Hypertension

Most of the patients in current scenario are treated with more than one anti-hypertensives and most often with fixed dose combinations. Hence the use and efficacy of fixed dose combination are controversial and is the most debated issue in Indian perspective  The aim of this randomized pilot study was to evaluate the rationality and side effect profile of fixed dose anti-hypertensive combinations used in our hospital. A total of 25 hypertensive patients prescribed with anti-hypertensive FDCs were randomly selected and their outpatient record were monitored and recorded for a period of 2 weeks. The data was then suitably analyzed. Out of the 13 FDCs, only one FDC (7.69%) have its APIs present in both EML of WHO and NLEM of India. There was no established evidence in terms of therapeutic efficacy and safety for the 3 combinations (23.07%).76.92% of FDCs were cost effective when compared with their individual components. 11 FDCs (84.61%) provide published literature on the reduction of either dose of individual drugs or their adverse effects. Only one FDC was found to be irrational in this study. Giddiness (33.33%) was the most frequently seen side effect among the prescribed FDCs. During this limited study period with only 13 anti-hypertensive FDCs, we were able to find an irrational FDC, which clearly show an urgent need to conduct further studies on evaluating the rationality of FDCs as a whole. As a clinical pharmacist, our immense role in evaluating the rationality of FDCs could enable the DCGI to withdraw irrational FDCs from the market.   

Hypertension is a global health problem with significant magnitude of morbidity and mortality, in recent years, most of the developing countries such as Sudan depend largely on the herbal remedies which are used for the treatment of hypertension such as: Hibiscus Sabdariffa. In folk medicine it is used for variety aspects such as: wound dressing, bronchitis and diabetes. The extract of this plant exerts its antihypertensive activity by at least three major specific mechanisms of action:  diuretic, vasodilator and angiotensin converting enzyme inhibitor (ACE inhibitor).The object of the work was to to discuss and evaluate the effectiveness of Hibiscus Sabdariffa as antihypertensive agent. In vitro, H. sabdariffa (HS) act as a vasodilator via relaxed the pre-contracted endothelium-intact and endothelium-denuded aortic rings. In man and laboratory animals, aqueous extraction of HS significantly reduced BP in essential hypertensive man, and the calyx extract reduced BP in the spontaneously hypertensive rat. It's also significantly reduced BP in normal rats and anesthetized cats. In addition, there are an evidence reports that the regular use of (HS) can protected the body from the cardiovascular disorder by lowering: total cholesterol, low-density lipoprotein cholesterol (LDL-C) and triglycerides in the majority of normolipidemic, hyperlipidemic and diabetic animal models. All the studies had agreed that Hibiscus Sabdariffa can significantly reduce the blood pressure, but all the problems that reported later on in the discussion that have founded on the conducted articles need further evaluation of this herbal remedy to be approved as an effective antihypertensive agent.

Cardiovascular and other non-communicable diseases are currently responsible for two thirds of global mortality. Hypertension is a consistent and independent risk factor for cardiovascular and kidney diseases and stroke. The prevalence of hypertension has increased in urban communities as well as in rural people. There is a strong correlation between changing lifestyle factors and increase in hypertension. Accurate and decisive data about hypertension prevalence and its risk factors is essential for scheming strategies for its effective regulation and prevention. A Community based cross-sectional study was carried out in rural community to monitor prevalence, risk factors, awareness, treatment and control of hypertension in rural population. A total of 627 subjects (males n=369 and females n=258) participated in the study (age > 18 years). The participant’s blood pressure was measured and they were asked to answer a pretested questionnaire. As per the JNC VII report, hypertension was defined. Analysis of data was done using chi square test. The prevalence of hypertension was found to be 49.12% (males: 57.18% and female: 37.50%). About 1/4th of the hypertensive population did not knew about their health status. 60-79 year age group had the highest prevalence of hypertension (49.02%). Bivariate analysis of data was indicative of significant relationship between hypertension with that of age, gender, literacy, body mass index (BMI), physical inactivity, and smoking and alcohol consumption. Hence the prevalence of hypertension was found to be highly prevalent in rural community. We also realized the importance of clinical pharmacist and other health care professional’s involvement in monitoring of health problems reporting possible drug related problems, measuring therapeutic compliance and counselling on lifestyle modification in rural populations.

The main aim of research work was to design novel bilayer fast dissolving films as a drug delivery system for treatment of severe hypertension and acute cases like angina pectoris. In present work two incompatible drugs Amlodipine and Benazapril was combined in single dosage form using impermeable membrane. The thin films of both drugs were prepared by using different concentration of polymers, plasticizers and super disintegrants. The films were casted in to bilayer films using impermeable membrane. These prepared Bilayer films were characterized on basis of thickness, folding endurance, tensile strength and dissolution time. On basis of study it was found that the optimized film dissolves within 60 sec. and both drugs do not show interaction during preparation and stability period. The proposed novel films will deliver the two incompatible drugs and releases the drug quickly thus can be preferred in hypertension emergencies.

  This community based study assessed the prevalence of obesity and associated factors among age group between 16 to 75 years. The obese and overweight subjects were from age group from 31 to 45 year which was 42.42% and 28.78% respectively and most of them were in sedentary jobs. Obese and overweight dipsomaniac smokers were from the age group46-60 year which was 90%. Prevalence of hypertension and diabetes among overweight elderly was observed in this study. Key words: Obesity, Overweight, Dipsomaniac, Hypertension, Diabetes