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Articles 1 - 30 of 44
Full-Text Articles in Medicine and Health Sciences
Association Of Birth Weight And Preterm Birth With Subsequent Risk For Hypertension In Women From The Women’S Health Initiative, Christian P. Daniele
Association Of Birth Weight And Preterm Birth With Subsequent Risk For Hypertension In Women From The Women’S Health Initiative, Christian P. Daniele
Masters Theses
Hypertension is a chronic disease with an estimated prevalence of nearly 50% in US adults. In addition to sociodemographic and lifestyle factors, evidence suggests that in utero and early life exposures may contribute to life-long risk of hypertension. This study aimed to investigate the potential associations between an individual’s birthweight and preterm birth status with their risk for hypertension in the Women’s Health Initiative (WHI) cohort. WHI is a large, multi-racial cohort of postmenopausal women. At study entry, birthweight and preterm birth status were self-reported by category (< 6 lbs., 6-7 lbs. 15 oz., 8-9 lbs. 15 oz., or ≥ 10 lbs.; ≥ 4 weeks premature or full term). Baseline and incident hypertension status were self-reported; mean systolic blood pressure, diastolic blood pressure, and 30-second pulse were also recorded at baseline by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to generate crude and adjusted beta estimates, odds ratios, and hazards ratios, respectively. After adjusting for demographic and lifestyle factors, we found that participants born at a low birthweight had a higher mean systolic blood pressure than participants born at a normal birthweight and were at increased risk for both baseline and incident hypertension. Women born at a higher birthweight had a lower mean systolic blood pressure and were at lower risk for baseline and incident hypertension. When compared to participants born full term, participants born preterm were at increased risk for baseline and incident hypertension. These results support current research on early life exposures and health risks later in life. Long term follow-up or targeted counseling may be required for individuals born prematurely or at low birthweights to prevent and treat hypertension and associated cardiovascular outcomes.
Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery
Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery
Student Scholarly Projects
Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.
PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?
Evidence: Hypertension is one of the leading preventable …
Implementation Of An Educational Teach-Back Program For Patients With Hypertension, Lakesha Hill
Implementation Of An Educational Teach-Back Program For Patients With Hypertension, Lakesha Hill
Dissertations
Implementation of an Educational Teach-back Program for Patients with Hypertension
Abstract
Problem: To improve health literacy and provide adequate health care to patients and their family, clear and effective dialogue is essential. The teach-back method is a technique utilized to confirm a patient’s level of understanding of care instructions done by relaying patient directions, and then confirming the patient understands by asking the patient to reiterate those directions. The purpose of this quality improvement project was to assess the effectiveness of using the teach-back method by health care professionals with their patients who have a diagnosis of hypertension or high …
Implementing A Self-Measured Blood Pressure Monitoring Process, Alecia Christensen
Implementing A Self-Measured Blood Pressure Monitoring Process, Alecia Christensen
Student Scholarly Projects
Practice Problem: Because of the prevalence of hypertension worldwide, it is prudent for all patients to have the knowledge and ability to self-monitor their blood pressure. Patients monitoring their own blood pressure and communicating the readings with healthcare providers facilitates a more comprehensive plan of care.
PICOT: The PICOT question that guided this project was: In adults 18-90 years old with primary hypertension (P), will a self-measured blood pressure monitoring that includes a monthly telehealth visit with a provider (I), compared to blood pressure monitoring at routine office visits (C), decrease patients' systolic blood pressure readings by five mmHg …
Patient Care Management Of Hypertension Through Improving Follow-Up And Reducing Missed Appointments In A Primary Care Clinic: A Qi Project, Victoria Idubor
Patient Care Management Of Hypertension Through Improving Follow-Up And Reducing Missed Appointments In A Primary Care Clinic: A Qi Project, Victoria Idubor
Doctor of Nursing Practice
Background. Missed follow-up appointments constitute significant problems clinics and health centers face nationwide. A significant portion of primary care providers’ patients will require follow-up appointments to manage their chronic illnesses. About 20 to 40% of patients seen at this clinic have a history of hypertension. Uncontrolled hypertension has been shown to increase the risk of certain cardiovascular disease events and mortality. Follow-up appointments are crucial for patients with hypertension to monitor for more life-threatening signs and manage their overall care. Purpose. The purpose of this project is to improve the timely management of care for patients with hypertension …
The Impact Of Social Determinants Of Health On Hypertension, Lakenya Forthner
The Impact Of Social Determinants Of Health On Hypertension, Lakenya Forthner
Doctoral Projects
ABSTRACT
Nearly 43% of African American men have Hypertension (HTN). HTN is a major reversible health problem for young adult, African American males. Identifying health behaviors to enhance longevity is essential due to the “excess burden of preventable, chronic diseases and premature death among African American men. The “role of social determinants of health (SDOH) on outcomes, and the possible role these determinants play in disparities have largely been ignored” (Haggart, 2018, pp. 2, 8).
Interventions that address SDOH must take a multicomponent approach. Evidence has been established that adhering to a healthy lifestyle reduces the burdens and risks associated …
Building An Artificial Intelligence Framework For Hypertension Diagnosis: A Use Case Of The Problem List Curation, Ketemwabi Yves Shamavu
Building An Artificial Intelligence Framework For Hypertension Diagnosis: A Use Case Of The Problem List Curation, Ketemwabi Yves Shamavu
Theses & Dissertations
Hypertension is the world's leading factor in cardiovascular disease. Forty-seven percent or close to one in two Americans aged 18 and older are affected. It predicts approximately a thousand deaths per day. Based on recent statistics from the Centers for Disease Control and Prevention, one in three patients with hypertension does not know they are hypertensive. Seventy-five percent of hypertensive patients have uncontrolled hypertension - meaning that they are not treated to target. While there is extensive literature on hypertension diagnosis and management, there is an apparent gap in understanding and acknowledging that a person is hypertensive. Moreover, blood pressure …
The Role Of Mitochondrial Dysfunction In Causing Hypertension During Pregnancy As Observed In The Rupp Model Of Preeclampsia, Michael Franks
The Role Of Mitochondrial Dysfunction In Causing Hypertension During Pregnancy As Observed In The Rupp Model Of Preeclampsia, Michael Franks
Honors Theses
Preeclampsia (PE) is a disease characterized by new-onset hypertension in the third trimester of pregnancy, endothelial dysfunction, and placental ischemia. Contributory to these characteristics are circulating factors such as agonistic autoantibodies to the angiotensin I type II receptor (AT1-AA), CD4+ T cells, natural killer cells (NK), and oxidative stress, which I will show to contribute to renal and placental mitochondrial dysfunction during pregnancy. The adoptive transfer of CD4+ T cells from the Reduced Uterine Perfusion Pressure (RUPP) rat model of PE to a healthy normal pregnant rat has been shown to result in many of these characteristics, including AT1-AA production. …
Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson
Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson
Evidence-Based Practice Project Reports
Elevated blood pressure (BP), or hypertension (HTN), can cause a cascade of detrimental effects to the body. It is associated with increased risk of stroke, angina, myocardial infarction, heart failure, peripheral artery disease, end-stage renal disease, and abdominal aortic aneurysms (Whelton et al., 2018). HTN is also a major risk factor for the development of cardiovascular disease (CVD), which is the United States’ (U.S.) leading cause of death in men and women (U.S. Preventive Services Task Force [USPSTF], 2020). The PICOT question for this project was: does an eight-week (T) structured walking program utilizing a smartwatch for step counts and …
The Influence Of Dash Diet Education On Knowledge And Adherence In Primary Care: A Quality Improvement Project, Paige Bekker
The Influence Of Dash Diet Education On Knowledge And Adherence In Primary Care: A Quality Improvement Project, Paige Bekker
Culminating Experience Projects
Background/Local Problem: A rural family practice was concerned about the number of
patients with uncontrolled hypertension, 19.86% n = 56, as defined by the Centers for Disease Control and Prevention (CDC). After several quality improvement (QI) initiates to lower the prevalence rate of uncontrolled hypertension, including proper measurement techniques and home monitoring, the modifiable risk factor of adapting one’s food intake was introduced using the Dietary Approach to Stop Hypertension (DASH) diet as an intervention. The DASH diet is an evidence-based approach for lowering blood pressure. The QI project was completed with the purpose of implementing DASH diet education and …
Occupational Fine Particulate Matter Exposure And Its Associated Effects On The Cardiovascular System: A Systematic Review, Jordan Rickwa
Occupational Fine Particulate Matter Exposure And Its Associated Effects On The Cardiovascular System: A Systematic Review, Jordan Rickwa
Honors Theses
Fine particulate matter (PM2.5), the solid and liquid portion of air pollution under 2.5 microns in diameter, has been shown to cause numerous negative effects on the body. These inhalable particles are often researched for their effects on the respiratory system in outdoor settings, however systemic health impacts have been observed following inhalation of PM2.5 . Additionally, exposures to PM2.5 can occur in occupational settings but are less frequently studied compared to outdoors. This literature review seeks to identify studies that determined associations between inhaled PM2.5 and the resulting cardiovascular effects in occupational settings. We conducted a search of literature …
Perceptions Of Hypertension And Treatment Adherence In Impoverished Hypertensive Adults: A Qualitative Analysis, Sarah E. Hogg
Perceptions Of Hypertension And Treatment Adherence In Impoverished Hypertensive Adults: A Qualitative Analysis, Sarah E. Hogg
Honors College Theses
Hypertension is a global public health crisis. It is the largest risk factor for cardiovascular disease, which is the leading cause of death globally (CDC, 2021). While it can be managed, there are additional barriers that hypertensive impoverished populations face in regards to hypertension management. The purpose of this study was to explore knowledge, attitudes, and perceptions of hypertension, and treatment adherence in impoverished hypertensive adults. Interviews were analyzed using thematic analysis, and were explained within the context of the health belief model. The results show that there was a lack of understanding of hypertension and its long term effects. …
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
Doctor of Nursing Practice Final Manuscripts
Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …
Health Service Utilization And Expenditure In Cardio-Metabolic Conditions In The United States Adults, Kavita Mosalpuria
Health Service Utilization And Expenditure In Cardio-Metabolic Conditions In The United States Adults, Kavita Mosalpuria
Theses & Dissertations
Metabolic syndrome is multicomponent risk factor for cardiovascular diseases (CVD) and type 2 diabetes that reflects the clustering of at least 3 cardiometabolic risk factors, among hypertension, impaired glucose regulations, hypercholesterolemia, and obesity. CVD are the leading cause of death in the U.S. CVD occur at earlier age and is a major cause of death and disability among people with diabetes. As compared to Japan, 13.3% to 44% of the excess CVD mortality in the U.S. can be explained by the metabolic syndrome. The prevalence of metabolic syndrome was 34.3% in 2007 to 2014 and it increases with age. Metabolic …
Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton
Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton
Dissertations
Abstract
Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.
Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …
Identifying Opportunities For Implementing Home Blood Pressure Monitoring In Newly Diagnosed Or Worsening Hypertension At A Family Health Clinic, Catherine Liikala
Identifying Opportunities For Implementing Home Blood Pressure Monitoring In Newly Diagnosed Or Worsening Hypertension At A Family Health Clinic, Catherine Liikala
Doctor of Nursing Practice Final Manuscripts
Abstract
The literature is clear that the diagnosis, treatment, and plan of care for hypertension in adults should rely, at least in part, on ambulatory blood pressure. Using in-office blood pressures alone risks inaccurate measurements and can result in inappropriate treatments. Many clinics, however, do not adhere to this recommendation and will fall back on clinic readings which puts the patient at risk of mismanaged hypertension and polypharmacy. This project was formulated to identify the extent to which hypertensive patients were diagnosed and managed without the use of home blood pressure monitoring in a small local community clinic. This …
The Effects Of Progesterone Induced Blocking Factor And 17-Hydroxyprogesterone Caproate On The Pathophysiology Of Preeclampsia, Kyleigh M. Comley
The Effects Of Progesterone Induced Blocking Factor And 17-Hydroxyprogesterone Caproate On The Pathophysiology Of Preeclampsia, Kyleigh M. Comley
Honors Theses
Preeclampsia (PE) is responsible for about 20% of the 13 million preterm births each year worldwide, including 100,000 cases annually in the United States. Despite being a leading cause of maternal and perinatal morbidity, the mechanisms of pathogenesis are still largely unknown. PE is progesterone deficient state characterized by hypertension, chronic immune activation, endothelial dysfunction and severe forms can lead to seizures. Treatment of seizures includes the administration of magnesium sulfate (MgSO4) though not all PE patients are responsive, and it does not decrease PE-associated hypertension. To resolve these conditions, PE patients are delivered early thereby making PE the leading …
Evaluating The Effect Of An Electronic Health Record Patient Portal On The Management Of Hypertension, Ashley Hall
Evaluating The Effect Of An Electronic Health Record Patient Portal On The Management Of Hypertension, Ashley Hall
DNP Projects
Background: Hypertension is the leading cause of cardiovascular disease and affects individuals globally, nationally, and locally. Consequences of uncontrolled hypertension include atherosclerosis, heart failure, stroke, and renal disease. The electronic health portal is a patient-specific, interactive tool that has been shown to promote adherence to provider recommendations and improve chronic disease management.
Purpose: The purpose of this project was to determine the effects of education via an electronic healthcare portal on the blood pressure management of adults at a primary care clinic in a small town in Kentucky.
Methods: This study was a one-group pre/post intervention designed to evaluate provider …
Covid-19 Infection In Hypertensive Patients In Correlation With Race, Elizabeth Durkin
Covid-19 Infection In Hypertensive Patients In Correlation With Race, Elizabeth Durkin
Honors Undergraduate Theses
Disparities in healthcare exist in the U.S., particularly between different racial categories. This study investigated the frequency of COVID-19 cases and hypertension cases among five different racial groups (White, Black, Asian, Native American, and Native Hawaiian). The study also examined the correlation between COVID-19 and hypertension. It was hypothesized that, because of genetic predisposition to certain diseases and existing socioeconomic barriers, Black populations would have the highest rates of both COVID-19 and hypertension. It was also proposed that a positive correlation exists between COVID-19 and hypertension frequency. To test this, the Kaiser Family Foundation's data for COVID-19 cases and race …
Characterization Of Spontaneous Preeclampsia In The African Green Monkey (Chlorocebus Aethiops Sabaeus), Chelsea Christina Weaver
Characterization Of Spontaneous Preeclampsia In The African Green Monkey (Chlorocebus Aethiops Sabaeus), Chelsea Christina Weaver
Theses and Dissertations--Biology
Hypertensive pregnancy disorders are a major contribution to maternal and neonatal mortality worldwide. Two of these disorders, preeclampsia and chronic hypertension in pregnancy, affect up to 10% of all pregnancies. These hypertensive disorders of pregnancy are associated with long-term, postnatal risk factors for both mother and offspring. Despite numerous recent advances in preeclampsia research, the underlying mechanisms are still not understood. This could be due to lack of a spontaneous animal model. This dissertation presents the African Green Monkey (AGM; Chlorocebus aethiops sabaeus) as the first known spontaneous animal model of preeclampsia and a highly translational model of chronic …
Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman
Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman
Electronic Theses and Dissertations
Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance …
Baseline Health Assessment Of A Rural Delta Community, Sydney Mitchell
Baseline Health Assessment Of A Rural Delta Community, Sydney Mitchell
Honors Theses
The Lower Mississippi Delta is characterized by poverty, chronic health issues, health disparities, and food insecurity. The rural Delta communities are primarily African American, experiencing disproportionately higher rates of poverty, job loss, and chronic health problems. Historically, chronic health issues have persisted in these areas over time, including obesity, hypertension, and diabetes, which have only seemed to increase in this region. The food environment in this rural region tends to assist in the creation of the largely obesogenic population which, in turn, contributes to the increased prevalence of diabetes and hypertension and a lower quality of life. Many residents in …
The Role Of Central Ace2 And Nrf2 In Sympatho-Excitation: Responses To Central Angiotensin Ii, Anyun Ma
The Role Of Central Ace2 And Nrf2 In Sympatho-Excitation: Responses To Central Angiotensin Ii, Anyun Ma
Theses & Dissertations
Sympatho-excitation is a key characteristic in cardiovascular diseases such as chronic heart failure (CHF) and primary Hypertension (HTN). Evidence suggests that increased sympathetic tone is closely related to activation of the Renin-Angiotensin-Aldosterone system (RAAS) in the central nervous system. An underlying mechanism for sympatho-excitation is thought to be oxidative stress resulting from Angiotensin II (AngII) type 1 receptor (AT1R) activation. Over the past several decades, pharmacological targeting of components of the RAAS have been used as standard therapy in CHF and HTN. However, additional therapeutic strategies are necessary to control these diseases. Oxidative stress is regulated, in part, by the …
An Initiative To Educate And Support Young Adults Diagnosed With Hypertension, Page Tomlinson
An Initiative To Educate And Support Young Adults Diagnosed With Hypertension, Page Tomlinson
College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications
An Initiative to Educate and Support Young Adults Diagnosed with Hypertension
Page Tomlinson, BS, RN, DNPc
Background: Hypertension is a common diagnosis in the US with significant long-term effects. While guidelines for optimal hypertension management exist, young adults lag behind older adults in treatment and control3. The young adult is arguably more capable of lifestyle changes, primarily due to fewer physical limitations than older adults. Promotion of disease self-management is the most effective way to engage young adults in seeking control over their blood pressure1,2. Lifestyle modification as a young adult decreases costs of care and …
Role Of Sodium And Potassium In The Diet Of School-Aged Children In Ireland: Findings From The National Children’S Food Survey Ii, Eoin James Morrissey
Role Of Sodium And Potassium In The Diet Of School-Aged Children In Ireland: Findings From The National Children’S Food Survey Ii, Eoin James Morrissey
Theses
A high sodium to potassium intake ratio (Na:K) resulting from a diet high in sodium and low in potassium can increase the risk of elevated blood pressure or hypertension in children, potentially leading to increased CVD in adulthood. The objective of this thesis was to estimate sodium and potassium intakes and Na:K in school-aged children (5-12y) in Ireland using data from the nationally representative National Children’s Food Survey II (NCFS II) (2017-18). The thesis study collected detailed dietary intake data for 600 children using 4-d food records and also collected spot urine samples from 95% of these participants. Sodium and …
The Effects Of Exercise On Pressure Natriuresis, Janet Komolafe
The Effects Of Exercise On Pressure Natriuresis, Janet Komolafe
All Graduate Theses, Dissertations, and Other Capstone Projects
Hypertension is a disease of high global burden and a leading risk factor for cardiovascular diseases and related deaths. The pressure natriuresis mechanism, which is an intrinsic response in the kidneys which increases urinary sodium excretion when renal perfusion pressure increases, plays a central role in the long-term regulation of mean arterial pressure. Studies have shown that a sustained impairment of the pressure natriuresis mechanism results in high blood pressure, making hypertension a disease of the kidneys.
Since exercise is recommended as a non-pharmacological treatment to manage hypertension, it is important to understand the means by which exercise is beneficial …
The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell
The Roles Of An Evidence-Based Weight Management Protocol In Hypertension Control, Belinda Akakpo Maxwell
Doctor of Nursing Practice Final Manuscripts
The Roles of an Evidence-Based Weight Management Protocol in Hypertension Control
Abstract
Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led protocol for patients with hypertension (HTN) and weight loss needs to improve weight control, cardiovascular risk and quality of life.
Background: Evidence shows that a 1.2-kg weight loss can reduce systolic blood pressure (SBP) by 3.8mmHg. Thus, a 10kg (22lbs) weight loss is likely to yield a SBP decrease of as much as 32mmHg. Such results would positively impact quality of life and costs. The simple approach of instructing patients to eat less …
Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean
Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean
Evidence-Based Practice Project Reports
Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …
Diuretic And Natriuretic Activity Of Faah Inhibition In The Renal Medulla: A Proposed Role Of Palmitoylethanolamide And Its Regulation By Renal Medullary Interstitial Cells, Sara Dempsey
Theses and Dissertations
Hypertension is a critical public health issue worldwide, and in the United States, it is the leading cause of heart disease, stroke, and kidney failure, contributing to more than 1,100 deaths per day. It is proposed that the renal medulla combats increased blood pressure by releasing a neutral lipid from the lipid droplets of medullary interstitial cells, termed medullipin, which induces diuresis- natriuresis and vasodepression. The renal medulla is enriched with fatty acid lipid ethanolamides including the endocannabinoid anandamide (AEA), palmitoylethanolamide (PEA), and oleoylethanolamide (OEA), along with their primary hydrolyzing enzyme fatty acid amide hydrolase (FAAH). Our lab is investigating …
Safety Constraint Optimization Of Combination Drug Therapy In Hypertension Clinical Trials, Victor Chukwu
Safety Constraint Optimization Of Combination Drug Therapy In Hypertension Clinical Trials, Victor Chukwu
Electronic Theses and Dissertations
In Clinical Practice, combination drug therapy has become common in treating many disease conditions. The purpose of these combinations is often to ensure optimal efficacy and to reduce adverse effects that may arise from monotherapy. Clinical trials have also been conducted to ensure efficacy and safety of these combinations before they are introduced into the market. However, adverse effects still occur with combination therapies. The objective of this study is to (1) To determine a region of optimum doses of Drug A and Drug B in combination while focusing on efficacy alone (2) To determine a region of optimum doses …