POPULARITY
Obstetric Physician and Nephrologist Dr Vishwas Raghunath has a wealth of experience in managing complex medical conditions in high-risk pregnancies.In this episode of sMater, Vish discusses hypertension, the most common medical problem encountered in pregnancy.From screening to management and preventative strategies, GPs can hear a range of approaches to ensuring mum and baby remain safe, from conception all the way through the post-partum period.To learn more about Mater, visit www.mater.org.au____00:00 - Introduction01:50 - Changes to preeclampsia guidelines02:33 - Determining risk and initial recommendations05:28 - Hypertensive disorders in pregnancy09:21 - Antihypertensive medication recommendations13:55 - Testing for non-typical cases16:15 - Delivery of baby19:45 - Advice for post-partum care22:10 - Biomarkers in early pregnancy24:11 - Future of treating hypertension in pregnancy26:15 - The Check Up----#maternityhealth #education #podcastTo learn more about Mater, visit https://www.mater.org.au/
N Engl J Med 2023;389:2319-2330Background: Percutaneous coronary intervention (PCI) does not reduce mortality or myocardial infarction as seen in COURAGE, FAME 2, ISCHEMIA and ISCHEMIA-CKD. However, unblinded studies have indicated that revascularization may improve symptoms, which is a key factor in driving PCI decisions for many patients. ORBITA was the first blinded, placebo-controlled trial of PCI for stable angina and found no significant improvement in exercise time with PCI. The trial had a high use of anti-anginal medications, with an average of 3 medications per patient pre-randomization. However, this level of medication use is not always achievable in clinical practice due to side effects and challenges with adherence.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.The ORBITA-2 trial sought to test the hypothesis that PCI improves symptoms in patients with stable angina who are not receiving background antianginal medications.Patients: Eligible patients had angina or angina equivalent, severe coronary stenosis of 70% or more in at least one coronary artery and evidence of ischemia on non-invasive testing or by invasive pressure wire assessment.Main exclusion criteria were acute coronary syndrome within 6 months, previous CABG, left main disease, chronic total occlusion of target vessel, and left ventricular ejection fraction of 35% or less.Baseline characteristics: The trial randomized 301 patients – 151 randomized to PCI and 150 to placebo PCI.The average age of patients was 64 years and 79% were men. Approximately 63% had hypertension, 28% had diabetes, 72% had hyperlipidemia, and 62% were current or previous smokers. Left ventricular systolic function was normal in 96% of the patients.Angina class based on the Canadian Cardiovascular Society (CCS) angina grade was 2 in 58% of the patients and 3 in 39%. Approximately 80% had single vessel disease, 17% had 2-vessel disease and 2% had 3-vessel disease. Left anterior descending coronary artery was the target vessel in 55% of the patients.Procedures: Patients initially underwent coronary angiogram and invasive physiologic assessment was performed in each vessel with 50% or more stenosis. Patients underwent the coronary angiography while wearing headphones with music playing for auditory isolation throughout the procedure. Patients who had evidence of ischemia in at least one territory were then randomized in a 1:1 ratio to PCI or placebo PCI. Patients were sedated until they were unresponsive to verbal and tactile stimuli. In the PCI group, all target vessels were treated during the index procedure. Patients in the placebo group did not receive intervention and were kept sedated for at least 15 minutes after randomization.The recovery room staff and all subsequent medical providers were unaware of the treatment assignments. The operator and research staff who were present during the randomization procedure had no further contact with the patients.Anti-anginal medications were stopped at enrollment. Antihypertensive medications that has antianginal properties were replaced with different agents.Patients were followed up for 12 weeks during which they reported daily angina symptoms using a smart phone application. New anti-anginal medications or increase in the dose of anti-anginal medications were also tracked. At the end of the 12 weeks, patients completed symptom and quality-of-life questionnaires, had an assessment of CCS class, and underwent a treadmill exercise test and dobutamine stress echocardiography. After all of these were completed, patients and medical staff were unblinded.Endpoints: The primary endpoint was an angina symptom score calculated based on the number of angina episodes that a patient reported on a given day and the number of units of antianginal medication prescribed on that day. In this score, each episode of angina on a particular day counts as 1 point for a maximum of 6 points per day (0 points given to no angina), and each unit of anti-anginal medications counts as 7 points (0 points given for no antianginal medications prescribed that day). In supplement table 3, authors provided what counted as one unit of anti-anginal medications. For example, atenolol 25 mg counted as 1 unit and amlodipine 2.5 mg counted as one unit.Secondary endpoints included frequency of angina, use of ant-anginal medications, exercise time on treadmill test and symptoms questionnaires.Analysis was performed based on the intention-to-treat principle. The estimated sample size to achieve 80% power at 0.05 alpha was 284 patients. This is based on assumed standard deviation of 6 angina symptom score units and a difference of 2 units between PCI and placebo.Results: Data were available on 99.7% of the total patient-days.Compared to placebo, PCI reduced the mean angina symptom score (2.9 vs 5.6, OR: 2.2, 95% CI: 1.4 - 3.5; p
This week, we have three compelling research papers that are sure to expand your clinical acumen. STUDY #1: We explore the debate surrounding the new PREVENT calculator's impact on predictions of 10-year risk for atherosclerotic cardiovascular disease and statin eligibility. Will the current guidelines from the American Heart Association and American College of Cardiology remain the gold standard, or are we on the cusp of a significant paradigm shift? Diao, JA, Shi, I, Murthy, VL, et al. 2024. Projected changes in statin and antihypertensive therapy eligibility with the AHA PREVENT cardiovascular risk equations. JAMA. Published online. (https://doi.org/10.1001/jama.2024.12537) Grant, JK, Ndumele, CE, and Martin, SS. 2024. The evolving landscape of cardiovascular risk assessment. JAMA. Published online. (https://doi.org/10.1001/jama.2024.13247) Khan SS, and Lloyd-Jones, DM. 2024. Statins for primary prevention of cardiovascular disease — With PREVENT, what's a clinician to do? JAMA. Published online. (https://doi.org/10.1001/jama.2024.13887) Khan, SS, Matsushita, K, Sang, Y, et al. 2023. Development and Validation of the American Heart Association's PREVENT Equations. J Circulation. 6: 430-449. (https://doi.org/10.1161/CIRCULATIONAHA.123.067626) STUDY #2: Next, we dive into a great study examining the connection between antihypertensive medications and eczematous dermatitis in older adults. This extensive population-based research offers great insights that could change your approach to managing hypertension in patients with dermatologic concerns. Could your favorite antihypertensive medication be the culprit behind your patient's new skin condition? Ye, M, Chan, LN, Douglas, I, et al. 2024. Antihypertensive medications and eczematous dermatitis in older adults. JAMA Dermatol. Published online. (https://doi.org/10.1001/jamadermatol.2024.1230) Joly, P, Benoit-Corven, C, Baricault, S, et al. Sophie Baricault. 2007. Chronic Eczematous Eruptions of the Elderly Are Associated with Chronic Exposure to Calcium Channel Blockers: Results from a Case–Control Study. J Invest Derm. 12: 2766-2771. (https://doi.org/10.1038/sj.jid.5701018) Summers, EM, Bingham, CS, Dahle, KW, et al. 2013. Chronic Eczematous Eruptions in the Aging Further Support for an Association With Exposure to Calcium Channel Blocker. JAMA Dermatol. 7: 814-818. doi:10.1001/jamadermatol.2013.511 STUDY #3: Finally, we dissect a hotly discussed study linking semaglutide with non-arteritic anterior ischemic optic neuropathy. Garnering attention both in academia and the lay media, this study's robust methodology lends significant weight to its findings. But does this potential risk necessitate altering prescribing habits for semaglutide? Hathaway, JT, Shah, MP, Hathaway, DB, et al. 2024. Risk of nonarteritic anterior ischemic optic neuropathy in patients prescribed semaglutide. JAMA Ophthalmol. 2024. Published online. (https://doi.org/10.1001/jamaophthalmol.2024.2296) Join us for a closer look at these pivotal studies. It's a conversation you won't want to miss. Learn more with Medmastery's courses: Hypertension Mini (1 CME) Get a Basic or Pro account, or, get a Trial account. Show notes: Visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
In this week's podcast, Neurology Today's editor-in-chief discusses data on an angiotensin receptor for blocker for hypertension associated with reduced risk for epilepsy, a study finding first responders to 9-11 clean-up sites had an increased risk for early dementia, and dementia experts comment on approval of donanemab.
Welcome to the latest episode of Cardiology Digest, where we chart a course through groundbreaking studies that are shaping cardiology practice! STUDY #1: First, we discuss the nuanced world of drug interactions involving diltiazem and direct-acting oral anticoagulants like apixaban and rivaroxaban. Tune in as we scrutinize the study's limitations and practical implications for your patients with atrial fibrillation. Ray, WA, Chung, CP, Stein, CM, et al. 2024. Serious bleeding in patients with atrial fibrillation using diltiazem with apixaban or rivaroxaban. JAMA. 18: 1565–1575. (https://jamanetwork.com/journals/jama/article-abstract/2817546) STUDY #2: Next, we turn our attention to a case-control study examining the bleeding risks associated with the combination of selective serotonin reuptake inhibitors and anticoagulants in patients with atrial fibrillation. Are the bleeding risks substantial enough to rethink this combination therapy, or are there scenarios where the benefits outweigh the dangers? We'll leave no stone unturned. Rahman, AA, Platt, RW, Beradid, S, et al. 2024. Concomitant use of selective serotonin reuptake inhibitors with oral anticoagulants and risk of major bleeding. JAMA. 3: e243208. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816687) STUDY #3: Finally, we explore a fascinating meta analysis that looked at renal denervation and its long-term efficacy in controlling blood pressure. See how renal denervation stacks up against traditional antihypertensive medications and what you need to consider when thinking about incorporating it into your treatment arsenal. Sesa-Ashton, G, Nolde, JM, Muente, I, et al. 2024. Long-term blood pressure reductions following catheter-based renal denervation: A systematic review and meta-analysis. Hypertension. 6: e63–e70. (https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.22314) Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions. Learn more with these courses: Atrial Fibrillation Essentials (1 CME): Pacemaker Essentials (5 CME) Pacemaker Essentials Workshop (1 CME) Get a Basic or Pro account, or, get a Trial account. Show notes: Visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
Theme: “Measure your Blood Pressure Accurately, Control It, Live Longer” Friday May 17th, 2024, is World Hypertension Day. This is a day to raise awareness on Hypertension also known as high blood pressure which affects many individuals, families and communities. The World Health Organization reports that an estimated 1.28 billion individuals aged 30 to 79 years have hypertension and approximately 46% are unaware that they have the condition. Less than half, that is 42% with the disease are diagnosed and treated. In 2019, our STEPS survey results estimated that approximately 2 out of 5 Saint Lucians, have hypertension. Hypertension is called the silent killer, because people who have high blood pressure usually do not have symptoms of the condition. Unfortunately, over time, uncontrolled high blood pressure causes serious damage to vital organs like the heart and the kidney. In St Lucia, about 40% of people with hypertension, have their condition under control This is concerning since uncontrolled hypertension is the most common preventable cause of strokes and heart attacks which are the second and third leading causes of death respectively, in St Lucia. This year's theme is “Measure your blood pressure accurately, control it, live longer.” Since high blood pressure does not usually cause symptoms, Let us all measure our blood pressure regularly at home or at our health care providers, including at health care facilities, where accurate or validated blood pressure monitors are available. Controlled hypertension results in significantly fewer strokes, heart attacks, disabilities and deaths from these health conditions. High blood pressure can be controlled by various methods including lifestyle or behaviour changes and the use and adherence to prescribed medicines called antihypertensives. Antihypertensive medicines are proven to be very effective in lowering blood pressure and preventing complications and deaths. From August 1st, 2023, patients can access antihypertensive medicines available at the wellness centers free of charge. Additionally, through the Performance Based Financing Project, lab tests are also provided at no cost at select wellness centres. The Government of St Lucia is working through the Universal Health Coverage Programme to make available free laboratory testing for all hypertensives and diabetics at all wellness centres. Taking control of hypertension is another step in taking control of your life. Make a choice to take control. Make a choice to live longer. Visit your health care provider or your nearest wellness center for blood pressure measurements. Make a choice and start by knowing what the numbers are. Measure blood pressure. Measure accurately. Call the Bureau of Standards for help with choosing the right blood pressure monitor. Use the appropriate methods to measure blood pressure. In addition, pay special attention to other measures that control blood pressure and overall well-being. Seek nutritional counselling, get adequate exercise and rest and stay hydrated among other things. By taking control of your blood pressure, you're not just adding years to your life but also adding life to your years. Again, measure your blood pressure accurately, control it, live longer. Happy World Hypertension Day.
Theme: “Measure your Blood Pressure Accurately, Control It, Live Longer” Friday May 17th, 2024, is World Hypertension Day. This is a day to raise awareness on Hypertension also known as high blood pressure which affects many individuals, families and communities. The World Health Organization reports that an estimated 1.28 billion individuals aged 30 to 79 years have hypertension and approximately 46% are unaware that they have the condition. Less than half, that is 42% with the disease are diagnosed and treated. In 2019, our STEPS survey results estimated that approximately 2 out of 5 Saint Lucians, have hypertension. Hypertension is called the silent killer, because people who have high blood pressure usually do not have symptoms of the condition. Unfortunately, over time, uncontrolled high blood pressure causes serious damage to vital organs like the heart and the kidney. In St Lucia, about 40% of people with hypertension, have their condition under control This is concerning since uncontrolled hypertension is the most common preventable cause of strokes and heart attacks which are the second and third leading causes of death respectively, in St Lucia. This year's theme is “Measure your blood pressure accurately, control it, live longer.” Since high blood pressure does not usually cause symptoms, Let us all measure our blood pressure regularly at home or at our health care providers, including at health care facilities, where accurate or validated blood pressure monitors are available. Controlled hypertension results in significantly fewer strokes, heart attacks, disabilities and deaths from these health conditions. High blood pressure can be controlled by various methods including lifestyle or behaviour changes and the use and adherence to prescribed medicines called antihypertensives. Antihypertensive medicines are proven to be very effective in lowering blood pressure and preventing complications and deaths. From August 1st, 2023, patients can access antihypertensive medicines available at the wellness centers free of charge. Additionally, through the Performance Based Financing Project, lab tests are also provided at no cost at select wellness centres. The Government of St Lucia is working through the Universal Health Coverage Programme to make available free laboratory testing for all hypertensives and diabetics at all wellness centres. Taking control of hypertension is another step in taking control of your life. Make a choice to take control. Make a choice to live longer. Visit your health care provider or your nearest wellness center for blood pressure measurements. Make a choice and start by knowing what the numbers are. Measure blood pressure. Measure accurately. Call the Bureau of Standards for help with choosing the right blood pressure monitor. Use the appropriate methods to measure blood pressure. In addition, pay special attention to other measures that control blood pressure and overall well-being. Seek nutritional counselling, get adequate exercise and rest and stay hydrated among other things. By taking control of your blood pressure, you're not just adding years to your life but also adding life to your years. Again, measure your blood pressure accurately, control it, live longer. Happy World Hypertension Day.
Interview with Chintan V. Dave, PharmD, PhD, author of Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents, and Muna Thalji Canales, MD, MS, author of Blood Pressure Management and Falls in Nursing Home Residents—A Matter of Balance. Hosted by Eve Rittenberg, MD. Related Content: Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents Blood Pressure Management and Falls in Nursing Home Residents—A Matter of Balance
Interview with Chintan V. Dave, PharmD, PhD, author of Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents, and Muna Thalji Canales, MD, MS, author of Blood Pressure Management and Falls in Nursing Home Residents—A Matter of Balance. Hosted by Eve Rittenberg, MD. Related Content: Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents Blood Pressure Management and Falls in Nursing Home Residents—A Matter of Balance
Commentary by Dr. Valentin Fuster
Lemon Juice Hypertension Discovery Episode 1181 MAR 2024 This video explores surprising new research on a potential natural remedy for high blood pressure: lemons! Studies suggest citric acid, a key component in lemons, might help lower blood pressure in rats. While the exact mechanism needs further investigation, this discovery opens doors for exploring natural approaches to managing hypertension. Important Note: This information is for educational purposes only and should not be taken as medical advice. Always consult a healthcare professional before making any dietary changes. #LemonPower #NaturalBloodPressure #ScienceDiscovery Nakamura K, Suzuki Y, Goto K, Yamaguchi S, Hiramitsu M. Antihypertensive and Vasorelaxant Effects of Citric Acid and Lemon Juice in Spontaneously Hypertensive Rats: In Vivo and Ex Vivo Studies. Nutrients. 2023; 15(17):3849. https://doi.org/10.3390/nu15173849 Alchepharma,Ralph Turchiano,citation,research,study,high blood pressure,hypertension,natural remedy,lemon juice,citric acid,blood pressure control,hypertension management,blood pressure reduction,lemon benefits,citric acid health benefits,vasorelaxant effect,DASH diet,vitamin C,flavonoids,antioxidant properties,alternative approaches,scientific discovery,endothelial function,nitric oxide production,arterial stiffness,blood pressure lowering effect --- Support this podcast: https://podcasters.spotify.com/pod/show/ralph-turchiano/support
This video explores surprising new research on a potential natural remedy for high blood pressure: lemons! Studies suggest citric acid, a key component in lemons, might help lower blood pressure in rats. While the exact mechanism needs further investigation, this discovery opens doors for exploring natural approaches to managing hypertension. Important Note: This information is for educational purposes only and should not be taken as medical advice. Always consult a healthcare professional before making any dietary changes. #LemonPower #NaturalBloodPressure #ScienceDiscovery Nakamura K, Suzuki Y, Goto K, Yamaguchi S, Hiramitsu M. Antihypertensive and Vasorelaxant Effects of Citric Acid and Lemon Juice in Spontaneously Hypertensive Rats: In Vivo and Ex Vivo Studies. Nutrients. 2023; 15(17):3849. https://doi.org/10.3390/nu15173849 Alchepharma,Ralph Turchiano,citation,research,study,high blood pressure,hypertension,natural remedy,lemon juice,citric acid,blood pressure control,hypertension management,blood pressure reduction,lemon benefits,citric acid health benefits,vasorelaxant effect,DASH diet,vitamin C,flavonoids,antioxidant properties,alternative approaches,scientific discovery,endothelial function,nitric oxide production,arterial stiffness,blood pressure lowering effect --- Support this podcast: https://podcasters.spotify.com/pod/show/ralph-turchiano/support
Case Discussion 113 Answer: Choosing the best antihypertensive agent
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this podcast episode, I discuss some of the most common antihypertensive drug interactions you need to know. One major interaction I discuss is the trifecta of a diuretic, an ACE or ARB, and an NSAID. This combination significantly increases the risk for acute renal failure. Nitrates aren't classically referred to as an antihypertensive but they can definitely cause some problems when combined with PDE5 Inhibitors. Lithium can interact with 3 blood pressure medication classes. ACEIs, ARBs, and diuretics can all increase the risk for lithium toxicity.
Case Discussion 113 Answer: Choosing the best antihypertensive agent
Commentary by Dr. Valentin Fuster
HEALTH NEWS · More antiaging effects for fisetin · Breast cancer overdiagnosis common among older women · Vegan diet has just 30% of the environmental impact of a high-meat diet, major study finds · Antihypertensive and antioxidant activity in black beans · Consuming added sugars may increase risk of kidney stones · Increased risk of dementia diagnosis, benzodiazepine exposure in seniors with anxiety
BP Control in Neurologic Emergencies Part II Special Guest: Andrew Webb, PharmD, BCCCP https://www.neurowiserx.com 02:25 – Antihypertensive treatment overview 10:02 – IV push agents 17:47 – Continuous IV agents 34:00 – Take-home points Reference List: https://pharmacytodose.files.wordpress.com/2023/07/bp-in-neurologic-emergencies-part-ii-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
Welcome all to IS PHARMACOLOGY DIFFICULT Podcast! I am Dr Radhika VijayIn this episode, I will be covering in detail the effect of Beta Blockers on CardioVascular System and details about states of exercise/stress and Coronary Heart Disease.I will also talk about the Antihypertensive effect of Beta Blockers and their additional mechanisms and effects. It will all in details enough for you all to comprehend this topic in a nice manner!These would be the highlights of this episode while in next episode I will be having a conference about Beta Blocker effects on Pulmonary and Metabolic systems.For all the updates and latest episodes of my podcast, please visit www.ispharmacologydifficult.com where you can also sign up for a free monthly newsletter of mine.It actually contains lot of updates about the medical sciences, drug information and my podcast updates also.You can follow me on different social media handles like twitter, insta, facebook and linkedin. They all are with same name "IS PHARMACOLOGY DIFFICULT". If you are listening for the first time, do follow me here, whatever platform you are consuming this episode, stay tuned, do rate and review on ITunes, Apple podcasts, stay safe, stay happy, stay enlightened, Thank you!! Please leave Review on Apple podcasts! My E-Newsletter sign up at Website! Connect on Twitter & Instagram! My books on Amazon & Goodreads!
Welcome all to IS PHARMACOLOGY DIFFICULT Podcast! I am Dr Radhika VijayIn this episode, I will be covering in detail the effect of Beta Blockers on CardioVascular System and details about states of exercise/stress and Coronary Heart Disease.I will also talk about the Antihypertensive effect of Beta Blockers and their additional mechanisms and effects. It will all in details enough for you all to comprehend this topic in a nice manner!These would be the highlights of this episode while in next episode I will be having a conference about Beta Blocker effects on Pulmonary and Metabolic systems.For all the updates and latest episodes of my podcast, please visit www.ispharmacologydifficult.com where you can also sign up for a free monthly newsletter of mine.It actually contains lot of updates about the medical sciences, drug information and my podcast updates also.You can follow me on different social media handles like twitter, insta, facebook and linkedin. They all are with same name "IS PHARMACOLOGY DIFFICULT". If you are listening for the first time, do follow me here, whatever platform you are consuming this episode, stay tuned, do rate and review on ITunes, Apple podcasts, stay safe, stay happy, stay enlightened, Thank you!!Please leave Review on Apple podcasts!My E-Newsletter sign up at Website!Connect on Twitter & Instagram!My books on Amazon & Goodreads!
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief of JAMA, the Journal of the American Medical Association, for the April 11, 2023, issue. Related Content: Audio Highlights
In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the April 2023 issue of DTB. They discuss evidence around morning and evening doses of antihypertensive medication (https://dtb.bmj.com/content/61/4/50). They review a study that analysed health technology assessment decisions made in Australia, Canada and England (https://dtb.bmj.com/content/61/4/51) and also talk about managing skin conditions in women who are planning pregnancy or who are pregnant (https://dtb.bmj.com/content/61/4/55). They begin by responding to a listener's letter about last month's podcast. The Prescribing for pregnancy series of articles can be found here: https://dtb.bmj.com/pages/prescribing-for-pregnancy-series/
Hypertension treatments are really about a few drug classes: ACEIs and ARBs, Beta Blockers, Calcium Channel Blockers, Diuretics, and a few more. This episode has a few mnemonics and a focus on prefixes and suffixes that will help you remember them. Need more help; you can find many of my mnemonics books on Audible that you might be able to get your first for free if you've never had one before. https://www.audible.com/pd/Memorizing-Pharmacology-Mnemonics-Audiobook/B07DLGC8MP?source_code=AUDFPWS0223189MWT-BK-ACX0-118296&ref=acx_bty_BK_ACX0_118296_rh_us
As Vice President, Derek Mitchell serves as the principal lead on a variety of company initiatives such as Tax-Exempt Municipal Lease Financing, Energy Performance Contract Management, Government Fleet Analytics and Financing, in addition to various growth and implementation strategies. In his current role, Derek has financed over $300 million in transactions within the public sector as well as managing multiple project management engagements. He also made history when he led the financing team which funded the largest Energy Performance Contract ever implemented by a Public Housing Authority. Derek has presented and engaged in panel discussions on the topic of tax-exempt financing at various organizations including the Council of Large Public Housing Authorities (“CLPHA”), the American Council for an Energy Efficient Economy (“ACEEE”), and the Birmingham Business Alliance. Prior to his work at Grant Capital Management, Derek successfully launched products in the Antihypertensive, Psychiatry, and Urology markets within the pharmaceutical industry. He is knowledgeable in developing and executing sound business strategies that increase sales numbers.Derek has over fourteen years of experience in building strong customer relationships, training of newly hired employees and organizational strategy within multiple business segments.Derek holds a B.S. in Marketing from Hampton University and a MBA-finance from Loyola University.Our services for both our clients and candidates can be found below✔️For Employers: https://www.nenniandassoc.com/for-employers/✔️For Candidates: https://www.nenniandassoc.com/career-opportunities/✔️Consulting: https://www.nenniandassoc.com/consulting-services/✔️Executive Search: https://www.nenniandassoc.com/executive-search/Nenni and Associates on Social Media:► Follow on LinkedIn: https://www.linkedin.com/company/nenni-and-associates/► Like on Facebook: https://www.facebook.com/nenniandassoc/► Email Listing: https://www.nenniandassoc.com/join-email-list/► Subscribe to our YouTube channel: https://www.youtube.com/c/NenniAssociates
Kevin Scott from Platanes shares how highbrows and platanes differ and how to best take care of your platanes.
This week, Rob and Zach will be talking about Antihypertensive Drugs to supplement our YouTube lecture on Antihypertensive Drugs.We will be discussing the following topics within this episode on Antihypertensive Drugs!Defining HypertensionMechanism of HypertensionMechanisms of Antihypertensive AgentsIndications and Adverse Drug Reactions of Antihypertensive AgentsDrug Categories of Antihypertensive AgentsCentrally ActingBeta BlockersNondihydropyridine Calcium Channel BlockersAlpha BlockersAlpha + Beta BlockersDihydropyridine Calcium Channel BlockersDirect ActingRAAS InhibitorsThiazide DiureticsLoop DiureticsAldosterone AntagonistsTo follow along with Notes & Illustrations for our podcasts please become a member on our website! https://www.ninjanerd.org/podcast/antihypertensive-drugsFollow us on:YouTube: https://www.youtube.com/ninjanerdscienceInstagram: https://www.instagram.com/ninjanerdlecturesFacebook: https://www.facebook.com/NinjaNerdLecturesTwitter: https://twitter.com/ninjanerdsciDiscord: https://discord.com/invite/3srTG4dngWTikTok: https://www.tiktok.com/@ninjanerdlecturesHolistic Life NavigationThis podcast explores how to heal stress & trauma holistically. I am your host, Luis...Listen on: Apple Podcasts SpotifySupport the show
Episode 107: Weight Gain Meds. Medications that cause weight gain are also called weight positive medications. Sapna, Danish, and Dr. Arreaza mention some of those medications in this episode. Introduction: Some meds cause weight gainBy Hector Arreaza, MD.You will see patients who keep gaining weight regardless of their sincere efforts to eat better and exercise. Some people experience serious difficulties to lose weight. If you want to know how frustrating it can be, imagine your doctor telling you to add one more inch to your height when you are 35 years old. For some people, losing weight is just as hard. One important step you can take to help your patients lose weight is performing a detailed medication reconciliation. Review the medication list, and you may find some meds that are proven to cause weight gain. Today we will discuss some of those medications, but it takes practice to learn all of them. I hope this episode is helpful for you. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________Weight Gain Meds. By Sapna Patel, MS4, and Danish Khalid, MS4. Ross University School of Medicine. Comments by Hector Arreaza, MD. S: Medications associated with weight gain: See Table 1.1 for medications associated with weight gain and alternatives. Antipsychotic agents:A: Ziprasidone is an antipsychotic medicine that causes the least amount of weight gain.Antidepressants:There are many antidepressants which are associated with weight gain, including the tricyclics, monoamine oxidase inhibitors (MAOIs), and some of the selective serotonin reuptake inhibitors (SSRIs). Tricyclic antidepressants, in particular amitriptyline, clomipramine, doxepin, and imipramine, are associated with significant weight gain.Selective serotonin reuptake inhibitors, paroxetine exhibited the greatest weight gain in its class. Whereas fluoxetine exhibited little to no weight gain and remains weight neutral in the class. Amongst the monoamine oxidase inhibitors, phenelzine had the greatest weight gain. Antiepileptics/Antiseizure: Amongst the antiepileptic drugs used to treat seizures, neuropathic pain, or other psychiatric conditions, valproate, carbamazepine, and gabapentin are associated with weight gain. Gabapentin is virtually used by all our diabetic patients. Antihypertensive agents: Beta BlockersBeta receptors, specifically beta-2 receptors, stimulate the release of insulin. Thus, patients on beta blockers may experience weight gain as a side effect. There are two beta blockers that cause the least amount of weight gain: Carvedilol (Coreg) and nebivolol (Bystolic). Hypoglycemic medications: Although intended to regulate blood sugar levels, several anti-diabetic medications are associated with weight gain, specifically sulfonylureas, Actos, and insulin. As mentioned earlier, metformin as well as GLP-1 agonists are associated with weight loss. Metformin can be considered weight neutral. Steroids: Steroid hormones such as corticosteroids or progestational steroids are associated with weight gain. Steroids may increase levels of cortisol, one of the end pathways in steroidogenesis. Cortisol, also known as the stress hormone, functions by increasing insulin resistance, and decreasing glucose utilization, thus causing weight gain. Antihistamine Medications: Diphenhydramine (Benadryl): commonly used for allergies…or how my mom used it, puts you to sleep right before a flight. However, a side effect of using this medication includes weight gain.Cyproheptadine: an antihistamine, used for antidote to serotonin syndrome and migraines, has an appetite stimulant effect causing weight gain. It can be used off-label as an appetite stimulant in children who do not gain weight. Fun Fact: Although it is a common belief that combined oral contraceptives cause weight gain, data suggest that significant weight gain is not a common side effect of combined oral contraceptives. A good practice: Medication reconciliation: Weight positive, weight neutral, or weight negative. Weight positive: Deprescribe or change for another medication if possible. Weight neutral and weight negative: Keep them. Don't be afraid to prescribe anti-obesity meds. We should learn about them, become familiar with side effects, contraindications, dosing, and more, and prescribe them appropriately as part of a weight loss program. Also, don't forget that these medications are used in conjunction with a proper diet. CategoryDrug ClassWeight GainAlternatives Psychiatric agentsAntipsychoticsClozapine, risperidone, olanzapine, quetiapine, haloperidol, perphenazineZiprasidone, aripiprazoleAntidepressants/mood stabilizers: tricyclic antidepressantsAmitriptyline, doxepin, imipramine, nortriptyline, trimipramine, mirtazapine Bupropion, nefazodone, fluoxetine (short term), sertraline (
Antihypertensive and antioxidant activity in black beans National Polytechnic Institute (Mexico) 16 July 2022 Beans are one of the most important crops for the Mexican population due to its nutritional qualities. In fact, the country is one of the top 10 producers of this legume in the world, and several studies have reflected the correlation between consumption and decreased chronic degenerative diseases, cardiovascular diseases, obesity and diabetes. Therefore, the National School of Biological Sciences of the National Polytechnic Institute (IPN-ENCB), conducted an investigation to evaluate the antioxidant and antihypertensive activity in black beans, and found that in addition to these qualities, proteins in the bean can remove heavy metals from the body. The polytechnic research identified bioactive peptides in the legume that have a beneficial effect as antihypertensive and antioxidant, which could favor the prevention and treatment of cardiovascular diseases, with a specific effect on blood pressure and oxidative stress. It was determined that fasolina and lectin hydrolysates (main proteins in the Jamapa black bean) had chelating activity (removal of heavy metals in the body) and, when hydrolyzed with pepsin-pancratin, they release peptides (amino acids) with antihypertensive and antioxidant effects. Could Eating Fruit More Often Keep Depression At Bay? Aston University (UK), July 15, 2022 People who frequently eat fruit are more likely to report greater positive mental well-being and are less likely to report symptoms of depression than those who do not, according to new research from the College of Health and Life Sciences, Aston University The study found frequent fruit eaters had greater positive mental wellbeing The study surveyed 428 adults and looked at the relationship between their consumption of fruit, vegetables, sweet and savoury food snacks and their psychological health The more often people ate fruit, the lower they scored for depression and the higher for mental well-being. Published in the British Journal of Nutrition, the study surveyed 428 adults from across the UK and looked at the relationship between their consumption of fruit, vegetables, sweet and savoury food snacks, and their psychological health. People who frequently snacked on nutrient-poor savoury foods (such as crisps) were more likely to experience 'everyday mental lapses' (known as subjective cognitive failures) and report lower mental wellbeing. A greater number of lapses, was associated with higher reported symptoms of anxiety, stress and depression, and lower mental wellbeing scores. Effect of Short-term Quercetin, Caloric Restriction in Late Life Effective to Counter Age-Related Oxidative Macromolecular Damage. Pondicherry University (India), July 13, 2022 According to news from Pondicherry, India, research stated, "Aging is characterized by gradual accumulation of macromolecular damage leading to progressive loss of physiological function and increased susceptibility to diverse diseases. Effective anti-aging strategies involving caloric restriction or antioxidant supplementation are receiving growing attention to attenuate macromolecular damage in age associated pathology." Research from Pondicherry University, "In the present study, we for the first time investigated the effect of quercetin, caloric restriction and combined treatment (caloric restriction with quercetin) on oxidative stress parameters, acetylcholinesterase and ATPases enzyme activities in the cerebral cortex of aged male Wistar rats. Our results demonstrate that combined treatment of caloric restriction and quercetin significantly improved the age associated decline in the activities of endogenous antioxidant enzymes [such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)] and glutathione (GSH), and nitric oxide (NO). According to the news reporters, the research concluded: "Finally, we conclude that combined treatment of caloric restriction and quercetin in late life is an effective anti-aging therapy to counteract the age related accumulation of oxidative macromolecular damage." How Drinking Soda on a Hot Day Can Damage Kidneys, Leading to Diabetes, Heart Disease University of Buffalo, July 18, 2022 Research demonstrates the acute deleterious effects soda can have on your kidney function when used to quench your thirst during exertion on a hot day. Drinking soda causes dehydration and raises markers for kidney disease when consumed after performing manual labor or exercise in 95-degree Fahrenheit weather. When you exert yourself in a hot environment, your body regulates blood pressure and conserves water by reducing blood flow to your kidneys. A sudden and steep drop in blood flow through your kidneys can cause acute kidney injury due to the fact that it reduces the amount of oxygen being delivered to your kidneys. Your diet has an overriding influence over the health of your kidneys, with sugar and excess protein topping the list of food components known to cause problems when consumed regularly. The study, published in the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, found soda caused dehydration and raised markers for kidney disease when consumed after performing manual labor in 95-degree F. weather. “The volunteers completed … a 30-minute treadmill workout followed by three different five-minute lifting, dexterity and sledgehammer swinging activities. After 45 minutes of exercise, the volunteers rested for 15 minutes … while drinking 16 ounces of either a high-fructose, caffeinated soft drink or water. After the break, they repeated the cycle three more times for a total of four hours. Before leaving the laboratory, the volunteers were given more of their assigned beverages to drink before consuming any further fluids. The volume was either 1 liter or a volume equal to 115% of their body weight lost through sweating if that amount was greater.” When volunteers drank soda, 75% of them had elevated levels of creatinine in their blood, a marker for kidney injury. Only 8% of participants in the water trial had elevated creatinine. When drinking soda, volunteers also had: A lower glomerular filtration rate, another marker for kidney injury Higher uric acid levels Mild dehydration Higher levels of vasopressin, an antidiuretic hormone that raises blood pressure Black Seed Oil Extract Causes Oral Cancer Cells To Self-Destruct Institute of Biochemistry and Biotechnology (Taiwan), July 20, 2022 A range of chemotherapeutic options for treating cancer are available, however many of the treatments are themselves associated with significant morbidity and mortality. Today many cancer sufferers search for alternatives to conventional chemotherapy. Increasingly natural alternative options are becoming available, often with little or no side-effects and concrete science is proving the effects of many natural substances against cancer. One substance which is increasingly making the headlines is thymoquinone, an active component of Nigella sativa or black seed oil. Scientists from the Institute of Biochemistry and Biotechnology, Taiwan, have found that this remarkable compound elicits cytotoxic effects on various squamous cancer cell lines through various mechanisms. The study examined a highly malignant strain of squamous cell carcinoma, which was taken from various patients with oral cancer; this particular cancer type also causes many other cancers of the head and neck. The cell lines were grown in a lab and treated with different concentrations of thymoquinone. The results showed that after just 24 hours of treatment there was a significant concentration-dependent cytotoxic effect on these cells. The study further examined why this was happening. Their findings are quite remarkable as they were able to demonstrate that thymoquinone was a potent inhibitor of oral cancer cell viability via two distinct anti-neoplastic mechanisms. No bones about it: Cannabis may be used to treat fractures Tel Aviv University researcher finds non-psychotropic compound in marijuana can help heal bone fissures Tel Aviv University (Israel), July 19, 2022 A study published in the Journal of Bone and Mineral Research by Tel Aviv University and Hebrew University researchers explores another promising new medical application for marijuana. According to the research, the administration of the non-psychotropic component cannabinoid cannabidiol (CBD) significantly helps heal bone fractures. The study, conducted on rats with mid-femoral fractures, found that CBD -- even when isolated from tetrahydrocannabinol (THC), the major psychoactive component of cannabis -- markedly enhanced the healing process of the femora after just eight weeks. Undeniable clinical potential The same team, in earlier research, discovered that cannabinoid receptors within our bodies stimulated bone formation and inhibited bone loss. This paves the way for the future use of cannabinoid drugs to combat osteoporosis and other bone-related diseases. "We found that CBD alone makes bones stronger during healing, enhancing the maturation of the collagenous matrix, which provides the basis for new mineralization of bone tissue," said Dr. Gabet. "After being treated with CBD, the healed bone will be harder to break in the future." The researchers injected one group of rats with CBD alone and another with a combination of CBD and THC. After evaluating the administration of THC and CBD together in the rats, they found CBD alone provided the necessary therapeutic stimulus. OCCUPY PEACE & FREEDOM RALLY INFO Saturday, July 23 -- 2:00 pm Kingston, NY (at the historical 4 corners -- Crown and John Streets) Speakers: Gerald Celente Judge Andrew Napolitano Gary Null Scott Ritter Phil Giraldi (former CIA official) Live music, food and drink
The Filtrate:Joel TopfNayan AroraSophia AmbrusoSwapnil HiremathJosh WaitzmanSpecial Guest:Natalie Bello Director of Hypertension Research at Cedars SinaiEditor:Nayan AroraShow Notes:NephJC summary of CHAPCHiPS TV showCHIPS study: Less-Tight versus Tight Control of Hypertension in PregnancyPrevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines (Pubmed)SFLT in preeclampsia from where else but NephMadness and here.Aspirin Use to Prevent Preeclampsia and Related Morbidity and MortalityUS Preventive Services Task Force Recommendation Statement (JAMA)The NNT for aspirin in pregnancy is like a relationship on Facebook, it's complicated. Astrologic signs as predictor of aspirin effectiveness in Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group (Pubmed) ACOG revises the guidelines on hypertension: Clinical Guidance for the Integration of the Findings of the Chronic Hypertension and Pregnancy (CHAP) StudyMeta-analysis showing treating blood pressure in pregnancy didn't help. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Suzanne Oparil, MD, FACC, FAHA, FASH, FAPS and Nanette Kass Wenger MD, MACC, discuss ACC.22 Late Breaker: Antihypertensive Therapy For Mild Chronic Hypertension Improves Pregnancy Outcomes: A Pragmatic Multicenter RCT.
ACE Inhibitors, Beta Blockers, ARB, Calcium Channel Blockers & many more.
Initial administration of two-drug combinations in HTN
In this episode, we review the high-yield topic of Antihypertensive Therapy from the Cardiovascular section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
Video auf Youtube: Kanal "Medizinmensch". Gicht ist eine schwerwiegende Krankheit bei der Harnsäure im Gelenk zu massiver Entzündung und extremen Schmerz führen kann. Grund für Gicht ist zu hohe Harnsäure und die Ausscheidung von Harnsäure wird auch durch Medikamente stark beeinflusst. Gerade entwässernde Mittel zur Therapie von Herzerkrankungen und Bluthochdruck senken die Ausscheidung von Harnsäure. In diesem Video besprechen wir den Effekt dieser weit verbreiteten Medikamente, und Tipps wie du trotzdem die Auswirkung von Gicht vermeiden kannst. Meine Website: https://medizinmensch.de Kaffee spenden: https://buymeacoffee.com/Medizinmensch Glossar: Diuretikum: Harnstreibendes Mittel, kann (durch Senkung der Ausscheidung von Harnsäure) den Harnsäurespiegel erhöhen HCT: Hydrochlorothiazid, ein Diuretikum welches bei Bluthochdruck eingesetzt wird, und die Harnsäure erhöht Furosemid: Ein potentes sog. Schleifendiuretikum, das vorallem bei Therapie akuter Herzschwäche eingesetzt wird Nephron: Die kleinste Einheit der Niere Kalziumkanalblocker: Blutdruckmedikamente, z.B. Amlodipin und Nifedipin, die die Harnsäure senken Losartan: Ein weiteres Blutdruckmedikament welches den Harnsäurespiegel durch erhöhte Ausscheidung von Harnsäure senkt Cyclosporin, Tacrolimus: Das Immunsystem unterdrückende Medikamente (Immunsuppressiva), die u.a. den Harnsäurespiegel erhöhen Weitere Videos von mir (Playlists): Autoimmunerkrankungen: https://bit.ly/MM-Autoimmunerkrankungen Blutwerte erklärt: https://bit.ly/MM-Blutwerte Coronavirus & Covid-19: https://bit.ly/MM-Corona Gicht & Pseudogicht: https://bit.ly/MM-Gicht Medizin leicht erklaert: https://bit.ly/MM-Medizin-erklaert Links / Quellen: Choi et al.: Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study https://www.bmj.com/content/344/bmj.d8190 Lizenzen: CC0: https://creativecommons.org/publicdomain/zero/1.0 CC BY 3.0: https://creativecommons.org/licenses/by/3.0 CC BY 4.0: https://creativecommons.org/licenses/by/4.0 Wichtiger Hinweis: Die Videos dienen ausschließlich der Allgemeinbildung. Die Informationen ersetzen keine persönliche Beratung, Untersuchung oder Diagnose. Die zur Verfügung gestellten Inhalte ermoeglichen nicht die Erstellung eigenständiger Diagnosen. Medizinisches Wissen unterliegt fortwaehrendem Wandel und es kann nicht garantiert werden dass die Informationen zu jedem Zeitpunkt noch korrekt sind, oder selbst korrekt waren. Haftung ausgeschlossen. Merk-würdiges Medizinwissen für Alle. Abonniere jetzt und erhalte neue Folgen, jeden Medizin-Mittwoch. Folge direkt herunterladen
SHR # 2694:: Antihypertensive Properties of Green and Black Tea - Dr. Geoffrey W. Abbott, M.S., Ph.D. - A new study from the University of California, Irvine shows that compounds in both green and black tea relax blood vessels by activating ion channel proteins in the blood vessel wall. The discovery helps explain the antihypertensive properties of tea and could lead to the design of new blood pressure-lowering medications. Published in Cellular Physiology and Biochemistry, the discovery was made by the laboratory of Geoffrey Abbott, PhD, a professor in the Department of Physiology and Biophysics at the UCI School of Medicine. Kaitlyn Redford, a graduate student in the Abbott Lab, was first author of the study titled, "KCNQ5 potassium channel activation underlies vasodilation by tea." Results from the research revealed that two catechin-type flavonoid compounds (epicatechin gallate and epigallocatechin-3-gallate) found in tea, each activate a specific type of ion channel protein named KCNQ5, which allows potassium ions to diffuse out of cells to reduce cellular excitability. As KCNQ5 is found in the smooth muscle that lines blood vessels, its activation by tea catechins was also predicted to relax blood vessels - a prediction confirmed by collaborators at the University of Copenhagen.
SHR # 2694:: Antihypertensive Properties of Green and Black Tea - Dr. Geoffrey W. Abbott, M.S., Ph.D. - A new study from the University of California, Irvine shows that compounds in both green and black tea relax blood vessels by activating ion channel proteins in the blood vessel wall. The discovery helps explain the antihypertensive properties of tea and could lead to the design of new blood pressure-lowering medications. Published in Cellular Physiology and Biochemistry, the discovery was made by the laboratory of Geoffrey Abbott, PhD, a professor in the Department of Physiology and Biophysics at the UCI School of Medicine. Kaitlyn Redford, a graduate student in the Abbott Lab, was first author of the study titled, "KCNQ5 potassium channel activation underlies vasodilation by tea." Results from the research revealed that two catechin-type flavonoid compounds (epicatechin gallate and epigallocatechin-3-gallate) found in tea, each activate a specific type of ion channel protein named KCNQ5, which allows potassium ions to diffuse out of cells to reduce cellular excitability. As KCNQ5 is found in the smooth muscle that lines blood vessels, its activation by tea catechins was also predicted to relax blood vessels - a prediction confirmed by collaborators at the University of Copenhagen.
Cardiovascular medications
This episode covers antihypertensive drugs!
Health care professionals often don't think twice about adding a new medication when a patient is not at goal. But we're reluctant to stop a medication for a chronic condition when the patient appears to be stable and doing well. Polypharmacy in older adults is a significant problem. It's costly and increases the likelihood of adverse effects. Several observational studies have suggested that lower blood pressure and multiple antihypertensive medications may be harmful in the elderly. Is it possible to discontinue medications without causing serious harm? Guest Authors: Keturah Weaver Pharm D, BCPS and Daniel Longyhore Pharm D, M.S., BCACP Music by Good Talk
This episode covers antihypertensive medications!
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.12.248955v1?rss=1 Authors: Wang, L., Niu, D., Wang, X., Shen, Q., Xue, Y. Abstract: Strategies to screen antihypertensive peptides with high throughput and rapid speed will be doubtlessly contributed to the treatment of hypertension. The food-derived antihypertensive peptides can reduce blood pressure without side effects. In present study, a novel model based on Extreme Gradient Boosting (XGBoost) algorithm was developed using the primary structural features of the food-derived peptides, and its performance in the prediction of antihypertensive peptides was compared with the dominating machine learning models. To further reflect the reliability of the method in real situation, the optimized XGBoost model was utilized to predict the antihypertensive degree of k-mer peptides cutting from 6 key proteins in bovine milk and the peptide-protein docking technology was introduced to verify the findings. The results showed that the XGBoost model achieved outstanding performance with the accuracy of 0.9841 and the area under the receiver operating characteristic curve of 0.9428, which were better than the other models. Using the XGBoost model, the prediction of antihypertensive peptides derived from milk protein was consistent with the peptide-protein docking results, and was more efficient. Our results indicate that using XGBoost algorithm as a novel auxiliary tool is feasible for screening antihypertensive peptide derived from food with high throughput and high efficiency. Copy rights belong to original authors. Visit the link for more info
Is it safe to reduce antihypertensive medications in some older patients? Find out about this and more in today’s PV Roundup podcast.
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Cardiovascular Nitro: Angina meds. Stable angina, unstable angina, Nitroglycerine, Stable angina drugs, unstable angina drugs, Nitric oxide, Nitroglycerine, Nitroprusside, Angina medication, Isosorbide, Nitrate, Nitrostat, Nitromist, Nitroquick, Nitrolingual, Nitro-Dur, Minitran, Nitro-Bid, Nitronol, Isosorbide dinitrate (ISDN) Minoxidil, Gonitro, Nitrobid, Nitrolingual, Nitrostat, isosorbide mononitrate (Ismo, Moneket) isosorbide dinitrate (Imdur, Isordil), Hydralazine (apresoline) Minoxidil Fenoldopam (carlopam) Nitroprusside (Nipride, Nitropress) Antianginal agent, Cardiac Pharmacology, Antihypertensive drugs, blood pressure medications, heart failure pharmacology Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
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Cardiovascular antihypertensive meds. Hydrochlorothiazide, loop diuretics, thiazide diuretics, potassium wasting diuretics, potassium sparing diuretics, Furosemide, torsemide, bumetanide, chlorthalidone, Cardiac Pharmacology, Antihypertensive drugs, blood pressure medications, heart failure pharmacology, HF drugs, CHF drugs, hypertensive drugs, high blood pressure drugs. Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
The Simple Nursing Podcast - The Simplest Way To Pass Nursing School
Cardiovascular meds. Nitric oxide, Nitroglycerine, Nitroprusside, Angina medication, Isosorbide, Nitrate, Nitrostat, Nitromist, Nitroquick, Nitrolingual, Nitro-Dur, Minitran, Nitro-Bid, Nitronol, Isosorbide dinitrate (ISDN Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
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Cardiac Pharmacology, Antihypertensive drugs, blood pressure medications, heart failure pharmacology, HF drugs, CHF drugs, hypertensive drugs, high blood pressure drugs, amlodipine (Norvasc), diltiazem (Cardizem LA, Tiazac), felodipine (Plendil), isradipine (Dynacirc), nifedipine (Adalat, Procardia), nicardipine (Cardene), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Covera-HS, Verelan PM, Calan). Verapamil, diltiazem, nicardipine, Chronotropic, inotropic, Dromotropics Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
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Cardiac Pharmacology, Antihypertensive drugs, blood pressure medications, hypertensive drugs, high blood pressure drugs, heart failure pharmacology, HF drugs, CHF drugs, hypertensive drugs, high blood pressure drugs, Acebutolol (Sectral) Atenolol (Tenormin) Bisoprolol (Zebeta) Metoprolol (Lopressor, Toprol-XL) Nadolol (Corgard) Nebivolol (Bystolic) Propranolol (Inderal LA, InnoPran XL) Chronotropic, Dromotropics Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
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Ace inhibitors, angiotensin receptor blockers, lisinopril, losartan Cardiac Pharmacology, Antihypertensive drugs, blood pressure medications, heart failure pharmacology, HF drugs, CHF drugs, hypertensive drugs, high blood pressure drugs, benazepril (Lotensin, Lotensin Hct), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc) perindopril (Aceon), quinapril (Accupril), Potassium wasting, azilsartan (Edarbi) candesartan (Atacand) eprosartan (Teveten) irbesartan (Avapro) telmisartan (Micardis) valsartan (Diovan) losartan (Cozaar) olmesartan (Benicar) Free quiz & full course at https://Simplenursing.com/nursing-school Pharmacology Master Class - 100 videos not on YouTube - Try it for Free! Pharmacology Master Class - Try it for Free: https://Simplenursing.com/nursing-school 100 videos not on YouTube FREE Access to new app + 1,000 videos not on youtube! https://Simplenursing.com/nursing-school NCLEX FREE TRIAL: https://simplenursing.com/NCLEX STAY IN TOUCH
LET'S TAKE ALL THEM PILLS AWAY FROM THE GERIATRIC POPULATION. WHO'S WITH ME?
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Nitrate rich, Anti oxidant, Antihypertensive, Increaeses atheletic performace and blood flow in the body...Dive in to know about this superfood in Hindi. --- Send in a voice message: https://anchor.fm/indimasala/message
Voltando para a Clínica Médica, Raphael, Fred e Pedro discutem as características de cada anti-hipertensivo que utilizamos como primeira droga, soltando algumas clinicagens no meio do caminho. Faltou falar algo? Compartilha com a gente no nosso Instagram e Twitter @tadeclinicagem. Minutagem: [05:00] Aspectos para droga ser de primeira linha [06:30] Quais são as drogas de primeira linha linha [07:10] Tiazídicos [13:00] Efeitos Colaterais dos Tiazídicos [15:20] IECA/BRA [16:40] Efeitos colaterais IECA/BRA [21:55] Bloqueadores de Canais de Cálcio [23:50] Efeitos colaterais dos BCC [27:10] E o Beta-bloqueador? [28:50] E os outros antihipertensivos? [30:20] ALLHAT [34:50] Monoterapia vs Duplaterapia [36:50] Qual antihas vc prescreveria nessa situação? [38:50] Salves [41:45] Desafio da Semana Referências: Furberg, Curt D., et al. "Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)." Journal of the American Medical Association 288.23 (2002): 2981-2997. Jamerson, Kenneth, et al. "Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients." New England Journal of Medicine 359.23 (2008): 2417-2428. Sociedade Brasileira de Cardiologia. "7ª Diretriz Brasileira de Hipertensão Arterial." Arquivos Brasileiros de Cardiologia 107.3 (2018). Whelton, Paul K., et al. "2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines." Journal of the American College of Cardiology 71.19 (2018): e127-e248. Williams, Bryan, et al. "2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)." European heart journal 39.33 (2018): 3021-3104. UPTODATE 2020. Choice of drug therapy in primary (essential) hypertension. Johannes FE Mann. Meta-analysis of dose-response relationships for hydrochlorothiazide, chlorthalidone, and bendroflumethiazide on blood pressure, serum potassium, and urate. CARLBERG, Bo; SAMUELSSON, Ola; LINDHOLM, Lars Hjalmar. Atenolol in hypertension: is it a wise choice? The Lancet, v. 364, n. 9446, p. 1684-1689, 2004. UPTODATE March 2020 ACE inhibitor-induced angioedema. Authors:Autumn Chandler Guyer, MDAleena Banerji, M-D
Antihypertensive Agents
A lot of medications can interfere with sexual function – meds for pain, for high blood pressure, for insomnia – the list is long. Dr. Carolyn Eaton sorts through the list and alternatives.
Scottish doctor, writer, speaker, and outspoken cholesterol sceptic Malcolm Kendrick is back on the podcast this week. He continues to challenge the widespread use of statin medications, despite being targeted personally and professionally by those opposing his message. Since we last talked he has authored a new book, A Statin Nation: Damaging Millions in a Brave New Post-health World, elucidating his position against mainstream medicine’s rampant cholesterol-lowering tactics. On this podcast, Dr. Kendrick describes in detail exactly what he believes drives the process of cardiovascular disease, informed from 35 years of research on the subject. He explains specifically why cholesterol has been misunderstood, and how medicine got it wrong. We discuss corruption in medical research and the money supporting the status quo, and Dr. Kendrick shares some of the best ways to avoid heart disease (which have little to do with diet!). Here’s the outline of this interview with Malcolm Kendrick: [00:00:07] Our first podcast with Malcolm Kendrick: Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think about Instead). [00:00:30] Book: A Statin Nation: Damaging Millions in a Brave New Post-health World, by Dr. Malcolm Kendrick. His previous two books: Doctoring Data and The Cholesterol Con. [00:02:00] Causes vs processes. [00:03:40] History behind his journey and questioning authority. [00:07:30] Articles written by Elspeth Smith. [00:09:00] Karl Rokitansky’s paper discussing an alternative way of looking at CVD: A manual of pathological anatomy, Vol. 4. Day GE, trans. London: Sydenham Society, 1852:261; in print here. [00:09:06] Rudolf Virchow, researcher who pointed to cholesterol in artery walls. [00:10:55] Researcher Nikolai N. Anichkov: fed rabbits a high-cholesterol diet and cholesterol appeared in their arteries (sort of). [00:12:07] Ancel Keys; blaming saturated fat. [00:14:11] France - highest saturated fat consumption, lowest rate of CVD. Georgia - lowest sat fat consumption, highest rate of CVD. See graph, here. [00:15:16] International Network of Cholesterol Skeptics (THINCS). Study: Ravnskov, Uffe, et al. "Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review." BMJ open 6.6 (2016): e010401. [00:16:50] Pleiotropic effects of statins. [00:17:29] Movie: 12 Angry Men (1957). [00:20:30] Robert Ross - response to injury hypothesis; Study: Ross, Russell, John Glomset, and Laurence Harker. "Response to injury and atherogenesis." The American journal of pathology 86.3 (1977): 675. [00:20:40] TV show: Stranger Things. [00:22:31] Infectious disease hypothesis. [00:22:52] Analogy of rust in the paint of a car; Sickle Cell Disease as an example. [00:27:12] 14-year old boy with Sickle Cell and atherosclerosis; Study: Elsharawy, M. A., and K. M. Moghazy. "Peripheral arterial lesions in patient with sickle cell disease." EJVES Extra 14.2 (2007): 15-18. [00:28:57] Endothelial progenitor cells, produced in the bone marrow, discovered in 1997. [00:29:31] Pig study of endothelial turnover: Caplan, Bernard A., and Colin J. Schwartz. "Increased endothelial cell turnover in areas of in vivo Evans Blue uptake in the pig aorta." Atherosclerosis 17.3 (1973): 401-417. [00:31:48] Vitamin C's role in maintaining collagen and blood vessels. [00:33:08] Lp(a) molecules - patching cracks in the artery walls. [00:33:42] Depriving guinea pigs of vitamin C caused atherosclerosis; Study: Willis, G. C. "The reversibility of atherosclerosis." Canadian Medical Association Journal 77.2 (1957): 106. [00:34:24] Linus Pauling - said CVD was caused by chronic low-level vitamin C deficiency. [00:35:53] What else damages endothelial cells? Many things, including smoking, air pollution, high blood sugar, Kawasaki disease, sepsis/infection. [00:41:19] Glycocalyx; Nitric oxide. [00:43:30] Health benefits of sun exposure. [00:44:26] Biomechanical stress (blood pressure) - atherosclerosis in arteries but not in veins. [00:47:57] Things that interfere with repair: steroids, vascular endothelial growth factor (VEGF) inhibitors. [00:55:00] The effects of stress on the cardiovascular system. [00:57:55] Red blood cells are what brings cholesterol into blood clots. [00:58:59] Cholesterol crystals in atherosclerotic plaques come from red blood cells. Study: Kolodgie, Frank D., et al. "Intraplaque hemorrhage and progression of coronary atheroma." New England Journal of Medicine 349.24 (2003): 2316-2325. [01:00:55] Very low-density lipoproteins (VLDLs) are procoagulant; High-density lipoprotein (HDL) is anticoagulant. [01:03:46] Familial hypercholesterolemia (FH); Factor VIII. [01:08:15] Cholesterol-lowering pharmaceuticals; Repatha. In the clinical trial, the total number of cardiovascular deaths was greater in the Repatha group than the placebo group. Study: Sabatine, Marc S., et al. "Evolocumab and clinical outcomes in patients with cardiovascular disease." New England Journal of Medicine 376.18 (2017): 1713-1722. [01:09:34] David Deamer, biologist and Research Professor of Biomolecular Engineering. [01:10:05] Karl Popper, philosopher. [01:10:28] Bradford Hill’s Criteria for Causation. [01:13:52] Michael Mosley, BBC journalist. [01:16:40] Statin denialism - an internet cult with deadly consequences? [01:19:18] The money behind the statin and low-fat industries. [01:20:06] Margarine; Trans-fatty acids, banned in several countries. [01:24:37] The impact of food; The focus on food to the exclusion of other pillars of health. [01:26:38] Dr. Phil Hammond; CLANGERS [01:28:21] Avoiding internet attacks. [01:32:00] ApoA-1 Milano. Original study: Nissen, Steven E., et al. "Effect of recombinant ApoA-I Milano on coronary atherosclerosis in patients with acute coronary syndromes: a randomized controlled trial." Jama 290.17 (2003): 2292-2300. [01:33:05] The Heart Protection (HPS) Study in the UK: Heart Protection Study Collaborative Group. "MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebo controlled trial." The Lancet 360.9326 (2002): 7-22. [01:33:36] Scandinavian Simvastatin Survival Study (4S) Scandinavian Simvastatin Survival Study Group. "Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)." The Lancet 344.8934 (1994): 1383-1389. [01:33:49] West of Scotland Coronary Prevention Study (WOSCOPS): Shepherd, James, et al. "Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia." New England Journal of Medicine 333.20 (1995): 1301-1308. [01:34:21] National Institute of Health’s ALLHAT-LLT trial: Officers, A. L. L. H. A. T. "Coordinators for the ALLHAT Collaborative Research Group: Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs. usual care: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)." JAMA 288.23 (2002): 2998-3007. [01:34:50] 2005 - Regulations guiding clinical trials changed. [01:35:14] Negative antidepressant studies not published; Study: Turner, Erick H., et al. "Selective publication of antidepressant trials and its influence on apparent efficacy." New England Journal of Medicine 358.3 (2008): 252-260. [01:37:11] Minnesota Coronary Experiment (MCE): Analysis of recovered data: Ramsden, Christopher E., et al. "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)." bmj 353 (2016): i1246. [01:39:44] Why Most Published Research Findings Are False: Ioannidis, John PA. "Why most published research findings are false." PLoS medicine 2.8 (2005): e124. [01:39:55] Richard Horton, editor of the Lancet: half of what is published is not true: Horton, Richard. "Offline: What is medicine’s 5 sigma." Lancet 385.9976 (2015): 1380. [01:41:11] The problem with reproducibility; a database of clinical trials that cannot be challenged or reproduced. [01:42:37] Editors of prominent journals losing faith in published research: Marci Angell, Richard Smith [01:44:55] Parachute study: Yeh, Robert W., et al. "Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial." bmj 363 (2018): k5094. [01:46:01] Benefits that are major are obvious; no randomized clinical trial necessary. [01:48:33] Preventing vs. screening. [01:51:42] Podcast: Movement Analysis and Breathing Strategies for Pain Relief and Improved Performance with physical therapist Zac Cupples. [01:51:59] Analysis of women who died in various ways, examining breast tissue; found that a high % of women had what you could diagnose as breast cancer. Study: Bhathal, P. S., et al. "Frequency of benign and malignant breast lesions in 207 consecutive autopsies in Australian women." British journal of cancer 51.2 (1985): 271. [01:53:34] Screening programs not associated with reduced CVD or death; Study: Krogsbøll, Lasse T., et al. "General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis." Bmj 345 (2012): e7191. [01:54:26] Coronary Artery Calcium (CAC) scan. Podcast: Coronary Artery Calcium (CAC): A Direct Measure of Cardiovascular Disease Risk, with Ivor Cummins. [01:54:46] Cardiologist Bernard Lown. [01:58:38] People who had measles/mumps less likely to get CVD; Study: Kubota, Yasuhiko, et al. "Association of measles and mumps with cardiovascular disease: The Japan Collaborative Cohort (JACC) study." Atherosclerosis 241.2 (2015): 682-686. [02:00:55] Life expectancy in US and UK is now falling. [02:06:46] Physical health doesn't exist without social health and psychological health. [02:07:40] Negative Twitter messages correlate with rates of heart disease; Study: Eichstaedt, Johannes C., et al. "Psychological language on Twitter predicts county-level heart disease mortality." Psychological science 26.2 (2015): 159-169. [02:09:58] People who take statins believe they’re protected so they stop exercising. Study: Lee, David SH, et al. "Statins and physical activity in older men: the osteoporotic fractures in men study." JAMA internal medicine 174.8 (2014): 1263-1270. [02:11:45] Simple changes: make friends, have good relationships, speak to your kids, exercise, eat natural food, sunshine. [02:16:53] Blood sugar measurements following funny lecture vs. boring lecture; Study: Hayashi, Keiko, et al. "Laughter lowered the increase in postprandial blood glucose." Diabetes care 26.5 (2003): 1651-1652. [02:18:08] Dr. Malcolm Kendrick’s blog.
ALLHAT ist doch ein nettes Akronym, man kommt auch sofort darauf, dass es für "Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial" stehen muss. Tatsächlich ist die Studie weiterhin ein Wegbereiter der modernen Blutdrucktherapie. Warum, erfahrt ihr in dieser INFOsion!
In this podcast, Maddi & I discuss various anti-hypertensive agents used in intensive care units and their pharmacology. As an ICU trainee, it's important to have a basic understanding of these agents.
Let’s talk Blood Pressure and Antihypertensive medications. A normal BP is defined as a systolic pressure of less than 120 over a diastolic pressure of less than 80. If the blood pressure ranges from 120-139 over 80-90, the patient is… The post Ep003: Antihypertensive Medications and Blood Pressure Ranges appeared first on NURSING.com.
Clinical Journal of the American Society of Nephrology (CJASN)
Dr. Emily Schroeder summarizes "Add-On Antihypertensive Medications to Angiotensin-Aldosterone System Blockers in Diabetes" on behalf of her co-authors.
Clinical Journal of the American Society of Nephrology (CJASN)
Dr. Emily Schroeder summarizes "Add-On Antihypertensive Medications to Angiotensin-Aldosterone System Blockers in Diabetes" on behalf of her co-authors.
Hypertension may be a medical emergency, but many time EM physicians are faced with the patient with asymptomatic hypertension. Join the EM GuideWire Team as it address with issue and helps us all know how to appropriately evaluate and manage these situations.
Commentary by Dr. Valentin Fuster
Interview with Gregory M. Marcus, MD, MAS, author of Effect of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) on Conduction System Disease, and Sanjiv M. Narayan, MD, PhD, author of Can Cardiac Conduction System Disease Be Prevented?
Commentary by Dr. Valentin Fuster
In this session of the PA Boads podcast, I take some time to speak about the following hypertensive medications: Beta Blockers, Calcium Channel Blockers, ACE Inhibitors/ARBs, and Diuretics.
Background: Several studies showed that blood pressure and lung function are associated. Additionally, a potential effect of antihypertensive medication, especially beta-blockers, on lung function has been discussed. However, side effects of beta-blockers have been investigated mainly in patients with already reduced lung function. Thus, aim of this analysis is to determine whether hypertension and antihypertensive medication have an adverse effect on lung function in a general adult population. Methods: Within the population-based KORA F4 study 1319 adults aged 40-65 years performed lung function tests and blood pressure measurements. Additionally, information on anthropometric measurements, medical history and use of antihypertensive medication was available. Multivariable regression models were applied to study the association between blood pressure, antihypertensive medication and lung function. Results: High blood pressure as well as antihypertensive medication were associated with lower forced expiratory volume in one second (p = 0.02 respectively p = 0.05; R-2: 0.65) and forced vital capacity values (p = 0.01 respectively p = 0.05, R-2: 0.73). Furthermore, a detailed analysis of antihypertensive medication pointed out that only the use of beta-blockers was associated with reduced lung function, whereas other antihypertensive medication had no effect on lung function. The adverse effect of beta-blockers was significant for forced vital capacity (p = 0.04; R-2: 0.65), while the association with forced expiratory volume in one second showed a trend toward significance (p = 0.07; R-2: 0.73). In the same model high blood pressure was associated with reduced forced vital capacity (p = 0.01) and forced expiratory volume in one second (p = 0.03) values, too. Conclusion: Our analysis indicates that both high blood pressure and the use of beta-blockers, but not the use of other antihypertensive medication, are associated with reduced lung function in a general adult population.
Background: Blood pressure lowering drugs are usually evaluated in short term trials determining the absolute blood pressure reduction during trough and the duration of the antihypertensive effect after single or multiple dosing. A lack of persistence with treatment has however been shown to be linked to a worse cardiovascular prognosis. This review explores the blood pressure reduction and persistence with treatment of antihypertensive drugs and the cost consequences of poor persistence with pharmaceutical interventions in arterial hypertension. Methods: We have searched the literature for data on blood pressure lowering effects of different antihypertensive drug classes and agents, on persistence with treatment, and on related costs. Persistence was measured as patients' medication possession rate. Results are presented in the form of a systematic review. Results: Angiotensin II receptor blocker (ARBs) have a competitive blood pressure lowering efficacy compared with ACE-inhibitors (ACEi) and calcium channel blockers (CCBs), beta-blockers (BBs) and diuretics. 8 studies describing the persistence with treatment were identified. Patients were more persistent on ARBs than on ACEi and CCBs, BBs and diuretics. Thus the product of blood pressure lowering and persistence was higher on ARBs than on any other drug class. Although the price per tablet of more recently developed drugs (ACEi, ARBs) is higher than that of older ones (diuretics and BBs), the newer drugs result in a more favourable cost to effect ratio when direct drug costs and indirect costs are also considered. Conclusion: To evaluate drugs for the treatment of hypertension several key variables including the blood pressure lowering effect, side effects, compliance/persistence with treatment, as well as drug costs and direct and indirect costs of medical care have to be considered. ARBs, while nominally more expensive when drug costs are considered only, provide substantial cost savings and may prevent cardiovascular morbidity and mortality based on the more complete antihypertensive coverage. This makes ARBs an attractive choice for long term treatment of hypertension.