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Bhasin MK, Denninger JW, Huffman JC, Joseph MG, Niles H, Chad-Friedman E, Goldman R, Buczynski-Kelley B, Mahoney BA, Fricchione GL, Dusek JA, Benson H, Zusman RM, Libermann TA. Specific Transcriptome Changes Associated with Blood Pressure Reduction in Hypertensive Patients After Relaxation Response Training. J Altern Complement Med 2018; 24:486-504. [PMID: 29616846 PMCID: PMC5961875 DOI: 10.1089/acm.2017.0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Mind-body practices that elicit the relaxation response (RR) have been demonstrated to reduce blood pressure (BP) in essential hypertension (HTN) and may be an adjunct to antihypertensive drug therapy. However, the molecular mechanisms by which the RR reduces BP remain undefined. DESIGN Genomic determinants associated with responsiveness to an 8-week RR-based mind-body intervention for lowering HTN in 13 stage 1 hypertensive patients classified as BP responders and 11 as nonresponders were identified. RESULTS Transcriptome analysis in peripheral blood mononuclear cells identified 1771 genes regulated by the RR in responders. Biological process- and pathway-based analysis of transcriptome data demonstrated enrichment in the following gene categories: immune regulatory pathways and metabolism (among downregulated genes); glucose metabolism, cardiovascular system development, and circadian rhythm (among upregulated genes). Further in silico estimation of cell abundance from the microarray data showed enrichment of the anti-inflammatory M2 subtype of macrophages in BP responders. Nuclear factor-κB, vascular endothelial growth factor, and insulin were critical molecules emerging from interactive network analysis. CONCLUSIONS These findings provide the first insights into the molecular mechanisms that are associated with the beneficial effects of the RR on HTN.
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Affiliation(s)
- Manoj K. Bhasin
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center, Beth Israel Deaconess Medical Center, Boston, MA
| | - John W. Denninger
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Marie G. Joseph
- BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center, Beth Israel Deaconess Medical Center, Boston, MA
| | - Halsey Niles
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Emma Chad-Friedman
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Roberta Goldman
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Beverly Buczynski-Kelley
- Department of Medicine, Corrigan-Minehan Heart Center, Cardiology Division, Section on Hypertension, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Barbara A. Mahoney
- Department of Medicine, Corrigan-Minehan Heart Center, Cardiology Division, Section on Hypertension, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gregory L. Fricchione
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jeffery A. Dusek
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, MN
| | - Herbert Benson
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Randall M. Zusman
- Department of Medicine, Corrigan-Minehan Heart Center, Cardiology Division, Section on Hypertension, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Towia A. Libermann
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center, Beth Israel Deaconess Medical Center, Boston, MA
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Lamarche C, Pichette M, Ouimet D, Vallée M, Bell R, Ouellet G, Stewart J, Pichette V. Pharmacokinetic and Dynamic of Furosemide in Peritoneal Dialysis Patients. Perit Dial Int 2016; 36:107-8. [PMID: 26838993 DOI: 10.3747/pdi.2014.00328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of our study was to evaluate the efficacy and bioavailibility of a commonly used oral furosemide dose (500 mg) compared to a 250 mg intravenous (IV) dose in PD patients with significant residual renal function (urine volume > 100 mL). We also evaluated the immediate blood pressure effect in these patients. The data were obtained from a study we performed for the homologation of a 500-mg dose of furosemide by Health Canada.
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Affiliation(s)
- Caroline Lamarche
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Maude Pichette
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Denis Ouimet
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Michel Vallée
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Robert Bell
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | - Georges Ouellet
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada
| | | | - Vincent Pichette
- Department of nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada
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London BK, Claville MOF, Babu S, Fronczek FR, Uppu RM. A co-crystal of nona-hydrated disodium(II) with mixed anions from m-chloro-benzoic acid and furosemide. Acta Crystallogr E Crystallogr Commun 2015; 71:1266-9. [PMID: 26594422 PMCID: PMC4647361 DOI: 10.1107/s2056989015017430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/17/2015] [Indexed: 11/11/2022]
Abstract
In the title compound, [Na2(H2O)9](C7H4ClO2)(C12H10ClN2O5S) {systematic name: catena-poly[[[triaquasodium(I)]-di-μ-aqua-[triaquasodium(I)]-μ-aqua] 3-chlorobenzoate 4-chloro-2-[(furan-2-ylmethyl)amino]-5-sulfamoylbenzoate]}, both the original m-chloro-benzoic acid and furosemide exist with deprotonated carboxyl-ates, and the sodium cations and water mol-ecules exist in chains with stoichiometry [Na2(OH2)9](2+) that propagate in the [-110] direction. Each of the two independent Na(+) ions is coordinated by three monodentate water mol-ecules, two double-water bridges, and one single-water bridge. There is considerable cross-linking between the [Na2(OH2)9](2+) chains and to furosemide sulfonamide and carboxyl-ate by inter-molecular O-H⋯O hydrogen bonds. All hydrogen-bond donors participate in a complex two-dimensional array parallel to the ab plane. The furosemide NH group donates an intra-molecular hydrogen bond to the carboxyl-ate group, and the furosemide NH2 group donates an intra-molecular hydrogen bond to the Cl atom and an inter-molecular one to the m-chloro-benzoate O atom. The plethora of hydrogen-bond donors on the cation/water chain leads to many large rings, up to graph set R 4 (4)(24), involving two chains and two furosemide anions. The chloro-benzoate is involved in only one R 2 (2)(8) ring, with two water mol-ecules cis-coordinated to Na. The furan O atom is not hydrogen bonded.
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Affiliation(s)
- Bianca King London
- Environmental Toxicology PhD Program and the Health Research Center, Southern University and A&M College, Baton Rouge, LA 70813, USA
| | | | - Sainath Babu
- School of Science, Hampton University, Hampton, VA 23668, USA
| | - Frank R. Fronczek
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803-1804, USA
| | - Rao M. Uppu
- Environmental Toxicology PhD Program and the Health Research Center, Southern University and A&M College, Baton Rouge, LA 70813, USA
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Fan H, Song F. An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries. Sci Rep 2015; 5:13221. [PMID: 26272174 PMCID: PMC4642521 DOI: 10.1038/srep13221] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/21/2015] [Indexed: 12/21/2022] Open
Abstract
Research is crucial to implement evidence-based health interventions for control of non-communicable diseases (NCDs). This study aims to assess main features of randomized controlled trials (RCTs) for control of NCDs, and to identify gaps in clinical research on NCDs between high-income and less developed countries. The study included 1177 RCTs in 82 Cochrane Systematic reviews (CSRs) and evaluated interventions for adults with hypertension, diabetes, stroke, or heart diseases. Multivariate logistic regression analyses were conducted to explore factors associated with risk of bias in included RCTs. We found that 78.2% of RCTs of interventions for major NCDs recruited patients in high-income countries. The number of RCTs included in the CSRs was increasing over time, and the increasing speed was more noticeable for RCTs conducted in middle-income countries. RCTs conducted in less developed countries tended to be more recently published, less likely to be published in English, with smaller sample sizes, and at a higher risk of bias. In conclusion, there is still a lack of research evidence for control of NCDs in less developed countries. To brace for rising NCDs and avoid waste of scarce research resources, not only more but also higher quality clinical trials are required in low-and-middle-income countries.
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Affiliation(s)
- Hong Fan
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, P.R. China
| | - Fujian Song
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, U.K
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Wang X, Reynolds AR, Elshahawi SI, Shaaban KA, Ponomareva LV, Saunders MA, Elgumati IS, Zhang Y, Copley GC, Hower JC, Sunkara M, Morris AJ, Kharel MK, Van Lanen SG, Prendergast MA, Thorson JS. Terfestatins B and C, New p-Terphenyl Glycosides Produced by Streptomyces sp. RM-5-8. Org Lett 2015; 17:2796-9. [PMID: 25961722 PMCID: PMC4472964 DOI: 10.1021/acs.orglett.5b01203] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Terfestatins B (1) and C (2), new p-terphenyls bearing a novel unsaturated hexuronic acid (4-deoxy-α-L-threo-hex-4-enopyranuronate), a unique β-D-glycosyl ester of 5-isoprenylindole-3-carboxylate (3) and the same rare sugar, and two new hygromycin precursors, were characterized as metabolites of the coal mine fire isolate Streptomyces sp. RM-5-8. EtOH damage neuroprotection assays using rat hippocampal-derived primary cell cultures with 1, 2, 3 and echoside B (a terfestatin C-3'-β-D-glucuronide from Streptomyces sp. RM-5-8) revealed 1 as potently neuroprotective, highlighting a new potential application of the terfestatin scaffold.
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Affiliation(s)
- Xiachang Wang
- Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Anna R. Reynolds
- Department of Psychology and Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Sherif I. Elshahawi
- Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Khaled A. Shaaban
- Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Larissa V. Ponomareva
- Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Meredith A. Saunders
- Department of Psychology and Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Ibrahim S. Elgumati
- Department of Psychology and Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Yinan Zhang
- Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Gregory C. Copley
- Center for Applied Energy Research, University of Kentucky, Lexington, Kentucky 40511, United States
| | - James C. Hower
- Center for Applied Energy Research, University of Kentucky, Lexington, Kentucky 40511, United States
| | - Manjula Sunkara
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Andrew J. Morris
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Madan K. Kharel
- School of Pharmacy, University of Maryland Eastern Shore, Princess Anne, Maryland 21853, United States
| | - Steven G. Van Lanen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Mark A. Prendergast
- Department of Psychology and Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky 40536, United States
| | - Jon S. Thorson
- Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, United States
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Schartum-Hansen H, Løland KH, Svingen GFT, Seifert R, Pedersen ER, Nordrehaug JE, Bleie Ø, Ebbing M, Berge C, Nilsen DWT, Nygård O. Use of Loop Diuretics is Associated with Increased Mortality in Patients with Suspected Coronary Artery Disease, but without Systolic Heart Failure or Renal Impairment: An Observational Study Using Propensity Score Matching. PLoS One 2015; 10:e0124611. [PMID: 26030195 PMCID: PMC4452510 DOI: 10.1371/journal.pone.0124611] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/03/2015] [Indexed: 11/18/2022] Open
Abstract
Background Loop diuretics are widely used in patients with heart and renal failure, as well as to treat hypertension and peripheral edema. However, there are no randomized, controlled trials (RCT) evaluating their long term safety, and several observational reports have indicated adverse effects. We sought to evaluate the impact of loop diuretics on long term survival in patients with suspected coronary artery disease, but without clinical heart failure, reduced left ventricular ejection fraction or impaired renal function. Method and Findings From 3101 patients undergoing coronary angiography for suspected stable angina pectoris, subjects taking loop diuretics (n=109) were matched with controls (n=198) in an attempted 1:2 ratio, using propensity scores based on 59 baseline variables. During median follow-up of 10.1 years, 37.6% in the loop diuretics group and 23.7% in the control group died (log-rank p-value 0.005). Treatment with loop diuretics was associated with a hazard ratio (95% confidence interval) of 1.82 (1.20, 2.76), and the number needed to harm was 7.2 (4.1, 30.3). Inclusion of all 3101 patients using propensity score weighting and adjustment for numerous covariates provided similar estimates. The main limitation is the potential of confounding from unmeasured patient characteristics. Conclusions The use of loop diuretics in patients with suspected coronary artery disease, but without systolic heart failure or renal impairment, is associated with increased risk of all-cause mortality. Considering the lack of randomized controlled trials to evaluate long term safety of loop diuretics, our data suggest caution when prescribing these drugs to patients without a clear indication.
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Affiliation(s)
- Hall Schartum-Hansen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Kjetil H. Løland
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Gard F. T. Svingen
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Reinhard Seifert
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva R. Pedersen
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jan E. Nordrehaug
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Øyvind Bleie
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Marta Ebbing
- Norwegian Institute of Public Health, Bergen, Norway
| | - Christ Berge
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Dennis W. T. Nilsen
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
- Stavanger University Hospital, Stavanger, Norway
| | - Ottar Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
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Chu PY, Campbell MJ, Miller SG, Hill KD. Anti-hypertensive drugs in children and adolescents. World J Cardiol 2014; 6:234-244. [PMID: 24944754 PMCID: PMC4062129 DOI: 10.4330/wjc.v6.i5.234] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 01/28/2014] [Accepted: 04/16/2014] [Indexed: 02/07/2023] Open
Abstract
Worldwide the prevalence of essential hypertension in children and adolescents continues to increase. Traditionally providers have used “off-label” drugs to treat pediatric hypertension, meaning that rigorous clinical trials of these drugs have not been specifically performed in pediatric patient populations. Consequently providers have extrapolated dosing, safety and efficacy from trials in adults. This practice is sub-optimal as children demonstrate unique differences in drug metabolism and response. Use of unstudied or understudied drugs increases risk of adverse events and/or can lead to sub-optimal efficacy. Recognizing these concerns, regulatory agencies have created financial incentives for industry to conduct pediatric clinical trials. These incentives, coupled with the emerging pediatric hypertension epidemic, have spurred over 30 clinical trials of anti-hypertensive drugs over the past 15 years and have resulted in labeling of 10 new drugs by the United States Food and Drug Administration for treatment of hypertension in children and adolescents. Unfortunately the financial incentive structures focus on newer drugs and drug classes. Consequently there is now a relative dearth of trial data for older but sometimes commonly prescribed 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.
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Santschi V, Chiolero A, Colosimo AL, Platt RW, Taffé P, Burnier M, Burnand B, Paradis G. Improving blood pressure control through pharmacist interventions: a meta-analysis of randomized controlled trials. J Am Heart Assoc 2014; 3:e000718. [PMID: 24721801 PMCID: PMC4187511 DOI: 10.1161/jaha.113.000718] [Citation(s) in RCA: 224] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/10/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Control of blood pressure (BP) remains a major challenge in primary care. Innovative interventions to improve BP control are therefore needed. By updating and combining data from 2 previous systematic reviews, we assess the effect of pharmacist interventions on BP and identify potential determinants of heterogeneity. METHODS AND RESULTS Randomized controlled trials (RCTs) assessing the effect of pharmacist interventions on BP among outpatients with or without diabetes were identified from MEDLINE, EMBASE, CINAHL, and CENTRAL databases. Weighted mean differences in BP were estimated using random effect models. Prediction intervals (PI) were computed to better express uncertainties in the effect estimates. Thirty-nine RCTs were included with 14 224 patients. Pharmacist interventions mainly included patient education, feedback to physician, and medication management. Compared with usual care, pharmacist interventions showed greater reduction in systolic BP (-7.6 mm Hg, 95% CI: -9.0 to -6.3; I(2)=67%) and diastolic BP (-3.9 mm Hg, 95% CI: -5.1 to -2.8; I(2)=83%). The 95% PI ranged from -13.9 to -1.4 mm Hg for systolic BP and from -9.9 to +2.0 mm Hg for diastolic BP. The effect tended to be larger if the intervention was led by the pharmacist and was done at least monthly. CONCLUSIONS Pharmacist interventions - alone or in collaboration with other healthcare professionals - improved BP management. Nevertheless, pharmacist interventions had differential effects on BP, from very large to modest or no effect; and determinants of heterogeneity could not be identified. Determining the most efficient, cost-effective, and least time-consuming intervention should be addressed with further research.
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Affiliation(s)
- Valérie Santschi
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (V.S., A.C., P.T., B.B.)
- Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland (V.S., M.B.)
- La Source, School of Nursing Sciences, University of Applied Sciences Western Switzerland, Lausanne, Switzerland (V.S.)
| | - Arnaud Chiolero
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (V.S., A.C., P.T., B.B.)
| | - April L. Colosimo
- McGill Library, Schulich Library of Science and Engineering, McGill University, Montreal, Quebec, Canada (A.L.C.)
| | - Robert W. Platt
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada (R.W.P., G.P.)
| | - Patrick Taffé
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (V.S., A.C., P.T., B.B.)
| | - Michel Burnier
- Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland (V.S., M.B.)
| | - Bernard Burnand
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland (V.S., A.C., P.T., B.B.)
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada (R.W.P., G.P.)
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Rende P, Paletta L, Gallelli G, Raffaele G, Natale V, Brissa N, Costa C, Gratteri S, Giofrè C, Gallelli L. Retrospective evaluation of adverse drug reactions induced by antihypertensive treatment. J Pharmacol Pharmacother 2013; 4:S47-50. [PMID: 24347982 PMCID: PMC3853669 DOI: 10.4103/0976-500x.120954] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The use of cardiovascular drugs is related to the development of adverse drug reactions (ADRs) in about 24% of the patients in the Cardiovascular Care Unit. Here, we evaluated the ADRs in patients treated with antihypertensive drugs. The study was conducted in two phases: In the first phase, we performed a retrospective study on clinical records of Clinical Divisions (i.e., Internal Medicine Operative Unit and Geriatric Operative Unit) from January 1, 2012 to December 31, 2012. Moreover from January 1, 2013 to March 30, 2013 we performed a prospective study on the outpatients attending the Emergency Department (ED) of the Pugliese-Ciaccio Hospital of Catanzaro, by conducting patient interviews after their informed consent was obtained. The association between a drug and ADR was evaluated using the Naranjo scale. We recorded 72 ADRs in the Clinical Divisions and six in the ED, and these were more frequent in women. Using the Naranjo score, we showed a probable association in 92% of these reactions and a possible association in 8%. The most vulnerable age group involved in ADRs was that of the elderly patients. In conclusion, our results indicate that antihypertensive drugs may be able to induce the development of ADRs, particularly in elderly women receiving multiple drug treatment. Therefore, it is important to motivate the healthcare providers to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs, as also all the essential activities for optimizing patient safety.
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Affiliation(s)
- Pierandrea Rende
- Centro Regionale di Informazione sul farmaco, AO Mater Domini, Catanzaro, and Department of Health Science, School of Medicine, University of Catanzaro, Italy
| | - Laura Paletta
- Centro Regionale di Informazione sul farmaco, AO Mater Domini, Catanzaro, and Department of Health Science, School of Medicine, University of Catanzaro, Italy
| | | | | | | | | | - Cinzia Costa
- Centro Regionale di Informazione sul farmaco, AO Mater Domini, Catanzaro, and Department of Health Science, School of Medicine, University of Catanzaro, Italy
| | - Santo Gratteri
- Centro Regionale di Informazione sul farmaco, AO Mater Domini, Catanzaro, and Department of Health Science, School of Medicine, University of Catanzaro, Italy
| | - Chiara Giofrè
- Centro Regionale di Informazione sul farmaco, AO Mater Domini, Catanzaro, and Department of Health Science, School of Medicine, University of Catanzaro, Italy
| | - Luca Gallelli
- Centro Regionale di Informazione sul farmaco, AO Mater Domini, Catanzaro, and Department of Health Science, School of Medicine, University of Catanzaro, Italy
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