Editorial [Hot Topic: The Clinical Management and Treatment of Hypertension, Its Pathophysiology and the Clinical Use of Antihypertensive Drugs (Executive Editor: Gregory Y.H. Lip)]

Thiazide diuretics such as bendrofluazide and chlorothiazide have been used for nearly 20 years in the treatment of hypertension. They have been regarded as rather weak antihypertensive agents which could be used alone only in mild hypertension and otherwise as adjuvants to more potent drugs in more serious cases.1 There are however some patients with ‘essential’ hypertension who are very sensitive to diuretics and in whom the pressure may be brought down to normal by a thiazide2 or spironolactone3 even when it is initially considerably raised. Furthermore a few patients who are responsive to thiazides are strikingly unresponsive to non-diuretic antihypertensive drugs. Patients particularly likely to respond to a thiazide diuretic4 or spironolactone3 commonly have low plasma renin activity and this occurs in about 25% of patients with essential hypertension.5 Since plasma renin activity is not routinely estimated it is simplest to identify these patients by observing the response to an adequate trial of a thiazide.

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Gender disparities in the prevalence, awareness, treatment, and control of high blood pressure

Current Pharmaceutical Design ◽

10.2174/1381612827666210125154749 ◽

2021 ◽

Vol 27 ◽

Author(s):

Maria Dorobantu ◽

Oana-Florentina Gheorghe-Fronea ◽

Alexandru Scafa-Udriste ◽

Sebastian Onciul ◽

Calin Pop ◽

...

Keyword(s):

Older Women ◽

Antihypertensive Drugs ◽

Gender Disparities ◽

Gender Effects ◽

Evolutionary Trend ◽

Treatment Of Hypertension ◽

Younger Men ◽

And Control ◽

Gender Discrepancies ◽

Time Awareness

: The gender effects in arterial hypertension (HT) epidemiology remains poorly clarified to date. We present an up-to-date review of the data regarding gender disparities in HT’s prevalence, awareness, treatment, and control. Based on the data from three consecutive national-representative SEPHAR (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania) surveys conducted between 2005 and 2016, we provide insights into gender differences in HT’s epidemiology and their 11- years evolutionary trend in a high-CV risk European country. Our data displays gender effects in different age-dependent epidemiological patterns in terms of hypertension prevalence, awareness, treatment, and control, mainly due to hormonal status. Hypertension’s prevalence is higher in younger men and older women. Although women are more often aware of their hypertensive condition and receive more often antihypertensive treatment, BP control is lower in older women compared to men of the same age, mainly due to a higher treatment side-effect rate. There is no solid evidence that different antihypertensive drugs exhibit different effects in lowering BP values between genders. In high CV risk European countries like Romania, if all the influencing conditions remain similar to those in the past 11 years, gender discrepancies in terms of HT's prevalence will diminish over time, awareness and treatment of hypertension will continue to be higher in females than in men, with an upward trend of BP control predicted only for women, while in men HT treatment control rate is expected to stagnate.

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Recent trend in the treatment of hypertension and antihypertensive drugs.

The Japanese Journal of Pharmacology ◽

10.1016/s0021-5198(19)36354-1 ◽

1996 ◽

Vol 71 ◽

pp. 23

Author(s):

Takao Saruta

Keyword(s):

Recent Trend ◽

Antihypertensive Drugs ◽

Treatment Of Hypertension

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Therapy-related issues: cardiovascular system

10.1093/med/9780199603640.003.0017 ◽

2012 ◽

Author(s):

Philip Wiffen ◽

Marc Mitchell ◽

Melanie Snelling ◽

Nicola Stoner

Keyword(s):

Heart Failure ◽

Vitamin K Antagonists ◽

Severe Heart Failure ◽

Clinical Use ◽

Cardiogenic Pulmonary Oedema ◽

System P ◽

Treatment Of Hypertension ◽

Nitrate Therapy ◽

Warfarin Dosing ◽

Drug Interventions

Angina 338Tolerance to nitrate therapy 341Heart failure 342Drug interventions for severe heart failure 348Acute cardiogenic pulmonary oedema 350Treatment of hypertension 352Understanding anticoagulation 356Clinical use of anticoagulants 358Warfarin dosing 362Counselling patients treated with warfarin 364Reversing the effects of warfarin (or other vitamin K antagonists) ...

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May Measurement Month 2018: an analysis of blood pressure screening campaign results from Poland

European Heart Journal Supplements ◽

10.1093/eurheartj/suaa041 ◽

2020 ◽

Vol 22 (Supplement_H) ◽

pp. H108-H111

Author(s):

Piotr Jankowski ◽

Maciej Banach ◽

Jolanta Małyszko ◽

Mirosław Mastej ◽

Andrzej Tykarski ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Multiple Imputation ◽

Alcohol Intake ◽

Antihypertensive Drugs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Raising Awareness ◽

Treatment Of Hypertension ◽

Global Initiative

Abstract Hypertension remains the most important cardiovascular risk factor in Poland. May Measurement Month is a global initiative organized by the International Society of Hypertension aimed at raising awareness of hypertension and the need for blood pressure (BP) screening and demonstrating the potential of the opportunistic BP measurements. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in 146 sites in May 2018. Blood pressure was measured in 6450 subjects (mean age: 41 ± 15 years; 59% females). After multiple imputation, the age and sex standardized systolic and diastolic BP was 126.7/78.4 mmHg in the whole analysed group, 132.8/81.3 mmHg in subjects taking antihypertensive drugs, and 125.7/78.0 mmHg in those not taking any antihypertensive drugs. After multiple imputation, the proportions of subjects with high BP (systolic ≥140 mmHg or diastolic ≥90 mmHg or on treatment for raised BP) were 22.2% in the whole analysed group, 39.2% in subjects taking antihypertensive drugs, and 18.6% those not taking any antihypertensive drugs. Overall, hypertension was present in 32.8% of participants, among them 38.7% were not aware of the disease, 53.1% were taking antihypertensive drugs, and 32.3% had BP controlled to target (<140/90 mmHg). Blood pressure was increasing with increasing body mass index and alcohol intake. Smokers and project participants with diabetes had increased average BP. In conclusion, this project provides additional evidence for a considerable potential for further reduction of cardiovascular risk through improvement in detection and treatment of hypertension in Poland.

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