The impact of China's national centralized volume-based procurement (NVBP) policy on antihypertensive drug procurement in underdeveloped, multi-ethnic regions remains understudied. This study evaluated changes in procurement prices, volumes, and costs for four antihypertensive drugs following the second NVBP batch in Guangxi, an economically disadvantaged region in southwestern China.

The title mol-ecule, C22H20ClN3O3S, adopts a shallow cup-shaped conformation with the chloro-benzamide portion as the bottom. A puckering analysis of the five-membered ring indicates an envelope conformation. In the crystal, helical chains along the a-axis direction are formed by N-H⋯O hydrogen bonds reinforced by C-H⋯π(ring) and weak π-stacking inter-actions. No directed inter-actions between chains appear to exist. A Hirshfeld surface analysis was performed.

Migraine is commonly regarded as a primary neurovascular disorder; however, systemic endothelial and autonomic factors may modulate its expression and course. A 41-year-old male with a 10-year history of migraine without aura and vasomotor rhinitis experienced sustained remission after initiation of nebivolol 5 mg and (perindopril 5 mg/indapamide 1.25 mg/amlodipine 5 mg) once daily for mild hypertension. Attacks occurred 3-4 times per month-often on Saturdays-were triggered by strong odors such as perfume, and occasionally accompanied by nausea or vomiting. Headaches fulfilled ICHD-3 criteria for migraine without aura and initially responded to triptans. Within two weeks of therapy, blood pressure normalized and both migraine and nasal symptoms resolved. Remission persisted for 12 months. The temporal sequence and clinical pattern appear consistent with a clinical improvement that may involve endothelial and autonomic modulation, among several plausible contributors, including combined antihypertensive therapy. The patient's blood pressure remained within the physiological range throughout the observation period, indicating that the sustained remission extended beyond antihypertensive control per se. This case illustrates a hypothesis-generating clinical pattern potentially involving endothelial and autonomic modulation and highlights how vascular homeostasis and circadian autonomic factors may influence migraine chronification and remission.

We sought to investigate whether remnant cholesterol (RC) modified the effect of intensive blood pressure (BP) lowering treatment. This study was a post hoc analysis of ESPRIT. In this trial, hypertensive patients with high cardiovascular risk were randomly assigned to intensive (systolic BP < 120 mmHg) or standard (systolic BP < 140 mmHg) treatment. Cox regression analysis was used to examine heterogeneity of treatment effect on the primary composite outcome (myocardial infarction, heart failure, stroke, coronary or non-coronary revascularization, or death from cardiovascular causes), individual components, and death from any cause in participants grouped by RC tertiles or the cut-off value (0.8 mmol/L). A total of 11,221 participants with complete data of baseline RC were included for analysis (females 41.3%, mean age 64.6 years). During a median follow-up of 3.3 years, 1163 primary outcomes occurred, and hazard ratios (HR) for the primary outcome were 0.98 (95% CI 0.80-1.20), 0.90 (95% CI 0.74-1.11), and 0.77 (95% CI 0.64-0.94) in the lowest, middle, and highest RC tertiles, respectively (P for interaction: 0.11). Additionally, intensive treatment only reduced the risk of myocardial infarction in the highest RC tertile (HR 0.56, 95% CI 0.36-0.89, P for interaction: 0.01). When grouping by RC level of 0.8 mmol/L, significant interactions were also noted for the primary outcome, myocardial infarction, death from cardiovascular causes, and death from any cause (all P for interaction <0.05). These results showed that effects of intensive treatment were shown to be modified by baseline RC level, and further research is needed to confirm our findings.