Blood pressure. Supplement最新文献

The superior diastolic blood pressure reduction (BP) of high-dose combination therapy with trandolapril (Tr) and verapamil-SR (Ve) compared with monotherapy has previously been reported. Guideline changes, placing greater emphasis on systolic BP, prompted a re-evaluation of TV-51 and an assessment of a subset of patients from the INternational VErapamil-SR Trandolapril STudy (INVEST). The objective of this analysis was to determine if the short-term antihypertensive effects of high-dose Tr+Ve (Tr/Ve study) could be confirmed in a sample of higher-risk INVEST patients with longer follow-up. The Tr/Ve study was a double-blind, randomized, parallel-group, placebo-controlled trial to evaluate the antihypertensive effects of trandolapril and verapamil-SR alone or in combination in 631 patients randomized to placebo, 4 mg trandolapril, 240 mg verapamil-SR or 4 mg/240 mg Tr+Ve combination for 6 weeks; 581 INVEST patients were selected for comparison with 24-month BP data, 90% use of trandolapril and verapamil-SR combination therapy and no triple therapy. Tr+Ve combination treatment achieved significantly greater systolic and diastolic BP reduction versus monotherapy. The BP-lowering effects of high-dose Tr+Ve achieved during short-term treatment were confirmed in INVEST during longer follow-up. Despite differences in the risk profiles of previously studied patients and INVEST patients, the antihypertensive effects of Ve+Tr were similar.

Reduction of blood pressure (BP) in hypertensive patients reduces cardiovascular risk, with substantial reductions in death from cardiovascular disease and all-cause mortality. This observational study assessed BP reduction in 17,242 patients with uncontrolled hypertension (mean baseline BP 165.4/95.8 mmHg) treated in clinical practice with a combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 12.5 mg by non-hospital specialists and general practitioners. BP was recorded at baseline and at 1 and 3 months with efficacy assessed as BP change from baseline at last timepoint. Mean systolic and diastolic BP reductions of -27.0 mmHg and -13.7 mmHg were achieved overall, with greater reductions in previously untreated patients or in those with a higher baseline BP. Response rates were high overall (78%), and in both formerly antihypertensive naive patients (87%) and in pre-treated patients (76%). The combination of valsartan and HCTZ was well tolerated with a discontinuation rate due to adverse events of <0.4%. In routine clinical practice, valsartan plus HCTZ is effective at reducing BP with high response rates despite patients having previously uncontrolled hypertension, and regardless of individual risk status. The low adverse event rates confirm the good tolerability profile and suitability for chronic use of antihypertensive regimens containing valsartan.

Despite evidence for the benefits of treating hypertension in old age, only a small number of elderly patients have adequate blood pressure control. The reasons are complex and include a combination of factors related to physician, patient adherence to therapy and properties of the antihypertensive drugs. Substantial gaps have been documented between the development and dissemination of recommendations and their implementation in practice. Older patients are more likely to have difficulty with medication adherence. Better compliance achievement among the elderly patients should include a complex strategy. Moreover, physician information strategies must be improved.

Non-compliance is an important factor in lack of appropriate control of blood pressure. Education of hypertensive patients on about consequences of hypertension and benefits of antihypertensive therapy has been reported to improve the results of the management of hypertension. The aim of this article is to present main factors influencing patients' compliance with antihypertensive treatment and the role of educational interventions in the process of therapy.

Hypertension is an important risk factor for cardiovascular diseases. An epidemiological survey in 1985 found that the prevalence of hypertension in Slovenia was comparable to rates reported from western European countries. Awareness of hypertension was poor and only a small fraction of patients had their blood pressure under satisfactory control. Since 1985, few population studies have been completed; the results suggest that little progress has been made in the field of hypertension control. The responsibility for the situation lies partly with family physicians, who often fail to react properly to uncontrolled blood pressure. Data from the last CINDI survey conducted in 2004 are more encouraging. Apparently, physicians now provide their patients with more information on how to attain their target blood pressure, and the percentage of hypertensive patients with controlled blood pressure seems to have increased. However, these are only assumptions, which should be verified by a nationwide epidemiological study. A pilot survey involving a random sample of the Slovenian adult population (about 11,000 subjects) is in progress and will be completed by the end of the year 2005.

The aims of investigations were to assess the prevalence of arterial hypertension (AH) among Latvian population aged > or = 45 years and to evaluate the current AH management situation in Latvia. Four epidemiological databases (Dbases) for analyses were selected: Dbases of a randomized urban population of Riga city (in 1997) and Kuldiga region (in 2000), a Dbase of the DIASCREEN population selected by high risk to diabetes from those visiting family doctors (in 2003) and a Dbase of a Latvian population selected from those visiting family doctors during 3 days in 2005. The prevalence of AH in the urban population was 41.8 +/- 1.4% (with 61.2% for persons over age 45), in rural population 40.5 +/- 1.6% (with 63.7% for those aged above 45). Therapeutic control of AH for patients over 45 years with regular medicine intake differed significantly in three samples of the population analysed: Riga 7.2 +/- 2.7%, Kuldiga 9.9 +/- 1.6% and DIASCREEN 6.4 +/- 0.8%. The addition of another risk factor decreases the control rate, especially in a combination of AH and overweight. The most widely prescribed drugs are angiotensin-converting enzyme inhibitors (ACEI) 31%, diuretics 21% and beta-blockers 20% of patients. AH control rate in the case of monotherapy with ACEI was 6.9 +/- 0.9%, calcium antagonists 5.6+1.2%, beta-blockers 12.5+2.0% and diuretics 3.8+1.4%. The current status of management of hypertension in Latvia is discussed.