RESUMO
Preeclampsia (PE) is a hypertensive pregnancy syndrome associated with target organ damage and increased cardiovascular risks, necessitating antihypertensive therapy. However, approximately 40% of patients are nonresponsive to treatment, which results in worse clinical outcomes. This study aimed to compare circulating proteomic profiles and identify differentially expressed proteins among 10 responsive (R-PE), 10 nonresponsive (NR-PE) patients, and 10 healthy pregnant controls (HP). We also explored correlations between these proteins and clinical data. Plasma protein relative quantification was performed using mass spectrometry, followed by bioinformatics analyses with the UniProt database, PatternLab for Proteomics 4.0, and MetaboAnalyst software (version 6.0). Considering a fold change of 1.5, four proteins were differentially expressed between NR-PE and R-PE: one upregulated (fibronectin) and three downregulated (pregnancy-specific beta-1-glycoprotein 1, complement C4B, and complement C4A). Between NR-PE and HP, six proteins were differentially expressed: two upregulated (clusterin and plasmin heavy chain A) and four downregulated (apolipoprotein L1, heparin cofactor II, complement C4B, and haptoglobin-related protein). Three proteins were differentially expressed between R-PE and HP: one downregulated (transthyretin) and two upregulated (apolipoprotein C1 and hemoglobin subunit beta). These findings suggest a complex interplay of these proteins involved in inflammatory, immune, and metabolic processes with antihypertensive therapy responsiveness and PE pathophysiology.
Assuntos
Anti-Hipertensivos , Pré-Eclâmpsia , Proteômica , Humanos , Feminino , Gravidez , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/metabolismo , Pré-Eclâmpsia/tratamento farmacológico , Anti-Hipertensivos/uso terapêutico , Anti-Hipertensivos/farmacologia , Adulto , Proteômica/métodos , Proteoma/metabolismo , Biomarcadores/sangue , Biologia Computacional/métodos , Estudos de Casos e ControlesRESUMO
The medical social significance of the arterial hypertension (AH) in the world is determined by its high prevalence, which allows to call it a non-infectious pandemic of today. The AH still remains the most common chronic disease that triggers the cardiovascular continuum, significantly reduces the body's adaptive capacity, worsens the living standards for people of socially minded age, and represents the leading global risk of increased cardiovascular mortality. The purpose of the study was comparison of informative value of various methods for measuring the arterial blood pressure (ABP) (office-based, home-based using electronic apps, and daily) in order to improve the risk assessment of the condition and monitoring the treatment efficiency for the AH patients. The method of qualitative and quantitative analysis of scientific literature and public online sources was used in the study. It has been established that the ABP analysis is an important tool to prevent the negative consequences of the AH. The results of the experimental study have revealed that hourly home-based ABP monitoring using a mobile electronic app is more informative than monitoring at long intervals, and provides information which is close to the average daily indicators obtained in the daily ABP monitoring.
Assuntos
Humanos , Estudos de Avaliação como Assunto/prevenção & controle , Estudos de Avaliação como Assunto/prevenção & controle , Doença Crônica/mortalidade , Ensaio Clínico , Resultado do Tratamento , Monitorização Ambulatorial da Pressão Arterial/métodos , Hipertensão/prevenção & controle , Hipertensão/terapiaAssuntos
Hipertensão/tratamento farmacológico , Proteinúria/prevenção & controle , Insuficiência Renal Crônica/tratamento farmacológico , Negro ou Afro-Americano/etnologia , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Comorbidade , Quimioterapia Combinada , Taxa de Filtração Glomerular/efeitos dos fármacos , Taxa de Filtração Glomerular/fisiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipertensão Maligna/complicações , Hipertensão Maligna/epidemiologia , Guias de Prática Clínica como Assunto/normas , Prevalência , Proteinúria/tratamento farmacológico , Proteinúria/epidemiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
HIV-positive adults with hypertension have increased risk of mortality but HIV clinics often do not provide hypertension care. The authors integrated hypertension management into existing HIV services at a large clinic in Haiti. Of 1729 documented HIV-positive adults presenting for care at the GHESKIO HIV clinic between March and July 2016, 551 screened positive for hypertension, with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. A convenience sample of 100 patients from this group received integrated hypertension and HIV care for 6 months. At time of identification, patients were screened for proteinuria and initiated on antihypertensive medication. Hypertension and HIV visits coincided; medications were free. Outcomes were retention in care and change in blood pressure over 6 months. Average blood pressure over 6 months was described using linear mixed-effects model. Of 100 HIV-positive adults with hypertension referred for integrated care, three were ineligible due to comorbidities. Among 97 participants, 82% (N = 80) remained in care at 6 months from time of positive hypertension identification. 96% (N = 93) were on antiretroviral therapy with median CD4+ count of 442 cells/µL (IQR 257-640). Estimated average blood pressure over 6 months decreased from systolic 160 mmHg (CI 156, 165) to 146 mmHg (CI 141, 150), P-value <0.0001, and diastolic 105 mmHg (CI 102, 108) to 93 mmHg (CI 89, 96), P-value <0.0001. HIV and hypertension management were successfully integrated at a HIV clinic in Haiti. Integrated management is essential to combat the growing burden of cardiovascular disease among HIV-positive adults.
Assuntos
Instituições de Assistência Ambulatorial/tendências , Prestação Integrada de Cuidados de Saúde/métodos , Infecções por HIV/tratamento farmacológico , Hipertensão/tratamento farmacológico , Adulto , Antirretrovirais/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/métodos , Diástole/efeitos dos fármacos , Diástole/fisiologia , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Haiti/epidemiologia , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sístole/efeitos dos fármacos , Sístole/fisiologiaRESUMO
Hypertension is a leading cause of cardiovascular mortality, but only about half of patients on antihypertensive therapy achieve blood pressure control. Preeclampsia is defined as pregnancy-induced hypertension and proteinuria, and is associated with increased maternal and perinatal mortality and morbidity. Similarly, a large number of patients with preeclampsia are non-responsive to antihypertensive therapy. Pharmacogenomics may help to guide the personalized treatment for non-responsive hypertensive patients. There is evidence for the association of genetic variants with variable response to the most commonly used antihypertensive drugs. However, further replication is needed to confirm these associations in different populations. The failure to replicate findings from single-locus association studies has prompted the search for novel statistical methods for data analysis, which are required to detect the complex effects from multiple genes to drug response phenotypes. Notably, gene-gene interaction analyses have been applied to pharmacogenetic studies, including antihypertensive drug response. In this perspective article, we present advances of considering the interactions among genetic polymorphisms of different candidate genes within pathways relevant to antihypertensive drug response, and we highlight recent findings related to gene-gene interactions on pharmacogenetics of hypertension and preeclampsia. Finally, we discuss the future directions that are needed to unravel additional genes and variants involved in the responsiveness to antihypertensive drugs.
RESUMO
Pre-eclampsia (PE) is defined as pregnancy-induced hypertension and proteinuria, and is a major cause of maternal and perinatal morbidity and mortality. A large subgroup of pregnant women with PE is nonresponsive to antihypertensive drugs, including methyldopa, nifedipine and hydralazine. Pharmacogenomics may help to guide the individualized therapy for this nonresponsive subgroup. However, just a few pharmacogenetic studies examined the effects of genetic polymorphisms on response to antihypertensive drugs in PE, and the criteria of responsiveness used to define responsive or nonresponsive subgroups to antihypertensive therapy should be replicated by others. We review these gene-drugs interactions, novel approaches to pharmacogenomics research and potential novel drugs for PE therapy. Finally, we discuss the challenges and perspectives of pharmacogenetics in the treatment of PE.
Assuntos
Anti-Hipertensivos/uso terapêutico , Testes Farmacogenômicos , Variantes Farmacogenômicos , Pré-Eclâmpsia/tratamento farmacológico , Pré-Eclâmpsia/genética , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/farmacocinética , Feminino , Humanos , Medicina de Precisão , GravidezRESUMO
JUSTIFICATIVA E OBJETIVOS: A hipertensão arterial (HA) é uma disfunção crônica com alta prevalência entre a população brasileira e mundial. A resposta terapêutica depende, na maioria dos casos, de politerapia o que propicia interações que podem impedir os benefícios do tratamento ou ainda causar sérios riscos à saúde dos pacientes. O objetivo deste estudo foi apresentar dados epidemiológicos descritivos acerca das interações medicamentosas presentes em prescrições, no sentido de apontar os potenciais riscos à saúde dos pacientes atendidos em centro médico público em uma cidade do interior do Estado de São Paulo. MÉTODO: Foi avaliada a população (600 pacientes de ambos os gêneros) que recebeu prescrições com, no mínimo, um medicamento anti-hipertensivo, tendo sido adquiridos na farmácia comunitária do Centro Médico "Januário Theodoro de Souza", Pradópolis, SP, entre fevereiro e março de 2009. RESULTADOS: Do total das prescrições, apenas 16,30% se baseou na monoterapia. Ao todo, foram prescritos 1855 medicamentos, ou seja, três medicamentos/paciente, não necessariamente fármacos anti-hipertensivos. Verificou-se 1440 interações, sendo 192 tipos diferentes, com média de 2,4 interações/paciente. Dos fármacos não anti-hipertensivos, os mais prescritos foram ácido acetilsalicílico (24,5%) e dipirona (14,0%). A maioria dos hipertensos foi submetida à politerapia e, portanto, frequentemente expostos às interações, principalmente com anti-inflamatórios não esteroides, o que, dentre outros efeitos adversos, corroboram para o aumento da pressão arterial. CONCLUSÃO: A politerapia anti-hipertensiva, inerente à prescrição, tem potencial para acarretar prejuízos à eficácia e segurança terapêutica (incluindo falta de adesão ao tratamento), devido às elevadas possibilidades de interações negativas.
BACKGROUND AND OBJECTIVES: Hypertension is a chronic disorder with high prevalence among the Brazilian and worldwide population. The therapeutic response depends, in most cases, on the polytherapy, which provides interactions that may avoid the benefits of treatment or cause serious health risks to patients. The aim of this study was to present descriptive epidemiological data about drug interactions in the prescriptions, in order to point out potential risks to the health of patients treated in a Public Medical Center in a cityin the São Paulo state. METHOD: It was evaluated the population (600 patients of both genders) who received prescriptions containing, at least one, antihypertensive medication, which were acquired in the community pharmacy of the Medical Center "Januário Theodoro de Souza," Pradópolis, SP, between February and March/2009. RESULTS: Of the total prescriptions, only 16.3% were based on monotherapy. A total of 1855 drug prescriptions were recorded considering antihypertensive and other drugs, an average of three drugs per patient. There were 1440 drug interactions of 192 different types, with an average of 2.4 interactions per patient. Considering the non-antihypertensive drugs the most prescribed were acetylsalicylic acid (24.5%) and dipyrone (14.0%). Most hypertensive patients underwent polytherapy and therefore were frequently exposed to interactions, particularlyof antihypertensive with steroidal anti-inflammatory drugs, which, amongst other adverse effects, corroborate to increase blood pressure. CONCLUSION: The antihypertensive polytherapy, inherent in the prescription for treating this disorder, is potentially harmful to the efficacy and safety (including lack of adherence to treatment), due to high chances of negative interactions.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Anti-Hipertensivos , Interações Medicamentosas , Uso de Medicamentos , HipertensãoRESUMO
Investigou-se o perfil de 80 pacientes diabéticos tipo 2 (PDT2), constituído de homens (45%) e mulheres (55%) com média de idade de 62,8 ± 8,5 anos, usuários de insulina NPH fornecida pela Secretaria Municipal de Saúde de Maringá, PR, Brasil. Obteve-se informações por meio de um questionário e pela medida do índice de massa corporal (IMC). Verificou-se que: 1) 72% apresentavam obesidade ou sobrepeso; 2) 67,5% utilizavam antihipertensivos dos quais os inibidores da enzima conversora (ECA) e os bloqueadores dos receptores de angiotensina (BRA) representavam 84%; 3) O IMC foi similar em PDT2 usuários ou não de agentes antihipertensivos; 4) 46% além da insulina utilizavam antidiabéticos orais; 5) a dose de insulina (unidades. kg-1. dia-1) foi inferior (p< 0,05) em usuários de antihipertensivos, sugerindo existir uma correlação entre terapia antihipertensiva e o uso de menores doses de insulina. Este efeito ocorreria de maneira independente do IMC ou da simultânea a terapia com antidiabéticos orais.
The profile of 80 type-2 diabetic patients (T2DP), male (45%) and female (55%), with mean age 62.8 ± 8.5 years old, receiving NPH insulin from the municipal health department of Maringa city, PR, Brazil, was investigated. Information about each volunteer was obtained using a questionnaire and an evaluation of body mass index (BMI). It was verified that: 1) 72% showed obesity or overweight; 2) 67.5% used antihypertensive drugs in which angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) were the main antihypertensive drugs (84%); 3) The BMI was similar in the T2DP with hypertension or without hypertension; 4) 46%, in addition to insulin therapy, also used antidiabetic drugs; 5) The daily dose of insulin (units. kg-1. day-1) in the group which received antihypertensive therapy was lower (p< 0.05), suggesting the presence of a relationship between antihypertensive treatment and lower doses of insulin. In addition, this relationship would occur independently of the influence of BMI or the simultaneous treatment with oral antidiabetic drugs.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus , Hipertensão , Insulina/administração & dosagem , Insulina/uso terapêutico , Antidepressivos/uso terapêuticoRESUMO
OBJECTIVE: Blood pressure(BP) and target organ responses to antihypertensive drugs are not well established in hypertensive obese patients. This study is aimed at evaluating the effects of obesity and adiposity distribution patterns on these responses. METHODS: 49 hypertensive obese women were designated to different groups according to waist to hip ratio measurements - 37 with troncular and 12 with peripheral obesity. Patients were treated for 24-weeks on a stepwise regimen with cilazapril alone or a cilazapril/hydrochlorothiazide/amlodipine combination therapy to achieve a BP lower than 140/90mmHg. Ambulatory blood pressure monitoring (ABPM), echocardiography, and albuminuria were assessed before and after the intervention. RESULTS: After 24 weeks, weight loss was less than 2 percent in both groups. ABPM targets were achieved in 81.5 percent of patients upon a combination of 2(26.5 percent) or 3(55.1 percent) drugs. Similar reductions in daytime-SBP/DBP: -22.5/-14.1(troncular obesity) / -23.6/-14.9mmHg (peripheral obesity) were obtained. Decrease in nocturnal-SBP was greater in troncular obesity patients. Upon BP control, microalbuminuria was markedly decreased, while only slight decrease in left ventricular mass was observed for both groups. CONCLUSIONS: In the absence of weight loss, most patients required combined antihypertensive therapy to control their BP, regardless of their body fat distribution pattern. Optimal target BP and normal albuminuria were achieved in the group as a whole and in both obese patient groups, while benefits to cardiac structure were of a smaller magnitude.
As respostas pressórica e de órgãos-alvo mediante o tratamento anti-hipertensivo medicamentoso, não estão bem estabelecidas em pacientes obesos hipertensos. O presente estudo tem por objetivo avaliar as repercussões da obesidade e da distribuição de gordura corporal sobre estas respostas. MÉTODOS: Foram avaliadas 49 mulheres obesas hipertensas, separadas em subgrupos com distribuição troncular (n = 37) e periférica (n = 12) de gordura, de acordo com a distribuição cintura/quadril. As pacientes foram tratadas por 24 semanas com um regime anti-hipertensivo escalonado, iniciando-se com cilazapril e adicionando-se na seqüência, hidroclortiazida e amlodipina, com alvo pressórico inferior a 140 x 90 mmHg. Foram realizados MAPA, ecocardiograma e microalbuminuria antes e após o tratamento. RESULTADOS: Depois de 24 semanas observou-se perda de peso inferior a 2 por cento em ambos os subgrupos. O controle pressórico à MAPA pode ser observado em 81,5 por cento das pacientes mediante a combinação de duas (26,5 por cento) ou três (55,1 por cento) drogas. Foram obtidas reduções similares nas medidas de PAS/PAD diurnas: -22,5/-14,1(obesas tronculares)/-23,6/-14,9 mmHg (obesas periféricas), enquanto se observou nas obesas tronculares redução maior na PAS noturna. Mediante o controle pressórico, houve redução acentuada da microalbuminúria nos dois subgrupos. Por outro lado, observou-se em ambos, apenas discreta redução na massa ventricular. CONCLUSÕES: Na ausência de perda significativa de peso, e independentemente da distribuição de gordura corporal, a maioria das pacientes obesas necessitou terapia anti-hipertensiva combinada a fim de obter controle pressórico. Em ambos os subgrupos foram alcançados níveis adequados de pressão arterial e redução satisfatória da microalbuminúria, ao passo que os benefícios para a regressão estrutural cardíaca foram menores.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Anti-Hipertensivos/uso terapêutico , Monitorização Ambulatorial da Pressão Arterial , Distribuição da Gordura Corporal , Pressão Sanguínea/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Obesidade/fisiopatologia , Análise de Variância , Anlodipino/uso terapêutico , Índice de Massa Corporal , Cilazapril/uso terapêutico , Quimioterapia Combinada , Ecocardiografia , Hidroclorotiazida/uso terapêutico , Hipertensão/etiologia , Obesidade/complicações , Análise de Regressão , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Los trastornos hipertensivos del embarazo son problemas médicos importantes que explican una proporción elevada de complicaciones maternas y fetales. La preeclampsia constituye la más grave de las complicaciones hipertensivas del embarazo y puede resultar catastrófica si pasa inadvertida, sin tratamiento o si evoluciona hacia una eclampsia. El tratamiento adecuado requiere tener presente los cambios normales de la presión arterial y del volumen intravascular que tienen lugar durante el embarazo. La preeclamsia se caracteriza por vasoconstricción extrema, aumento de la reactividad vascular y disminución del volumen intravascular. El desafío mayor es enfrentar el tratamiento por el hecho de estar en riesgo 2 vidas y porque no existen estudios de vigilancia prolongada con los diferentes fármacos antihipertensivos. En esta revisión se presenta una propuesta de tratamiento donde se discuten las pautas terapéuticas fundamentales basadas en la correcta utilización de los pilares principales de terapia antihipertensiva, con eficacia y seguridad reconocida, que incluye la metildopa, la hidralacina, los bloqueadores a y ß (labetalol), los anticálcicos y los betabloqueadores.
The hypertensive disorders of pregnancy are important medical problems that explain a great number of maternal and fetal complications. Preeclampsia is the most severe of the hypertensive complications of pregnancy and it may be catastrophic if it is not treated or if it evolves towards eclampsia. The adequate treatment requires to have in mind the normal changes of arterial hypertension and of the intravascular volume taking place during pregnancy. Preeclampsia is characterized by an extreme vasoconstriction, increase of the vascular reactivity and decrease of the intravascular volume. The greatest challenge is to face the treatment, due to the fact that two lives are at risk and that no studies of prolonged surveillance have been conducted with the different antihypertensive drugs. In this review, a treatment is proposed and the fundamental therapeutic guidelines are discussed based on the correct utilization of the main milestones of antihypertensive therapy with efficacy and recognized safety, inlcuding methyldopa, hydralazine, a and b blockers (labetalol), calcium antagonists and betablockers.
RESUMO
La magnitud, velocidad y eficacia antihipertensiva de la nifedipina de liberación programada en microgránulos (NLPM) fue evaluada en pacientes con hipertensión moderada a severa. Un total de ciento treinta y cinco pacientes fueron evaluados durante seis semanas en un estudio prospectivo, abierto, comparativo y cruzado. 25.9% (n = 35) fueron pacientes controles normales, del resto eran pacientes hipertensos, 40% (n = 54 pacientes) recibieron 30 mgrs (8am ó 8pm) de NLPM y 20.7% (n = 28 pacientes) recibieron 60 mgrs (8am ó 8pm) de NLPM, el 13.3% de los pacientes admitidos (n = 18) fueron considerados como fracasos de la medicación. Ambas dosis a los distintos horarios de la toma disminuyeron significativamente las presiones arteriales (p < 0.05). En los pacientes que lograron el punto deseado con 30 mgrs, éste se logró desde la 3ra. semana de administrado el medicamento manteniéndose en los niveles tensionales buscados hasta el final del estudio, siendo la magnitud más elevada de reducción de: 8am PAS 15.5 mmHg (12.2%), PAD 12 mmHg (12.6%), PAM 12.2 mmHg (10.9%) y 8pm de: PAS 14.1 mmHg (9.7%), PAD 9.5 mmHg (10.6%) y PAM 11.2 mmHg (10.05%), en cambio en aquellos que lograron el punto deseado con la administración de 60 mgrs, se observaron reducciones desde la 3ra. semana obteniéndose el efecto máximo a la 6ta.semana siendo la magnitud más elevada de reducción de: 8am PAS 26.3 mmHg (16.34%), PAD 18.5 mmHg (17.69%) y PAM 20.9 mmHg (17.0%) y 8pm PAS 22.5 mmHg (15.15%), PAD 18 mmHg (18.1%) y PAM 21.8 mmHg (18.5%). La magnitud de la respuesta antihipertensiva de la NLPM fue numéricamente mayor con 60 mgrs que con 30 mgrs, pero la velocidad de respuesta fue mayor con 30 mgrs probablemente debido a que las cifras tensionales al inicio del estudio eran mayores en el grupo que requirió 60 mgrs, (p < 0.05) llegándose al final del estudio (6ta. semana) a cifras tensionales normales y similares en ambos grupos (p > 0.05). La FC en el grupo de 30 mgrs (8am y 8pm) mostró una disminución significativa luego del tratamiento (p < 0.05), en cambio en el grupo de 60 mgrs éstas se mantuvieron inalteradas (p > 0.05). En conclusión NLPM demostró ser eficaz para el manejo de los pacientes con hipertensión leve a moderada, obteniéndose con la dosis de 60 mgrs mayor magnitud en el efecto hipotensor que con la dosis de 30 mgrs, exhibiendo esta última mayor velocidad de respuesta antihipertensiva.
The magnitude, velocity and antihypertensive effectiveness of the nifedipine liberation programmed in microgranules (NLPM) was evaluated in patients with moderate to severe hypertension. A total of one hundred and thirty five patients were evaluated during six weeks in a prospective, open, comparative and crossed study. Of that group, 25.9% (n = 35) were normal patients, the remainder of them were hypertensive patients, 40% (n = 54 patients) received 30 mgrs (8am or 8pm) of NLPM and 20.7% (n = 28 patients) received 60 mgrs (8am or 8pm) of NLPM, 13.3% of the admitted patients (n = 18) were considered as failures of the medication. Both doses at different schedules of the taking diminished the arterial pressures significantly (p <0.05). There were patients that reached the end point a 30 mgrs dose, this achievement was obtained from the 3rd week of medication keeping on these pressure levels until the end of the study, being the highest magnitude of reduction were: 8am PAS 15.5 mmHg (12.2%), PAD 12 mmHg (12.6%), PAM 12.2 mmHg (10.9%) and 8pm of: PAS 14.1 mmHg (9.7%), PAD 9.5 mmHg (10.6%) and PAM 11.2 mmHg (10.05%), on the other hand, in those who achieved the end point with the administration of 60 mgrs, reductions were observed from the 3rd week obtaining the maximum effect at the 6th week being the highest magnitude of reduction of: 8am PAS 26.3 mmHg (16.34%), PAD 18.5 mmHg (17.69%) and PAM 20.9 mmHg (17.0%) and 8pm PAS 22.5 mmHg (15.15%), PAD 18 mmHg (18.1%) and PAM 21.8 mmHg (18.5%). The magnitude of the antihypertensive response of the NLPM was numerically bigger with 60 mgrs than with 30 mgrs, but the response velocity was bigger with 30 mgrs maybe because the blood pressure at the beginning of the study were bigger in that group that required 60 mgrs, (p <0.05) arriving at the end of the study (6th week) to normal pressure figure, similar in both groups (p> 0.05). The heart rate in the group of 30 mgrs (8am and 8pm) showed a significant decrease after the treatment (p <0.05), on the other hand in the group of 60 mgrs these stayed unaffected (p> 0.05). In conclusion NLPM demonstrated to be effective for the managing of patients with light to moderate hypertension, obtaining a bigger magnitude in the blood pressure effect with a dose of 60 mgrs than with a dose 30 mgrs, however, with this last dose, the antihypertensive response was more fast.