Hypertension management guidelines recommend titrating antihypertensive drugs stepwise every 4-6 weeks.We compared efficacy and safety of early versus late titration after 10 weeks' treatment with irbesartan/hydrochlorothiazide. Hypertensive patients uncontrolled on monotherapy were randomized into two groups. Read More
Objective: To evaluate the efficacy and safety of valsartan in Taiwanese patients with essential hypertension.
Methods: This 12-week multi-center, open-label, observational, post-marketing surveillance study enrolled 2046 hypertensive patients who were prescribed valsartan 80 or 160 mg as monotherapy or in combination with other antihypertensives based on clinical judgment. The primary endpoint was the incidence rate of dizziness with valsartan 160 mg monotherapy or combination therapy at Week 4. Read More
Aim: To compare two strengths of a fixed drug combination (FDC) containing metoprolol XL and amlodipine (metoprolol/amlodipine 50/5; and metoprolol/amlodipine 25/2.5) with its components in hypertension.
Methods: We conducted this multicentre, randomized, open-label, trial in Indian patients with hypertension (140-180 mmHg/90-114 mmHg) in 11 centres from nine cities. Read More
The GIFU substudy of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial was conducted to compare the long-term effects of candesartan and amlodipine on office- and home-measured blood pressure (BP), QTc dispersion and left ventricular mass index (LVMI) in high-risk Japanese patients with hypertension. We used a prospective, randomized, open-label design with blinded assessment of endpoints. Patients were assigned to candesartan-based therapy up to 12 mg/day (n = 100) or amlodipine-based therapy up to 10 mg/day (n = 101) and followed for 3 years. Read More
Objective: To compare the efficacy and safety of olmesartan medoxomil (O) and ramipril (R) in elderly patients with essential arterial hypertension.
Methods: After a 2-week placebo washout, 351 elderly hypertensive patients aged 65-89 years (office sitting diastolic blood pressure, DBP, 90-109 mmHg and office sitting systolic blood pressure, SBP, 140-179 mmHg) were randomized double-blind to 12-week treatment with O 10 mg or R 2.5 mg once daily. Read More
Introduction: Acute and severe hypertension is common, especially in patients with renal dysfunction (RD). Clevidipine is a rapidly acting (t½∼1 min) intravenous (IV) dihydropyridine calcium-channel blocker metabolized by blood and tissue esterases and may be useful in patients with RD. The purpose of this analysis was to assess the safety and efficacy of clevidipine in patients with RD. Read More
Aims: An international randomized controlled trial has shown that anti-hypertensive therapy using perindopril and indapamide significantly reduces the recurrence of stroke. To evaluate the efficacy and safety of diuretics given as add-on therapy to stroke patients, as needed, to perindopril, we conducted a prospective multicenter observational study.
Methods: A total of 3825 hypertensive patients with a history of stroke were enrolled. Read More
Objective: Four oscillometric devices for self-measurement of blood pressure (SBPM) were evaluated according to the International Protocol of the European Society of Hypertension (ESH) in four separate studies. The Pic Indolor Personal Check, Comfort Check and My Check measure blood pressure (BP) at the brachial level; the Travel Check measures radial BP at the wrist level.
Methods: The International Protocol includes a total number of 33 subjects. Read More
Background: Nebivolol is a highly selective beta-adrenoreceptor antagonist with vasodilating properties. This study investigated its effect on quality of life (QoL) and blood pressure (BP) in real life conditions. In total, 1468 patients were enrolled, 12% diabetics. Read More
Objectives: This study aimed to demonstrate that irbesartan is successful in reducing diastolic blood pressure (BP) even following a missed dose after 6-8-weeks' treatment as measured by 24-hour ambulatory BP monitoring (ABPM).
Methods: Eighty-eight patients (64 females, mean age: 53.4 +/- 10. Read More
Aims: This multicenter, open-label, single-arm trial assessed the efficacy of the combination of amlodipine 10 mg and valsartan 160 mg to provide additional blood pressure reduction and tolerability in patients with moderate hypertension not adequately responding to the combination of ramipril 5 mg and felodipine 5 mg.
Results: Of 133 patients treated for 5 weeks with ramipril 5 mg and felodipine 5 mg, 105 failed to achieve mean sitting systolic blood pressure <140 mmHg. These non-responders were then treated for an additional 5 weeks with amlodipine 10 mg and valsartan 160 mg, which resulted in clinically and statistically significant additional reductions in mean sitting systolic blood pressure of 15. Read More
Objective: To describe the real-world effectiveness of amlodipine add-on therapy for hypertensive patients receiving valsartan.
Methods: Retrospective cohort study based on USA electronic medical records. The study population included hypertensive patients who, between January 1998 and December 2005, were receiving valsartan and subsequently initiated add-on therapy with amlodipine. Read More
Objectives: To evaluate the efficacy, safety and tolerability of a single-pill combination of the direct renin inhibitor aliskiren and hydrochlorothiazide (HCT) in patients with hypertension and an inadequate BP response to aliskiren monotherapy (mean sitting diastolic BP [msDBP] > 90 and < or = 110 mmHg following 4 weeks of aliskiren 300 mg).
Methods: In this study, 880 patients with hypertension and an inadequate BP response to aliskiren monotherapy were randomized to once-daily, double-blind treatment with a single-pill combination of aliskiren/HCT 300/25 mg or 300/12.5 mg, or aliskiren 300 mg monotherapy. Read More
Aim: To evaluate the efficacy and tolerability of candesartan cilexetil 32 mg in combination with hydrochlorothiazide (HCT) 12.5 mg or 25 mg in hypertensive patients not optimally controlled with candesartan monotherapy.
Patients And Methods: A total of 3521 patients with treated or untreated hypertension and sitting diastolic blood pressure (DBP) 90-114 mmHg, entered a single-blind run-in phase with candesartan (16 mg for 2 weeks, followed by 32 mg for 6 weeks). Read More
Background: To compare the tolerability and safety of telmisartan +/- hydrochlorothiazide (HCTZ).
Methods: This retrospective analysis was performed on all hypertensive patients that were enrolled in telmisartan studies. A total of 30 double-blind (n=8023) and 20 open-label (n=8393) studies were available at the time of this analysis, and were included. Read More
Aims: This study sought to compare the antihypertensive efficacy and tolerability of a fixed-dose combination with amlodipine/benazepril with that of amlodipine monotherapy in Chinese hypertensive subjects.
Results: This multicenter, double-blind, 8-week study randomized 111 patients to fixed-dose amlodipine besylate/benazepril HCl (2.5/5 mg/day titrated to 5/10 mg/day as needed at week 4 to reach goal blood pressure (BP) <140/90 mmHg) or amlodipine besylate monotherapy (5 mg/day titrated to 10 mg/day as needed). Read More
It is well documented that reducing blood pressure (BP) in hypertensive individuals reduces the risk of cardiovascular (CV) events. Despite this, many patients with hypertension remain untreated or inadequately treated, and fail to reach the recommended BP goals. Suboptimal BP control, whilst arising from multiple causes, is often due to poor patient compliance and/or persistence, and results in a significant health and economic burden on society. Read More
Two first-line antihypertensive therapies for initiating treatment in hypertension were compared, the angiotensin-converting enzyme inhibitor (ACEI) zofenopril and the beta-blocker atenolol. The study was multi-centre and double-blind, and included 304 middle-aged to elderly patients with mild to moderate hypertension who were randomized to receive either zofenopril 30-60 mg once daily (od) or atenolol 50-100 mg od for 4 weeks with the possibility to an up-titration in non-responding patients. The higher dose level was then administered until 12 weeks after randomization. Read More
Angiotensin-converting enzyme inhibitors (ACEIs) and calcium antagonists are today extensively used as first-line monotherapy as well as appropriate combination therapy in mild to moderate hypertension. In a parallel-group study, using clinically recommended doses, the ACEI zofenopril was compared with the calcium antagonist amlodipine in respect of their antihypertensive properties. In the study, 303 hypertensive patients, aged 18-75 years, were compared in terms of antihypertensive response and adverse effects after treatment with zofenopril, 30-60 mg once daily or amlodipine 5-10 mg od. Read More
Angiotensin-converting enzyme inhibitors (ACEIs) are used in the management of a range of cardiovascular disorders and are well established in primary as well as secondary cardiovascular prevention programmes. Over the years, several second- and third-generation ACEIs have been introduced into the clinic. In a comparative study in patients with mild to moderate hypertension, the efficacy and safety of zofenopril 30 mg od (with an up-titration to 60 mg od after 4 weeks in non-responder patients) was compared with enalapril 20 mg od (with an up-titration to 40 mg od after 4 weeks in nonresponders) during 12 weeks of treatment. Read More
In a parallel double-blind multicentre study, 375 hypertensive patients were enrolled and treated with either the angiotensin-converting enzyme inhibitor (ACEI) zofenopril 30 mg once daily (titration 60 mg od) or the angiotensin II type 1 receptor (AT1) antagonist losartan 50 mg od (titration 100 mg od). Patients with mild to moderate hypertension, defined as a diastolic blood pressure (DBP) between 95 and 110 mmHg in the sitting position without other signs of cardiovascular disease were enrolled and treated for 12 weeks. BP was assessed in the clinic, and self-measured by the patients at home during a working day and a holiday, as well as before and at the clinic follow-ups. Read More
Purpose: This post-marketing surveillance study assessed the efficacy, safety and tolerability of the treatment with nifedipine GITS (gastro-intestinal therapeutic system) in hypertensive patients under normal daily practice conditions in China.
Patients And Methods: A total of 3003 patients were included in 174 outpatient clinics. Patients received 30 mg or 60 mg of nifedipine GITS. Read More
Background: This study compared the efficacy and safety of amlodipine/benazepril (10/40 mg/day and 10/20 mg/day) with amlodipine 10 mg/day in patients whose blood pressure (BP) was not adequately controlled with amlodipine monotherapy.
Methods: After a lead-in period with amlodipine monotherapy, 812 non-responder patients (mean sitting diastolic BP > or =95 mmHg) were randomized to one of three treatment groups. Ambulatory BP monitoring was conducted in 276 patients. Read More
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. Read More
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. Read More
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. Read More
Currently blood pressure (BP) is considered normal (for most subjects) if below 140 mmHg for systolic and 90 mmHg for diastolic BP. However, the risk of death displays an approximately linear relationship with BP levels below this cut-off. Therefore more attention is now being paid to the portion of the population characterized by BP levels remaining within normal limits but approaching the 140/90 mmHg level. Read More
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. Read More
The incidence of resistant hypertension remains to be clarified. In this article, three categories of resistance are distinguished: resistant patient, resistant clinician and refractory hypertension. Inadequate compliance, which in case of antihypertensive treatment means taking fewer doses of medications than prescribed, remains a significant cause of poor blood pressure control. Read More
The aim of our study was to investigate blood pressure (BP) control and different factors with possible influence on BP control in Croatian hypertensive patients. In this cross-sectional investigation, a representative sample of target populations (primary care physicians and patients) from different parts of Croatia was included according to the study protocol. During December 2003 and January 2004, we included, according to correctly completed questionnaires, 141 physicians and 814 hypertensive patients. Read More
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. Read More
Hypertension increases the risk of coronary heart disease, stroke, peripheral arterial disease and heart failure. Five independent cross-sectional surveys for cardiovascular risk factors have been conducted in the Czech Republic (1985, 1988, 1992, 1997/98 and 2000/01), always involving a representative population sample aged 25-64 years. Over a period of 15-16 years, there was a statistically significant downward trend in population mean systolic (from 133. Read More
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. Read More
Hypertension affects nearly one-third of total Polish adult population. Poor control of hypertension largely contributes to high cardiovascular disease (CVD) mortality in Poland. However, satisfactory hypertension control at the national level could be beyond economical conditions. Read More
The authors review the present situation in epidemiology and prevention of arterial hypertension in Poland. In 2002, the NATPOL PLUS survey on representative sample of adults (n=3051, age range 18-93) was conducted. Prevalence of hypertension, diagnosed on basis of three separate visits, was 29%, awareness 67% and efficacy of treatment 12. Read More
The goal of the paper is to summarize the current status of blood pressure management in patients with ischaemic heart disease. Recently published results from Europe and North America showed that about half of ischaemic heart disease patients have their blood pressure over 140/90 mmHg. Moreover, these data provide further evidence that poor hypertension management is common in a variety of healthcare settings. Read More
The pathophysiological role of endothelial cells is important in the mechanism of progression of atherosclerosis and improvement of endothelial function may be important for cardiovascular morbidity. Calcium antagonists are reported to have protective effects on the endothelium in vitro and in vivo. In this clinical study, we investigated the effect of calcium antagonist, benidipine, on endothelial function in the patients with essential hypertension, which causes endothelial dysfunction. Read More