Cardiovascular Prevention and Pharmacotherapy

Most-read articles are from the articles published in 2022 during the last three month.

Review Articles

Calcium channel blockers for hypertension: old, but still useful: Eun Mi Lee; Cardiovasc Prev Pharmacother. 2023;5(4):113-125. Published online October 30, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e16

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Calcium channel blockers (CCBs) constitute a heterogeneous class of drugs that can be divided into dihydropyridines (DHPs) and non-DHPs. DHP-CCBs are subcategorized into four generations based on the duration of activity and pharmacokinetics, while non-DHP-CCBs are subcategorized into phenylethylamine and benzodiazepine derivatives. DHP-CCBs are vascular-selective and function as potent vasodilators, whereas non-DHP-CCBs are cardiac-selective and are useful for treating tachyarrhythmia, but reduce cardiac contractility and heart rate. Traditional DHP-CCBs (nifedipine) mainly block L-type calcium channels, whereas novel CCBs block N-type (amlodipine) and/or T-type channels (efonidipine) in addition to L-type channels, leading to organ-protective effects. DHP-CCBs have a potent blood pressure–lowering effect and suppress atherosclerosis and coronary vasospasm. Diltiazem, a non-DHP-CCB, is highly effective for vasospasm control. CCBs reduce left ventricular hypertrophy and arterial stiffness. Amlodipine, a DHP-CCB, reduces blood pressure variability. L/N- and L/T-type CCBs combined with renin-angiotensin system blockers reduce proteinuria and improve kidney function compared with L-type CCBs. According to large-scale trials, DHP-CCBs reduce cardiovascular events in patients with isolated systolic hypertension, as well as in elderly and high-risk patients. Accordingly, CCBs are indicated for hypertension in elderly patients, isolated systolic hypertension, angina pectoris, and coronary vasospasm. Non-DHP-CCBs are contraindicated in high-grade heart block, bradycardia (<60 beats per minute [bpm]), and heart failure with reduced ejection fraction (HFrEF). DHP-CCBs should be used with caution in patients with tachyarrhythmia, HFrEF, and severe leg edema, and non-DHP-CCBs should be used carefully in those with constipation. Each CCB has distinct pharmacokinetics and side effects, underscoring the need for meticulous consideration in clinical practice.

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Design of Experimental Approach for Development of Rapid High Performance Liquid Chromatographic Process for Simultaneous Estimation of Metoprolol, Telmisartan, and Amlodipine from Formulation: Greenness and Whiteness Evaluation
Mahesh Attimarad, Mohammed Jassim Alali, Hussain Ali Alali, Dana Hisham Alabdulmuhsin, Aljohara Khalid Alnajdi, Katharigatta Narayanaswamy Venugopala, Anroop B. Nair
Molecules.2024; 29(5): 1087. CrossRef
The Evolving Role of Calcium Channel Blockers in Hypertension Management: Pharmacological and Clinical Considerations
Kamryn E. Jones, Shaun L. Hayden, Hannah R. Meyer, Jillian L. Sandoz, William H. Arata, Kylie Dufrene, Corrado Ballaera, Yair Lopez Torres, Patricia Griffin, Adam M. Kaye, Sahar Shekoohi, Alan D. Kaye
Current Issues in Molecular Biology.2024; 46(7): 6315. CrossRef
Home blood pressure-lowering effect of esaxerenone versus trichlormethiazide for uncontrolled hypertension: a predefined subanalysis of the EXCITE-HT randomized controlled trial by basal calcium channel blocker versus angiotensin receptor blocker
Kazuomi Kario, Hiroyuki Ohbayashi, Masami Hashimoto, Naoki Itabashi, Mitsutoshi Kato, Kazuaki Uchiyama, Kunio Hirano, Noriko Nakamura, Takahide Miyamoto, Hirotaka Nagashima, Hidenori Ishida, Yusuke Ebe, Tsuguru Hatta, Toshiki Fukui, Tatsuo Shimosawa, Tomo
Hypertension Research.2024;[Epub] CrossRef

Decision-making for recurrent atrial fibrillation after catheter ablation: Jum Suk Ko, Sung Soo Kim, Hyung Ki Jeong, Nam Ho Kim; Cardiovasc Prev Pharmacother. 2023;5(4):102-112. Published online October 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e15

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Abstract PDF

Catheter ablation for atrial fibrillation (AF), especially pulmonary vein (PV) isolation, is widely used for rhythm control. However, AF recurrence remains a challenge, affecting 20% to 50% of cases. This review focuses on AF recurrence after catheter ablation. AF recurrence can be categorized into early recurrence (ER) within 3 months after index procedure, late recurrence (LR) within 1 year, and very LR (VLR) occurring beyond 1 year. ER has emerged as a significant predictor of LR, contrary to the traditional understanding. LR is primarily caused by PV reconnection, while VLR more involves non-PV triggers or substrates. Managing AF recurrence includes antiarrhythmic drugs, steroids, colchicine, and repeat ablation. Antiarrhythmic drugs reduce ER but have a limited impact on LR. Steroids have been shown to reduce ER, but not long-term recurrence. Colchicine, an anti-inflammatory agent, shows promise in reducing both ER and LR, although further research is necessary. Whether to perform early repeat ablation after ER remains uncertain, as not all patients require immediate intervention. In conclusion, AF recurrence after ablation remains a complex issue. Understanding the underlying mechanisms is essential for personalized management. Tailored approaches, considering individual characteristics, are crucial for long-term success. Future research should focus on improving therapeutic strategies for AF recurrence.

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Meta-analysis of Pulsed Field Ablation Versus Thermal Ablation for Pulmonary Vein Isolation in AF: A Broad Overview Focusing on Efficacy, Safety and Outcomes
Mohammad Iqbal, William Kamarullah, Raymond Pranata, Iwan Cahyo Santosa Putra, Giky Karwiky, Chaerul Achmad, Young Hoon Kim
Arrhythmia & Electrophysiology Review.2024;[Epub] CrossRef
Beyond Clinical Factors: Harnessing Artificial Intelligence and Multimodal Cardiac Imaging to Predict Atrial Fibrillation Recurrence Post-Catheter Ablation
Edward T. Truong, Yiheng Lyu, Abdul Rahman Ihdayhid, Nick S. R. Lan, Girish Dwivedi
Journal of Cardiovascular Development and Disease.2024; 11(9): 291. CrossRef

Adverse effects of statin therapy and their treatment: Dae Young Cheon, Sang-Ho Jo; Cardiovasc Prev Pharmacother. 2022;4(1):1-6. Published online January 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e4

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Abstract PDF

Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.

Citations

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The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients
Roxana Nartea, Brindusa Ilinca Mitoiu, Ioana Ghiorghiu
Current Issues in Molecular Biology.2023; 45(4): 3146. CrossRef
The effects of L-carnitine in reducing hepatotoxicity of statins in rats
Doaa Ibrahim, Shahad Bader, Omar Bader
Medicinski casopis.2023; 57(3): 59. CrossRef

Optimal target blood pressure in older patients with hypertension: Kwang-il Kim; Cardiovasc Prev Pharmacother. 2023;5(2):41-48. Published online April 24, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e4

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Abstract PDF: Hypertension is a common condition among older adults, and blood pressure (BP) control is effective for preventing cardiovascular morbidity and mortality even among the oldest-old adults. However, the optimal target BP for older patients with hypertension has been a subject of debate, with previous clinical trials providing conflicting evidence. Determining the optimal target BP for older adults is a complex issue that requires considering comorbidities, frailty, quality of life, and goals of care. As such, BP targets should be individualized based on each patient's unique health status and risk factors, and treatment should be closely monitored to ensure that it is effective and well-tolerated. The benefits and risks of intensive BP control should be carefully weighed in the context of the patient's overall health status and treatment goals. Ultimately, the decision to pursue intensive BP control should be made through shared decision-making between patients and their healthcare providers.

Using medical big data for clinical research and legal considerations for the protection of personal information: the double-edged sword: Raeun Kim, Jiwon Shinn, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2024;6(1):8-16. Published online January 22, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e1

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Abstract PDF: The advent of medical big data has increased the scope of the clinical use of such data; however, these data have raised serious concerns regarding personal privacy protection, which hinders their usage. For instance, as the pseudonymization or anonymization of data increases, the quality of its clinical use decreases. Thus, a balanced approach is required to maximize clinical data use while protecting personal information as much as possible. However, Korea’s existing laws mandate several kinds of consent; soliciting some of these types of consent can be cumbersome. Moreover, while the collection of medical data by hospitals requires considerable time and money, its ownership is difficult to ascertain. To bridge the enormous gap between the protection of personal information and the use of clinical data, the European Union and countries such as Finland have already proposed various modes of guaranteeing the free movement of personal information that simultaneously strengthen people’s personal rights. Similarly, Korea has initiated the MyData Service, although it faces several limitations. Therefore, this study reviews Korea’s current healthcare big data system, the laws governing data sharing and usage, and compares them with similar laws enacted by the European Union and Finland. It then provides future direction for Korea’s personal information protection legislation. Ultimately, governments must expand and elaborate upon the scope and content of personal information protection laws to enable the development of healthcare and other industries without sacrificing either personal information protection or clinical use of medical data.

Original Article

Health behaviors, knowledge, and attitudes toward cardiovascular disease risk factors in young Iraqi adults: a sample from Erbil, Iraq: Halmat Ahmed Sulaiman, Isil Isik Andsoy; Cardiovasc Prev Pharmacother. 2024;6(3):92-101. Published online July 30, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e12

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Abstract PDF: Background
Cardiovascular disease continues to be a leading cause of death among young people globally. This cross-sectional study was designed to assess the health behaviors, knowledge, and attitudes regarding cardiovascular disease risk factors among young adults in Erbil, Iraq.
Methods
Data were collected using the WHO STEPS Instrument for Chronic Disease Risk Factor Surveillance and the Heart Disease Fact Questions.
Results
Ninety percent of participants demonstrated moderate to high knowledge and exhibited a positive attitude. Multiple linear regression analysis revealed that while a history of smoking, a lack of knowledge, and the absence of formal education negatively impacted knowledge levels, being aged 38 to 45 years, recognizing the importance of consuming less salt, walking for at least 10 minutes on 5 or more days per week, and regularly checking blood sugar levels positively contributed to knowledge. Unwillingness to change lifestyle had the most significant negative influence on knowledge.
Conclusions
Establishing effective educational interventions may increase knowledge and promote more positive attitudes.

Review Articles

Recent evidence on target blood pressure in patients with hypertension: Hack-Lyoung Kim; Cardiovasc Prev Pharmacother. 2024;6(1):17-25. Published online January 22, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e3

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Abstract PDF: Hypertension is a significant risk factor for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral arterial disease. Achieving and maintaining a specific target blood pressure (BP) is crucial for effectively reducing the risk associated with these conditions. This involves customizing treatments to meet the individual needs of patients with hypertension, ensuring that each person receives the most appropriate care for their particular circumstances. Previously, based on the findings from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study conducted over the past decade, the target BP for patients with hypertension was set at <140/90 mmHg, regardless of the patient's risk profile. However, new insights from reanalyzed data of studies such as the SPRINT (Systolic Blood Pressure Intervention Trial), the STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) study, and ACCORD subgroup reanalysis have led to a change in this approach. These studies support a more aggressive target BP of <130/80 mmHg, especially for high-risk patients. The purpose of this article is to offer a thorough review of these updated recommendations and to explain the reasoning behind the revised target BP guidelines for individuals with hypertension.

Expectations and concerns regarding medical advertisements via large commercial medical platform advertising companies: a legal perspective: Raeun Kim, Hakyoung Park, Jiwon Shinn, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2024;6(2):48-56. Published online April 26, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e8

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Abstract PDF: Advertising in the medical and legal fields, which are among Korea's leading professions, has increasingly utilized major advertising platforms such as LawTalk and UNNI—two of the most prominent and contentious platforms in their respective fields. While it is generally unproblematic for professionals like lawyers and doctors to promote public interest through advertising on these commercial platforms, the creation of a profit-driven structure has the potential to undermine their professional ecosystems. This article explores the issues associated with advertising in the medical field through large commercial platforms, drawing on notable examples from the legal and medical fields in Korea. Specifically, we analyze two of the most popular yet controversial platforms in these sectors, LawTalk and UNNI. In Korea, the format and method of advertising are legal as long as they do not involve referring or soliciting clients, thereby making platform advertising lawful when used solely for that purpose. Nevertheless, it is crucial to prevent medical advertising platforms from establishing market monopolies by skirting various profit regulations and laws. In response to these concerns, the Korean Bar Association has prohibited all advertisements by platform companies. The medical community should closely examine the rationale and process behind this decision. Given the significant social influence of large corporate platforms and the unique social responsibilities of the medical and legal professions, future platform advertising should be subject to distinct legal and institutional regulations that differ from those applied to general services.

Original Article

Correlation between metformin intake and prostate cancer: Raeun Kim, Minsun Song, Jiwon Shinn, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2023;5(3):91-97. Published online July 31, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e12

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Abstract PDF: Background
The relationship between metformin intake and prostate cancer incidence remains unclear. Therefore, we examined the correlation between prostate cancer and metformin use.
Methods
The subjects were diabetes patients aged ≥50 years who had been diagnosed with prostate cancer and had undergone surgery at Seoul St. Mary's Hospital. Groups taking metformin (MET(+) group) and not taking metformin (MET(–) group) were divided and compared.
Results
The mean preoperative prostate-specific antigen (PSA) levels in the MET(–) and MET(+) groups were 10.7±11.9 and 8.0±5.6 ng/mL, respectively, with no statistically significant difference between the two groups (P=0.387). The average prostate volume of the MET(–) group was 82.4±98.0 mL, and the average prostate volume of the MET(+) group was 55.4±20.1 mL, but there was no statistically significant difference between the two groups (P=0.226). The mean PSA velocity also did not show a significant difference between the two groups (0.025±0.102 ng/mL vs. 0.005±0.012 ng/mL, P=0.221).
Conclusions
We did not identify a significant positive correlation between metformin and prostate cancer. However, preoperational PSA and PSA velocity tended to be lower in the MET(+) group. A sophisticated prospective study with a large sample size should be planned.

Review Articles

Re-evaluating the PCSK9 guidelines for low-density lipoprotein cholesterol targets: weighing the benefits against the risks: Terry Gbaa, John Bolodeoku; Cardiovasc Prev Pharmacother. 2024;6(3):85-91. Published online July 30, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e11

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Abstract PDF: Cardiovascular disease management has made significant progress with lipid-lowering interventions, primarily statin therapy. However, statins' side effects, combined with their variable efficacy, have sparked interest in alternative treatments, particularly proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies. These biologics, approved by the US Food and Drug Administration and the European Medicines Agency, have shown a significant impact on lipid levels, particularly low-density lipoprotein cholesterol (LDL-C), resulting in a 50% to 60% reduction. Despite the benefits of PCSK9 inhibitors, the guidelines for their use differ, with specific thresholds determining eligibility. The National Institute for Health and Care Excellence recommends starting PCSK9 therapy for patients with LDL-C levels above 3.5 mmol/L and lipid levels above 5.0 mmol/L who do not have cardiovascular disease. This rigid framework, while cost-effective, may exclude a subset of patients who do not meet these criteria despite having a high cardiovascular risk. The limited scope of these guidelines presents a challenge for specialists managing patients excluded as a result of LDL-C levels that fall just below the threshold but still show signs of significant cardiovascular risk. Recent audits revealed that a significant proportion of patients fall into this grey area, emphasizing the importance of re-evaluating LDL targets for PCSK9 inhibitor initiation. Biological variations, pharmacogenomics, and other factors all contribute to this challenge, highlighting the importance of personalized medicine.

Anti-inflammatory effects of colchicine on coronary artery disease: Hun-Jun Park; Cardiovasc Prev Pharmacother. 2022;4(1):7-12. Published online January 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e5

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Abstract PDF: Inflammation plays a crucial role in the pathophysiology of coronary artery disease (CAD). Several types of sterile inflammation are mediated through the nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome. Colchicine has recently been shown to effectively block NLRP3 inflammasome assembly in addition to several other actions on inflammatory cells. Recent evidence also points to favorable effects of colchicine in patients with CAD, including lower levels of inflammatory markers, coronary plaque stabilization, and more favorable cardiac recovery after injury. This review focuses on the role of colchicine in the process of atherosclerosis and discusses its potential as a therapeutic option for the prevention and treatment of CAD.

Original Article

Effects of physical activity on cardiovascular outcomes and mortality in Korean patients with diabetes: a nationwide population-based cohort study: Inha Jung, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(1):42-55. Published online January 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e3

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Abstract PDF Supplementary Material

Background
Since a sedentary lifestyle is considered a modifiable risk factor for cardiovascular disease (CVD), physical activity (PA) is recommended for type 2 diabetes mellitus (T2DM) patients to prevent CVD. We investigated the association between different levels of PA and the risk for CVD and all-cause mortality in patients with T2DM using nationwide data.
Methods
We examined health examination data and claims records of 2,745,637 participants with T2DM at baseline from the Korean National Health Insurance Service who underwent health examinations between 2009 and 2012. We excluded subjects with a history of myocardial infarction or stroke. Each participant was asked to report their weekly PA levels according to three categories: vigorous, moderate, and walking. The incidence of CVD and death was analyzed until 2017.
Results
The risk of CVD was lower in regular exercisers than in nonexercisers after adjusting for confounding variables. A dose-response trend was evident in the association between the degree of PA and CVD risk. All categories of PA were inversely associated with CVD risk and mortality. The reduction in CVD risk and all-cause mortality was more profound in patients aged ≥65 years.
Conclusions
Augmenting PA might have positive effects on the prevention of CVD and all-cause death, especially in the elderly. The benefits of PA were consistently observed in various subgroups regardless of the presence of chronic conditions. Therefore, clinicians should encourage elderly patients with T2DM to increase their daily PA.

Citations

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Incentivised physical activity intervention promoting daily steps among university employees in the workplace through a team-based competition
Ayazullah Safi, Sanjoy Deb, Adam Kelly, Matthew Cole, Natalie Walker, Mohammed Gulrez Zariwala
Frontiers in Public Health.2024;[Epub] CrossRef
Effect of physical activity on incident atrial fibrillation in individuals with varying duration of diabetes: a nationwide population study
JungMin Choi, So‑Ryoung Lee, Eue-Keun Choi, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Kyung‑Do Han, Seil Oh, Gregory Y. H. Lip
Cardiovascular Diabetology.2024;[Epub] CrossRef

Review Article

Adverse reactions to antiarrhythmic drugs: Ungjeong Do; Cardiovasc Prev Pharmacother. 2023;5(1):1-14. Published online January 16, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e1

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Abstract PDF: There are various types of adverse reactions to antiarrhythmic drugs (AADs). Proarrhythmia, which refers to an exacerbation of the preexisting arrhythmia or occurrence of a new arrhythmia, may occur under the therapeutic concentration of an AAD. Bradyarrhythmia is the most common type of proarrhythmia due to AADs, and prior myocardial infarction and old age are known risk factors. Atrial flutter with 1:1 atrioventricular conduction usually occurs during rhythm control of atrial fibrillation with class IC AADs. QT prolongation due to AADs, mainly class III AADs, elevates the risk of torsade de pointes by triggered activity due to early afterdepolarization. The addition of clinical factors that promote QT prolongation, such as hypokalemia, hypomagnesemia, female sex, and bradycardia, increases the risk of developing torsade de pointes. Proarrhythmic monomorphic ventricular tachycardia usually occurs as a result of slow conduction and disparity of refractoriness due to class IC AADs. In patients with preexisting left ventricular systolic dysfunction or structural heart disease, the risk of hypotension or cardiogenic shock caused by negative inotropic effects due to AADs should be considered. To prevent these major adverse reactions to AADs, we need to understand the electrophysiologic properties of AADs in detail. Furthermore, the risk of proarrhythmia could be heightened by interplay with clinical factors, such as electrolyte unbalances, heart rate, and hepatic/renal or myocardial dysfunction. Sufficient awareness about drug-drug interactions, which may affect the metabolism of AADs, will improve patient safety during the management of arrhythmia.

Original Article

Safety and efficacy of low-dose aspirin in patients with coronary artery spasm: long-term clinical follow-up: Byoung Geol Choi, Kyung-Hee Kim, Seung-Woon Rha; Cardiovasc Prev Pharmacother. 2022;4(1):26-33. Published online January 21, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e6

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Abstract PDF

Background
Aspirin is known to aggravate coronary artery spasm (CAS) regardless of the dose (100–325 mg/day). However, it is unclear whether low-dose aspirin (LDA; 100 mg) has deleterious impacts on the clinical course of CAS patients in the long-term. Thus, we investigated the impact of LDA on the long-term clinical outcomes of CAS patients.
Methods
A total of 5,697 consecutive patients without significant coronary artery disease who underwent an acetylcholine provocation test from November 2004 to May 2015 were enrolled. Of these patients, 3,072 CAS patients were enrolled in the study and divided into two groups based on whether they took LDA: the LDA group (n=338) and the non-LDA group (n=2,734). All CAS patients were prescribed anti-anginal medication as appropriate. To adjust for any potential confounders that could cause bias, a propensity score matching analysis was performed using a logistic regression model.
Results
After propensity score matching, two propensity-matched groups (524 pairs, 1,048 patients, C-statistic=0.827) were generated, and the baseline characteristics of the two groups were balanced. The two groups were showed no significant differences in any follow-up events, such as major adverse cardiac events and recurrent angina.
Conclusions
The main finding of the present study is that the use of LDA did not affect cardiovascular events up to 5 years in CAS patients. Therefore, the prescription of LDA in these patients should be individualized considering their clinical status.

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Long-term prognostic factors for cardiovascular events in patients with chest pain without diabetes mellitus nor significant coronary stenosis
Seung-Woon Rha, Kyuho Lee, Se Yeon Choi, Jae Kyeong Byun, Jinah Cha, Sujin Hyun, Woo Jin Ahn, Soohyung Park, Dong Oh Kang, Eun Jin Park, Cheol Ung Choi, Byoung Geol Choi
Heart and Vessels.2024; 39(5): 382. CrossRef

Review Article

Blood pressure control in hypertensive disorders of pregnancy: Helsi Rismiati, Hae-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(3):99-105. Published online July 29, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e16

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Abstract PDF

Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.

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Combined Effects of Methyldopa and Baicalein or Scutellaria baicalensis Roots Extract on Blood Pressure, Heart Rate, and Expression of Inflammatory and Vascular Disease-Related Factors in Spontaneously Hypertensive Pregnant Rats
Michał Szulc, Radosław Kujawski, Przemysław Ł. Mikołajczak, Anna Bogacz, Marlena Wolek, Aleksandra Górska, Kamila Czora-Poczwardowska, Marcin Ożarowski, Agnieszka Gryszczyńska, Justyna Baraniak, Małgorzata Kania-Dobrowolska, Artur Adamczak, Ewa Iwańczyk-S
Pharmaceuticals.2022; 15(11): 1342. CrossRef

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