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

Amlodipine, a new long-acting dihydropyridine calcium antagonist, was compared with hydrochlorothiazie (HCTZ) in 145 patients with mild to moderate hypertension. After 4 weeks of single-blind placebo runin, patients were randomly allocated to receive amlodipine (2.5-10 mg once daily, n = 97) or HCTZ (25-100 mg once daily, n = 48). At study week 12 response rates for amlodipine and HCTZ were 61.5 and 60.5%, respectively. There were clinically significant reductions in 24-h postdose blood pressures with both amlodipine (-18/-11 mm Hg supine: -14/-10 mm Hg standing) and HCTZ (-18/-10 mm Hg supine, -18/-9 mm Hg standing). After study week 12, atenolol (50-100 mg once daily) was added to the regimen of those patients whose hypertension was not controlled with monotherapy. Neither amlodipine nor HCTZ produced clinically significant changes in pulse rate, electrocardiogram, or chest x-ray film. Although amlodipine increased and HCTZ decreased the high-density lipoprotein (HDL)/total cholesterol ratio and the HDL/(low-density lipoprotein + very-low-density lipoprotein) ratio, the difference between the two treatments was not statistically significant. The incidence of side effects and the rate of patient withdrawal was comparable in the two groups. The incidence of laboratory abnormalities was 56% with HCTZ (mainly hypokalemia and hyperuricemia) and 16% with amlodipine. Amlodipine was an effective, well-tolerated agent for treatment of mild-to-moderate hypertension in this study, as single-daily-dose monotherapy and in combination with atenolol.
 ...
PMID:Double-blind comparison of amlodipine and hydrochlorothiazide in patients with mild to moderate hypertension. 246 40

Angiotensin converting enzyme (ACE) inhibition has provided a new approach to the treatment of hypertension. The broad efficacy of ACE inhibitors across the entire spectrum of hypertension exceeds original predictions. Diuretics have been shown to extend efficacy to over 85% of noncomplicated hypertensives. In addition to efficacy, combination of ACE inhibitors with diuretics permits prevention or attenuation of many undesirable side effects of diuretic therapy, including hypokalemia, hyperuricemia, hyperglycemia, and hypercholesterolemia. Thus, considerations of both efficacy and beneficial effects on cardiovascular disease risk factors make the combination of ACE inhibitors and diuretics an attractive one in the treatment of hypertension.
 ...
PMID:Angiotensin converting enzyme inhibitors enhance the antihypertensive efficacy of diuretics and blunt or prevent adverse metabolic effects. 247 93

In a randomized, double-blind crossover trial, indapamide (IND) 2.5 mg and hydrochlorothiazide 25 mg + amiloride 2.5 mg (HCTZ + A) were found to be equally effective in reducing blood pressure (BP) in 13 patients with moderate to severe hypertension already receiving chronic treatment with a beta blocker and a vasodilatator (supine BP during run-in: 169/103 +/- 21/5 mmHg; on IND: 149/91 +/- 21/14 mmHg; on HCTZ + A 144/88 +/- 23/5 mmHg). Both drugs induced insignificant reductions in body weight, and no change in plasma volume was seen. Serum potassium was significantly reduced on both regimens--the values recorded on IND being significantly lower than those seen on HCTZ + A. Values below 3.0 mmol/l were found in two patients receiving IND, but no subjective side effects were reported. Hyperuricemia occurred with the same frequency on both regimens. It is concluded that IND, just like the thiazide diuretics, is useful as the third drug in patients needing triple drug therapy to control BP, but metabolic adverse effects are not avoided by the choice of this drug.
 ...
PMID:Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension. 248 29

DHEA, a steroid precursor of androgens and estrogens has also an inhibitory effect on several enzymes, namely on 11 beta-hydroxylase, NADH oxidase and glucose 6-phosphate dehydrogenase. The latter is the rate limiting enzyme of the pentose phosphate cycle. This metabolic pathway provides the cells with extramitochondrial NADPH and pentose phosphates. NADPH is used for the synthesis of fatty acids and steroids. Together with ribose 5-phosphate, NADPH (as coenzyme of folate reductases) is required for the synthesis of nucleic acids. A deficient production of DHEA has been found to be responsible for several diseases obesity, diabetes type 2, hypertension, arteriosclerosis and hyperuricemia as well as malignant growth (low DHEA syndrome). DHEA administration favourably modified several of these metabolic disorders. These studies were started in our laboratory in 1962 and stopped in 1976 because we were short of DHEA. At that time the response to our results was rather theoretical, but the last years a new wave of interest in DHEA called for two consecutive symposia, where important findings were presented (Paris in January and Jena in April 1989). It is a damage that this new trend, started in our laboratory, could not be pursued up to now without interruption.
 ...
PMID:[Dehydroepiandrosterone. Renaissance after 13 years]. 252 67

In any therapeutic situation, the choice of drug therapy depends on an estimation of relative risk and benefit. With respect to moderate hypertension, and with less certainty, mild hypertension, the use of drug therapy has resulted in a decrease in overall mortality, a decrease in the incidence of stroke and renal impairment, but little or no change in the incidence of ischemic heart disease. For several years, the choice of first drug in these situations has rested between thiazide diuretics and beta-adrenoceptor blocking agents. There is probably little to choose between these two groups in terms of efficacy, and equally there is little evidence that patient response to one or other agents can be predicted either on demographic or biochemical evidence. There are, however, several studies both in Africa and America suggesting that black patients have a relatively greater hypotensive response to thiazides than to beta-blockers. The adverse reaction profile of these two groups is quite different. There is currently much debate whether the administration of large doses of thiazide diuretics (for example, 10 mg bendrofluazide per day) may cause a constellation of metabolic side effects (hyperlipemia, hypokalemia, abnormal glucose tolerance, and hyperuricemia) which may result in an increase of the risk of developing coronary artery disease in spite of lowering blood pressure. Further, there is no good evidence that the hypotensive effect of diuretics is dose dependent. On the other hand, the evidence that beta-blockers when used as antihypertensive agents have a primary preventive effect for ischemic heart disease is currently very small.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Angiotensin converting enzyme inhibition in clinical practice. Re-examination of step care: choice of first drug. 258 Jan 63

Rates of elevated urinary albumin concentration, defined as microalbuminuria (30-299 micrograms/ml) and macroalbuminuria (greater than or equal to 300 micrograms/ml), were determined on random morning urine specimens in the population of Nauru, which has a high prevalence of non-insulin-dependent diabetes mellitus. The prevalence of elevated urinary albumin levels in the total Nauruan population was very high: 26 and 30% of men and women, respectively, had microalbuminuria, whereas 13% of both sexes had macroalbuminuria. Of the subjects with macroalbuminuria, 66% had diabetes. The prevalence increased with worsening glucose tolerance; 26% of subjects with normal glucose tolerance had either micro- or macroalbuminuria, increasing to 43% of subjects with impaired glucose tolerance, 63% of newly diagnosed diabetic subjects, and 75% of previously diagnosed diabetic subjects. Associations between elevated urinary albumin concentration and putative risk factors were assessed for both the total population (n = 1184) and the diabetic subgroup alone (n = 318). Fasting plasma glucose and hypertension were the most important independent correlates for the whole population, whereas plasma creatinine was also important in diabetic subjects. Age at onset and duration of diabetes were not found to be significantly associated with elevated albumin concentration. In subjects with normal glucose tolerance, hypertension and hyperuricemia were the most important associated factors. These results suggest that blood glucose, blood pressure, and possibly obesity and plasma uric acid are important modifiable risk factors for both micro- and macroalbuminuria in this population.
 ...
PMID:Prevalence and risk factors for micro- and macroalbuminuria in diabetic subjects and entire population of Nauru. 258 79

We examined hyperuricemia in patients with coronary heart disease. In 85 patients with coronary sclerosis confirmed by coronary angiography, the serum urate level (6.08 +/- 1.60 mg/dL) was not different from that in subjects with normal coronary arteries (6.47 +/- 1.69 mg/dL). The incidence of hyperuricemia in patients with coronary sclerosis was 26%, and was significantly correlated with diuretics, obesity and hypertriglyceridemia, but not with hypertension or hypercholesterolemia. To elucidate the mechanism of urate metabolism in coronary sclerosis, we separated coronary sclerosis patients without complicating factors into hyperuricemics and normouricemics, and studied urate metabolism in comparison with subjects with normal coronary arteries. We found that normouricemics with coronary sclerosis had decreases in the filtered urate load and urate clearance with a normal urate-creatinine clearance ratio. Hyperuricemics with coronary sclerosis had decreases in urate clearance and urate-creatinine clearance ratios, but the filtered urate load was similar to that in normouricemics. It is suggested that in coronary sclerosis patients, normouricemics had a low glomerular filtration of urate with normal tubular urate transport, whereas hyperuricemics had enhanced tubular reabsorption of urate without any difference of urate filtration from normouricemics.
 ...
PMID:Differences in urate metabolism between normouricemia and hyperuricemia in coronary heart disease in man. 262 19

The fertile woman is generally protected by her hormone status from myocardial infarct. Since the introduction of oral contraceptives, however, isolated cases of myocardial infarct have been observed in young women. Although some authors have assigned a causal effect to oral contraceptives, other studies have indicated a simultaneous occurrence of such risk factors as smoking, high blood pressure and hyperlipoproteinemia (HLP). In this study 68 women who had undergone definite myocardial infarct and who had not reached 49 years of age or menopause were studied for the occurrence of these risk factors. None of the patients were found to be without other risk factors. Oral contraceptives, carbohydrate intolerance, hyperuricemia and obesity were never observed as single risk factors. High blood pressure and obesity affected 2 out of 5 under 40 years old, 4 out of 5 between 40-44 years, and 17 out of 18 between 45-49 years. The combination of carbohydrate intolerance and obesity rose in the 3 age groups from 1 in 5 to 2 in 5 to 10 in 18. 86% of the patients with body weight 120% of normal also had high blood pressure. Obesity was always associated with other risk factors among these patients. With a prevalence of 38%, diabetes was an important factor in the 45-49 year group. Before prescribing oral contraceptives, the physician should always determine the presence of other factors such as smoking, HLP, diabetes and obesity and attempt to remove these factors before proceeding with oral contraception.
 ...
PMID:[Profile of cardiovascular risk factors in females with a definitive myocardial infarct up to 49 years of age]. 272 60

Of 1894 patients registered in a family medicine clinic, 101 (5.3%) had been taking diuretics for at least 6 months. The sex distribution was equal and the average age was 68.7 years. 60% were taking Kaluril, 30% Aquadon and 10% Frusemide. Most had hypertension or heart failure, or both. 6 patients developed hyperglycemia, 2 hyponatremia, 5 hypokalemia, 2 hyperkalemia and 10 hyperuricemia. In 19 the ECG showed arrhythmias. 5 of 56 patients had hypomagnesemia and another 12 had low borderline levels. In the light of these results and those in the literature, we conclude that diuretics are not as safe as previously thought.
 ...
PMID:[Use of diuretics in family practice]. 273 88

The authors carried out studies on 28 women with the syndrome of Stein-Leventhal with obesity. It was established that patients with hypothalamic genuine obesity of III degree predominated. The number of patients with liver steatosis was the largest among accompanying metabolic disturbances, followed by those with arterial hypertension and asymptomatic hyperuricemia. Menarche occurred on time, but it was succeeded by various menstrual disturbances. There was increased level of testosterone in sera of 12 out of 20 examined women patients, of LH-in 17, of 17-ketosteroids-in 8, of estrogens-in 6, of prolactin-in 8 patients. These data in parallelism between menstrual disturbances and hirsutism were interpreted by the authors as an expression of primary disturbances in hypothalamic-hypophysial-gonadal interrelationships with secondary changes in the ovaries. The role of fatty tissue in the metabolism of steroid hormones is discussed as well as the possibility for participation of genetic factors in the development of the syndrome of Stein-Leventhal and obesity.
 ...
PMID:[The Stein-Leventhal syndrome with obesity]. 280 82


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>