What other possibilities of reducing blood pressure we have, apart from antihypertensives


Authors: Miroslav Souček
Authors‘ workplace: II. interní klinika LF MU a ICRC FN u sv. Anny v Brně
Published in: AtheroRev 2016; 1(3): 155-159
Category: Reviews

Overview

Reaching the target value of blood pressure is still a big problem. A mere 30% of treated hypertensives reach blood pressure values < 140/90 mm Hg. Hypertensive patients often exhibit further risk factors (RF) – diabetes mellitus, dyslipoproteinemia, excess weight, obesity and hyperuricemia, all of which are covered by the definition of the meta­bolic syndrome. The cardiovascular risks associated with the individual risk factors are not summed, they are multiplied. Unfortunately, the respective RFs have been treated separately until now. However, an effort has been made to treat individual RFs in the way that may positively affect other RFs. The paper focuses on the treatment of type 2 dia­betes mellitus, dyslipidemia, excess weight, obesity and hyperuricemia, taking account of possible influencing blood pressure values.

Key words:
allopurinol – blood pressure – glyflozin – hypertension – metabolic syndrome


Sources

1. [Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adult]. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, in Adults (Adult Treatment Panel III). Jama 2001; 285(19): 2486–2497.

2. Rosolová H. Kardiometabolický syndrom. In: Rosolová H et al. Preventivní kardiologie v kostce. Axonite CZ: Praha 2013. ISBN 978–80–904899–5–0.

3. Yusuf S, Haewken S, Ounpuu S et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364 (9438): 937–952.

4. Haluzík M. Antihypertenzní účinky inkretinové léčby u diabetes mellitus 2. typu. In: Widimský J jr (ed). Arteriální hypertenze – současné klinické trendy XI. Triton: Praha 2013: 2–39. ISBN 9788073876753.

5. Klonoff DC, Buse JB, Nielsen LL et al. Exenatide effects on diabetes, obesity, cardiovascular risk factors and hepatic biomarkers in patients with type 2 diabetes treated for at least 3 years. Curr Med Res Opin 2008; 24(1): 275–286.

6. Zinman B, Schmidt WE, Moses A et al. Achieving a clinically relevant composite outcome of an HbA1c of pod 7% without weight gain or hypoglycaemia in type 2 diabetes: a meta-analysis of the liraglutide clinical trial programme. Diabetes Obes Metab 2012; 14(1): 77–82. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1463–1326.2011.01493.x>.

7. Buse JB, Rosenstock J, Sesti G et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LESD-6). Lancet 2009; 374(9683): 39–47. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)60659–0>.

8. White WB, Cannon CHP, Heller ST et al. [EXALMINE Investigators]. Alogliptin after Acute Coronary Syndrome in Patients with Type 2 Diabetes. N Engl Med 2013; 369(14):1327–1335. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1305889>.

9. Scirica BM, Bhatt DL, Braunnwald E. [SAVOR-TIMI 53 Steering Committee and Investigators]. Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus. N Engl J Med 2013; 369(14): 1317–1326. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1307684>.

10. Bethel MA, Green JB, Milton J et al. Regional, age and sex differences in baseline characteristics of patients enrolled in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). Diabetes Obes Metab 2015; 17(4): 395–402. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12441>.

11. Weber MA, Mansfield TA, Alessi F et al. Effects of Dapagliflozin on Blood Pressure in Diabetic Patients With Hypertension Inadequately Controlled by a Renin-Angiotensin. System blocker. Annual Meeting of the American Heart Association, Dallas, USA, 2013: Poster 2095.

12. Weber MA, Mansfield TA, Alessi F et al. Dapagliflozin for Reduction of Blood Pressure in Diabetic Patients Inadequately Controlled With Combination Antihypertensive Regimen. Meeting of the American Heart Association, Dallas, USA, 2013: Poster 2097.

13. Svačina Š. Nová antidiabetika, jejich tolerance a bezpečnost. In: Widimský J (ed). Arteriální hypertenze – současné klinické trendy XIII. Triton: Praha 2015: 9–14. ISBN 9788073878832.

14. Nickenig G. Should angiotensin II receptor blockers and statins be combined? Circulation 2004; 110(8): 1013–1020.

15. 15.Vrablík M. Hypertenze a dyslipidemie: synergie v patogenezi i prevenci aterosklerózy. In: Widimský J (ed). Arteriální hypertenze – současné klinické trendy XII. Triton: Praha 2014: 47–55. ISBN 978–80–7387–763–7

16. Borghi C, Dormi A, Veronesi M et al. Association between different lipid-lowering treatment strategies and blood pressure control in the Brisighella Heart Study. Am Heart J 2004; 148(2): 285–292.

17. Prandin MG, Cicero AF, Dormi A et al. Prospective evaluation of the effect of statins on blood pressure control in hypertensive patients in clinical practice. Nutr Metab Cardiovasc. Dis 2010; 20(7): 512–518. Dostupné z DOI: <http://dx.doi.org/10.1016/j.numecd.2009.05.010>.

18. Juncos LI, Jucos LA, Garcia NH. The antihypertensive actions of statins: modulation by salt intake. Am J Hypertens 2012; 25(11): 1140–1148. Dostupné z DOI: <http://dx.doi.org/10.1038/ajh.2012.105>.

19. Banach M, Nikfar S, Rahimi R et al. The effects of statins on blood pressure in normotensive or hypertensive subjects – a meta-analysis of randomized controlled trials. Int J Cardiol 2013 Oct 3: 168(3): 2816–2824. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ijcard.2013.03.068>.

20. Sucharda P. Vedou výkony metabolické chirurgie k dlouhodobému ovlivnění krevního tlaku? In: Arteriální hypertenze – současné klinické trendy XIII. Triton: Praha 2015: 23–29. ISBN 9788073878832.

21. Staessen J, Fagard R, Emery A. The relationship between body weight and blood pressure. J Hum Hypertens 1988; 2(4): 207–217.

22. Sugerman HJ, Wolfe LG, Sica DA et al. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg 2003; 237(6): 751–756.

23. Hinojosa MW, Varela JE, Smith BR et al. Resolution of systemic hypertension after laparoscopic gastric bypass. J Gastrointest Surg 2009; 13(4): 793–797. Dostupné z DOI: <http://dx.doi.org/10.1007/s11605–008–0759–5>.

24. Ricci C, Gaeta M, Rausa E et al. Long-Term Effects of Bariatric Surgery on Type II Diabetes, Hypertension and Hyperlipidemia: A Meta-Analysis and Meta- Regression study with 5-Year Follow-Up. Obes Surg 2015; 25(3): 397–405. Dostupné z DOI: <http://dx.doi.org/10.1007/s11695–014–1442–4>.

25. Wilhelm SM, Young J, Kale-Pradhan PB. Effect of bariatric surgery on hypertension: a meta-analysis. Ann Pharmacother 2014; 48(6): 674–682. Dostupné z DOI: <http://dx.doi.org/10.1177/1060028014529260>.

26. Cannon PJ, Stason WB, Demartini EF et al. Hyperuricemia in primary and renal hypertension. N Engl J mEd 1966; 275(9): 457–464.

27. Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on the blood pressure of adolescents with newly diagnosed essential hypertension. JAMA 2008; 300(8): 924–932. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.300.8.924>.

28. Kanbay M, Ozkara A, Selcoki Y et al. Effect of treatment of hyperuricemia with allopurinol on blood pressure, creatine clearance, and proteinuria in patients with normal renal functions. Int Urol Nephrol 2007; 39(4): 1227–1233.

29. Siu YP, Leung KT, Tong MK et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006; 47(1): 51–59.

30. Talaat KM, El-Sheikh AR. The effect of mild hyperuricemia on urinary transforming growth factor beta and the progression of chronic kidney disease. Am J Nephrol 2007; 27(5): 435–440.

Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
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