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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical efficacy and acceptability of once-daily perindopril (4 to 8 mg) monotherapy and in combination with hydrochlorothiazide (50 mg/day) was studied in mild to moderate stable essential hypertensive patients in 4 centres in Thailand. After 2-4 weeks of placebo run-in period, patients received active treatment for 3 months starting with 4 mg perindopril once daily. Dose titration was at second and third month of active treatment if the supine DBP was > 90 mmHg. The dose was doubled and if necessary, 50 mg/day hydrochlorothiazide was added in the last month. The results in 95 patients showed that the mean reduction in supine SBP/DBP at 1, 2 and 3 months of treatment was 10.3/8.0, 13.2/8.7 and 19.1/13.7 mmHg respectively. At the end of the study, 80 per cent of the patients showed normalisation of the supine diastolic blood pressure (supine DBP < or = 90 mmHg) with 30 per cent receiving combined therapy of perindopril and hydrochlorothiazide. There was no significant change in routine haematology or serum biochemistry except for slight increase of potassium levels in patients receiving 8 mg perindopril monotherapy. The incidence of side effects and withdrawal from treatment were quite low. Cough was the major side effect reported comprising 13.6 per cent with only 1 case withdrawn. The study confirms the previous studies that perindopril had satisfactory antihypertensive efficacy and acceptability profiles.
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PMID:Efficacy and acceptability of perindopril in essential hypertension. 786 13

The efficacy and acceptability of perindopril were assessed over one year by 4800 French general practitioners in an open label study of 47,351 freely consenting adults with mild to moderate hypertension. Perindopril was administered as a single daily dose each morning. The starting dose of 4 mg (or 2 mg in patients over 70 years) was doubled after one month, to a maximum of 8 mg if diastolic blood pressure (DBP) was greater than 95 mmHg. Thereafter a non-potassium sparing diuretic was added to the 8 mg dose if necessary. At 12 months, effective blood pressure control, defined as recumbent DBP below 90 mmHg, was achieved in between 68 and 77% of patients. The majority of patients (80% [n = 37,348]) received perindopril alone throughout the 12-month study period. The final prescription (at six months) revealed that 65% of patients were treated with the once daily 4 mg dose. Throughout the 12 months of the study, 7.6% of patients (n = 3564) discontinued treatment, 5.1% (n = 2401) due to adverse events and 0.4% (n = 187) due to fatal events (principally cardiovascular reasons). Cough was the most frequent adverse symptom, leading to withdrawal of 3.28% of patients; this symptom was spontaneously reported in an additional 6.4% of patients throughout the one-year period but did not lead to discontinuation. All other adverse events leading to withdrawal were present in less than 0.4% of cases. The majority of fatal outcomes was due to cardiovascular events (n = 78), 37 were due to cancer, 19 due to road accidents and 53 due to miscellaneous causes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of essential hypertension in general practice: an open-label study of 47,351 French hypertensive patients treated for one year with perindopril. 795 35

Glucocorticosteroids represent the "drugs of choice" for treatment of sarcoidosis. Steroids can be given by all routes of administration. Daily therapy with oral steroids is most widely applied. Initial therapy should consist of prednisolone 30-60 mg/day or its equivalent. Alternate day therapy can be used during the maintenance phase. Inhaled steroids can also be tried during the maintenance phase for treatment of pulmonary sarcoidosis. Other drugs, which may be effective in sarcoidosis, and have a steroid-sparing capacity, are methotrexate, azathioprine, chlorambucil and cyclophosphamide. Chloroquine can be used for chronic skin lesions and potassium para-aminobenzoate may soften fibrotic lesions and keloids. Duration of treatment varies with the clinical situation; from between 6 and 18 months to lifetime. In principle, continuing signs of disease activity and functional impairment require continuing treatment. Determination of on-going activity may be a difficult task. Symptomatic patients with stage II-III pulmonary sarcoidosis, and many extrapulmonary manifestations of the disease, must be adequately treated. Symptom-free patients with deteriorating lung function and/or biochemical signs of disease activity also require treatment. Steroids are not indicated for pulmonary stage I disease (hilar lymphadenopathy) with or without erythema nodosum unless there are troublesome persistent chest symptoms (cough, pain, pressure symptoms) or arthralgia, oedema and pain of the legs.
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PMID:Treatment of sarcoidosis. 803 53

1062 patients with moderate to severe hypertension were enrolled in an open-label multicenter trial investigating the antihypertensive efficacy and safety of the preconstituted formulation enalapril (20 mg) and hydrochlorothiazide (12.5 mg) over a treatment period of 12 weeks. According to the inclusion criteria of the study protocol 489 patients had to be excluded from statistical evaluation of efficacy. Results were calculated from 573 patients (339 females, 234 males, mean age 59.1 +/- 12.3 years) of whom 89% (n = 510) received the standard dosage of 1 tablet daily. They revealed a significant reduction (p < 0.001) of both diastolic and systolic blood pressure (BP) from a mean of 108.2 +/- 7.8 mm Hg (182.2 +/- 17.6 mm Hg) before treatment to a mean of 88.4 +/- 6.7 mm Hg (152.6 +/- 10.8 respectively) after 12 weeks of treatment. 81% responded to therapy defined as a lowering of diastolic BP < 90 mm Hg. Heart frequency dropped significantly (from a mean of 77.8 +/- 10.6 to a mean of 71.7 +/- 8.0, p < 0.01), too. Adverse effects leading to discontinuation were seen in 2.8% (n = 30) of all participating patients. Cough and gastrointestinal discomfort were the most frequent side effects. None of the safety parameters i.e. serum potassium and creatinine changed during the period of investigation. In conclusion, the preconstituted formulation enalapril (20 mg) and hydrochlorothiazide (12.5 mg) was shown to be an effective and well tolerated treatment not only for patients with newly diagnosed moderate to severe hypertension, but also for nonresponders to previous antihypertensive therapy.
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PMID:[Antihypertensive effectiveness of enalapril and hydrochlorothiazide as a combination drug]. 821 15

Amiloride inhalation as treatment for cystic fibrosis (CF) lung disease has been shown in independent studies to increase mucus clearance by ciliary and/or cough action and to retard the decline in lung function. It is hypothesized that amiloride therapy decreases the excess sodium and water absorption that is a characteristic of CF airway epithelium and that it leads to an improvement in the rheologic properties of mucus favoring airway mucus clearance. The aim of this study was to investigate whether amiloride treatment (5 x 10(-3) M amiloride in one-third normal saline four times a day) would change sputum electrolyte composition in patients with CF after 25 wk of therapy as compared with placebo (one-third normal saline), and whether appropriate changes in sputum water content and rheologic properties would accompany any changes in electrolyte composition. Sputum samples were obtained from six patients with CF undergoing amiloride therapy, using the dental cotton protection technique to avoid salivary contamination. The samples were stored at -80 degrees C until analyzed. For electrolyte analyses an aliquot of the sputum (minimum, 30 mg) was analyzed with ion-selective electrodes for sodium and potassium, and a chloride meter was used to measure chloride content. Chronic (25-wk) amiloride therapy increased significantly the sputum sodium (94.8 +/- 16.4 to 121.4 +/- 15.4 mmol/L, p = 0.001) and chloride (64.4 +/- 11.8 to 77.2 +/- 8.0 mmol/L, p = 0.10) content when compared with 25 wk of saline treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Amiloride inhalation therapy in cystic fibrosis. Influence on ion content, hydration, and rheology of sputum. 811 99

The antihypertensive efficacy and acceptability of perindopril, an angiotensin-converting enzyme (ACE) inhibitor, was evaluated in 2,927 elderly (> or = 70 years) hypertensive patients in general practice, as part of an open 6-month trial conducted on a total of 23,460 patients with mild-to-moderate hypertension. Patients were ambulatory and selected if diastolic blood pressure (DBP) was between 94 and 115 mm Hg and no serious illness or ACE inhibitor intolerance was known. Perindopril was started at 2 or 4 mg once daily and, if supine DBP remained > 90 mm Hg, the daily dose could be doubled after 1 or 3 months (or a diuretic added if perindopril titration reached 8 mg). At entry, the 2,927 patients (65% females) were on average 74 years old, body weight was 68.2 kg, duration of hypertension was 9.4 years, and prior antihypertensive treatment was present in 78%. Percentage of normal DBP (< or = 90 mm Hg) was 69% at 1 month, 86% at 3 months (in patients on perindopril alone), and 94% at 6 months. At 6 months the reduction of systolic blood pressure and DBP was 28 and 16.6 mm Hg, respectively. Of the 2,927 patients at entry, 8.6% dropped out during the trial, including 6.1% due to side effects. Cough was the most common symptom (8.9%) leading to withdrawal in 3.4% of cases. In one patient, serum creatinine increased (3-fold at 1 month), but overall no significant variation of renal function occurred, as shown by stable plasma creatinine and potassium levels.
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PMID:Antihypertensive efficacy and acceptability of perindopril in elderly hypertensive patients. 832 64

We present the case of a patient with a history of asthma who developed cough and hemoptysis that were unresponsive to antituberculous therapy. Chest roentgenography demonstrated right-sided collapse with consolidation and a pleural effusion. Bronchial biopsy revealed fungal hyphae, and cultures later yielded Bipolaris spicifera. In addition, weight loss and intractable hypotension in association with hyponatremia and elevated potassium levels suggested addisonian crisis, which was confirmed by measurement of serum ACTH and cortisol levels. Computed tomography of the abdomen revealed bilateral adrenal involvement. Tissue obtained on biopsy of the adrenal glands yielded B. spicifera. The patient responded to treatment with 2 g of iv amphotericin B; the adrenal masses and pneumonia resolved, and he remained well until last seen in July 1992. However, he requires replacement therapy with prednisone and fludrocortisone. On review of the available literature, we were unable to find a previously reported case.
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PMID:Disseminated bipolaris infection in an asthmatic patient: case report. 839 76

To investigate whether dietary salt intake and urinary sodium and potassium levels are related to respiratory symptoms and bronchial responsiveness, a cross-sectional study among 2593 subjects aged 9 to 16 was conducted in four communities of the Latium region (Italy). Questionnaires were administered to the parents, urine samples were collected, lung function, methacholine challenge tests and prick tests were performed. Information about familial and personal dietary salt use and respiratory health was collected from the parents of 2439 (94%) subjects. A total of 2020 methacholine challenge tests and 916 urinary sodium and potassium levels were available for analysis. Personal table salt use was strongly related to cough and phlegm apart from colds (adjusted odds ratios, OR, 1.87, 95% confidence intervals, CI, 1.20-2.90), wheezing apart from colds (OR, 2.19, 95% CI, 1.27-3.77), wheezing with dyspnoea (OR, 1.45, 95% CI, 0.98-2.12) and wheezing after exercise (OR, 2.16, 95% CI, 1.35-3.44). These associations were mainly found in boys. Use of familial table salt and canned food showed no relation to respiratory symptoms. Increased bronchial responsiveness was associated with a higher urinary potassium excretion in boys, but not with urinary sodium. In conclusion, personal table salt use is related to an increased prevalence of bronchial symptoms; an increase in bronchial responsiveness among those with higher potassium excretion also seems to be implied. Although it is difficult to interpret the results of this study in causal terms, the findings might be relevant to the distribution of bronchial symptoms and diseases in the population.
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PMID:Respiratory symptoms and bronchial responsiveness are related to dietary salt intake and urinary potassium excretion in male children. 849 1

The aim of this 3-month double-blind study was to assess the antihypertensive effect and acceptability of perindopril in comparison with enalapril in patients with mild to moderate essential hypertension. After a 4-week placebo run-in period, 161 patients with supine diastolic blood pressure (DBP) between 95 and 115 mmHg were randomized to receive perindopril 4 mg or enalapril 10 mg once daily. If supine DBP was higher than 90 mmHg, treatment was adjusted monthly, first by doubling the dose and then by addition of hydrochlorothiazide 12.5 mg. After 3 months of active treatment the decrease in supine and standing blood pressures was statistically significant within both groups but was not statistically different between groups. The percentage of patients (65%) who achieved supine DBP of < or = 90 mmHg in the perindopril group was not significantly different from the enalapril group (73%). Monotherapy resulted in control of supine DBP in 56% of the perindopril group and 58% of the enalapril group; the addition of hydrochlorothiazide resulted in control of supine DBP in 6% and 15% respectively. The number of withdrawals for adverse events was statistically significant between groups (0 in the perindopril group and 7 in the enalapril group, p = 0.01). During active treatment the most frequently reported complaints were headaches and cough; there was not statistically difference between groups. Changes in laboratory parameters were minor and not significantly different between the two groups except for serum glucose, potassium, and triglyceride levels. In conclusion, there was no significance between perindopril and enalapril in terms of efficacy. Clinical acceptability seems to be better in the perindopril group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical acceptability of ACE inhibitor therapy in mild to moderate hypertension, a comparison between perindopril and enalapril. 852 53

A one-year open study was focused on the therapeutic effect and tolerance of spirapril in 171 patients with mild to moderate hypertension in 11 centres in the Czech and Slovak Republic. The antihypertensive effectiveness was investigated after four weeks, after 12 weeks and after 52 weeks. Only the results recorded after one year are reported. The study was completed after one year by 139 patients, incl. 120 (86.3%) with a normal diastolic pressure of 90 mmHg or less. The study was not completed by 32 patients (18.8%): because treatment was not effective--9.4%, because of undesirable effects--4.7%, 3.5% were eliminated by the investigators for various reasons (change of domicile, poor collaboration) and 1.2% because the protocol was not respected. According to the analysis "intention to treat" the diastolic pressure was normalized by monotherapy with spirapril in 25.1% of the baseline group; combination of spirapril with bopindolol led to normalization of the pressure in another 38.0% patients and in 7.0% patients normal diastolic pressure was achieved by a combination of spirapril with a hydrochlorothiazide; i.e. a total of 70.1% of the baseline group had a normal diastolic pressure after one year of treatment. In another 9.4% of the baseline group the diastolic pressure declined by 10 mmHg or more but not to normal levels. Thus normalization or effective control of pressure was achieved after one year in 79.6% patients according to the analysis "intention to treat". The combination of spirapril and bopindolol proved very effective. Patients where it was necessary to combine spirapril with bopindolol or hydrochlorothiazide had significantly higher baseline readings of blood pressure. During treatment the authors did not record in any of the groups a change of lipids, potassium, uric acid, the haemogram, liver tests or creatinine. Treatment was well tolerated and undesirable effects were rare (most frequent side effects: cough 3.5%, vertigo also 3.5%). The results of the study indicate that spirapril is an effective and well tolerated ACE inhibitor in the treatment of hypertension and its combination with bopindolol is equally suitable as the combination of spirapril with hydrochlorothiazide.
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PMID:[Spirapril in the therapy of mild and moderately severe hypertension. A Czech and Slovak multicenter study]. 855 92


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