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

Disagreement in the literature about the occurrence of rebound hypertension (hypertensive overshoot) in animal models initiated this investigation. Oral doses of clonidine (0.03 mg kg-1) or guanfacine (0.3 mg kg-1) were administered twice daily during three weeks to groups of normotensive and renal hypertensive rats. Blood pressure and heart rate were measured immediately before and 3 h after the first daily dose, and compared with values obtained from placebo-treated control rats. Treatment with either drug induced large daily fluctuations rather than sustained falls in blood pressure. In the normotensive, but not in the hypertensive groups, the morning blood pressures measured before the first daily dose were significantly elevated over those of the control groups after 9 and 5 days of treatment with clonidine or guanfacine. This elevation persisted for 3 days after drug withdrawal. It is concluded that in the rat the duration of action of both drugs was short, so that twice daily administration of both drugs similarly produced large daily fluctuations rather than sustained falls in blood pressure. Blood pressure rises developed during treatment rather than after withdrawal in normotensive rats only. Therefore, this type of study does not relate well to the human situation and different experimental approaches to this problem are needed.
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PMID:The effects of treatment and of withdrawal of treatment with guanfacine and clonidine on blood pressure and heart rate in normotensive and renal hypertensive rats. 3 58

1 Labetalol, a beta- and alpha-adrenoreceptor-blocking drug, has been used in the treatment of hypertension in a total of 32 patients for over 4.5 yr, 14 patients for 3 yr or more. 2 Labetalol seems to have a similarly potency of methyldopa and the adrenergic neurone-blocking drugs. 3 Postural hypotension was only observed at doses over 2 g/d. It was the reason for stopping treatment in two patients. 4 Dosage varied; average 889 mg/d, range 75-3,200 mg. Tolerance did not develop. 5 Side-effects led to drug withdrawal in four patients
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PMID:Labetalol in long-term treatment of hypertension. 6 82

From June 1987 to June 1991 at the Belgrade University Children's Hospital 10 patients, 5 males and 4 females, aged 2-16 years, with chronic glomerular disease, were treated with CyA. Seven patients had INS, 2 lupus nephritis and one IgA nephritis. Before initiation of CyA, all but one, were treated with classic immunosuppressive therapy, which had no effect (8/10) and/or had serious adverse effects (9/10). CyA dosage was initiated at 4-6 mg/kg/BW, and was subsequently adjusted to achieve CyA concentrations in blood at range 50-100 ng/ml. Treatment duration was 2-17 months. Patient compliance to CyA therapy was observed in 5/7 INSs: 2 cortico-sensitive (1 with FSGS was cortico-dependent and 1 had frequent relapses) and 3 cortico-resistant patients (2 with FSGS and 1 with minimal histologic changes). After drug withdrawal, only one of the patients who responded, had no relapse. One of the two patients with SLE showed improvement during CyA administration, while no response was observed in the patient with IgA nephritis. Adverse experiences with CyA therapy involved decreased renal function (2/10), arterial hypertension (1/10), hyperbilirubinaemia (1/10), transient LDH increase and hyperuricaemia (1/10).
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PMID:[Cyclosporine in the treatment of glomerular diseases in children]. 146 61

Thirty adults with essential hypertension (systolic BP greater than 150 mmHg or diastolic BP greater than 100 mmHg) were treated with 5-20 mg of enalapril to study its anti-hypertensive efficacy and safety. Ten patients had mild hypertension (diastolic BP greater than 90 mmHg and less than 105 mmHg), 10 had moderate hypertension (diastolic BP greater than 105 mmHg and less than 115 mmHg) and 6 had severe hypertension (diastolic BP greater than 115 mmHg). Of the 20 patients who completed the trial, 9 (45%) showed optimum reduction of BP to less than 130/90 mmHg) and a further 7 (35%) showed significant reduction. The mean fall in systolic BP was 32.5 mmHg (0-80 mmHg) and in diastolic BP was 18.5 mmHg (0-50 mmHg). The peak fall in BP was achieved in 3.5 weeks (1-6 weeks) with a mean dose of 7.2 mg of enalapril daily (5-15 mg/day). Mild side effects not needing drug withdrawal were seen in 8/20 patients (40%). Monotherapy with enalapril appears to be effective and safe as step one therapy for patients with essential hypertension.
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PMID:Enalapril monotherapy in essential hypertension. 162 42

In 51 patients with stage II essential hypertension (mild and moderate arterial hypertension), a cross-over study was carried out to estimate the efficacy of the use of ketanserin (KS), an antagonist of serotonin receptors, as compared to the efficacy of placebo, the beta-adrenoblocker propranolol (PP), the diuretic triampur and the beta 1-adrenoblocker prazosin. When administered in the daily dose 40-80 mg, KS produced an antihypertensive effect in 43.7% of the patients. The efficacy of KS administered once or twice a day did not practically differ. The side effects of the monotherapy were unmarked and required the drug withdrawal only in 2 patients (4%). KS produced no material shifts in the biochemical parameters with the exception of a slight increase of the activity of alanine transferase and led to a certain reduction of carbohydrate tolerance. In patients who responded to KS, the drugs belonging to the other three groups appeared effective as well. Both KS combined with triampur and KS combined with PP provided a higher antihypertensive effect than monotherapy with each of those drugs. The combination of KS and prazosin produced the same effect as monotherapy with prazosin.
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PMID:[A cross-over study of ketanserin compared to placebo, beta-adrenergic blockader, diuretic and alpha 1-adrenergic blockader. Cooperative research in the USSR (the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension). Working Group (4)]. 168 78

Felodipine is a dihydropyridine that blocks the slow entry channel for calcium. It is highly vascular selective and reduces blood pressure (BP) by dilatation of peripheral arterioles. It reduces BP in mild, moderate, and severe hypertension, and the fall in BP depends upon the initial level. It has been compared with a variety of other drugs as monotherapy or as add-on therapy. In these studies, felodipine (10-40 mg/day) has caused a similar or greater fall in BP and a similar or greater percentage of patients have achieved a diastolic BP less than or equal to 90 mm Hg. The plain tablet of felodipine needs to be given twice a day but an extended-release form can be given once daily. Some patients respond to 5 mg/day and most patients respond to a daily dose of 20 mg or less. The adverse effects are few except for a constellation of symptoms related to the vasodilator ability of the drug. These include palpitations, flushing, fatigue, dizziness, and headaches. These occur, if at all, usually within the first 2 weeks and diminish as the drug is continued. They can be limited by starting on a small dose of felodipine (5 mg/day). People who have these adverse effects usually have a good response to the drug. Another adverse effect, which is the most frequent reason for drug withdrawal, is ankle edema. This is more common on the higher doses of the drug. It is due to dilatation of the precapillary resistance vessels rather than sodium and water retention. Felodipine is a useful and effective antihypertensive drug and can be used as monotherapy or added to other antihypertensive drugs. It is effective in people with all grades of hypertension.
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PMID:A review of the antihypertensive effects of felodipine alone or in combination. 169 35

Pemphigus lesions appeared in a 58-year-old man who was taking captopril for his hypertension. Drug withdrawal resulted in complete remission of the eruption. The subsequent use of enalapril as an antihypertensive agent caused a recurrence of pemphigus lesions along with onset of itching and dermographism. Intercellular antibodies were not found. Discontinuance of enalapril therapy had no effect on the clinical course. Steroid treatment was needed to resolve the eruption. Recently repeated immunofluorescent studies disclosed intercellular IgG antibodies in the serum at a low titer. Pemphigus induction could be initially related to the thiol acantholytic property of captopril. Subsequent production of intercellular antibodies and drug-activation of the kinin system could be responsible for relapsing.
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PMID:"Two-step" pemphigus induction by ACE-inhibitors. 173 86

Severe uveitis is a relatively common and difficult clinical management problem in ophthalmology. Recently, cyclosporine-A (Cs-A) has been shown to be of therapeutic benefit in the management of sight threatening inflammatory eye disease. In order to examine the efficacy and long term safety of Cs-A, we conducted an open uncontrolled study in 22 patients with sight threatening uveitis whose disease had previously been refractory to treatment with systemic corticosteroids (22 patients), azathioprine (5 patients) and cyclophosphamide (2 patients). Uveitis was idiopathic in 16 cases, one patient had Reiter's syndrome, two had Vogt Koyanagi Harada disease and one patient had sarcoidosis. There were twelve males and ten females with a mean age of 40.5 years (range 22-67 yrs). Nineteen patients (86%) showed significant clinical improvement after treatment with Cs-A (10 mgm/kg/day) with decreased inflammatory activity and improved visual acuity. Three patients failed to respond to Cs-A therapy, while 4 subjects whose disease had initially responded to Cs-A relapsed on attempted withdrawal of this medication. Side effects were common in patients receiving Cs-A [5 mgm/kg/day (or greater)], with hypertension, tremor, hirsutism and raised serum creatinine being most frequent. We conclude that CS-A is an effective immunosuppressive agent in the treatment of patients with uveitis; however, its usefulness is limited by frequent side effects and disease relapse on attempted drug withdrawal.
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PMID:Cyclosporine: a therapy in inflammatory eye disease. 178 55

Captopril has attained widespread use as an effective agent in the treatment of heart failure and hypertension. Dermatological, renal and haematological toxicity associated with its use has been widely described and is usually well recognized. There have been comparatively few reports implicating it as causing hepatic drug reactions. Most descriptions have emphasized strongly cholestatic features, although a mixed hepatocellular cholestatic picture and predominant hepatocellular reactions have been reported. Between November 1972 and June 1990 only five cases of possible Captopril-associated hepatic dysfunction were reported to the Australian Adverse Drug Reaction Advisory Committee. Cases reported suggest equal sex distribution, latent period to development of abnormality between 1 week and 20 months, with slow resolution of jaundice and biochemical abnormality from 1 week to 6 months after withdrawal of the drug. One case of hepatic coma and death with massive acute hepatic necrosis on biopsy has been reported. Not uncommonly the accompanying systemic features suggest a syndrome of drug hypersensitivity. We report a case of Captopril-induced cholestatic jaundice in which the abnormality occurred 2 weeks after commencement of the drug and resolved slowly upon discontinuation. The case illustrates two important points: first, the importance of taking a full history, obtaining detailed information about previous drug administration in patients admitted with jaundice; and second, in the case of Captopril-induced liver disease, the jaundice may persist for many weeks after drug withdrawal.
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PMID:Cholestatic jaundice associated with captopril therapy. 193 74

We encountered a renal transplant recipient who developed an unexplained 0.09 decrease in hematocrit value while taking enalapril for hypertension, which reversed when the drug was stopped. This experience, and a previous similar case report, prompted a review of all our 27 transplant patients treated with enalapril. Of these, 10 patients (37%) had developed an otherwise unaccounted for anemia: the pre-enalapril hematocrit value was 0.42 +/- 0.01 and it decreased to the nadir value of 0.33 +/- 0.01 (P less than 0.001) within 12.3 +/- 0.9 weeks after initiation of 9 +/- 2.4 mg of enalapril daily; enalapril was stopped in seven patients and their anemia resolved within 9.1 +/- 0.7 weeks to a final hematocrit value of 0.40 +/- 0.01. The remaining three patients were maintained on enalapril at their physicians' discretion, without further decrease in hematocrit values. No appreciable changes in drug regimens, clinical course, or other laboratory parameters were noted during this period. A causal relationship between enalapril and anemia was suggested by the effect of drug withdrawal and rechallenge on hematocrit in one of the patients. There were no statistically significant differences in baseline clinical and laboratory characteristics between those patients who did (group I) and those who did not (group II) develop enalapril-associated anemia, with the exception of a normal hematocrit value of 0.42 +/- 0.01 in group I versus a lower hematocrit value of 0.36 +/- 0.02 in group II (P less than 0.05). We conclude that enalapril should be considered in the differential diagnosis of anemia following renal transplantation. Susceptibility to this effect might emanate from the immunosuppressed state.
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PMID:Enalapril-associated anemia in renal transplant recipients treated for hypertension. 199 63


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