Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carvedilol, a beta-blocking drug with vasodilator activity, has been used in 4 studies in 107 elderly patients with essential hypertension and has reduced blood pressure effectively. In the first study the pharmacokinetics and clinical response were compared between 21 patients greater than 65 years of age and 8 patients aged 35-50 years). The peak blood levels, time to maximal concentration, area under the curve, half-life and trough level of the drug with chronic administration did not differ. The clinical responses to the drug were similar, with a greater fall in systolic blood pressure in the older group. However the initial systolic blood pressure in the older group was higher. Carvedilol was compared with metoprolol, pindolol and nitrendipine in elderly patients. The responses to carvedilol were at least equal to those obtained with the other drugs. Control was achieved in the three studies with once-daily therapy. There was no significant postural hypotensive effect. A feature of all studies was the large number of patients who responded to carvedilol. The side-effect profile of the drug was acceptable; headache and dizziness were more common than with placebo or the comparison drugs and were frequently associated. There were no adverse biochemical effects and the lipid profile was not altered. Carvedilol is an effective antihypertensive drug that lowers blood pressure equally well in the young and the old.
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PMID:The use of carvedilol in elderly hypertensive patients. 197 3

Twenty-six patients with mild-to-moderate essential hypertension participated in a 6-week outpatient, multicenter, randomized, double-blind, placebo-controlled two-way crossover study to assess the hemodynamic effects of bisoprolol (20 mg QD) at steady state. Hemodynamic assessments included sitting blood pressure, heart rate, and left-ventricular ejection fraction by radionuclide ventriculography after 7 days of bisoprolol or placebo at trough (24 h post-dose) and peak (3 h post-dose) values. The group adjusted mean ejection fraction was not significantly different in patients receiving bisoprolol compared with the placebo group at either peak or trough measurements; in fact, means in patients taking bisoprolol were slightly higher than in the placebo group. No symptomatic hypotension was documented. Blood pressure, measured 24 hours after dosing, was significantly lower in those receiving bisoprolol when compared with the placebo group, by 7.7 mm Hg and 9 mm Hg for diastolic and systolic blood pressure, respectively. Similarly, mean values of heart rate were 10 beats/min lower in the bisoprolol patients than in the placebo group. Only headache and insomnia occurred as adverse events. Bisoprolol (20 mg QD) effectively lowered blood pressure over a 24-hour period without significantly reducing ejection fraction or causing adverse clinical or biochemical events.
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PMID:Multicenter evaluation of the hemodynamic effects of bisoprolol in patients with mild to moderate hypertension. 198 Feb 78

The antihypertensive effects, as assessed by clinical and ambulatory blood pressure measurement, of nifedipine slow-release (SR), atenolol and the two in combination were evaluated in 28 known hypertensives in a placebo-controlled, double-blind, randomised cross-over trial. Clinical blood pressure was significantly lower on combination therapy (P less than 0.025) than on either agent alone, although all therapeutic agents reduced blood pressure significantly when compared with placebo (P less than 0.01). All ambulatory blood pressure measurements obtained on any therapeutic agent were significantly lower than those obtained on placebo (P less than 0.01). The mean daytime (08h00-17h00) ambulatory blood pressure measurement as well as the percentage of this monitoring period during which patients were hypertensive were significantly lower (P less than 0.01) on combination therapy than on nifedipine SR. A similar pattern was observed for 24-hour ambulatory blood pressure measurements. Headache was the most significant adverse effect. This was most common with nifedipine SR, less common with combination therapy and least common with atenolol. Combination therapy with nifedipine SR and atenolol is therefore a viable therapeutic alternative in the treatment of patients with benign essential hypertension.
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PMID:A comparative study of atenolol, nifedipine and their combination in the treatment of hypertension. 198 40

Improved measurement of plasma concentrations of nitrendipine demonstrates a plasma half-life of 17 to 21 h allowing once daily dosing for antihypertensive treatment. To determine the effectiveness and tolerability of nitrendipine given once versus twice daily, 78 patients with mild to moderate essential hypertension were randomized in a double-blind fashion to 12 weeks of treatment with either nitrendipine 20 mg once daily (n = 39) or nitrendipine 10 mg bid (n = 39). Blood pressures measured at the end of the dosing interval were similar on 20 mg once daily and 10 mg bid. Adverse events considered to be drug related (flushing and headaches) occurred mostly at the beginning of active treatment and more frequently on the once daily dosing, resulting in a greater number of patients being withdrawn from the once daily treatment group. Thus, nitrendipine 20 mg once daily lowered blood pressure as effectively as 10 mg bid but was associated with a higher incidence of adverse events. These could be minimized by starting at nitrendipine 10 mg once daily and increasing to 20 mg once daily after two to four weeks.
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PMID:Effectiveness and tolerability of once versus twice daily nitrendipine in the treatment of mild to moderate hypertension. The Canadian Nitrendipine Study Group. 204 84

Thirty six symptomatic hospitalized hypertensive children were evaluated for clinical profile and etiology. They were divided into two groups of 23 and 13 patients, respectively of chronic persistent hypertension and acute transient hypertension. Headache, failure to thrive, dyspnea and edema were common clinical features. Renal parenchymal pathology was the commonest etiology in both groups with a tubulo-interstitial pathology being more common amongst chronic hypertensives and acute glomerulonephritis in acute transient hypertensives. Essential hypertension was uncommon, found in only two patients with chronic hypertension reflecting probably an asymptomatic status of most patients with essential hypertension.
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PMID:Pediatric hypertension: clinical profile and etiology. 205 28

The purpose of this study, designed as an open multicenter trial, was to test the antihypertensive efficacy, patient acceptability, and side effects of long-term treatment with slow-release nifedipine in a large population. The drug was studied in 330 outpatients with essential hypertension, WHO stage 1-2, recruited in 20 hospital centers. After washout period was completed, nifedipine (20 mg bid) was given for 1 month (phase 1). Then, the treatment was extended for 4 months (phase 2) with variable doses (range 20-80 mg daily). No other antihypertensive drugs were administered during phase 1. However diuretics, beta blockers, or captopril were added to nifedipine during phase 2 in 11 patients. Seventy patients did not meet criteria for inclusion at washout. During phase 1 and 2, 66 additional patients were excluded due to side effects, the need of other antihypertensive drugs, or non-compliance. Systolic blood pressure significantly lowered (10% or more) in 84% patients in phase 1 and in 76% in phase 2. No responders were 6.1% and 3.6%, respectively. Diastolic blood pressure was normalized in 60% of patients after 5 months of therapy. Effects on blood pressure were equal in young patients and in the elderly, but a minimal rise in heart rate was recorded in younger patients. At least one side effect occurred in 46.6% patients, mainly headache (15.4%), hot flashes (13.3%), ankle edema (12.8%), or palpitation (6.6%). Sixteen patients (8.2%) were obliged to stop nifedipine treatment due to the severity of the side effects. This trial confirms the efficacy of nifedipine in hypertension, both in young and in aged patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term therapy with slow-release nifedipine in essential hypertension. 207 4

Estrogen-related cardiovascular dysfunction was noted in 23 out of 30 patients with prostatic cancer (PC). Coronary subjects with PC suffered from cardiac pain evident on ECG necessitating correction by effective doses of coronary active drugs. PC patients with essential hypertension exhibited frequent headache, progressive edema of the legs, drastic hypertensive reactions. It is held that estrogen therapy for prostatic cancer should be preceded and monitored by therapeutic evaluation responsible for optimal conditions to prevent and early diagnose cardiovascular complications.
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PMID:[Diagnosis and therapeutic correction of changes in the cardiovascular system of patients with prostatic cancer treated with estrogens]. 208 39

The efficacy, tolerability and safety of dilevalol in essential hypertension has been documented in an international clinical trials programme which was conducted with doses up to 1600mg daily. Initial double-blind trials confirmed the superiority of dilevalol over placebo in essential hypertensive patients and documented the suitability of a once-daily dosage. Almost all of the subsequent trials have been randomised, double-blind comparative trials of dilevalol versus established anti-hypertensive agents with the duration of treatment ranging from four weeks up to one year. The recommended dosage range of dilevalol, of 200-400 mg once-daily, has generally been shown to be at least as effective at lowering raised blood pressure as established antihypertensive agents given according to their recommended doses. In one study in elderly hypertensives, dilevalol was significantly more effective than atenolol in lowering systolic blood pressure. Safety data is available from a consolidated database of 2011 dilevalol-treated patients representing over 500 patient-years exposure. Overall, dilevalol was well tolerated and evidence of dose-related adverse effects became apparent only for nausea and dizziness above the recommended dose range. The most common adverse effects considered probably or definitely related to treatment were fatigue (2.5%), nausea (1.9%), headache (1.8%) and dizziness (1.7%). 'Typical' beta-blocker adverse effects were observed, though many of these effects were less frequent than seen with comparator beta-blockers. Evidence of excessive vasodilation was rarely found, consistent with the counter-balancing effect of beta-blockade.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Overview of clinical trials of dilevalol in essential hypertension. 214 8

Isradipine is a dihydropyridine calcium-entry blocking agent with pronounced vasodilator activity and no significant cardiac effects at clinical doses, a desirable profile for an antihypertensive drug. Prazosin, a post-junctional alpha-adrenoceptor blocking agent, may produce a similar hemodynamic pattern. Therefore, we compared the effects of isradipine (2.5-10 mg bid) with those of prazosin (2-8 mg bid) in 83 patients with established essential hypertension, using a randomized, double-blind, parallel-group design. Patients received a placebo for 3-5 weeks, then either isradipine or prazosin over a 6-week titration period, followed by a 4-week plateau phase. During the plateau period, isradipine therapy lowered sitting blood pressure more effectively than did the administration of prazosin: Mean systolic BP fell 16.7 versus 8.1 mmHg (p less than 0.001) and mean diastolic BP was reduced 15.6 versus 12.6 mmHg (p less than 0.01). In the dosing range used (while also noting that prazosin is occasionally titrated up to doses of 30 mg qd), 83% of isradipine-treated patients had at least a 10 mmHg reduction in diastolic BP, compared with 64% of prazosin-treated patients (p = 0.05, FET). Tachyphylaxis did not occur with either drug. The rate of occurrence of side effects was similar in both treatment groups; the most common adverse event seen with isradipine was headache (20%) and with prazosin, dizziness (19%).
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PMID:A multicenter comparison of isradipine and prazosin for treatment of essential hypertension. 214 12

1. The aim of the study was to compare the efficacy and the tolerability of treatment with atenolol (50-100 mg once daily), nitrendipine (20-40 mg once daily) and their combination (atenolol 50 mg + nitrendipine 20 mg) once daily in patients with mild to moderate essential hypertension. 2. The study was a randomised, double-blind, placebo controlled parallel groups design: blood pressures were measured at 'trough' effect (i.e. 24 h after dosing) to assess the adequacy of once-daily treatment. 3. Mean blood pressures (mm Hg) recorded on four occasions over 12 weeks of treatment were significantly lower both with atenolol (155/97 sitting: 155/104 standing) and with the combination of atenolol plus nitrendipine (153/96 sitting: 152/104 standing) than with placebo (169/108 sitting: 169/114 standing). Nitrendipine alone had no significant effect on blood pressure 24 h after dosing (165/104 sitting: 165/110 standing). 4. Withdrawals due to adverse effects were more common during treatment with nitrendipine: 7/32 of the patients experienced adverse effects attributable to intense systemic vasodilatation (e.g., flushing, erythema, headache). 2/37 patients taking atenolol were withdrawn: one because he developed a psoriatic rash and the other because of impaired peripheral circulation. Of the 35 patients taking combination treatment, two were withdrawn: one developed headaches and dyspnoea, and the other asthma. 5. The results suggest that once daily dosing with nitrendipine does not control blood pressure throughout the 24 h period in the majority of patients, and is associated with a considerable burden of adverse effects. Combination treatment was better tolerated but appeared to offer no advantages over atenolol alone in terms either of blood pressure control or adverse effects.
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PMID:Comparison of once daily atenolol, nitrendipine and their combination in mild to moderate essential hypertension. 218 68


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