Objective: Taking low sodium diet enhances the hemodynamic effect of reninangiotensin system blockers. In a recent study, the systemic exposures of candesartan and atenolol, substrates of P-glycoprotein (Pgp) or cytochrome P 3A4 (CYP3A4), was reduced around 30% when on a high-sodium diet, but that of valsartan and ramipril, non-substrates of Pgp or CYP3A4, was not. This study aimed to investigate the effect of high sodium diet on the pharmacokinetics of fimasartan.Design and method: The study design was a two-diet, two-period, two-sequence, randomized, open label and cross-over with 1-week diet-washout and 2-weeks drugwashout interval. Eligible subjects had either low sodium (50 mEq/day) or high sodium diet (300 mEq/day) for 7 days on the 1st hospitalization period and had the other diet at the 2nd period. On the 7th morning of each period, subjects received a single dose of fimasartan 60 mg in the fasting state. The pharmacokinetic blood samples were drawn for 24 hours after the administration. The pharmacokinetic parameters were estimated by noncompartmental analysis.
Results:A total of 17 subjects completed the study and 1 of them had 24-urinary sodium values over 100 mEq while on low sodium diet. The pharmacokinetic analysis was performed in 16 subjects excluding a noncompliant subject. The geometric mean ratios (high/low sodium diet) and their 90% confidence intervals (CIs) for Cmax, AUC(0-24) and AUC(inf) were 0.84 (0.60-1.18), 0.91 (0.78-1.05) and 0.90 (0.79-1.03), respectively. There were no serious adverse events reported.
Conclusions:The systemic exposure of fimasartan, which is a CYP3A4 substrate but not a Pgp substrate, was slightly (about 10%) lower on high sodium diet than on low sodium diet, but the difference was not clinically nor statistically significant (<0.05).Objective: Results of the real-world studies suggest that cardiovascular prognosis depends on the initial antihypertensive therapy (AHT). There are no data concerning it in Bulgaria. The aim of study was to examine the initial antihypertensive therapeutic strategy (monotherapy/combination therapy (CT) and individual therapeutic classes in Bulgaria.Design and method: Prospective, observational, noninterventional design. Data were obtained from 770 geographically diverse primary care sites (77% GPs, 23% cardiologists). All patients didn't receive any AH drugs at least 3 months before inclusion in observation. BP control (<140/90 mmHg) was estimated on months 2, 4, 6 and 12 after initiated of AHT.Objective: To determine the correlations of mean daily parameters of the central aortic pressure with level of glomerular filtration rate (GFR) and microalbuminuria (MAU), and to assess their dynamics during the 16-week treatment in patients with metabolic syndrome (MS) and arterial hypertension (AH) 1-2 degrees.
Design and method:The study included 20 patients with MS combined with hypertension (16 men and 4 women), mean age -49,9 ± 9,8 years, BMI -33,4 ± 4,5 kg/m2, WC -109 8 ± 9,9 cm. An ambulatory BP monitoring using the device BpLab with analy...
