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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk on July 2, 2005, at 1:16:11
Half of patients with mild to moderate hypertension show an early morning blood pressure (BP) surge of 25mmHg or more, which could increase their risk of cardiovascular events, warned researchers at last week’s European Meeting on Hypertension held in Milan.
The PRISMA I and II studies assessed a total of 1,358 patients with mild to moderate hypertension (without other cardiovascular risk factors such as uncontrolled type 2 diabetes) using 24-hour ambulatory BP monitoring (ABPM). Results showed the mean early morning blood pressure surge was 26/23mmHg, with half of the patients having a surge of 25mmHg or more.
One of the researchers, Bryan Williams, professor of medicine, University of Leicester, and a member of the British Hypertension Society committee, said the findings underlined the importance of achieving 24-hour control of blood pressure to reduce the risk of cardiovascular events. He said: “There is a strong correlation between the early morning BP surge and clinical events. Since it is not practical to monitor every patient with ABPM to check their BP is well controlled in the early morning, the best option is a treatment regimen that provides effective 24-hour BP control.”
Further data from the studies showed that treatment with the long-acting angiotensin receptor blocker telmisartan (Micardis), which has a 24-hour half life, reduced the early morning BP surge.Patients treated with telmisartan (80mg) taken once a day in the morning, showed a 12mmHg reduction in systolic blood pressure during the early hours compared with 7.9mmHg for the angiotensin converting enzyme inhibitor ramipril (10mg) (P<0.0001).
Posted by ed_uk on July 2, 2005, at 1:16:11
In reply to Early morning BP surge in hypertensive patients, posted by ed_uk on July 1, 2005, at 12:07:43
Older antihypertensive drugs more likely to cause erectile dysfunction than newer agents
Older antihypertensives — and combinations of agents — are more likely to cause erectile dysfunction (ED) than some of the newer agents, according to new research.A Greek study assessed 358 young and middle-aged men (mean age 49.1 years) with hypertension, who were asked to fill in a standard questionnaire about ED. Nearly one in six (89/358) of the men were not yet taking any antihypertensive medicines. Nearly half (160/358) were taking monotherapy. Of these, around 25 per cent were on beta-blockers, 25 per cent on calcium antagonists and a similar proportion were on angiotensin converting enzyme inhibitors. A small number were taking diuretics or angiotensin receptor blockers. Nearly one-third of the group were taking combination antihypertensive therapy.
Results showed that 19.8 per cent of men not on drug treatment for their hypertension had ED compared with 36.3 per cent of men on one antihypertensive and 46.7 per cent of those on combination therapy. ED was more frequent in men on older drugs (diuretics and beta-blockers) than those on newer agents (calcium antagonists, ACE inhibitors and angiotensin receptor blockers).
Data were presented at the European Meeting on Hypertension in Milan last week.
Lorna Smalley, medicines management pharmacist, Greater and Central Derby Primary Care Trust, said: “Since I began prescribing the number of patients with ED has surprised me. Careful counselling regarding potential side effects before prescribing and at follow up is essential if we are to prevent problems that may impair compliance.”
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