Chronotherapeutic delivery of verapamil in obese versus non-obese patients with essential hypertension.
TLDR
COER-verapamil is effective in reducing BP, heart rate, and rate-pressure product independently of BMI, and well tolerated in both subgroups.Abstract:
Background: The effect of controlled-onset, extended-release (COER) verapamil on haemodynamic parameters in obese and non-obese patients is evaluated in this analysis. Methods: Data were pooled from three clinical trials evaluating efficacy and tolerability of COER-verapamil. Hypertensive men and women (stage I to III) were randomised to COER-verapamil (180–540 mg at bedtime) or placebo for 4–8 weeks and stratified according to body mass index (BMI-obese >28 kg/m2). Efficacy was assessed as change from baseline in blood pressure (BP), heart rate, and rate-pressure product during four time periods throughout the dosing interval. Safety and tolerability were assessed by monitoring all adverse events and changes in metabolic laboratory parameters. Results: Reductions in all haemodynamic parameters were significantly greater following COER-verapamil compared with placebo for all time periods. The haemodynamic effects of COER-verapamil in obese (n= 166, BMI = 32.8 kg/m2) and non-obese patients (n = 115, BMI = 25.0 kg/m2) were similar. COER-verapamil was well tolerated in both subgroups, but the incidence of constipation was significantly less in obese patients (P < 0.001). Conclusions: COER-verapamil is effective in reducing BP, heart rate, and rate-pressure product independently of BMI.read more
Citations
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Evening versus morning dosing regimen drug therapy for hypertension
TL;DR: The data suggests that better blood pressure control was achieved with bedtime dosing than morning administration of antihypertensive medication, the clinical significance of which is not known.
Drug Class Review on Calcium Channel Blockers
TL;DR: Renoprotective effect of losartan in comparison to amlodipine in patients with chronic kidney disease and hypertension: a report from Japan intended for the global renal protection in hypertensive patients (jlight study).
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Is Pentraxin 3 Involved in Obesity-Induced Decrease in Arterial Distensibility?
Asako Miyaki,Seiji Maeda,Mutsuko Yoshizawa,Maiko Misono,Hiroyuki Sasai,Nobutake Shimojo,Kiyoji Tanaka,Ryuichi Ajisaka +7 more
TL;DR: Arterial compliance was significantly lower and the beta-stiffness index was significantly higher in obese men than in non-obese men; therefore, higher PTX3 levels and decreased arterial distensibility coexist in obesity men.
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Management of hypertension in overweight and obese patients: a practical guide for clinicians.
TL;DR: Based on studies involving obese and nonobese patients, first-line treatment options include a diuretic alone or an angiotensin-converting enzyme (ACE) inhibitor alone and/or combining either of these drugs with a calcium channel blocker.
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Hemodialysis Timing, Survival, and Cardiovascular Outcomes in the Hemodialysis (HEMO) Study
Yue Harn Ng,Klemens B. Meyer,John W. Kusek,Guofen Yan,Michael V. Rocco,Paul L. Kimmel,Robert L. Benz,Srinivasan Beddhu,Johanna T. Dwyer,Robert D. Toto,Garabed Eknoyan,Mark Unruh +11 more
TL;DR: Making extensive adjustment for patient characteristics, this report does not support the association of lower all-cause mortality with morning hemodialysis or a particular benefit for older patients.
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