Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Pearl Toh, 30 Jan 2018
Use of statins may not be neuroprotective, in contrast to findings from previous observational studies. On the contrary, fungus-derived or lipophilic statins appeared to be associated with a slightly increased risk of Alzheimer's disease (AD) compared with synthetic and hydrophilic statins, suggests a new study based on real-world clinical practice data.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Rachel Soon, 21 Feb 2018

MIMS Pharmacist sits down with pharmacist researcher Dr Mai Chun Wai to find out more about his work in drug discovery, including his investigations of Antarctic soil microorganisms.

Intensive BP control recommended for Asian patients at high CV risk

12 Jun 2018

Intensive blood pressure (BP) control is recommended for Asian patients with hypertension and increased cardiovascular (CV) risk, such as those with comorbid type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD) or atrial fibrillation (AF), according to a recently published consensus document.

The consensus document on improving hypertension management in Asian patients was developed by experts from China, Japan, South Korea and Taiwan in view of the significant ethnic differences in determinants of hypertension and hypertension-related demographics of CV disease (CVD) between Asian and Western populations. [Hypertension 2018;71:375-382]

“Stroke, especially haemorrhagic stroke, and nonischaemic heart failure are common outcomes of hypertension-related CVD in Asia. The association between BP and CVD is stronger in Asia than in the West. Higher salt sensitivity, even with mild obesity and higher salt intake, is an Asian characteristic of hypertension,” the experts noted.

For Asian hypertensive patients with T2DM, the experts suggested a BP goal of <130/80 mm Hg. For those with CKD, intensive BP control is recommended, along with more intensive out-of-office BP monitoring and comprehensive CV evaluation. In those with AF receiving anticoagulant therapy, a target systolic BP of <130 mm Hg can be considered.

For elderly patients, the experts recommended a BP target of <140/90 mm Hg, to be achieved with calcium channel blockers (CCBs), renin-angiotensin system (RAS) blockers and diuretics.

Highlighting the importance of strict 24-hour BP control in Asian patients, the experts recommended a home BP-guided approach as the first practical step. “The use of a long-acting and potent CCB and RAS inhibitor, with or without a diuretic, is preferable,” they noted.

In addition, out-of-office BP measurement is recommended to detect white-coat hypertension, while accurate detection and management of masked or masked uncontrolled hypertension is also important. “The initial focus should be on morning BP, then nocturnal BP, in Asian populations,” the experts advised.

“Morning BP surge confers CV risk independent of 24-hour ambulatory BP. Morning BP control can and should be improved with the use of long-acting antihypertensives in appropriate, often full, dosages and in proper combinations,” they added.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacist - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Pearl Toh, 30 Jan 2018
Use of statins may not be neuroprotective, in contrast to findings from previous observational studies. On the contrary, fungus-derived or lipophilic statins appeared to be associated with a slightly increased risk of Alzheimer's disease (AD) compared with synthetic and hydrophilic statins, suggests a new study based on real-world clinical practice data.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Rachel Soon, 21 Feb 2018

MIMS Pharmacist sits down with pharmacist researcher Dr Mai Chun Wai to find out more about his work in drug discovery, including his investigations of Antarctic soil microorganisms.