Frontiers in Clinical Drug Research - Hematology: Volume 2

Atta-ur-Rahman

• Publisher: Bentham Science Publishers
• Year: 2016
• ISBN:
  9781681081816
• Topic: Physical Sciences
• Subtopic: Clinical Chemistry

Frontiers in Clinical Drug Research – Hematology is an eBook series that brings updated reviews to readers interested in learning about advances in the development of pharmaceutical agents for the treatment of hematological disorders. The scope of the eBook series covers a range of topics including the medicinal chemistry, pharmacology, molecular biology and biochemistry of natural and synthetic drugs employed in the treatment of anemias, coagulopathies, vascular diseases and hematological malignancies. Reviews in this series also include research on specific antibody targets, therapeutic methods, genetic hemoglobinopathies and pre-clinical / clinical findings on novel pharmaceutical agents. Frontiers in Clinical Drug Research – Hematology is a valuable resource for pharmaceutical scientists and postgraduate students seeking updated and critically important information for developing clinical trials and devising research plans in the field of hematology, oncology and vascular pharmacology.
The second volume of this series features 5 chapters that cover a variety of topics including:
-Chronic myeloid leukemia
-Bispecific and multivalent antibodies
-Natural Killer cells therapy for bone marrow transplantation
-Nanoparticles in health and disease
-Monoclonal antibody therapy for lymphoma

Herbal Pharmacotherapy of Hypertension

INTRODUCTION

Cardiovascular disease (CVD) is the leading cause of mortality worldwide and hypertension remains the most common cardiovascular disease and a major public health issue in both developed and developing countries [1].

Hypertension, according to the National High Blood Pressure Education Program (NHBPEP) [2], is defined as systolic blood pressure (SBP) equal or greater than 140 mmHg and diastolic blood pressure (DBP) as equal or more than 90 mmHg, taking antihypertensive medication, or being told twice by a physician or other professional that one has hypertension. It is also defined as a condition in which the arterial blood pressure is chronically elevated. Hypertension is considered an independent, useful and powerful prognostic indicator for cardiovascular and renal disease, whereas it is significantly associated with the increased morbidity and mortality from cerebrovascular disease, myocardial infarction, congestive heart failure and renal insufficiency [3]. Hypertension remains a major risk factor for chronic renal failure, cardiovascular disease and stroke and prevention is crucial in reducing the risk of the appearance of these complications [4].

EPIDEMIOLOGY OF HYPERTENSION

Cardiovascular disease including hypertension is the leading non-communicable disease affecting both sexes and occurring more at much younger age-group and is now regarded as the leading contributory cause of death worldwide [5]. Hypertension contributes to about 57% of all deaths from strokes and 24% of all deaths from coronary artery disease [1]. Recent World Health Statistics (2012) [6] showed that among about 57 million global deaths in 2008, 36 million (63%) deaths were due to non-communicable diseases (NDCs) with the largest proportion (48%) attributed to cardiovascular disease. In terms of attributable deaths, hypertension is one of the leading behavioral and physiological risk factors to which 13% of global deaths are attributed. Indeed, hypertension is reported to be the fourth contributor to premature death in developed countries and the seventh in developing countries [1].

On a global perspective, approximately 20%-30% of the world’s adult population is estimated to be hypertensive, when hypertension is defined as blood pressure in excess of 140/90 mmHg [7]. This figure increases exponentially in population older than 60 years. In many countries, 50% of individuals in this age-group have hypertension. Overall, approximately 1 billion of the adult world’s population suffered from hypertension in the year 2000 and this figure is expected to rise to 1.56 billion by 2025, and contributing to more than 7.1 million deaths annually [8]. National health surveys in various countries have shown a high prevalence of poor control of hypertension [9]. Thus, the prevalence of hypertension is 22% in Canada, of which only 16% is well controlled; 26.3% in Egypt, of which 8% is controlled; and 13.6% in China, of which only 3% is well controlled [9]. However, a progressive rise in blood pressure with increasing age has been reported. Age-related hypertension appears to be predominantly systolic rather than diastolic. The SBP rises into the eighth or ninth decade, whereas the DBP remains constant or declines after the age 40 years [10].

Arterial hypertension prevalence rates vary significantly from country to country, presenting prevalence values of 44% in Europe, 28% in the USA and 50% in Greece [11, 12]. Today, while the mean blood pressure has been reported to have decreased in nearly all high-income countries, it has been increasing in most African and some European countries, apparently due to adoption of western lifestyles. Indeed, the prevalence of hypertension in 2008 was highest in the WHO African Region at 36.8% (range: 34.0-39.7%) [13].

In 1991, NHBPEP estimated 43.3 million adults in the USA to be suffering from hypertension [14]. According to statistical data from the National Health Examination Surveys (NHANES), the age-adjusted prevalence of hypertension in the USA varies from 18-32% with about 79% of the affected patient engaged in hypertension treatment [15]. Similarly, a 2005 NHANES report in USA found that in the population aged 20 years or older, an estimated 41.9 million men and 27.8 million women had prehypertension (SBP, 120-139 mmHg; DBP, 80-99 mmHg), 12.8 million men and 12.2 million women had stage 1 hypertension (SBP, 140-159 mmHg; DBP, 90-99 mmHg), and 4.1 million men and 6.9 women had stage 2 hypertension (SBP ≥ 160 mmHg; DBP ≥ 100 mmHg) [15]. Another NHANES survey reported that the prevalence of hypertension grows significantly with increasing age in all sex race groups [16]. The age-specific prevalence was 3.3% in white men (aged 18- 29 years); this rate increased to 13.2% in the group aged 30-39 years. The prevalence further increased to 22% in the group aged 40-49 years, to 37.5% in the age-group 50-59 years and to 51% in the age-group 60-74 years [16]. In a related study, the incidence of hypertension increases approximately 5% for each 10-year age interval.

According to the recent statistical data emanating from the American Heart Association, about 77.9 million (1 out of every 3) adults have hypertension in USA [17]. It is projected that by 2030, the prevalence of hypertension will increase 7.2% from 2013 estimate. It was further reported that a higher percentage of men than women have high blood pressure until age 45. From ages 45-54 and 55-64 years, the percentage of men and women is similar; after that a much higher percentage of women than men have high blood pressure. Hypertension was listed on death certificates as the primary cause of death of 61,762 Americans in 2009; hypertension was listed as a primary or contributing cause of death in about 348,102 of 2.4 million deaths in the USA in 2009; high blood pressure mortality was 44.8% in men and 55.2% of death in women. Thus, the overall death rate from high blood pressure was 18.5 per 100,000 and the death rates were 17.0 for white males, 14.4 for white female, 51.6 for black males, and 38.3 for black females. It was also reported that in 2009 alone, the direct and indirect c...