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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Most frequently encountered causes of intractable pain and intractable medical problems, including headache, post-herpetic neuralgia, tinnitus with hearing difficulty, brachial essential hypertension, cephalic hypertension and hypotension, arrhythmia, stroke, osteo-arthritis, Minamata disease, Alzheimer's disease and neuromuscular problems, such as Amyotrophic Lateral Sclerosis, and cancer are often found to be due to co-existence of 1) viral or bacterial infection, 2) localized microcirculatory disturbances, 3) localized deposits of heavy metals, such as lead or mercury, in affected areas of the body, 4) with or without additional harmful environmental electro-magnetic or electric fields from household electrical devices in close vicinity, which create microcirculatory disturbances and reduced acetylcholine. The main reason why medications known to be effective prove ineffective with intractable medical problems, the authors found, is that even effective medications often cannot reach these affected areas in sufficient therapeutic doses, even though the medications can reach the normal parts of the body and result in side effects when doses are excessive. These conditions are often difficult to treat or may be considered incurable in both Western and Oriental medicine. As solutions to these problems, the authors found some of the following methods can improve circulation and selectively enhance drug uptake: 1) Acupuncture, 2) Low pulse repetition rate electrical stimulation (1-2 pulses/second), 3) (+) Qi Gong energy, 4) Soft lasers using Ga-As diode laser or He-Ne gas laser, 5) Certain electro-magnetic fields or rapidly changing or moving electric or magnetic fields, 6) Heat or moxibustion, 7) Individually selected Calcium Channel Blockers, 8) Individually selected Oriental herb medicines known to reduce or eliminate circulatory disturbances. Each method has advantages and limitations and therefore the individually optimal method has to be selected. Applications of (+) Qi Gong energy stored paper or cloth every 4 hours, along with effective medications, were often found to be effective, as Qigongnized materials can often be used repeatedly, as long as they are not exposed to rapidly changing electric, magnetic or electro-magnetic fields. Application of (+) Qi Gong energy-stored paper or cloth, soft laser or changing electric field for 30-60 seconds on the area above the medulla oblongata, vertebral arteries or endocrine representation area at the tail of pancreas reduced or eliminated microcirculatory disturbances and enhanced drug uptake.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Common factors contributing to intractable pain and medical problems with insufficient drug uptake in areas to be treated, and their pathogenesis and treatment: Part I. Combined use of medication with acupuncture, (+) Qi gong energy-stored material, soft laser or electrical stimulation. 135 50

The safety and tolerability of carvedilol, a new antihypertensive agent with the combined pharmacological activities of beta-blockade and vasodilation, and of nifedipine were investigated in patients with essential hypertension and non-insulin-dependent (type II) diabetes mellitus. Twenty patients were openly randomized to receive 25 mg carvedilol once daily (five men and five women; mean age, 63 years) or 10 mg nifedipine t.i.d. (three men and seven women; mean age, 64 years) for a period of 4 weeks. Baseline mean sitting blood pressures were 168/98 and 169/95 mm Hg in the carvedilol and nifedipine groups, respectively. Baseline mean areas under the curve (AUC) of the intravenous glucose tolerance test (IVGTT) for the carvedilol and nifedipine groups were 6,136 +/- 1,195 and 6,287 +/- 1,228 mg/dl/min, respectively. Demographic and efficacy variables were not statistically different between treatment groups. After 4 weeks of therapy, mean sitting blood pressure was significantly (p less than 0.02) reduced to 144/91 mm Hg in the carvedilol group and to 149/87 mm Hg in the nifedipine group. Week 4 IVGTT AUC values of 5,735 +/- 1,464 mg/dl/min in the carvedilol group and 5,988 +/- 993 mg/dl/min in the nifedipine group, representing mean reductions of 6.14% and 3.17%, respectively, were not statistically different from baseline. Both treatments were well tolerated. No patient experienced adverse events in the carvedilol treatment group, whereas two patients in the nifedipine group reported episodes of headache (one patient) and palpitations (one patient); each episode was mild in severity and considered to be related to study medication.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of the effects of carvedilol and nifedipine in patients with essential hypertension and non-insulin-dependent diabetes mellitus. 137 56

The authors relate the data on the hypotensive effect and procedure of cranial electric stimulation (CES). The method was applied to the treatment of 66 patients aged 20-40 years suffering from stage I essential hypertension (EH) (WHO classification). To provide clinical and physiological evidence for CES, the EEG and ECG were recorded. In addition, computer was employed to average out and to design the histograms of the R-R intervals as was echocardiography to examine central hemodynamics. Before the treatment of SAP (179.2 +/- 4.3 mm Hg), DAP (104.2 +/- 2.6 mm Hg) the patients manifested cephalgia, cardialgia, pronounced vegetative dysfunction. The EEG showed phenomena of irritation in the upper stem structures of the brain. The histograms of R-R intervals distribution demonstrated the signs of a decrease of the tonic influence of the parasympathetic nervous system. The hyperkinetic type of hemodynamics was revealed. After CES the patients manifested an improvement of subjective symptomatology: headache attacks ceased in 85% of the patients, heart pains in 76%; AP got stabilized within normal, which correlated with normalization of central hemodynamics. The histograms of R-R intervals distribution demonstrated an increase of the model value, a decline of the mode, and a rise of the variation range, attesting to the changes in vegetative regulation of heart activity, with a reduction of sympathetic regulation and a simultaneous increment of parasympathetic effects. The authors hold that CES is an effective and prospective method of the treatment of the initial stage of EH.
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PMID:[Cranial electrostimulation--a new nondrug method of treating the initial stage of hypertension]. 152 56

Cilazapril is a new once-daily angiotensin-converting (ACE) enzyme inhibitor which has been administered to 4,500 patients with mainly mild to moderate essential hypertension in a multinational clinical research program. Sitting diastolic blood pressure was reduced by about 9 mm Hg from baseline (p less than 0.01) after 4 weeks of treatment with cilazapril 1.25-10 mg/day in double-blind placebo-controlled studies. Total responder rates to cilazapril were usually 50-60% compared with 30% to placebo. Adding hydrochlorothiazide 12.5 mg/day to cilazapril 5.0 mg/day increased the total responder rate from 52 to 71%. Double-blind dose titration studies for 8 weeks showed that cilazapril 2.5-5 mg/day possessed equivalent efficacy to usual therapeutic regimens of sustained release propranolol, captopril, hydrochlorothiazide, atenolol and enalapril, Cilazapril did not affect heart rate. During long-term open administration for 52 weeks, or longer, cilazapril, either alone or in combination with hydrochlorothiazide, effectively maintained control of blood pressure. Treatment of patients with severe hypertension with cilazapril plus hydrochlorothiazide achieved a total responder rate of 73%. Adverse events were mostly observed within the first 8-16 weeks of treatment, with headache, dizziness, fatigue, nausea, cough and chest pain being the most frequent. Non-life-threatening angioedema, facial edema and mild hypotension occurred in less than or equal to 0.2% of patients, and orthostatic hypotension was reported in 2%. Abnormal laboratory test values were rarely found with cilazapril treatment. Of the 2.3% of patients with elevated serum creatinine, at any time point during the study and irrespective of outcome on continuation with cilazapril therapy, about two thirds had prior renal impairment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cilazapril: an overview of its efficacy and safety in hypertension. 153 34

Amlodipine and nitrendipine are calcium antagonists of the 1,4-dihydropyridine group which differ in their pharmacokinetic and pharmacodynamic properties. The clinical relevance of these differences was investigated in a study designed to compare the efficacy and safety of once-daily amlodipine (5 mg) and nitrendipine (20 mg) in patients with mild-to-moderate essential hypertension. Ambulatory blood pressure monitoring and conventional measurements showed that amlodipine and nitrendipine produced comparable reductions in blood pressure after 4 weeks of treatment. However, the onset of the antihypertensive effect was gradual for amlodipine, while most of the reduction achieved at the end of treatment with nitrendipine was seen after the first dose. There were no significant changes in heart rate with amlodipine, but significant increases occurred during the first 6 h of nitrendipine treatment. Amlodipine was associated with a significantly lower incidence of vasodilator-related adverse effects at initiation of therapy (headache, flushing, tachycardia) compared with nitrendipine, which may reflect its slower onset of action. The different pharmacodynamic and toleration profiles of amlodipine and nitrendipine at therapeutically equivalent doses suggest that amlodipine may have advantages in the treatment of hypertension, especially in terms of the low incidence of acute side effects, which may ultimately translate into improved patient compliance.
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PMID:Amlodipine compared to nitrendipine in hypertensive patients: the effects on toleration in relationship to the onset of action. 153 15

This trial was performed to determine the safe and effective dosage range of once daily diltiazem (diltiazem CD) capsules for treatment of essential hypertension. Patients with essential hypertension having supine diastolic blood pressure values greater than or equal to 95 mm Hg and less than or equal to 110 mm Hg were randomly assigned to receive placebo or one of four doses of diltiazem CD: 90, 180, 360, or 540 mg. Blood pressure was measured at trough, 24 hours after the dose, and at the time of peak effect, 10 hours after the dose. Diltiazem CD lowered both supine diastolic and systolic blood pressure. A linear dose response was seen with changes in diastolic and systolic blood pressure and heart rate for trough and peak measurements. Trough/peak ratios for the 180, 360, and 540 mg doses were all greater than 0.50. Adverse effects were dose related; those most commonly reported were headache (8.6%), bradycardia (8.1%), and edema (7%), with bradycardia and edema possibly dose related. It is therefore concluded that diltiazem CD is a safe and effective antihypertensive agent.
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PMID:A dose-response trial of once-daily diltiazem. 154 66

The acceptability of perindopril in the long-term treatment of patients with mild to severe essential hypertension was assessed in a large European multicenter trial including 856 patients. Diastolic blood pressure (DBP) at inclusion was 95-125 mm Hg after 1 month of placebo. Normalization of blood pressure was defined as a DBP less than or equal to 90 mm Hg. Treatment was started with perindopril 4 mg once daily and increased when necessary to 8 mg daily. If DBP was not controlled, a second drug (hydrochlorothiazide) and finally a third drug were added. After 1 year of treatment in all 690 evaluable patients, supine systolic and diastolic blood pressure decreased by 29 mm Hg (from 172 +/- 1 to 143 +/- 1 mm Hg, p less than 0.001) and 19 mm Hg (from 105 +/- 1 to 86 +/- 1 mm Hg, p less than 0.001), respectively. Perindopril monotherapy normalized blood pressure in 55% of patients and total percentage of normalization was 78%. The overall incidence of withdrawals for side effects was 6.8%, the most common side effect being cough (2.2%). The most frequent complaints reported were cough (7.0%), headache (5.6%), asthenia (5.1%), mood and/or sleep disturbance (5.1%), and dizziness (3.2%). The small changes observed in hematologic and biochemical parameters were not clinically relevant.
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PMID:Long-term acceptability of perindopril: European multicenter trial on 856 patients. 158 Feb 87

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The efficacy and tolerability of enalapril--hydrochlorothiazide combination as a first line therapy in black patients with mild to moderate arterial hypertension: a clinical study in Kenya. 162 42

Fifty-four patients aged 25 to 66 years suffering from hemicrania were examined. 21 patients showed certain changes in the clinical picture and course of hemicrania itself: enhancement of paroxysms or transformation of one form of hemicrania to the other one, more severe (e.g. a simple form transforms to an ophthalmic or an associated one). In 15 patients, ++vegeto-dystonic manifestations associated mostly with a significant reduction of migrainous paroxysms themselves and, more rarely, with their dramatic enhancement began with time to play the leading part in the disease clinical picture. Superimposition of essential hypertension or atherosclerosis was also coupled with changes in the course of hemicrania, in particular by an increase of the period of cephalgia and appearance of constant headaches.
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PMID:[Various problems of transformation of migraine]. 165 91

The new alpha 1-blocker alfuzosin was compared with propranolol as monotherapy for hypertension in a double-blind, parallel group study of 8-week duration in 40 patients with essential hypertension. The patients (11 males, 29 females; mean age 47.8 +/- 2.2 years in the alfuzosin group and 46.6 +/- 2.4 years in the propranolol group) randomly received either alfuzosin from 2.5 mg b.i.d. up to 10 mg b.i.d. or propranolol from 40 mg b.i.d. up to 160 mg b.i.d. according to an individualized dose-titration schedule. The two groups were comparable with respect to disease history, cardiovascular risk factors, concomitant diseases, previous treatments and end-placebo blood pressure and heart rate values. Four patients did not complete the study, two patients in the alfuzosin group: one patient because of postural hypotension and the second one because of breast cancer; and two patients in the propranolol group: one patient for inefficacy and the second one lost to follow-up. At the end of the 8-week trial the mean daily doses were 12.2 +/- 0.61 mg and 196 +/- 9.82 mg for alfuzosin and propranolol, respectively. The antihypertensive effects of the two drugs were comparable. Upright and supine blood pressures decreased significantly with both treatments from the second week on (P less than 0.001 for all BP values). At the end of the 8-week double-blind trial, 83% of alfuzosin patients and 67% of propranolol patients were normalized. The two treatments differed significantly with respect to their effect on heart rate. Alfuzosin did not induce marked changes in heart rate: only a slight increase was observed. In contrast, propranolol caused bradycardia, more marked in the upright position. Palpitations, headache, asthenia and orthostatic hypotension were reported in the alfuzosin group. Asthenia and decreased libido were reported in the propranolol group. These data prove that alfuzosin has antihypertensive effects equivalent to propranolol and it is an interesting agent for the therapy of essential hypertension. It can be used as a first agent at doses between 5 and 20 mg/day with satisfactory therapeutic response and without relevant side-effects.
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PMID:Comparison of the new alpha 1-blocker alfuzosin with propranolol as first-line therapy in hypertension. 168 5


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