Rilmenidine – its antihypertensive efficacy, safety and impact on quality of life in perimenopausal women with mild to moderate essential hypertension

Imidazoline I2 receptors: target for new analgesics?

Pain remains a major clinical challenge because there are no effective analgesics for some pain conditions and the mainstay analgesics for severe pain, opioids, have serious unwanted effects. There is a dire need for novel analgesics in the clinic. Imidazoline receptors are a family of three receptors (I(1), I(2) and I(3)) that all can recognize compounds with an imidazoline structure. Accumulating evidence suggests that I(2) receptors are involved in pain modulation. Ligands acting at I(2) receptors are effective for tonic inflammatory and neuropathic pain but are much less effective for acute phasic pain. When studied in combination, I(2) receptor ligands enhance the analgesic effects of opioids in both acute phasic and chronic tonic pain. During chronic use, patients can develop tolerance to and dependence on opioids. Imidazoline I(2) receptor ligands can attenuate the development of tolerance to opioid analgesia and inhibit drug withdrawal or antagonist precipitation induced abstinence syndrome in animals. Taken together, drugs acting on I(2) receptors may be useful as a monotherapy or combined with opioids as an adjuvant for treating pain. Future studies should focus on understanding the relative efficacy of I(2) receptor ligands and developing new compounds to fill the gap in intrinsic efficacy continuum of I(2) receptors.

Nondipping phenomenon and quality of life: are they related in essential hypertensive patients?

Hypertensive patients report lower general well-being, more severe psychological distress, poorer perceived health status, more physical symptoms, and functional disability when compared to normotensive patients. Nondipping of blood pressure (BP) is related to increased target organ damage in essential hypertension. However, the specific relationship between nocturnal nondipping and quality of life has not been extensively investigated. Patients with essential hypertension underwent the following procedures: anamnesis, office BP measurement, physical examination, routine biochemistry, and 24-hour ambulatory BP monitoring. To determine renal function, 24-hour urine specimens were collected. Quality of life was assessed by a short form of medical outcomes study (SF-36). Totally, 132 patients (male/female: 55/75) were included. Fifty-five of the patients were nondippers. The dippers and nondippers were not statistically different in terms of socio-demographic parameters. Dippers had higher physical functioning (P- 0.004), bodily pain (P- 0.008), and PCS (P - 0.003) than nondippers. PCS of SF-36 was independently associated with age (P - 0.029), body mass index (P - 0.022), presence of coronary artery disease (P - 0.01), gender (P - 0.009), and dipping phenomenon (P - 0.006). A mental component summary score of SF-36 was not associated with dipping phenomenon. Nocturnal nondipping, apart from having important prognostic implications for cardiovascular complications in essential hypertensive patients, is also related to quality of life, especially in its physical aspects.