• 제목/요약/키워드: Antihypertensive

검색결과 413건 처리시간 0.031초

한국적 의학 기준에 근거한 고혈압환자의 Angiotensin II Receptor Blockers와 Calcium Channel Blockers의 약물 평가 (Evaluation of Therapeutic Differences of Angiotensin II Receptor Blockers and Calcium Channel Blockers Among Hypertensive Patients Classified by Oriental Traditional Way)

  • 이옥상;천영주;예경남;윤희영;김정태;이윤정;임성실
    • 약학회지
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    • 제58권2호
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    • pp.141-149
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    • 2014
  • Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.

고혈압 치료 지침 Vl에 의한 항고혈압제의 사용평가 (Drug Use Evaluation of Antihypertensive Agents by JNC VI Guidelines)

  • 김경화;이숙향
    • 한국임상약학회지
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    • 제12권1호
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    • pp.29-38
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    • 2002
  • Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

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저단백 식이 및 항고혈압제의 투여가 만성신부전증의 진행에 미치는 영향에 관한 실험적 연구 (Renal Effects of a Low Protein Diet and Antihypertensive Drugs on the Progression of Early Chronic Renal Failure in 5/6 Nephrectomized Rats)

  • 김교순;김기혁;김상윤;강용주;맹원재
    • Childhood Kidney Diseases
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    • 제2권2호
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    • pp.125-132
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    • 1998
  • 목 적 : 초기만성신부전증에서 저단백식이를 항고혈압제와 병행 투여하였을 때 저단백식이 단독 투여 때보다 만성신부전의 진행속도 및 혈압조절에 어떠한 영향을 주는지 알기 위하여 저자들은 실험동물 백서를 이용하여 excision remnant kidney model로 만성 신부전을 유발시켰다. 방 법 : 5/6신 절제술로 만성 신부전을 유발시킨 백서를 순술 제 7일부터 무작위로 저단백식이 ($6\%$단백식이) 단독투여군, 저단백식이 enalapril 투여군 (식수 1 L당 50 mg),저단백식이 nicardipine 투여군 (사료 g당 0.2mg)로 나누어 신절제술후 4주, 12주, 16주에 단백뇨의 변화, 신 조직의 mesangial matrix expansion score 및 morphometric analysis로 분석한 사구체용적의 변화를 비교 분석하였다. 결 과 : 1)저단백식이 단독투여군은 신절제술후 계속 혈압이 증가됨을 볼 수 있었으며, 저단백식이 항고혈압제투여군은 신절제술후 8주부터 항고혈압제 투여 7주 후부터 저단백식이 단독투여군에 비해 혈압이 조절되기 시작하였다. 2)신절제술후 16주 째의 24시간 뇨단백은 세군 모두 크게 증가되지 않았으나 저단백식이 enalapril 투여군, 저단백식이 nicardipine투여군은 저단백식이 단독투여군에 비해 24시간 뇨단백의 양이 통계적으로 의미있게 낮았다. 3) 신절제술후 16주째 크레아티닌 청소 율은 저단백식이 단독투여군은 $1.57{\pm}0.11\;mL/min$, 저단백식이 enalapril 투여군 $1.37{\pm}0.14\;mL/min$, 저단백식이 nicardipine 투여군 $1.11{\pm}0.16\;ml/min$ 이었다. 4) 저단백식이 단독투여군의 잔여 신장무게는 신절제술후 4주 $1.33{\pm}0.04g$, 12주 $1.45{\pm}0.05g$, 16주 $1.44{\pm}0.16g$으로 12주 이후 잔여 신장무게의 증가를 관찰할 수 없었다. .신절제술후 16주에 관찰한 저단백식이 단독투여군과 저단백식이 항고혈압제투여군간의 잔여 신장무게는 통계적인 차이는 없었다. 5) 저단백식이 단독투여군의 mesangial matrix expansion score는 12주째 증가소견을 보였고 저단백식이 항고혈압제투여군은 항고혈압제 투여에도 불구하고 12주 이후 mesangial matrix expansion score의 의미있는 증가소견이 없었고 세군 간의 차이도 없었다. 6) 저단백식이 단독투여군의 사구체용적은 12주째 증가소견을 보였고 저단백식이 항고혈압제 투여군은 항고혈압제 투여에도 불구하고 12주 이후 사구체용적의 의미있는 증가소견이 없었고 세군 간의 차이도 없었다. 결 론 : 초기만성신부전증에서 저단백식이는 혈압을 조절시키지 못하였고 저단백식이 항고혈압제투여군은 저단백식이 단독투여군보다 혈압조절 및 단백뇨의 감소 소견은 유의한 차이를 보였으나, mesangial matrix expansion score,대상성 사구체비대는 통계적으로 유의한 차이를 보이지 않았다. 그러므로 만성신부전의 진행을 지연시키는데 있어서 저단백식이와 함께 항고혈압제를 추가하였을 때 항고혈압제에 의한 추가적인 지연 효과는 관찰되지 않았다.

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Digestion Pattern of Antihypertensive Angiotensin I-Converting Enzyme Inhibitory Peptides from Saccharomyces cerevisiae in a Successive Simulated Gastricintestinal Bioreactor

  • Jang, Jeong-Hoon;Jeong, Seung-Chan;Lee, Jung-Kee;Lee, Jong-Soo
    • Mycobiology
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    • 제39권1호
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    • pp.67-69
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    • 2011
  • A cell-free extract of Saccharomyces cerevisiae containing the angiotensin I-converting enzyme (ACE) inhibitory peptide was treated in a successive simulated gastric-intestinal bioreactor (step 1: amylase digestion, step 2: gastric fluid digestion, step 3: intestinal fluid digestion) to illustrate the absorption pattern of antihypertensive ACE inhibitory peptide, and the ACE inhibitory activities of each step were determined. Total ACE inhibitory activities of step 1, step 2, and step 3 were 55.96%, 80.09%, and 76.77%, respectively. The peptide sequence of each steps was analyzed by MS/MS spectrophotometry. Eleven kinds of representative peptide sequences were conserved in each step, and representative new peptides including RLPTESVPEPK were identified in step 3.

Effect of an herbal formulation on DOCA-salt and fructose induced models of hypertension in rats

  • Athare, CL;Mohan, M;Kasture, SB
    • Advances in Traditional Medicine
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    • 제8권4호
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    • pp.354-364
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    • 2008
  • The present study was carried out to investigate the antihypertensive effect of a folklore herbal formulation (HF) (300mg/kg/day; p.o.) in deoxycorticosterone acetate (DOCA)-salt induced and fructose induced hypertensive rats. In DOCA model, DOCA (15 mg/kg, s.c., twice a week) was administered to unilateral nephrectomized rats for 4 weeks. In fructose model, drinking water was replaced with 10% fructose solution for 6 weeks to induce hypertension. Systolic blood pressure (BP) was measured once every week during the treatment schedule. After completion of treatment schedule, BP and vascular reactivity to various agonists like Noradrenaline, Adrenaline, Phenylephrine and Serotonin (5-hydroxytrptamine; 5-HT) were recorded in rats of both models. A cumulative concentration response curve of 5-HT was carried out in isolated rat fundus strip of the DOCA-salt induced and fructose induced hypertensive rats. The results tend to suggest that HF possesses antihypertensive activity.

Cinnarizine을 Propranolol이나 Metoprolol과 병용할 때의 혈압(血壓) 강하(降下) 효과(效果)에 관한 약리학적(藥理學的) 연구(硏究)(II) -적출(摘出) 평활근(平滑筋)에 대한 효과- (Pharmacological Studies on the Antihypertensive Effects of Cinnarizine Coadministered with Propranolol or Metoprolol(II) -Effects on the Isolated Smooth Muscle-)

  • 허인회;안형수
    • 약학회지
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    • 제28권5호
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    • pp.257-263
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    • 1984
  • In our former report we observed that cinnarizine influenced the antihypertensive effect of propranolol beneficially, but not of metoprolol in SHR and normal cat. Cardiac contractilities and smooth muscle relaxations induced by above drugs were measured to elucidate their mechanism of action. In cinnarizine and propranolol treated group, both of negative inotropic and ${\beta}-blocking$ activity of propranolol in perfused rat hearts were increased and propranolol induced contraction in isolated arterial and trachea smooth muscle of the guinea pig was antagonized comparing to propranolol alone treated group. However, in the cinnarizine and metoprolol treated group, no significant differences in activity on the above were observed compared to metoprolol alone treated group.

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프로베네시드의 혈관 알파 수용체 길항 작용 (Probenecid inhibit $\alpha$-adrenergic receptor mediated vasoconstriction)

  • Kim, Sung-Jin
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 2001년도 추계학술대회 및 정기총회
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    • pp.98-98
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    • 2001
  • It has been suggested that hyperuricemia is related to the development of essential hypertension. Hypertensive patients with hyperuricemia has decreased glomerular filtration activity as compared to normotensive patients with hyperuricemia. These studies indicates uric acid concentrations in blood is associated with hypertension, Probenecid is an uricosuric agent which decreases uric acid reabsorption at the proximal tubule. Recently, we have shown that probenecid exerts anti-hypertensive action in Spontaneously Hypertensive Rats. Considering these results, I have designed a series of experiments to explore potential mechanism of antihypertensive action, of probenecid. In isolated rat thoracic aorta. probenecid significantly prevented phenylephrine-induced contraction of the blood vessel. When endothelium removed blood vessels were used, probenecid produced same effect as the intact blood vessels, indicating that probenecid directly act through the ${\alpha}$ -adrenergic receptor in vascular smooth muscles rather than through endothelium. These results suggest that one of the mechanism of antihypertensive effects of probenecid is due to the direct inhibition of ${\alpha}$ -adrenergic receptor in blood vessels.

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각종 미강 추출물들의 항고혈압성 엔지오텐신 전환효소 저해 활성 (Antihypertensive Angiotensin I-Converting Enzyme Inhibitiory Activity of Various Extracts from Some Rice Brans)

  • 김형종;김재호;손종록;이종수
    • 자연과학논문집
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    • 제13권1호
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    • pp.65-71
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    • 2003
  • 각종 미강 추출물들의 항고혈압성 엔지오텐신 전환효소 저해 활성을 측정하고 이들의 추출 최적조건을 검토하였다. 각종 미강 추출물들중에서 일품벼 미강의 물 추출물이 77%의 가장 높은 안지오텐신 전환효소 저해활성 보였다. 일품벼 미강중의 안지오텐신 전환효소 저해물질은 물을 1:10(w/v)으로 미강 분말에 첨가한 후 $30^{\circ}C$에서 12시간 추출하였을 때 가장 많이 용출되었다.

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Sambucus속(屬) 식물(植物)의 성분연구(成分硏究) [제2보](第二報) -접골목엽(接骨木葉) 추출물(抽出物)의 약리학적(藥理學的)인 고찰(考察)- (Studies on the Components of Sambucus Species II -pharmacological studies on the extracts from the leaves of Sambucus latipinna var. coreana-)

  • 이순철;안영란;김학성;김재완
    • Journal of Pharmaceutical Investigation
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    • 제6권3호
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    • pp.70-76
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    • 1976
  • Pharmacological studies on the water extracts of Sambbcus latipnna var. coreana have confirmed that there are: 1) Remarkable sedative actions in preteated mice with C.N.B (caffeine and sodium benzoate) by the administration of intraperitoneal injection. 2) Antihypertensive actions in rabbits intraperitoneally injected with the extract, and as antihypertensive components, rutin, and crystal A (m.p. $250{\sim}254^{\circ}$, Liberman-Buchard's reaction, positive) were isolated from Sambucus latipinna var. coreana. 3) Marked diuretic actions in mice intramuscular injection with the dose of 600mg/kg.

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양측 대동맥-신동맥 동시 우회술 치험;1례 보고 (Bilateral Aorto-Renal Bypasses - Report of One Case -)

  • 윤영철
    • Journal of Chest Surgery
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    • 제25권2호
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    • pp.200-204
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    • 1992
  • A 63 year old male had suffered from hypertension and angina pectoris for 4 years, On physical examination, blood pressure was 150/110 mmHg with medication of antihypertensive drugs. Aortogram showed the stenosis of the left renal artery, the complete occlusion of the right renal artery, and atherosclerotic change of abdominal aorta. Blood urea nitrogen was 25 mg/dl, serum creatinine was 1.2 mg/dl, and renin activity in peripheral blood was 8.7 ng /ml /hour, The stenosis of left renal artery and the complete occlusion of right renal artery should have produced the renovascular hypertension Bilateral aorto-renal bypasses with saphenous grafts were done for treatment of ren-ovascular hypertension Postoperatively, blood pressure was normalized with only small dosage of antihypertensive drugs.

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