OBJECTIVESTo analyse the control rate of irbesartan/hydrochlorothiazide (HCTZ) combination tablets (COAPROVEL) in the treatment of patients with mild to moderate primary hypertension.

METHODSIn this multi-center, open, single therapy trial, the enrolled patients aged 18-75 were treated with irbesartan/HCTZ combination tablets for 8 weeks. The initial dose comprised one tablet of irbesartan (150 mg)/HCTZ (12.5 mg) once a day during the first 2 weeks. If diastolic blood pressure was greater than 85 mm Hg at the end of the second or fourth weeks, irbesartan (300 mg)/HCTZ (12.5 mg) once a day or irbesartan (300 mg)/HCTZ (25 mg) once a day were added respectively.

RESULTSIn 968 patients with mild to moderate hypertension enrolled, 920 patients were followed up for 8 weeks. (1) After 1 week of treatment, irbesartan/HCTZ combination tablets lowered systolic blood pressure by 11.87 mm Hg and diastolic blood pressure by 8.54 mm Hg (P < 0.01). After 8 weeks of treatment, the corresponding decreases were 21.97 mm Hg and 16.08 mm Hg, respectively (P < 0.01). (2) After 2, 4 and 8 weeks of treatment, 526, 703 and 769 patients reached blood pressure target (diastolic blood pressure less than 85 mm Hg). The control rates were 57.17%, 76.41% and 83.59%, respectively. (3) Among the 920 patients who completed the trial, 637 patients took irbesartan (150 mg)/HCTZ (12.5mg) once a day (69.24%), 211 patients took irbesartan (300 mg)/HCTZ (12.5 mg) once a day (22.93%), and 72 patients took irbesartan (300 mg)/HCTZ (25 mg) once a day (7.82%). (4) In the intention-to-treat analysis, no adverse reaction was observed in 903 patients (93.29% of the patients enrolled).

CONCLUSIONSWhen irbesartan/HCTZ combination regimen are used in the treatment of patients with mild to moderate primary hypertension, the proportion of patients reaching blood pressure target is high and adverse reactions are rare.

Adolescent ; Adult ; Aged ; Antihypertensive Agents ; adverse effects ; therapeutic use ; Biphenyl Compounds ; adverse effects ; therapeutic use ; China ; Drug Combinations ; Humans ; Hydrochlorothiazide ; adverse effects ; therapeutic use ; Hypertension ; drug therapy ; Middle Aged ; Tablets ; Tetrazoles ; adverse effects ; therapeutic use ; Young Adult

OBJECTIVETo assess the efficacy and safety of valsartan/hydrochlorothiazide (HCTZ) 80/12.5 mg once daily (o.d.) in Chinese patients with mild to moderate essential hypertension who was not adequately controlled by valsartan 80 mg o.d. monotherapy.

METHODSIn this multi-center, double-blind, randomized, active controlled, parallel group trial, 1051 out of 1175 Chinese patients with mild to moderate essential hypertension [DBP >or= 95 mm Hg and < 110 mm Hg (1 mm Hg = 0.133 kPa)] completed single-blind run-in period (valsartan 80 mg o.d. therapy for 4 weeks) after 2 week's wash-out period. At the end of the single-blind run-in period, those patients with DBP >or= 95 mm Hg (n = 864) were randomized in 1:1 ratio to Valsartan and Valsartan 80 mg (n = 429)/HCTZ80/12.5 mg (n = 435) treatment o.d. for 8 weeks. Safety and efficacy was assessed every 4 weeks during double blind phase.

RESULTSAt the end of study, valsartan/HCTZ 80/12.5 mg combination treatment further reduced systolic (-3.5 mm Hg) and diastolic (-2.2 mm Hg) pressures and increased the rate of patients reaching goal BP level (53.9% vs. 40.9%) compared to valsartan 80 mg o.d. monotherapy. Incidence of side effects was similar between the combination therapy and monotherapy groups (8.9% vs. 5.1%, P > 0.05).

CONCLUSIONEfficacy of Valsartan 80 mg/HCTZ 12.5 mg compound was superior to valsartan 80 mg on BP reduction and goal BP control rate in Chinese patients with mild to moderate essential hypertension. The combination of Valsartan 80 mg/hydrochlorothiazide (HCTZ) 12.5 mg provides a suitable treatment for Chinese patients who are not adequately controlled by valsartan 80 mg o.d. monotherapy.

Adult ; Antihypertensive Agents ; adverse effects ; therapeutic use ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Humans ; Hydrochlorothiazide ; adverse effects ; therapeutic use ; Hypertension ; drug therapy ; Male ; Middle Aged ; Tetrazoles ; adverse effects ; therapeutic use ; Valine ; adverse effects ; analogs & derivatives ; therapeutic use ; Valsartan

This paper presents a case of reversible dysphasia occurring in a patient prescribed atorvastatin in combination with indapamide. A milder dysphasia recurred with the prescription of rosuvastatin and was documented on clinical examination. This resolved following cessation of rosuvastatin. The case highlights both a need for a wider understanding of potential drug interactions through the CYP 450 system and for an increased awareness, questioning and reporting of drug side-effects.
Anticholesteremic Agents/adverse effects/*therapeutic use ; Antihypertensive Agents/therapeutic use ; Anxiety/diagnosis ; Aphasia/diagnosis/*etiology ; Cytochrome P-450 Enzyme System/metabolism ; Depression/diagnosis ; Drug Interactions ; Female ; Fluorobenzenes/adverse effects/*therapeutic use ; Heptanoic Acids/adverse effects/*therapeutic use ; Humans ; Hypercholesterolemia/drug therapy ; Indapamide/therapeutic use ; Middle Aged ; Pyrimidines/adverse effects/*therapeutic use ; Pyrroles/adverse effects/*therapeutic use ; Sulfonamides/adverse effects/*therapeutic use

OBJECTIVETo assess the antihypertensive effect and safety on medicine named 'Beijing Hypertensive No. 0' in a three-year treatment of primary hypertension.

METHODSA community-based intervention study was conducted. The antihypertensive effects and adverse events were observed.

RESULTS4000 patients with primary hypertension were randomly divided into two groups with 1529 patients treated with 'Beijing Hypertensive No. 0' and 976 patients treated with other antihypertensive drugs, among which 946 and 853 patients in the two groups completed the three-year study. After treatment, the systolic blood pressure decreased 13 mm Hg and 7 mm Hg while diastolic blood pressure decreased 8 mm Hg and 4 mm Hg in the 'No. 0' group and controlled group respectively. After three years of treatment, 90.0% and 79.5% in the 'No.0' group and in the control group had reached the BP 'fulfillment criteria', which were much higher than the baseline data. Side effects occurred in 33/1274 (2.6%) cases during three years' treatment with most commonly seen as dizziness, headache, palpitation and weakness. No serious adverse reactions occurred. There were some positive effects after treated by 'No. 0', including 0.13 mmol/L decrease of TC, 0.70 mmol/L decrease of LDL-C and an average 0.12 mmol/L increase of HDL-C. All of these changes were statistically significant. There were also opposite effects as 0.13 mmol/L increase of TG, 0.24 mmol/L increase of K+, and 0.88 mmol/L increase of Na+ on average, which were also statistically significant.

CONCLUSIONCompared with the conventional treatment, this treatment of 'Beijing Hypertensive No.0' was more convenient, safe and effective in treating mild to moderate primary hypertension in the community.

Aged ; Antihypertensive Agents ; adverse effects ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Hypertension ; drug therapy ; Male ; Safety

Some patients with chronic obstructive pulmonary disease (COPD) have pulmonary hypertension (PH) that adversely affects survival. We performed a systematic review and meta-analysis to assess whether PH-specific therapies have an effect for stable COPD. Data sources were Medline, EMBASE, Cochrane Central Register of Controlled Trials, Korea med and references from relevant publications. Randomized prospective trials that compared PH specific therapy in COPD for more than 6 weeks with placebo were included. The outcomes were the exercise capacity and adverse events. Four randomized controlled trials involving 109 subjects were included in the analysis. Two trials involved bosentan, one sildenafil and one beraprost. The studies varied in duration of treatment from 3 to 18 months. In a pooled analysis of four trials, exercise-capacity was not significantly improved with PH-specific treatment for COPD (risk ratio, -5.1; 95% CI, -13.0 to 2.8). COPD with overt PH significantly improved the exercise capacity (mean difference, 111.6; 95% CI, 63.3 to 159.9) but COPD with PH unknown did not (mean difference, 26.6; 95% CI, -24.3 to 77.5). There was no significant difference in hypoxemia (mean difference, 2.6; 95% CI, -3.7 to 8.8). PH specific treatments have a significant effect in improving exercise capacity in COPD with overt PH.
Anoxia ; Antihypertensive Agents/adverse effects/*therapeutic use ; Clinical Trials as Topic ; Databases, Factual ; Epoprostenol/adverse effects/analogs & derivatives/therapeutic use ; Humans ; Hypertension, Pulmonary/complications/*drug therapy ; Piperazines/adverse effects/therapeutic use ; Pulmonary Disease, Chronic Obstructive/*etiology ; Purines/adverse effects/therapeutic use ; Questionnaires ; Risk Factors ; Sulfonamides/adverse effects/therapeutic use ; Sulfones/adverse effects/therapeutic use

OBJECTIVETo evaluate the efficacy and safety of olmesartan medoxomil compared with losartan potassium in patients with mild to moderate essential hypertension.

METHODThis is a randomized, double-blind, double-dummy, active-controlled, parallel, multi-center study. After a 2-week placebo run-in period, a total of 287 eligible subjects were randomized at 1:1 ratio to receive olmesartan medoxomil 20 mg or losartan potassium 50 mg, once daily for 8 weeks. The blood pressure was assessed after 4 weeks treatment. If the subject's seating diastolic blood pressure (SeDBP) was still >or=90 mm Hg, the dosage was doubled for another 4 weeks; for those subjects whose SeDBP was <90 mm Hg after 4-week treatment, the initial dosage remained unchanged and the treatment continued until completion of the study.

RESULTS(1) The mean trough reduction in SeDBP from baseline in olmesartan group was significantly greater than that in losartan group after 4 weeks (11.72 mm Hg vs 9.23 mm Hg, P=0.004) and 8 weeks treatment (12.94 mm Hg vs 11.01 mm Hg, P=0.035). (2) The number and percentage of responders in olmesartan group (81, 65.3%) were statistically higher than those (68, 52.7%) in losartan group (P=0.028) after 4 weeks treatment and were similar between the two groups after 8 weeks treatment (P>0.05). (3) Individual and overall trough/peak ratios of DBP and SBP in 24-hour ambulatory blood pressure monitoring were higher in olmesartan group than losartan group. The hypotensive effect of olmesartan was more durable than losartan at 24 hour interval. (4) The incidence of study drug-related adverse events (AEs) in olmesartan group (10.5%) was similar as that in losartan group (13.9%, P>0.05). Most of these AEs were mild and transient.

CONCLUSIONThis study shows that olmesartan medoxomil, at oral dose of 20 mg-40 mg once daily was effective and safe for hypertension treatment and the hypotensive effect was superior to losartan potassium (50 mg-100 mg once daily).

Adolescent ; Adult ; Aged ; Antihypertensive Agents ; administration & dosage ; China ; Double-Blind Method ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Imidazoles ; adverse effects ; therapeutic use ; Losartan ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Olmesartan Medoxomil ; Tetrazoles ; adverse effects ; therapeutic use

OBJECTIVETo investigate the effects and safety of Western medicine combined with Chinese medicine (CM) based on syndrome differentiation in the treatment of elderly polarized hypertension (PHPT), or isolated systolic hypertension with low diastolic blood pressure (DBP).

METHODSA total of 125 elderly patients with PHPT were randomly assigned to two groups: 59 in the control group treated by Western medicine and 66 in the intervention group treated by Western medicine combined with CM treatment. Based on syndrome differentiation, the patients in the intervention group were further divided into subgroups of yang-qi deficiency and yin-qi deficiency. All subjects were treated with Western medicine of Amlodipine Besylate Tablets and Irbesartan Tablets (or Irbesartan and Hydrochlorothiazide Tablets), to decrease their systolic blood pressure (SBP) slowly to 125-135 mm Hg in 2-6 weeks. In the intervention group, Shiyiwei Shenqi Capsule was given additionally to the subgroup of yang-qi deficiency at the dosage of 3-5 capsules, thrice a day, while Dengzhan Shengmai Capsule was given additionally to the subgroup of yin-qi deficiency at the dosage of 2 capsules, 2-3 times per day. For all subjects, SBP, pulse pressure (PP), and DBP were measured before treatment and at the terminal of a 6-week treatment. For subjects in the intervention group, left ventricular ejection fraction (LVEF) was also recorded.

RESULTSAfter a 6-week treatment, the SBP in the two groups and the PP in the intervention group decreased significantly compared to those before treatment (P<0.05), while the PP in the control group showed no significant difference between prior and post-treatment (P>0.05). After treatment, the DBP in the control group decreased (P>0.05), while the DBP and LVEF in the intervention group showed an increase tendency although it had no statistical significance (P>0.05). When subjects in the intervention group were classified further by the course of disease, the DBP and LVEF of subjects whose course of disease were less than 2 years, increased significantly after treatment (P<0.05).

CONCLUSIONWestern medicine combined with CM treatment based on syndrome differentiation was safer and more effective than Western medicine alone in the treatment of elderly PHPT, because it not only reduced SBP but also improved DBP, which might lower the incidence of the cardiovascular and cerebrovascular events.

Aged ; Amlodipine ; adverse effects ; pharmacology ; therapeutic use ; Antihypertensive Agents ; adverse effects ; pharmacology ; therapeutic use ; Biphenyl Compounds ; adverse effects ; pharmacology ; therapeutic use ; Blood Pressure ; drug effects ; Diastole ; drug effects ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Stroke Volume ; drug effects ; Syndrome ; Tetrazoles ; adverse effects ; pharmacology ; therapeutic use

This review provides an overview of the pharmacology mechanism of sildenafil. The efficacy and safety of the medicine are briefly summarized. The special conclusion was made for the usage of sildenafil to the particular patients such as those with hypertension or those taking any antihypertensive agent, with cardiovascular disease, with diabetes, with spinal cord injury, after radical prostatectomy and on chronic dialysis. In general, sildenafil is effective and safe for various ED patients.
Antihypertensive Agents ; adverse effects ; Diabetes Complications ; Drug Interactions ; Erectile Dysfunction ; drug therapy ; Heart Diseases ; complications ; Humans ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; adverse effects ; therapeutic use ; Prostatectomy ; adverse effects ; Purines ; Sildenafil Citrate ; Spinal Cord Injuries ; complications ; Sulfones

AIMTo investigate the effect of substituting beta-blockers with nebivolol on the erectile function of patients suffering from essential hypertension.

METHODSForty-four young and middle-aged men (31-65 years) with essential hypertension visited our outpatient clinic and took beta-blocker treatment (atenolol, metoprolol or bisoprolol) for more than 6 months. All the patients completed a questionnaire regarding erectile function (International Index for Erectile Function). Patients were then switched to an equipotent dose of nebivolol for 3 months and, at the end of this time period, filled out the same questionnaire.

RESULTSTwenty-nine out of the 44 (65.9%) patients who took beta-blockers (atenolol, metoprolol or bisoprolol) had exhibited erectile dysfunction (ED). Their systolic and diastolic blood pressure did not change significantly with the treatment switch. In 20 out of these 29 (69%) patients, a significant improvement in the erectile function score was exhibited after 3 months of nebivolol administration, and in 11 of these 20 patients, erectile function was normalized.

CONCLUSIONNebivolol seems to have a beneficial effect on ED (possibly due to increased nitric oxide availability); however, further prospective, randomized, placebo-controlled studies are needed to confirm the beneficial effects of nebivolol.

Adrenergic beta-Antagonists ; adverse effects ; therapeutic use ; Adult ; Aged ; Antihypertensive Agents ; adverse effects ; Benzopyrans ; therapeutic use ; Erectile Dysfunction ; chemically induced ; drug therapy ; Ethanolamines ; therapeutic use ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Nebivolol ; Surveys and Questionnaires

OBJECTIVETo investigate the long-term effect, safety and tolerability of benazepril in general hypertensive patients.

METHODSWe conducted a three-year community-based postmarketing surveillance on benazepril among 1831 essential hypertensive patients (age range from 35 to 88 years) in Shanghai.

RESULTS74.3% of patients persisted in medication taking and were with optimal compliance in a 3-year-follow-up program. Among those taking medication as prescribed after 3 years, 75.7% of them attained systolic blood pressure (SBP) target level of 140 mm Hg (1 mm Hg = 0.133 kPa), 87.4% attained diastolic blood pressure (DBP) target level of 90 mm Hg, and 71.5% attained total target level of 140/90 mm Hg. The reductions were approaching 15 mm Hg for SBP, 10 mm Hg for DBP, and 5 mm Hg for pulse pressure (PP) during the 3 year period. No serious adverse drug reactions (ADRs) were detected during the 3 years follow-up. Cough was the most common ADR. The cumulative incidence of benazepril related cough was 23.6% in women, significant higher than in men (18.8%).

CONCLUSIONBenazepril was safe and tolerable when applied in hypertensive patients.

Adult ; Aged ; Aged, 80 and over ; Antihypertensive Agents ; adverse effects ; therapeutic use ; Benzazepines ; adverse effects ; therapeutic use ; China ; epidemiology ; Cough ; chemically induced ; epidemiology ; Female ; Humans ; Hypertension ; drug therapy ; epidemiology ; Male ; Middle Aged ; Product Surveillance, Postmarketing