Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.23.15 (renin)
 35,795 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We wished to determine whether prolonged therapy with the Ca2+ channel blocker verapamil has beneficial structural and functional cardiac effects. Nine hypertensive outpatients [systolic blood pressure (SBP) 164 +/- 4 and diastolic BP (DBP) 103 +/- 4 mm Hg: men and women, blacks and whites, mean age 48.6 years] received 240-480 mg slow-release verapamil (Calan-SR) a day. BP, left ventricle (LV) wall thickness and mass, and mitral flow characteristics on echocardiography, and plasma catechols and renin were determined at 0, 5, 10, and 15 months. Patients were compared with 10 normotensive controls, of similar group composition (SBP 130 +/- 3 and DBP 82 +/- 1 mm Hg; age 47.2 years). In the hypertensive patients, SBP and DBP decreased significantly (p < 0.05), by 14 and 12 mm Hg, respectively, but remained well above that of controls and > 140/90 mm Hg. Diastolic LV septal thickness decreased from 15.3 +/- 0.6 to 14.5 +/- 1.1 mm (not significant), while diastolic LV posterior wall thickness (PWTd) decreased significantly (p < 0.05) from 15.7 +/- 0.6 to 14.1 +/- 0.7 mm after 8 months, but not to the value of the controls. LV diastolic and systolic and left atrial dimensions remained constant. Normalized LV mass, initially 60% greater than the controls, decreased slightly (11%) but nonsignificantly and remained above that of controls. Neither LV mass nor LV posterior wall thinning was correlated with reduction in BP. Patient peak systolic wall stress was initially significantly lower than that of controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Structural and functional myocardial responses to chronic treatment with the Ca2+ blocker verapamil (Calan-SR) in hypertensive patients. 750 68

Although sudden cardiac death, myocardial infarction, or stroke can occur at any time of day, event rates increase during the waking hours, particularly in the morning. In most people-both normotensive and hypertensive-blood pressure (BP) rises rapidly in the early morning hours, the time when most individuals wake and begin their day. This rise in BP corresponds to increased secretion of catecholamines and increased plasma renin activity. Thus, vascular tone and total peripheral resistance increase in the morning hours, and BP rises as a result. At the same time, heart rate increases. In the late morning or early afternoon, BP reaches its peak. After that, BP declines, falling 15 to 20 mm Hg between about 8 PM and 2 AM, the time when BP is usually lowest. These findings have led to an interest in chronotherapy for hypertension. A major objective of chronotherapy for hypertension is to deliver the drug in higher concentrations during the early-morning post-awakening period, when BP is highest, and in lesser concentrations during the middle of a sleep cycle, when BP is low. Traditional sustained-release pharmacologic agents, which deliver a near-constant drug concentration, were not designed to complement the circadian pattern. There are currently two antihypertensive agents, Verelan PM (verapamil HCl) and Covera HS (verapamil HCl), that provide chronotherapy for hypertension. These drugs use novel delivery systems that provide 24-h BP control while maximizing drug concentrations in the morning and minimizing drug concentrations during sleep.
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PMID:Pharmacology of cardiovascular chronotherapeutic agents. 1158 43