Review on in vivo and in vitro experimental model of anti-hypertensive agent (original) (raw)
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CLINICAL ANALYSIS OF ANTI-HYPERTENSIVE DRUGS: THE HEALTH CARE STUDY FOR HYPERTENSION
PHARMANEST JOURNAL
Hypertension is a common problem encountered in day to day practice by physicians and often termed as “silent killer” because patients with mild to moderate disease are often asymptomatic. Essential hypertension, as a complex disorder with unknown etiology cause, is a major public health problem worldwide. Patients need constant drug therapy to maintain their blood pressure in a normal range. Genetic and environmental factors associated with individual variation in response to anti-hypertensive drug. The primary goal of anti-hypertensive therapy is to prevent morbidity and mortality associated with hypertension. However, continued efforts must progress in these areas and the effects of therapeutic strategies in hypertensive patients need to be further explored in larger trials over a longer period of time. So, a prospective and observational study was designed to evaluate prescribing pattern of anti-hypertensive drugs in elderly population.Key Words: Hypertension, Prospective study, Pharmacoepidemiology.
Drug Utilisation Study in the Treatment of Hypertension in a Tertiary Care Hospital
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Hypertension, a common clinical problem is considered as an 'iceberg disease' because its unknown morbidity far exceeds the known morbidity. In terms of attributable deaths, it is one of the leading behavioural and physiological risk factors amounting to 13% of global deaths. Drug selection is based on efficacy in lowering BP (blood pressure) and in reducing Cardiovascular (CV) endpoints like stroke, myocardial infarction and heart failure. This study was carried out to evaluate the pattern, extent, rationality and frequency of the use of antihypertensive drugs in the treatment of hypertension. The aim of the study is to analyse drug utilisation in the treatment of hypertension in a tertiary care hospital. MATERIALS AND METHODS This study was conducted during January 2014 to December 2015 in Medicine OPD (Outpatient Department) in a tertiary care hospital. The sample size was selected as per the WHO recommendations on conducting Drug Utilisation Studies (DUS). Statistical Analysis-The collected data was numerically coded and entered in Microsoft Excel 2007 and analysed by SPSS version 16. Settings and Design-Prospective, cross-sectional, observational study. RESULTS Out of 612 patients, 262 (42.81%) were in the age group of 60 and above. Considering gender distribution, 328 (53.59%) were males and 284 (46.41%) were females. Of these, 274 (44.78%) were prescribed monotherapy, 256 (41.83%) were prescribed two-drug therapy, 72 (11.76%) were prescribed three-drug therapy and 10 (1.63%) were prescribed four-drug therapy. Among 274 (44.78%) patients prescribed with monotherapy, 112 (40.87%) were prescribed with CCB (calcium channel blocker), 76 (27.73%) were given BB (B-blocker), 45 (16.42%) were prescribed ACEI (angiotensin converting enzyme inhibitor), 35 (12.77%) were prescribed with ARB (angiotensin receptor blocker) and 6 (2.18%) were prescribed with Diuretics (D). Of the total antihypertensive drugs prescribed, 68.30% were prescribed by generic name, while 25.98% were prescribed as FDCs (fixed drug combination) and 39.05% of antihypertensive drugs were from NLEM (national list of essential medicine). Average number of drugs prescribed per encounter in our study was 2.42, while number of antihypertensive drugs per encounter were 1.34. CONCLUSION The findings of our study suggest that majority of prescriptions had generic names of the drugs. Improving practitioners' knowledge and attitude in rational prescribing can prove to be a cornerstone in achieving rational use of antihypertensive drugs.
International Journal of Pharmacy and Pharmaceutical Sciences, 2016
The aim of the study is to assess the various prescribing patterns in hypertension with different compelling indications. Methods: It is a prospective observational study and carried out for a period of 1 y from Feb-2014 to Feb-2015. All the required data was collected from patients through personal interview and prescriptions. The data collected from the participants was entered into Microsoft excel spreadsheet and descriptive statistics were used. The mean and standard deviation (SD) were calculated. Results: A total of 394 hypertensive patients with different comorbidities were included in which 251(63.70%) males and 143(36.29%) females were present with a mean (SD) age of 59.21±1.54. The most commonly reported first three co-morbidities along with hypertension were diabetes mellitus 191 (48.47%), stroke accounts for 57 (14.46%) and coronary artery disease in 32 (8.12%). Monotherapy was given in almost 200 (50.76%) patients and dual drug therapy was indicated in 166 (42.13%) patients, triple therapy was used only in 24 (6.09%) patients in the total sample size. Quadruple therapy is the least preferred combination therapy accounts only in 4 (1.01%) patients. Conclusion: We conclude that calcium channel blockers and angiotensin II receptor blockers were the most commonly prescribed class of drugs either alone or in combination with other class of drugs for effective control of blood pressure patients with different compelling indications. Monotherapy was preferred than combination therapy.
Journal of clinical hypertension (Greenwich, Conn.), 2015
The authors investigated the differences in office and ambulatory blood pressure (BP) among major antihypertensive drug classes and among frequently used drugs in each class in 22,617 patients treated with monotherapy from the Spanish ABPM Registry. Using thiazides as the reference group, patients treated with calcium channel blockers have significantly (P<.01) elevated ambulatory BP and less ambulatory control after adjusting for confounders. Inside each class, no significant differences were observed among thiazides or angiotensin receptor blockers. Atenolol and bisoprolol among β-blockers, amlodipine among calcium channel blockers, and lisinopril and enalapril among angiotensin-converting enzyme inhibitors exhibited lower ambulatory BP and better control than other agents. Differences exist among antihypertensive drug classes and among different compounds in each class with respect to ambulatory BP control. This can help physicians choose among drug classes and among compounds...
Indian Research Journal of Pharmacy and Science, 2018
Background: Hypertension is the continuous increased arterial blood pressure. More than 25 antihypertensive agents are present for therapy according to patient factors. Administration of agents depends on the scale of therapy according to degree of hypertension. Aim: To follow up the model use of antihypertensive agents in hypertensive Jordanian subjects for hypertension control. Methods: This prospective and double blind investigation included 211 outpatient adult hypertensive participants having or not other Comorbid diseases , aged 30-70 years, of both sexes and who visited the general medicine clinic at Prince Hashim military hospital, Zarqa, JORDAN, during the period Apr 2016-Feb 2018. The data's for use of antihypertensive agents were collected from patient's medical files. The antihypertensive agents included were: Beta Blockers (BBs), Diuretics, Angiotensin Converting Enzyme Inhibitors (ACEI), Calcium Channel Blockers (CCBs), and angiotensin receptor blockers (ARBs) .Antihypertensive agents use prevalence and percentage as single or multiple therapy was evaluated. Z test was used to record the P value of age difference between two sexes. P value was considered statistically significant if it was less than 0.05. Results: The most commonly single used antihypertensive agents were Angiotensin Converting Enzyme Inhibitors (ACEI) (28.3%). In decreasing order come: Calcium Channel Blockers (CCBs) (23.3%), BBs (Beta Blockers)(18.3%), angiotensin receptor blockers (ARBs) (18.3%) and diuretics(11.7%). Multiple therapies was administered more in 71.6% (151) of patients than single therapy which was administered in 28.4% (60) of patients. Hypertension was more in men with increasing age than women. Conclusion: Angiotensin Converting Enzyme Inhibitors were the commonest antihypertensive used agents whether in single or multiple therapies.
Research advance in clinical evaluation of antihypertensive Drug
INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES, 2024
Hypertension, a prevalent cardiovascular condition, has been recognized as a significant risk factor for various adverse health outcomes, including stroke, myocardial infarction, and renal failure. Over the decades, a plethora of antihypertensive drugs have been developed and introduced into clinical practice. This review synthesizes the current state of research and evaluation of these drugs, providing an overview of their mechanisms of action, efficacy profiles, safety considerations, and comparative effectiveness. The paper commences with a discussion on the pathophysiology of hypertension, laying the foundation for understanding the targets and mechanisms of action of antihypertensive medications. Subsequent sections delve into the classes of antihypertensive drugs, including diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, ARBs, and newer agents like mineralocorticoid receptor antagonists. For each class, the review presents pivotal clinical trials, highlighting key findings related to blood pressure reduction, cardiovascular outcomes, and adverse effects. Safety profiles, drug interactions, and considerations for monitoring are critically evaluated to provide clinicians with evidence-based guidance for optimizing therapeutic outcomes while minimizing potential harms. The review also underscores the evolving landscape of antihypertensive drug development, with a focus on emerging therapies and research directions.
A Prospective Observational Study On Antihypertensive Agents In A Tertiary Care Corporate Hospital
International Journal For Scientific Research and Publications, 2020
Background: Hypertension represents the major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. The aim of the present study was to determine the existing practice of prescribing pattern of Anti Hypertensive medication in tertiary care hospital in prospective of standard treatment of guidelines. Methods and materials: A hospital based prospective observational study on Anti Hypertensive agent prescriptions was carried out among patients who were above 20 years of age and Inpatients in the tertiary care corporate hospital. The total of 270 prescriptions of patients suffering from hypertension were included. The collected data were sorted and analyzed on the basis of demographic characteristics and co-morbidities. Results: It was a prospective observational study in which 270 patients were selected. The most commonly prescribed Antihypertensive drugs in our study was telmisartan and least prescribed was spironolactone, diltiazem and indapamide. The drugs were prescribed as mono therapy, dual therapy, triple therapy and poly therapy. Mono therapy of about (51%) was most frequently prescribed and Poly therapy was least prescribed of about (7%). Conclusion: The study revealed that the prevalence of hypertension was predominantly more in male patients than in female patients. Present study represents the current prescribing trend of antihypertensive agents. Angiotensin receptor blockers were the most frequently prescribed class of drug in monotherapy.
2020
Objective: Hypertension is a very serious risk factor for the development of cardiovascular diseases. The evaluation of the effectiveness and safety of the anti-hypertension medication in different private hospitals is significant. This research work assessed the usage of Anti-hypertension medications among the patients present with hypertension alone or with some other clinical condition. Methodology: This research work carried out on 400 hypertension patients who were recruited randomly from different private hospitals of Islamabad to assess the effectiveness and safety of the anti-hypertension medication. Diagnosis of hypertension alone or in combination with other clinical condition carried out in the patients. Patients from both genders were the participants of this research work. The collection of the data carried out from the medical history of the patients, conducting interviewing with doctors, nurses or by taking interviews of patients in the duration of this research work. Results: The findings of this research work showed that most of the patients were males (87.50%). There was association of some factors with hypertension as profession, age and gender. 82% patients of hypertension were present with the history of hypertension in their family. We found no significant difference in diastolic blood pressure between patients of both genders (Average Diastolic Blood Pressure; 79.0 Vs 82.90 mmHg correspondingly, P = 0.0760), but we found a significant difference in average SBP between both genders (average SBP 149.0 Vs 138.0 mmHg correspondingly, P= 0.0440). The adverse reactions of the medications in this research work breathe shortness, headache, edema, dizziness, vomiting, and problems of gastro-intestinal tract and cramps of muscle. Conclusion: There are many factors which are accountable for the contribution of the rise in blood pressure; most important risk factors are the life style and history of the complications in family. Combination treatment has association with very high rate of occurrence of adverse reactions of drugs; enough to permit either reducing the amount of medications or change in the prescribed medication. There is requirement of more efforts from the patients and professionals to reduce the danger of uncontrolled hypertension in our region.
Evaluation of Prescribing Pattern Of Antihypertensives Against The Clinical Condition
IOSR Journal of Pharmacy and Biological Sciences, 2014
Background :The prescribing pattern of antihypertensives by different physicians is not in compliance with that of the standard guidelines given by WHO/JNC-7.The patient factors associated with hypertension like age,sex,the presence or absence of co-morbid diseases along with hypertension will also play a major role in prescribing a particular class of antihypertensive drug. If the standard guidelines and the patient factors are not taken into consideration while prescribing the drugs then the final BP control remains unsatisfactory. Objective:The purpose of this study was to evaluate the prescribing pattern,to determine the factors associated with the treatment of the disease. Methods: It is an observational,prospective,non-interventional study in which prescriptions were collected during July-2013 to January-2014 (for a duration of 7 months) in a tertiary care hospital to comprise a study population of 400 hypertensive patients. Results: As monotherapy ACE-Inhibitors (38.25%) were the most commonly prescribed antihypertensives followed by calcium channel blockers(19.25%), Diuretics (13.25%) ranked third in the prescribing pattern.combination treatment usually consisted of 2 antihypertensive drugs as a coformulation.the most common combination was a ACE-Inh+CCB(5%), followed by Beta-blocker+CCB(3.5%).patients gender,age and comobidities significantly influenced which treatment was prescribed. Limitations: The main limitation of this study was that all the prescriptions were collected from inpatient from a single hospital and it may not be a representative of prescribing pattern across the city. Conclusion: In this study it was observed that the ACE-Inhibitors are the most commonly prescribed monotherapy agents (38.25%) and their prescribing pattern was in consistent with the global trends.Thiazides and the combination drugs were underutilized in this study,despite robust evidence to support their use.
BMC Health Services Research, 2010
Background Interventions to improve blood pressure control in hypertension have had limited success in clinical practice despite evidence of cardiovascular disease prevention in randomised controlled trials. The objectives of this study were to evaluate blood pressure control and antihypertensive pharmacotherapy patterns in a population of Eastern Central Region of Portugal, attending a hospital outpatient clinic (ambulatory setting) for routine follow-up. Methods Medical data of all patients that attended at least two medical appointments of hypertension/dyslipidemia in a university hospital over a one and a half year period (from January 2008 to June 2009) were retrospectively analysed. Demographic variables, clinical data and blood pressure values of hypertensive patients included in the study, as well as prescribing metrics were examined on a descriptive basis and expressed as the mean ± SD, frequency and percentages. Student's test and Mann-Whitney rank sum test were used to compare continuous variables and χ2 test and Fisher exact probability test were used to test for differences between categorical variables. Results In all, 37% of hypertensive patients (n = 76) had their blood pressure controlled according to international guidelines. About 45.5% of patients with a target blood pressure <140/90 mmHg (n = 156) were controlled, whereas in patients with diabetes or chronic kidney disease (n = 49) the corresponding figure was only 10.2% (P < 0.001). Among patients initiating hypertension/dyslipidemia consultation within the study period 32.1% had stage 2 hypertension in the first appointment, but this figure decreased to 3.6% in the last consultation (P = 0.012). Thiazide-type diuretics were the most prescribed antihypertensive drugs (67%) followed by angiotensin receptor blockers (60%) and beta-blockers (43%). About 95.9% patients with comorbid diabetes were treated with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Conclusions Clinically important blood pressure decreases can be achieved soon after hypertension medical appointment initiation. However, many hypertensive patients prescribed with antihypertensive therapy fail to achieve blood pressure control in clinical practice, this control being worse among patients with diabetes or chronic kidney disease. As pharmacotherapy patterns seem to coincide with international guidelines, further research is needed to identify the causes of poor blood pressure control.