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

Two studies are presented on the possibility of treating hypertension with pindolol once daily. In the first one, patients already treated with multiple doses of pindolol, propranolol or alprenolol were shifted to single dose regime with pindolol, given in the morning. In most cases an adequate blood pressure control could be maintained on a dose of up to 20 mg pindolol. In the other study, previously untreated patients with mild to moderate hypertension were treated from the beginning with a single dose of pindolol. An adequate pressure control was also obtained in most of these patients with a dose not surpassing 20 mg pindolol once daily. In non-responders, the addition of a once daily dose of a diuretic resulted in an adequate pressure control. In both studies side-effects were few. The absence of sleep disturbances and beta-blocker induced bradycardia was particularly noteworthy.
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PMID:Once a day treatment of hypertension. 26 34

The authors have studied the sleep of 6 hydrocephalic infants. In 4 cases disturbed sleep was noticed, characterized by insomnia in 2 cases, and frequent interruptions of sleep in the other 2 cases. In the last cases no other particular alterations were observed. The research was continued in 2 cases, operated on with the Pudenz Valve. In one of which the valve functioned well, sleep was restructured. In the second case the valve did not function well and sleep was not restructured. This suggests the hypothesis that the endocranial hypertension may alter the sleep cycles.
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PMID:[Sleep cycles of hydrocephalic infants (author's transl)]. 92 10

Sea pilots must be capable of carrying out their work in all situations. Thus, they must not have any disease or defect, that could impair their job performance. By periodic medical examinations attempts are made to ensure their working capacity. In most countries these examinations are carried out by a general practitioner and they include only few if any objective laboratory tests. The aim of the present investigation was to study the effectiveness of the periodic medical examinations to find out in the population of pilots examined persons with health risks, especially risks for cardiovascular diseases. All the pilots examined were over 45 years old (n = 135, response rate 88%). Self-evaluation of health was carried out by a questionnaire. Blood analyses were made and chest X-ray as well as exercise-ECC were taken. The most common subjective symptoms concerned musculoskeletal and gastrointestinal systems; sleep disturbances were also quite common. The three most frequent diseases diagnosed earlier by a doctor were musculoskeletal and gastrointestinal diseases, and arterial hypertension. About 24% of pilots had a lower physical working capacity than predicted. The body mass index indicated at least 11% overweight in half of the cases. At exercise-ECG four pilots appeared to have an ischaemic heart disease and additionally eleven pilots had abnormal ECG. Over 80% of pilots had a serum cholesterol value higher than 5 mmol/l, and serum triglyceride values exceeded the normal value of 2.0 mmol/l in every fourth case. Serum glutamyl transaminase was pathological in over 20% of the cases, and serum glucose level in 8%. The findings by routine physical examinations were very few consisting of stiffness in musculoskeletal system, two cases of elevated blood pressure, two heart murmurs, varicose veins etc. In two cases an inguinal hernia was suspected. The current periodic health examinations does not seem to effectively prevent a person with possible health defect from working as a sea pilot. More objective tests must be included in these examinations and more attention should be paid to prevention of overweight, effective treatment of musculoskeletal symptoms, improving physical working capacity and helping pilots to manage their psychic stress.
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PMID:Is there need for change of health examinations for sea pilots? 134 94

Echocardiograms were taken from the parasternal long axis view during nocturnal sleep in ten patients diagnosed with OSAS. A table designed to support the echocardiographic probe prevented significant sleep disturbances during monitoring and allowed continuous data collection with and without nasal CPAP administration. In five of ten patients, there was before CPAP treatment a diastolic LSIVS during NREM sleep, inducing a flattening of the left ventricle. Arterial blood pressure recordings showed pulsus paradoxus when LSIVS was occurring. Nasal CPAP led to normal, unobstructed breathing, significant decrease in Pes nadir and disappearance of LSIVS and pulsus paradoxus. Increase in left ventricular afterload and increase in total peripheral resistance could lead to hypertrophy and hypertension in some OSAS patients. The presence of pulsus paradoxus in OSAS indicates a marked increase in Pes nadir, and its disappearance with nasal CPAP may be one of the signs of effective treatment of OSAS.
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PMID:Leftward shift of the interventricular septum and pulsus paradoxus in obstructive sleep apnea syndrome. 191 3

During the last decade beta-adrenoceptor antagonists have become one of the first-line treatments for hypertension. Generally, they have been shown to be safe with a low frequency of serious side effects. However, minor subjective symptoms, usually considered to be CNS-related, have been reported for all beta-blockers used. Thus, all beta-blockers on the market seem to have a high benefit:risk ratio; independent of their physicochemical properties and pharmacodynamic profile, however, they seem to cause CNS-related side effects to about the same extent. These minor side effects, the mechanisms of which are unclear, consist of subtle effects on general well being, decreased initiative, a depressed frame of mind, and disturbed sleep. Generally, however, beta-blockers in therapeutic dosages do not affect the qualitative functions of the brain. The results so far available have been obtained primarily by using objective methods. Further comparison has now been initiated using documented subjective methods to investigate whether the objectively documented differences are of any clinical relevance to the patient's quality of life. Although it cannot be claimed with certainty, nonselective beta-blockers seem to cause CNS-related side effects to a greater extent than beta 1-selective blockers. Differences in the degree of hydrophilicity of the beta-blocker are apparently of no clinical relevance in this respect. Rather, the plasma concentration of the beta-blocking drug (degree of beta-blockade) seems to be the major determinant of whether or not CNS-related symptoms appear in susceptible patients.
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PMID:Side effects of beta-blocker treatments as related to the central nervous system. 196 14

beta-receptor antagonists have for many years been considered appropriate alternatives in the primary management of mild to moderate hypertension. Generally, they have been shown to be safe with a low frequency of serious side-effects. Among the predictable and usually doserelated side-effects are bradycardia, bronchospasm, hypotension, muscle fatigue and cold extremities. Examples of unexpected side-effects are gastrointestinal symptoms such as nausea and disturbed intestinal motility, skin reactions, sexual dysfunction, as well as effects related to the central nervous system (CNS) such as emotional disturbances. The CNS-related side-effects, the mechanisms of which are unclear, consist of subtle effects on general well-being, decreased initiative, a depressed frame of mind and disturbed sleep. Generally, however, beta-blockers in therapeutic dosages do not affect the qualitative functions of the brain. Thus, all beta-blockers on the market seem to have high benefit-risk ratio, but independent of their physiochemical properties and pharmacodynamic profile, they seem to cause side-effects to about the same extent. The results so far available have been obtained by primarily using objective methods. Further comparison has now been initiated using documented subjective methods to investigate whether the objectively documented differences are of any clinical relevance to the patient's quality of life. Although it cannot be claimed with certainty, nonselective beta-blockers seem to cause CNS-related side-effects to a greater extent than beta 1-selective blockers. Differences in the degree of hydrophilicity of the beta-blocker are apparently of no clinical relevance in this respect.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Quality of life/subjective symptoms during beta-blocker treatment. 198 27

The effects of enalapril maleate were studied in a group of 6 patients with arterial hypertension, hypertensive cardiopathy, multiple metabolic disorders and habitual snoring. Earlier treatment with antihypertensive drugs (diuretics, antiadrenergics, calcium antagonists) had been suspended when a marked deterioration was noted in metabolic parameters and plasmatic electrolytes as well as extremely disturbed sleep. The latter is probably attributable to increased respiratory obstruction during the night as a result of the increased hypertonia of the muscles of the upper air ways due to low blood potassium as well as the central and peripheral effects of the antiadrenergic drugs. After the wash-out period there was a marked improvement in laboratory parameters that continued after treatment with enalapril maleate. In particular, apart from a further slight fall in blood cholesterol and uricaemia there was a statistically significant drop in triglyceride levels. The improvement in the laboratory parameters made it possible to reduce the doses of the drugs being taken for the metabolic disorders. A distinct improvement was also noted in the sleep disturbances especially the excessive drowsiness during the day. There was also a statistically significant drop in arterial, systolic, diastolic and mean blood pressure without any significant change in heart beat. The results indicate that enalapril maleate should be the treatment of choice for those patients in whom high blood pressure is accompanied by alterations to the main metabolic parameters and habitual snoring.
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PMID:[Treatment with enalapril maleate in patients with arterial hypertension, pluri-metabolic syndrome and habitual snoring]. 282 86

Many centrally acting drugs which are prescribed for hypertension, depression, epilepsy, insomnia and asthma may also affect fetal brain neurotransmission and behavioral states. Nearly all these drugs enter the fetal circulation following maternal administration. The immaturity of the blood-brain barrier and greater accumulation in the developing brain make the fetal brain a major target of its mother's medication. Adverse effects that are seen in the fetus are not necessarily evident in its mother. We have shown that drugs like clonidine (an antihypertensive) and clomipramine (an antidepressant), which act on noradrenaline and serotonin neurotransmission in the brain, suppress rapid eye movement sleep in the developing rat. In adulthood, the neonatally treated rats showed hyperactivity, hyperanxiety, reduced sexual behavior, disturbed sleep patterns and reduced cerebral cortical size. Furthermore, such treatment induced an increase in voluntary alcohol consumption and a decreased adaptability of responses to changes in water deprivation in a Y-maze. Little is known about long-lasting consequences of centrally acting drugs used during late gestation in humans. Minor neurological disturbances, such as delayed visual motor performance, smaller head circumference, increased anxiety and disturbed sleep-wake patterns, have been reported in children born to hypertensive mothers treated with clonidine or alpha-methyl-dopa.
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PMID:Neurochemical and electrophysiological disturbances mediate developmental behavioral alterations produced by medicines. 287 4

Neurotransmitters are present at very early stages of brain development. They may have trophic effects on maturation of target neurons and mediate the behavioral repertoire of the immature brain. Many centrally acting drugs which are used during pregnancy and early childhood for the treatment of e.g. hypertension, depression, epilepsy, sleep disorders, or hyperkinetism influence brain neurotransmitters and behavioral states. Disturbances observed later in life in animal and man, due to perinatal interference of such drugs with brain neurotransmitters and behavioral states, are not gross physical malformations but rather subtle behavioral and neurological symptoms such as hyperactivity, emotional lability, perceptual motor disturbances, attentional distractibility and sleep disturbances.
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PMID:Influence of drugs on brain neurotransmitters and behavioral states during development. 288 12

The present study reports on polysomnographic findings of sleep apnea syndrome in a representative sample of otherwise healthy middle-aged blue collar workers (age 45.7 +/- 8.5) with normal to borderline blood pressure (systolic 135.5 +/- 16.1; diastolic: 88.3 +/- 10.2), mild overweight (Broca 114.9 +/- 14.7) and with reported nocturnal sleep disturbances. The prevalence of sleep apnea in this sample (N = 20 out of a total of 78 workers with reported sleep disturbances) is 40%. Mean frequency of apnoeic episodes during night was 97.6 +/- 42.7 in the apnea-positive group as compared to 27.1 +/- 19.9 in the apnea-negative group (T = 5.0; p less than 0.0001), with an apnea index of 13.3 +/- 6.2 as compared to 3.5 +/- 2.3 (T = 7.2, p less than 0.0001). Left ventricular hypertrophy (mean diameter of end diastolic left ventricle: 64.0 +/- 9.5 mm) was found in individuals with apnea although manifest hypertension was absent in most individuals.
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PMID:Prevalence of sleep apnea in healthy industrial workers. 293 98


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