• The Korea Journal of Herbology
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• v.33 no.6
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• pp.9-18
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• 2018

Objective : Many patients take antihypertensive drugs as well as herbal medicines at the same time in order to treat other symptoms or to keep their well-being. In this study, interactions between herbal medicines and synthetic antihypertensive drugs were analyzed. Methods : To investigate the interaction between herbal medicines and synthetic antihypertensive drugs, three electronic databases, including OASIS, Mediline and Sciencedirect were searched. Experimental and clinical studies on the interaction between herbal medicines and antihypertensive drugs were independently reviewed and included. Results : Analyzing selected studies, twenty herbs were found to interact with antihypertensive drugs. Herbs found to increase the antihypertensive effect were Panax ginseng, Carthamus tinctorius, Magnolia officinalis, Silybum marianum, Scutellaria baicalensis, Schisandra chinensis, Sophora flavescens, Piper nigrum, Curcuma longa, Ginkgo biloba, Juncus effuses and Hydrastis canadensis. In contrast, Commiphora myrrha, Rhodiola rosea, Hypericum perforatum, Eurycoma longifolia, and Daturae metel were found to inhibit the antihypertensive effect. Stephania tetrandra could increase or decrease the effect depending on the type of antihypertensive drug. Epedria sínica was suspected of pharmacodynamic interaction with antihypertensive drug. Glycyrrhiza uralensis has been reported to have serious side effects in combination with antihypertensive drugs. Conclusion : These results imply that when used in combination with herbal medicines and synthetic antihypertensive drugs, proper doses and herbs which are to avoid need to be informed to the patients. Despite concerns about interactions between herbal medicines and synthetic drugs, related research is very limited. More systematic researches are needed to give information on patient safety as well as to guide clinical practice.

• Biomolecules & Therapeutics
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• v.4 no.2
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• pp.205-207
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• 1996

Clonidine, an antihypertensive drug, stimulates postsynaptic alpha-2 adrenergic receptors in the central nervous system and lowers arterial pressure through the effects on both cardiac output and peripheral resistance. However, many patients experience that sedation and xerostomia occur upon oral administration of clonidine. These side effects are due to high plasma peak concentration and can be avoided when clonidine is given transdermally. In this study, we tested the antihypertensive effects of trandermal administration of clonidine patch on spontaneously hypertensive rat (SHR) which is a model animal for human essential hypertension. Forty eight SHR (male) were divided into six groups according to the dose levels, respectively. After transdermal administration of clonidine patch of each dose, systolic blood pressure and heart rate were measured. Clonidine patch produced maximal antihypertensive and bradycardiac effects 48 hrs after administration and antihypertensive effects showed dose-dependency. We suggest that antihypertensive effects of clonidine patch are similar to those of orally given clonidine and clonidine patch can be used instead of clonidine tablet.

• Journal of Preventive Medicine and Public Health
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• v.36 no.3
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• pp.289-297
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• 2003

Objectives : The main objectives of this study are to identify the factors associated with hypertension control and to determine the influencing factors associated with antihypertensive therapy. Methods : The study was conducted on 107 subjects who participated in the 1999 and 2002 Gwacheon Study and who had had uncontrolled hypertension (systolic$\geq$140 or diastolic$\geq$ 90mmHg) in 1999, We compared the characteristics of the controlled and uncontrolled hypertensive group and investigated the characteristics of those taking antihypertensive medication. Univariate associations between hypertension control and its characteristics and the association between antihypertension treatment and its characteristics were tested with $x^2$-test. We also peformed logistic regression analysis. Results : The participants who had their blood pressure checked within 6 months before their first measurement and those who had taken the antihypertensive medication showed significantly better hypertension control during the follow-up. The multivariate analysis showed that baseline antihypertensive therapy was the most important determinant factor of hypertension control during the follow-up. Socioeconomic level and life style did not affect hypertension control when controlled by the treatment variable in this study. The factors associated with antihypertensive therapy at follow-up were previous antihypertensive therapy, old age, and high educational level. Conclusions : Those who received antihypertensive therapy and those who had their blood pressure re-checked within 6 months both showed well controlled hypertension. The subjects with high educational level complied well with the antihypertensive regimen, but those in their forties did not.

• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.48-60
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• 2016

Purpose: The purpose of this study was to identify the attributes of the concept, of psychological resistance to antihypertensive medication. Methods: The study was conducted in accordance with Walker and Avant's conceptual analysis process. We reviewed 47 related studies selected from 4 international and Korean databases including Medline, CINAHL, NDSL, and RISS to perform the analytical processes from January 1980 to September 2015. Results: The attributes of psychological resistance to antihypertensive medication include 1) reservation, 2) opposition, 3) denial, 4) refusal, and 5) seeking alternative therapy. The antecedents of the concept can be classified into patient factors such as reactance trait and knowledge deficit, provider factors, interpersonal factors, and environmental factors. The consequences of psychological resistance to antihypertensive medication are non-compliance, deterioration of the disease, developing complications, increased anxiety, and changes in life. Conclusions: The concept of psycho logical resistance to antihypertensive medication can provide guidance for the development of an intervention program that promotes the compliance to medication regimen of hypertensive patients. Further research needs to be done to develop a measurement tool for psychological resistance to antihypertensive medication.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.43 no.5
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• pp.421-427
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• 2010

To isolate natural antihypertensive substances from edible seaweeds, we screened for and separated active compounds contained in natural Underia pinnatifida, cultural Underia pinnatifida, Laminaria japonica, Sporophylls and Agarum cribrosum. They were extracted using room temperature water, boiling water, acetone, and methanol in turn or using room temperature water, ether, acetone, methanol and boiling water in order. The in vitro antihypertensive activity was quantified as inhibitory efficacy against angiotensin-I converting enzyme (ACE), which is a factor inducing hypertension. For all of the seaweeds tested, the fractions soluble in room temperature water and in boiling water showed the strongest ACE inhibitory effect among the extracted fractions. Conversely, the methanol-extracted fractions for all of the seaweeds tested showed no antihypertensive activity. While the ether and acetone fractions had slight antihypertensive effects. The compounds in the aqueous extracts that had antihypertensive activity were presumed to be polysaccharides, such as fucoidan and alginate.

• Biomolecules & Therapeutics
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• v.11 no.2
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• pp.133-138
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• 2003

The vascular relaxant and antihypertensive effects of newly developed salts of amlodipine-maleate and camsylate-were evaluated on isolated aorta from rats and in spontaneously hypertensive rats, and compared with those of amlodipine besylate, a standard drug. Amlodipine besylate concentration-dependently inhibited $Ca^{2＋}$-induced contraction in depolarised rat aorta($IC_{50}$/: 4.17 nM), with a very slow onset of action. Amlodipine maleate and amlodipine camsylate also showed vascular relaxant effect with a pattern and a potency similar to those of amlodipine besylate($IC_{50}$/: 3.62 and 3.28 nM, respectively). Amloclipine besylate produced a dose-dependent and long-lasting(>10∼24h) antihypertensive effect with a slow onset of action (ED$_{20}$: 2.31 mg/kg) in spontaneously hypertensive rats. Amlodipine maleate and amlodipine camsylate also exerted antihypertensive effects with a pattern and a potency similar to those of amlodipine besylate(ED$_{20}$: 2.09 and 2.21 mg/kg, respectively). These results suggest that amlodipine maleate and amlodipine camsylate are not statistically differ with amlodipine besylate in relaxant effect of $Ca^{2＋}$-induced contraction in depolarised rat aorta and in antihypertensive effect in spontaneously antihypertensive rats.

• Biomolecules & Therapeutics
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• v.12 no.1
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• pp.19-24
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• 2004

The vascular relaxant effect of amlodipine adipate, a new salt of amlodipine, was evaluate in isolated rat aorta, and compared with that of amlodipine besylate. Furthermore, antihypertensive effects were measured in hypertensive rat models, such as spontaneously hypertensive rats (SHR) and rena1 hypertensive rats (RHR). Amlodipine adipate concentration-dependently inhibited $Ca^{2+}$-induced contraction of rat aorta with a very slow onset of action (reached its maximum at 3.5 h;$IC_{50}$: 3.76 nM), having a pattern and a potency similar to those of amlodipine besylate ($IC_{50}$: 4.01 nM). In SHR and RHR, orally administered amlodipine adipate produced a dosedependent and long-lasting (>10-24 h) antihypertensive effect ($ED_{20}$: 2.48 and 1.57 mg/kg, respectively), with a pattern and a potency similar to those of amlodipine besylate ($ED_{20}$: 2.50 and 1.99 mg/kg in SHR and RHR, respectively). These results suggest that amlodipine adipate is a potent and long-lasting antihypertensive agent and that its antihypertensive effect is not significantly different to that of amlodipine besylate.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.218-237
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• 1997

In order to investigate the antihypertentive effects and its mechanism of the Siegesbeckia pubescens aqua-acupuncture treatment, experiments were performed on immediate and continuous antihypertensive effects, vasodilatation-autonomic nerve block, diuretic activity, and angiotensin converting enzyme inhibitory activity. The results were as follows; 1. Acupuncture treatment group showed significantly immediate antihypertensive effects in 4 hours after treatment. Normal saline aqua-acupuncture treatment group showed significantly immediate antihypertensive effects in 2, 4 and 6 hours after treatment. Siegesbeckia pubescens aqua-acupuncture treatment group showed significantly immediate antihypertensive effects in 30 minutes, 1, 2, 4 and 6 hours after treatment. 2. Siegesbeckia pubescens aqua-acupuncture treatment group showed significantly continuous antihypertensive effects in 6, 8, 9 and 10 days after treatment. 3. Siegesbeckia pubescens aqua-acupuncture extract solution showed significantly vasodilatatory and sympathetic nerve block effects with concentration of $10^{-6},\;10^{-5},\;10^{-4},\;10^{-3}g/m{\ell}$. 4. Oral administration group of the Siegesbeckia pubescens aqua-acupuncture extract solution didn't show no significantly diuretic effects. 5. Siegesbeckia pubescens aqua-acupuncture extract solution showed 28.8% angiotensin converting enzyme inhibitory activity.

• Korean Journal of Clinical Pharmacy
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• v.23 no.3
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• pp.239-247
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• 2013

Background: Fixed drug combinations are formulations containing two or more active ingredients in a single dosage form. Such combination therapies are commonly applied to improve efficacy, reduce adverse events and replace co-administration, etc. National and international guidelines for hypertension treatment recommend addition of other classes of antihypertensive drugs rather than incremental dose of mono-therapy, when blood pressure is not adequately controlled. Thus, many dual combinations of antihypertensive drugs have been approved and pharmaceutical companies are recently interested in developing antihypertensive triple combinations. Clinical trial designs for the fixed combinations are various depending on the target patients, dosage and clinical endpoints. Thereby, further discussions for the clinical trials of antihypertensive triple therapies are required regarding the indication claimed. Conclusion: This article provides a review for the assessment of the label and medical reports of the clinical trials on antihypertensive triple therapies in advanced foreign countries.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.325-332
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• 2018

Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.