Main Article Content
Abstract
The purpose of our study was to perform a combined analysis of prospective study of diuretics to evaluate the safety and efficacy of the diuretics prescribed in our study. To understand the mechanism of diuretic drugs and statin, to evaluate the use of diuretics, to find the best diuretic drug according to the clinical indications and to formulate future treatment guidelines and protocol.
METHOD: 120 cases were collected, and the data collection form will be prepared and used. This form mainly contains the demographic details of the patients and medication chart. All information relevant to the study was collected from outpatient as well as inpatient department from the time of admission till the date of discharge after taking consent from patient.
RESULT: A total of 120 cases of cardiovascular diseases were observed. Majority of the cases were males (73%) compared to females (27%). Most of them were between the age group of 41-50 years (27%). Hypertension (85%), coronary artery disease (81%) and Diabetes Mellitus (DM) (76%) were the most common comorbidities. Our analysis shows that (20%) are vegetarian and (80%) are non-vegetarian. Analyzing the patient report, it was noticed that Aspirin (92%), Metoprolol (89%), Atorvastatin (85%), Cilnidipine (83%), and Clopidogrel (80%) were the most widely prescribed medications whereas the most widely prescribed Diuretic was Hydrochlorothiazide (60%), Furosemide (45%), and Spironolactone (25%).
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References
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- 23. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee to Review the Dietary Reference Intakes for Sodium and Potassium. Oria M, Harrison M, Stallings VA, editors. Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar 5. The National Academies Collection: Reports funded by National Institutes of Health. PMID: 30844154 Bookshelf ID: NBK538102 DOI: 10.17226/25353.
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- 25. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid.
- 26. Rehman I, Rehman A. Anatomy, Thorax, Heart. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470256/
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References
1. Roth GA, Johnson C, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol. 2017 Jul 4;70(1):1-25. Doi: 10.1016/j.jacc.2017.04.052. Epub 2017 May 17. PMID: 28527533; PMCID: PMC5491406.
2. Benjamin EJ, Muntner P, et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation. 2019 Jan 31;139:e56-e528. doi:10.1161/CIR.0000000000000659
3. . Roth GA, Mensah GA, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020 Dec 22;76(25):2982-3021. doi:10.1016/j.jacc.2020.11.010.
4. Cooper HA, Dries DL, Davis CE, Shen YL, Domanski MJ. Diuretics and risk of arrhythmic death in patients with left ventricular dysfunction. Circulation. 1999 Sep 21;100(12):1311-5. doi:10.1161/01.CIR.100.12.1311
5. Boger-Megiddo I, Heckbert SR, Weiss NS, McKnight B. Myocardial infarction and stroke associated with diuretic based two drug antihypertensive regimens: population based case-control study. BMJ. 2010;340:c103. doi:10.1136/bmj.c103. PMID: 20100777; PMCID: PMC2811239.
6. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999 Oct 7;341(15):1097- 105. DOI: 10.1056/NEJM199910073411501. PMID: 10511607.
7. Patel AV, Hildebrand JS, Gapstur SM. Body Mass Index and All-Cause Mortality in a Large Prospective Cohort of White and Black U.S. Adults. PLoS One. 2014 Oct 8;9(10):e109153. DOI: 10.1371/journal.pone.0109153.
8. Hjartåker A, Adami HO, Lund E, et al. Body Mass Index and Mortality in a Prospectively Studied Cohort of Scandinavian Women: The Women’s Lifestyle and Health Cohort Study. Eur J Epidemiol. 2005;20:747–754. DOI: 10.1007/s10654-005- 2145-x.
9. Hypertension [Image on the Internet]. 2024 [cited 2024 Jan 21]. Available from: https://nurseslabs.com/hypertension
10. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med. 2013 May 23;368(21):2004-13. doi: 10.1056/NEJMra1216063. PMID: 23697515.
11. Hemphill JC., et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015 Jul;46(7):2032-60. doi: 10.1161/STR.0000000000000069. Epub 2015 May 28.
12. Shafiya B, Madani M, Hassan M. Nephrolithiasis: An update on current concepts. IAJPS. 2019; 06(11): 14073-14087. DOI:10.5281/zenodo.3526876
13. Wright JT Jr, Bakris G, Greene T, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002 Nov 20;288(19):2421-31. doi: 10.1001/jama.288.19.2421.
14. National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management. NICE Guideline, No. 136. London: National Institute for Health and Care Excellence; 2023 Nov 21. ISBN-13: 978-1-4731-5589- 3.
15. Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med. 2011 Mar 3;364(9):797-805. doi: 10.1056/NEJMoa1005419.
16. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999 Sep 2;341(10):709-17. doi: 10.1056/NEJM199909023411001.
17. Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, Bittman R, Hurley S, Kleiman J, Gatlin M, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003 Apr 3;348(14):1309-21. doi: 10.1056/NEJMoa030207. Epub 2003 Mar 31.
18. Physical Activity [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity
19. Health Diet [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
20. Routine Screenings [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/routine- screenings
21. Tobacco [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco
22. Mastering Sleep Hygiene: Your path to quality Sleep [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.sleepfoundation.org/sleep-hygiene
23. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee to Review the Dietary Reference Intakes for Sodium and Potassium. Oria M, Harrison M, Stallings VA, editors. Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar 5. The National Academies Collection: Reports funded by National Institutes of Health. PMID: 30844154 Bookshelf ID: NBK538102 DOI: 10.17226/25353.
24. Freis ED. Veterans Administration Cooperative Study Group on Hypertensive Agents: effects of age on treatment results. Am J Med. 1991 Mar;90(3A):20S-23S. doi: 10.1016/0002-9343(91)90431-v. PMID: 2006655.
25. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid.
26. Rehman I, Rehman A. Anatomy, Thorax, Heart. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470256/
27. Heart [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://my.clevelandclinic.org/health/body/21704-heart
28. Anatomy of the Heart [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.physio-pedia.com/Anatomy_of_the_Human_Heart
29. Atria of the Heart [Internet]. 2024 [cited 2024 Jan 21]. Available from: https://www.kenhub.com/en/library/anatomy/the-atria-of-the-heart