Antihypertensive drugs pdf

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been made to initiate antihypertensive treatment, choice of medicine should be based on . antihypertensive drugs may be required to achieve adequate blood . Antihypertensive drugs are frequently used by pa- tients and may influence conduct of anaesthesia. • Relatively few drug classes are used to. Choices of antihypertensive drugs and goals of therapy. The ultimate goal of . from: wm-greece.info 6. Dahlof B.

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Antihypertensive Drugs Pdf

Antihypertensive Drugs. William B. Abrams, M.D., F.G.C.P.·. The current treatment of essential hypertension is based on the following concepts: (1) a single. The article analyzes the prescribed antihypertensive drugs classes and their combination between the amount of antihypertensive drugs. Hypertension, Antihypertensive Drugs and Atherosclerosis. By WILLIAM HOLLANDER, M.D.. HYPERTENSION is one of the major precursors of atherosclerotic.

Adverse effects of this class of drugs include sedation, drying of the nasal mucosa and rebound hypertension. Endothelium receptor blockers[ edit ] Bosentan belongs to a new class of drug and works by blocking endothelin receptors. It is specifically indicated only for the treatment of pulmonary artery hypertension in patients with moderate to severe heart failure. Choice of initial medication[ edit ] For mild blood pressure elevation, consensus guidelines call for medically supervised lifestyle changes and observation before recommending initiation of drug therapy. However, according to the American Hypertension Association, evidence of sustained damage to the body may be present even prior to observed elevation of blood pressure.

Atenolol has been associated with intrauterine growth retardation, as well as decreased placental growth and weight when prescribed during pregnancy. The JNC8 guidelines indicate reasons to choose one drug over the others for certain individual patients. Research[ edit ] Blood pressure vaccines[ edit ] Vaccinations are being trialed and may become a treatment option for high blood pressure in the future.

Antihypertensive drug - Wikipedia

CYTAngQb was only moderately successful in studies, but similar vaccines are being investigated. Health Technology Assessment.

Nelson, Mark. Australian Prescriber 33 : — Archived from the original on 26 August Retrieved August 11, The Medical Journal of Australia. Wright JM ed.

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The Cochrane Database of Systematic Reviews. Archived PDF from the original on So, it appears to be important to use every opportunity to reduce the numbers of new onset diabetes. In that context, antihypertensive drugs which increase blood sugar, however, can add to the challenge of striving for good glycemic control. The latter has been thought to improve metabolic control [ 6 ].

There was no difference in the incidence of side effects or hypoglycaemic episodes between those allocated to atenolol or captopril, but those allocated to atenolol increased their body weight by a mean of 2. Allocation to atenolol was also associated with a slight increase of triglycerides and decreases of HDL and LDL cholesterol [ 33 , 34 ].

JNC 8 Guidelines for the Management of Hypertension in Adults

More importantly, allocation to atenolol was associated with a mean increase of HbA1c of 0. Despite these differential metabolic effects, however, the overall microvascular and macrovascular outcomes obtained in the UKPDS Blood Pressure Study seemed to be quite comparable in the two treatment groups irrespective whether therapy was based on atenolol or captopril.

Unfortunately, however, no further details of glycemic control, e.

No CV outcome data are yet available from this cohort. Importantly, no negative effects of this blood pressure lowering therapy have been reported in the ADVANCE Trial, neither on glycemic control nor on microvascular or macrovascular outcomes [ 38 ].

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So, at present time, the situation remains inconclusive and it is unfortunate that no further systemic evaluations seem to be available in diabetic patients on the metabolic impact of the various antihypertensive drugs that increase blood glucose.

In all likelihood, provided it is looked for, significant glycemic worsening of some 0. However, in combination with other blood glucose worsening drugs, e. Labetalol versus hydralazine When labetalol was compared with hydralazine in women with very high blood pressure, no statistically significant differences were observed for any of the critical or proxy outcomes addressed in the trials: persistent high blood pressure two trials, women; RR 1.

No events were recorded in both arms of the studies that reported eclampsia, maternal death and disseminated intravascular coagulation. The trials providing these results had moderate risk of bias, relatively small sample sizes and very sparse events, thus generating generally very-low-quality of evidence for the critical outcomes EB Table Calcium channel blockers versus hydralazine Compared with hydralazine, calcium channel blockers nifedipine and isradipine showed a statistically significant reduction in the risk of persistent high blood pressure five trials, women; RR 0.

No statistically significant differences were observed for any other critical or proxy outcomes addressed: further episode s of very high blood pressure two trials, women; RR 0.

Most of the trials providing these critical outcomes were small and at moderate or high risk of bias, thus generating very-low-quality evidence for the outcomes EB Table Prostacyclin versus hydralazine One trial 47 women comparing prostacyclin with hydralazine showed no statistically significant differences between the comparison groups for the critical outcomes addressed: persistent high blood pressure RR 0.

This trial had moderate risk of bias and yielded generally imprecise estimates due to the very small sample size and few events EB Table Ketanserin versus hydralazine Compared with hydralazine, ketanserin was more likely to be associated with persistent high blood pressure three trials, women; RR 4.

No statistically significant differences were observed in the effects of the two drugs for other critical or proxy outcomes addressed: eclampsia two trials, 64 women; RR 0. Uradipil versus hydralazine Two small trials 59 women compared uradipil with hydralazine.

There were no differences between the comparison groups for the critical outcomes addressed: persistent high blood pressure two trials, 59 women; RR 1. No case of eclampsia or stillbirth was recorded in either arm of both trials.

The moderate risk of bias in the trials providing these results, in addition to the very small sample size and few events, generated evidence of very-low-quality for the critical outcomes EB Table Labetalol versus calcium channel blockers Two small trials 80 women that compared labetalol with calcium channel blockers showed no statistical differences between the two drugs for any of the critical outcomes: eclampsia one trial, 20 women, RR 0.

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No case of hypotension was recorded in either of the two arms of the trials EB Table Labetalol versus methyldopa One small trial 72 women comparing labetalol with methyldopa showed no statistical differences between the two drugs for any of the critical outcomes addressed: persistent high blood pressure RR 1.

The trial providing these results had moderate risk of bias and few events, thus yielding generally very-low-quality evidence for the reported critical outcomes EB Table Labetalol versus diazoxide One small trial 90 women showed that labetalol was less likely to cause hypotension requiring treatment compared with diazoxide, although the confidence interval was borderline for statistical significance RR 0.

There were no statistical differences observed for the other critical outcomes addressed: persistent high blood pressure RR 0. Nitrates versus magnesium sulfate A small trial 36 women comparing isosorbide with magnesium sulfate reported no case of eclampsia in association with either drug and showed no statistically significant differences between them for the proxy outcome of persistent high blood pressure RR 0. Nimodipine versus magnesium sulfate Compared with magnesium sulfate, nimodipine was statistically significantly more likely to be associated with eclampsia two trials, women; RR 2.

No statistical differences were observed for any other critical or proxy outcomes addressed: coagulopathy one trial, women; RR 1. The quality of evidence for these outcomes ranges between very-low- to low quality, mainly because the principal study women was at high risk of bias EB Table Nifedipine versus chlorpromazine One small trial 60 women comparing nifedipine with chlorpromazine showed no statistically significant differences for the critical and proxy outcomes addressed: eclampsia 55 women; RR 2.

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