The Therapeutic Approach to Arterial Hypertension—The Pharmaceutical Perspective

A special issue of Pharmaceutics (ISSN 1999-4923). This special issue belongs to the section "Clinical Pharmaceutics".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 8320

Special Issue Editor

Special Issue Information

Dear Colleagues,

It is scientifically confirmed that a tremendous proportion of cases of severe cardiovascular diseases are a direct consequence of high blood pressure, which is considered the main risk factor for cardiac morbidity and mortality. Notwithstanding the extraordinary prevalence of high blood pressure and despite the fact that many pharmacological strategies are used in antihypertensive treatment, blood pressure is often not adequately controlled. Considering the lifestyle interventions and the diverse and complete pharmaceutical guidelines in this field, reducing the devastating effects of hypertension seems to be the most attainable target in cardiac and vascular pathological care.

In this framework, the aim of this Special Issue on “The Therapeutic Approach to Arterial Hypertension—The Pharmaceutical Perspective” is to unify the most relevant papers addressing the state-of-the-art trends and future directions in arterial hypertension therapeutic strategies and innovative cardiovascular drug formulations, with details on rational design, the relevant preclinical and clinical testing of efficacy, pharmacokinetics and toxicity.

We welcome articles dealing with all aspects of pharmaceutical care in arterial hypertension and invite researchers and drug developers to publish their original research, review articles, communications with expert opinions and perspectives in the area of therapeutics.

Prof. Cristina Manuela Drăgoi
Guest Editor

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Keywords

  • Hypertension
  • Antihypertensive drugs
  • Drug design
  • Beta blockers
  • Diuretics
  • ACE inhibitors
  • Angiotensin II antagonists
  • Calcium channel blockers
  • Alpha blockers
  • Vasodilators
  • Clinical care

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Published Papers (2 papers)

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Review

13 pages, 849 KiB  
Review
Arterial Hypertension: Individual Therapeutic Approaches—From DNA Sequencing to Gender Differentiation and New Therapeutic Targets
by Constantin-Tudor Luca, Simina Crisan, Dragos Cozma, Alina Negru, Mihai-Andrei Lazar, Cristina Vacarescu, Mihai Trofenciuc, Ciprian Rachieru, Laura Maria Craciun, Dan Gaita, Lucian Petrescu, Alexandru Mischie and Stela Iurciuc
Pharmaceutics 2021, 13(6), 856; https://doi.org/10.3390/pharmaceutics13060856 - 9 Jun 2021
Cited by 8 | Viewed by 3237
Abstract
The aim of this paper is to provide an accurate overview regarding the current recommended approach for antihypertensive treatment. The importance of DNA sequencing in understanding the complex implication of genetics in hypertension could represent an important step in understanding antihypertensive treatment as [...] Read more.
The aim of this paper is to provide an accurate overview regarding the current recommended approach for antihypertensive treatment. The importance of DNA sequencing in understanding the complex implication of genetics in hypertension could represent an important step in understanding antihypertensive treatment as well as in developing new medical strategies. Despite a pool of data from studies regarding cardiovascular risk factors emphasizing a worse prognosis for female patients rather than male patients, there are also results indicating that women are more likely to be predisposed to the use of antihypertensive medication and less likely to develop uncontrolled hypertension. Moreover, lower systolic blood pressure values are associated with increased cardiovascular risk in women compared to men. The prevalence, awareness and, most importantly, treatment of hypertension is variable in male and female patients, since the mechanisms responsible for this pathology may be different and closely related to gender factors such as the renin–angiotensin system, sympathetic nervous activity, endothelin-1, sex hormones, aldosterone, and the immune system. Thus, gender-related antihypertensive treatment individualization may be a valuable tool in improving female patients’ prognosis. Full article
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16 pages, 1511 KiB  
Review
The Road to Better Management in Resistant Hypertension—Diagnostic and Therapeutic Insights
by Elisabeta Bădilă, Cristina Japie, Emma Weiss, Ana-Maria Balahura, Daniela Bartoș and Alexandru Scafa Udriște
Pharmaceutics 2021, 13(5), 714; https://doi.org/10.3390/pharmaceutics13050714 - 13 May 2021
Cited by 4 | Viewed by 4222
Abstract
Resistant hypertension (R-HTN) implies a higher mortality and morbidity compared to non-R-HTN due to increased cardiovascular risk and associated adverse outcomes—greater risk of developing chronic kidney disease, heart failure, stroke and myocardial infarction. R-HTN is considered when failing to lower blood pressure below [...] Read more.
Resistant hypertension (R-HTN) implies a higher mortality and morbidity compared to non-R-HTN due to increased cardiovascular risk and associated adverse outcomes—greater risk of developing chronic kidney disease, heart failure, stroke and myocardial infarction. R-HTN is considered when failing to lower blood pressure below 140/90 mmHg despite adequate lifestyle measures and optimal treatment with at least three medications, including a diuretic, and usually a blocker of the renin-angiotensin system and a calcium channel blocker, at maximally tolerated doses. Hereby, we discuss the diagnostic and therapeutic approach to a better management of R-HTN. Excluding pseudoresistance, secondary hypertension, white-coat hypertension and medication non-adherence is an important step when diagnosing R-HTN. Most recently different phenotypes associated to R-HTN have been described, specifically refractory and controlled R-HTN and masked uncontrolled hypertension. Optimizing the three-drug regimen, including the diuretic treatment, adding a mineralocorticoid receptor antagonist as the fourth drug, a β-blocker as the fifth drug and an α1-blocker or a peripheral vasodilator as a final option when failing to achieve target blood pressure values are current recommendations regarding the correct management of R-HTN. Full article
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