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*It is only for medical professionals to read for reference.
Simple compatibility can have more benefits.
This type of drug is worthy of choice for hypertensive patients.
According to the "China Cardiovascular Health and Disease Report 2019" released in September 2020, there are currently an estimated 245 million patients with hypertension in my country.
As hypertension is a chronic disease, a key point of treatment is that patients need to manage themselves, take medications on time, and take them in a standardized manner.
As of 2016, the number of standardized management of hypertension patients in my country was only 90.
23 million.
At the same time, the standardized prevalence of adult diabetes in China is about 10.
9%, and there are currently about 390 million adults with pre-diabetes.
So when the self-control of hypertensive patients is not good, and the possibility of diabetic hypertension is getting higher and higher, how to choose drugs to bring greater benefits to patients? We can get some enlightenment from OLAS research.
The antihypertensive effect is good, and the compliance is high.
OA combination is worth choosing.
OLAS is a parallel grouping, open-label prospective, double-blind, randomized controlled study.
The study used the effects of olmesartan medoxomil/amlodipine and olmesartan medoxomil/hydrochlorothiazide combination treatment on inflammation-related factors and metabolic parameters as the main observation index, and newly-onset type 2 diabetes (T2DM) as the auxiliary observation index.
The research design is shown in the figure.
Firstly, blood pressure, fasting plasma glucose concentration, insulin, adiponectin, tumor necrosis factor a (TNF-a), C-reactive protein (CRP), and intercellular adhesion molecule 1 (ICAM) were performed on all patients.
-1) Baseline measurement of vascular cell adhesion molecule 1 (VCAM-1), interleukin (IL) and urine albumin indicators.Then 120 patients were randomly assigned to two groups.
The OA group received olmesartan medoxomil (20 mg) + amlodipine (5 mg) every day, and the OH group received olmesartan medoxomil (20 mg) + hydrochlorothiazide (12.
5 mg) every day.
.
And after standard treatment for 13 ± 2 weeks, 26 ± 2 weeks, 39 ± 2 weeks, and 78 ± 2 weeks (approximately 3, 6, 9 and 18 months), all measurements were repeated.
If the patient does not reach the target systolic blood pressure (140 mmHg around 13 weeks), the dose will be doubled after 13 weeks; doxazosin 4 mg will be added after 26 weeks, and the dose of doxazosin will be doubled after 39 weeks.
Figure 1 Research and experimental design Low insulin levels and high fasting plasma glucose concentrations are directly related to diabetes.
Low levels of adiponectin and high levels of inflammatory factors are closely related to new T2DM.
After a 78-week follow-up, the researchers finally found that in the comparison of the benefits of the two groups of drugs for lowering blood pressure, the OA group achieved better results: throughout the study, the final systolic blood pressure values of the OA group and the OH group They were 126.
5 ± 9.
0 mmHg and 129.
9 ± 10.
9 mmHg, respectively, and the diastolic blood pressure values were 84.
9 ± 7.
3 mmHg and 86.
3 ±8.
6 mmHg, respectively.
The difference between the two groups is that the average systolic blood pressure lowering effect of the OA group is better than that of the OH group -1.
5 mmHg (-1.
4 mmHg to -4.
4 mmHg) and the average diastolic blood pressure lowering effect is better than the OH group -0.
8 mmHg (-1.
8 mmHg to- 3.
6mmHg).
Figure 2 Comparison of antihypertensive effects In terms of blood pressure control for patients, the overall performance of the OA group is better than that of the OH group.
It is embodied in two aspects: drug adjustment strategy and blood pressure level.
During the trial, 53.
3% of patients in the OA group needed to double the initial drug dose, and 30.
0% of patients needed to add doxazosin.
The corresponding rates in the OH group were 53.
3% and 31.
7%, respectively. By the 26th week, 68.
3% of the patients in the OA group and 66.
7% of the patients in the OH group reached the target blood pressure before adding doxazosin.
In terms of compliance, the compliance of the two groups is high, but the compliance of the OA group is better than that of the OH group: in the first 26 weeks, the compliance of the OA group is 2% higher than that of the OH group, and the compliance of the OA group is by the end of the study It was 0.
9% higher than the OH group.
(26-week compliance in the OA group: 96.
1%, compliance at the end of the study: 92.
7%; 26-week compliance in the OH group: 94.
1%, compliance at the end of the study: 91.
8%) In terms of safety, adverse reactions of patients in the OA group The incidence of events was: edema (8.
3%), headache (6.
7%), facial flushing or dizziness (1.
7%).
The adverse event incidence of patients in the OH group was: edema (3.
3%), headache (5.
0%) and flushing or dizziness ( 5.
0%).
Three patients (5.
0%) in each group withdrew from the study due to poor blood pressure control.
The OA group has good metabolic benefits, and the risk of new-onset diabetes is low.
The combination of OA reduced the insulin resistance index by 24% (P=0.
01), increased the plasma adiponectin level by 16% (P=0.
05) and significantly reduced the study All inflammation indicators, except for CRP, did not see significant differences.
In other project indicators, it can be found that the inflammation control of OA is much better than that of OH.
(OA group: TNF-a decreased by 16.
1%, IL-1b decreased by 18.
5%, IL-6 decreased by 18.
1%, IL-8 decreased by 12.
8%, ICAM-1 decreased by 20.
8%, VCAM-1 decreased by 30.
8%).
Such performance of the test indicators, the clinical results also have corresponding conclusions.
During the study period, 3 patients (5.
0%) in the OA group were newly diagnosed with T2DM, while there were 11 patients (18.
3%) in the OH group.
The rate of T2MD in the OH group was 324% higher than that in the OA group.
(The ratio of OA to OH was 4.
24; the absolute risk of OA group was 13.
3% lower than that of OH group). Figure 3 Comparison of various indicators, better OA effect The author pointed out that olmesartan medoxomil + amlodipine and olmesartan medoxomil + hydrochlorothiazide these two antihypertensive drugs have good effects on non-diabetic hypertensive patients with metabolic syndrome At the same time, patient compliance is also relatively high.
A simple combined treatment strategy can achieve blood pressure control in most patients, and the combined treatment of two drugs in the OA group can improve the treatment effect while reducing adverse reactions.
In addition, the author specifically mentioned that another meta-analysis involving 11,000 participants indicated that the blood pressure reduction benefit obtained by using a combination of different types of drugs is approximately the blood pressure reduction produced by doubling the dose of one drug.
5 times.
TIME Interactive Time Q1: What does the research in this literature suggest can increase the blood pressure drop? And the conclusions about the dose of antihypertensive drugs and the results of antihypertensive do not fully comply with dose compliance.
What are the possible reasons in your opinion? In addition, could you also briefly talk about the advantages of combination drugs? Long-acting and stable blood pressure reduction, Olmesartan medoxomil and amlodipine help blood pressure reach the target as soon as possible.
Chen Zhengdi, Deputy Chief Physician, Department of Cardiology, Qingdao Central Hospital This article studies the cholesterol levels of patients with family hereditary hypercholesterolemia and their age Matched peers without the disease, studied the carotid artery intima thickness in the test group and the placebo group.
At the same time, the level of blood lipids decreased in these patients after taking pravastatin was also studied.
I think pravastatin is effective for lowering blood lipids in such patients.
In the future, in clinical work, you can try pravastatin when you encounter such patients.
This article also tells us that in the process of using pravastatin, we must insist on long-term medication.
This can effectively reduce the patient's blood lipid level and the thickness of the carotid artery intima, and prevent the occurrence of cardiovascular and cerebrovascular diseases.
For patients with renal impairment with proteinuria, olmesartan medoxomil and amlodipine is the right choice.
Wang Yahong, the attending physician of the Department of Cardiology, Wuhan Asia Heart Hospital, is generally admitted to the hospital for patients with high blood pressure and above.
For such patients, Combination therapy is required for the initial treatment plan.
In addition, most patients with hypertension have complications and proteinuria.
Therefore, considering that the patient's compliance may be poor, taking two drugs is not as good as taking a compound preparation.
The antihypertensive effect of olmesartan medoxomil and amlodipine is beyond doubt, and many patients are satisfied with the efficacy of the drug.
The second is that the side effects are small, and side effects such as dry cough, ankle edema, and hypotension are rare.
In addition, it can be observed that the patient's proteinuria has also been reduced, not only in patients, but also in evidence-based medicine.
In the hypertension clinic, olmesartan medoxomil and amlodipine will be chosen as the first-choice antihypertensive drug.
Compared with other drugs, olmesartan medoxomil and amlodipine have less damage to target organs and are cost-effective.
It is worth recommending.
Olmesartan medoxomil and amlodipine stabilize and effectively lower blood pressure and help improve patient compliance.
Liu Dan Attending physician, Department of Cardiology, Fifth People's Hospital Affiliated to Fudan University Single-tablet compound preparations are recommended.
Because clinical studies have found that in the case of single-tablet preparations, the antihypertensive effect is not obvious but the side effects are obvious.
For example, when the calcium antagonist is increased, many patients will experience palpitation, blushing, and ankle edema.
These reactions are rarely seen in conventional treatment doses.
However, after double the dose, the probability of occurrence will be much higher.
After the dose of aldosterone receptor antagonist drugs, patients are more likely to develop intolerance such as skin itching.
The side effects of diuretics have a greater impact and may cause electrolyte disturbances.
They are not the first choice for treatment and are not recommended.
At present, compound preparations can make our blood pressure reach the standard faster, so the acceptance of patients is also higher.
The single-tablet compound preparation is stable in lowering blood pressure, and the cost performance is higher than that of the two-tablet preparation.
Olmesartan medoxomil and amlodipine are a combination of angiotensin receptor antagonist (ARB) drugs with the strongest efficacy and CCB drugs with the best antihypertensive effect.
Both are strong joint. At the same time, the two have complementary effects.
ARB drugs are likely to cause insufficient renal blood flow.
Calcium channel blockers (CCB) drugs may cause facial flushing and faster reflex heartbeat.
The compound preparation does not produce such side effects and improves Patient compliance with medication.
Clinical application experience sharing Chen Zhengdi, deputy chief physician of the Department of Cardiology, Qingdao Central Hospital, has a long-term and stable effect on blood pressure, olmesartan medoxomil and amlodipine help blood pressure reach the standard as soon as possible.
The application of compound preparations can increase the patient's compliance rate, while improving patient compliance, thereby reducing high blood pressure The risk of various adverse reactions in patients with blood pressure is a clinical preference, and more compound preparations are expected.
Olmesartan medoxomil also has good benefits.
Wang Yahong, the attending physician of the Department of Cardiology, Wuhan Asian Heart Hospital, has proteinuria and renal impairment patients.
Olmesartan medoxomil and amlodipine is a suitable choice.
The clear effect of olmesartan medoxomil and amlodipine in lowering blood pressure can be observed clinically.
In addition, its effect on improving proteinuria is also obvious.
Therefore, it is recommended to give priority to this drug in hypertension clinics.
Zheng Hongfang, Attending Physician of the Department of General Medicine, Putuo District Central Hospital, Olmesartan medoxomil and amlodipine stabilizes and effectively lowers blood pressure and helps improve patient compliance.
Olmesartan medoxomil and amlodipine is a powerful combination of compound preparations that can effectively lower blood pressure and are cost-effective.
The adverse reactions of the two drugs can be avoided.
The antihypertensive effect is superimposed to suppress adverse reactions.
Scan the QR code below to get more cardiovascular knowledge.
Simple compatibility can have more benefits.
This type of drug is worthy of choice for hypertensive patients.
According to the "China Cardiovascular Health and Disease Report 2019" released in September 2020, there are currently an estimated 245 million patients with hypertension in my country.
As hypertension is a chronic disease, a key point of treatment is that patients need to manage themselves, take medications on time, and take them in a standardized manner.
As of 2016, the number of standardized management of hypertension patients in my country was only 90.
23 million.
At the same time, the standardized prevalence of adult diabetes in China is about 10.
9%, and there are currently about 390 million adults with pre-diabetes.
So when the self-control of hypertensive patients is not good, and the possibility of diabetic hypertension is getting higher and higher, how to choose drugs to bring greater benefits to patients? We can get some enlightenment from OLAS research.
The antihypertensive effect is good, and the compliance is high.
OA combination is worth choosing.
OLAS is a parallel grouping, open-label prospective, double-blind, randomized controlled study.
The study used the effects of olmesartan medoxomil/amlodipine and olmesartan medoxomil/hydrochlorothiazide combination treatment on inflammation-related factors and metabolic parameters as the main observation index, and newly-onset type 2 diabetes (T2DM) as the auxiliary observation index.
The research design is shown in the figure.
Firstly, blood pressure, fasting plasma glucose concentration, insulin, adiponectin, tumor necrosis factor a (TNF-a), C-reactive protein (CRP), and intercellular adhesion molecule 1 (ICAM) were performed on all patients.
-1) Baseline measurement of vascular cell adhesion molecule 1 (VCAM-1), interleukin (IL) and urine albumin indicators.Then 120 patients were randomly assigned to two groups.
The OA group received olmesartan medoxomil (20 mg) + amlodipine (5 mg) every day, and the OH group received olmesartan medoxomil (20 mg) + hydrochlorothiazide (12.
5 mg) every day.
.
And after standard treatment for 13 ± 2 weeks, 26 ± 2 weeks, 39 ± 2 weeks, and 78 ± 2 weeks (approximately 3, 6, 9 and 18 months), all measurements were repeated.
If the patient does not reach the target systolic blood pressure (140 mmHg around 13 weeks), the dose will be doubled after 13 weeks; doxazosin 4 mg will be added after 26 weeks, and the dose of doxazosin will be doubled after 39 weeks.
Figure 1 Research and experimental design Low insulin levels and high fasting plasma glucose concentrations are directly related to diabetes.
Low levels of adiponectin and high levels of inflammatory factors are closely related to new T2DM.
After a 78-week follow-up, the researchers finally found that in the comparison of the benefits of the two groups of drugs for lowering blood pressure, the OA group achieved better results: throughout the study, the final systolic blood pressure values of the OA group and the OH group They were 126.
5 ± 9.
0 mmHg and 129.
9 ± 10.
9 mmHg, respectively, and the diastolic blood pressure values were 84.
9 ± 7.
3 mmHg and 86.
3 ±8.
6 mmHg, respectively.
The difference between the two groups is that the average systolic blood pressure lowering effect of the OA group is better than that of the OH group -1.
5 mmHg (-1.
4 mmHg to -4.
4 mmHg) and the average diastolic blood pressure lowering effect is better than the OH group -0.
8 mmHg (-1.
8 mmHg to- 3.
6mmHg).
Figure 2 Comparison of antihypertensive effects In terms of blood pressure control for patients, the overall performance of the OA group is better than that of the OH group.
It is embodied in two aspects: drug adjustment strategy and blood pressure level.
During the trial, 53.
3% of patients in the OA group needed to double the initial drug dose, and 30.
0% of patients needed to add doxazosin.
The corresponding rates in the OH group were 53.
3% and 31.
7%, respectively. By the 26th week, 68.
3% of the patients in the OA group and 66.
7% of the patients in the OH group reached the target blood pressure before adding doxazosin.
In terms of compliance, the compliance of the two groups is high, but the compliance of the OA group is better than that of the OH group: in the first 26 weeks, the compliance of the OA group is 2% higher than that of the OH group, and the compliance of the OA group is by the end of the study It was 0.
9% higher than the OH group.
(26-week compliance in the OA group: 96.
1%, compliance at the end of the study: 92.
7%; 26-week compliance in the OH group: 94.
1%, compliance at the end of the study: 91.
8%) In terms of safety, adverse reactions of patients in the OA group The incidence of events was: edema (8.
3%), headache (6.
7%), facial flushing or dizziness (1.
7%).
The adverse event incidence of patients in the OH group was: edema (3.
3%), headache (5.
0%) and flushing or dizziness ( 5.
0%).
Three patients (5.
0%) in each group withdrew from the study due to poor blood pressure control.
The OA group has good metabolic benefits, and the risk of new-onset diabetes is low.
The combination of OA reduced the insulin resistance index by 24% (P=0.
01), increased the plasma adiponectin level by 16% (P=0.
05) and significantly reduced the study All inflammation indicators, except for CRP, did not see significant differences.
In other project indicators, it can be found that the inflammation control of OA is much better than that of OH.
(OA group: TNF-a decreased by 16.
1%, IL-1b decreased by 18.
5%, IL-6 decreased by 18.
1%, IL-8 decreased by 12.
8%, ICAM-1 decreased by 20.
8%, VCAM-1 decreased by 30.
8%).
Such performance of the test indicators, the clinical results also have corresponding conclusions.
During the study period, 3 patients (5.
0%) in the OA group were newly diagnosed with T2DM, while there were 11 patients (18.
3%) in the OH group.
The rate of T2MD in the OH group was 324% higher than that in the OA group.
(The ratio of OA to OH was 4.
24; the absolute risk of OA group was 13.
3% lower than that of OH group). Figure 3 Comparison of various indicators, better OA effect The author pointed out that olmesartan medoxomil + amlodipine and olmesartan medoxomil + hydrochlorothiazide these two antihypertensive drugs have good effects on non-diabetic hypertensive patients with metabolic syndrome At the same time, patient compliance is also relatively high.
A simple combined treatment strategy can achieve blood pressure control in most patients, and the combined treatment of two drugs in the OA group can improve the treatment effect while reducing adverse reactions.
In addition, the author specifically mentioned that another meta-analysis involving 11,000 participants indicated that the blood pressure reduction benefit obtained by using a combination of different types of drugs is approximately the blood pressure reduction produced by doubling the dose of one drug.
5 times.
TIME Interactive Time Q1: What does the research in this literature suggest can increase the blood pressure drop? And the conclusions about the dose of antihypertensive drugs and the results of antihypertensive do not fully comply with dose compliance.
What are the possible reasons in your opinion? In addition, could you also briefly talk about the advantages of combination drugs? Long-acting and stable blood pressure reduction, Olmesartan medoxomil and amlodipine help blood pressure reach the target as soon as possible.
Chen Zhengdi, Deputy Chief Physician, Department of Cardiology, Qingdao Central Hospital This article studies the cholesterol levels of patients with family hereditary hypercholesterolemia and their age Matched peers without the disease, studied the carotid artery intima thickness in the test group and the placebo group.
At the same time, the level of blood lipids decreased in these patients after taking pravastatin was also studied.
I think pravastatin is effective for lowering blood lipids in such patients.
In the future, in clinical work, you can try pravastatin when you encounter such patients.
This article also tells us that in the process of using pravastatin, we must insist on long-term medication.
This can effectively reduce the patient's blood lipid level and the thickness of the carotid artery intima, and prevent the occurrence of cardiovascular and cerebrovascular diseases.
For patients with renal impairment with proteinuria, olmesartan medoxomil and amlodipine is the right choice.
Wang Yahong, the attending physician of the Department of Cardiology, Wuhan Asia Heart Hospital, is generally admitted to the hospital for patients with high blood pressure and above.
For such patients, Combination therapy is required for the initial treatment plan.
In addition, most patients with hypertension have complications and proteinuria.
Therefore, considering that the patient's compliance may be poor, taking two drugs is not as good as taking a compound preparation.
The antihypertensive effect of olmesartan medoxomil and amlodipine is beyond doubt, and many patients are satisfied with the efficacy of the drug.
The second is that the side effects are small, and side effects such as dry cough, ankle edema, and hypotension are rare.
In addition, it can be observed that the patient's proteinuria has also been reduced, not only in patients, but also in evidence-based medicine.
In the hypertension clinic, olmesartan medoxomil and amlodipine will be chosen as the first-choice antihypertensive drug.
Compared with other drugs, olmesartan medoxomil and amlodipine have less damage to target organs and are cost-effective.
It is worth recommending.
Olmesartan medoxomil and amlodipine stabilize and effectively lower blood pressure and help improve patient compliance.
Liu Dan Attending physician, Department of Cardiology, Fifth People's Hospital Affiliated to Fudan University Single-tablet compound preparations are recommended.
Because clinical studies have found that in the case of single-tablet preparations, the antihypertensive effect is not obvious but the side effects are obvious.
For example, when the calcium antagonist is increased, many patients will experience palpitation, blushing, and ankle edema.
These reactions are rarely seen in conventional treatment doses.
However, after double the dose, the probability of occurrence will be much higher.
After the dose of aldosterone receptor antagonist drugs, patients are more likely to develop intolerance such as skin itching.
The side effects of diuretics have a greater impact and may cause electrolyte disturbances.
They are not the first choice for treatment and are not recommended.
At present, compound preparations can make our blood pressure reach the standard faster, so the acceptance of patients is also higher.
The single-tablet compound preparation is stable in lowering blood pressure, and the cost performance is higher than that of the two-tablet preparation.
Olmesartan medoxomil and amlodipine are a combination of angiotensin receptor antagonist (ARB) drugs with the strongest efficacy and CCB drugs with the best antihypertensive effect.
Both are strong joint. At the same time, the two have complementary effects.
ARB drugs are likely to cause insufficient renal blood flow.
Calcium channel blockers (CCB) drugs may cause facial flushing and faster reflex heartbeat.
The compound preparation does not produce such side effects and improves Patient compliance with medication.
Clinical application experience sharing Chen Zhengdi, deputy chief physician of the Department of Cardiology, Qingdao Central Hospital, has a long-term and stable effect on blood pressure, olmesartan medoxomil and amlodipine help blood pressure reach the standard as soon as possible.
The application of compound preparations can increase the patient's compliance rate, while improving patient compliance, thereby reducing high blood pressure The risk of various adverse reactions in patients with blood pressure is a clinical preference, and more compound preparations are expected.
Olmesartan medoxomil also has good benefits.
Wang Yahong, the attending physician of the Department of Cardiology, Wuhan Asian Heart Hospital, has proteinuria and renal impairment patients.
Olmesartan medoxomil and amlodipine is a suitable choice.
The clear effect of olmesartan medoxomil and amlodipine in lowering blood pressure can be observed clinically.
In addition, its effect on improving proteinuria is also obvious.
Therefore, it is recommended to give priority to this drug in hypertension clinics.
Zheng Hongfang, Attending Physician of the Department of General Medicine, Putuo District Central Hospital, Olmesartan medoxomil and amlodipine stabilizes and effectively lowers blood pressure and helps improve patient compliance.
Olmesartan medoxomil and amlodipine is a powerful combination of compound preparations that can effectively lower blood pressure and are cost-effective.
The adverse reactions of the two drugs can be avoided.
The antihypertensive effect is superimposed to suppress adverse reactions.
Scan the QR code below to get more cardiovascular knowledge.
