OBJECTIVE: Antihypertensive medications increase osteoblasts differentiation and bone mineral formation. Osseointegration of dental implants depends on new bone formation and remodelling. Consequently, improved osseointegration may be speculated in patients receiving antihypertensive drugs. Aim - Asses the effect of antihypertensive medications on osseointegration of dental implants.
METHODS: Retrospective cohort study. All individuals (792) who received at least one dental implant during a 6-year period at a single medical centre. The cohort was divided into three groups: normotensive (74.8% - 593) patients (NT group), hypertensive (23.4% - 185) patients using antihypertensive medications (HTN +med group), and hypertensive patients not using (1.8% - 14) antihypertensive medications (HTN -med group). Interventions-Installation of dental implants by experienced oral and maxillofacial surgeons with or without bone augmentation. Main measures - Early implant failure (EIF) (≤12 months from loading) reflects lack of new bone formation or excessive bone turnover during osseointegration.
RESULTS: The study included 792 individuals, 14 in the HTN-med group, 185 in the HTN +med group and 593 in the NT group. At the patient level, the HTN -med group were most likely (P = .041) to experience EIF 28.60% (4/14 patients). Due to the small sample of the HTN -med group, an additional analysis was carried out excluding this group. EIF of 9.70% (18/185 patients) in the HTN +med group was significantly (P = .047) lower than the NT group 14.50% (86/593 patients). 2971 implants were inserted in all study groups, 71.4% (2123) in the NT group, 26.4% (784) in the HTN +med group and 2.2% (64) in the HTN -med group. Collectively, EIF was recorded for 114 (3.84%) implants. In the HTN -med group, EIF of 6.25% (4 implants), was significantly (P < .001) higher than the two other groups. The EIF rate of the HTN +med group was 2.29% (18 implants) which was significantly less than that of the NT group 4.33% (92 implants). Controlling modifying parameters, using antihypertensive medication yielded lower EIF with marginal significance (P = .059) and OR = 0.618.
CONCLUSIONS: Based on statistically significant lower EIF rate found in the HTN +med group, antihypertensive medications may decrease the EIF rate of dental implants.
CONCLUSIONS: Clinicians should be encouraged to treat hypertensive patients with implant-supported prostheses, provided patient compliance regarding medications intake is good.

BACKGROUND: The association between antihypertensive medication and schizophrenia has received increasing attention; however, evidence of the impact of antihypertensive medication on subsequent schizophrenia based on large-scale observational studies is limited. We aimed to compare the schizophrenia risk in large claims-based US and Korea cohort of patients with hypertension using angiotensin-converting enzyme (ACE) inhibitors versus those using angiotensin receptor blockers (ARBs) or thiazide diuretics.
METHODS: Adults aged 18 years who were newly diagnosed with hypertension and received ACE inhibitors, ARBs, or thiazide diuretics as first-line antihypertensive medications were included. The study population was sub-grouped based on age (> 45 years). The comparison groups were matched using a large-scale propensity score (PS)-matching algorithm. The primary endpoint was incidence of schizophrenia.
RESULTS: 5,907,522; 2,923,423; and 1,971,549 patients used ACE inhibitors, ARBs, and thiazide diuretics, respectively. After PS matching, the risk of schizophrenia was not significantly different among the groups (ACE inhibitor vs. ARB: summary hazard ratio [HR] 1.15 [95% confidence interval, CI, 0.99-1.33]; ACE inhibitor vs. thiazide diuretics: summary HR 0.91 [95% CI, 0.78-1.07]). In the older subgroup, there was no significant difference between ACE inhibitors and thiazide diuretics (summary HR, 0.91 [95% CI, 0.71-1.16]). The risk for schizophrenia was significantly higher in the ACE inhibitor group than in the ARB group (summary HR, 1.23 [95% CI, 1.05-1.43]).
CONCLUSIONS: The risk of schizophrenia was not significantly different between the ACE inhibitor vs. ARB and ACE inhibitor vs. thiazide diuretic groups. Further investigations are needed to determine the risk of schizophrenia associated with antihypertensive drugs, especially in people aged > 45 years.

UNASSIGNED: hypertension is prevalent among patients attending hemodialysis. However, published information on hypertension management among patients on hemodialysis in African countries is scarce. This study assessed antihypertensive medication prescribing patterns and blood pressure control among patients with hypertension on hemodialysis in Tanzania.
UNASSIGNED: an analytical cross-sectional study was conducted at Muhimbili National Hospital in Dar es Salaam from April to June 2022. The study population consisted of patients with hypertension undergoing hemodialysis. Data on demographic, clinical characteristics and the antihypertensive medications used by the patients was collected using a structured questionnaire. Analysis was performed using Statistical Package for the Social Sciences software version 26. Uncontrolled pre-dialysis blood pressure determinants were assessed using a modified Poisson regression model. A p-value < 0.05 was considered statistically significant.
UNASSIGNED: out of 314 participants, the majority (68.2%, n= 214) were male, and the median age was 52 (interquartile range: 42, 60) years. Only 16.9% (n= 53) of patients had their pre-dialysis blood pressure controlled. The most frequent antihypertensive medications prescribed were calcium channel blockers (73.2%, n= 230). Patients with less than three dialysis sessions were 20% more likely to have uncontrolled blood pressure than those with three sessions in a week (adjusted prevalence ratio = 1.2).
UNASSIGNED: most patients on hemodialysis with hypertension had poor blood pressure control, according to the study. Patients with hypertension should be strongly encouraged to adhere to at least three hemodialysis treatments to achieve optimal blood pressure control.

To determine whether antihypertensive medication (AHM) acting through the renin angiotensin system (RAS-AHM), compared with other AHM, can mitigate effects on cognitive function and risk for impairment in a population with type 2 diabetes mellitus (T2DM).
This secondary analysis of the randomized controlled Action for Health in Diabetes (Look AHEAD) study included 712 community-dwelling participants who were followed over 15 years. Logistic regression was used to relate RAS-AHM use to cognitive impairment, and linear regression was used to relate RAS-AHM use to domain-specific cognitive function after adjusting for potential confounders.
A total of 563 individuals reported RAS-AHM use and 149 reported other-AHM use during the study. RAS-AHM users have college or higher education (53%), had higher baseline glycated haemoglobin (57 mmol/mol), and reported higher diabetes medication use (86%), while other-AHM users were more likely to be White (72%), obese (25%) and to have cardiovascular history (19%). RAS-AHM use was not associated with a reduced risk of dementia compared with other-AHM use. We did observe better executive function (Trail Making Test, part B, P < 0.04), processing speed (Digit Symbol Substitution Test, P < 0.004), verbal memory (Rey Auditory Verbal Learning Test-delayed recall, P < 0.005), and composite score (P < 0.008) among RAS-AHM users compared with other-AHM users.
In this sample of adults with T2DM, free of dementia at baseline, we observed a slower decline in processing speed, executive function, verbal memory, and composite score among RAS-AHM users.

Abnormal blood pressure is a potential risk factor for glaucoma. However, the role of antihypertensive medications on glaucoma pathogenesis is controversial. This study aims to investigate the association between the use of antihypertensive medications and glaucoma onset.
This nested case-control study, based on a large-scale longitudinal cohort in Australia, retrieved participants\' claims records on drugs and Medicare services from national health databases. Participants with three or more claim records of anti-glaucoma medications from 2009 to 2016 were classified as glaucoma patients; those with none were classified as controls. Claim records of antihypertensive medications were identified within the 5 years before glaucoma onset and contemporary periods in matched controls without glaucoma. The association between the use of antihypertensive medications and glaucoma onset was assessed by multivariable logistic regression models.
A total of 6748 cases and 13 496 controls were analysed. Compared with controls, the proportion of users of antihypertensive medications was slightly higher in glaucoma patients (46.9% vs. 46.0%, p > 0.05). After adjustments for demographics, health-related factors and medical history, the association between the use of antihypertensive medications and glaucoma onset was nonsignificant (OR 0.95, 95% CI = 0.89-1.02). As for specific subtypes, only beta-blocking agents (BBA) (OR 0.82, 95% CI = 0.75-0.90) and diuretics (OR 0.85, 95% CI = 0.77-0.95) were significantly associated with reduced risks of glaucoma onset.
This study indicated that the use of antihypertensive medications was not associated with glaucoma onset. Decreased risks of glaucoma onset in users of BBA and diuretics require further validation.

The use of antihypertensive medications is critical for controlling high blood pressure. We aimed to investigate associations between socio-demographic factors and antihypertensive medications use, and antihypertensive medications use with different types of drugs use with levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP).
For the present report we derived data from the baseline measurements of a cluster randomised control trial on 307 participants with previously diagnosed hypertension from the rural district of Narial in Bangladesh. We measured the participant\'s current blood pressure levels and recorded antihypertensive medications uses. Associated factors included socio-economic status, diabetes, antihypertensive medications use, and types of drugs and doses used for controlling blood pressure. We applied analysis of variance and logistic regression techniques to identify factors associated with blood pressure.
Of the total participants, 144 (46.9%) were on antihypertensive medications. After multivariate adjustment, binary logistic regression revealed that employees (odds ratio, (95% confidence interval (CI)) (OR 3.58, 95%CI 1.38-9.28) compared to farmers, and people with diabetes (OR 2.43, 95%CI 1.13-5.26) compared to people without diabetes were associated with a higher proportion of antihypertensive medications use. Of 144 participants on antihypertensive medications, 7 (5%) had taken two doses, 114 (79%) had taken one dose per day and the rest were irregular in medication use. The mean (standard deviation) [min, max] SBP and DBP were 149 (19) mmHg [114, 217] and 90 (10) mmHg [75, 126], respectively. Overall, there was no significant difference in SBP (p = 0.10) or DBP (p = 0.67) between participants with or without antihypertensive medications or using any type of medications (p = 0.54 for SBP and 0.76 for DBP). There was no significant association between antihypertensive medications use and elevated BP levels SBP/DBP≥140/90 mmHg (p = 0.42) CONCLUSION: Less than half of the people with hypertension were on medication. Irrespective of the antihypertensive medications use, most of the participant\'s blood pressure was high. Further study is needed with a large sample to understand the factors and aetiology of unmanaged hypertension in rural areas of Bangladesh where the prevalence of hypertension is very high.

BACKGROUND: We aimed to identify associations between the risk of acute respiratory failure (ARF) and types of antihypertensive agents in patients with viral pneumonia.
METHODS: In this case-control study, data extracted from the Taiwan National Health Insurance Research Database were analysed. The base population comprised patients with viral pneumonia treated from 2000 to 2013. The case group comprised patients with ARF and the control group comprised participants without ARF. Adjusted odds ratios (ORs) were calculated using a multivariable logistic regression model.
RESULTS: In total, 4427 viral pneumonia patients with ARF and 4427 matched control participants without ARF were recruited. Patients with diabetes, alcohol-related disease, asthma, chronic kidney disease or end-stage renal disease, chronic obstructive pulmonary disease, cancer, congestive heart failure, stroke, acute pulmonary oedema and shock had increased odds of developing ARF, especially shock (adjusted OR = 49.3; 95% CI = 27.4, 88.7), cancer (12.6; 8.67, 18.2) and stroke (7.51; 5.32, 10.6). Increasing odds of developing ARF were noted in patients using potassium-sparing diuretics (2.95; 1.54, 5.64), loop diuretics (68.2; 48.1, 96.6), calcium channel blockers (1.64; 1.26, 2.13) and angiotensin-converting enzyme inhibitors (1.70; 1.15, 2.53). Patients with prescriptions of α-blockers (0.44; 0.26, 0.74), β-blockers (0.37; 0.26, 0.52), thiazides (0.38; 0.25, 0.59) and angiotensin receptor blockers (0.65; 0.51, 0.83) had lower odds of having ARF.
CONCLUSIONS: Patients with viral pneumonia who received α-blockers, β-blockers, thiazides or angiotensin receptor blockers during hospitalisation had a lower risk of developing ARF.

Observational studies suggest that the use of antihypertensive medications (AHMs) is associated with a reduced risk of Alzheimer\'s disease (AD); however, these findings may be biased by confounding and reverse causality. We aimed to explore the effects of blood pressure (BP) and lowering systolic BP (SBP) via the protein targets of different AHMs on AD through a two-sample Mendelian randomization (MR) approach.
Genetic proxies from genome-wide association studies of BP traits and BP-lowering variants in genes encoding AHM targets were extracted. Estimates were calculated by inverse-variance weighted method as the main model. MR Egger regression and leave-one-out analysis were performed to identify potential violations.
There was limited evidence that genetically predicted SBP/diastolic BP level affected AD risk based on 400/398 single nucleotide polymorphisms (SNPs), respectively (all P > 0.05). Suitable genetic variants for β-blockers (1 SNP), angiotensin receptor blockers (1 SNP), calcium channel blockers (CCBs, 45 SNPs), and thiazide diuretics (5 SNPs) were identified. Genetic proxies for CCB [odds ratio (OR) = 0.959, 95% confidence interval (CI) = 0.941-0.977, P = 3.92 × 10-6] and overall use of AHMs (OR = 0.961, 95% CI = 0.944-0.978, P = 5.74 × 10-6, SNPs = 52) were associated with a lower risk of AD. No notable heterogeneity and directional pleiotropy were identified (all P > 0.05). Additional analyses partly support these results. No single SNP was driving the observed effects.
This MR analysis found evidence that genetically determined lowering BP was associated with a lower risk of AD and CCB was identified as a promising strategy for AD prevention.

BACKGROUND: Hypertension is a chronic medical condition in which blood pressure in the arteries is elevated. Given the large proportion of dental implant patients using antihypertensive medications, it is crucial to evaluate the effects of these drugs on the clinical parameters of osseointegrated implants. The aim of the present retrospective cohort study was to evaluate the influence of antihypertensive medications on clinical peri-implant tissue parameters.
METHODS: Thirty-five patients received a total of 77 anodized dental implants. Based on the history of the use of antihypertensive medications, the patients were divided into two groups: the group taking antihypertensive medications (AH group) and the group of healthy patients (H group). Implants were followed up clinically and radiologically, with a focus on the peri-implant soft tissue parameters probing pocket depth, bleeding on probing, modified plaque index, and marginal peri-implant bone level stability.
RESULTS: None of the implants were lost, and no technical failures occurred. The mean follow-up duration was 7 years and 1 month. A significant difference was observed in the probing pocket depth 3.8 ± 1.3 mm in the AH group and 3.0 ± 0.7 mm in the H group. In the AH and H groups, 26.5% (9/34) and 4.7% (2/43) of the patients were diagnosed with peri-implantitis at the implant level, respectively.
CONCLUSIONS: Our findings suggest some correlations between antihypertensive medication use and clinical parameters in anodized peri-implant tissue.

BACKGROUND: Poor adherence to antihypertensives is associated with negative outcome of the disease as well as loss of health-care resources. Addressing the epidemic of poor adherence requires identifying factors associated with this behaviour. The aim of this study is to describe adherence to antihypertensive medication among Lebanese hypertensive patients and to evaluate the association between socio-economic, patient- and conditions-related factors and non-adherence.
METHODS: A cross-sectional study was carried out on adherence to antihypertensive medications covering all governorates of Lebanon. This study was conducted between February 2018 and January 2019 on a random sample of 1497 hypertensive patients. A face-to-face questionnaire was used to assess adherence to antihypertensive medication and its determinants according to the five World Health Organization (WHO) main categories. Logistic regression analysis was performed to test the adjusted association between the multiple exposure factors, and drug adherence data were collected by trained interviewers.
RESULTS: Adherence to antihypertensive medications was reported by 1253 (83.7%) of the patients. After multivariate analysis, patients who tried to control their stress level (OR = 0.77, 95% CI [0.38-0.95]), those who had normal BP readings (OR =0.49, 95% CI [0.18-0.97]), and those who believed in the effectiveness of their treatment (OR = 0.31, 95% CI [0.14-0.76]) had a significantly lower chance to exhibit non-adherence to their treatment. However, older patients (OR= 1.87, 95% CI [1.23-2.21]), divorced/separated patients (OR= 2.14, 95% CI [1.31-5.48]), married (OR=1.96, 95% CI [1.27-3.90]), widowed (OR=2.11, 95% CI [1.62-6.50]), obese patients (OR = 1.76, 95% CI [1.21-1.94]), and patients who smoked hookah and cigarettes (OR = 2.62, 95% CI [1.17-6.76]) were more likely to exhibit non-adherence.
CONCLUSIONS: Our study highlights the influence of factors such as old age, marital status, BMI and high level of emotional stress on non-adherence to medication in hypertensive patients. These determinants should be incorporated into adherence improving strategies.