Displaying publications 1 - 20 of 157 in total

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  1. Shirbhate E, Pandey J, Patel VK, Kamal M, Jawaid T, Gorain B, et al.
    Pharmacol Rep, 2021 Dec;73(6):1539-1550.
    PMID: 34176080 DOI: 10.1007/s43440-021-00303-6
    Angiotensin-converting enzyme (ACE) and its homologue, ACE2, are commonly allied with hypertension, renin-angiotensin-aldosterone system pathway, and other cardiovascular system disorders. The recent pandemic of COVID-19 has attracted the attention of numerous researchers on ACE2 receptors, where the causative viral particle, SARS-CoV-2, is established to exploit these receptors for permitting their entry into the human cells. Therefore, studies on the molecular origin and pathophysiology of the cell response in correlation to the role of ACE2 receptors to these viruses are bringing novel theories. The varying level of manifestation and importance of ACE proteins, underlying irregularities and disorders, intake of specific medications, and persistence of assured genomic variants at the ACE genes are potential questions raising nowadays while observing the marked alteration in response to the SARS-CoV-2-infected patients. Therefore, the present review has focused on several raised opinions associated with the role of the ACE2 receptor and its impact on COVID-19 pathogenesis.
    Matched MeSH terms: Hypertension/drug therapy
  2. Zar CT, Das S
    Clin Ter, 2013;164(6):529-35.
    PMID: 24424219 DOI: 10.7417/CT.2013.1633
    BACKGROUND AND OBJECTIVE: Diabetes mellitus is commonly known to lead to life threatening complications. Among them, hypertension is one complication which may be highlighted. In modern medical society, several drugs and treatment regimen have developed to treat diabetes mellitus. Although they obtain positive impacts, yet there are certain limitations encountered in the management of the disease due to their adverse effects and non-compliance by the patients. Herbs have been valued as a supplement in treating chronic oxidative stress disorder like diabetes mellitus. In the present review, some of the herbs which possess both anti-hyperglycemic and anti-hypertensive properties are being highlighted. Potential herbs which include Andrographis Paniculata, Ammi Visnaga, Allium sativum, Phyllanthus amarus, Ginkgo biloba, Solanum tuberosum, Tuberosum L. Piper sarmentosum and Lamiaceae family are known to possess antihypertensive properties. Various researches have been conducted on these herbs and positive results have been obtained. Based on these results, the present review article discusses the alternative management of diabetic hypertension with the herbal medicine. In conclusion, the present review article stresses on the need to ensure global awareness about the traditional medicines while treating diabetic hypertension.
    Matched MeSH terms: Hypertension/drug therapy*
  3. Segasothy M
    Med J Malaysia, 1982 Dec;37(4):384.
    PMID: 7167095
    Matched MeSH terms: Hypertension/drug therapy
  4. Burns-Cox CJ
    Lancet, 1970 Sep 26;2(7674):673-4.
    PMID: 4195819
    Matched MeSH terms: Hypertension/drug therapy
  5. Fah NT
    Med J Malaysia, 1977 Dec;32(2):127-32.
    PMID: 614478
    Matched MeSH terms: Hypertension/drug therapy*
  6. Aftab RA, Khan AH, Syed Sulaiman SA, Khan TM, Adnan AS
    Medicine (Baltimore), 2017 Apr;96(14):e6198.
    PMID: 28383400 DOI: 10.1097/MD.0000000000006198
    INTRODUCTION: Volume overload and the renin-aldosterone-angiotensin system (RAAS) are 2 major factors contributing to hypertension (HTN) among hemodialysis (HD) patients. Although volume-dependent components of HTN can be corrected by appropriate volume removal, a proportion of HD patients experience elevated blood pressure (BP) despite achieving euvolemic and ideal dry weight.

    METHOD AND ANALYSIS: A single center, prospective, randomized, parallel design, single-blind trial will be conducted in the Malaysian state of Kelantan among postdialysis euvolemic hypertensive patients that are on regular dialysis at least 3 times a week. The primary outcome of the trial will be to note the effectiveness of losartan (RAAS inhibitor) in reducing systolic BP  140 mm Hg will be randomized using Covariate Adaptive Randomization to standard or treatment arm. Participants in the treatment arm will be given 50 mg of losartan once daily except on dialysis days, whereas the standard arm patients will be prescribed non-RAAS antihypertensive agents. The study participants will be followed for a period of 12 months. A Wilcoxon statistical test will be performed to note the difference in BP from baseline up to 12 months using Statistical Package for the Social Sciences (SPSS) 20.

    ETHICAL AND TRIAL REGISTRATION: The study protocols are approved from the Ethical and Research Committee of the Universiti Sains Malaysia (USM/JEPeM/15050173). The trial is registered under the Australia New Zealand Clinical Trial Registry (ACTRN12615001322527). The trial was registered on 2/12/2015 and the 1st patient was enrolled on 10/12/2015. The trial was formally initiated on 16/02/2016.

    CONCLUSION: Management of HTN among HD patients requires understanding the primary cause of HTN and treating accordingly. The current trial is an attempt to reduce BP among postdialysis euvolemic but hypertensive patients.

    Matched MeSH terms: Hypertension/drug therapy*
  7. Wong AP, Kassab YW, Mohamed AL, Abdul Qader AM
    Pak J Pharm Sci, 2018 Jan;31(1):237-244.
    PMID: 29348109
    Hypertension is one of the major causes of morbidity and mortality. Worldwide, Hypertension is estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths. This accounts for 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS. This led WHO to set a target of 25% reduction in prevalence by 2025. To reach that, WHO has adopted non-conventional methods for the management of hypertension? Despite worldwide popularity of such non-conventional therapies, only small volume of evidence exists that supports its effectiveness. This review attempted to make a critical appraisal of the evidence, with the aim to (1) describe the therapeutic modalities frequently used, and (2) review the current level of evidence attributable to each modality. Databases from Cochrane Library, MEDLINE, PUBMED, and EMBASE were searched from 2005-2015. A total of 23 publications have been identified and selected. Out of these, 15 systematic reviews and/or meta-analysis of RCTs, 5 RCTs, 1 non-RCT, and 2 observational studies without control. Among those 23 publications, therapeutic modalities identified are: fish oil, qigong, yoga, coenzyme Q10, melatonin, meditation, vitamin D, vitamin C, monounsaturated fatty acids, dietary amino-acids, chiropractic, osteopathy, folate, inorganic nitrate, beetroot juice, beetroot bread, magnesium, and L-arginine. The followings were found to have weak or no evidence: fish oil, yoga, vitamin D, monounsaturated fatty acid, dietary amino-acids, and osteopathy. Those found to have significant reduction in blood pressure are: magnesium, qigong, melatonin, meditation, vitamin C, chiropractic, folate, inorganic nitrate, beetroot juice and L-arginine. Coenzyme Q10on the other hand, showed contradicting results were some studies found weak or no effect on blood pressure while others showed significant blood pressure reduction effect. By virtue of the research designs and methodologies, the evidence contributed from these studies is at level 1. Results from this review suggest that certain non-conventional therapies may be effective in treating hypertension and improving cardiac function and therefore considered as part of an evidence-based approach.
    Matched MeSH terms: Hypertension/drug therapy
  8. Lim TO, Ngah BA
    Singapore Med J, 1991 Aug;32(4):249-51.
    PMID: 1776004
    Sixty hypertensives admitted into medical wards were interviewed in depth to determine reasons for their previous drop out of treatment. Eighty five percent of the patients were lacking in motivation. This was related to patients' lack of understanding concerning hypertension and its treatment, erroneous beliefs concerning hypertension held by patients and patients' perceived barrier to treatment. The evidence for these reasons were as follows: 95% of the patients were unaware that hypertension is a long term condition requiring life-long treatment, 60% were unable to state the likely consequences of uncontrolled hypertension, 78% equated relief of symptoms like headache, dizziness with control of hypertension, 52% believed long term consumption of 'western' medication was harmful, 12% believed they had been cured by traditional (bomoh or sinseh) treatment, 72% complained of long waiting time required to obtain care. Economic reasons however were unimportant. Patient education and more convenient clinic locations are necessary but insufficient to ensure compliance. They are particular elements, among others, of a 'good' doctor-patient relationship, which fundamentally is the critical determinant of compliance.
    Matched MeSH terms: Hypertension/drug therapy*
  9. Ong HT, Cheah JS
    N Z Med J, 2004 Feb 20;117(1189):U773.
    PMID: 15014562
    Numerous trials and meta-analyses have been conducted over the last five years to identify an ideal anti-hypertensive drug. These reports, and the JNC 7 and European hypertension guidelines, have generated some controversy and confusion. A review of the comparative anti-hypertensive drug trials shows that the differences between drugs are minor and not consistently demonstrated by different studies. However, much data have now accumulated on the safety and value of diuretics, beta blockers, calcium-channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs) in reducing blood pressure and preventing clinical disease. The importance of tight blood pressure control in reducing adverse events has been clearly shown, and clinicians should concentrate on achieving target blood pressure levels, which often requires a combination of anti-hypertensive drugs. The choice of anti-hypertensive drug should be guided by the presence of concomitant clinical disease, as evidence has accumulated on the special efficacy of certain drugs in reducing damage to particular organ systems. In the absence of any associated clinical disease, it is good to initiate anti-hypertensive therapy with diuretics, provided the metabolic parameters are regularly reviewed.
    Matched MeSH terms: Hypertension/drug therapy*
  10. Abdul Rahman AR, Reyes EB, Sritara P, Pancholia A, Van Phuoc D, Tomlinson B
    Curr Med Res Opin, 2015 May;31(5):865-74.
    PMID: 25707364 DOI: 10.1185/03007995.2015.1020368
    Hypertension incurs a significant healthcare burden in Asia-Pacific countries, which have suboptimal rates of blood pressure (BP) treatment and control. A consensus meeting of hypertension experts from the Asia-Pacific region convened in Hanoi, Vietnam, in April 2013. The principal objectives were to discuss the growing problem of hypertension in the Asia-Pacific region, and to develop consensus recommendations to promote standards of care across the region. A particular focus was recommendations for combination therapy, since it is known that most patients with hypertension will require two or more antihypertensive drugs to achieve BP control, and also that combinations of drugs with complementary mechanisms of action achieve BP targets more effectively than monotherapy. The expert panel reviewed guidelines for hypertension management from the USA and Europe, as well as individual Asia-Pacific countries, and devised a treatment matrix/guide, in which they propose the preferred combination therapy regimens for patients with hypertension, both with and without compelling indications. This report summarizes key recommendations from the group, including recommended antihypertensive combinations for specific patient populations. These strategies generally entail initiating therapy with free drug combinations, starting with the lowest available dosage, followed by treatment with single-pill combinations once the BP target has been achieved. A single reference for the whole Asia-Pacific region may contribute to increased consistency of treatment and greater proportions of patients achieving BP control, and hence reducing hypertension-related morbidity and mortality.
    Matched MeSH terms: Hypertension/drug therapy*
  11. Zyoud SH, Al-Jabi SW, Sweileh WM, Wildali AH, Saleem HM, Aysa HA, et al.
    Int J Cardiol, 2013 Oct 3;168(3):2981-3.
    PMID: 23647601 DOI: 10.1016/j.ijcard.2013.04.105
    Matched MeSH terms: Hypertension/drug therapy*
  12. Sabanayagam C, Shankar A, Lim SC, Tai ES, Wong TY
    Asia Pac J Public Health, 2011 Nov;23(6):936-45.
    PMID: 20460283 DOI: 10.1177/1010539510361637
    Studies conducted in Western populations demonstrate that blood pressure (BP) is a major risk factor for chronic kidney disease (CKD). The authors examined the cross-sectional association between BP and CKD in 3280 adults of Malay ethnicity aged 40 to 80 years living in Singapore. CKD was defined as (1) estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m(2) and (2) presence of microalbuminuria/macroalbuminuria. They observed a dose-dependent positive association between BP and CKD (P trend < .0001). In multivariable-adjusted analysis, compared with participants with normal BP, the odds ratio (OR; 95% confidence interval [CI]) of eGFR < 60 mL/min/1.73 m(2) was 1.85 (0.95-3.62), 2.95 (1.55-5.64), and 4.96 (2.63-9.37) for prehypertension, and stage 1 and stage 2 hypertension, respectively. Similar results were obtained for microalbuminuria/macroalbuminuria. Stage 2 hypertension had the greatest population-attributable risk of CKD (23%). The strong positive association of hypertension with CKD emphasizes the need to control BP in Asian populations to reduce the burden of kidney disease.
    Matched MeSH terms: Hypertension/drug therapy
  13. Ong HT, Oung LS, Ong LM, Tan KP
    Med J Malaysia, 2010 Mar;65(1):18-20.
    PMID: 21265241 MyJurnal
    A study of residents at the Silver Jubilee Home for the Aged was conducted to determine the prevalence, awareness and control of hypertension in this elderly community in Penang, Malaysia. Prevalence of hypertension was 36%, with 81% of patients being initially aware of this diagnosis. This relatively low hypertension prevalence rate may be because residents have a fairly sheltered lifestyle with less social stress and a daily routine that incorporates adequate exercise. Similarly, the high hypertension awareness rate compared to reported figures in the community may be because residents are more regularly monitored by the attending medical care-givers. At the beginning of the study, only 34% of hypertensive patients were well controlled with a blood pressure less than 140/90 mm Hg. This proportion rose to 53% at the end of study period. Compliance is better at a residential home because medication is served by their care-givers and cost is absorbed in this charitable organization. Our study suggests that hypertension awareness and control can be reasonable for the elderly in a residential home.
    Matched MeSH terms: Hypertension/drug therapy
  14. Ong HT
    BMJ, 2007 May 5;334(7600):946-9.
    PMID: 17478848
    Matched MeSH terms: Hypertension/drug therapy*
  15. Hoe SZ, Kamaruddin MY, Lam SK
    Med Princ Pract, 2007;16(3):203-8.
    PMID: 17409755
    To investigate the hypotensive and angiotensin-converting enzyme (ACE) inhibitory activities of a partially purified fraction (FA-I) of the leaves of Gynura procumbens and to qualitatively analyse the putative compounds present in the fraction.
    Matched MeSH terms: Hypertension/drug therapy*
  16. Yusoff K
    Med J Malaysia, 2005 Jun;60(2):239-45.
    PMID: 16114170
    ALLHAT study is the biggest randomized clinical trial in hypertension ever conducted. Its objective was to ompare the efficacy of newer (calcium channel blocker amlodipine and angiotensin-converting enzyme inhibitor inopril) to the older (diuretic chlorthalidone) antihypertensive agents in the treatment of patients with hypertension. After enrolling 42,000 patients who were followed for an average of 4.9 years, ALLHAT did not find significant differences in the primary end-points between these antihypertenive agents. ALLHAT however found significant differences in the secondary end-points such as heart failure and strokes between chlorthalidone and amlodipine or lisinopril. Based on these and on economic reasons, the investigators unequivocally recommended diuretics as the first line therapy for hypertension. Since its publication, ALLHAT has been much discussed, debated A and opined. The choice of drugs for study, the study design, the conduct of the study and the conclusions drawn by the investigators had all been criticised or controversial. Yet ALLHAT has been widely quoted, commented upon or referred to and it has been instrumental in initiating the JNC VII Guidelines. Thus a thorough understanding of ALLHAT is necessary for clinical practice and in designing and evaluating clinical trials in the future. Moving Points: in Medicine will capture the essence of ALLHAT, discusses its implications to clinical trials and explores its possible impact on the practice of medicine in this country.
    Matched MeSH terms: Hypertension/drug therapy*
  17. GACD Hypertension Research Programme, Writing Group, Peiris D, Thompson SR, Beratarrechea A, Cárdenas MK, Diez-Canseco F, et al.
    Implement Sci, 2015;10:158.
    PMID: 26553092 DOI: 10.1186/s13012-015-0331-0
    The Global Alliance for Chronic Diseases comprises the majority of the world's public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst vulnerable populations in high-income countries. In its inaugural research call, 15 projects were funded, focussing on lowering blood pressure-related disease burden. In this study, we describe a reflexive mapping exercise to identify the behaviour change strategies undertaken in each of these projects.
    Matched MeSH terms: Hypertension/drug therapy*
  18. Amudha K, Wong LP, Choy AM, Lang CC
    Curr Pharm Des, 2003;9(21):1691-701.
    PMID: 12871202
    Physiological and pharmacological responses may be influenced by ethnicity as a result of genetic factors, environmental factors and/or their interaction. This review is divided into 2 parts. Firstly, there will be overview of ethnicity as a determinant of drug metabolism and response with reference to antihypertensive agents. The concept of ethnicity has been applied extensively to the study of hypertension especially in American blacks in whom the hypertension is more common and more aggressive. Thus, the second part of this review will then focus on examining the black-white differences in physiological responses to pharmacological challenge that may provide a link between these models and known ethnic differences in drug responses. We will discuss the hypertension studies that have examined the relative effectiveness of different classes of antihypertensive agents including several recent cardiovascular outcome trials that either have a high proportion of blacks or were conducted entirely in black subjects.
    Matched MeSH terms: Hypertension/drug therapy*
  19. Khoo KL, Liew YM, Tan H, Sambhi JS, Hatijah BA
    Med J Malaysia, 1999 Mar;54(1):37-46.
    PMID: 10972003
    The telephone survey of 2,526 hypertensive subjects showed 94% of the respondents were aware of the importance in controlling hypertension. Among these 504 were not on anti-hypertensive medication while the majority of 2,022 were currently on anti-hypertensive medication. Of those who were not on medication, 80% (n = 403) were found non-hypertensive on follow-up. The remaining 20% (n = 101) were confirmed hypertensive and were offered medication. However, 38 subjects refused to take medication and 63 subjects complied with medication but subsequently gave up. The main reasons for giving up medication included lack of motivation (38%), doctors' advice (20%), side effects (19%) and concern of side effects (10%). Of 2,022 hypertensive respondents who were currently on medication, almost half (44%, n = 890) required a change of medication due to side effects (40%, n = 356) or the blood pressure not controlled with the previous medication (33%, n = 294). Despite the change in medication, 42% (n = 150) still continued to suffer from some form of side effects. The information obtained from this survey suggested it is important to recommend some strategies to improve patient compliance. These strategies comprise of motivating the patient, improving medication with less side effects, improving potency and efficiency of medication, and reduction of cost in medication. In addition, convenient blood pressure monitoring such as home blood pressure monitoring is also encouraged.
    Matched MeSH terms: Hypertension/drug therapy*
  20. Yusoff K, Razak TA, Yusof N, Rafee NM
    Int J Clin Pract, 1999 Jun;53(4):277-80.
    PMID: 10563072
    ACE inhibitors are important therapeutic agents in controlling hypertension, correcting some of its pathophysiological derangement and improving its prognosis. While there are many such agents, there may be some important differences between them. This placebo run-in, double blind, crossover study, using 24-hour ambulatory blood pressure monitoring, compares the efficacy of perindopril 4-8 mg and enalapril 10-20 mg as once daily antihypertensive agents on 32 patients. For diastolic blood pressure (DBP), perindopril had a placebo-corrected peak (P) reduction of blood pressure (BP) of -6.4 +/- 1.3 mmHg vs its placebo-corrected trough (T) of -5.2 +/- 1.7 mmHg. Enalapril had a reduction in DBP of -8.5 +/- 1.3 mmHg (P) and -5.7 +/- 1.7 mmHg (T). For systolic blood pressure (SBP), perindopril had a reduction of -7.5 +/- 1.6 mmHg (P) vs -7.3 +/- 2.2 mmHg (T) compared to enalapril with -10.8 +/- 1.6 mmHg (P) vs -8.3 +/- 2.3 mmHg (T). Placebo-corrected trough-to-peak ratio (SBP/DBP) for perindopril was 0.97/0.81 vs 0.77/0.67 for enalapril. There was no difference noted in 24-hour mean BP, area under the curve or post-dose casual BP measurements. Both perindopril and enalapril were well tolerated and the two treatment groups had similar safety profiles. Perindopril thus had a predictable and sustained blood pressure effect giving a 24-hour cover for the patient without excessive peak effect or poor trough effect.
    Matched MeSH terms: Hypertension/drug therapy*
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