Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Guanfacine, an alpha 2-adrenoceptor agonist, was compared with clonidine as step-2 therapy of mild to moderate essential hypertension in a 24-week, double-blind, randomized, parallel evaluation to determine efficacy, safety and occurrence of withdrawal syndrome. During a 5-week period, patients were weaned from current antihypertensives, if any, and stabilized on step-1 therapy with 25 mg of chlorthalidone once a day. Those with a diastolic blood pressure (BP) from 95 to 114 mm Hg while taking chlorthalidone were randomized to treatment. The 2 agents had equal efficacy; 149 of 270 patients treated with guanfacine (55%) and 164 of 276 treated with clonidine (59%) achieved goal diastolic BP of less than or equal to 90 mm Hg. Terminations because of adverse effects were relatively low. Dry mouth (30% of guanfacine and 37% of clonidine groups) and somnolence (21% of guanfacine and 35% of clonidine groups, p less than 0.05) were reported most frequently. Nonsyncopal dizziness was reported in 11% of guanfacine-treated and 8% of clonidine-treated patients. This difference was not statistically significant. To evaluate the occurrence of a withdrawal syndrome in 316 outpatients and 156 inpatients, vital signs were monitored at least twice a day for up to 7 days after the end of therapy. Segmented 24-hour urine studies were performed on inpatients. Abrupt withdrawal of clonidine produced a rapid increase in diastolic and, especially, systolic BP, whereas guanfacine withdrawal produced more gradual increases. The differences were significant over the first 3 withdrawal days. It is concluded that guanfacine is a safe, effective, second-generation alpha 2-adrenoceptor agonist.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of guanfacine versus clonidine for efficacy, safety and occurrence of withdrawal syndrome in step-2 treatment of mild to moderate essential hypertension. 351 30

We compared verapamil and propranolol hydrochloride for monotherapy of hypertension. Verapamil lowered blood pressure (BP) more effectively than propranolol in black and white patients. Verapamil was equally effective in blacks and whites, whereas propranolol was more effective in whites. Heart rate was reduced by 6.0 beats per minute by verapamil, and by 13.6 beats per minute by propranolol. In blacks, verapamil lowered systolic BP 16.9 vs 8.1 mm Hg for propranolol; verapamil reduced diastolic BP 12.8 vs 8.6 mm Hg for propranolol. In whites, verapamil lowered systolic BP 19.0 vs 12.7 mm Hg for propranolol; verapamil reduced diastolic BP 16.7 vs 12.3 mm Hg for propranolol. Increases in systolic BP were observed in 22% and 3.4% of patients receiving propranolol and verapamil, respectively. The PR interval was increased from 163.5 to 174.9 ms for verapamil vs 160.3 to 164.4 ms for propranolol. Constipation (15%) and headaches (10%) were most frequent complaints for verapamil vs fatigue (18%) and dizziness (7%) for propranolol. Changes in blood biochemistry values were of small magnitude. We conclude that verapamil monotherapy is a safe and effective means of achieving BP control in patients with essential hypertension.
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PMID:A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response. 353 60

The antihypertensive efficacy and tolerability of a fixed-dose combination containing 40 mg penbutolol (a beta-blocking agent) and 6 mg piretanide (a diuretic) in comparison to placebo was investigated in a double-blind, crossover study in 20 patients with mild to moderate essential hypertension. After a 1-week period on placebo, patients were allocated at random to receive 1 tablet daily for 4 weeks of either the combination preparation or placebo and were then crossed over to the alternative medication for a further 4 weeks. The reduction in systolic and diastolic blood pressure both at rest, during maximal ergometric exercise and isometric word load, and also in the diurnal blood pressure profile over 24 hours was significantly greater in the group treated with the fixed-dose combination than in the placebo group. Pulse rate was also decreased to a greater extent. Mean diastolic blood pressure before exercise was reduced to normal (85.5 mmHg) after 4-weeks' treatment with the fixed-dose combination. Biochemical, haematological and urinary parameters showed no clinically relevant changes after either treatment. One patient complained of transient dizziness during treatment with the fixed-dose combination. No patient withdrew prematurely from the study because of side-effects.
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PMID:Efficacy of a fixed-dose combination of 40 mg penbutolol with 6 mg piretanide in the treatment of mild to moderate hypertension: a double-blind study against placebo. 355 58

It has been reported that the first-dose response to prazosin is more common in patients who are salt-depleted or already receiving beta blockers. The relationship between the first-dose blood pressure and plasma renin responses to oral administration of 1 mg prazosin in 13 (seven male, six female) patients with essential hypertension (average blood pressure = 150/100 +/- 5/2 mm Hg) was studied. Eight of 13 patients experienced marked orthostatic decreases in blood pressure associated with nausea and dizziness. The degree of the orthostatic depressor response was inversely correlated with the baseline plasma renin activity (p less than 0.005). This unique sensitivity of low-renin essential hypertension to prazosin may reflect an underlying increased alpha tone and/or an attendant blunted renin reactivity in this form of human essential hypertension.
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PMID:Relationship of blood pressure response and the renin-angiotensin system to first-dose prazosin. 388 42

An open, co-operative study was carried out in 227 patients with mild to severe essential hypertension to assess the efficacy and tolerance of penbutolol, given as monotherapy, in controlling blood pressure. Patients received a single daily dose (40 mg in the majority) for 8 weeks and were assessed every 2 weeks. The results showed that there was a significant reduction (p less than 0.01) in systolic, diastolic and mean arterial blood pressure and in pulse rate after 2 weeks compared with pre-treatment values, and there was a further significant reduction (p less than 0.01) comparing 8-week values with those measured after 2 weeks. Response to treatment did not differ significantly between those patients who were newly diagnosed and those who had received previous antihypertensive medication. The largest percentage reduction in blood pressure from initial values was recorded in those patients with the more severe hypertension (diastolic 116 to 130 mmHg) and a considerable number of all the patients became normotensive during the trial period. Records of side-effects indicated a global incidence of 17.6%, the most frequently reported being dizziness and mild gastro-intestinal disorders; only 1 patient complained of bradycardia and another of cold extremities. Eighteen (7.9%) patients dropped out of the study due to side-effects.
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PMID:Antihypertensive efficacy and tolerance of penbutolol: results of a co-operative study in 227 patients. 388 7

Pinacidil, a new cyanoguanidine derivative, is an antihypertensive agent with arteriolar vasodilating properties, which acts on precapillary resistance vessels. A trial was carried out in 30 patients with essential hypertension WHO I-II. The treatment period was divided into three phases. Hydrochlorothiazide (HCTZ) and amiloride were administered for 4 weeks in Phase 1 and supine and standing blood pressure decreased significantly. During Phase 2 pinacidil was added to HCTZ/amiloride for the following 3 months. A further significant reduction in blood pressure was obtained. In the next period of treatment (Phase 3) patients were divided into two groups. For 1 month Group A (15 patients) received pinacidil alone and Group B (15 patients) received HCTZ/amiloride. Conventional laboratory blood tests in all patients remained unchanged during treatment. Reported side effects during Phase 2 were headache (2 patients), dizziness (3 patients), palpitations (2 patients) and ankle oedema (2 patients). Plasma renin activity was slightly increased at the end both of Phases 1 and 2. Plasma catecholamines were increased but not significantly at the end of Phase 2 as compared to Phase 1. The results indicate that pinacidil is effective in lowering blood pressure in mild to moderate essential hypertension.
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PMID:Effect of pinacidil on blood pressure, plasma catecholamines and plasma renin activity in essential hypertension. 389 69

114 patients from four clinics participated in a double blind study designed to assess the efficacy of a nifedipine-acebutolol fixed combination -10 mg + 100 mg - as compared with acebutolol -200 mg- in essential hypertension. During the ten week study the mean blood pressure readings (s.d.) 1-3 h after treatment decreased from 179.2/104.8 (10.2/6.2) to 150.3/87.7 (9.8/7.7) in the combination group and from 181.7/106.5 (14.4/7.0) to 150.4/89.0 (15.0/10.4) in the acebutolol group. The mean systolic and diastolic blood pressures were also decreased after exertion (load) and 24 hours after treatment at the end of the 6th week of the study. A doubling of the dose from week 7 to 10 did not change these figures. These results reveal the possibility of treating essential hypertension with a low dose of beta-adrenergic blocking agents in combination with 10 mg nifedipine. Both drugs were well tolerated. 3 patients (5%) in the combination group and 3 patients in the acebutolol group were withdrawn from the study because of headache and dizziness.
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PMID:Effects of a fixed combination of low dose nifedipine and acebutolol on essential hypertension: comparison with standard dose acebutolol. 391 Mar 3

In 20 patients with long-standing essential hypertension, a comparison was made in a randomized cross-over study of the effect of once and twice daily prazosin administration on blood pressure levels. Concurrent medication (beta-blocker and/or saluretic once daily) remained constant throughout the study. Blood pressure measurements were carried out by a nurse using a Hawksley random zero sphygmomanometer, both in the clinic and at home, and using a Roche Kontron Arteriosonde SR-2 at home. Observations made in the morning and in the evening showed no significant difference in blood pressure between the once and twice daily treatments. Eight patients complained of dizziness and faintness half an hour after taking the once daily dose. However, they felt quite well on the twice daily regimen. The mean daily dose in these 8 patients was prazosin 8.4 mg, range 6-12 mg. No indication was found that the subjective adverse side effects were correlated with the serum prazosin level. The complaints noted may possibly be overcome by taking the once daily dose late in the evening, just before retiring. Better still, the development of a slow-release formulation for daily dosages of 6 mg and over is suggested.
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PMID:Prazosin once or twice daily? 398 82

Twenty three patients with essential hypertension who were uncontrolled on diuretic and/or beta-receptor antagonist therapy were treated additionally with the vasodilator, pinacidil, in an open study. Significant reduction in mean blood pressure was achieved. Supine and erect systolic and diastolic blood pressure fell by 44/25 mmHg and 37/24 mmHg respectively over the study period of 12 weeks. Side-effects such as dizziness, headache, facial flushing and mild oedema were experienced by 10 patients during the study, all of which were mild and transient and did not require withdrawal from pinacidil therapy. Pinacidil is an effective and well tolerated agent in the treatment of essential hypertension.
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PMID:Pinacidil, a new vasodilator, in the treatment of mild to moderate essential hypertension. 400 40

An open study was undertaken to investigate the efficacy and adverse effects of indoramin in 33 patients with essential hypertension whose blood pressure was uncontrolled (diastolic blood pressure 96 to 115 mm Hg) despite previous treatment with one or two antihypertensive drugs. Indoramin was added to the existing antihypertensive therapy and the dose titrated to a maximum of 150 mg/day or until blood pressure control was achieved (diastolic blood pressure less than 90 mm Hg or a reduction in diastolic blood pressure of 15 mm Hg). Patients were then followed up for a further 4 weeks. Indoramin significantly reduced mean standing systolic and diastolic blood pressure from 167/113 +/- 19.8/7.2 (SD) mm Hg to 150.3/101.1 +/- 23.4/8.9 (SD) mm Hg after 10 weeks and mean supine systolic and diastolic blood pressure from 169.8/110.8 +/- 16.4/5.6 (SD) mm Hg to 154.2/102.1 +/- 23.8/12 (SD) mm Hg after 10 weeks. Blood pressure was controlled in 21 of the 33 patients (63.6%) studied. Indoramin caused a small but significant fall in pulse rate of 3.9 beats per minute, in the supine position, after 4 weeks therapy. 10 patients experienced adverse effects, the most common being dizziness and headache (3 patients each), and lightheadedness/fainting on standing (2 patients). No patient experienced sedation. Only 1 patient was withdrawn from the trial because of adverse effects (fainting on standing). Biochemical and haematological investigations carried out pretreatment and during treatment showed no abnormalities related to indoramin treatment.
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PMID:[Open study on the effect and side effects of indoramin, used at the 2d and 3d therapeutic step in essential hypertension]. 406 Jul 42


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