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[PMID]:28813123
[Au] Autor:Musini VM; Gueyffier F; Puil L; Salzwedel DM; Wright JM
[Ad] Endereço:Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, 2176 Health Science Mall, Vancouver, BC, Canada, V6T 1Z3.
[Ti] Título:Pharmacotherapy for hypertension in adults aged 18 to 59 years.
[So] Source:Cochrane Database Syst Rev;8:CD008276, 2017 08 16.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hypertension is an important risk factor for adverse cardiovascular events including stroke, myocardial infarction, heart failure and renal failure. The main goal of treatment is to reduce these events. Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older. We wanted to know what the effects of therapy are in people 18 to 59 years of age. OBJECTIVES: To quantify antihypertensive drug effects on all-cause mortality in adults aged 18 to 59 years with mild to moderate primary hypertension. To quantify effects on cardiovascular mortality plus morbidity (including cerebrovascular and coronary heart disease mortality plus morbidity), withdrawal due adverse events and estimate magnitude of systolic blood pressure (SBP) and diastolic blood pressure (DBP) lowering at one year. SEARCH METHODS: The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to January 2017: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We contacted authors of relevant papers regarding further published and unpublished work. SELECTION CRITERIA: Randomized trials of at least one year' duration comparing antihypertensive pharmacotherapy with a placebo or no treatment in adults aged 18 to 59 years with mild to moderate primary hypertension defined as SBP 140 mmHg or greater or DBP 90 mmHg or greater at baseline, or both. DATA COLLECTION AND ANALYSIS: The outcomes assessed were all-cause mortality, total cardiovascular (CVS) mortality plus morbidity, withdrawals due to adverse events, and decrease in SBP and DBP. For dichotomous outcomes, we used risk ratio (RR) with 95% confidence interval (CI) and a fixed-effect model to combine outcomes across trials. For continuous outcomes, we used mean difference (MD) with 95% CI and a random-effects model as there was significant heterogeneity. MAIN RESULTS: The population in the seven included studies (17,327 participants) were predominantly healthy adults with mild to moderate primary hypertension. The Medical Research Council Trial of Mild Hypertension contributed 14,541 (84%) of total randomized participants, with mean age of 50 years and mean baseline blood pressure of 160/98 mmHg and a mean duration of follow-up of five years. Treatments used in this study were bendrofluazide 10 mg daily or propranolol 80 mg to 240 mg daily with addition of methyldopa if required. The risk of bias in the studies was high or unclear for a number of domains and led us to downgrade the quality of evidence for all outcomes.Based on five studies, antihypertensive drug therapy as compared to placebo or untreated control may have little or no effect on all-cause mortality (2.4% with control vs 2.3% with treatment; low quality evidence; RR 0.94, 95% CI 0.77 to 1.13). Based on 4 studies, the effects on coronary heart disease were uncertain due to low quality evidence (RR 0.99, 95% CI 0.82 to 1.19). Low quality evidence from six studies showed that drug therapy may reduce total cardiovascular mortality and morbidity from 4.1% to 3.2% over five years (RR 0.78, 95% CI 0.67 to 0.91) due to reduction in cerebrovascular mortality and morbidity (1.3% with control vs 0.6% with treatment; RR 0.46, 95% CI 0.34 to 0.64). Very low quality evidence from three studies showed that withdrawals due to adverse events were higher with drug therapy from 0.7% to 3.0% (RR 4.82, 95% CI 1.67 to 13.92). The effects on blood pressure varied between the studies and we are uncertain as to how much of a difference treatment makes on average. AUTHORS' CONCLUSIONS: Antihypertensive drugs used to treat predominantly healthy adults aged 18 to 59 years with mild to moderate primary hypertension have a small absolute effect to reduce cardiovascular mortality and morbidity primarily due to reduction in cerebrovascular mortality and morbidity. All-cause mortality and coronary heart disease were not reduced. There is lack of good evidence on withdrawal due to adverse events. Future trials in this age group should be at least 10 years in duration and should compare different first-line drug classes and strategies.
[Mh] Termos MeSH primário: Anti-Hipertensivos/uso terapêutico
Hipertensão/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Anti-Hipertensivos/efeitos adversos
Bendroflumetiazida/uso terapêutico
Pressão Sanguínea/efeitos dos fármacos
Causas de Morte
Doença das Coronárias/mortalidade
Doença das Coronárias/prevenção & controle
Seres Humanos
Hipertensão/mortalidade
Metildopa/uso terapêutico
Meia-Idade
Infarto do Miocárdio/mortalidade
Infarto do Miocárdio/prevenção & controle
Pacientes Desistentes do Tratamento/estatística & dados numéricos
Propranolol/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/mortalidade
Acidente Vascular Cerebral/prevenção & controle
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Antihypertensive Agents); 56LH93261Y (Methyldopa); 5Q52X6ICJI (Bendroflumethiazide); 9Y8NXQ24VQ (Propranolol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008276.pub2


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[PMID]:26884077
[Au] Autor:Chong SJ; Howard KA; Knox C
[Ad] Endereço:Brighton and Sussex Medical School, Brighton, UK.
[Ti] Título:Hypokalaemia and drinking green tea: a literature review and report of 2 cases.
[So] Source:BMJ Case Rep;2016, 2016 Feb 16.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We report the association between excessive consumption of green tea and hypokalaemia in an Oriental couple. Both patients were asymptomatic and the abnormal electrolyte level was only detected on routine blood tests. When they were advised to reduce the consumption of green tea, the abnormally low potassium level was reversed. We have not found such an association reported in the medical literature. The health benefits of green tea consumption are well publicised but the potential side-effects of overconsumption are less well known. We would like to report this association to alert clinicians about this potentially serious complication. This is especially relevant for those who are also taking prescribed medications that can lower potassium levels and/or sensitise patients to potential harm from hypokalaemia.
[Mh] Termos MeSH primário: Comportamento de Ingestão de Líquido
Hipopotassemia/etiologia
Chá/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Anlodipino/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Bendroflumetiazida/uso terapêutico
Feminino
Seres Humanos
Hipertensão/complicações
Hipertensão/tratamento farmacológico
Lisinopril/uso terapêutico
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Tea); 1J444QC288 (Amlodipine); 5Q52X6ICJI (Bendroflumethiazide); E7199S1YWR (Lisinopril)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160218
[St] Status:MEDLINE


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[PMID]:26783007
[Au] Autor:Kobel MC; Nielsen TK; Graumann O
[Ad] Endereço:Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark.
[Ti] Título:Acute renal failure and arterial hypertension due to subcapsular haematoma: is percutaneous drainage a feasible treatment?
[So] Source:BMJ Case Rep;2016, 2016 Jan 18.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected urothelial neoplasm in the right renal pelvis. The left kidney had recently been removed due to renal cell carcinoma. At admission, the patient's blood pressure and plasma creatinine levels were massively elevated. Ultrasonography revealed a moderate right-sided renal subcapsular haematoma. When the patient did not respond to antihypertensive treatment, Page kidney was suspected. A pigtail catheter was placed in the haematoma and, shortly after drainage, the diuresis resumed and plasma creatinine together with blood pressure decreased. This condition had previously been managed by open surgery, but recent case reports have described successful management by laparoscopy-assisted and radiology-assisted drainage, as described in this case report.
[Mh] Termos MeSH primário: Lesão Renal Aguda/etiologia
Anti-Hipertensivos/uso terapêutico
Bendroflumetiazida/uso terapêutico
Drenagem/métodos
Hematoma/complicações
Hipertensão/etiologia
Metoprolol/uso terapêutico
[Mh] Termos MeSH secundário: Lesão Renal Aguda/terapia
Idoso
Pressão Sanguínea/fisiologia
Feminino
Hematoma/terapia
Seres Humanos
Rim/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 5Q52X6ICJI (Bendroflumethiazide); GEB06NHM23 (Metoprolol)
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160120
[St] Status:MEDLINE


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[PMID]:25765252
[Au] Autor:Whitehead J; Cleary F; Turner A
[Ad] Endereço:Department of Mathematics and Statistics, Lancaster University, Lancaster, U.K.
[Ti] Título:Bayesian sample sizes for exploratory clinical trials comparing multiple experimental treatments with a control.
[So] Source:Stat Med;34(12):2048-61, 2015 May 30.
[Is] ISSN:1097-0258
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In this paper, a Bayesian approach is developed for simultaneously comparing multiple experimental treatments with a common control treatment in an exploratory clinical trial. The sample size is set to ensure that, at the end of the study, there will be at least one treatment for which the investigators have a strong belief that it is better than control, or else they have a strong belief that none of the experimental treatments are substantially better than control. This criterion bears a direct relationship with conventional frequentist power requirements, while allowing prior opinion to feature in the analysis with a consequent reduction in sample size. If it is concluded that at least one of the experimental treatments shows promise, then it is envisaged that one or more of these promising treatments will be developed further in a definitive phase III trial. The approach is developed in the context of normally distributed responses sharing a common standard deviation regardless of treatment. To begin with, the standard deviation will be assumed known when the sample size is calculated. The final analysis will not rely upon this assumption, although the intended properties of the design may not be achieved if the anticipated standard deviation turns out to be inappropriate. Methods that formally allow for uncertainty about the standard deviation, expressed in the form of a Bayesian prior, are then explored. Illustrations of the sample sizes computed from the new method are presented, and comparisons are made with frequentist methods devised for the same situation.
[Mh] Termos MeSH primário: Drogas em Investigação
Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
Tamanho da Amostra
[Mh] Termos MeSH secundário: Anti-Hipertensivos/administração & dosagem
Anti-Hipertensivos/farmacologia
Teorema de Bayes
Bendroflumetiazida/administração & dosagem
Bendroflumetiazida/farmacologia
Viés
Pressão Sanguínea/efeitos dos fármacos
Relação Dose-Resposta a Droga
Determinação de Ponto Final
Seres Humanos
Hipertensão/tratamento farmacológico
Modelos Estatísticos
Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
Ensaios Clínicos Controlados Aleatórios como Assunto/normas
Incerteza
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Drugs, Investigational); 5Q52X6ICJI (Bendroflumethiazide)
[Em] Mês de entrada:1602
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150314
[St] Status:MEDLINE
[do] DOI:10.1002/sim.6469


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[PMID]:25271354
[Au] Autor:Ripley DP; Negrou K; Oliver JJ; Worthy G; Struthers AD; Plein S; Greenwood JP
[Ad] Endereço:Multidisciplinary Cardiovascular Research Centre (MCRC) & Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds , Leeds , UK .
[Ti] Título:Aortic remodelling following the treatment and regression of hypertensive left ventricular hypertrophy: a cardiovascular magnetic resonance study.
[So] Source:Clin Exp Hypertens;37(4):308-16, 2015.
[Is] ISSN:1525-6006
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Increased arterial stiffness independently predicts adverse prognosis. While different antihypertensive strategies produce different magnitudes of left ventricular hypertrophy (LVH) regression, there are no comparative data on how these strategies affect arterial stiffness. The aim was to determine the longitudinal change in aortic stiffness following the treatment of essential hypertension with two mechanistically different antihypertensive treatment strategies. METHODS AND RESULTS: Forty-two patients with essential hypertension and CMR confirmed with LVH were randomly assigned to antihypertensive regimes for 6 months. Treatment strategies were designed either to inhibit the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) (valsartan and moxonidine, group VM) or to have neutral effect on these systems (bendroflumethiazide and amlodipine, group BA). Both treatment groups underwent identical baseline and a 6-month follow-up CMR and were compared with a healthy age-matched control group. Baseline aortic distensibility (AD) was lower in both hypertensive groups compared with controls (2.8 × 10(-3 )mmHg(-1) in group VM (p = 0.001) and 3.3 × 10(-3 )mmHg(-1) group BA (p = 0.039) compared with 4.5 × 10(-3 )mmHg(-1) in the control group). AD increased after antihypertensive therapy (VM: 2.8 × 10(-3 )mmHg(-1)-4.2 × 10(-3 )mmHg(-1) (p = 0.001); BA 3.3 × 10(-3 )mmHg(-1)-4.6 × 10(-3 )mmHg(-1) (p < 0.01)). In both treatment groups AD returned to a level comparable with the normal control group (p = 0.81) after 6 months. CONCLUSIONS: In patients with essential hypertension and LVH, AD was lower than in matched normal controls. Despite the opposing pharmacological mechanisms utilised across the treatment groups, the improvement in AD was similar, suggesting that blood pressure reduction per se may be more important than RAAS and SNS inhibition for the improvement of aortic remodelling.
[Mh] Termos MeSH primário: Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem
Anti-Hipertensivos/administração & dosagem
Aorta Torácica/fisiopatologia
Hipertensão/tratamento farmacológico
Hipertrofia Ventricular Esquerda/fisiopatologia
Imagem Cinética por Ressonância Magnética/métodos
Remodelação Vascular/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Anlodipino/administração & dosagem
Aorta Torácica/efeitos dos fármacos
Aorta Torácica/patologia
Bendroflumetiazida/administração & dosagem
Relação Dose-Resposta a Droga
Quimioterapia Combinada
Hipertensão Essencial
Feminino
Seguimentos
Ventrículos do Coração/patologia
Ventrículos do Coração/fisiopatologia
Seres Humanos
Hipertensão/complicações
Hipertensão/fisiopatologia
Hipertrofia Ventricular Esquerda/diagnóstico
Hipertrofia Ventricular Esquerda/etiologia
Imidazóis/administração & dosagem
Masculino
Meia-Idade
Simpatolíticos
Resultado do Tratamento
Valsartana/administração & dosagem
Remodelação Vascular/efeitos dos fármacos
Rigidez Vascular/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Angiotensin II Type 1 Receptor Blockers); 0 (Antihypertensive Agents); 0 (Imidazoles); 0 (Sympatholytics); 1J444QC288 (Amlodipine); 5Q52X6ICJI (Bendroflumethiazide); 80M03YXJ7I (Valsartan); CC6X0L40GW (moxonidine)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141002
[St] Status:MEDLINE
[do] DOI:10.3109/10641963.2014.960974


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[PMID]:22696152
[Au] Autor:Tomek M; Nandoskar A; Chapman N; Gabriel C
[Ad] Endereço:From the Department of Medicine, Charing Cross Hospital, Department of Neurology, Department of Clinical Pharmacology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK michal.tomek@cantab.net.
[Ti] Título:Facial nerve palsy in the setting of malignant hypertension: a link not to be missed.
[So] Source:QJM;108(2):145-6, 2015 Feb.
[Is] ISSN:1460-2393
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Paralisia de Bell/diagnóstico
Nervo Facial/fisiopatologia
Paralisia Facial/fisiopatologia
Hipertensão Maligna/complicações
Hipertensão Maligna/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Anti-Hipertensivos/uso terapêutico
Bendroflumetiazida/uso terapêutico
Bisoprolol/uso terapêutico
Seres Humanos
Hipertensão Maligna/tratamento farmacológico
Imagem por Ressonância Magnética
Masculino
Nifedipino/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 5Q52X6ICJI (Bendroflumethiazide); I9ZF7L6G2L (Nifedipine); Y41JS2NL6U (Bisoprolol)
[Em] Mês de entrada:1605
[Cu] Atualização por classe:150130
[Lr] Data última revisão:
150130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:120615
[St] Status:MEDLINE
[do] DOI:10.1093/qjmed/hcs110


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[PMID]:24631797
[Au] Autor:Moosavi SM; Karimi Z
[Ad] Endereço:Shiraz University of Medical Sciences Department of Physiology, School of Medicine Shiraz 71365-1689 Iran.
[Ti] Título:Cooperative mechanisms involved in chronic antidiuretic response to bendroflumethiazide in rats with lithium-induced nephrogenic diabetes insipidus.
[So] Source:Acta Physiol Hung;101(1):88-102, 2014 Mar.
[Is] ISSN:0231-424X
[Cp] País de publicação:Hungary
[La] Idioma:eng
[Ab] Resumo:Previous studies of central diabetes insipidus suggested that thiazides acutely exerted a paradoxical antidiuresis by either indirectly activating volume-homeostatic reflexes to decrease distal fluid-delivery, or directly stimulating distal water-reabsorption. This study investigated whether the direct and indirect actions of bendroflumethiazide (BFTZ) simultaneously cooperated and also whether the renal nerves were involved in inducing long-term antidiuresis in nephrogenic diabetes insipidus (NDI). BFTZ or vehicle was gavaged into bilateral renal denervated and innervated rats with lithium-induced NDI for 10 days, constituting four groups. At one day before (D0) and one, five and ten days after starting administration of BFTZ or vehicle, rats were placed in metabolic cages to collect urine for 6 hours. BFTZ-treatment in both renal innervated and denervated rats caused equivalent reductions in urine-flow, creatinine clearance, lithium clearance and free-water clearance, but rises in urine-osmolality, fractional proximal reabsorption and fractional distal reabsorption at all days compared to D0, as well as to those of their relevant vehicle-received group. Therefore, the chronic antidiuretic response to BFTZ in conscious NDI rats was exerted through a concomitant cooperation of its direct distal effect of stimulating water-reabsorption and its indirect effect of reducing distal fluid-delivery by activating volume-homeostatic mechanisms, which appeared independent of the renal nerves.
[Mh] Termos MeSH primário: Antidiuréticos/farmacologia
Bendroflumetiazida/farmacologia
Diabetes Insípido Nefrogênico/tratamento farmacológico
Diurese/efeitos dos fármacos
Rim/efeitos dos fármacos
Cloreto de Lítio
[Mh] Termos MeSH secundário: Animais
Denervação Autônoma
Biomarcadores/sangue
Biomarcadores/urina
Pressão Sanguínea/efeitos dos fármacos
Nitrogênio da Ureia Sanguínea
Peso Corporal/efeitos dos fármacos
Creatinina/sangue
Diabetes Insípido Nefrogênico/sangue
Diabetes Insípido Nefrogênico/induzido quimicamente
Diabetes Insípido Nefrogênico/fisiopatologia
Diabetes Insípido Nefrogênico/urina
Modelos Animais de Doenças
Ingestão de Líquidos/efeitos dos fármacos
Rim/inervação
Rim/metabolismo
Rim/fisiopatologia
Masculino
Natriurese/efeitos dos fármacos
Concentração Osmolar
Ratos
Ratos Sprague-Dawley
Fatores de Tempo
Urodinâmica/efeitos dos fármacos
Equilíbrio Hidroeletrolítico/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antidiuretic Agents); 0 (Biomarkers); 5Q52X6ICJI (Bendroflumethiazide); AYI8EX34EU (Creatinine); G4962QA067 (Lithium Chloride)
[Em] Mês de entrada:1408
[Cu] Atualização por classe:151119
[Lr] Data última revisão:
151119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140318
[St] Status:MEDLINE
[do] DOI:10.1556/APhysiol.101.2014.1.10


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[PMID]:24218432
[Au] Autor:Barron AJ; Hughes AD; Sharp A; Baksi AJ; Surendran P; Jabbour RJ; Stanton A; Poulter N; Fitzgerald D; Sever P; O'Brien E; Thom S; Mayet J; ASCOT Investigators
[Ad] Endereço:Imperial College London, 59 North Wharf Rd, London W2 1LA, United Kingdom. anthonybarron@hotmail.co.uk.
[Ti] Título:Long-term antihypertensive treatment fails to improve E/e' despite regression of left ventricular mass: an Anglo-Scandinavian cardiac outcomes trial substudy.
[So] Source:Hypertension;63(2):252-8, 2014 Feb.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Antihypertensive treatment can improve tissue Doppler indices of left ventricular diastolic function in the short term, but little is known about the longer-term effect of different antihypertensive treatments on progression of left ventricular diastolic function and left ventricular hypertrophy. We hypothesized that long-term treatment of hypertension will lead to improvements in left ventricular hypertrophy and diastolic function. We collected detailed cardiovascular phenotypic data on 1006 participants from a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial. Patients randomized to either an amlodipine±perindopril-based or an atenolol±bendroflumethiazide-based regimen underwent conventional and tissue Doppler echocardiography at time of control of blood pressure after randomization (≈1.5 years; phase 1) and after a further 2 years of antihypertensive treatment (phase 2). There were no prerandomization data. Five hundred thirty-six patients had complete data collection at both phases. Left ventricular mass index regressed from phase 1 to 2 with no significant difference between treatment groups (amlodipine: 119.5-116.8; atenolol: 122.9-117.5; P<0.001 for both). Conversely, tissue Doppler diastolic indices did not change in the amlodipine±perindopril-based regimen (E/e', 7.5-7.6 cm/s; P=not significant), but deteriorated in the atenolol±bendroflumethiazide-based regimen (E/e', 8.0-8.5 cm/s; P<0.01). Despite regression of left ventricular hypertrophy, there was no associated improvement in diastolic function. In fact, long-term treatment with atenolol±bendroflumethiazide resulted in a progressive deterioration in E/e'. This may be a factor contributing to the previously described worse clinical outcome in patients treated with atenolol±bendroflumethiazide compared with amlodipine±perindopril.
[Mh] Termos MeSH primário: Anlodipino/administração & dosagem
Anti-Hipertensivos/administração & dosagem
Atenolol/administração & dosagem
Bendroflumetiazida/administração & dosagem
Hipertrofia Ventricular Esquerda/diagnóstico por imagem
Perindopril/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Quimioterapia Combinada
Ecocardiografia Doppler
Grupo com Ancestrais do Continente Europeu
Feminino
Seres Humanos
Hipertrofia Ventricular Esquerda/prevenção & controle
Masculino
Meia-Idade
Tempo
Falha de Tratamento
Função Ventricular Esquerda/efeitos dos fármacos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antihypertensive Agents); 1J444QC288 (Amlodipine); 50VV3VW0TI (Atenolol); 5Q52X6ICJI (Bendroflumethiazide); Y5GMK36KGY (Perindopril)
[Em] Mês de entrada:1403
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:131113
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.113.01360


  9 / 551 MEDLINE  
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[PMID]:23874973
[Au] Autor:Tricarico D; Mele A; Calzolaro S; Cannone G; Camerino GM; Dinardo MM; Latorre R; Conte Camerino D
[Ad] Endereço:Department of Pharmacy-Drug-Science, University of Bari, Bari, Italy. domenico.tricarico@uniba.it
[Ti] Título:Emerging role of calcium-activated potassium channel in the regulation of cell viability following potassium ions challenge in HEK293 cells and pharmacological modulation.
[So] Source:PLoS One;8(7):e69551, 2013.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Emerging evidences suggest that Ca(2+)activated-K(+)-(BK) channel is involved in the regulation of cell viability. The changes of the cell viability observed under hyperkalemia (15 mEq/L) or hypokalemia (0.55 mEq/L) conditions were investigated in HEK293 cells expressing the hslo subunit (hslo-HEK293) in the presence or absence of BK channel modulators. The BK channel openers(10(-11)-10(-3)M) were: acetazolamide(ACTZ), Dichlorphenamide(DCP), methazolamide(MTZ), bendroflumethiazide(BFT), ethoxzolamide(ETX), hydrochlorthiazide(HCT), quercetin(QUERC), resveratrol(RESV) and NS1619; and the BK channel blockers(2 x 10(-7)M-5 x 10(-3)M) were: tetraethylammonium(TEA), iberiotoxin(IbTx) and charybdotoxin(ChTX). Experiments on cell viability and channel currents were performed using cell counting kit-8 and patch-clamp techniques, respectively. Hslo whole-cell current was potentiated by BK channel openers with different potency and efficacy in hslo-HEK293. The efficacy ranking of the openers at -60 mV(Vm) was BFT> ACTZ >DCP ≥RESV≥ ETX> NS1619> MTZ≥ QUERC; HCT was not effective. Cell viability after 24 h of incubation under hyperkalemia was enhanced by 82+6% and 33+7% in hslo-HEK293 cells and HEK293 cells, respectively. IbTx, ChTX and TEA enhanced cell viability in hslo-HEK293. BK openers prevented the enhancement of the cell viability induced by hyperkalemia or IbTx in hslo-HEK293 showing an efficacy which was comparable with that observed as BK openers. BK channel modulators failed to affect cell currents and viability under hyperkalemia conditions in the absence of hslo subunit. In contrast, under hypokalemia cell viability was reduced by -22+4% and -23+6% in hslo-HEK293 and HEK293 cells, respectively; the BK channel modulators failed to affect this parameter in these cells. In conclusion, BK channel regulates cell viability under hyperkalemia but not hypokalemia conditions. BFT and ACTZ were the most potent drugs either in activating the BK current and in preventing the cell proliferation induced by hyperkalemia. These findings may have relevance in disorders associated with abnormal K(+) ion homeostasis including periodic paralysis and myotonia.
[Mh] Termos MeSH primário: Sobrevivência Celular/efeitos dos fármacos
Canais de Potássio Cálcio-Ativados/metabolismo
Potássio/metabolismo
[Mh] Termos MeSH secundário: Bendroflumetiazida/farmacologia
Linhagem Celular
Charibdotoxina/farmacologia
Diclorofenamida/farmacologia
Etoxzolamida/farmacologia
Seres Humanos
Metazolamida/farmacologia
Peptídeos/farmacologia
Canais de Potássio Cálcio-Ativados/agonistas
Canais de Potássio Cálcio-Ativados/antagonistas & inibidores
Tetraetilamônio/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Peptides); 0 (Potassium Channels, Calcium-Activated); 115422-61-2 (Charybdotoxin); 5Q52X6ICJI (Bendroflumethiazide); 66-40-0 (Tetraethylammonium); 773HER9B6T (iberiotoxin); RWP5GA015D (Potassium); VVJ6673MHY (Dichlorphenamide); W733B0S9SD (Methazolamide); Z52H4811WX (Ethoxzolamide)
[Em] Mês de entrada:1402
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130723
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0069551


  10 / 551 MEDLINE  
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[PMID]:23730981
[Au] Autor:Basile JN; Bloch MJ
[Ad] Endereço:Seinsheimer Cardiovascular Health Program, Division of General Internal Medicine/Geriatrics, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
[Ti] Título:Determining the relative antihypertensive potency and relative cardiovascular risk reduction associated with different thiazide and thiazide-type diuretics.
[So] Source:J Clin Hypertens (Greenwich);15(6):359-61, 2013 Jun.
[Is] ISSN:1751-7176
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Bendroflumetiazida/uso terapêutico
Pressão Sanguínea/efeitos dos fármacos
Clortalidona/uso terapêutico
Hidroclorotiazida/uso terapêutico
Potássio/sangue
Ácido Úrico/sangue
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:COMMENT; JOURNAL ARTICLE
[Nm] Nome de substância:
0J48LPH2TH (Hydrochlorothiazide); 268B43MJ25 (Uric Acid); 5Q52X6ICJI (Bendroflumethiazide); Q0MQD1073Q (Chlorthalidone); RWP5GA015D (Potassium)
[Em] Mês de entrada:1312
[Cu] Atualização por classe:130604
[Lr] Data última revisão:
130604
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130605
[St] Status:MEDLINE
[do] DOI:10.1111/jch.12079



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