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This paper reports the findings of an open evaluation of 100 patients treated with prazosin. When prazosin was added to existing hypotensive regimens in 50 patients whose blood pressure was poorly controlled, 36 (72 percent) became normotensive. Treatment was initiated with prazosin in a further 50 patients. Satisfactory control was achieved with prazosin alone in 24 and 20 of these became normotensive. The remaining 26 patients received in addition a beta-adrenoreceptor blocking agent together with a thiazide diuretic in 14. While prazosin alone caused a mean fall of 26/14mmHg in this group, the enchanced efficacy of combined therapy achieved a normal blood pressure in 19 (73 percent) and a total mean fall in pressure of 42/28mmHg. The most frequent side effect was dizziness or faintness at the start of therapy or, less often, when the dose was increased. This is minimised by using a low initial dose of 0.5mg two or three times daily. Prazosin is an effective hypotensive agent, used alone or in combination, in most patients with hypertension of all degrees of severity.
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PMID:Prazosin in hypertension. Part I. Clinical experience in 100 patients. 2 93

The efficacy of labetalol in lowering blood pressure was assessed in 18 patients with chronic renal failure and hypertension. Before the start of labetalol therapy, all patients were receiving combined antihypertensive therapy, the most common being a beta-blocker and hydrallazine. Over the period of about four weeks labetalol was substituted for the prior therapy. 51Cr edetic acid (EDTA) estimations of glomerular filtration rate were performed before labetalol therapy, and then again after one and six months. Before the therapy with labetalol, 12 of the 18 patients had supine diastolic blood pressures of 100 mm Hg or more. At six months, 14 patients remained in the trial and, of these, only four had a supine diastolic blood pressure of 100 mm Hg or more. In the supine position there was a significant reduction of systolic, but not of diastolic, blood pressure. However, in the erect position there was a significant reduction both in systolic and in diastolic blood presure. Pulse rate did not vary significantly. Few side effects were encountered, transient postural dizziness being the most common side effect. Labetalol seems to be an effective substitute for the beta-blocker plus hydrallazine therapy. However, it is not as potent as minoxidil.
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PMID:Labetalol in the treatment of hypertensive renal patients. 2 15

Twenty-two chronic hemodialysis patients with hypertension were treated with prazosin. Eight patients had volume-responsive hypertension, 11 volume-indpendent, and 3 high-renin hypertension. Blood pressure fell in all volume-responsive patients from a predialysis level of 175 +/- 5/100 +/- 3 to 148 +/- 4/75 +/- 3 mm Hg (p less than 0.001) after 3 months of therapy. Prazosin alone was effective in volume responsive patients at a dose of 5 +/- 1.0 mg daily. The blood pressure fell in volume-indpendent patients from 192 +/- 7/105 +/- 2 mm Hg predialysis to 155 +/- 6/80 +/- 3 after 3 months (p less than 0.001). Two were controlled on prazosin alone at a dose of 12 +/- 2 mg daily. Nine required 27 +/- 5 mg of prazosin daily as well as additional antihypertensive treatment. The blood pressure fell from 183 +/- 3/109 +/- 6 mm Hg predialysis to 173 +/- 17/85 +/- 3 mm Hg in high-renin patients after 3 months. One patient was controlled on 40 mg of prazosin daily. Two required 40 mg of prazosin daily as well as additional antihypertensive medication. Eleven patients described transient dizziness within the first month of therapy. One patient had recurrent syncope necessitating prazosin withdrawal; Prazosin is an effective antihypertensive agent which can be used in all types of hypertensive dialysis patients either alone or in combination with minimal side effects.
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PMID:Effects of prazosin in the control of blood pressure in hypertensive dialysis patients. 9 39

Long-acting oral contraceptives (OCs) for women were available for clinical experimentation in 1969. Through the country, 29 provinces, cities, and autonomous regions participated in this expirement. Based upon the cases between 1969 and 1976 findings from this expirement can be summarized as follows: 1) the 3 types of long-acting OCs have proved to be very effective, and the rate of breast cancer and cervical cancer is lower than the normal rate. The childbearing ability can be restored rapidly after discontinued use of the contraceptives. The impact on menses and metaboliism is not very serious. The health of the users and the newborn babies has not been found to be endangered. Statistics show that long-acting OCs are comparatively more secure measures for birth control; 2) some users have experienced dizziness, nausea, and excessive leukorrhea, and discontdiscontinued because of discomfort and inconvenience. This situation has some impact on the popular use of long-acting OCs. Research and studies are underway on a reduced dosage and reduction of side effects; 3) women who suffer from hepatitis, nephritis, a history of liver and kidney problems, breast tumors, cervical cancer, diabetes, active low blood sugar, or a history of having over-sized babies, or an overweight problem should not use OCs. Women who suffer from high blood pressure can only use OCs with a doctor's advice and caution.
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PMID:[Clinical observations on long-acting oral contraceptives--a report of 43,373 (author's transl)]. 26 34

A total of 242 women with moderate hypertension in pregnancy completed a controlled trial of methyldopa (Aldomet). The hypotensive effect of methyldopa was similar to its action in non-pregnant individuals and greatly reduced the frequency of severe hypertension occurring antenatally and in labour. As pregnancy advanced, an increasing daily dose of methyldopa was needed and there was a greater use of additional hypotensive therapy. Seventeen (14-5 per cent) women assigned to methyldopa had to be transferred to another drug or had to stop treatment completely because of minor side effects, of which the commonest were lack of energy and dizziness. No serious side effects were encountered. Nine per cent of the untreated women developed severe hypertension which required treatment later in their pregnancies. Six weeks after delivery, nearly all the patients were able to stop treatment.
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PMID:Treatment of hypertension in pregnancy with methyldopa: blood pressure control and side effects. 32 59

Different causes of dizziness or vertigo can only be recognized by thorough anamnestic explorations. Following a classification in vestibular and nonvestibular causes for vertigo, a further differentiation is possible by defining different characteristic qualities of the symptoms involved. In addition to the classical vestibular forms of vertigo seen, dizziness currently results from drug overdosages, hypertension, polyneuropathy and--less commonly, but equally important--brief epileptic seizures. Psychosomatic and neurotic symptoms may also lead to unsteady gait, dizziness or vertigo, all of which are distinguished only with difficulty by the patient.
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PMID:[Diagnostic problems in dizziness or vertigo (author's transl)]. 35 Aug 16

A large, open, multi-centre study was carried out in general practice to evaluate the effectiveness and tolerance of a combination of 10 mg pindolol plus 5 mg clopamide, in single tablet form, in the treatment of patients with essential hypertension. Computer analysis of the records of 8989 patients who completed the 8-weeks' study period showed that treatment with the combination product, in a dosage of 1 tablet daily in 83% of the patients, resulted in excellent blood pressure control in the majority (75%) of cases, irrespective of age or previous antihypertensive treatment, and was particularly effective in those with mild to moderate hypertension who had previously not received any therapy. Side-effects were generally not troublesome and only 8.3% of patients stopped treatment for this reason. The most commonly reported side-effects were dizziness, nausea, tiredness and headache.
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PMID:A multi-centre general practice trial of a pindolol/clopamide combination ('Viskaldix') in essential hypertension. 39 10

40 women were given Oestro-feminal (Mack), a menopause drug as outpatients of the Obstetrics Clinic of the Institute of Gynecology and Obstetrics in Wroclaw. 10 of the women who were at the pre-menopause stage took 1 capsule before breakfast from the 5th to the 25th day of their menstrual cycle. During the last 4 days they took in addition, 50mg of progesterone in tablet form. Another 10 women experiencing slight menopausal symptoms such as dizziness, occasional high blood pressure, heat flashes, increased irritability, some swelling and in 6 cases, irregular and heavy periods, took 1 capsule before breakfast for 20 days. After a 7 day break they began the series again. 20 women with acute menopausal symptoms such as those already described, which had appeared after hysteroctomy, took 2 capsules, one in the morning and one in the evening for 5 days and then 1 capsule in the morning for 10 days. Following a 7 day break, they took 1 capsule in the morning for 20 days. All 3 groups completed 3 cycles of treatment. Ostro-feminal quickly relieved their menopausal complaints. 1 capsule of Oestro-feminal consists of 1.25 mg natural estrogens: 70-90% estrone; 8-15% equilin; up to 4% equilinine; 17 alpha estradiol, delta-17-alpha estradiol and delta 6.8-17 alpha estradiol 2-8%; other alpha and beta estrogens below 2%. The authors cannot explain the drug's successful therapeutic results but nevertheless, strongly recommend prescribing it and eventually, drawing conclusions from a much larger sample of users.
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PMID:[Clinical evaluation of estro-feminal preparation]. 68 78

The antihypertensive effect of labetalol, a new alpha- and beta-adrenoceptor inhibiting agent, was studied in 20 patients in a double-blind crossover trial. A dose of 300 mg daily reduced blood pressure only moderately in the supine position, though in the sitting and standing positions the effect was more pronounced. A dose of 600 mg daily produced statistically significant and clinically relevant reductions in blood pressure in all positions studied. The effect on heart rate was small and of significance only in reducing the heart rate increment due to a change in posture. Side effects were mild: only one patient complained of postural dizziness with the higher dose. We conclude that labetalol is useful in the treatment of mild and moderately severe hypertension.
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PMID:Combined alpha- and beta-adrenoceptor blockade with labetalol in hypertension. 77 98

Debrisoquine, an antihypertensive agent, was compared with methyldopa in a double-blind trial in the treatment of hypertension in 20 patients. The cross-over method was used to treat each patient with first one and then the other drug for two periods of six weeks each. Two placebo periods of two weeks each were also included, one before the trial, and the other between the two therapy periods. The maximum daily dose was 3 X 10 mg debrisoquine compared with 3 X 250 mg methyldopa. Hydrochlorothiazide, 50 mg daily, was added in all cases for the entire trial. Both preparations lowered blood pressure statistically significantly (p less than 0.005). Tablet for tablet, debrisoquine had a slightly more pronounced effect than methyldopa, but the difference was not statistically significant. Both drugs were well tolerated and in no case had treatment to be interrupted because of side effects. Debrisoquine produced less sedation and dizziness than methyldopa. The conclusion was that both drugs were equally effective in the doses studied and well tolerated and that debrisoquine is of value in the treatment of moderate hypertension.
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PMID:A comparison of debrisoquine and methyldopa in hypertension. 77 88


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