Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

102 patients using Trinordiol, a triphasic oral contraceptive (OC) containing ethinyl estradiol and d-norgestrel, were followed for 932 cycles in a study of secondary effects. Follow-up visits were scheduled after 1,3, and 6 months and every 6 months thereafter. 26 patients discontinued use of the pills during the study after using them for a total of 159 cycles. 5 discontinued because of abdominal pain, 1 for breast tenderness, and 1 because of headaches or migraines. 7 discontinued because of metrorrhagia, 4 for weight gain, 3 for amenorrhea, 2 for nausea and vomiting, and 1 each for nervousness, water retention, acne, desire for pregnancy, leaving the country, hypertension, and unknown motivation. the average age of patients was 23.6 years, with a range from 14-48. 76% were aged 15-29 years. 52.9% were nulliparas. 58.8% were Belgian, 21.6% were from Mediterranean Europe, 10.8% were Moroccan, and 7.9% were from black Africa. Only 1 patient, a 37 year old, developed hypertension. 15 patients gained more than 2 kg and 17 lost more than 2 kg. 15.8% complained of spotting during the 1st cycle compared to 3.1% during the 6th cycle, 5.2% during cycle 7-12, and 9.1% during cycle 13-30. Among 35 patients who did not discontinue treatment, 7 complained of amenorrhea and 1 of scanty menstrual bleeding, 14 of pain including 7 cases of pelvic pain, 2 of dysmenorrhea, 3 of breast tenderness, and 2 of headaches, 15 of leukorrhea, 3 of nausea, 2 of dizziness, and 1 each of fatigue, acne, galactorrhea, and cutaneous pruritus. 1 case of myoma at the level of the uterine cornu was identified after 24 cycles of treatment. In all, 61 patients had some complaint, while 41 were totally satisfied. No patient became pregnant during the study.
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PMID:[Clinical study of the secondary effects associated with taking a triphasic anti-ovulatory contraceptive]. 670 4

The acute and long-term (6 months) effects of captopril (C) were studied in 23 patients with previously uncontrolled severe (DBP greater than 120 mmHg) hypertension of different origin: essential (EH,) n=10, renovascular (RVH) n=9, and renal (RH) n=4. In addition, four patients were treated with renal transplant artery stenosis and hypertension (TRVH), refractory to conventional therapy. Before treatment supine blood pressure (BP, mmHg) averaged: 205/131 (EH), 204/124 (RVH), 207/132 (RH) and 194/117 (TRVH). All patients received diuretics and other antihypertensive drugs, the dosages of which are expressed in arbitrary equivalent units (U) per day (UD = diuretics; UA = other antihypertensive drugs). Antihypertensive therapy before study: UD:EH 1.6; RVH 1.0; UA: EH 7.3; RVH 5.5. After admission, C dosage was increased from 25 mg to a maximum of 150 mg t.i.d. Antihypertensive treatment was reduced as far as possible. DBP decrease after 25 mg C was related to pretreatment PRA in RVH only. After 3 months of C treatment, BP decreased to 190/116 in EH and 145/89 in RVH (EH vs RVH P less than 0.01), 158/98 in RH, and 154/90 in TRVH. After 6 months, BP response was maintained in RH and TRVH. BP increased slightly in RVH to 158/102 mmHg, mainly because of impaired renal function in three patients with bilateral renovascular disease. In EH,BP decreased to 167/109, since three non-responders were taken out of the group. After 6 months, EH still received higher dosages of antihypertensive drugs than RVH. Acute and chronic hypotensive effects of C were not significantly correlated. Side-effects occurred in five patients: skin rash and pruritus [2], taste disturbances [1], proteinuria [1], and acute renal failure in one patient with TRVH. In our hands, captopril in combination with diuretics was significantly more potent in severe RVH than in EH. Dosages and side-effects of other antihypertensive drugs could be markedly reduced in most patients, which may improve long-term drug compliance.
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PMID:The antihypertensive effect of captopril in severe essential, renovascular, renal and transplant renovascular hypertension. 675 59

Forty-five patients who have been maintained on hemodialysis using a regenerated cellulose hollow fiber artificial kidney (HFAK) were dialyzed on a cuprophan HFAK for the first time. Three black patients (6.6%), one male and two females, ages 43-61, who had been stable on hemodialysis for 30-88 months developed hypersensitivity reactions. The recommended setup procedure was carefully followed. Within seconds in 1 patient and within 10-16 minutes in the remaining two, respiratory distress, urticaria, pruritus, hypertension/hypotension, and facial edema developed. Dialysis was discontinued immediately. They were treated with oxygen, epinephrine, and diphenhydramine. Two patients received IPPB treatments and one received IV methyl-prednisolone. After allowing 10-15 minutes for stabilization, the dialysis was resumed on a non-cuprophan HFAK. Patients were discharged with no sequelae. The cause of the hypersensitivity reaction is unknown. It could be due to substances used in the sterilization procedure, to the membrane itself, or to substances that leach out of the potting compound or membrane. Hypersensitivity reaction during hemodialysis has been reported to be very severe or even fatal. Personnel delivering direct patient care should be aware of the symptoms and react quickly with proper treatment. Patients suspected to have this reaction should be changed to a dialyzer without a cuprophan membrane.
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PMID:Hypersensitivity reaction on first-time exposure to cuprophan hollow fiber dialyzer. 684 36

26 patients with severe hypertension (10 essential, 9 renal parenchymatous, 7 renovascular) and a mean age of 42 years were treated with the new oral converting enzyme inhibitor captopril (SQ 14225). During the initial phase with a standardized triple therapy (STT) consisting of propranolol (maximum 320 mg/day), hydralazine (maximum 200 mg/day) and hydrochlorothiazide (maximum 100 mg/day) or furosemide (maximum 250 mg/day) mean systolic and diastolic blood pressure values remained almost unchanged (184 +/- 32/111 +/- 17 mm Hg to 179 +/- 34/112 +/- 19 mm Hg), indicating true therapy resistance to conventional antihypertensive therapy. After discontinuing each antihypertensive agent captopril was then titrated from 3 X 25 mg/day to a maximum of 4 X 150 mg/day. Mean systolic and diastolic blood pressure values 2, 4, 8, and 16 weeks after starting captopril were 154/95, 155/97, 149/93 and 143/91 mm Hg. The corresponding mean captopril doses were 242, 280, 325 and 299 mg daily. During captopril medication mean systolic and diastolic blood pressure values were significantly lower (p less than 0.05 to p less than 0.005) than during STT. Throughout the observation period of 16 weeks only 15% of the cases were on monotherapy with captopril whereas 62% needed the addition of a diuretic (hydrochlorothiazide or furosemide). In 23% of the cases even the combination of captopril and diuretic was insufficient and thus propranolol was added as a third drug. The side effects observed were 1 case with renal water and fluid retention and with reversible skin rash and 1 with pruritus. The results demonstrate that captopril has good blood pressure lowering activity in patients with treatment-resistant hypertension. However, in the majority of our cases the addition of a diuretic was necessary. Finally, some patients required a beta-blocker as a third drug.
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PMID:[Captopril in treatment-resistant hypertension (author's transl)]. 702 91

More than 1200 patients who received pindolol for the treatment of hypertension, angina pectoris, and various arrhythmias in studies conducted in the United States were included in the New Drug Application submitted to the FDA. Nearly 1000 of these patients received pindolol as monotherapy. The side effects reported were generally transient and of mild or moderate severity. The most frequently reported side effects seen after pindolol administration, compared to those seen after placebo, were in decreasing order of incidence: headache, dizziness, insomnia, muscle pain, fatigue, weakness, nervousness, joint pain, edema, nausea, and muscle cramps. Other side effects that occurred more frequently with pindolol than with placebo but at a rather low incidence induced weight gain, bizarre dreams, visual disturbances, lethargy, and diarrhea. Nasal congestion, throat discomfort, nocturia, impotence, pruritus, anxiety, hypotension, bradycardia, and heart failure occurred only rarely. Of the 323 patients who received pindolol alone for the treatment of mild to moderate hypertension, only 20 (6.2%) were withdrawn from the study because of side effects. Overall, 3.4% of the patients treated with pindolol were withdrawn because of side effects, most of which involved the central nervous system, that is, insomnia, anxiety, dizziness, and headache. However, a few patients manifested some edema and weight gain while receiving pindolol alone. Review of the side effects data did not reveal a tendency for the incidence of side effects to be dose related. One placebo-controlled, double-blind study designed to evaluate the fixed dosages of 15, 30, and 60 mg in the treatment of mild to moderate hypertension suggested that only the incidences of insomnia and nervousness increased with increasing doses. However, these side effects were generally transient and of mild or moderate severity. The evidence indicates that pindolol has an acceptable safety profile and that any side effects that appear are generally well tolerated and disappear with continued treatment.
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PMID:Adverse reactions to pindolol administration. 704 82

Twenty one sequential ultrafiltration dialysis were performed to 14 patients with chronic hemodialysis, with a duration of the dialysis treatment from 2 months to 5 years. Dry ultrafiltration--2.1-5.2 litres filtrate was obtained within 90 minutes. The sequential dialysis has numerous advantages over the usual hemodialysis. Apart from the good tolerance of the patients with overweight, some other indications for its performance was stressed upon in the paper, namely: cardiac asthma, arterial hypertension difficult to correct by hemodialysis and drugs, osteodystrophia, itching during dialysis and after it, vomiting and headache during dialysis and in-between dialysis periods, pains in the legs. The patients tolerated the procedure without any complaints.
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PMID:[Clinical use of sequential ultrafiltration with chronic hemodialysis patients]. 726 38

A multicenter, randomized, double-blind trial compared the safety and efficacy of the dihydropyridine isradipine with the angiotensin-converting enzyme (ACE) inhibitor enalapril given twice daily for mild hypertension. 160 patients received either isradipine (starting at 1.25 mg twice daily) or enalapril (starting at 2.5 mg twice daily) for 10 weeks. The dosage was increased if the average sitting diastolic blood pressure was > 90 mm Hg. Significantly greater mean reductions in systolic blood pressure were seen after 2, 6, and 8 weeks of isradipine. However, by the end of the trial, 83% of patients receiving isradipine and 78% receiving enalapril showed a decrease of at least 5 mm Hg in sitting diastolic blood pressure to a level below 96 mm Hg. Possible or probable drug-related adverse effects were reported in 36% of patients showing a good antihypertensive response to isradipine, and in 30% of those who responded to enalapril. There was a trend for a lower frequency of adverse effects in isradipine non-responders (25%) and a higher frequency in enalapril non-responders (43%). Pruritus, dizziness, edema, and fatigue were reported more often with isradipine, and cough and changed bowel habits were more common with enalapril. The relationship between the pattern of adverse effects and the extent of blood pressure reduction may be dependent on the mechanism of action of a drug. In responders, isradipine and enalapril showed differing patterns, but a similar overall incidence of adverse effects.
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PMID:A multicenter comparison of adverse reaction profiles of isradipine and enalapril at equipotent doses in patients with essential hypertension. 765 48

The new immunosuppressive agent FK506 was used with steroids to treat 22 pediatric patients who received living-related partial liver transplantation. Seventeen recipients survived and 5 died between one and 16 months after transplantation. Three of the 5 patients who died had required intensive care preoperatively. Autopsy findings showed no evidence of rejection. There was no episode of rejection that required retransplantation in any of the patients. Liver allograft dysfunction, which was suspected to be a rejection response, was encountered in 2 recipients with ABO-nonidentical but compatible grafts. However, their clinical and biochemical findings were ameliorated upon steroid pulse therapy or upon augmented FK506 administration without additional potent immunosuppressive agents. Steroid treatment has been discontinued in all surviving patients at 1-9 months after transplantation. Infectious complications encountered in 9 patients included 2 bacterial, 5 viral, and 2 fungal infections. One recipient died of fungal pneumonia. Abnormal increase of serum creatinine level was confined to the complicated patients. Hypertension was a temporary adverse reaction in the early postoperative period, and only one patient needed an antihypertensive drug at 2 months after transplantation. Acute pancreatitis with hyperamylasemia was observed in one patient who was treated successfully with reduction of FK506 administration. Tremor was observed in 8 patients, itching in 4, insomnia in 2, and vomiting in one. Hirsutism, gingival hypertrophy, and lymphoma were not observed. FK506 was highly effective in living-related partial liver transplantation not only in terms of immunosuppressive potential but also because it produced fewer adverse effects.
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PMID:Experience with FK506 in living-related liver transplantation. 767 28

This study reports the result of a 12-month, open-label multicenter study of the efficacy and tolerability of pravastatin in the management of hypercholesterolemia associated with non-insulin-dependent diabetes mellitus. Pravastatin produced a decrease, in 138 diabetic and 51 non-diabetic patients, in total serum cholesterol by 19 and 20%, in low-density lipoprotein (LDL) cholesterol by 25 and 29%, in apolipoprotein B by 15 and 19% and in triglycerides by 8 and 5%, respectively. High-density lipoprotein cholesterol levels were increased by 9% in both groups. All of these changes were significant (P < 0.001) except for triglycerides changes in non-diabetic patients, where the change was not significant and no significant differences were observed between the two groups. These favorable effects on LDL cholesterol and apolipoprotein B were not influenced by gender, the type of diabetic therapy, baseline hemoglobin A1c levels and by the presence of hypertension or gross proteinuria, although a decrease in the two variables were less in those with body mass index > or = 26.4 kg/m2 or in those with age < 60 years. Adverse experiences were similar between treatment groups and the drug was well tolerated. Only one diabetic patient was withdrawn from the study because of pruritus. Pravastatin produced no change in fasting plasma glucose concentrations and hemoglobin A1c levels in diabetic patients throughout the study. Pravastatin was generally effective in improving the serum lipids of hypercholesterolemic diabetic patients.
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PMID:Long-term efficacy and tolerability of pravastatin in hypercholesterolemia in patients with non-insulin-dependent diabetes mellitus. Hyogo Pravastatin Study Group. 778 95

During normal pregnancy, serum transaminase levels remain within normal limits. An elevated level observed in a pregnant woman always signals a disease process, most often of hepatic origin, but in certain cases, of muscular origin. During the last three months of pregnancy and in the immediate post partum period a large number of liver diseases can cause elevated transaminase levels, depending upon the clinical presentation. In everyday practice, a complete liver battery together with specialized consultation is required for all pregnant women with raised transaminase levels. Toxaemia gravis may be evident in patients with severely raised blood pressure, especially if seizures occur. Epigastric or subcostal pain should suggest hepatic involvement. Hypertension may however be absent and epigastric or left shoulder pain may be the only clinical signs. Acute liver steatosis is 20 to 50 times more rare than toxaemia and may cause nausea and vomiting. Certain non-specific signs such as asthenia, anorexia, polyalgia, abdominal pain, diarrhoea and fever, together with pruritus should suggest acute hepatitis. A 25-fold increase in transaminase level is commonly encountered. The risk of fulminating hepatitis is less than 1/1000 but should always be entertained. All drugs should be stopped and careful research for recent xenobiotic contamination (drugs, infusions, alphamethyldopa, etc.) should be undertaken. Viral hepatitis requires serovaccination of the newborn at birth. Herpetic hepatitis is rare but requires rapid diagnosis (liver biopsy) and treatment with acyclovir in addition to cesarean section and treatment of the newborn at birth. Rare cases of hepatitis E may occur after a stay in North Africa, the Middle-East, Southeast Asia or Mexico. Chronic cases with or without temporary pruritus suggest infectious hepatitis B or C although, in chronic hepatitis C, serum transaminase levels often return to normal during pregnancy. Rare cases of asymptomatic elevations of serum transaminase levels can reveal subclinical chronic hepatitis.
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PMID:[Significance of elevated transaminase levels at the end of pregnancy]. 802 21


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