Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The action of nifedipine tablets was examined in 17 patients with essential hypertension focusing particularly on the profile of blood pressure (BP) reduction over 24 hours resulting from both twice-daily and once-daily therapy (dose range 40 to 120 mg daily). This new formulation of nifedipine has a more prolonged and lower peak plasma level than an equivalent dose of nifedipine capsules. Our patients were fully ambulant and studied by continuous intraarterial recording techniques. BP responses during isometric and dynamic exercise testing were also observed. Within-patient comparisons of consecutive mean hourly systolic and diastolic BP showed a highly significant effect from twice-daily therapy (p less than 0.001) for nearly the entire day. Also, significantly lower BP was maintained during isometric and dynamic exercise. Mean hourly heart rates were not significantly altered. The profile of action of the single morning dose was initially similar, but its efficacy diminished from 6 P.M. to 8 A.M. on the following day. Side effects were not unduly troublesome and did not cause any patient withdrawals. Four patients developed mild ankle edema. Two others had facial flushing. Nifedipine given twice daily in tablet form, therefore, is an effective antihypertensive drug capable of lowering BP consistently over 24 hours in ambulant patients and during formal exercise testing. We suggest that this agent may be useful as initial therapy for systemic hypertension, although the tablets are not as yet widely available.
 ...
PMID:Nifedipine tablets for systemic hypertension: a study using continuous ambulatory intraarterial recording. 684 59

The calcium antagonist nifedipine (Adalat) was administered to 60 patients with essential hypertension and investigations were performed on acute and chronic hypotensive effects. The following results were obtained: 1. Acute hypotensive effects: Nifedipine (20 mg) was either orally or sublingually administered. Following oral administration, significant hypotensive effect was attained 20 min after administration and the maximum hypotensive response was obtained 2-4 h after administration. In cases of sublingual administration, significant hypotensive effect was notable 5 min after administration and blood pressure reached the lowest level 2-3 h after administration. The hypotensive effects lasted for a relatively longer period and significantly lower blood pressure than the control level was observed even 3 h after administration. 2. Chronic hypotensive effects: Nifedipine (30-60 mg/d) was orally administered consecutively. Significant hypotensive effect was attained in and after the 4th week of administration. The yearly changes in the long-term administration cases over 3 years demonstrated significant hypotensive effects. The cases who did not respond to single administration of thiazides or beta-blockers exhibited significant hypotensive response by the combined use of nifedipine. 3. Change in heart rate: In the acute study, heart rate increased after nifedipine administration and lasted for several hours. In the long-term administration cases, the changes in heart rate were not significant. 4. Side effects attributable to nifedipine such as headache in 2 cases, facial flushing, palpitation, warm sensation and nausea in 1 case each were observed early after the administration but there were no cases in whom administration was discontinued due to these side effects.
 ...
PMID:Antihypertensive effects of the calcium antagonistic agent nifedipine. 720 Jul 85

A limitation of clonidine therapy is the syndrome of rebound hypertension and sympathetic overactivity after withdrawal. Ten patients, four male, six female, aged 28--64 years, with essential hypertension, were treated for one year with an imidazoline derivative, tiamenidine. Blood pressure fell from an average of 178/108 mm Hg pretreatment to 152/86 mm Hg after 1 year. Tiamenidine was then withdrawn in hospital, replaced by identical placebo under single blind conditions and observations made over 96 h. The study was interrupted in five patients (4 patients within 36 h) because blood pressure rose to greater than 30 mm Hg (systolic) or greater than 20 mm Hg (diastolic) above pretreatment values. For the group, blood pressure was maximal at 194/112 mm Hg, 18 h post withdrawal, significantly higher than pretreatment (p less than 0.005). Headache, tremor, flushing and insomnia were noted. Saliva production rose 100% at 24 h. Plasma noradrenaline rose within 24 h with an accompanying rise in urinary metanephrine and catecholamine excretion. Tiamenidine appears to share with other imidazolines rebound cardiovascular and autonomic effects following abrupt withdrawal.
 ...
PMID:Changes in blood pressure, heart rate, and sympathetic activity on abrupt withdrawal of tiamenidine (HOE 440) in essential hypertension. 746 Oct 12

Lacidipine is an orally administered calcium channel blocker of the dihydropyridine class, which shows selectivity for vascular smooth muscle over cardiac tissue and has a long duration of action. In studies using ambulatory blood pressure monitoring, lacidipine 2 to 8mg administered once daily in the morning reduced blood pressure over 24 hours, with the reductions being greater during the day than at night in some studies. 77 to 87% of patients with mild to moderate hypertension had their blood pressure controlled by treatment with lacidipine 2 to 8 mg/day for 1 to 4 months in dose-finding studies. When administered once daily, lacidipine 4 to 6 mg was equivalent in antihypertensive efficacy to hydrochlorothiazide 25 to 50 mg/day, atenolol 50 to 100 mg/day, and the prototype calcium channel blocker nifedipine 20 to 40 mg twice daily (sustained-release formulation). The adverse effects of lacidipine are those common to other dihydropyridine calcium channel blockers, and include headache, flushing, ankle oedema, dizziness and palpitations. The long term effects of lacidipine on cardiovascular morbidity and mortality, and possible additional clinical benefits in terms of its antiatherosclerotic effects, are under investigation; the outcome of these studies will be important in defining the future role of this agent in the treatment of hypertension. Thus, available evidence suggests lacidipine provides a further alternative to the dihydropyridine calcium channel blockers currently available for the treatment of essential hypertension.
 ...
PMID:Lacidipine. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the treatment of hypertension. 752 28

The anti-hypertensive efficacy and safety of extended-release (ER) felodipine (5, 10 or 20 mg) and amlodipine (5 or 10 mg) once daily were compared in patients with mild to moderate essential hypertension in a double-blind, double-dummy, randomised, comparative study. One hundred and eighteen patients were randomised to receive either felodipine ER (n = 57) or amlodipine (n = 61) for 12 weeks. Efficacy was assessed by measuring office blood pressure (BP) at baseline and after 4, 6, 8 and 12 weeks, together with 24h ambulatory blood pressure monitoring (ABPM) at baseline, on day 1 of treatment and at the end of the study. The mean office BP changes from baseline to week 12 were -13.4/-11.8 mmHg for felodipine ER (mean daily dose 11.2 mg) and -15.3/-12.9 mm Hg for amlodipine (mean daily dose 7.4 mg). Changes in office BP between treatment groups were not significant. The mean 24h ambulatory BP changes from baseline to end of the study were -11.6/-10.0 mm Hg for felodipine ER and -16.3/-9.6 mm Hg for amlodipine, both significant (P < 0.01). The fall in systolic ambulatory BP was significantly greater (P < 0.001) in the amlodipine-compared with felodipine ER-treated patients but there was no difference between the groups with respect to diastolic ambulatory BP. Both drugs were well tolerated with only seven patients withdrawing because of side-effects, equally distributed between treatment groups. Headache and flushing were significantly (P < 0.05) more frequent in the felodipine ER group. Amlodipine appears to be more potent on a milligram to milligram basis and induces fewer side-effects than does felodipine ER.
 ...
PMID:Comparative effects of amlodipine and felodipine ER on office and ambulatory blood pressure in patients with mild to moderate hypertension. Danish Multicentre Group. 778 10

The aim of the present study was to evaluate the effect of dihydropyridine calcium antagonist isradipine on left ventricular (LV) structure and function in patients with essential hypertension. Cuff blood pressure and Doppler echocardiographic variables were assessed in 26 patients with mild to moderate hypertension (diastolic blood pressure range 95-110 mmHg) before and after 12 weeks of therapy with either isradipine 5 mg daily or enalapril 20 mg daily. The study was of double-blind, parallel design, with a placebo run-in period of 15 days. Three subjects withdrew from isradipine treatment because of flushing and 2 from enalapril treatment due to cough before completing the study. Both drugs significantly reduced cuff systolic and diastolic blood pressure (p < 0.001) without affecting heart rate. By virtue of the decrease in both septal wall (p < 0.01) and posterior wall thicknesses (p < 0.05), isradipine treatment produced a significant reduction in LV mass adjusted for height (p < 0.001) in comparison with placebo; also LV end-systolic dimension showed a slight decrease (p < 0.05). Enalapril induced a similar reduction in LV end-systolic dimension (p < 0.05) but the changes of wall thickness and LV mass did not reach statistical significance. In conclusion, our results indicate that isradipine treatment improves LV systolic function and causes a significant reduction in LV mass. This reduction is observed early in the course of antihypertensive treatment and is effective in both patients with and without LV hypertrophy.
 ...
PMID:Reduction of left ventricular mass by short-term antihypertensive treatment with isradipine: a double-blind comparison with enalapril. 792 33

This study compared the efficacy and tolerability of monotherapy with felodipine and enalapril in patients with essential hypertension using a double-blind randomised crossover design. Thirty-five subjects (22 male, 13 female--ages: median 48 years, range 31-69 years) entered the randomised phases of the study and 32 subjects completed the study. Following a 4-week run-in placebo phase, the treatments were felodipine ("Plendil ER") 5-20 mg and enalapril 5-20 mg orally once daily for 8 weeks, each with matching placebos. Dose titration was at 2 and/or 4 weeks in each phase. Number of subjects with each different end-of-phase dose were for felodipine: 5 mg--8, 10 mg--11, 20 mg--13 and enalapril: 5 mg--6, 10 mg--9, 20 mg--17. Predose supine blood pressure (mean +/- SEM) was reduced in both active treatment phases compared with the run-in phase (159 + 2/101 +/- 1), but there was no significant difference in blood pressure between the active phases: felodipine 143 +/- 2/90 +/- 1 and enalapril 146 +/- 2/92 +/- 1. The most common adverse effects were for felodipine: headache, flushing, ankle swelling; and for enalapril: cough. Felodipine and enalapril as once daily monotherapy are thus of similar antihypertensive efficacy but with predictably different adverse effect profiles.
 ...
PMID:Comparison of felodipine and enalapril monotherapy in essential hypertension. 819 32

To investigate the 24-hour efficacy of nilvadipine (8 and 16 mg)in patients with mild to moderate essential hypertension, a double-blind, randomized, placebo-controlled, multicenter study with 3 parallel medication groups (placebo, 8, and 16 mg nilvadipine) was performed. Included in the study were 172 outpatients of both sexes with a mean age of 56 years. The primary target variable for the evaluation of efficacy was the difference in sitting diastolic blood pressure 24 hours after administration of the trial medication, in mmHg, achieved by the different doses after 8 weeks of therapy compared to baseline. This difference was -6.8 in the placebo group (n = 59), -10.4 in the nilvadipine 8 mg group (n = 60), and -11.0 in the nilvadipine 16 mg group (n = 49). Paired comparison showed a significant and clinically relevant difference between placebo and both nilvadipine doses. There were no serious adverse events reported. Nonserious adverse events were reported in 40.1% of all patients. Most frequently reported adverse drug reactions were flushing, headache, edema, and tachycardia. The adverse events occurred dose-dependently. As the dose-response relationship shows clinical saturation at a daily dose of 16 mg, the recommended dose is 8 mg taken once daily.
 ...
PMID:Nilvadipine in hypertension--experience in ambulatory treatment. 917 74

Optimal treatment of hypertension requires the use of effective antihypertensive drugs. Calcium channel blockers are widely used in the treatment of hypertension and appear to be particularly efficacious in ethnic Chinese patients. The aim of this open-label study was to prospectively investigate the efficacy and tolerability of three dihydropyridine calcium channel blockers in sequence, using the same protocol for each. After 2 weeks of placebo treatment, 73 males and 45 females (mean age, 45 +/- 10 years; mean weight, 67 +/- 10 kg) with essential hypertension (diastolic blood pressure, 95 to 115 mm Hg) were treated with amlodipine (n = 41), felodipine (n = 38), or isradipine (n = 39) for 8 weeks, with dose titration after 4 weeks. Mean seated systolic and diastolic blood pressure decreased by 23/17, 30/17, and 20/15 mm Hg after 8 weeks of treatment with amlodipine, felodipine, and isradipine, respectively. These reductions were all statistically significant. Blood pressure was controlled (defined as diastolic pressure < 90 mm Hg at the final visit or a decrease from baseline of > or = 10 mm Hg) in 85%, 74%, and 74% of patients receiving amlodipine, felodipine, and isradipine, respectively. There were no significant changes in heart rate, plasma lipid levels, or serum biochemistry markers with any of the three treatments. No serious adverse events occurred, but mild adverse effects, including headaches, flushing, tachycardia, dizziness, and edema, were reported; 1 (2%), 6 (16%), and 5 (13%) patients receiving amlodipine, felodipine, and isradipine, respectively, withdrew from the study (P < 0.05). The results of this study indicate that all three drugs are highly effective in lowering blood pressure and are well tolerated in Chinese patients with mild-to-moderate hypertension.
 ...
PMID:Amlodipine, felodipine, and isradipine in the treatment of Chinese patients with mild-to-moderate hypertension. 991 9

The efficacy and acceptability of 5 mg nebivolol once daily, a long-acting, vasodilating cardioselective beta blocker that additionally facilitates the L-arginine/nitric oxide system, was assessed in a double-blind, randomized trial in comparison with 20 mg nifedipine retard twice daily in patients with essential hypertension. At 2 weeks of treatment, nebivolol was significantly more effective. Thereafter, both drugs effectively and similarly lowered systolic and diastolic pressures without orthostatic effect. Nebivolol had a trough-to-peak antihypertensive effect ratio of 90%. Nifedipine gave the expected side effects of headache, flushing, and edema. Nebivolol was well tolerated. Nebivolol slightly but significantly lowered heart rate. Neither drug adversely affected plasma levels of lipids.
 ...
PMID:Nebivolol versus nifedipine in the treatment of essential hypertension: a double-blind, randomized, comparative trial. 1009 65


<< Previous 1 2 3 4 5 6 Next >>