Hypertension plays a major role in the development and progression of micro-and macrovascular disease.Moreover,increased blood pressure often coexists with additional cardiovascular risk factors such as insulin resist...Hypertension plays a major role in the development and progression of micro-and macrovascular disease.Moreover,increased blood pressure often coexists with additional cardiovascular risk factors such as insulin resistance.As a result the need for a comprehensive management of hypertensive patients is critical.However,the various antihypertensive drug categories have different effects on glucose metabolism.Indeed,angiotensin receptor blockers as well as angiotensin converting enzyme inhibitors have been associated with beneficial effects on glucose homeostasis.Calcium channel blockers(CCBs)have an overall neutral effect on glucose metabolism.However,some members of the CCBs class such as azelnidipine and manidipine have been shown to have advantageous effects on glucose homeostasis.On the other hand,diuretics andβ-blockers have an overall disadvantageous effect on glucose metabolism.Of note,carvedilol as well as nebivolol seem to differentiate themselves from the rest of theβ-blockers class,being more attractive options regarding their effect on glucose homeostasis.The adverse effects of some blood pressure lowering drugs on glucose metabolism may,to an extent,compromise their cardiovascular protective role.As a result the effects on glucose homeostasis of the various blood pressure lowering drugs should be taken into account when selecting an antihypertensive treatment,especially in patients which are at high risk for developing diabetes.展开更多
AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. ...AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administration.RESULTS:Peristaltic contractions by the esophageal body were separated into three segments by two troughs. The peak peristaltic pressures in the mid and lower segments of the esophageal body under atenolol administration were signifi cantly higher than those without medication in a supine position. On the other hand,peristaltic pressures under nifedipine administration were lower than those observed without drug ad-ministration. Losartan did not change esophageal body peristalsis. Atenolol elevated LES pressure and slowed peristaltic wave transition,while the effects of nifedip-ine were the opposite. CONCLUSION:Among the anti-hypertensive drugs tested,atenolol enhanced esophageal motor activity,which was in contrast to nifedipine.展开更多
Background: The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline (2017 ACA/AHA Guideline) in November 2017. However, other organizat...Background: The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline (2017 ACA/AHA Guideline) in November 2017. However, other organizations such as the European Society of Cardiology and European Society of Hypertension maintained their diagnostic thresholds. It is necessary to evaluate the effects of blood pressure (BP) and antihypertensive drugs on the probability of having heart disease (HD). Data and Methods: The effects of BP, antihypertensive drugs and other factors on the probability of undergoing HD treatment were analyzed. We used a dataset containing 83,287 medical check-up and treatment records obtained from 35,504 individuals in 5 fiscal years. The probit models were used in the study. Considering the possibility of endogeneity problems, different types of models were used. Results: We could not find evidence that a higher systolic BP increased the probability of undergoing HD treatment. However, diastolic BP increased the probability in most of the models. Taking antihypertensive drugs also increased the probability of undergoing HD treatment. Diabetes was another important risk factor. Conclusion: The results of this study did not support the new 2017 ACC/AHA Guideline. It is necessary to choose proper drugs and methods to reduce the risks of side effects. Limitations: The dataset was observatory, the data were obtained from just one medical society, and sample selection bias might exist.展开更多
Worldwide the prevalence of essential hypertension inchildren and adolescents continues to increase. Tradi-tionally providers have used "off-label" drugs to treatpediatric hypertension, meaning that rigorous...Worldwide the prevalence of essential hypertension inchildren and adolescents continues to increase. Tradi-tionally providers have used "off-label" drugs to treatpediatric hypertension, meaning that rigorous clinicaltrials of these drugs have not been specifically per-formed in pediatric patient populations. Consequentlyproviders have extrapolated dosing, safety and efficacyfrom trials in adults. This practice is sub-optimal as chil-dren demonstrate unique differences in drug metabo-lism and response. Use of unstudied or understudieddrugs increases risk of adverse events and/or can leadto sub-optimal efficacy. Recognizing these concerns,regulatory agencies have created financial incentivesfor industry to conduct pediatric clinical trials. Theseincentives, coupled with the emerging pediatric hyper-tension epidemic, have spurred over 30 clinical trialsof anti-hypertensive drugs over the past 15 years andhave resulted in labeling of 10 new drugs by the UnitedStates Food and Drug Administration for treatment ofhypertension in children and adolescents. Unfortunatelythe financial incentive structures focus on newer drugsand drug classes. Consequently there is now a relativedearth of trial data for older but sometimes commonlyprescribed pediatric antihypertensive drugs. This article reviews recent pediatric antihypertensive drug trials with a focus on trial design and endpoints, drug dosing, safety, efficacy and specific drug indications. We also review the available data and experience for some of the more commonly prescribed, but less well studied "older" pediatric antihypertensive drugs.展开更多
Background: Stroke is a worldwide health problem, the world’s second-leading cause of death and third-leading cause of disability. Currently, the majority of stroke patients are ischemic stroke patients. It is necess...Background: Stroke is a worldwide health problem, the world’s second-leading cause of death and third-leading cause of disability. Currently, the majority of stroke patients are ischemic stroke patients. It is necessary to evaluate risk factors to prevent ischemic stroke. Data and Methods: The risk factors for stroke in the previous fiscal year were analyzed. They were divided into nonmodifiable and modifiable factors. The probit and ordered probit models were used in the study, with 59341 and 50542 observations used in the estimation of the models, respectively. Results: Among the nonmodifiable factors, age, gender and cerebrovascular disease history are important risk factors. The history of cerebrovascular diseases is considered to be an especially important factor. Among the modifiable factors, taking antihypertensive drugs and recent large weight change are negative risk factors;however, sleeping well significantly reduces the probability of ischemic stroke. Conclusion: It is very important to ensure that medical personnel know a patient’s history of cerebrovascular diseases for proper treatments. Ischemic stroke might be considered an important side effect of antihypertensive drugs. Limitations: The dataset was observatory. There are various types of antihypertension drugs, and their effects are not analyzed.展开更多
The aim of this study was to clarify the response of sympathetic activity to antihypertensive drugs using a mental stress test in hypertensive patients and to determine the effects of antihypertensive drugs on the sym...The aim of this study was to clarify the response of sympathetic activity to antihypertensive drugs using a mental stress test in hypertensive patients and to determine the effects of antihypertensive drugs on the sympathetic activitymediated hemodynamic response to mental stress. Hypertensive patients were divided into three groups according to the type of drug(s) being taken: a calcium antagonist group, an angiotensin II receptor blocker group, and a combination therapy group of calcium antagonists and angiotensin II receptor blockers. The Stroop color-word conflict test was applied as a mental stress test and hemodynamic responses to mental stress were measured, including blood pressure, pulse rate, and skin blood flow. Elevation of blood pressure by mental stress was suppressed in the combination therapy group compared with the calcium antagonist group. Reduction of skin blood flow by mental stress was suppressed in both the angiotensin II blocker group and the combination therapy group compared with the calcium antagonist group. In conclusion, skin blood flow can be a useful tool to evaluate sympathetic activity and combination therapy with calcium antagonists and angiotensin II receptor blockers were the most useful therapy for suppressing the hemodynamic response to mental stress.展开更多
Proceeding from natural amino acid L-asparagine and commercially available aldehydes a stereoselective synthesis was developed of (2S,4S)-2-alkyl(aryl)-3-(3-sulfanylpropanoyl)-6-oxohexahy- dropyrimidine-4-carboxylic a...Proceeding from natural amino acid L-asparagine and commercially available aldehydes a stereoselective synthesis was developed of (2S,4S)-2-alkyl(aryl)-3-(3-sulfanylpropanoyl)-6-oxohexahy- dropyrimidine-4-carboxylic acids, potential antihypertensive drugs, inhibitors of the angiotensin converting enzyme.展开更多
Objective To find out several patented technologies of antihypertensive drugs with the most market value through analysis,and provide a reference for the research and development of enterprises.Methods The most valuab...Objective To find out several patented technologies of antihypertensive drugs with the most market value through analysis,and provide a reference for the research and development of enterprises.Methods The most valuable patented technologies of antihypertensive drugs from 2009 to 2019 were analyzed to explore the patent layout and technical characteristics of the main patent applicants,and then the key directions of their research and development were gotten.Results and Conclusion Based on the method of patent analysis,five patents with the most market value are extracted to provide important technical support and market value reference for the research and development of generic drugs or new drugs.展开更多
Objective To compare the difference between 24-h ambulatory blood pressure(ABP)and trough clinic blood pressure(CBP)after 8 weeks of therapy.Methods The study used meta-regression analysis to summarize three randomize...Objective To compare the difference between 24-h ambulatory blood pressure(ABP)and trough clinic blood pressure(CBP)after 8 weeks of therapy.Methods The study used meta-regression analysis to summarize three randomized,double-blind,active controlled trials in order to compare the difference between the magnitude of the reduction in 24-h average ABP and CBP Patients.Chinese patients with seated diastolic blood pressure(SDBP)95-115 mmHg and ambulatory diastolic blood pressure(ADBP)≥85 mmHg.Results The average age of 126 patients was 47.7 ± 8.3 years,ranging from 25 to 67(95 males and 31 females).All regimens reduced 24-h ABP and CBP after 8 weeks of treatment.In the 126 patients the baseline 24-h SBP and DBP values(142.7/94.4 mmHg)were markedly lower than those for clinic values(152.6/102.6 mmHg;P<0.0001).Similarly,the 24-h SBP and DBP values(132.7/87.7 mmHg)in week 8 were markedly lower than the clinic values(138.9/92.7 mmHg;P<0.0001).The differences between the treatment-induced reductions in 24-h ABP and CBP were statistically significant(the difference was 3.7/3.3 mmHg for SBP/DBP,P=0.0069/P<0.0001).Conclusion All regimens significantly reduced seated CBP and ABP.The effect of antihypertensive treatment was greater on CBP than that on ABP,suggesting that assessment on effectiveness of an antihypertensive treatment using CBP readings only has to be carefully interpreted,and a more systematic application of ABP monitoring should be adopted.展开更多
Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis.Although primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incide...Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis.Although primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related contraindications.With recent advances in precision medicine,precise drug treatment provides better treatment efficacy.Data sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May 2022.Information on clinical trials was obtained from https://clinicaltrials.gov/and http://www.chictr.org.cn/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising drugs.According to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and others.All these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.Conclusions:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.展开更多
BACKGROUND Hypertension usually clusters with multiple comorbidities.However,the association between cardiometabolic multimorbidity(CMM)and mortality in hypertensive patients is unclear.This study aimed to investigate...BACKGROUND Hypertension usually clusters with multiple comorbidities.However,the association between cardiometabolic multimorbidity(CMM)and mortality in hypertensive patients is unclear.This study aimed to investigate the association between CMM and all-cause and cardiovascular disease(CVD)mortality in Chinese patients with hypertension.METHODS The data used in this study were from the China National Survey for Determinants of Detection and Treatment Status of Hypertensive Patients with Multiple Risk Factors(CONSIDER),which comprised 5006 participants aged 19–91 years.CMM was defined as the presence of one or more of the following morbidities:diabetes mellitus,dyslipidemia,chronic kidney disease,coronary heart disease,and stroke.Cox proportional hazard models were used to calculate the hazard ratios(HR)with 95%CI to determine the association between the number of CMMs and both all-cause and CVD mortality.RESULTS Among 5006 participants[mean age:58.6±10.4 years,50%women(2509 participants)],76.4%of participants had at least one comorbidity.The mortality rate was 4.57,4.76,8.48,and 16.04 deaths per 1000 person-years in hypertensive patients without any comorbidity and with one,two,and three or more morbidities,respectively.In the fully adjusted model,hypertensive participants with two cardiometabolic diseases(HR=1.52,95%CI:1.09–2.13)and those with three or more cardiometabolic diseases(HR=2.44,95%CI:1.71–3.48)had a significantly elevated risk of all-cause mortality.The findings were similar for CVD mortality but with a greater increase in risk magnitude.CONCLUSIONS In this study,three-fourths of hypertensive patients had CMM.Clustering with two or more comorbidities was associated with a significant increase in the risk of all-cause and cardiovascular mortality among hypertensive patients,suggesting more intensive treatment and control in this high-risk patient group.展开更多
Cancer immunotherapy has emerged as a promising approach in cancer treatment and is considered a major advancement after surgical interventions, radiotherapy, chemotherapy, and targeted therapy. The clinical use of im...Cancer immunotherapy has emerged as a promising approach in cancer treatment and is considered a major advancement after surgical interventions, radiotherapy, chemotherapy, and targeted therapy. The clinical use of immunotherapeutic drugs, particularly antibody-based drugs that target immune checkpoints, has notably increased~1.展开更多
Some bacteria have the ability to co-exist, proliferate and survive in a multicellular community, biofilm. Each participating bacteria can form its colonies and encases itself by a self-produced insoluble extracellula...Some bacteria have the ability to co-exist, proliferate and survive in a multicellular community, biofilm. Each participating bacteria can form its colonies and encases itself by a self-produced insoluble extracellular matrix substance (EPS). Microcolonies within biofilm are held together by interactions and bonding of the substances present in the EPS with their separation from the water channels. Similar to insoluble EPS, bacterial microcolonies release soluble exofactors that have direct impacts on the survivability, growth and antibacterial resistivity of other microcolonies made of single- or multi-species bacteria in the same biofilm. How the exofactors of microcolonies of one-type bacteria impact on microcolonies of other-type bacteria is still unclear. We studied about the role of exofactors released from Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, which are common biofilm-forming pathogenic bacteria. Exofactors facilitate to transform the microenvironment where bacteria can acquire alternative lifestyle with a long survival period and resistivity to certain antimicrobial drugs.展开更多
[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and ...[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.展开更多
Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determin...Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.展开更多
The angiotensin-converting enzyme(ACE)inhibitory peptide NCW derived from Mizuhopecten yessoensis has been demonstrated to have significant in vivo anti-hypertensive effects,however,its anti-hypertensive mechanism is ...The angiotensin-converting enzyme(ACE)inhibitory peptide NCW derived from Mizuhopecten yessoensis has been demonstrated to have significant in vivo anti-hypertensive effects,however,its anti-hypertensive mechanism is still not fully clarified.This study established a UPLC-Q-TRAP-MS/MS-based widely targeted kidney metabolomics approach to explore the changes of kidney metabolic profiles and to clarify the antihypertensive mechanism of peptide NCW in spontaneously hypertensive rats(SHRs).Multivariate statistical analysis indicated that the kidney metabolic profiles were clearly separated between the SHR-NCW and SHRUntreated groups.A total of 85 metabolites were differentially regulated,and 16 metabolites were identified as potential kidney biomarkers,e.g.,3-hydroxybutyrate,malonic acid,deoxycytidine,and L-aspartic acid.The peptide NCW might regulate kidney metabolic disorder of SHRs to alleviate hypertension by suppressing inflammation and improving nitric oxide production under the regulation of linoleic acid metabolism,folate related pathways,synthesis and degradation of ketone bodies,pyrimidine metabolism,β-alanine metabolism,and retinal metabolism.展开更多
Background and Objectives: Chronic kidney disease (CKD) is now a global public health problem. In low- and middle-income countries such as the Congo, access to dialysis is low and inequitable. The prevention of CKD in...Background and Objectives: Chronic kidney disease (CKD) is now a global public health problem. In low- and middle-income countries such as the Congo, access to dialysis is low and inequitable. The prevention of CKD involves raising awareness among patients at risk, such as those suffering from arterial hypertension (AH), by improving their knowledge of CKD. The objectives of our work were to determine the level of knowledge about CKD among hypertensive patients and to identify the factors associated with a low level of knowledge. Methodology: We conducted a 3-month descriptive and analytical cross-sectional study from 1 August to 30 October 2023 in 3 large public hospitals in Brazzaville (capital of the Republic of Congo). We included: hypertensive patients aged 18 and over who had freely consented to participate in our study and were able to answer the questions on the survey form. Patients with known hypertension who had been followed for less than 3 years and those with known chronic renal failure were not included. Results: The mean age was 58.4 ± 14.4 years (29 - 88 years). There were 121 men and 150 women (sex ratio = 0.8). All the patients were educated;37.2% with a higher level of education and 13.6% with primary education. 24 patients (9%) had a good level of knowledge about CKD and 153 (56%) had poor knowledge. A good level of knowledge was associated with the duration of hypertension, intellectual level and the existence of associated heart disease. Conclusion: Our study reveals a significant lack of knowledge about chronic kidney disease among hypertensive patients in Brazzaville.展开更多
Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack ...Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).展开更多
Background:Alcohol and illicit drugs(AID)continue to be a major global health concern.Although preventable,AID is linked to millions of deaths annually worldwide.The situation is particularly grave for young people,wi...Background:Alcohol and illicit drugs(AID)continue to be a major global health concern.Although preventable,AID is linked to millions of deaths annually worldwide.The situation is particularly grave for young people,with AID being a major direct risk factor for disability-adjusted youth life-years lost and death.It further contributes to assaults,road crashes,accidental poisoning,and suicide,leading to long-term issues and public health concerns.Objective:This study aimed at disclosing current AID prevalence data for Argentinian,Bulgarian,Chilean and Romanian youth.It shed light on the predictors of AID in young people from those countries.Method:The study used an online survey to gather data from people aged 18 to 25(n=1,297).The survey was underpinned by the theory of planned behaviour(TPB).Predictors were investigated separately for drinking alcohol and using illicit drugs.Results:Our data revealed that across the four target countries,49%to 90%of the participants drank alcohol,and 8%to 35%used illicit drugs in the past three months.Between 20%and 91%of them intended to drink,and between 8%and 31%intended to use illicit drugs in the following three months.Our TPB model predicted statistically significant(P<0.001)amounts of variance in drinking alcohol(between 61%and 72%)and using illicit drugs(between 20.3%and 74.4%).Intention was consistent in significantly predicting both behaviours.Evidence around the predictive validity of self-efficacy,age and gender was mixed across the investigated countries.Conclusion:This research provided an update on the scarce AID epidemiological data.It also supplied evidence about what theoretically-informed measures might be useful targets of interventions in the case of Argentina,Bulgaria,Chile and Romania.This new knowledge of understanding substance abuse determinants and prevalence may help researchers and practitioners better meet young people's health prevention needs.展开更多
文摘Hypertension plays a major role in the development and progression of micro-and macrovascular disease.Moreover,increased blood pressure often coexists with additional cardiovascular risk factors such as insulin resistance.As a result the need for a comprehensive management of hypertensive patients is critical.However,the various antihypertensive drug categories have different effects on glucose metabolism.Indeed,angiotensin receptor blockers as well as angiotensin converting enzyme inhibitors have been associated with beneficial effects on glucose homeostasis.Calcium channel blockers(CCBs)have an overall neutral effect on glucose metabolism.However,some members of the CCBs class such as azelnidipine and manidipine have been shown to have advantageous effects on glucose homeostasis.On the other hand,diuretics andβ-blockers have an overall disadvantageous effect on glucose metabolism.Of note,carvedilol as well as nebivolol seem to differentiate themselves from the rest of theβ-blockers class,being more attractive options regarding their effect on glucose homeostasis.The adverse effects of some blood pressure lowering drugs on glucose metabolism may,to an extent,compromise their cardiovascular protective role.As a result the effects on glucose homeostasis of the various blood pressure lowering drugs should be taken into account when selecting an antihypertensive treatment,especially in patients which are at high risk for developing diabetes.
基金Supported by The Grants-in-Aid from Science Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, No. 19590724
文摘AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administration.RESULTS:Peristaltic contractions by the esophageal body were separated into three segments by two troughs. The peak peristaltic pressures in the mid and lower segments of the esophageal body under atenolol administration were signifi cantly higher than those without medication in a supine position. On the other hand,peristaltic pressures under nifedipine administration were lower than those observed without drug ad-ministration. Losartan did not change esophageal body peristalsis. Atenolol elevated LES pressure and slowed peristaltic wave transition,while the effects of nifedip-ine were the opposite. CONCLUSION:Among the anti-hypertensive drugs tested,atenolol enhanced esophageal motor activity,which was in contrast to nifedipine.
文摘Background: The American College of Cardiology (ACC), American Heart Association (AHA) and other organizations announced a new hypertension guideline (2017 ACA/AHA Guideline) in November 2017. However, other organizations such as the European Society of Cardiology and European Society of Hypertension maintained their diagnostic thresholds. It is necessary to evaluate the effects of blood pressure (BP) and antihypertensive drugs on the probability of having heart disease (HD). Data and Methods: The effects of BP, antihypertensive drugs and other factors on the probability of undergoing HD treatment were analyzed. We used a dataset containing 83,287 medical check-up and treatment records obtained from 35,504 individuals in 5 fiscal years. The probit models were used in the study. Considering the possibility of endogeneity problems, different types of models were used. Results: We could not find evidence that a higher systolic BP increased the probability of undergoing HD treatment. However, diastolic BP increased the probability in most of the models. Taking antihypertensive drugs also increased the probability of undergoing HD treatment. Diabetes was another important risk factor. Conclusion: The results of this study did not support the new 2017 ACC/AHA Guideline. It is necessary to choose proper drugs and methods to reduce the risks of side effects. Limitations: The dataset was observatory, the data were obtained from just one medical society, and sample selection bias might exist.
文摘Worldwide the prevalence of essential hypertension inchildren and adolescents continues to increase. Tradi-tionally providers have used "off-label" drugs to treatpediatric hypertension, meaning that rigorous clinicaltrials of these drugs have not been specifically per-formed in pediatric patient populations. Consequentlyproviders have extrapolated dosing, safety and efficacyfrom trials in adults. This practice is sub-optimal as chil-dren demonstrate unique differences in drug metabo-lism and response. Use of unstudied or understudieddrugs increases risk of adverse events and/or can leadto sub-optimal efficacy. Recognizing these concerns,regulatory agencies have created financial incentivesfor industry to conduct pediatric clinical trials. Theseincentives, coupled with the emerging pediatric hyper-tension epidemic, have spurred over 30 clinical trialsof anti-hypertensive drugs over the past 15 years andhave resulted in labeling of 10 new drugs by the UnitedStates Food and Drug Administration for treatment ofhypertension in children and adolescents. Unfortunatelythe financial incentive structures focus on newer drugsand drug classes. Consequently there is now a relativedearth of trial data for older but sometimes commonlyprescribed pediatric antihypertensive drugs. This article reviews recent pediatric antihypertensive drug trials with a focus on trial design and endpoints, drug dosing, safety, efficacy and specific drug indications. We also review the available data and experience for some of the more commonly prescribed, but less well studied "older" pediatric antihypertensive drugs.
文摘Background: Stroke is a worldwide health problem, the world’s second-leading cause of death and third-leading cause of disability. Currently, the majority of stroke patients are ischemic stroke patients. It is necessary to evaluate risk factors to prevent ischemic stroke. Data and Methods: The risk factors for stroke in the previous fiscal year were analyzed. They were divided into nonmodifiable and modifiable factors. The probit and ordered probit models were used in the study, with 59341 and 50542 observations used in the estimation of the models, respectively. Results: Among the nonmodifiable factors, age, gender and cerebrovascular disease history are important risk factors. The history of cerebrovascular diseases is considered to be an especially important factor. Among the modifiable factors, taking antihypertensive drugs and recent large weight change are negative risk factors;however, sleeping well significantly reduces the probability of ischemic stroke. Conclusion: It is very important to ensure that medical personnel know a patient’s history of cerebrovascular diseases for proper treatments. Ischemic stroke might be considered an important side effect of antihypertensive drugs. Limitations: The dataset was observatory. There are various types of antihypertension drugs, and their effects are not analyzed.
文摘The aim of this study was to clarify the response of sympathetic activity to antihypertensive drugs using a mental stress test in hypertensive patients and to determine the effects of antihypertensive drugs on the sympathetic activitymediated hemodynamic response to mental stress. Hypertensive patients were divided into three groups according to the type of drug(s) being taken: a calcium antagonist group, an angiotensin II receptor blocker group, and a combination therapy group of calcium antagonists and angiotensin II receptor blockers. The Stroop color-word conflict test was applied as a mental stress test and hemodynamic responses to mental stress were measured, including blood pressure, pulse rate, and skin blood flow. Elevation of blood pressure by mental stress was suppressed in the combination therapy group compared with the calcium antagonist group. Reduction of skin blood flow by mental stress was suppressed in both the angiotensin II blocker group and the combination therapy group compared with the calcium antagonist group. In conclusion, skin blood flow can be a useful tool to evaluate sympathetic activity and combination therapy with calcium antagonists and angiotensin II receptor blockers were the most useful therapy for suppressing the hemodynamic response to mental stress.
文摘Proceeding from natural amino acid L-asparagine and commercially available aldehydes a stereoselective synthesis was developed of (2S,4S)-2-alkyl(aryl)-3-(3-sulfanylpropanoyl)-6-oxohexahy- dropyrimidine-4-carboxylic acids, potential antihypertensive drugs, inhibitors of the angiotensin converting enzyme.
文摘Objective To find out several patented technologies of antihypertensive drugs with the most market value through analysis,and provide a reference for the research and development of enterprises.Methods The most valuable patented technologies of antihypertensive drugs from 2009 to 2019 were analyzed to explore the patent layout and technical characteristics of the main patent applicants,and then the key directions of their research and development were gotten.Results and Conclusion Based on the method of patent analysis,five patents with the most market value are extracted to provide important technical support and market value reference for the research and development of generic drugs or new drugs.
文摘Objective To compare the difference between 24-h ambulatory blood pressure(ABP)and trough clinic blood pressure(CBP)after 8 weeks of therapy.Methods The study used meta-regression analysis to summarize three randomized,double-blind,active controlled trials in order to compare the difference between the magnitude of the reduction in 24-h average ABP and CBP Patients.Chinese patients with seated diastolic blood pressure(SDBP)95-115 mmHg and ambulatory diastolic blood pressure(ADBP)≥85 mmHg.Results The average age of 126 patients was 47.7 ± 8.3 years,ranging from 25 to 67(95 males and 31 females).All regimens reduced 24-h ABP and CBP after 8 weeks of treatment.In the 126 patients the baseline 24-h SBP and DBP values(142.7/94.4 mmHg)were markedly lower than those for clinic values(152.6/102.6 mmHg;P<0.0001).Similarly,the 24-h SBP and DBP values(132.7/87.7 mmHg)in week 8 were markedly lower than the clinic values(138.9/92.7 mmHg;P<0.0001).The differences between the treatment-induced reductions in 24-h ABP and CBP were statistically significant(the difference was 3.7/3.3 mmHg for SBP/DBP,P=0.0069/P<0.0001).Conclusion All regimens significantly reduced seated CBP and ABP.The effect of antihypertensive treatment was greater on CBP than that on ABP,suggesting that assessment on effectiveness of an antihypertensive treatment using CBP readings only has to be carefully interpreted,and a more systematic application of ABP monitoring should be adopted.
基金This work was supported by grants from the National Natural Science Foundation of China(81902484)China Postdoctoral Science Foundation(2020M670864)+2 种基金Youth Support Project of Jilin Association for Science and Technology(202028)Jilin Provincial Health Special Project(2020SCZT039)Jilin Health and Healthy Youth Science and Technology Training Plan(2020Q017).
文摘Background:Gastroesophageal variceal bleeding is one of the most severe complications of patients with cirrhosis.Although primary prevention drugs,including non-selectiveβ-blockers,have effectively reduced the incidence of bleeding,their efficacy is limited due to side effects and related contraindications.With recent advances in precision medicine,precise drug treatment provides better treatment efficacy.Data sources:Literature search was conducted in PubMed,MEDLINE and Web of Science for relevant articles published up to May 2022.Information on clinical trials was obtained from https://clinicaltrials.gov/and http://www.chictr.org.cn/.Results:The in-depth understanding of the pathogenesis and advances of portal hypertension has enabled the discovery of multiple molecular targets for promising drugs.According to the site of action,these drugs could be classified into four classes:intrahepatic,extrahepatic,both intrahepatic and extrahepatic targets and others.All these classes of drugs offer advantages over traditional treatments in prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.Conclusions:This review classified and summarized the promising drugs,which prevent gastroesophageal variceal bleeding by targeting specific markers of pathogenesis of portal hypertension,demonstrating the significance of using the precision medicine strategy to discover and develop promising drugs for the primary prevention of gastroesophageal variceal bleeding in patients with cirrhotic portal hypertension.
基金supported by the National Key Research and Development Program of China(2022YFC 3602501)the Pfizer Inc.(New York,USA)offices in Beijing,China。
文摘BACKGROUND Hypertension usually clusters with multiple comorbidities.However,the association between cardiometabolic multimorbidity(CMM)and mortality in hypertensive patients is unclear.This study aimed to investigate the association between CMM and all-cause and cardiovascular disease(CVD)mortality in Chinese patients with hypertension.METHODS The data used in this study were from the China National Survey for Determinants of Detection and Treatment Status of Hypertensive Patients with Multiple Risk Factors(CONSIDER),which comprised 5006 participants aged 19–91 years.CMM was defined as the presence of one or more of the following morbidities:diabetes mellitus,dyslipidemia,chronic kidney disease,coronary heart disease,and stroke.Cox proportional hazard models were used to calculate the hazard ratios(HR)with 95%CI to determine the association between the number of CMMs and both all-cause and CVD mortality.RESULTS Among 5006 participants[mean age:58.6±10.4 years,50%women(2509 participants)],76.4%of participants had at least one comorbidity.The mortality rate was 4.57,4.76,8.48,and 16.04 deaths per 1000 person-years in hypertensive patients without any comorbidity and with one,two,and three or more morbidities,respectively.In the fully adjusted model,hypertensive participants with two cardiometabolic diseases(HR=1.52,95%CI:1.09–2.13)and those with three or more cardiometabolic diseases(HR=2.44,95%CI:1.71–3.48)had a significantly elevated risk of all-cause mortality.The findings were similar for CVD mortality but with a greater increase in risk magnitude.CONCLUSIONS In this study,three-fourths of hypertensive patients had CMM.Clustering with two or more comorbidities was associated with a significant increase in the risk of all-cause and cardiovascular mortality among hypertensive patients,suggesting more intensive treatment and control in this high-risk patient group.
基金supported by grants from the National Natural Science Foundation of China (Grant No. U20A20369)GuangDong Basic and Applied Basic Research Foundation (Grant No. 2022B1515120085)。
文摘Cancer immunotherapy has emerged as a promising approach in cancer treatment and is considered a major advancement after surgical interventions, radiotherapy, chemotherapy, and targeted therapy. The clinical use of immunotherapeutic drugs, particularly antibody-based drugs that target immune checkpoints, has notably increased~1.
文摘Some bacteria have the ability to co-exist, proliferate and survive in a multicellular community, biofilm. Each participating bacteria can form its colonies and encases itself by a self-produced insoluble extracellular matrix substance (EPS). Microcolonies within biofilm are held together by interactions and bonding of the substances present in the EPS with their separation from the water channels. Similar to insoluble EPS, bacterial microcolonies release soluble exofactors that have direct impacts on the survivability, growth and antibacterial resistivity of other microcolonies made of single- or multi-species bacteria in the same biofilm. How the exofactors of microcolonies of one-type bacteria impact on microcolonies of other-type bacteria is still unclear. We studied about the role of exofactors released from Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, which are common biofilm-forming pathogenic bacteria. Exofactors facilitate to transform the microenvironment where bacteria can acquire alternative lifestyle with a long survival period and resistivity to certain antimicrobial drugs.
基金Supported by Science and Technology Innovation Plan for Medical Workers in Shandong Province(SDYWZGKCJH2023095)Clinical Pharmacy Research Project of Shandong Provincial Medical Association(YXH2022ZX010)+1 种基金Traditional Chinese Medicine Science and Technology Development Project of Shandong Province(2019-0400&2021Q097)Traditional Chinese Medicine Research Program of Qingdao City(2020-zyy031)Medical Research Guidance Plan of Qingdao City(2020-WJZD087).
文摘[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.
文摘Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.
基金supported by the National Natural Science Foundation of China(No.31901635)。
文摘The angiotensin-converting enzyme(ACE)inhibitory peptide NCW derived from Mizuhopecten yessoensis has been demonstrated to have significant in vivo anti-hypertensive effects,however,its anti-hypertensive mechanism is still not fully clarified.This study established a UPLC-Q-TRAP-MS/MS-based widely targeted kidney metabolomics approach to explore the changes of kidney metabolic profiles and to clarify the antihypertensive mechanism of peptide NCW in spontaneously hypertensive rats(SHRs).Multivariate statistical analysis indicated that the kidney metabolic profiles were clearly separated between the SHR-NCW and SHRUntreated groups.A total of 85 metabolites were differentially regulated,and 16 metabolites were identified as potential kidney biomarkers,e.g.,3-hydroxybutyrate,malonic acid,deoxycytidine,and L-aspartic acid.The peptide NCW might regulate kidney metabolic disorder of SHRs to alleviate hypertension by suppressing inflammation and improving nitric oxide production under the regulation of linoleic acid metabolism,folate related pathways,synthesis and degradation of ketone bodies,pyrimidine metabolism,β-alanine metabolism,and retinal metabolism.
文摘Background and Objectives: Chronic kidney disease (CKD) is now a global public health problem. In low- and middle-income countries such as the Congo, access to dialysis is low and inequitable. The prevention of CKD involves raising awareness among patients at risk, such as those suffering from arterial hypertension (AH), by improving their knowledge of CKD. The objectives of our work were to determine the level of knowledge about CKD among hypertensive patients and to identify the factors associated with a low level of knowledge. Methodology: We conducted a 3-month descriptive and analytical cross-sectional study from 1 August to 30 October 2023 in 3 large public hospitals in Brazzaville (capital of the Republic of Congo). We included: hypertensive patients aged 18 and over who had freely consented to participate in our study and were able to answer the questions on the survey form. Patients with known hypertension who had been followed for less than 3 years and those with known chronic renal failure were not included. Results: The mean age was 58.4 ± 14.4 years (29 - 88 years). There were 121 men and 150 women (sex ratio = 0.8). All the patients were educated;37.2% with a higher level of education and 13.6% with primary education. 24 patients (9%) had a good level of knowledge about CKD and 153 (56%) had poor knowledge. A good level of knowledge was associated with the duration of hypertension, intellectual level and the existence of associated heart disease. Conclusion: Our study reveals a significant lack of knowledge about chronic kidney disease among hypertensive patients in Brazzaville.
基金supported by the National Natural Science Foundation of China(81825009,82071505,81901358)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2MC&T-B-099,2019-I2M-5–006)+2 种基金the Program of Chinese Institute for Brain Research Beijing(2020-NKX-XM-12)the King’s College London-Peking University Health Science Center Joint Institute for Medical Research(BMU2020KCL001,BMU2019LCKXJ012)the National Key R&D Program of China(2021YFF1201103,2016YFC1307000).
文摘Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).
文摘Background:Alcohol and illicit drugs(AID)continue to be a major global health concern.Although preventable,AID is linked to millions of deaths annually worldwide.The situation is particularly grave for young people,with AID being a major direct risk factor for disability-adjusted youth life-years lost and death.It further contributes to assaults,road crashes,accidental poisoning,and suicide,leading to long-term issues and public health concerns.Objective:This study aimed at disclosing current AID prevalence data for Argentinian,Bulgarian,Chilean and Romanian youth.It shed light on the predictors of AID in young people from those countries.Method:The study used an online survey to gather data from people aged 18 to 25(n=1,297).The survey was underpinned by the theory of planned behaviour(TPB).Predictors were investigated separately for drinking alcohol and using illicit drugs.Results:Our data revealed that across the four target countries,49%to 90%of the participants drank alcohol,and 8%to 35%used illicit drugs in the past three months.Between 20%and 91%of them intended to drink,and between 8%and 31%intended to use illicit drugs in the following three months.Our TPB model predicted statistically significant(P<0.001)amounts of variance in drinking alcohol(between 61%and 72%)and using illicit drugs(between 20.3%and 74.4%).Intention was consistent in significantly predicting both behaviours.Evidence around the predictive validity of self-efficacy,age and gender was mixed across the investigated countries.Conclusion:This research provided an update on the scarce AID epidemiological data.It also supplied evidence about what theoretically-informed measures might be useful targets of interventions in the case of Argentina,Bulgaria,Chile and Romania.This new knowledge of understanding substance abuse determinants and prevalence may help researchers and practitioners better meet young people's health prevention needs.
