UMLS:C0012833 - FACTA Search

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Query: UMLS:C0012833 (dizziness)
9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an open multicenter trial (uncontrolled study) in 4,247 patients (49.1% male, 50.9% female; aged 17-89 years) with mild, moderate, or severe hypertension, the antihypertensive efficacy and in particular the tolerability of verapamil slow-release (SR) 240 mg (Isoptin RR) were studied. The dosage of the drug was adjusted to the therapeutic response; in 88.7% of the patients it was titrated according to the study protocol: 63.2% received constantly one SR tablet throughout the 6-week treatment period; in 15.6% the dosage was increased to one and a half tablet after 2 weeks, and in 9.9% to one tablet b.i.d. after a further 2 weeks. Monotherapy with verapamil SR 240 mg normalized diastolic blood pressure (less than or equal to 90 mm Hg) in 90% of the patients with mild hypertension, 77% of those with moderate, and 61% of those with severe hypertension. It was evident that blood pressure reduction was more pronounced the higher the baseline value. Cardiac and extracardiac tolerability of verapamil SR 240 mg was good. Mean heart rate was slightly reduced, none of the patients developed a second- or third-degree atrioventricular block. Side effects were reported by 480 of the 4,247 patients (11.3%). As expected, constipation (4.03%) was the predominant adverse reaction, followed by dizziness (3.65%), headache (1.54%), and other (less than 1%). In 217 patients (5.1%) therapy was discontinued prematurely, in 139 (3.27%) because of side effects.
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PMID:Efficacy and safety of verapamil SR 240 mg in essential hypertension: results of a multicentric phase IV study. 247 86

Throughout the developed world, populations are growing older. Blood pressure, especially systolic blood pressure, increases with aging, and this increase leads to increased risks of cardiovascular morbidity and mortality. Clinical trials demonstrate that treatment of hypertension in the elderly reduces overall cardiovascular mortality, cardiac mortality, nonfatal cardiovascular events, congestive heart failure, progression to severe hypertension, and strokes. Drug treatment has been well tolerated, but diuretic therapy has been known to increase plasma glucose, uric acid, and creatinine. Therapeutic trials of nonpharmacologic treatment may be indicated in those with mild elevation in blood pressure and no serious end organ disease. However, most people up to age 80 will require drug treatment. Many drugs are effective in the elderly, but, some like beta-blockers, may not be as effective as in younger patients. Controlled clinical trials demonstrate that nitrendipine, a calcium channel blocking drug, significantly reduced mean systolic and diastolic blood pressure in older hypertensive patients, (successfully controlling pressure in a high percentage) and was well tolerated. Drug effects persist for 12 h or more. The drug decreased the exercise-induced rise in the rate-pressure product. Although there is a temporary increase in heart rate, this returns to baseline after a short time. Side effects include headache, flushing, dizziness, edema, and palpitations. Therefore, nitrendipine offers a reasonable and useful alternative to many other drugs in the treatment of combined systolic and diastolic hypertension in the elderly.
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PMID:Epidemiologic aspects of elderly hypertensive patients and the results of treatment with nitrendipine. 248 68

AFR 35-11, dated 10 April 1985, included standards for physical fitness performance tests with the option of a 1.5-mile run or a 3-mile walk. Since that time, ANG units have begun initial physical fitness testing of all personnel. This program brought with it new responsibilities for ANG medical units including the screening of individuals in whom health problems might indicate that they are at risk in taking the physical fitness test (PFT). The 111th TAC Clinic used a questionnaire, screened by physicians utilizing a predetermined grid of responses to designate individuals cleared for the run or walk test or as at risk. Of 823 individuals screened, 91 (11%) were designated at risk. These individuals are being further evaluated and 31 (29%) have been subsequently cleared to date. Physical testing of cleared individuals was accomplished, and both running and walking courses were carefully monitored by ambulance crews. Four casualties came to medical attention (blisters, severe fatigue, dizziness, and indigestion). The patient with severe fatigue was a patient on medical hold, S/P myocardial infarction, who had not been medically cleared to participate. The patient with light-headedness was found to have newly diagnosed hypertension. In view of the relatively small number of casualties incurred during this initial PFT, it is felt that the screening process employing a questionnaire evaluated by medical personnel is an appropriate method of minimizing risk.
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PMID:Report of an Air National Guard clinic's experience with screening at-risk individuals before initial physical fitness testing. 250 60

The clinical features of an inner-city population of 304 patients presenting with acute myocardial infarction (MI) with and without typical chest pain, were studied retrospectively. This population consisted of 172 men and 132 women; 155 (51%) were black, 88 (29%) hispanic, and 61 (20%) white, by self-identification. Typical ischemic chest pain was the presenting symptom in 85% (258); 15% (46) presented with nonchest symptoms, most frequently shortness of breath, abdominal pain, and dizziness. But the frequency of such nonchest symptoms was similar in both groups. When patients were grouped by the presence or absence of chest pain, the proportions of those without chest pain were significantly higher for blacks (22.7%) than hispanics (9.1%, P = 0.001) or whites (4.9%, P less than 0.01). Patients without chest pain also had higher admission systolic (P less than 0.01) and diastolic (P less than 0.01) blood pressures and more frequent histories of congestive heart failure (P less than 0.05), and more often presented with pulmonary edema (P = 0.001) than those with chest pain. Both groups were similar in age, sex, history of hypertension, and presence of hypertension on admission, defined as greater than or equal to 160/95 mmHg, prevalence of diabetes, history of smoking, previous MI, type of MI, history of angina, and mortality rates. Patients without chest pain were characterized by black race, history of congestive heart failure, elevated blood pressure and pulmonary edema than those with typical ischemic chest pain. Thus significant delays in the diagnosis and treatment of this important clinical entity may be reduced by alerting clinicians to these features and by educating selected patient groups.
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PMID:Clinical features of patients with acute myocardial infarction presenting with and without typical chest pain: an inner city experience. 252 Aug 50

Most alpha-receptor blocking drugs require divided daily administration because of a short plasma half-life. This multicenter study examined the effectiveness and safety of once-daily administration with doxazosin, a quinazoline analog alpha 1-receptor blocking drug with a plasma half-life of 19 hours. Patients with diastolic blood pressure (BP) of 90 to 115 mm Hg entered 4 weeks of single-blind placebo therapy and then were randomized to double-blind treatment with doxazosin (63 patients) or placebo (67 patients). After 10 weeks of titration, standing arterial BP was lowered by 14/11 mm Hg with doxazosin and by 0.5/0.9 mm Hg with placebo (p less than 0.001). Measured hourly for 12 hours after the dose, all standing and supine arterial BP values were significantly lower in the doxazosin group at each hour. Pulse rate increased slightly in both groups int he double-blind phase, but the increase with doxazosin never significantly exceeded that of placebo. Dizziness was the most common complaint with doxazosin, but syncope did not occur. Side effects were mild and transient and did not necessitate withdrawing any participants from the study. Body weight increased by 1.5 kg in the doxazosin group and decreased by 0.2 kg in the placebo group (p less than 0.01). Safe and effective in once-daily administration, doxazosin is suitable for initial therapy in mild and moderate hypertension.
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PMID:Effectiveness of doxazosin in systemic hypertension. 252 70

In order to develop the tentative criteria of the differential diagnosis, 18 patients with obstructive hypertrophic cardiomyopathy (OHCMP), 3 with nonobstructive hypertrophic cardiomyopathy (NOHCMP), 8 with essential hypertension (EH) with inadequate left ventricular hypertrophy (LVH) and 10 normal persons were subjected to clinical examination and to ultracardiosonography. The patients with OHCMP mainly complained of dizziness and syncopes. Since childhood they had systolic murmur and ECG abnormalities. Ultracardiosonography showed asymmetrical LVH, a considerable decrease of the ventricular cavity as well as abnormalities of the localization and function of the papillary muscles. NOHCMP was marked by the combination of the good well-being of the patients with gross abnormalities on the ECG. Ultracardiosonography demonstrated moderately pronounced and asymmetrical LVH. The group suffering from EH with inadequate LVH was characterized by the early development of severe circulatory failure with arterial hypertension of moderate intensity. The changes in the architectonics of the left ventricle and its subvalvular structures turned out to be similar to those in OHCMP but were less remarkable.
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PMID:[The differential diagnosis of various forms of hypertrophic cardiomyopathy and hypertension with inadequate left ventricular hypertrophy]. 253 35

The effect of cilazapril, a new inhibitor of angiotensin-converting enzyme, in a dosage of 2.5 or 5 mg once daily, was compared with that of hydrochlorothiazide 25 or 50 mg in 169 patients with mild to moderate hypertension. Blood pressure at entry was 158/103 mm Hg (cilazapril) and 160/103 mm Hg (hydrochlorothiazide). Cilazapril 2.5 mg caused a decrease in blood pressure of 14.7 +/- 2.3/12.6 +/- 1.2 mm Hg compared with a decrease of 12.6 +/- 2.2/10.2 +/- 1.2 mm Hg with hydrochlorothiazide 25 mg. Those patients who required an increase of dosage to the higher level then showed decreases of 15.0 +/- 2.1/14.3 +/- 1.2 (cilazapril) and 19.7 +/- 1.9/13.3 +/- 1.2 hydrochlorothiazide. All decreases in blood pressure were statistically significant but were not statistically different from each other. Fifty-one percent of patients reached a sitting diastolic blood pressure of 90 mm Hg or less receiving 2.5 mg of cilazapril and an additional 28 percent of patients reached this goal receiving 5 mg. The figures for patients receiving hydrochlorothiazide were comparable: 36 and 35 percent. Twenty-one adverse events remotely, possibly, or probably related to therapy were reported with cilazapril and 32 with hydrochlorothiazide. Three patients withdrew from cilazapril because of mild angioedema, headaches, and chest pain, respectively, and three patients withdrew from hydrochlorothiazide treatment because of fatigue, dizziness, and gastric hemorrhage. Hydrochlorothiazide caused a decrease in potassium levels and an increase in levels of cholesterol, uric acid, urea and - gamma cilazapril had no adverse biochemical effects. Cilazapril lowered blood pressure to the same extent as hydrochlorothiazide. Young patients had better responses to cilazapril than to hydrochlorothiazide. It is concluded that cilazapril is an effective and safe drug for patients with mild to moderate hypertension.
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PMID:Efficacy of cilazapril compared with hydrochlorothiazide in the treatment of mild-to-moderate essential hypertension. Multicentre Study Group. 253 59

Cilazapril is a structurally new angiotensin-converting enzyme inhibitor that lacks a sulfhydryl moiety. Its duration of action is consistent with a once-daily regimen. Cilazapril was studied in multiple-dose trials that included more than 4,500 hypertensive patients worldwide. Approximately 450 patients received cilazapril as monotherapy for more than one year, and another 430 patients were treated with cilazapril in combination with hydrochlorothiazide for more than six months. Cilazapril at doses of 2.5 to 5 mg once daily is clinically and statistically significantly more effective than placebo and as effective after eight weeks of therapy as hydrochlorothiazide, atenolol, propranolol sustained release, captopril, and enalapril at the doses recommended by the manufacturers. The overall incidence of adverse events observed during cilazapril therapy is comparable with that seen with placebo in double-blind studies. Cilazapril 2.5 to 5 mg once daily seems to be better tolerated than hydrochlorothiazide and atenolol. Only five adverse events were reported at an incidence of 1 percent or more in controlled trials; these were headache, dizziness, fatigue, nausea, and chest pain, which all occurred at a frequency similar to that with placebo. Overall, cilazapril is effective and well-tolerated in the treatment of patients with hypertension.
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PMID:Cilazapril: a new non-thiol-containing angiotensin-converting enzyme inhibitor. Worldwide clinical experience in hypertension. 253 61

Although calcium antagonists may impair insulin release in vitro, clinical studies have produced conflicting results. Felodipine is a highly selective dihydropyridine calcium antagonist effective in the treatment of hypertension. The efficacy of felodipine was assessed in a double-blind randomized placebo cross-over study of 21 Type 2 diabetic patients with primary hypertension, 13 men and 8 women, with an age of 61 (range 46-73) years. Thirteen were controlled on oral hypoglycaemic therapy and 8 on diet alone. Mean (SD) blood pressure (mmHg) was 176(20)/102(8) after a 2-4 week placebo run-in period, 169(21)/101(8) during the subsequent placebo period compared with 151(15)/88(9) after 4 weeks felodipine therapy (p less than 0.001). Nineteen patients required 5 mg twice daily and 2 patients 10 mg twice daily to achieve a target diastolic pressure of 95 mmHg. Side-effects seen with felodipine included ankle oedema, facial flushing, headache, and dizziness. During oral glucose tolerance tests performed after the felodipine and placebo phases, mean (SD) fasting blood glucose was 9.5(3.1) and 9.0(3.0) mmol l-1, respectively (NS), and the 90 min (peak) blood glucose was 19.1(4.8) and 18.1(4.8) mmol l-1, respectively (NS). Glycosylated haemoglobin and fructosamine concentrations likewise showed no significant changes.
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PMID:A trial of the calcium antagonist felodipine in hypertensive type 2 diabetic patients. 253 42

The safety and tolerability of lisinopril (1.25-160 mg daily) were assessed in 3,270 patients (2,688 hypertensives and 582 patients with congestive heart failure (CHF] and 280 healthy subjects. The duration of therapy ranged from a single dose to 43 months; 438 patients received lisinopril for at least 12 months (mean 20 months). In the hypertensive population, the most frequent adverse events reported were headache, dizziness, cough, nausea, diarrhoea and fatigue, although not all of these events were thought to be related to lisinopril; 6.1% discontinued lisinopril due to adverse clinical events, most commonly cough and nausea. Twelve hypertensive patients died (0.45%), but most of these were not receiving lisinopril at the time of death and none was considered to be drug-related. In CHF patients, the most frequently reported adverse events were dizziness, dyspnoea, diarrhoea, hypotension and fatigue. Again, not all of these reports were considered to be drug-related. Therapy was withdrawn in 9.6% of patients--hypotension, dizziness, diarrhoea and rash being the most frequent reasons. Fifty-three CHF patients died (9.1%) and in three cases death was considered to be related to lisinopril therapy. Hypotension, orthostatic effects or dizziness following the initial dose of lisinopril occurred infrequently (in 1.3% of the hypertensive group, including those receiving hydrochlorothiazide, and in 4.8% of CHF patients). Changes in laboratory parameters were generally minor and seldom resulted in discontinuation of therapy. Long-term treatment of hypertension and CHF with lisinopril for at least 3 years confirms that the drug is well tolerated. Overall, the side-effect profile is very similar to that of other ACE inhibitors with regard to class-specific effects. However, taste disturbance was rarely observed.
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PMID:Clinical experience with lisinopril. Observations on safety and tolerability. 255 Jun 41

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