Management Options for Hypertension Syndrome

Rf, Abarquez

doi:10.1111/j.1742-1241.2001.tb11118.x

Int J Clinical Practice

2001

DOI: 10.1111/j.1742-1241.2001.tb11118.x

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Management Options for Hypertension Syndrome

Abarquez Rf

Abstract: SUMMARYHypertension is usually managed on a case‐finding basis, and yet continued blood pressure control can be inadequate. Furthermore, hypertension is often a ‘silent’ condition until comorbid events, target organ damage and subsequent heart failure become manifest, leading to a reactive rather than a proactive approach. Management of the hypertension syndrome becomes complex, because blood pressure control may not be just an isolated concern. This review considers the various options, in addition to existin… Show more

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Chronic Heart Failure Clinical Practice Guidelines’ Class 1-A Pharmacologic Recommendations: Start-to-End Synergistic Drug Therapy?

et al. 2016

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Background:Chronic heart failure (HF) disease as an emerging epidemic has a high economic-psycho-social burden, hospitalization, readmission, morbidity and mortality rates despite many clinical practice guidelines’ evidenced-based and consensus driven recommendations that include trials’ initial-baseline data.Objective:To show that the survival and hospitalization-free event rates in the reviewed chronic HF clinical practice guidelines’ class I-A recommendations as initial HF drug therapy (IDT) is possibly a combination and ‘start-to-end’ synergistic effect of the add-on (‘end’) HF drug therapy (ADT) to the baseline (‘start’) HF drug therapy (BDT).Methodology:The references cited in the chronic HF clinical practice guidelines of the 2005, 2009, and 2013 American Heart Association/American College of Cardiology (AHA/ACC), the 2006 Heart Failure Society of America (HFSA), and the 2005, 2008, and 2012 European Society of Cardiology (ESC) were reviewed and compared with the respective guidelines’ and other countries’ recommendations.Results:The BDT using glycosides and diuretics is 79%-100% in the cited HF trials. The survival rates attributed to the BDT (‘start’) is 46%-89% and IDT (‘end’) 61%-92.8%, respectively. The hospitalization-free event rate of the BDT group: 47.1% to 85.3% and IDT group 61.8%-90%, respectively. Thus, the survival and hospitalization-free event rates of the ADT is 0.4%-15% and 4.6% to 14.7%, respectively. The extrapolated BDT survival is 8%-51% based on a 38% estimated natural HF survival rate for the time period109.Conclusion:The contribution of baseline HF drug therapy (BDT) is relevant in terms of survival and hospitalization-free event rates compared to the HF class 1-A guidelines initial drug therapy recommendations (IDT). Further, the proposed initial HF drug (‘end’) therapy (IDT) has possible synergistic effects with the baseline HF drug (‘start’) therapy (BDT) and is essentially the add on HF drug therapy (ADT) in our analysis. The polypharmacy HF treatment is a synergistic effect due to BDT and ADT.

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Chronic Heart Failure Clinical Practice Guidelines’ Class 1-A Pharmacologic Recommendations: Start-to-End Synergistic Drug Therapy?

et al. 2016

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Management Options for Hypertension Syndrome

Cited by 1 publication

References 70 publications

Chronic Heart Failure Clinical Practice Guidelines’ Class 1-A Pharmacologic Recommendations: Start-to-End Synergistic Drug Therapy?

Chronic Heart Failure Clinical Practice Guidelines’ Class 1-A Pharmacologic Recommendations: Start-to-End Synergistic Drug Therapy?

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