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)

We report the case of myasthenia gravis in a 74-year-old woman, 2 weeks after acebutolol had been introduced as the sole treatment for systemic hypertension. The disease developed at a fulminant and fatal course despite drug withdrawal. The possibilities of coincidental association between the two events, triggering of a preexisting latent myasthenia gravis or full induction of the disease by acebutolol, are discussed.
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PMID:Fulminant myasthenia gravis soon after initiation of acebutolol therapy. 226 19

A local vascular tissue renin-angiotensin system (RAS) may contribute to blood pressure control and the maintenance of high blood pressure in some forms of hypertension, independently of the plasma RAS. Vascular converting enzyme (CE), present mainly in the endothelial layer of arteries and veins, can be altered in hypertension. Locally generated vascular angiotensin II (ANG II) may exert a number of actions on vascular tone and function, including directly and sympathetically mediated vasoconstriction, changes in vascular compliance in larger vessels, influence on vascular reactions to inflammation and injury, and alterations in vascular texture. Orally administered CE inhibitors have been shown to block not only the plasma RAS but also CE in the vasculature, leading to decreased vascular ANG II concentrations and possibly to an accumulation of locally generated vasodilator peptides and prostaglandins in the vascular wall. In spontaneously hypertensive rats, the slow recovery of CE activity in the vasculature on drug withdrawal was more closely associated with the slow return of blood pressure to hypertensive levels than the fast recovery of the plasma RAS. These and other experimental data discussed in this article favor the hypothesis that local CE inhibition in the vascular wall of resistance vessels, large arteries and veins contributes to the beneficial therapeutic effects of CE inhibitors in cardiovascular disorders such as hypertension and congestive heart failure.
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PMID:Converting enzyme inhibitors and their effects on the renin-angiotensin system of the blood vessel wall. 247 11

Angiotensin-converting enzyme inhibitors (ACEI) constitute an effective and well tolerated class of drugs for the treatment of arterial hypertension. Yet they have been blamed for the occurrence of side-effects the most frequently reported of which are renal function impairment, hypotension and cough. For this reason, the renal function of hypertensive patients has been evaluated after short - and long - term treatment with perindopril. In patients with normal renal function on short-term treatment (1 and 5 days) perindopril produced an increase of renal plasma flow without change in glomerular filtration. In long-term treatment (up to 18 months), no significant change in plasma creatinine level was observed. In old age hypertensive patients or in patients with chronic renal failure glomerular filtration was also preserved, apart from rare cases of creatinine clearance reduction, notably after addition of hydrochlorothiazide. A very slight and clinically not significant rise of kaliemia was noted when perindopril was used as single-drug treatment. Cases of symptomatic hypotension were rare (0.2 p. 100), even in situations of water and salt depletion. Among the other side-effects of ACEI, cough, which has more recently been described, has carefully been looked for. Its incidence has been determined in a double-blind trial comparing perindopril (1.2 p. 100) with captopril (2.4 p. 100). It has also been evaluated in a long-term study involving 632 hypertensive patients, 391 of whom were treated for 1 year; its incidence then was 2.9 p. 100, and drug withdrawal was required in 8 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tolerance and safety of the use of perindopril]. 250 18

Recent advances in central dihydropyridine (DHP)-binding sites are reviewed. DHP-binding sites are pre-synaptically and post-synaptically localized in the brain. The functional role of post-synaptic sites is still unknown, whereas pre-synaptic sites seem to contribute to the control of calcium uptake and of neurotransmitter release. DHP-binding sites may be modualated in physiological (age, sex) and pathological events (hypertension, ischaemia, neurological diseases) or after drug treatments (alcohol, morphine, etc.). The reviewed data suggest new therapeutic implications of DHP calcium channel antagonists in the treatment of other diseases and of drug withdrawal syndrome.
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PMID:Central neurochemical effects of dihydropyridine calcium antagonists. 255 12

Patients with cochleovestibular disorders of central and peripheral origin were treated with monothreane (produced by Luitpold Werk, FRG). The drug was given to 70 patients (19 men and 51 women) at the age of 28 to 64 years, 28 patients of which had disorders of peripheral origin and 42 patients disorders of mixed origin. The patients were examined by clinical methods and special tests and hypertension was diagnosed in 32 patients. The therapy yielded good effects in 61 patients: complete recovery of vestibular disorders was seen in 28 patients and relief of headaches in 42 subjects. Side effects were observed in nine patients who showed reduction of perception thresholds which disappeared after drug withdrawal. Monothreane had a beneficial effect on the course of the hypertensive disease.
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PMID:[Use of monotreane in the treatment of patients with cochleovestibular disorders]. 258 7

Multicenter study of the effectiveness and safety of prazosin (Minipress) in patients with arterial hypertension was carried out in 15 medical centers. Of 366 patients who entered the study, 328 persons satisfying all the protocol conditions were included into the final analysis. The treatment lasted 3 months. Highly significant decrease of systolic and diastolic blood pressure was obtained in all periods of observation. In about two-thirds of patients Minipress was effective as a single drug and in the remaining persons the decrease of blood pressure was achieved using prazosin in combination with other antihypertensive drugs. Patients requiring combination therapy were almost 2 years older (however, the difference was not significant), had higher initial blood pressure and greater body mass. Mean daily doses of Minipress in the monotherapy and combination treatment were 5.6 and 10 mg, respectively. Side effects were observed in 27% of patients, but only in 5% they were the cause of drug withdrawal.
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PMID:[Minipress in the treatment of arterial hypertension in light of results from a multicenter study. I. 3-month treatment: monotherapy versus combination treatment]. 270 Oct 9

Of 218 patients with arterial hypertension, who responded to monotherapy with prazosin (Minipress) during the first 3 months, 178 persons completed the 12-month treatment according to the study protocol. In 9 patients (4.1%) treatment was discontinued because of increase of blood pressure and/or side effects. In the remaining cases patients did not apply for the control examination or the obtained records were incomplete. During all periods of treatment the mean values of systolic and diastolic blood pressure were significantly lower than the corresponding initial values. No significant symptoms of drug tolerance were observed. Mean daily dose of Minipress after 12 months was 5.9 in comparison with 5.6 mg after 3-month therapy. Normal systolic and diastolic pressures at the end of treatment were found in 114 (64%) and 153 (86%) patients, respectively. Full normalization of blood pressure (less than or equal to 140/90) was achieved in 105 (59%) patients. It was found that an important factor determining the antihypertensive effectiveness of Minipress is the initial blood pressure. The inverse correlation between the decrease of systolic pressure and age was found, whereas the age did not affect requiring the drug withdrawal occurred in 27 (14.4%) patients; they were usually the efficacy of Minipress in relation to diastolic blood pressure. Side effects not of moderate intensity and transient character.
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PMID:[Minipress in the treatment of arterial hypertension in light of results from a multicenter study. II. Results of long-term monotherapy]. 270 Oct 10

The antihypertensive activity of spirapril given alone or in combination with felodipine was investigated in spontaneously hypertensive rats (SHR) during a 3-week treatment regimen and for one week after drug withdrawal. Systolic blood pressure and heart rate were recorded once a week just before dosing and at varying time intervals up to 6 hr thereafter. Recordings were continued for one week after drug withdrawal. Spirapril alone at 1 and 5 mg/kg p.o. was found to produce dose-related antihypertensive effects throughout the treatment period. Felodipine alone at 5 mg/kg p.o. reduced blood pressure slightly more than did the low dose of spirapril. The combination of spirapril and felodipine induced a marked antihypertensive response which was greater than that observed in rats treated with either drug alone. One week after treatment withdrawal, blood pressure was at initial levels with no evidence of rebound phenomena. No significant heart rate changes were observed in the treated groups, as compared with the controls, except for an increase on the 1st day of treatment in rats given felodipine. These findings indicate that the combination of an angiotensin converting enzyme (ACE) inhibitor with a calcium antagonist leads to an effective control of hypertension over a prolonged period of treatment. Since the combination allows effectiveness with lower doses of ACE inhibitor, it is expected that the antihypertensive efficacy might be associated with a lower liability to untoward effects.
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PMID:Antihypertensive effect of spirapril and felodipine during repeated administration to spontaneously hypertensive rats. 283 72

The effect of withdrawal of terazosin therapy in patients with mild to moderate hypertension was assessed in two double-blind, placebo-controlled studies. All patients had demonstrated a stable blood pressure response to terazosin prior to withdrawal of the drug. Patients were randomly assigned either to continue treatment with terazosin at a previously established dose that had brought blood pressure under control (dose range: 1 to 40 mg daily) or to receive a matching placebo. At the end of a six- or eight-week withdrawal period, placebo-treated patients experienced mean increases of 7.3 and 12.4 mm Hg in supine diastolic blood pressure (studies M81-020 and M81-028 site 1, respectively). These increases were significantly greater than those observed for patients who continued to receive terazosin. Similar results were observed in other blood pressure variables. Withdrawal of terazosin was accompanied by a significant weight loss (2.8 and 3.6 pounds in studies M81-020 and M81-028, respectively). There were no clinically significant changes in pulse rates, physical examinations, laboratory test results, or electrocardiograms. Headache was the most common adverse experience reported by those who received placebo during the drug withdrawal period. These studies demonstrate that withdrawal of terazosin therapy is associated with an increase in supine diastolic blood pressure, often to hypertensive levels, without signs of a withdrawal syndrome.
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PMID:Effect of withdrawal of terazosin therapy in patients with hypertension. 287 5

A group of 205 patients with mild to moderate essential uncomplicated hypertension was chosen from 3,183 hypertensive patients referred to a hypertension clinic for the first time, and was asked to participate in a six-month double-blind parallel trial. A single physician was in charge of all the patients. After a two-week single-blind placebo period, the patients were randomly assigned to regimens of either enalapril (20 mg per day) or placebo. Both groups were then followed up every two weeks, and increasing doses of hydrochlorothiazide (25 and 50 mg), oxprenolol (160 and 320 mg), and dihydralazine (50 and 100 mg) were added until the diastolic blood pressure was lower than 90 mm Hg. After a six-month follow-up, the enalapril group showed lower systolic and diastolic blood pressures than the control group (129/82 +/- 12/6 mg Hg versus 135/86 +/- 10/5 mm Hg; p less than 0.001). The number of daily tablets of active drugs was 2.7 +/- 1.8 in the enalapril group and 4.4 +/- 2.4 in the control group (p less than 0.01). The mean plasma potassium level was 4.16 +/- 0.4 mmol/liter in the enalapril group versus 3.92 +/- 0.4 mmol/liter in the control group (p less than 0.001), despite more frequent use of amiloride (p less than 0.001). This difference is explained by the lower dose of hydrochlorothiazide used in the enalapril group by comparison to the control group, and a lower excretion of urinary aldosterone in the enalapril group than in the control group (11.6 +/- 7.4 versus 19.8 +/- 11.8 micrograms per 24 hours, p less than 0.001). Drug withdrawal was necessary in eight patients in the enalapril group and in 16 patients in the control group (p less than 0.05). These results show that first-step treatment of mild to moderate uncomplicated essential hypertension with enalapril permits better blood pressure control than the standard treatment, requires fewer tablets to be taken daily, and involves a smaller risk of hypokalemia.
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PMID:Treatment of mild to moderate hypertension with or without the converting enzyme inhibitor enalapril. Results of a six-month double-blind trial. 303 42


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