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Jo S, Um T, Shin J, Lee D, Park K, Son M. Factors associated with suboptimal adherence to antihypertensive medication: Cross-sectional study using nationally representative databases. Heliyon 2024; 10:e38531. [PMID: 39391484 PMCID: PMC11466572 DOI: 10.1016/j.heliyon.2024.e38531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 08/31/2024] [Accepted: 09/25/2024] [Indexed: 10/12/2024] Open
Abstract
Suboptimal adherence to antihypertensive medication is a major challenge in controlling blood pressure. However, limited studies exist on suboptimal adherence to hypertension, especially in Korea. This study investigates factors associated with suboptimal adherence, including non-treatment and non-adherence. Study populations were collected from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2021. Participants were classified into three groups based on treatment and adherence to antihypertensive medication using a self-reported questionnaire. Multivariable adjusted logistic regression analysis was performed using KNHANES data to investigate associations for suboptimal adherence with covariates. In KNHANES, the adherent, non-adherent, and non-treatment groups consisted of 13,831 (92.8 %), 460 (3.1 %), and 612 (4.1 %) subjects, respectively. In the adjusted model, age, hypertension diagnosis duration, diabetes, dyslipidemia, and high hemoglobin levels were associated with receiving treatment. Older age, longer hypertension diagnosis duration, comorbid diabetes mellitus, and ischemic heart disease were associated with adherence. This study showed the characteristics of non-adherent and non-treatment hypertensive patient groups in Korea. Based on this study, further individualized health interventions are required.
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Affiliation(s)
- Sangyong Jo
- Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Taegyu Um
- Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Jihye Shin
- Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Dongchan Lee
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, United States
| | - Kyungil Park
- Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Minkook Son
- Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea
- Department of Data Sciences Convergence, Dong-A University Interdisciplinary Program, Busan, Republic of Korea
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Fox HC, Milivojevic V, Sinha R. Therapeutics for Substance-Using Women: The Need to Elucidate Sex-Specific Targets for Better-Tailored Treatments. Handb Exp Pharmacol 2023; 282:127-161. [PMID: 37592081 DOI: 10.1007/164_2023_687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
In the last decade, alcohol consumption in the US has risen by 84% in women compared with 35% in men. Furthermore, research has shown that sex- and gender-related differences may disadvantage women in terms of developing a range of psychological, cognitive, and medical problems considerably earlier in their drinking history than men, and despite consuming a similar quantity of substances. While this "telescoping" process has been acknowledged in the literature, a concomitant understanding of the underlying biobehavioral mechanisms, and an increase in the development of specific treatments tailored to women, has not occurred. In the current chapter we focus on understanding why the need for personalized, sex-specific medications is imperative, and highlight some of the potential sex-specific gonadal and stress-related adaptations underpinning the accelerated progress from controlled to compulsive drug and alcohol seeking in women. We additionally discuss the efficacy of these mechanisms as novel targets for medications development, using exogenous progesterone and guanfacine as examples. Finally, we assess some of the challenges faced and progress made in terms of developing innovative medications in women. We suggest that agents such as exogenous progesterone and adrenergic medications, such as guanfacine, may provide some efficacy in terms of attenuating stress-induced craving for several substances, as well as improving the ability to emotionally regulate in the face of stress, preferentially in women. However, to fully leverage the potential of these therapeutics in substance-using women, greater focus needs to the placed on reducing barriers to treatment and research by encouraging women into clinical trials.
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Affiliation(s)
- Helen C Fox
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Verica Milivojevic
- The Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- The Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Niranjan PK, Bahadur S. Recent Developments in Drug Targets and Combination Therapy for the Clinical Management of Hypertension. Cardiovasc Hematol Disord Drug Targets 2023; 23:226-245. [PMID: 38038000 DOI: 10.2174/011871529x278907231120053559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
Raised blood pressure is the most common complication worldwide that may lead to atherosclerosis and ischemic heart disease. Unhealthy lifestyles, smoking, alcohol consumption, junk food, and genetic disorders are some of the causes of hypertension. To treat this condition, numerous antihypertensive medications are available, either alone or in combination, that work via various mechanisms of action. Combinational therapy provides a certain advantage over monotherapy in the sense that it acts in multi mechanism mode and minimal drug amount is required to elicit the desired therapeutic effect. Such therapy is given to patients with systolic blood pressure greater than 20 mmHg and/or diastolic blood pressure exceeding 10 mmHg beyond the normal range, as well as those suffering from severe cardiovascular disease. The selection of antihypertensive medications, such as calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and low-dose diuretics, hinges on their ability to manage blood pressure effectively and reduce cardiovascular disease risks. This review provides insights into the diverse monotherapy and combination therapy approaches used for elevated blood pressure management. In addition, it offers an analysis of combination therapy versus monotherapy and discusses the current status of these therapies, from researchbased findings to clinical trials.
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Affiliation(s)
| | - Shiv Bahadur
- Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh, India
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Brogi S, Tabanelli R, Calderone V. Combinatorial approaches for novel cardiovascular drug discovery: a review of the literature. Expert Opin Drug Discov 2022; 17:1111-1129. [PMID: 35853260 DOI: 10.1080/17460441.2022.2104247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION In this article, authors report an inclusive discussion about the combinatorial approach for the treatment of cardiovascular diseases (CVDs) and for counteracting the cardiovascular risk factors. The mentioned strategy was demonstrated to be useful for improving the efficacy of pharmacological treatments and in CVDs showed superior efficacy with respect to the classical monotherapeutic approach. AREAS COVERED According to this topic, authors analyzed the combinatorial treatments that are available on the market, highlighting clinical studies that demonstrated the efficacy of combinatorial drug strategies to cure CVDs and related risk factors. Furthermore, the review gives an outlook on the future perspective of this therapeutic option, highlighting novel drug targets and disease models that could help the future cardiovascular drug discovery. EXPERT OPINION The use of specifically designed and increasingly rational and effective drug combination therapies can therefore be considered the evolution of polypharmacy in cardiometabolic and CVDs. This approach can allow to intervene on multiple etiopathogenetic mechanisms of the disease or to act simultaneously on different pathologies/risk factors, using the combinations most suitable from a pharmacodynamic, pharmacokinetic, and toxicological perspective, thus finding the most appropriate therapeutic option.
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Affiliation(s)
- Simone Brogi
- Department of Pharmacy, University of Pisa, Pisa, Italy
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Soltani Hekmat A, Farjam M, Javanmardi K, Behrouz S, Zarenezhad E, Soltani Rad MN. Design, Synthesis and In Vivo Cardiovascular Evaluation of Some Novel Aryloxy Propanol Amino Acid Derivatives. ChemistrySelect 2021. [DOI: 10.1002/slct.202101920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ava Soltani Hekmat
- Department of Physiology School of Medicine Fasa University of Medical Sciences Fasa Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center Fasa University of Medical Sciences Fasa Iran
- Department of Medical Pharmacology School of Medicine Fasa University of Medical Sciences Fasa Iran
| | - Kazem Javanmardi
- Department of Physiology School of Medicine Fasa University of Medical Sciences Fasa Iran
| | - Somayeh Behrouz
- Medicinal Chemistry Research Laboratory Department of Chemistry Shiraz University of Technology 71555–313 Shiraz Iran
| | - Elham Zarenezhad
- Noncommunicable Diseases Research Center Fasa University of Medical Sciences Fasa Iran
| | - Mohammad Navid Soltani Rad
- Medicinal Chemistry Research Laboratory Department of Chemistry Shiraz University of Technology 71555–313 Shiraz Iran
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Ferrario CM, R Iyer S, Burnett JC, Ahmad S, Wright KN, VonCannon JL, Saha A, Groban L. Angiotensin (1-12) in Humans With Normal Blood Pressure and Primary Hypertension. Hypertension 2021; 77:882-890. [PMID: 33461312 PMCID: PMC7878412 DOI: 10.1161/hypertensionaha.120.16514] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/18/2020] [Indexed: 11/16/2022]
Abstract
The importance of canonical versus noncanonical mechanisms for the generation of angiotensins remains a major challenge that, in part, is heavily swayed by the relative efficacy of therapies designed to inhibit renin, ACE (angiotensin-converting enzyme), or the Ang II (Angiotensin II) receptor. Ang (1-12) (angiotensin [1-12]) is an Ang II forming substrate serving as a source for Ang II-mediated tissue actions. This study identifies for the first time the presence of Ang (1-12) in the blood of 52 normal (22 women) and 19 (13 women) patients with hypertension not receiving antihypertensive medication at the time of the study. Normal subjects of comparable ages and body habitus had similar circulating plasma Ang (1-12) concentrations (women: 2.02±0.62 [SD] ng/mL; men 2.05±0.55 [SD] ng/mL, P>0.05). The higher values of plasma Ang (1-12) concentrations in hypertensive men (2.51±0.49 ng/mL, n=6) and women (2.33±0.63 [SD] ng/mL, n=13) were statistically significant (P<0.02) and correlated with elevated plasma renin activity, systolic and pulse pressure, and plasma concentrations of NT-proBNP (N-terminal prohormone BNP). The increased plasma Ang (1-12) in patients with hypertension was not mirrored by similar changes in plasma angiotensinogen and Ang II concentrations. The first identification of an age-independent presence of Ang (1-12) in the blood of normotensive subjects and patients with hypertension, irrespective of sex, implicates this non-renin dependent substrate as a source for Ang II production in the blood and its potential contribution to the hypertensive process.
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Affiliation(s)
- Carlos M Ferrario
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Seethalakshmi R Iyer
- Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905
| | - John C Burnett
- Division of Circulatory Failure, Department of Cardiovascular Medicine, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905
| | - Sarfaraz Ahmad
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Kendra N Wright
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Jessica L VonCannon
- Department of Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Amit Saha
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157
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Alghamdi SA, Aldahneen MS, Beitar FS, Dyab NA, Afaneh LK, Almutairi RO, Almanneai FA, Albalawi KSA, Alghanmi AMS, Elfaham S. The Efficiency of Telmisartan in Hypertension Management as a Monotherapy or Combined; Literature Review. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/nqvysmca4j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Masoudi-Sobhanzadeh Y, Masoudi-Nejad A. Synthetic repurposing of drugs against hypertension: a datamining method based on association rules and a novel discrete algorithm. BMC Bioinformatics 2020; 21:313. [PMID: 32677879 PMCID: PMC7469914 DOI: 10.1186/s12859-020-03644-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Drug repurposing aims to detect the new therapeutic benefits of the existing drugs and reduce the spent time and cost of the drug development projects. The synthetic repurposing of drugs may prove to be more useful than the single repurposing in terms of reducing toxicity and enhancing efficacy. However, the researchers have not given it serious consideration. To address the issue, a novel datamining method is introduced and applied to repositioning of drugs for hypertension (HT) which is a serious medical condition and needs some improved treatment plans to help treat it. RESULTS A novel two-step data mining method, which is based on the If-Then association rules as well as a novel discrete optimization algorithm, was introduced and applied to the synthetic repurposing of drugs for HT. The required data were also extracted from DrugBank, KEGG, and DrugR+ databases. The findings indicated that based on the different statistical criteria, the proposed method outperformed the other state-of-the-art approaches. In contrast to the previously proposed methods which had failed to discover a list on some datasets, our method could find a combination list for all of them. CONCLUSION Since the proposed synthetic method uses medications in small dosages, it might revive some failed drug development projects and put forward a suitable plan for treating different diseases such as COVID-19 and HT. It is also worth noting that applying efficient computational methods helps to produce better results.
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Affiliation(s)
- Yosef Masoudi-Sobhanzadeh
- Laboratory of Systems Biology and Bioinformatics (LBB), Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Ali Masoudi-Nejad
- Laboratory of Systems Biology and Bioinformatics (LBB), Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
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Contribution of Four Polymorphisms in Renin-Angiotensin-Aldosterone-Related Genes to Hypertension in a Thai Population. Int J Hypertens 2019; 2019:4861081. [PMID: 31511791 PMCID: PMC6710803 DOI: 10.1155/2019/4861081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/16/2019] [Indexed: 01/19/2023] Open
Abstract
Introduction The roles of genes in the renin-angiotensin-aldosterone system (RAAS) in hypertension, including angiotensin-converting enzyme (ACE), angiotensinogen (AGT), angiotensin II receptor type 1 (AGTR1), and aldosterone synthase (CYP11B2), have been widely studied across different ethnicities, but there has been no such investigation in Thai population. Materials and Methods Using 4,150 Thais recorded in the Electricity Generating Authority of Thailand (EGAT) study, we examined the association of rs1799752, rs699, rs5186, and rs1799998 located in or near ACE, AGT, AGTR1, and CYP11B2 genes in hypertension. We investigated their roles in hypertension using multivariate logistic regression and further examined their roles in blood pressure (BP) using quantile regression. Sex, age, and BMI were adjusted as potential confounders. Results We did not observe associations between hypertension and rs1799752 (P=0.422), rs699 (P=0.36), rs5186 (P=0.49), and rs1799998 (P=0.71). No evidence of association between these SNPs and BP was found across an entire distribution. A nonlinear relationship between age and BP was observed. Conclusion In Thai population, our study showed no evidence of association between RAAS-related genes and hypertension. While our study is the first and largest study to investigate the role of RAAS-related genes in hypertension in Thai population, restricted statistical power due to limited sample size is a limitation.
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Hiebler K, Soritz S, Gavric K, Birrer S, Maier MC, Grabner B, Gruber-Woelfler H. Multistep synthesis of a valsartan precursor in continuous flow. J Flow Chem 2019. [DOI: 10.1007/s41981-019-00044-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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