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      Preliminary Consequences of Blood Pressure Management and Blood Homocysteine Levels with Perindopril in Newly Diagnosed Hypertensive Patients in the Vietnamese Population

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          Abstract

          Background

          Perindopril is an ACE inhibitor that aids in both blood pressure regulation and homocysteine reduction.

          Objectives

          Our study aimed to evaluate the results of controlling blood pressure and blood homocysteine levels by perindopril in patients with primary hypertension.

          Materials and Methods

          A cross-sectional descriptive study with a longitudinal follow-up was conducted on 105 primary hypertensive patients treated with perindopril.

          Results

          The results of our study showed that after 6 weeks of treatment with perindopril, the proportion of patients with the target blood pressure (BP) level accounted for 70.5%, the rate of grade 1 hypertension decreased from 61.0% to 25.7%, grade 2 blood pressure decreased from 17.1% to 3.8%, and there was no case of grade 3 hypertension. At the same time, we also found that the rate of BP control in the group of patients who controlled Hcy below a threshold of 15  μmol/L was significantly higher than in the other group ( p  <  0.05). Concerning the efficacy of decreasing homocysteine in blood, we discovered that after 6 weeks of treatment with perindopril, the proportion of patients with elevated homocysteine reduced considerably from 74.3% to 40% ( p  <  0.05). In addition, the homocysteine concentration was 4.33 mol/L lower after treatment than before treatment (95% CI: 3.69–4.97) ( p  <  0.05).

          Conclusion

          Perindopril helps control blood pressure and reduces blood homocysteine levels in patients with primary hypertension.

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          Most cited references38

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          2018 ESC/ESH Guidelines for the management of arterial hypertension

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            2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

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              2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8).

              Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Although this guideline provides evidence-based recommendations for the management of high BP and should meet the clinical needs of most patients, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient.
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                Author and article information

                Contributors
                Journal
                Int J Hypertens
                Int J Hypertens
                IJHY
                International Journal of Hypertension
                Hindawi
                2090-0384
                2090-0392
                2023
                18 October 2023
                : 2023
                : 1933783
                Affiliations
                1Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam
                2Department of Cardiology, An Giang Cardiovascular Hospital, Long Xuyen 880000, Vietnam
                3Department of Foreign Language, Can Tho University, Can Tho 90000, Vietnam
                4Department of Cardiology, Can Tho Central General Hospital, Can Tho 90000, Vietnam
                5Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam
                Author notes

                Academic Editor: Emanuele Pivetta

                Author information
                https://orcid.org/0000-0002-0688-4754
                https://orcid.org/0000-0003-4420-1966
                Article
                10.1155/2023/1933783
                10599879
                37886230
                ac1104e4-6e26-42a6-9e14-0b52bc83f599
                Copyright © 2023 Son Kim Tran et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 May 2023
                : 11 August 2023
                : 9 October 2023
                Categories
                Research Article

                Cardiovascular Medicine
                Cardiovascular Medicine

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