• Korean Journal of Clinical Pharmacy
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• v.23 no.3
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• pp.239-247
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• 2013

Background: Fixed drug combinations are formulations containing two or more active ingredients in a single dosage form. Such combination therapies are commonly applied to improve efficacy, reduce adverse events and replace co-administration, etc. National and international guidelines for hypertension treatment recommend addition of other classes of antihypertensive drugs rather than incremental dose of mono-therapy, when blood pressure is not adequately controlled. Thus, many dual combinations of antihypertensive drugs have been approved and pharmaceutical companies are recently interested in developing antihypertensive triple combinations. Clinical trial designs for the fixed combinations are various depending on the target patients, dosage and clinical endpoints. Thereby, further discussions for the clinical trials of antihypertensive triple therapies are required regarding the indication claimed. Conclusion: This article provides a review for the assessment of the label and medical reports of the clinical trials on antihypertensive triple therapies in advanced foreign countries.

• The Korea Journal of Herbology
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• v.33 no.6
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• pp.9-18
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• 2018

Objective : Many patients take antihypertensive drugs as well as herbal medicines at the same time in order to treat other symptoms or to keep their well-being. In this study, interactions between herbal medicines and synthetic antihypertensive drugs were analyzed. Methods : To investigate the interaction between herbal medicines and synthetic antihypertensive drugs, three electronic databases, including OASIS, Mediline and Sciencedirect were searched. Experimental and clinical studies on the interaction between herbal medicines and antihypertensive drugs were independently reviewed and included. Results : Analyzing selected studies, twenty herbs were found to interact with antihypertensive drugs. Herbs found to increase the antihypertensive effect were Panax ginseng, Carthamus tinctorius, Magnolia officinalis, Silybum marianum, Scutellaria baicalensis, Schisandra chinensis, Sophora flavescens, Piper nigrum, Curcuma longa, Ginkgo biloba, Juncus effuses and Hydrastis canadensis. In contrast, Commiphora myrrha, Rhodiola rosea, Hypericum perforatum, Eurycoma longifolia, and Daturae metel were found to inhibit the antihypertensive effect. Stephania tetrandra could increase or decrease the effect depending on the type of antihypertensive drug. Epedria sínica was suspected of pharmacodynamic interaction with antihypertensive drug. Glycyrrhiza uralensis has been reported to have serious side effects in combination with antihypertensive drugs. Conclusion : These results imply that when used in combination with herbal medicines and synthetic antihypertensive drugs, proper doses and herbs which are to avoid need to be informed to the patients. Despite concerns about interactions between herbal medicines and synthetic drugs, related research is very limited. More systematic researches are needed to give information on patient safety as well as to guide clinical practice.

• YAKHAK HOEJI
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• v.51 no.5
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• pp.336-342
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• 2007

Treatment of hypertension is important in reducing death and attack rates by Ischemic heart disease (IHD). The purposes of this study are to investigate recent prescriptions for patients with IHD and to evaluate antihypertensive drug use. On the basis of the guidelines proposed by Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure, we analyzed prescriptions of antihypertensive drugs for patients with IHD. It is necessary to set up new guideline for appropriate treatment to lower death and attack rates for patients with IHD.

• Biomolecules & Therapeutics
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• v.4 no.2
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• pp.205-207
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• 1996

Clonidine, an antihypertensive drug, stimulates postsynaptic alpha-2 adrenergic receptors in the central nervous system and lowers arterial pressure through the effects on both cardiac output and peripheral resistance. However, many patients experience that sedation and xerostomia occur upon oral administration of clonidine. These side effects are due to high plasma peak concentration and can be avoided when clonidine is given transdermally. In this study, we tested the antihypertensive effects of trandermal administration of clonidine patch on spontaneously hypertensive rat (SHR) which is a model animal for human essential hypertension. Forty eight SHR (male) were divided into six groups according to the dose levels, respectively. After transdermal administration of clonidine patch of each dose, systolic blood pressure and heart rate were measured. Clonidine patch produced maximal antihypertensive and bradycardiac effects 48 hrs after administration and antihypertensive effects showed dose-dependency. We suggest that antihypertensive effects of clonidine patch are similar to those of orally given clonidine and clonidine patch can be used instead of clonidine tablet.

• Biomolecules & Therapeutics
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• v.15 no.1
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• pp.40-45
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• 2007

The vascular relaxant effects on isolated rat aorta of amlodipine camsylates (S-, R-enantiomer, and R/S-racemate), were evaluated and compared with that of S-amlodipine besylate. Furthermore, antihypertensive effects were measured in spontaneously hypertensive rat (SHR). The S-amlodipine camsylate concentration-dependently inhibited $Ca^{2+}$-induced contraction of rat aorta with a very slow onset of action (reached its maximum at 3.5h; $ED_{50}:\;1.50\;{\pm}\;0.24$ nM), having a potency 2-fold higher than those of R/S-amlodipine camsylate $(ED_{50}:\;3.36\;{\pm}\;0.91\;nM)$ and similar to those of S-amlodipine besylate $(ED_{50}:\;1.44\;{\pm}\;0.14\;nM)$, whereas the R-amlodipine camsylate has 590-fold lower vasorelaxant activity $(ED_{50}:\;886.4\;{\pm}\;49.7\;nM)$. In SHR, orally administered S-amlodipine camsylate produced a dose-dependent and long-lasting (>>10 h) antihypertensive effect $(ED_{20}:\;0.89\;mg/kg)$, with a potency 2-fold higher than those of R/S-amlodipine camsylate $(ED_{20}:\;1.82\;mg/kg)$ and similar to those of S-amlodipine besylate $(ED_{20}:\;0.71\;mg/kg)$. In contrast, the R-amlodipine camsylate has no effect even-though administrated high concentration 10 mg/kg. These results suggest that S-amlodipine camsylate has the potency and long-lasting antihypertensive activity as single enantiomer drug, and its antihypertensive effect is not significantly different to that of S-amlodipine besylate.

• Journal of Acupuncture Research
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• v.20 no.2
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• pp.11-17
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• 2003

Objective : The aim of this research was to investigate the depressive effect of depletion of B15(心兪), B23(腎兪), L5(尺澤), B40(委中) in hypertentive stroke patients. Methods : Depletion on B15(心兪), B23(腎兪), L5(尺澤), B40(委中) in hypertentive stroke patient who were admitted in Dong-Seo Oriental Medical Hospital every other day form 4 weeks, without western antihypertensive drug. Results : After treatment in 2nd week, depletion on B15(心兪), B23(腎兪), L5(尺澤), B40(委中) without western antihypertensive drug increased the systolic and diastolic blood pressure. After treatment in 4th week, depletion on B15(心兪), B23(腎兪), L5(尺澤), B40(委中) without western antihypertensive drug decreased the systolic and diastolic blood pressure. After treatment in 4th week, values of RBC and hemoglobine were not significantly changed. Conclusions : Continous depletion on B15(心兪), B23(腎兪), L5(尺澤), B40(委中) in hypertentive stroke patient without western antihypertensive drug implies decreasement of blood pressure, without change of values of RBC and hemoglobine.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.93-106
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• 2003

Objectives: This study was conducted to investigate the treatment status and its related factors of the rural hypertensives. Methods: A questionnaire survey was performed to 618 rural hypertensives during September, 2002. Results: The proportion of those who were compliant to the antihypertensive medication was 68.9%. The compliance rate to the antihypertensive medication was significantly related with sex and economic status(p<0.05). That is, if they were female, higher economic level, the regular antihypertensive medication rate was higher. The regular antihypertensive medication rate was higher when they had higher knowledge for hypertension, higher severity for hypertension of him or her(p<0.01). And the compliance rate to the antihypertensive medication was significantly related with hypertensives' own explanatory model for hypertension(p<0.01). The rate of drug use except antihypertensives was 12.5%. The rate of drug use except antihypertensives was higher when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rate of medical equipment use was 18.9%. The utilization rate of medical equipment such as jade mat, germanium material was significantly related with age, experience of side effects of antihypertensive drug, medication status for antihypertensive drug(p<0.05). The rate of folk therapy use was 16.2%. The rate of folk therapy use was higher when they had no family, when they had knowledge about hypertension on the average, when they had hypertension over 10 years(p<0.05), and when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rates of drug use except antihypertensives, medical equipment use, and folk therapy were significantly related with hypertensives' own explanatory model for hypertension(p<0.05). Conclusions: On consideration of above findings, it would be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• Journal of Medicine and Life Science
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• v.19 no.3
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• pp.79-89
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• 2022

Whereas systolic blood pressure (SBP) continuously rises with age, diastolic blood pressure (DBP) gradually decreases after the age of 55 years. Therefore, hypertension in the elderly shows the pattern of isolated systolic hypertension. There is evidence on the benefits of controlling blood pressure (BP) in elderly patients with hypertension. The BP lowering effect has also been demonstrated in patients over 80 years of age with hypertension. The BP threshold for the initiation of antihypertensive drug treatment for older adults with hypertension is gradually decreasing. The antihypertensive treatment is recommended if, despite therapeutic lifestyle modifications, SBP ≥140 mmHg or DBP ≥90 mmHg in those aged 65-79 years old, and SBP ≥140-160 mmHg or DBP ≥90 mmHg in those aged ≥80 years old. Although there is no consensus on the target BP for older adults with hypertension, a target SBP of <130-140 mmHg and DBP of <80-90 mmHg are recommended. In older adults over 80 years of age with hypertension, the target SBP is <140-150 mmHg. When the dose of antihypertensive drugs is increased to reach the target SBP, DBP may decrease to less than 70 mmHg, but it should not be <60 mmHg. Thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers can be selected as the first-line drug for older adults with hypertension. Beta-blockers may be selected in case of compelling indications.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.333-341
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• 1999

Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

• Biomolecules & Therapeutics
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• v.11 no.2
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• pp.133-138
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• 2003

The vascular relaxant and antihypertensive effects of newly developed salts of amlodipine-maleate and camsylate-were evaluated on isolated aorta from rats and in spontaneously hypertensive rats, and compared with those of amlodipine besylate, a standard drug. Amlodipine besylate concentration-dependently inhibited $Ca^{2＋}$-induced contraction in depolarised rat aorta($IC_{50}$/: 4.17 nM), with a very slow onset of action. Amlodipine maleate and amlodipine camsylate also showed vascular relaxant effect with a pattern and a potency similar to those of amlodipine besylate($IC_{50}$/: 3.62 and 3.28 nM, respectively). Amloclipine besylate produced a dose-dependent and long-lasting(>10∼24h) antihypertensive effect with a slow onset of action (ED$_{20}$: 2.31 mg/kg) in spontaneously hypertensive rats. Amlodipine maleate and amlodipine camsylate also exerted antihypertensive effects with a pattern and a potency similar to those of amlodipine besylate(ED$_{20}$: 2.09 and 2.21 mg/kg, respectively). These results suggest that amlodipine maleate and amlodipine camsylate are not statistically differ with amlodipine besylate in relaxant effect of $Ca^{2＋}$-induced contraction in depolarised rat aorta and in antihypertensive effect in spontaneously antihypertensive rats.