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

The antihypertensive effect and possible adverse effects of verapamil were assessed in 30 Thai patients with mild to moderate hypertension. All patients had normal blood chemistry evaluations and electrocardiograms. After a 4-week placebo period, 80 mg of verapamil was given 2 times a day for 8 weeks. Blood pressure and pulse rate were recorded both in supine and standing positions every 2 weeks. Verapamil decreased blood pressure significantly both in supine and standing positions. The pulse rate was not significantly affected. The most common adverse effect was constipation. No vivid dreams or breathlessness were reported. The blood chemistry and electrocardiograms at the end of the study period were not significantly changed. It is concluded that verapamil reduces blood pressure in mild to moderate hypertensive Thai patients.
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PMID:A multicenter study of verapamil in systemic hypertension in Thailand. 351 11

Many studies have confirmed that the treatment of mild and moderate hypertension reduces mortality and morbidity from cardiovascular accidents and cardiac and renal failure; more recent studies suggest that there is some beneficial effect on ischemic heart disease. The harmful metabolic effects of some hypotensive agents on serum potassium, magnesium, uric acid, glucose, renin and lipids might reduce the beneficial effect of controlling raised blood pressure. Also, the adverse effects associated with most antihypertensive drugs have decreased quality of life and, possibly, compliance in many patients. In assessing the value of newer antihypertensive agents, other effects of the drugs must be taken into account. The calcium-channel antagonist verapamil produces a dose-dependent reduction in blood pressure with little postural effect. There is little change in heart rate and the major antihypertensive effect results from a decrease in peripheral vascular resistance, with no accompanying increase in cardiac output. In 75 patients followed for more than 1 year, tolerance to verapamil did not appear to develop, nor were there any significant changes in serum electrolytes or creatinine clearance. Fasting serum lipid levels were measured in 15 patients before and after 3 months of treatment with verapamil (80 to 160 mg, 3 times a day); there was no change in cholesterol, triglycerides or high-density lipoproteins. Verapamil is, therefore, an effective hypotensive agent with a rapid onset of action. Tolerance does not develop with prolonged use, nor does it appear to affect electrolytes or serum lipids adversely. Constipation appears to be its only limiting adverse effect.
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PMID:Long-term results with verapamil in essential hypertension and its influence on serum lipids. 351 14

We compared verapamil and propranolol hydrochloride for monotherapy of hypertension. Verapamil lowered blood pressure (BP) more effectively than propranolol in black and white patients. Verapamil was equally effective in blacks and whites, whereas propranolol was more effective in whites. Heart rate was reduced by 6.0 beats per minute by verapamil, and by 13.6 beats per minute by propranolol. In blacks, verapamil lowered systolic BP 16.9 vs 8.1 mm Hg for propranolol; verapamil reduced diastolic BP 12.8 vs 8.6 mm Hg for propranolol. In whites, verapamil lowered systolic BP 19.0 vs 12.7 mm Hg for propranolol; verapamil reduced diastolic BP 16.7 vs 12.3 mm Hg for propranolol. Increases in systolic BP were observed in 22% and 3.4% of patients receiving propranolol and verapamil, respectively. The PR interval was increased from 163.5 to 174.9 ms for verapamil vs 160.3 to 164.4 ms for propranolol. Constipation (15%) and headaches (10%) were most frequent complaints for verapamil vs fatigue (18%) and dizziness (7%) for propranolol. Changes in blood biochemistry values were of small magnitude. We conclude that verapamil monotherapy is a safe and effective means of achieving BP control in patients with essential hypertension.
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PMID:A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response. 353 60

The antihypertensive effect of an oral slow release (retard) formulation of verapamil was evaluated in a negative (placebo) and positive (nifedipine) controlled study. After a run-in period of one week without antihypertensive therapy, 54 patients were classified as having mild to moderate hypertension (diastolic blood pressure 95-115 mm Hg) and assigned randomly to one of three groups (n = 18 each). These received one of the following treatments over 2 weeks: either placebo b.i.d., or a nifedipine retard preparation 20 mg b.i.d., or a verapamil retard preparation 240 mg b.i.d. Assessments of blood pressure were made at rest and during a standardized bicycle stress test. Data were recorded at baseline and at the end of each week. After one week of treatment, 1 patient receiving nifedipine and 14 patients receiving placebo dropped out of the study because their diastolic pressures were equal to or above the values before treatment. After two weeks of treatment, 13 of 18 patients on verapamil and 9 of 18 patients on nifedipine had resting diastolic pressures less than or equal to 90 mm Hg. Also systolic pressure and blood pressures during exercise were significantly lowered by both active drugs. Verapamil caused a fall in heart rate during rest and under maximal exercise. Undesired side effects from verapamil were constipation (6 of 18) and headache (1 of 18); those from nifedipine were flush or headache (5 each of 18); ankle edema, dizziness, or tachycardia were each reported by one patient. In comparison with placebo values, verapamil lengthened the atrioventricular conduction time (PQ-interval) significantly, however, PQ-interval did not exceed 0.24 s.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Controlled study on the treatment of hypertension with verapamil in retard form]. 390 62

Two hundred and eighty-nine patients operated on for primary hyperparathyroidism (PHPT) in the years 1956-79 have been followed up for a mean period of 5 years. The aim of the study was to investigate the symptomatology of PHPT and the disappearance of the symptoms after operative treatment. Of the presenting symptoms hypercalcaemic crisis and cystic bone changes were cured, and none of the patients with pancreatitis as presenting symptom had a recurrence. In the renal stone group, 10% of the patients had recurring stones during the follow-up period. The presenting symptom disappeared in 84% of the patients. Thirty-five% of the patients had no presenting symptom and were classified as "asymptomatic", though, on questioning, most of them had various symptoms which disappeared postoperatively. Malaise, fatigue and muscular weakness disappeared in 79% of the patients, upper abdominal pains in 66%, constipation in 63%, pains in the extremities in 51% depression in 65%. Hypertension increased by 28% during the follow-up period; only three of the 90 patients with hypertension has discontinued antihypertensive treatment postoperatively. During the follow-up study, 6% of the patients were hypercalcaemic, though the serum calcium was only slightly elevated in almost all of these patients (mean +/- SD 2.75 +/- 0.09 mmol/l) and most of them had the multiglandular form of PHPT. The renal function did not deteriorate as much as was expected on the basis of earlier reports; only two patients had a serum creatinine over 500 mumol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term effect of surgical treatment on the symptoms of primary hyperparathyroidism. 407 2

There is no agreement among scientists on which particular aspects of civilisation are most to blame for the emergence and undoubted increase in Western nations during this century of common degenerative diseases. Duodenal ulcer, coronary thrombosis, hypertension and other degenerations appear to be as common in quiet rural communities as in the cities. The frequency of these conditions in the Scottish Highlands where the tempo of life remains slow would seem to rule out stress or psychological factors as important. Changes in diet are now thought by many scientists to be the most likely cause for the increase in diseases of civilisation. The work of McCarrison, Cleave and Burkitt suggests that of all dietary developments in advanced nations during the last two centuries the refining of carbohydrates is the most damaging. A high intake of sugar tends to displace protective vitamin-rich foods and adds to the fibre depletion of refined white flour, with the inevitable consequences--widespread constipation and the serious complications of that distressing condition. Cleave has published strong evidence incriminating 'over-consumption' from dependence on refined carbohydrates, rather than traditional animal fats, as the main cause of coronary thrombosis. The high mortality and morbidity of degenerative diseases with all the attendant human suffering can truly be termed an ecological disaster. The cause is the failure of the food and drink industry to give overall priority to the needs of human health. Increasing demand from consumers for unprocessed fresh whole food would reverse modern trends and would have far-reaching effects on agriculture and industry.
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PMID:Modern diseases, seen from a Highland practice. An ecological approach. 633 6

The antihypertensive efficacy of monotherapy with the calcium antagonists nifedipine (n = 60) and verapamil (n = 43) was investigated in patients with essential hypertension. Relationships between age, pretreatment blood pressure, pretreatment plasma renin activity, and hypotensive response were examined. Intraindividual differences in the responses to both drugs were also studied (n = 16). Treatment with verapamil had to be discontinued because of constipation in one patient; treatment with nifedipine was discontinued because of headache in 11 and ankle edema in one. The antihypertensive efficacy of nifedipine and verapamil was comparable and was positively related to pretreatment mean blood pressure (p less than 0.001) and inversely to pretreatment plasma renin activity (p less than 0.05). With verapamil, the fall in blood pressure correlated positively with the patient's age (p less than 0.001). Thus, calcium antagonists can be used as first-line drugs, especially in older and low renin patients. The relationship between the antihypertensive response and pretreatment blood pressure suggests that there may be a calcium influx-dependent vasoconstrictor mechanism in essential hypertension which may be more pronounced in patients with low plasma renin.
Hypertension
PMID:Factors influencing the hypotensive effects of calcium antagonists. 634 78

Verapamil hydrochloride, a prototype calcium antagonist, is now marketed in the United States for the acute treatment of supraventricular tachyarrhythmias and for chronic management of vasospastic and chronic stable angina. It inhibits the slow inward channel in in the heart and blocks calcium influx in smooth muscle. Its intrinsic negative inotropic action, which is apparent in isolated tissues, is offset in vivo by peripheral vasodilation. It has a mild, noncompetitive sympathetic antagonist effect; its most important electrophysiologic action is a depression of AV nodal conduction, accounting for its effect in supraventricular tachyarrhythmias. Its hemodynamic actions are characterized by a complex interplay of changes in preload, afterload, contractility, heart rate, and coronary blood flow. It does not depress cardiac function, except in severe heart failure. The drug has a mild dilator action on coronary arteries and reverses ergonovine-induced vasoconstriction. Controlled trials have established its role in Prinzmetal's variant angina, unstable angina, and chronic stable angina. It has also been found to be effective in obstructive cardiomyopathies. The potential role of verapamil in such conditions as hypertension, cardioprotection, and Raynaud's phenomenon needs further evaluation; at present these indications have not been approved by the Food and Drug Administration. The most common side effects include constipation, skin rash, and dizziness; AV block, heart failure, and sinus arrest may occasionally be encountered, especially when ventricular function is compromised or conduction system disease is present.
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PMID:Verapamil hydrochloride: pharmacological properties and role in cardiovascular therapeutics. 676 30

1. Sixteen patients with essential hypertension were treated with guanfacine and with clonidine for 5 weeks each in a double-blind, placebo-controlled, cross-over trial. Dosage ranged from 2 to 6 mg guanfacine and from 0.3 to 0.9 mg clonidine daily in two or three divided doses. 2. Both compounds caused a significant and comparable decrease in blood pressure. Patients whose blood pressure was not reduced to normal by 2 to 3 mg guanfacine daily did not respond better to an increase in the dose. 3. Dryness of the mouth and constipation occurred with about equal frequency with both agents, but sedation and orthostatic circulatory effects were considerably more frequent with clonidine. 4. A withdrawal syndrome was observed on discontinuation of clonidine in one patient as opposed to no rebound hypertension on stopping guanfacine treatment. 5. Guanfacine caused a significant decrease in plasma noradrenaline and adrenaline, suggesting a decrease in sympatho-adrenal activity.
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PMID:Antihypertensive effect of guanfacine: a double-blind cross-over trial compared with clonidine. 699 78

The centrally-acting antihypertensive drug guanfacine was studied in a group of 11 moderate hypertensives. In doses of 2 mg daily, an average reduction in diastolic blood pressure of 10.8 mmHg was achieved. Side-effects were few when doses were maintained below 3 mg daily. The blood pressure reduction was associated with a fall in plasma renin activity and an average weight gain of 1.8 kg. When guanfacine was tried in 6 very severe hypertensives who had proved resistant to other antihypertensive drugs, a similar reduction in diastolic pressure of 7 mmHg was achieved using a dose of 3 mg daily. It is considered that guanfacine is a useful new antihypertensive drug, effective in mild hypertension, and side-effects are few if doses are maintained below 3 mg daily. Above this dose, side-effects became prominent, and these included sedation, dry mouth and constipation.
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PMID:Guanfacine: a new centrally-acting antihypertensive agent. 701 31


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