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A Randomized Controlled Trial Studying the Effect of Medication Adherence Tools in Patients With Heart Failure.

Background Heart failure significantly contributes to the global increase in morbidity and mortality. In managing such chronic conditions, m … ysin inhibitor, (B) beta-blockers/funny channel blocker (ivabradine), (C) companion drugs (digoxin, hydralazine+isosorbide dinitrate, intravenous iron, statins, oral anticoagulants/antiplatelets, antiarrhythmics, etc.), and (D) diuretics/mineralocorticoid receptor antagonists. The intervention included the ABCD drug regimen as a pharmacological approach, heal …

A review of heart failure management in the elderly population.

BACKGROUND: In the United States, the incidence of heart failure (HF) in the elderly population (age, > or =65 years) approached 10 per 1000 … sts; and, in patients who cannot tolerate ACE inhibitors or ARBs or who are black, a combination of hydralazine and nitrates. For symptom control and morbidity benefit, therapies include diuretics and digoxin. For HF with preserved ejection fraction (HF-PEF), no particular pharmacotherapeutic agent has been found to have mortality benefits. Managing the under …

The prince and the pauper. A tale of anticancer targeted agents.

Cancer rates are set to increase at an alarming rate, from 10 million new cases globally in 2000 to 15 million in 2020. Regarding the pharmacological treatment of cancer, we currently are in the interphase of two treatment eras. The so-called pregenomic therapy which names the traditional cancer drugs, mainly cytotoxic drug types, and post-genomic era-type drugs referring to rationally-based designed. Although there are successful examples of this newer drug discovery approach, most target-specific agents only provide small gains in symptom control and/or survival, whereas others have consiste

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… Hydralazine's half-life is 1 hour and systemic clearance of the drug is approximately 50 mL/kg/min. … In silico models have demonstrated that residues Lys162 and Arg 240 within the enzyme active site interact with hydralazine at distances between these residues and hydralazine nitrogen atoms not exceeding 4A°. …

Nicardipine is superior to esmolol for the management of postcraniotomy emergence hypertension: a randomized open-label study.

BACKGROUND: Emergence hypertension after craniotomy is a well-documented phenomenon for which natural history is poorly understood. Most cli … perative day. In the event of study medication "failure," a "rescue" antihypertensive (labetalol or hydralazine) was used. The O'Brien-Fleming Spending Function was used to calculate the appropriate α value for each interim analysis of the primary outcome; univariate analysis was performed otherwise, with a 2-sided P<0.05 considered statistically significant. …

Combined alpha- and beta-receptor inhibition in the treatment of hypertension.

Both beta- and alpha-adrenergic mechanisms are important in the control of blood pressure; alpha-mediated vasoconstriction is responsible for the regulation of vascular tone, and beta-mediated responses stimulate the heart directly and indirectly by liberating renin and affecting vascular smooth muscle tone. beta-Adrenergic blocking drugs have long been established in the treatment of hypertension. The development of drugs which combine this action with an alpha-blocking effect represents an additional mode of action to lower the blood pressure. Numerous studies have demonstrated that labetalo

Regulation of myogenic tone and structure of parenchymal arterioles by hypertension and the mineralocorticoid receptor.

Proper perfusion is vital for maintenance of neuronal homeostasis and brain function. Changes in the function and structure of cerebral parenchymal arterioles (PAs) could impair blood flow regulation and increase the risk of cerebrovascular diseases, including dementia and stroke. Hypertension alters the structure and function of large cerebral arteries, but its effects on PAs remain unknown. We hypothesized that hypertension increases myogenic tone and induces inward remodeling in PAs; we further proposed that antihypertensive therapy or mineralocorticoid receptor (MR) blockade would reverse

Identification of factors associated with delayed treatment of obstetric hypertensive emergencies.

BACKGROUND: Obstetric hypertensive emergency is defined as having systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥110 mm Hg, confirmed 15 minutes apart. The American College of Obstetricians and Gynecologists recommends that acute-onset, severe hypertension be treated with first line-therapy (intravenous labetalol, intravenous hydralazine or oral nifedipine) within 60 minutes to reduce risk of maternal morbidity and death. OBJECTIVE: Our objective was to identify barriers that lead to delayed treatment of obstetric hypertensive emergency. STUDY DESIGN: A retrospective cohort …

Heart Failure.

Heart failure affects more than 6 million people in the United States and incurs a heavy toll in morbidity, mortality, and health care costs. It frequently coexists with other important disorders, including hypertension, coronary artery disease, diabetes, and obesity. Decades of clinical trials have shown that several medications and interventions are effective for improving outcomes; however, mortality and hospitalization rates remain high. More recently, additional medications and devices have shown promise in reducing the health burden of heart failure.

Common teratogenic medication exposures-a population-based study of pregnancies in the United States.

BACKGROUND: Risk mitigation for most teratogenic medications relies on risk communication via drug label, and prenatal exposures remain comm … or lithium (242 vs 89), gabapentin (1639 vs 653), and duloxetine (1914 vs 860). Steady increases in hydralazine and gabapentin exposures were observed during the study years, whereas atenolol exposure decreased (561 to 280). CONCLUSION: Several medications with teratogenic risk for which there are potentially safer alternatives continue to be used during pre …

Guidelines-similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension.

OBJECTIVE: This study aimed to review pregnancy hypertension clinical practice guidelines to inform international clinical practice and rese … t of severe hypertension, most commonly with intravenous labetalol, oral nifedipine, or intravenous hydralazine; (6) treatment for nonsevere hypertension when undertaken, with oral labetalol (in particular), methyldopa, or nifedipine, with recommendations against the use of renin-angiotensin-aldosterone inhibitors; (7) magnesium sulfate for eclampsia treatmen …

Oral beta-blockers for mild to moderate hypertension during pregnancy.

BACKGROUND: Hypertension is a common complication of pregnancy. Antihypertensive drugs are widely used in the belief these will improve outc … nal and perinatal perspectives) as methyldopa. Single small trials have compared beta-blockers with hydralazine and with nicardipine. It is unusual for women to change drugs due to side effects. REVIEWER'S CONCLUSIONS: The improvement in control of maternal blood pressure with use of beta-blockers would be worthwhile only if it were reflected in other more s …

Genetic disruption of guanylyl cyclase/natriuretic peptide receptor-A upregulates ACE and AT1 receptor gene expression and signaling: role in cardiac hypertrophy.

Inverse acinar regulation of Mrp2 and 3 represents an adaptive response to hepatocellular cholestatic injury. We studied whether obstructive cholestasis (bile duct ligation) and LPS treatment affect the zonal expression of Bsep (Abcb11), Mrp4 (Abcc4), Ntcp (Slc10a1), and Oatp isoforms (Slco1a1, Slco1a4, and slco1b2) in rat liver, as analyzed by semiquantitative immunofluorescence. Contribution of TNF-alpha and IL-1beta to transporter zonation in obstructive cholestasis was studied by cytokine inactivation. In normal liver Bsep, Mrp4, Ntcp, and Oatp1a1 were homogeneously distributed in the acin

Factors associated with appropriate treatment of acute-onset severe obstetrical hypertension.

BACKGROUND: The American College of Obstetricians and Gynecologists recommends that pregnant patients receive expeditious treatment with fir … atment as administration of a first-line antihypertensive agent (intravenous labetalol, intravenous hydralazine, or immediate-release oral nifedipine) within 60 minutes of the first or second severe-range blood pressure measurement during their delivery hospitalization. Delayed treatment was defined as the administration of a first-line agent >60 minutes afte …

Epigenetics-targeted drugs: current paradigms and future challenges.

Epigenetics governs a chromatin state regulatory system through five key mechanisms: DNA modification, histone modification, RNA modification, chromatin remodeling, and non-coding RNA regulation. These mechanisms and their associated enzymes convey genetic information independently of DNA base sequences, playing essential roles in organismal development and homeostasis. Conversely, disruptions in epigenetic landscapes critically influence the pathogenesis of various human diseases. This understanding has laid a robust theoretical groundwork for developing drugs that target epigenetics-modifyin

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… Hydralazine DNMT1/3a/3b Rectal cancer Withdrawn (No enrollment) Phase I/II — NCT00575640 Hydralazine DNMT1/3a/3b Ovarian cancer Unknown Phase III In combination with Magnesium valproate; placebo-controlled NCT00533299 Hydralazine DNMT1/3a/3b Cervical cancer Completed (exhibits advantages in progression-free … 301 Hydralazine | DNMT1/3a/3b | HCC | Completed (exhibits good efficacy and manageable toxicities) | Phase II | In combination with Valproic acid | TPVGH97-07-07 1028 Hydralazine | DNMT1/3a/3b | MDS | Unknown | Phase II | In combination with Valproic acid; BSC (active comparator) | NCT01356875 Hydralazine …

Bradykinin B2 null mice are prone to renal dysplasia: gene-environment interactions in kidney development.

Congenital abnormalities of the kidney and urinary tract are a common cause of end-stage renal disease in children. Host and environment factors are implicated in the pathogenesis of aberrant renal development. However, direct evidence linking gene-environment interactions with congenital renal disease is lacking. We report an animal model of renal dysgenesis that is dependent on a defined genetic defect and specific embryonic stressor. Specifically, mice that are deficient in the bradykinin type 2 receptor gene (B(2)) and salt loaded during embryogenesis acquire an aberrant kidney phenotype a

INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profiling Identifies Ambulatory Patients at High Risk on Medical Therapy After Hospitalizations for Heart Failure.

BACKGROUND: INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profiles provide important prognostic information for patients with advanced heart failure (HF) receiving mechanical support. The value of INTERMACS profiling has not been shown for patients followed on medical therapy for advanced HF at centers that also offer mechanical circulatory support. METHODS AND RESULTS: This prospective, observational study enrolled 166 patients with chronic New York Heart Association class III-IV HF, ejection fraction ≤30%, and ≥1 HF hospitalization in the previous year, excl