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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The past 10 years have firmly established the role of beta-adrenoceptor blocking agents in the treatment of hypertension. They have been shown to lower systolic and diastolic blood pressure in the lying and standing position in mild, moderate and severe hypertension. Precise indications for beta-blockade have not yet been completely defined. Some authorities regard them as the drug of first choice in the management of most grades of idiopathic hypertension. There are in addition certain situations where beta-blockade seems especially suitable. These include the presence of associated coronary heart disease manifest either as angina pectoris or dysrhythmia. These agents can be introduced when side effects from other drugs are severe or intolerable and are valuable in the management of hypertensive young males since beta-blocking drugs do not interfere with sexual function. Compared with normotensive subjects 'stress' has been shown to produce excessive rise of blood pressure in those with labile or sustained idiopathic hypertension. After therapy with beta-blocking agents the rise in blood pressure after 'stress' is reduced. If labile and/or mild hypertension are the precursors of subsequently more severe sustained hypertension, then long term beta-blockade may help to control this response.
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PMID:Indications for beta-adrenoceptor blocking drugs in hypertension. 0 35

We reported on the haemodynamic effects of 0.03 mg/kg flunitrazepam during surgical procedures in neuroleptanalgesia in 39 patients with congenital or acquired heart diseases, functional class II-IV. The benzodiazepine derivative did not cause any relevant effect on the inotropic state of the myocardium. There were only minor changes in cardiac index, stroke index, right and left atrial pressure. Changes in arterial pressure and left ventricular pressure during and immediately after surgical procedures, and in arterial perfusion pressure during extracorporeal circulation, as well as an only short lasting increase in heart rate were demonstrative a peripheral vasodilator effect. The decrease in ventricular work and myocardial oxygen consumption are of value in patients with coronary heart disease, especially immediately after surgical procedures. Flunitrazepam is considered an additional drug during neuroleptanalgesia, when hypertension is causing some problems.
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PMID:[Cardiovascular effects of flunitrazepam (rohypnol, RO-5-4200) (author's transl)]. 1 70

1. A study was conducted amongst 1247 treated hypertensive patients to determine the predictive power of untreated baseline and achieved treated blood pressures in the development of the complications of hypertension. In addition the relative importance of systolic and diastolic pressures was calculated. 2. Statistical analysis was done by calculating univariate differences in blood pressure between cases with and without complications. The higher the univariate distance, the greater the predictive power. 3. Blood pressures achieved during treatment were more important than baseline pressures for predicting stroke in both men and women, confirming the benefits of antihypertensive therapy in preventing strokes. 4. There was some evidence of prevention of myocardial infarction in men and of angina in women as a result of therapy. 5. There was no evidence to suggest that any one group of drugs, including beta-adrenoreceptor-blocking drugs and thiazides, conferred any extra benefit in preventing coronary heart disease. 6. The systolic blood pressures achieved during treatment predicted stroke better than diastolic pressure, but no consistent trends were found for coronary heart disease.
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PMID:Relation between prognosis and the blood pressure before and during treatment of hypertensive patients. 3 9

224 patients with coronary heart disease, hypertension, disturbances of cardiac rhythm or hyperkinetic heart syndrome were treated with the cardioselective beta-blocker Talinolol (Cordanum) for a period up to 3 years. In 239 examinations in intravenous or peroral application of this medicament we controlled among others the appearance of side effects. This test was carried out with the help of standardised questionings and clinical controls. Apart from registrations of ECG and blood pressure clinico-chemical investigations were included and in the long-term experiment also tests by dermatologists, otorhinolaryngologists and ophthalmologists. In the total number of patients the proportion of side appearances was 17,6%, in the long-term experiment (100 patients with on an average 12.9 months) 7%. The symptoms most frequently cited in the initial phase, such as fatigue, weakness, insomnia and nausea receded within 4 weeks apart from few exceptions. There did not appear any essential bradycardic disturbances of the cardiac rhythm, just as little were references to disadvantageous reactions in the sense of a practolol syndrome.
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PMID:[Long-term studies on the beta blocker talinolol (cordanum) with special reference to side effects]. 3 87

Cardiovascular disease is a major cause of morbidity and mortality in the U.K. and other developed countries. In the U.K., mortality from coronary heart disease has increased progressively over the past 25 years, particularly in males. This paper examines the possible role of trace metals in the development of cardiovascular disease, with particular reference to the effects of cobalt, cadmium and lead in myocardial disease, atherosclerosis and hypertension. It is concluded that cobalt is an unimportant factor in community levels of cardiovascular disease, that cadmium has striking effects on blood pressure in animals and that there is some evidence for an association between environmental lead and high blood pressure.
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PMID:Cardiovascular disease and trace metals. 4 Feb 34

The wide variety of antihypertensive agents now available allows considerable flexibility in the pharmacologic management of hypertension. The newly available alpha- and beta-adrenergic blocking agents have added considerably to this flexibility. Their safety and efficacy insure that they will find increasing use in the treatment of hypertension. The new postsynaptic alpha-receptor blocker prazosin, is generally free of the side effects that precluded the use of alpha-blockers which affected both pre- and postsynaptic receptors. Is is moderately effective and, excepting the problem of "first-dose" hypotension, it is usually well tolerated. Labetalol, a compound possessing both alpha- and beta-receptor blocking properties, has been found to be effective both as an oral therapy for chronic hypertension and as an intravenous agent in treating hypertensive crisis. Further experience with labetolol will determine its safety and efficacy for the long-term management of hypertension. Although the usefulness of beta-adrenergic receptor blocking agents in hypertension is unquestionable, the mechanism by which they lower the blood pressure remains in question. Most of our experience has been with propranolol, but other beta-blockers, now used in England and Europe, are likely to become available in the United States. As of January, 1979 only metoprolol has been added to propranolol as approved beta-blockers for the treatment of hypertension. General guidelines for the use of propranolol are given in Table 6. Metoprolol will likely find increasing use since it seems to work as well as propranolol and probably causes fewer side effects. Nevertheless, the experiences with one beta-blocker, both good and bad, cannot be interpolated to another beta-blocker since there are obvious and subtle differences in their actions. Patients doing well on propranolol therapy should continue to receive that drug; patients being started on a beta-blocker therapy can be given the choice of metoprolol and, in the near future, other beta-blockers as well. Beyond their efficacy and freedom from side effects in about 80% of patients, beta-blockers may offer a special advantage in protecting from coronary heart disease. Such protection has been suggested in limited trials but needs further documentation. In the meantime, the known advantages of beta-blockers ensure their increasing use in the treatment of hypertension. Regardless of which alpha- or beta-blocker is chosen, a diuretic should be used concomitantly to enhance and preserve the effectiveness of the adrenergic blocker.
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PMID:Alpha- and beta-receptor blocking drugs in the treatment of hypertension. 4 Jul 55

The pattern of heart disease in 404 patients seen prospectively from the guinea savanna region of Africa is presented. Over 90% presented with cardiac failure. Hypertension, Peripartal Cardiac Failure (PPCF), Congestive Cardiomyopathy and Rheumatic Heart Disease are major problems. The highest incidence of PPCF in the world probably occurs in this area but the prognosis is good. The reasons for this and the possible interrelationship of hypertension with cardiomyopathy and PPCF are discussed. In contrast to the tropical rainforests, no case of endomyocardial fibrosis was seen. During the period of study, vascular thrombosis is uncommon and coronary heart disease is non-existent in Zaria.
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PMID:Pattern of heart disease in adults of the Nigerian Savanna: a prospective clinical study. 9 46

Precursors of sudden death were sought in men--1838 civil servants in Albany, New York, and 2282 residents of Framingham, Massachusetts--under continuous surveillance for 16 years. In men 45-74 years old there were 234 deaths attributed to coronary heart disease (CHD) of which 109 occurred within one hour of onset of symptoms. More than half of all deaths due to CHD occurred outside the hospital and about 80 per cent of these were sudden. Most were unheralded by prior symptoms of CHD. Persons at high risk of death from CHD, including sudden death, can be identified long before the terminal unexpected catastrophe. The same precursive stigmata exist in persons subject ot coronary attacks whether or not immediately fatal. The risk of sudden death in these two populations was positively correlated with high blood pressure, the electrocardiographic pattern of left ventricular enlargement, obesity, and heavy cigarette usage. Sudden death is a common and possibly incidental expression of lethal coronary heart disease. The potential candidate for sudden death cannot be confidently distinguished from the individual who succumbs more slowly of myocardial infarction. The inescapable conclusion is that the prevention of sudden death requires the prevention of coronary attacks.
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PMID:Precursors of sudden coronary death. Factors related to the incidence of sudden death. 12 82

A seven-year follow-up in 1973 of a prospective cardiovascular study of 1820 initially, healthy, middle-aged Chinese men of 40-59 years of age identified 1745 (95.9%) known survivors, 49 (2.7%) interim deaths, and 26 (1.4) who could not be traced. Of the survivors, 1462 (83.8%) were re-examined, 292 (16.7%) had another treadmill test of maximal exercise, and 283 (16.2%) failed to return for re-examination. On the basis of interim surveillance of hospital admissions, questionnaires and re-examination, a greater incidence of noncardiovascular events (338 or 18.6%) than evidence of cardiovascular disease (220 or 12.1%) was found while the majority (1021 or 56.1%) remained healthy. Total mortality was 0.29 for men under 50 and 0.76 per 100 person-years for men of 50 or more years of age. Only nine, or 18.4% of the deaths were due to cardiovascular causes, and unexpectedly for this population sample, only three were attributed to stroke. When cardiovascular morbidity was related to presence of ST depression after maximal exercise, to hypertension at rest by WHO criteria, to both findings, or to absence of either on initial intake examination, incidence increased from 2.3% for NEITHER group, to 5.7% for ST group, to 11.9% for HT group, and to 25.0% for BOTH groups. Re-examination revealed more evidence of cardiovascular disease than did surveillance of hospital admissions. Additional to effects of aging and mild adiposity, longitudinal changes in blood pressure and ST depression, increasing in the NEITHER group, but less frequent in the other groups, showed some evidence of regression toward the mean, as well as emerging disease and the confounding effects of uncontrolled treatment of hypertension in many. The potential for prediction of subsequent cardiovascular morbidity or mortality appeared stronger for hypertension than for postexertional ST depression, although the two were additive in this population, which is more prone to hypertension and stroke but now is developing clinical manifestations of coronary heart disease more frequently.
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PMID:Seven-year follow-up of cardiovascular study and maximal exercise of Chinese men. 12 87

Heart insufficiency, cardiomegaly and pathological changes of the ECG after exclusion of coronary heart disease, congenital or acquired vitia cordis and hypertension of the greater or lesser circulatory system result in the diagnosis cardiomyopathy with the liability of further differential-diagnostic demarcation. If causes of a secondary cardiomyopathy can be detected, a causal therapy is often possible, as to the remaining group of the idiopathic cardiomyopathies one must for the time being limit to an exclusively symptomatic treatment (protective therapy, limitation of the fluid supply, glycosides, diuretics, medicamentous and electric therapy of disturbances of the rhythm).
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PMID:[Cardiomypathies]. 12 20


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