ABSTRACT
@#Abstract: Objective By analyzing the frequency distribution of antihypertensive drug-related genotypes in hypertensionpatients treated in our hospital, so as to provide a clinical basis for individualized treatment of hypertension patients. Methods A total of 72 hypertensive patients treated in Hainan Hospital of PLA General Hospital from June 2021 to April 2022 were collected. PCR-melting curve method was used to detect CYP2D6*10 (c.100 C>T), CYP2C9*3 (c.1075 A>C), ADRB1 (c.1165 G>C), AGTR1 (c.1166 A>C), ACE (I/D), NPPA (T2238C) and CYP3A5*3 (A6986G), and the relationship between different genotypes and biochemical indexes was analyzed. Results According to the statistics of the gene and genotype frequency of each point in 72 patients, the gene frequencies of 7 sites all conformed to Hardy Weinberg equilibrium. There were gender differences in ADRB1 genotypes (χ2 = 5.878, P<0.05). There were statistical differences in triglycerides [AA: 1.4 (1.0, 2.0)mmol/L; AC: 2.2 (1.5, 2.5)mmol/L; P=0.038], total cholesterol [AA: 4.0 (3.1, 4.9) mmol/L; AC: 4.8 (4.0, 5.3) mmol/L; P=0.040] and low-density lipoprotein cholesterol [(AA: 2.4 (1.8, 3.3) mmol/L; AC: 3.2 (2.5, 3.5) mmol/L; P=0.035] among patients with different genotypes of AGTR1 locus. The patients with different genotypes of CYP2C9 locus had significant differences in their alanine transferase (ALT) [AA:16.9 (11.4,30.2) mmol/L; AC:10.4 (9.4, 18.2) mmol/L; P=0.040]. Aftergene-directed individualized therapy, different genotypes of CYP3A5 andAGTR1 affected the heart rate [CYP3A5: AA: (79.3±7.0) beats/min; AG： (69.8±6.8) beats/min; GG： (68.8±7.3) beats/min; P=0.010], systolic blood pressure [AGTR1: AA: (131.3±16.7) mmHg; AC: (140.6±11.8) mmHg; P=0.014] and diastolic blood pressure [CYP3A5: AA: (90.0±8.3) mmHg; AG: (78.7±10.8) mmHg; GG: (74.9±10.7) mmHg; P=0.025; AGTR1: AA: (75.3±10.2) mmHg; AC: (86.3±10.6) mmHg; P=0.001] of patients. Conclusions The related gene loci of antihypertensive drugs are an important basis for guiding the diversification and individualization of clinical medication. Clinicians need to consider the impact of related genes on drug efficacy and adverse reactions when prescribing.
ABSTRACT
Objective:To evaluate the effects of different blood pressure control levels on left ventricular myocardial mechanics in patients with primary elderly hypertension by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 315 elderly patients with essential hypertension diagnosed in Bethune Hospital Affiliated to Shanxi Medical University from January to June 2017 were collected and randomly divided into standard antihypertensive group and intensive antihypertensive group. The patients who were receiving antihypertensive drugs were treated with antihypertensive drugs more or less, and the patients who had not yet been treated started antihypertensive drugs therapy. The blood pressure was adjusted to the target value within 3 months (blood pressure in standard antihypertensive group was controlled at 130-150/<90 mmHg, intensive antihypertensive group was controlled at 110-130/<80 mmHg). All patients were followed up for 24 months. After 24 months of antihypertensive drugs treatment, 26 cases of lost follow-up, substandard blood pressure or poor image quality were excluded, and 289 patients were included, standard antihypertensive group ( n=148), intensive antihypertensive group ( n=141) . During the same period, 71 age-matched people without essential hypertension were selected as control group. Comprehensive echocardiography were performed in all subjects at baseline and 24 months. The longitudinal strain of the inner, middle and outer layers (GLS-endo, GLS-mid, GLS-epi) of the whole left ventricle were obtained by two-dimensional speckle tracking technique. The routine echocardiographic and left ventricular strain parameters were compared at baseline and 24 months. Results:①At baseline, the end-diastolic thickness of interventricular septum (IVSD), the end-diastolic thickness of left ventricular posterior wall (LVPWD), the end-diastolic diameter of left ventricle (LVEDD), the left ventricular mass index (LVMI), the relative wall thickness (RWT) and the ratio of early diastolic mitral flow velocity to early diastolic mitral annulus velocity(E/e′) in two antihypertensive groups were higher than those in the control group, and the levels of GLS-endo, GLS-mid and GLS-epi were lower than those in the control group(all P<0.05). There were no significant differences in routine echocardiographic parameters and strain parameters between standard antihypertensive group and intensive antihypertensive group (all P>0.05). ②After 24 months of antihypertensive drugs treatment, LVEDD and E/e′ in standard antihypertensive group and IVSD, LVPWD, LVEDD, LVMI, RWT, E/e′in intensive antihypertensive group were lower than those at baseline, and IVSD, LVMI and RWT in intensive antihypertensive group were lower than those in standard antihypertensive group (all P<0.05). ③After 24 months of antihypertensive drugs treatment, GLS-endo, GLS-mid and GLS-epi in two antihypertensive groups were higher than those at baseline, and GLS-endo, GLS-mid, GLS-epi in intensive antihypertensive group were higher than those in standard antihypertensive group(all P<0.05). Conclusions:①The left ventricular myocardial mechanics is damaged and the systolic function is decreased in elderly patients with essential hypertension; ②The myocardial mechanics is significantly improved after antihypertensive treatment, with more improvement in intensive antihypertensive treatment patients.
ABSTRACT
Tetrahydroberberine (THB) belongs to the alkaloid of tetrahydroisoquinoline, which is derived from the roots of Corydalis yanhusuo and can also be hydrogenated from berberine. THB has a variety of significant biological activities compared to berberine. It is reported that THB has the effects of anti-hypertension, anti-arrhythmia, anti-fibrillation and against acute myocardial infarction, and also can treat and protect the injury of ischemic and reperfusion. Moreover, other research has found its effects upon anti-oxidant and regulating the functions of gastrointestinal tract. By searching literature of domestic and foreign from Pubmed, CNKI and other databases, pharmacological activities of THB were summarized in this paper, in order to provide reference for the further study of THB.
ABSTRACT
Objective:To study the antihypertensive effect of the extract from compound Prunella vulgaris L. in spontaneous hy-pertension(SH)rats. Methods:Forty SH rats were randomly divided into the model group,high,middle and low dose groups of ex-tract from vompound Prunella vulgaris L. ,the compound kendir leaves tablets Ⅰ group with 8 ones in each. Non-invasive blood pres-sure measurement was used to detect the SBP and DBP of the SHR rats. Then the serum NO,AngⅡ ,ET-1 and ANP content were measured after the eight-week treatment. The pathological changes were observed after kidney HE staining in the SH rats. Results:Compared with that in the model group,the blood pressure in high-dose treatment group,middle-dose treatment group and the positive model group was significantly decreased(P < 0. 05). The AngⅡ and ET-1 levels in high-dose treatment group,middle-dose treatment group and the positive model group were decreased(P < 0. 01),and NO and ANP contents in serum were significantly increased when compared with those in the model group(P < 0. 01). The pathological examination showed that the pathological changes in the model group were faster than those in all the drug-treatment groups,the pathological changes included glomerular and renal tubular atrophy, glomerular vascular wall thickening and renal tubular epithelial cell degeneration or necrosis. Conclusion:The extract from compound Prunella vulgaris L. can reduce blood pressure of SH rats. The mechanism may be associated with the level reduction of AngII and ET-1 and content elevation of NO and ANP.
ABSTRACT
OBJECTIVE:To study the antihypertensive effects of water decoction of Eupatorium lindleyanum on spontaneously hypertensive rats (SHR) and corresponding mechanism. METHODS:50 SHR were randomly divided into model group,captopril tablets group(positive drug,10 mg/g)and the groups of high,medium and low-dose(65.45,32.73,16.36 g/kg)water decoction of E. lindleyanum,with 10 rats in each group. The rats in the model group were given normal saline ig,while those in other groups were given corresponding drugs ig,once a day,for 7 consecutive weeks. The systolic blood pressure (SBP) and diastolic blood pressure(DBP)of the caudal arteries of the rats were measured every week,and the dynamic changes in the blood pressure of the rats as a result of drug intervention were recorded. The rats were sacrificed 7 weeks later,and the levels of endothelin(ET), angiotensin (AngⅡ) and nitric oxide (NO) in serum were determined. RESULTS:After 7 weeks of drug use,compared to the model group,the rats in the drug administration groups had significantly lower SBP and DBP of the caudal artery(P<0.05),show-ing obvious dose-effect and time-effect relationships in the antihypertensive effect of water decoction of E. lindleyanum,and had ob-viously lower levels of NO and AngⅡ and markedly higher level of ET in serum,demonstrating a dose-effect relationship. CON-CLUSIONS:The water decoction of E. lindleyanum has an obvious antihypertensive effect by a mechanism which may be related to decrease in the levels of NO and AngⅡin serum and increase in the level of ET therein.
ABSTRACT
OBJECTIVE: To synthesize and evaluate of antihypertensive activity of novel nitric oxide-releasing N-phenyl-1H-pyrrole derivatives. METHODS: By connecting key structural elements present in an AT1 receptor antagonist irbesartan with N-phenyl-1H-pyrrole carboxylic acid, a novel AT1 antagonist compound 4 was designed and synthesized, and a series of novel NO-donating derivatives (IN 1-10) were obtained by introducing NO donor. The amount of NO production in vitro of the target compounds were determined by Greiss assay. And the antagonism of Ang II induced vascular contraction assay was used to value the inhibition rate. RESULTS: The antagonism of Ang II induced vascular contraction assay indicated that the novel compound exhibited similar activity as losartan. The NO derivative, compound IN9, found to release the maximum amount of NO during the NO releasing assay, was more potent than the lead compound 4 and positive control losartan. CONCLUSION: These date indicate that the improved activities of these hybrid molecules contribute to the NO donor and the protection ability of NO donor make them promising candidates as antihypertensive agents.
ABSTRACT
OBJECTIVE:To explore the safety,superiority and reliability of the application of dexmedetomidine-assisted con-trolled anti-hypertension combined with high capacity hemodilution in spinal surgeries. METHODS:40 patients with spinal surger-ies under general anesthesia were randomly divided into dexmedetomidine group (group D) and normal saline (group S) with 20 cases in each group. Both groups were given controlled anti-hypertension combined with high capacity hemodilution to carry out blood conservation and intraoperative wakeup experiment. Group D was given 1 μg/kg dexmedetomidine within 10 min by micro pump 10 min before anesthesia induction;maintained with 0.4-0.8 μg/(kg·h)during controlled anti-hypertension;injected with dex-medetomidine 0.2 μg/(kg·h) during wakeup experiment and anesthesia maintenance period until tracheal catheter was extracted. Group S was given normal saline instead,and the usage was same as group D. Heart rate (HR),mean arterial pressure (MAP) and central venous pressure(CVP)of patients were observed and recorded before pump injection of dexmedetomidine(T0),1 min after tracheal intubation(T1),10 min after anesthesia induction(T2),30 min after anesthesia induction(T3),wakeup(T4),at the end of controlled anti-hypertension(T5),at the end of operation(T6),during tracheal extubation(T7). Meanwhile,the wakeup ex-periment time,blood loss when wakeup,total amount of nitroglycerin,mean density of inhaled isoflurane,total amount of nitro-glycerin,total blood loss,and post-operative wakeup time of both groups were recorded. The case number of post-operative de-layed wakeup chill and dysphoria were calculated in both groups. RESULTS:Compared with at T0,HR of both groups at T1 and T7 were faster,and MAP and CVP increased,and that of group S was more significant than that of group D(P<0.05). HR and MAP of both groups at T3 were significantly lower than T0(P<0.05). Compared to group D at T4,MAP and CVP of group S at T4 were increased and HR were faster (P<0.05);the wakeup experiment time and post-operative wakeup time of group D were shorter than those of group S (P<0.05);the blood loss when awaken and total blood loss were less than group S (P<0.05);the total amount of nitroglycerin,mean density of inhaled isoflurane and total amount of remifentanil were all lower than those of group S (P<0.05);the incidence of post-operative delayed wakeup,chill and dysphoria in group D were significantly lower than those of group S (P<0.05). CONCLUSIONS:The application of dexmedetomidine-assisted controlled anti-hypertension combined with high capacity hemodilution in spinal surgeries can bring more stable and effective controlled anti-hypertension. It can also reduce the amount of nitroglycerin,remifentanil,propofol and isoflurane significantly. It is a reliable and safe drug to be applied in assist-ed controlled anti-hypertension combined with high capacity hemodilution in spinal surgeries.
ABSTRACT
Objective:To confirm the efficacy and safety of Tiankui antihypertension tablets combined with chemical drugs in the treatment of patients with hypertension whose blood pressure can 't reach the standard after the treatment only with chemical drugs. Methods:Randomized, double-blind, placebo control and multicenter clinical trials were performed on 240 subjects (160 in the ex-periment group and 80 in the control group) in 6 clinical trial centers. Tiankui antihypertension tablets and the placebo were respec-tively given with 4 tablets per time and 3 times a day. The efficacy and safety were observed. Results:For the blood pressure control, the significant efficiency of the experimental group was 63. 23%, while that of the control group was 31. 65%. The significant efficien-cy and effective rate of the traditional Chinese medicine (TCM) syndrome of the experimental group was 48. 39% and 20. 25%, re-spectively, while that of the control group was 20. 25% and 36. 71%, respectively. All of the studied clinical indicators showed signifi-cant differences between the two groups (P<0. 05). No severe adverse reaction was shown in the two groups. Conclusion:Tiankui an-tihypertension tablets combined with chemical drugs exhibits better curative effect and safety in the treatment of hypertension patients whose blood pressure can’ t reach the standard after the treatment only with chemical drugs.
ABSTRACT
This article was aimed to study the effect of polyphenols fromRubus suavissirnusS. Lee (RSLP) on spontaneous hypertensive rats (SHR) and to explore its mechanism of anti-hypertensive. The water extraction of RSLP was prepared. And the polyphenols was extracted with macroporous resin. The non-invasive blood pressure analysis system was used to detect the blood pressure. SHR model was selected to study the anti-hypertensive effect. The 16 normal Wistar rats were randomly divided into the control group and the normal RSLP high-dose group (RSLP-NH). The 40 SHR were randomly divided into the model group, Captopril group, RSLP-L group, RSLP-M group and RSLP-H group. SBP, DBP, HR, body weight and organ index were observed after the drug administration for 8 weeks and drug withdrawal for 2 weeks. The contents of SOD, MDA, GSH-Px, NO, NOS and ANP in serum were measured. The results showed that the blood pressure of SHR was significantly higher than that of the control group, which can be used for anti-hypertensive studies. Each RSLP group can obviously reduce the SBP and DBP of SHR (P 0.05). RSLP can elevate GSH-Px, SOD levels and reduce the activity of MDA (P < 0.05). RSLP can reduce NO, NOS and ANP contents in serum (P < 0.05). It was concluded that RSLP can significantly reduce the SBP and DBP of SHR, but it had no significant effect on HR. It can increase the activity of GSH-Px, SOD, NO, NOS levels, and reduce the contents of MDA, ANP in serum. It had certain inhibitory effect on the left ventricular hypertrophy.
ABSTRACT
Arterial hypertension is a worldwide health problem with multiple origins. Its management remains difficult, particularly because of the pathology dependence on human lifestyle. Several ethno pharmaceutical are used to treat hypertension. Herein we investigated, for the first time, the effect of the water-boiled extract of Artemisia campestris on Human hemodynamic system. To do so, the blood pressure parameters of two groups of adult volunteers (smokers and non-smokers) were recorded before and each 15 minutes after drinking 20 ml of the boiled extract (20g of dried leaves / 1 L of water). The diastolic pressure and heart rate significantly diminished following the treatment, in both smoker and non-smoker men. In exception to a punctual reduction at 45 minutes in non- smokers, the systolic pressure did not significantly change. The classification of subjects in accordance to their hypertension statute at each time-point of recording, showed an important reduction of the stage 2 in smoking men, following the consumption of the extract. It is concluded that the water-boiled extract of Artemisia campestris could tip over arterial hypertension, especially in smokers. It is suggested that the mechanism of such effect involves epinephrine synthesis or binding to its receptor inhibition.
ABSTRACT
Objective: To explore the research method suitable for the component compatibility and optimization design of Chinese materia medica (CMM) by taking the blood pressure-lowering effect of the effective components in Ramulus Uncariae cum Uncie total alkaloids (RUCUTA) and Semen Raphani total alkaloids (SRTA) as the research objects. Methods: According to the procedure of "orthogonal design-evaluation on drug effect-partial least-squares regression (PLSR)", using contractive pressure as index, the ratio of RUCUTA and SRTA was optimized by orthogonal design method. The data were analyzed by range analysis, variance analysis, multiple regression analysis, and PLSR analysis. Results: According to the result of the data analysis and considering the economic costs, the optimal ratio of the two components was 25 μg/g RUCUTA and 30 μg/g SRTA. Conclusion: The compatibility of RUCUTA and SRTA could effectively reduce blood pressure. The orthogonal design method combined with PLSR could eliminate the interaction among the various factors and be suitable for the component compatibility in CMM and optimization design.
ABSTRACT
Childhood hypertensive crisis is a relatively rare emergency event,and is associated with a high risk of morbidity and mortality.Children in this situation need rapid,safe and effective treatment to release clinical symptoms,relieve injuries of target organs,improve quality of life,and reduce mortality.Many kinds of anti-hypertension drugs have been used in children for decades,but most data were extrapolated from studies in adult.There is limited number of randomized controlled trials in children.Therefore it is still difficult to choose drugs for pediatric hypertensive crisis based on evidence-based medicine.This paper sought to summarize the experience of medical management of childhood hypertensive crisis in children.
ABSTRACT
The aim of this study was to investigate the antihypertensive effect of the methanol extract of the leaf of Napoleona imperialis (p. beauv) in adrenaline induced hypertensive rats (AlHR) and compared with those of Propanolol in a cross over design. Napoleona imperialis leaf extract and the commercial drug (Propanolol) were administered orally and through intraperitoneal (I.P) route respectively for one week. Effect of the extract on different biochemical parameters such as blood glucose, serum triglycerides, serum cholesterol, serum creatine phosphokinase, lactate dehydrogenase, pulse rate and body weight were measured utilizing standard methods. Napoleona imperialis leaf extract at the doses of 26mg/130±17g and 52mg/130±17g of body weight were given orally every morning during treatment to show the effect of dose concentration. Propanolol at a dose of 0.084mg/130±17g of body weight was injected into rats according to its pharmacokinetic parameters. The extract administered rats had significantly lowered serum lactate dehydrogenase, creatine phosphokinase and pulse rate compared to the non-extract administered AlHR group (P<0.05). Blood glucose, serum triglycerides and serum cholesterol were not lowered and significantly different (P<0.05) when compared with the control. These results suggest that oral administration of methanol extract of Napoleona imperialis may be useful for prevention and treatment of hypertension.
ABSTRACT
Monascus-fermented rice is a natural food and traditional Chinese medicine. Besides its wellknown effectiveness in lowering blood lipids, Monascus-fermented rice is also beneficial for decreasing blood pressure, preventing osteoporosis, and lowering blood sugar. This article reviews recent advances in its non-anti-hyperlipemic effects and their potential mechanisms.
ABSTRACT
Usage of natural substances as therapeutic agents in modern medicine has sharply declined from the predominant position held in the early decades of last century, but search for bioactive molecules from nature (plants, animals, microflora) continues to play an important role in fashioning new medicinal agents. With the advent of modern techniques, instrumentation and automation in isolation and structural characterisation, we have on hand an enormous repository of natural compounds. In parallel to this, biology has also made tremendous progress in expanding its frontiers of knowledge. An interplay of these two disciplines constitutes the modern thrust in research in the realm of compounds elaborated by nature. The purpose of this article is to underline how natural products research continues to make significant contributions in the domain of discovery and development of new medicinal products. It is proposed to present the material under several heads, each of which has made natural products research relevant in the search for new and better medication.
ABSTRACT
Objective To study the effect of anti-hypertensive therapy on the characteristics of platelet in essential hypertension(EH) patients. Methods Thirty-two healthy people(CT) and 37 patients with primary hypertension (gradeⅠ) were recruited . Blood pressure and 4 platelet parameters: platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet hematocrit (PCT) were determined by whole blood automatic analysis apparatus. Results The 4 platelet parameters were increased in hypertension patients compared with healthy people and decreased after anti-hypertensive therapy[PLT:(before 201.8?72.9 vs after 187.1?68.6 )10~ 9 L+{-1}; MPV:(before 10.3?1.9 vs after 10.0?1.9)fL, PDW:(before 15.5?1.1 vs after 15.2?1.0)fL; PCT:(before 0.198%?0.047% vs after 0.187%?0.036%)](P
ABSTRACT
OBJECTIVE: To develop a rapid, accurate and sensitive method for the determination of nifedipine, nitrendipine and nimodipine which were added into traditional patent medicine illegally. METHODS: The LC-MS method was used to detect the extractive of Chinese patent medicine for antihypertension in respects of relative molecular mass, tandem mass spectrometry fragment, retention time, UV spectrum. The compounds added into the Chinese patent medicine were identified by comparing with standard sample in terms of spectrum, chromatographic and mass spectrometric behavior. RESULTS: According to four aspects of determination, nifedipine, nitrendipine and nimodipine were found in three kinds of Chinese patent medicine for antihypertension. CONCLUSION: The method is selective and sensitive for the detection of nifedipine, nitrendipine and nimodipine which were added into traditional patent medicine illegally.
ABSTRACT
O estudo comparou 100 hipertensos atendidos no Pronto-socorro com 100 pacientes do Ambulatório. Os hipertensos do Pronto-Socorro foram diferentes (p < 0,05) em relação a: maior pressão arterial; menor renda salarial; maior consumo de bebida alcoólica; não pertenciam à comunidade do hospital; descobriram ser hipertensos por sentirem-se mal; mediram menos a pressão; e deixaram de tomar mais medicamentos. A análise multivariada revelou diferenças significativas entre os dois grupos quanto à renda, ao local onde é medida a pressão e não tomar os medicamentos. Concluiu-se que características desfavoráveis podem contribuir para não realizar o tratamento anti-hipertensivo, levando a atendimentos em unidades de emergência.
This study compares 100 hypertensive patients in emergency units with those who were seen in outpatient clinics. Hypertensive patients seen at the emergency unit showed to be different (p < 0.05) from those seen at the outpatient clinic regarding: higher blood pressure; lower income; not belonging to the hospital community; greater alcohol intake; became aware of their hypertension because felt bad; measured blood pressure less often; did not take the medicine more often. In conclusion, unfavorable characteristics can contribute to hypertensive patients who do not follow anti-hypertension treatment adequately, leading to care in emergency units.
Este estudio comparó 100 hipertensos atendidos en un servicio de emergencia, con 100 pacientes de consulta externa. Los hipertensos de emergencia fueron diferentes (p<0,05) en relación a: presión arterial más elevada; menor renta salarial; no pertenecían a la comunidad del hospital; mayor consumo de bebidas alcohólicas; descubrieron ser hipertensos por sentirse mal; se midieron menos la presión y dejaron de tomar los medicamentos. El análisis multivariado muestra que la renta, el local donde se mide la presión y dejar de tomar los medicamentos marcaron diferencias entre los dos grupos. Se concluyó que estas características desfavorables pueden contribuir al abandono del tratamiento antihipertensivo llevando a los pacientes a ser atendidos en unidades de emergencia.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Ambulatory Care , Emergency Medical Services , Hypertension/epidemiology , Hypertension/therapy , Prospective StudiesABSTRACT
Objectives To evaluate the effectiveness of ARB in antihypertensive therapy and judge whether it can also protect cardiovascular. Methods A randomized double-blinded placebo-controlled study was used to survey over ten thousand patients in ARB clinical practices. The primary endpoint was stroke, acute myocardial infarction, heart failure, deadly cardiovascular diseases, total mortal. The results were given comprehensive analysis and statistical processing. Results In LIFE study, ARB was more effective than ?-blockers and ARB had the role of protecting the cardiovascular besides lowering the blood pressure. But the VALUE study showed that ARB was not more effective than Besylate. Conclusion There is no obvious distinction between ARB and the other drugs in reducing the blood pressure.
ABSTRACT
Bioactive peptides in the marine organisms such as sponges,ascidian,fishes,shellfish,etc. and their bioactivities of antineoplastic, antimicrobial, antihypertension and antioxidation were reviewed in this paper.