, % CAD, % CKD, % Medications CCB, % β-blocker, % α-blocker, % Continuous variables are expressed as mean ± standard deviation. BMI: body mass index; WC: waist circumference; DL: dyslipidemia; DM: diabetes mellitus; HU: hyperuricemia; CAD: coronary artery disease; CKD: chronic kidney disease; CCB: calcium channel blocker serum UA level of 7.0 mg/dl. Chronic kidney disease (CKD) was defined as an egfr level of < 60 ml/min per 1.73 m 2. Statistical analysis Statistical analysis was performed using the StatView statistical software package (StatView 5; SAS Institute Inc., Cary, NC, USA). Data are shown as the mean ± standard deviation (SD). Categorical variables were compared between groups by a chi-square analysis. The significance of differences between mean values was evaluated by paired and unpaired t-tests or one-way analysis of variance followed by Fisher s protected-least-significant-difference test, as appropriate. Results Patient characteristics Table 2 shows the characteristics of the 40 patients, who included nine (23%) males. No patients withdrew from the study. The prevalence of DL, DM, HU and CKD was 63%, 13%, 35% and 40%, respectively. In addition, the percentage use of calcium channel blocker (CCB), β-blocker and α-blocker was 98%, 35% and 10%, respectively. There were no significant differences in the baseline patient characteristics between the controlled and uncontrolled groups. We did not change these medications throughout the study period. Changes in BP and PR In all patients, SBP/DBP and PR at baseline were 126±17/69±11 mmhg and 69±9 beats/min, respectively (Figure 1). SBP significantly decreased from 126±17 mmhg at baseline to 119±13 at three months after changeover in all subjects. In particular, the uncontrolled group showed a significant decrease in SBP (143±12 mmhg to 126±11 mmhg at three months). There were no significant changes in DBP or PR during the study period. Changes in biochemical parameters As shown in Table 3, there were no significant changes in biochemical parameters such as serum blood urea nitrogen (BUN), Cr, K, HbA1c, BNP and lipid profile in all subjects, or in the controlled and uncontrolled groups. Changes in serum UA, U-UA/U-Cr and FEUA in all subjects, and in the controlled and uncontrolled groups The combination of high-dose losartan and HTCZ significantly decreased serum UA after three months in all subjects, and in the controlled and uncontrolled groups (Figure 2), whereas there were no changes in U-UA/U-Cr or FEUA in all subjects, or in the controlled and uncontrolled groups (Table 3). Changes in serum UA, K and HbA1c between sub-groups The normal UA, K and HbA1c values at our University Hospital are mg/dl, meq/l and %, respectively. Therefore, we divided all of the patients into two groups according to each normal range described as previously. 6 Our relatively high UA group was defined as
4 Shiga et al Figure 1. Changes in systolic blood pressure (SBP)/diastolic blood pressure (DBP) and pulse rate (PR) in all subjects (n=40), and in the controlled (n=27) and uncontrolled groups (n=13) at zero and three months. *p<0.01 vs. zero months. HR: heart rate Figure 2. Changes in serum uric acid (UA) in all subjects (n=40), and in the controlled (n=27) and uncontrolled groups (n=13) at zero and three months. *p<0.01 vs. zero months. ***p< vs. zero months. UA > 6.0 mg/dl, and the relatively low UA group was defined as 6.0 mg/dl UA. Our relatively high K group was defined as K > 4.3 meq/l, and the relatively low K group was defined as 4.3 meq/l K. Our relatively high HbA1c group was defined as HbA1c > 5.1%, and the relatively low HbA1c group was defined as 5.1% HbA1c. In the relatively low and high UA groups, their values at three months were significantly less than those at baseline (Figure 3). In the relatively high K group, although the level of K at three months was significantly less than
5 1082 Journal of the Renin-Angiotensin-Aldosterone System 16(4) Table 3. Change in biochemical parameters in all subjects, controlled and uncontrolled groups. All subjects (n=40) Controlled group (n=27) Uncontrolled group (n=13) 0 months 3 months 0 months 3 months 0 months 3 months BUN, mg/dl 18.8± ± ± ± ± ±5.3 Cr, mg/dl 0.8± ± ± ± ± ±0.2 egfr, ml/min per 1.73 m 2 62±15 61±18 59±15 59±18 66±15 65±18 Na, meq/l 140±4 141±3 140±4 140±3 141±3 142±2 K, meq/l 4.2± ± ± ± ± ±0.5 TG, mg/dl 125±96 121±57 108±47 116±59 160± ±55 LDL-C, mg/dl 106±29 97±22 106±31 99±23 105±26 95±22 HDL-C, mg/dl 56±15 57±17 57±15 57±15 54±16 56±21 FPG, mg/dl 100±20 96±13 101±19 96±12 100±21 97±14 HbA1c, % 5.2± ± ± ± ± ±0.7 BNP, pg/ml 47±57 56±100 57±66 70±117 27±17 23±15 U-Alb, mg/g Cr 33±78 33±88 20±28 18±26 61±130 65±148 U-UA/U-Cr 0.5± ± ± ± ± ±0.2 FEUA, % 7.4± ± ± ± ± ±7.6 BUN: blood urea nitrogen; Cr: creatinine; egfr: estimated glomerular filtration rate; Na: sodium; K: potassium; TG: triglyceride; LDL-C: low density lipoprotein cholesterol; HDL-C: high density lipoprotein cholesterol; FPG: fast plasma glucose; HbA1c: hemoglobin A1c; BNP: brain natriuretic peptide; U-Alb: urinary albumin; UA: uric acid; FEUA: fractional excretion of UA. Figure 3. Changes in uric acid (UA) (a) (UA > 6.0 mg/dl vs. 6.0 mg/dl UA), potassium (K) (b) (K > 4.3 meq/l vs. 4.3 meq/l K) and hemoglobin A1c (HbA1c) (c) (HbA1c > 5.1% vs. 5.1% HbA1c). p<0.05 vs. zero months ***p< that at baseline, the average value was still within the normal range (K=4.3 meq/l at three months). Moreover, there were no significant changes after three months in either the relatively low K group or the low and high HbA1c groups. Discussion In the present study, the combination of high-dose losartan and HTCZ significantly reduced SBP and serum UA after the switch from high-dose telmisartan and HTCZ. Moreover, there were no serious adverse effects in any of the patients. High-dose losartan and HTCZ significantly reduced SBP. BP control is the best strategy for achieving remarkable clinical benefits with regard to cardiovascular and renal protection. Since the change in SBP using highdose losartan and HTCZ was 7 mmhg in all subjects, SBP reduction should provide tremendous clinical
6 Shiga et al benefits. For example, a 2 mmhg reduction in SBP should provide a 10% lower incidence of stroke mortality and about a 7% lower incidence of mortality from coronary artery disease or other vascular causes in middle age. 15 The synergistic effect of the combination of high-dose losartan and HTCZ may be stronger than that with highdose telmisartan and HTCZ. In a previous study, 12.5 mg/day of HCTZ significantly increased plasma renin activity (PRA). 16 In this case, the blockade of the activation of PRA induced by HTCZ with high-dose losartan may be stronger than that with high-dose telmisartan. Since the combination of medium-dose losartan (50 mg/ day) and HTCZ had the same depressor effect as that of medium-dose telmisartan (40 mg/day) and HCTZ, 17 we did not expect that a changeover from high-dose telmisartan and HTCZ to high-dose losartan and HTCZ would be a useful strategy for inducing a more significant reduction in SBP. In this study, high-dose losartan and HTCZ significantly decreased serum UA after a switch from high-dose telmisartan and HCTZ. Losartan has been shown to have uricosuric action via URAT1 in hypertensive patients. 14 Hamada et al. reported that losartan and HCTZ increased the ratio of UA clearance to creatinine clearance (CUA/ Ccr) in patients with a serum UA above 5.5 mg/dl, whereas telmisartan and HCTZ significantly reduced CUA/Ccr. 17 Unexpectedly, U-UA/U-Cr and FEUA did not change after the changeover to high-dose losartan and HTCZ. The classification of HU into one of two types (i.e. the overproduction of UA or a decrease in the urinary excretion of UA) based on a 60-min spot urine or 24-h urine collection in outpatients is important for determining the treatment strategy, 18 but there are no standardized methods available. Thus, further studies will be needed to resolve this issue. Benson et al. indicated that telmisartan activated peroxisome proliferator-activated receptor (PPAR)-γ, which may improve insulin sensitivity, 19 whereas losartan did not activate PPAR-γ. 20 Telmisartan may be useful in hypertensive patients with insulin resistance or DM. 21 Nonetheless, in this study, the levels of HbA1c and FBS did not change at three months after a changeover from high-dose telmisartan and HTCZ to high-dose losartan and HTCZ. Telmisartan-induced activation of PPAR-γ may not be clinically important in this study, and this result was consistent with a previous report. 22 Zillich et al. reported that the treatment of thiazideinduced hypokalemia might reverse glucose intolerance. 23 Although the level of K at three months after changeover was significantly decreased in the relatively high K group, the average value (K=4.3 meq/l at three months) was still within the normal range and was clinically ignorable. Therefore, the level of K may not influence glucose intolerance. Study limitations This study has three important limitations. First, the sample size is relatively small, which limits our ability to determine significance. Second, we applied a changeover with switching from high-dose telmisartan and HTCZ to high-dose losartan and HTCZ. However, a crossover study would be preferable. Third, we applied a changeover strategy with switching from one tablet (Micombi BP) to two tablets (Preminent + losartan). Twenty-four patients received Micombi BP in the morning and the rest of patients received it in the evening before changeover, whereas we did not change the administration time in all patients after changeover. The numbers of tablets and administration time may affect drug adherence and BP lowering effects. Conclusions The combination of high-dose losartan and HTCZ significantly reduced SBP and decreased serum UA after three months. In addition, there were no serious adverse effects in any of the patients. Conflict of interest KS, SM and YU have received grants and lecture honoraria from MSD, Co. Ltd. KS is a Chief Director and SM is a Director of NPO Clinical and Applied Science, Fukuoka, Japan. KS has an Endowed Department of Department of Molecular Cardiovascular Therapeutics supported by MSD, Co. Ltd. SM and YU belong to the Department of Molecular Cardiovascular Therapeutics supported by MSD, Co. Ltd. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. References 1. Ogihara T, Kikuchi K, Matsuoka H, et al.; Japanese Society of Hypertension Committee. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res 2009; 32: Mancia G, De Backer G, Dominiczak A, et al.; Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: Dahlöf B, Sever PS, Poulter NR, et al.; ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm (ASCOT-BPLA): A multicentre randomized controlled trial. Lancet 2005; 366:
7 1084 Journal of the Renin-Angiotensin-Aldosterone System 16(4) 4. Kato J and Eto T. Diuretics in the LIFE study. Lancet 2004; 364: Sharma AM, Davidson J, Koval S, et al. Telmisartan/ hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese hypertensive patients with type 2 diabetes: The SMOOTH study. Cardiovasc Diabetol 2007; 6: Shiga Y, Miura S, Mitsutake R, et al. Efficacy and safety of a single-pill fixed-dose combination of high-dose telmisartan/hydrochlorothiazide in patients with uncontrolled hypertension. J Renin Angiotensin Aldosterone Syst 2012; 13: Culleton BF, Larson MG, Kannel WB, et al. Serum uric acid and risk for cardiovascular disease and death: The Framingham heart study. Ann Intern Med 1999; 131: Alderman MH, Cohen H, Madhavan S, et al. Serum uric acid and cardiovascular events in successfully treated hypertensive patients. Hypertension 1999; 34: Verdecchia P, Schillaci G, Reboldi G, et al. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension: The PIUMA study. Hypertension 2000; 36: Okura T, Higaki J, Kurata M, et al.; Japanese Coronary Artery Disease Study Investigators. Elevated serum uric acid is an independent predictor for cardiovascular events in patients with severe coronary artery stenosis: Subanalysis of the Japanese Coronary Artery Disease (JCAD) Study. Circ J 2009; 73: Goicoechea M, de Vinuesa SG, Verdalles U, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol 2010; 5: Edwards RM, Trizna W, Stack EJ, et al. Interaction of nonpeptide angiotensin II receptor antagonists with the urate transporter in rat renal brush-border membranes. J Pharmacol Exp Ther 1996; 276: Enomoto A, Kimura H, Chairoungdua A, et al. Molecular identification of a renal urate anion exchanger that regulates blood urate levels. Nature 2002; 417: Hamada T, Ichida K, Hosoyamada M, et al. Uricosuric action of losartan via the inhibition of urate transporter 1 (URAT 1) in hypertensive patients. Am J Hypertens 2008; 21: Lewington S, Clarke R, Qizilbash N, et al.; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: Villamil A, Chrysant SG, Calhoun D, et al. Renin inhibition with aliskiren provides additive antihypertensive efficacy when used in combination with hydrochlorothiazide. J Hypertens 2007; 25: Hamada T, Kuwabara M, Watanabe A, et al. A comparative study on the effectiveness of losartan/hydrochlorothiazide and telmisartan/hydrochlorothiazide in patients with hypertension. Clin Exp Hypertens 2014; 36: Ohta Y, Tsuchihashi T and Kiyohara K. Usefulness of conventional methods of the classification of hyperuricemia in hypertensive patients with hyperuricemia. Gout and Nucleic Acid Metabolism 2012; 36: Benson SC, Pershadsingh HA, Ho CI, et al. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARgamma-modulating activity. Hypertension 2004; 43: Morii J, Miura S, Shiga Y, et al. Comparison of the efficacy and safety of irbesartan and olmesartan in patients with hypertension (EARTH study). Clin Exp Hypertens 2012; 34: Suksomboon N, Poolsup N and Prasit T. Systematic review of the effect of telmisartan on insulin sensitivity in hypertensive patients with insulin resistance or diabetes. J Clin Pharm Ther 2012; 37: Minami J, Furukata S, Ishimitsu T, et al. Comparison of therapies between fixed-dose telmisartan/hydrochlorothiazide and losartan/hydrochlorothiazide in patients with mild to moderate hypertension. Int Heart J 2009; 50: Zillich AJ, Garg J, Basu S, et al. Thiazide diuretics, potassium, and the development of diabetes: A quantitative review. Hypertension 2006; 48:
Methods. Study design
Elmer ress Original Article J Clin Med Res. 2017;9(2):98-103 Efficacy and Safety of Combination Therapy Consisting of Angiotensin II Type 1 Receptor Blocker, Calcium Channel Blocker and Hydrochlorothiazide
More informationEfficacy and Safety of a Single-Pill Fixed-Dose Combination of Azilsartan and Amlodipine
Elmer ress Original Article J Clin Med Res. 2016;8(12):888-892 Efficacy and Safety of a Single-Pill Fixed-Dose Combination of Azilsartan and Amlodipine Kota Motozato a, b, Shin-ichiro Miura a, c, d, Yuhei
More informationKeywords: Visit-to-visit variability; Seasonal variation; Blood pressure. Introduction
Elmer ress Original Article J Clin Med Res. 2015;7(10):802-806 Visit-to-Visit Variability and Seasonal Variation in Blood Pressure With Single-Pill Fixed-Dose Combinations of Angiotensin II Receptor Blocker/Calcium
More informationHiroyuki Daikuhara 1, Fumi Kikuchi 2 and Toshihiko Ishida 2. Introduction. Original Article
447310DVR9410.1177/1479164112447310Daikuhara et al.diabetes and Vascular Disease Research 2012 Original Article The combination of OLmesartan and a CAlcium channel blocker (azelnidipine) or candesartan
More informationAssociation Between Hypertension and Coronary Artery Disease as Assessed by Coronary Computed Tomography
Original Paper Association Between Hypertension and Coronary Artery Disease as Assessed by Coronary Computed Tomography Ryoko Mitsutake, MD, PhD; Shin-ichiro Miura, MD, PhD; Yuhei Shiga, MD; Yoshinari
More informationBy Prof. Khaled El-Rabat
What is The Optimum? By Prof. Khaled El-Rabat Professor of Cardiology - Benha Faculty of Medicine HT. Introduction Despite major worldwide efforts over recent decades directed at diagnosing and treating
More informationHypertension Update 2009
Hypertension Update 2009 New Drugs, New Goals, New Approaches, New Lessons from Clinical Trials Timothy C Fagan, MD, FACP Professor Emeritus University of Arizona New Drugs Direct Renin Inhibitors Endothelin
More informationJared Moore, MD, FACP
Hypertension 101 Jared Moore, MD, FACP Assistant Program Director, Internal Medicine Residency Clinical Assistant Professor of Internal Medicine Division of General Medicine The Ohio State University Wexner
More informationEffectiveness of Add-On Low-Dose Diuretics in Combination Therapy for Hypertension: Losartan/Hydrochlorothiazide vs. Candesartan/Amlodipine
831 Original Article Hypertens Res Vol.3 (27) No.9 p.831-837 Effectiveness of Add-On Low-Dose Diuretics in Combination Therapy for Hypertension: Losartan/Hydrochlorothiazide vs. Candesartan/Amlodipine
More informationClinical cases with Coversyl 10 mg
Clinical cases Coversyl 10 mg For upgraded benefits in hypertension A Editorial This brochure, Clinical cases Coversyl 10 mg for upgraded benefits in hypertension, illustrates a variety of hypertensive
More informationSignificance of Cardiac Rehabilitation on Visit-to-Visit Variability of Blood Pressure in Patients With Cardiovascular Disease in a 12-Month Follow-Up
Elmer ress Original Article J Clin Med Res. 2017;9(4):345-352 Significance of Cardiac Rehabilitation on Visit-to-Visit Variability of Blood Pressure in Patients With Cardiovascular Disease in a 12-Month
More informationDiabetes and Hypertension
Diabetes and Hypertension M.Nakhjvani,M.D Tehran University of Medical Sciences 20-8-96 Hypertension Common DM comorbidity Prevalence depends on diabetes type, age, BMI, ethnicity Major risk factor for
More informationMetabolic Consequences of Anti Hypertensives: Is It Clinically Important?
Metabolic Consequences of Anti Hypertensives: Is It Clinically Important?,FACA,FICA,MASH,FVBWG,MISCP CONSULTANT OF CARDIOLOGY DIRECTOR OF PORT-FOUAD HOSPITAL CCU Consideration of antihypertensive agents
More informationHigh-dose monotherapy vs low-dose combination therapy of calcium channel blockers and angiotensin receptor blockers in mild to moderate hypertension
(2005) 19, 491 496 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh ORIGINAL ARTICLE High-dose monotherapy vs low-dose combination therapy of calcium channel blockers
More informationSupplementary Online Content
Supplementary Online Content Afkarian M, Zelnick L, Hall YN, et al. Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014. JAMA. doi:10.1001/jama.2016.10924 emethods efigure
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and
More informationMetabolic Syndrome and Chronic Kidney Disease
Metabolic Syndrome and Chronic Kidney Disease Definition of Metabolic Syndrome National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Abdominal obesity, defined as a waist circumference
More informationNew Lipid Guidelines. PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN: Implications of the New Guidelines for Hypertension and Lipids.
PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN: Implications of the New Guidelines for Hypertension and Lipids Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Disclosure No relevant
More informationIn the Literature 1001 BP of 1.1 mm Hg). The trial was stopped early based on prespecified stopping rules because of a significant difference in cardi
Is Choice of Antihypertensive Agent Important in Improving Cardiovascular Outcomes in High-Risk Hypertensive Patients? Commentary on Jamerson K, Weber MA, Bakris GL, et al; ACCOMPLISH Trial Investigators.
More informationHypertension Update Clinical Controversies Regarding Age and Race
Hypertension Update Clinical Controversies Regarding Age and Race Allison Helmer, PharmD, BCACP Assistant Clinical Professor Auburn University Harrison School of Pharmacy July 22, 2017 DISCLOSURE/CONFLICT
More informationOutcomes and Perspectives of Single-Pill Combination Therapy for the modern management of hypertension
Outcomes and Perspectives of Single-Pill Combination Therapy for the modern management of hypertension Prof. Massimo Volpe, MD, FAHA, FESC, Chair of Cardiology, Department of Clinical and Molecular Medicine
More informationHypertension (JNC-8)
Hypertension (JNC-8) Southern California University of Health Sciences Physician Assistant Program Management and Treatment of Hypertension April 17, 2018, presented by Ezra Levy, Pharm.D.! The 8 th Joint
More informationNew Hypertension Guideline Recommendations for Adults July 7, :45-9:30am
Advances in Cardiovascular Disease 30 th Annual Convention and Reunion UERM-CMAA, Inc. Annual Convention and Scientific Meeting July 5-8, 2018 New Hypertension Guideline Recommendations for Adults July
More informationVA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension - Pocket Guide Update 2004 Revision July 2005
VA/DoD Clinical Practice Guideline for the Diagnosis and Management of Hypertension - Pocket Guide Update 2004 Revision July 2005 1 Any adult in the health care system 2 Obtain blood pressure (BP) (Reliable,
More informationEFFICACY & SAFETY OF ORAL TRIPLE DRUG COMBINATION OF TELMISARTAN, AMLODIPINE AND HYDROCHLOROTHIAZIDE IN THE MANAGEMENT OF NON-DIABETIC HYPERTENSION
EFFICACY & SAFETY OF ORAL TRIPLE DRUG COMBINATION OF TELMISARTAN, AMLODIPINE AND HYDROCHLOROTHIAZIDE IN THE MANAGEMENT OF NON-DIABETIC HYPERTENSION Khemchandani D. 1 and * Arif A. Faruqui 2 1 Bairagarh,
More informationRisk Assessment of developing type 2 diabetes mellitus in patient on antihypertensive medication
41 Research Article Risk Assessment of developing type 2 diabetes mellitus in patient on antihypertensive medication Amarjeet Singh*, Sudeep bhardwaj, Ashutosh aggarwal Department of Pharmacology, Seth
More informationALLHAT. Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic
1 U.S. Department of Health and Human Services National Institutes of Health Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker
More informationCharacteristics and Future Cardiovascular Risk of Patients With Not-At- Goal Hypertension in General Practice in France: The AVANT AGE Study
ORIGINAL PAPER Characteristics and Future Cardiovascular Risk of Patients With Not-At- Goal Hypertension in General Practice in France: The AVANT AGE Study Yi Zhang, MD, PhD; 1 Helene Lelong, MD; 2 Sandrine
More informationThe CARI Guidelines Caring for Australasians with Renal Impairment. ACE Inhibitor and Angiotensin II Antagonist Combination Treatment GUIDELINES
ACE Inhibitor and Angiotensin II Antagonist Combination Treatment Date written: September 2004 Final submission: September 2005 Author: Kathy Nicholls GUIDELINES No recommendations possible based on Level
More informationSupplementary Online Content
Supplementary Online Content Xu X, Qin X, Li Y, et al. Efficacy of folic acid therapy on the progression of chronic kidney disease: the Renal Substudy of the China Stroke Primary Prevention Trial. JAMA
More informationReframe the Paradigm of Hypertension treatment Focus on Diabetes
Reframe the Paradigm of Hypertension treatment Focus on Diabetes Paola Atallah, MD Lecturer of Clinical Medicine SGUMC EDL monthly meeting October 25,2016 Overview Physiopathology of hypertension Classification
More informationHypertension and Cardiovascular Disease
Hypertension and Cardiovascular Disease Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or by any means graphic,
More informationDISCLOSURE PHARMACIST OBJECTIVES 9/30/2014 JNC 8: A REVIEW OF THE LONG-AWAITED/MUCH-ANTICIPATED HYPERTENSION GUIDELINES. I have nothing to disclose.
JNC 8: A REVIEW OF THE LONG-AWAITED/MUCH-ANTICIPATED HYPERTENSION GUIDELINES Tiffany Dickey, PharmD Assistant Professor, UAMS COP Clinical Pharmacy Specialist, Mercy Hospital Northwest AR DISCLOSURE I
More informationManagement of Hypertension
Clinical Practice Guidelines Management of Hypertension Definition and classification of blood pressure levels (mmhg) Category Systolic Diastolic Normal
More informationSupplementary Table 1. Baseline Characteristics by Quintiles of Systolic and Diastolic Blood Pressures
Supplementary Data Supplementary Table 1. Baseline Characteristics by Quintiles of Systolic and Diastolic Blood Pressures Quintiles of Systolic Blood Pressure Quintiles of Diastolic Blood Pressure Q1 Q2
More informationThe underestimated risk of
Earn 3 CPD Points online The underestimated risk of hypertension Dr David Webb Johannesburg Introduction The high and increasing worldwide burden of hypertension is a major global health challenge. Hypertension
More informationModule 2. Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension
Module 2 Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension 1 Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored,
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 7 January 2009
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 7 January 2009 LERCAPRESS 10 mg/10 mg, film-coated tablets Pack of 30 (CIP code: 385 953-3) Pack of 90 (CIP code:
More informationMetoprolol Succinate SelokenZOC
Metoprolol Succinate SelokenZOC Blood Pressure Control and Far Beyond Mohamed Abdel Ghany World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2014. 1 Death Rates From Ischemic
More informationOriginal Article. Introduction
97 Original Article Hypertens Res Vol.31 (2008) No.1 p.97-105 Current Status and Characteristics of Hypertension Control in Community Resident Elderly Korean People: Data from a Korean Longitudinal Study
More informationThe Road to Renin System Optimization: Renin Inhibitor
The Road to Renin System Optimization: Renin Inhibitor A New Perspective on the Renin-Angiotensin System (RAS) Yong-Jin Kim, MD Seoul National University Hospital Human and Economic Costs of Hypertension
More informationSupplementary Table 1. Criteria for selection of normal control individuals among healthy volunteers
Supplementary Table 1. Criteria for selection of normal control individuals among healthy volunteers Medical parameters Cut-off values BMI (kg/m 2 ) 25.0 Waist (cm) (Men and Women) (Men) 85, (Women) 90
More informationHypertension Update Warwick Jaffe Interventional Cardiologist Ascot Hospital
Hypertension Update 2008 Warwick Jaffe Interventional Cardiologist Ascot Hospital Definition of Hypertension Continuous variable At some point the risk becomes high enough to justify treatment Treatment
More informationTreating Hypertension in Individuals with Diabetes
Treating Hypertension in Individuals with Diabetes Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or by any
More informationegfr > 50 (n = 13,916)
Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according
More informationADVANCES IN MANAGEMENT OF HYPERTENSION
Prevalence 29%; Blacks 33.5% About 72.5% treated; 53.5% uncontrolled (>140/90) Risk for poor control: Latinos, Blacks, age 18-44 and 80,
More informationJNC Evidence-Based Guidelines for the Management of High Blood Pressure in Adults
JNC 8 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults Table of Contents Why Do We Treat Hypertension? Blood Pressure Treatment Goals Initial Therapy Strength of Recommendation
More informationDISCLOSURES OUTLINE OUTLINE 9/29/2014 ANTI-HYPERTENSIVE MANAGEMENT OF CHRONIC KIDNEY DISEASE
ANTI-HYPERTENSIVE MANAGEMENT OF CHRONIC KIDNEY DISEASE DISCLOSURES Editor-in-Chief- Nephrology- UpToDate- (Wolters Klewer) Richard J. Glassock, MD, MACP Geffen School of Medicine at UCLA 1 st Annual Internal
More informationWhich antihypertensives are more effective in reducing diastolic hypertension versus systolic hypertension? May 24, 2017
Which antihypertensives are more effective in reducing diastolic hypertension versus systolic hypertension? May 24, 2017 The most important reason for treating hypertension in primary care is to prevent
More informationALLHAT RENAL DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED INTO 4 GROUPS BY BASELINE GLOMERULAR FILTRATION RATE (GFR)
1 RENAL DISEASE OUTCOMES IN HYPERTENSIVE PATIENTS STRATIFIED INTO 4 GROUPS BY BASELINE GLOMERULAR FILTRATION RATE (GFR) 6 / 5 / 1006-1 2 Introduction Hypertension is the second most common cause of end-stage
More informationDisclosures. Diabetes and Cardiovascular Risk Management. Learning Objectives. Atherosclerotic Cardiovascular Disease
Disclosures Diabetes and Cardiovascular Risk Management Tony Hampton, MD, MBA Medical Director Advocate Aurora Operating System Advocate Aurora Healthcare Downers Grove, IL No conflicts or disclosures
More informationCauses of Poor BP control Rates
Goals Of Hypertension Management in Clinical Practice World Hypertension League (WHL) Meeting Adel E. Berbari, MD, FAHA, FACP Professor of Medicine and Physiology Head, Division of Hypertension and Vascular
More informationManagement of Lipid Disorders and Hypertension: Implications of the New Guidelines
Management of Lipid Disorders and Hypertension Management of Lipid Disorders and Hypertension: Implications of the New Guidelines Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine
More informationHypertension Management in Diabetic Patients
Hypertension Management in Diabetic Patients Park, Chang G, MD, PhD Cardiovascular Center, Guro Hospital, Korea University Medical School Contents (Treatment of 2 Cases) Type 2 Diabetes Mellitus Hypertension
More informationHypertension Update. Objectives 4/28/2015. Beverly J. Mathis, D.O. OOA May 2015
Hypertension Update Beverly J. Mathis, D.O. OOA May 2015 Objectives Learn new recommendations for BP treatment goals Approach to hypertension in the office Use of hypertensive drugs, and how to tailor
More informationCARDIOVASCULAR RISK FACTORS & TARGET ORGAN DAMAGE IN GREEK HYPERTENSIVES
CARDIOVASCULAR RISK FACTORS & TARGET ORGAN DAMAGE IN GREEK HYPERTENSIVES C. Liakos, 1 G. Vyssoulis, 1 E. Karpanou, 2 S-M. Kyvelou, 1 V. Tzamou, 1 A. Michaelides, 1 A. Triantafyllou, 1 P. Spanos, 1 C. Stefanadis
More informationBlood Pressure Goal in Elderly Hypertensive Patients with Diabetes Mellitus: A Subanalysis of the CASE-J Trial
Blood Pressure Goal in Elderly Hypertensive Patients with Diabetes Mellitus: A Subanalysis of the CASE-J Trial Kenji Ueshima 1, Shinji Yasuno 1, Sachiko Tanaka 1, Akira Fujimoto 1, Toshio Ogihara 2, Takao
More informationReceived: / Revised: / Accepted: / Published:
World Journal of Pharmaceutical Sciences ISSN (Print): 2321-3310; ISSN (Online): 2321-3086 Published by Atom and Cell Publishers All Rights Reserved Available online at: http://www.wjpsonline.org/ Original
More informationThe Open Hypertension Journal, 2015, 7, 1-6 1
Send Orders for Reprints to reprints@benthamscience.ae The Open Hypertension Journal, 2015, 7, 1-6 1 Open Access Home Blood Pressure Measurement in the Morning Related to Cancer in Patients with Type 2
More informationDon t let the pressure get to you:
Balanced information for better care Don t let the pressure get to you: Current evidence-based goals for treating hypertension A cornerstone of primary care: Lowering high blood pressure prevents cardiovascular
More informationADVANCES IN MANAGEMENT OF HYPERTENSION
Advances in Management of Robert B. Baron MD Professor of Medicine Associate Dean for GME and CME Declaration of full disclosure: No conflict of interest Current Status of Prevalence 29%; Blacks 33.5%
More informationCONCORD INTERNAL MEDICINE HYPERTENSION PROTOCOL
CONCORD INTERNAL MEDICINE HYPERTENSION PROTOCOL Douglas G. Kelling Jr., MD Carmella Gismondi-Eagan, MD, FACP George C. Monroe, III, MD Revised, April 8, 2012 The information contained in this protocol
More informationABSTRACT ORIGINAL RESEARCH. Joel Neutel Ali Shojaee Jen-Fue Maa. Adv Ther (2012) 29(6): DOI /s z
Adv Ther (212) 29(6):58 523. DOI 1.17/s12325-12-3-z ORIGINAL RESEARCH Efficacy of Amlodipine/Olmesartan ± Hydrochlorothiazide in Patients Uncontrolled on Prior Calcium Channel Blocker or Angiotensin II
More informationΑΡΥΙΚΗ ΠΡΟΔΓΓΙΗ ΤΠΔΡΣΑΙΚΟΤ ΑΘΔΝΟΤ. Μ.Β.Παπαβαζιλείοσ Καρδιολόγος FESC - Γιεσθύνηρια ιζμανόγλειον ΓΝΑ Clinical Hypertension Specialist ESH
ΑΡΥΙΚΗ ΠΡΟΔΓΓΙΗ ΤΠΔΡΣΑΙΚΟΤ ΑΘΔΝΟΤ Μ.Β.Παπαβαζιλείοσ Καρδιολόγος FESC - Γιεσθύνηρια ιζμανόγλειον ΓΝΑ Clinical Hypertension Specialist ESH Hypertension Co-Morbidities HTN Commonly Clusters with Other Risk
More informationHypertension Pharmacotherapy: A Practical Approach
Hypertension Pharmacotherapy: A Practical Approach Ronald Victor, MD Burns & Allen Chair in Cardiology Director, The Hypertension Center Associate Director, The Heart Institute Hypertension Center 1. 2.
More informationCombination therapy with losartan/ hydrochlorothiazide for blood pressure reduction and goal attainment in a real-world clinical setting in Japan
464285TAK661753944712464285Therapeutic Advances in Cardiovascular DiseaseH Suzuki, Y Shimada 2012 Therapeutic Advances in Cardiovascular Disease Original Research Combination therapy with losartan/ hydrochlorothiazide
More informationAntihypertensive Trial Design ALLHAT
1 U.S. Department of Health and Human Services Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic National Institutes
More informationRenal Protection Staying on Target
Update Staying on Target James Barton, MD, FRCPC As presented at the University of Saskatchewan's Management of Diabetes & Its Complications (May 2004) Gwen s case Gwen, 49, asks you to take on her primary
More informationTrial to Reduce. Aranesp* Therapy. Cardiovascular Events with
Trial to Reduce Cardiovascular Events with Aranesp* Therapy John J.V. McMurray, Hajime Uno, Petr Jarolim, Akshay S. Desai, Dick de Zeeuw, Kai-Uwe Eckardt, Peter Ivanovich, Andrew S. Levey, Eldrin F. Lewis,
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 27 May 2009
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 27 May 2009 RASILEZ HCT 150 mg/12.5 mg, film-coated tablets B/30 (CIP code: 392 151-6) RASILEZ HCT 150 mg/25 mg, film-coated
More information1. Albuminuria an early sign of glomerular damage and renal disease. albuminuria
1. Albuminuria an early sign of glomerular damage and renal disease albuminuria Cardio-renal continuum REGRESS Target organ damage Asymptomatic CKD New risk factors Atherosclerosis Target organ damage
More informationHypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents
Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents Stella Stabouli Ass. Professor Pediatrics 1 st Department of Pediatrics Hippocratio Hospital Evaluation of
More informationAnn Thorac Cardiovasc Surg 2016; 22: Online April 18, 2016 doi: /atcs.oa Original Article
Ann Thorac Cardiovasc Surg 216; 22: 161 167 Online April 18, 216 doi: 1.5761/atcs.oa.16-54 Original Article Changeover Trial of and Comparing Effects on the Renin-Angiotensin- Aldosterone System in Patients
More informationWill the recent hypertension trials change the guidelines?
710891JRA0010.1177/1470320317710891Journal of the Renin-Angiotensin-Aldosterone SystemSever research-article2017 Commentary Will the recent hypertension trials change the guidelines? Journal of the Renin-Angiotensin-
More informationSITA 100 mg (n = 378)
Supplementary Table 1. Summary of Sulfonylurea Background Therapy at Baseline and During the Treatment Period. Sulfonylurea at baseline, n (%) SITA 100 mg (n = 378) CANA 300 mg (n = 377) Total (N = 755)
More informationClinical Recommendations: Patients with Periodontitis
The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease. Friedewald VE, Kornman KS, Beck JD, et al. J Periodontol 2009;
More informationReducing proteinuria
Date written: May 2005 Final submission: October 2005 Author: Adrian Gillin Reducing proteinuria GUIDELINES a. The beneficial effect of treatment regimens that include angiotensinconverting enzyme inhibitors
More informationStages of Chronic Kidney Disease (CKD)
Early Treatment is the Key Stages of Chronic Kidney Disease (CKD) Stage Description GFR (ml/min/1.73 m 2 ) >90 1 Kidney damage with normal or GFR 2 Mild decrease in GFR 60-89 3 Moderate decrease in GFR
More informationHypertension in 2015: SPRINT-ing ahead of JNC-8. MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic
Hypertension in 2015: SPRINT-ing ahead of JNC-8 MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic Conflits of interest? None Disclaimer The opinions contained herein are not to be considered
More informationSUPPLEMENTARY DATA. Supplementary Table 1. Baseline Patient Characteristics
Supplementary Table 1. Baseline Patient Characteristics Normally distributed data are presented as mean (±SD), data that were not of a normal distribution are presented as median (ICR). The baseline characteristics
More informationYounger adults with a family history of premature artherosclerotic disease should have their cardiovascular risk factors measured.
Appendix 2A - Guidance on Management of Hypertension Measurement of blood pressure All adults from 40 years should have blood pressure measured as part of opportunistic cardiovascular risk assessment.
More informationAmlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy
ORIGINAL ARTICLE Korean J Intern Med 2014;29:315-324 and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy Seung-Ah Lee 1,
More informationCardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003
Authorized By: Medical Management Guideline Committee Approval Date: 12/13/01 Revision Date: 12/11/03 Beta-Blockers Nitrates Calcium Channel Blockers MEDICATIONS Indicated in post-mi, unstable angina,
More informationPrevention And Treatment of Diabetic Nephropathy. MOH Clinical Practice Guidelines 3/2006 Dr Stephen Chew Tec Huan
Prevention And Treatment of Diabetic Nephropathy MOH Clinical Practice Guidelines 3/2006 Dr Stephen Chew Tec Huan Prevention Tight glucose control reduces the development of diabetic nephropathy Progression
More informationHow Low Do We Go? Update on Hypertension
How Low Do We Go? Update on Beth L. Abramson, MD, FRCPC, FACC As presented at the University of Toronto s Saturday at the University Session (September 2003) Arecent World Health Organization report states
More informationHypertension and obesity. Dr Wilson Sugut Moi teaching and referral hospital
Hypertension and obesity Dr Wilson Sugut Moi teaching and referral hospital No conflict of interests to declare Obesity Definition: excessive weight that may impair health BMI Categories Underweight BMI
More information5.2 Key priorities for implementation
5.2 Key priorities for implementation From the full set of recommendations, the GDG selected ten key priorities for implementation. The criteria used for selecting these recommendations are listed in detail
More informationRAS Blockade Across the CV Continuum
A Summary of Recent International Meetings RAS Blockade Across the CV Continuum Copyright New Evidence Presented at the 2009 Congress of the European Society of Cardiology (August 29-September 2, Barcelona)
More informationLow-Dose Candesartan Cilexetil Prevents Early Kidney Damage in Type 2 Diabetic Patients with Mildly Elevated Blood Pressure
453 Original Article Low-Dose Candesartan Cilexetil Prevents Early Kidney Damage in Type 2 Diabetic Patients with Mildly Elevated Blood Pressure Satoru MURAYAMA, Tsutomu HIRANO, Taro SAKAUE, Kenta OKADA,
More informationAssociation of Serum Uric Acid With Blood Pressure in Japanese Men
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp Advance Publication by J-STAGE Association of Serum Uric Acid With Blood Pressure in Japanese Men Cross-Sectional
More informationWhat s In the New Hypertension Guidelines?
American College of Physicians Ohio/Air Force Chapters 2018 Scientific Meeting Columbus, OH October 5, 2018 What s In the New Hypertension Guidelines? Max C. Reif, MD, FACP Objectives: At the end of the
More informationClinical Updates in the Treatment of Hypertension JNC 7 vs. JNC 8. Lauren Thomas, PharmD PGY1 Pharmacy Practice Resident South Pointe Hospital
Clinical Updates in the Treatment of Hypertension JNC 7 vs. JNC 8 Lauren Thomas, PharmD PGY1 Pharmacy Practice Resident South Pointe Hospital Objectives Review the Eighth Joint National Committee (JNC
More informationRESISTENT HYPERTENSION. Dr. Helmy Bakr Professor and Head of Cardiology Dept. Mansoura University
RESISTENT HYPERTENSION Dr. Helmy Bakr Professor and Head of Cardiology Dept. Mansoura University Resistant Hypertension Blood pressure remaining above goal in spite of concurrent use of 3 antihypertensive
More informationAdult Blood Pressure Clinician Guide June 2018
Kaiser Permanente National CLINICAL PRACTICE GUIDELINES Adult Blood Pressure Clinician Guide June 2018 Adult Blood Pressure Clinician Guide June 2018 Introduction This Clinician Guide is based on the 2018
More informationNew Treatment Options for Diabetic Nephropathy patients. Prof. M. Burnier, Service of Nephrology and Hypertension CHUV, Lausanne, Switzerland
New Treatment Options for Diabetic Nephropathy patients Prof. M. Burnier, Service of Nephrology and Hypertension CHUV, Lausanne, Switzerland Diabetes and nephropathy Diabetic nephropathy is the most common
More informationHypertension Update. Mayo Clinic 90 th Annual Clinical Reviews November 2 nd and 16 th, 2016
Mayo Clinic 90 th Annual Clinical Reviews November 2 nd and 16 th, 2016 Hypertension Update Vincent J. Canzanello, M.D. Consultant, Division of Nephrology and Hypertension Professor or Medicine College
More informationCentral Pressures and Prehypertension
Central Pressures and Prehypertension Charalambos Vlachopoulos Associate Professor of Cardiology 1 st Cardiology Dept Athens Medical School Central Pressures and Prehypertension Charalambos Vlachopoulos
More informationPreventing the cardiovascular complications of hypertension
European Heart Journal Supplements (2004) 6 (Supplement H), H37 H42 Preventing the cardiovascular complications of hypertension Peter Trenkwalder* Department of Internal Medicine, Starnberg Hospital, Ludwig
More informationHypertension. Does it Matter What Medications We Use? Nishant K. Sekaran, M.D. M.Sc. Intermountain Heart Institute
Hypertension Does it Matter What Medications We Use? Nishant K. Sekaran, M.D. M.Sc. Intermountain Heart Institute Hypertension 2017 Classification BP Category Systolic Diastolic Normal 120 and 80 Elevated
More information