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

The course of eight pregnancies in seven renal transplant patients was analyzed. Immunosuppression consisted of Azathioprine and Prednisone. Pregnancy lasted from 32 to 39 weeks and the fetal development corresponded to the gestational age in every case. There were three cases which had complications during the pregnancy. One case had severe arterial hypertension, proteinuria and pedal edema, which was thought to be due to pre-eclampsia. Another patient had cholestatic jaundice and premature fissure of membranes and the third patient also had this last complication. Four patients had vaginal deliveries and in four cesarean section was performed. Renal function did not deteriorate during any of the pregnancies nor during the follow-up period, but the expected increase in creatinine clearance was not found. Clinical evaluation of the children, 4 months to 8 years of age, did not disclose any abnormalities.
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PMID:[Pregnancy in renal transplant recipients. Long-term evaluation of their children]. 145 32

The subjects were 24 patients, aged 37 to 66 years, with mild to moderate hypertension, treated with nifedipine retard (mean dose, 47 mg daily) for 7 to 16 weeks. The mean 24-hour ambulatory blood pressure (BP) declined significantly from 158/101 before treatment to 136/87 mmHg after treatment. Daytime BP declined from 160/101 to 133/86 mmHg and nighttime BP from 152/98 to 132/85 mmHg; the diurnal variation in diastolic BP was lost during treatment with nifedipine. The consecutive hourly BPs were all significantly lower after treatment. BPs in response to physiologic tests were significantly reduced after treatment. Heart rate increased significantly during treatment. Side effects (palpitations, pedal edema, and flushing of the face) were reported by four patients. It is concluded that nifedipine retard is safe and effective in the treatment of mild to moderate hypertension.
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PMID:Nifedipine retard in the treatment of hypertension. A study using ambulatory blood pressure recordings. 228 19

Nicardipine is currently being evaluated in clinical trials as a treatment for angina and hypertension. Over 2,000 patients have received nicardipine, most at dosages of 20 to 40 mg 3 times daily. In 12 double-blind, parallel-group studies (4 of them placebo-controlled) the efficacy of nicardipine was evaluated in mild to moderate hypertension; supine systolic blood pressure was lowered by 10 to 15 mm Hg and supine diastolic blood pressure by 10 mm Hg. A clear dose response is present at dosages from 10 to 40 mg 3 times daily. Patients with angina were treated in 9 double-blind, crossover design studies: 4 of these were placebo-controlled; 3 were comparison studies with beta blockers; 2 were comparisons with nifedipine. Treadmill exercise tests were the major measure of efficacy. Results of these studies showed consistent, statistically significant improvement in exercise tolerance and time to onset of angina, and clinical improvement in patients with chronic stable angina. The effective dosages of nicardipine were 30 or 40 mg 3 times daily. A placebo-controlled study demonstrated remarkable efficacy in patients with vasospastic angina. No deaths or serious adverse reactions were attributed to nicardipine during clinical trials. The most common side effects reported were flushing, palpitations, headache and pedal edema. These appeared to be due to the drug's pharmacologic property of vasodilatation.
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PMID:An overview of the safety and efficacy of nicardipine in clinical trials. 330 Feb 39

A study of 31 patients with mild or moderate hypertension and 17 patients with severe hypertension was conducted to evaluate the long-term safety and efficacy of nitrendipine, a new calcium channel blocker with a long duration of action. Nitrendipine (5-40 mg bid) was given as monotherapy or in combination with hydrochlorothiazide and/or propranolol. Seventeen patients (54%) with mild to moderate hypertension were controlled with nitrendipine alone, but all except one patient with severe hypertension required combination therapy. In patients with mild or moderate hypertension, nitrendipine reduced supine blood pressure from a baseline mean 154/100 mm Hg to 136/87 mm Hg after 1 year of treatment (P less than .05). In patients with severe hypertension, supine blood pressure was reduced from 186/124 mm Hg to 148/91 mm Hg by the end of the planned treatment period (P less than .05; mean duration, 10 weeks). During extended observation, antihypertensive effect was sustained for up to 2.5 years and 1.6 years in patients with mild or moderate and severe hypertension, respectively. Nitrendipine was well tolerated; and only one patient, a moderate hypertensive, discontinued treatment because of pedal edema. The results of this long-term study show that nitrendipine alone or in combination with a diuretic and/or a beta blocker is a safe and effective agent for the treatment of patients with all degrees of hypertension.
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PMID:Long-term antihypertensive effects and safety of nitrendipine in patients with mild, moderate, and severe hypertension. 343 66

The influence of long-term nifedipine treatment on body fluid compartments, renal function, the renin-angiotensin system, and the adrenergic system was studied in 18 patients with essential hypertension. A placebo period of 4 weeks was followed by a 6-week dose-titration period. Thereafter, the dose was kept constant for an additional 6 weeks (mean dose, 51 mg/day). As compared with placebo values, diastolic blood pressure decreased approximately 12% during nifedipine treatment. Plasma volume, extracellular fluid volume, and the ratio of plasma to interstitial fluid volume did not change significantly, either in the group as a whole or in a subgroup in which pedal edema developed. Plasma concentrations of epinephrine and norepinephrine increased slightly after 2 weeks of treatment, but they returned to control values after 6 weeks of therapy. Plasma concentrations of renin, angiotensin II, and aldosterone did not change significantly. Glomerular filtration rate and renal clearances of sodium and potassium were unchanged as well. These results indicate that long-term nifedipine treatment does not lead to activation of counterregulatory mechanisms, such as fluid retention or the renin-angiotensin or adrenergic systems. This may well be of importance for the antihypertensive efficacy of nifedipine treatment.
Hypertension 1986 Aug
PMID:Lack of effect of nifedipine on counterregulatory mechanisms in essential hypertension. 352 3

This study was conducted to assess the therapeutic utility of combining amlodipine with captopril in patients with moderate-to-severe hypertension. Patients had hypertension of WHO grades I-III, with initial mean sitting and standing diastolic blood pressure of 100-119 mm Hg (phase V) after 2-4 weeks on placebo, and had remained uncontrolled (diastolic blood pressure > 95 mm Hg) despite a further 4 weeks on low-dose captopril. Twenty-nine patients entered the computer-randomized, double-blind, placebo-controlled, 2-way crossover comparison of either amlodipine 10 mg once daily or matching placebo added to continued therapy with captopril 25 mg twice daily for 4 weeks. Patients then acted as their own control and received the alternative amlodipine/placebo treatment plus their continued captopril therapy for another 4 weeks. Once-daily amlodipine was shown to be effective when combined with captopril. Mean baseline supine systolic blood pressure decreased from 167 to 149 mm Hg and standing systolic blood pressure from 167 to 144 mm Hg. Mean supine diastolic blood pressure decreased from 105 to 92 mm Hg, and standing diastolic blood pressure decreased from 110 to 96 mm Hg. The placebo-corrected amlodipine differences in mean changes from captopril baseline were -18/-12.2 mm Hg for supine and -20.1/-11.9 mm Hg for standing systolic and diastolic blood pressures, respectively (p < 0.001 for all 4 measurements). The most common side effects encountered with amlodipine were flushing and pedal edema. The combination of amlodipine and captopril was well tolerated, and no patient discontinued therapy. No significant treatment-related effects on biochemical and hematologic parameters were noted.
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PMID:Combination therapy with amlodipine and captopril for resistant systemic hypertension. 831 Sep 78

Ten cases of acute renal failure (ARF) were seen in the period from July 1990 to August 1991 in the Nephrology Department of the SIMS Hospital, Srinagar. All were males in the age group of 18-28 years and in apparent good health when apprehended by the police. There was alleged history of physical torture of different types. All had been beaten on the buttocks, back and limbs; in addition, 2 cases had been given repeated electric shocks and 1 case put to 'sit-and-stand' exercise for about 3 h. The interval between the first day of torture till they came to our observation varied from 4 to 11 days. The main clinical features at the time of presentation were generalized aches and weakness (10), oligoanuria (9), vomiting (8), hypertension (6), acidosis (10), facial puffiness and pedal edema (6), fever and shivering (3), pulmonary edema (2), stupor (4), and hyperkalemia (5). All the cases had an established ARF (serum creatinine 668-1,997 mumol/l and serum urea 21.8-71.8 mmol/l) when first seen. Muscle enzymes, creatine phosphokinase, lactic dehydrogenase and serum glutamic oxaloacetic transaminase were all significantly raised indicating rhabdomyolysis. All showed evidence of myoglobin casts in urine. Nine had oliguric and 1 had nonoliguric ARF. All except the 1 case with nonoliguric ARF were managed with peritoneal dialysis and/or hemodialysis. All recovered. Early recognition of ARF is important since the main attention in such cases is directed towards the surgical aspect.
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PMID:Acute renal failure following physical torture. 845 79

We describe a 56-year-old white man who presented with gradual and progressive visual loss and subsequent hypertension and pedal edema. A computed tomographic scan of the orbits showed bilateral diffuse retrobulbar masses, and an abdominal computed tomographic scan showed a diffuse retroperitoneal mass invading the aorta, ureters, and inferior vena cava. Biopsies of the orbit and abdomen confirmed a heterogeneous cell population and marked fibrosis consistent with a sclerosing inflammatory process. Bilateral sclerosing orbital inflammatory disease should cue the physician to suspect coexisting systemic disease. This report is the fourth to document bilateral sclerosing orbital inflammatory disease and the second to have obtained biopsies of the orbit and abdomen showing histologic similarities.
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PMID:Multifocal fibrosclerosis. Report of a case of bilateral idiopathic sclerosing pseudotumor and retroperitoneal fibrosis. 851 88

The efficacy and tolerability of felodipine, in a low dose of 5-10 mg daily was assessed in 32 patients with mild-to-moderate hypertension, aged 53 +/- 11 years. The results of office vs 24 h ambulatory blood pressure measurements (ABPM) were compared. Inclusion criteria included an office systolic and diastolic blood pressure (SBP/DBP) > 140/90 mm Hg and a 24 h ABPM SBP/DBP > 135/85 mm Hg. Felodipine was initiated at a dose of 5 mg daily. At day 28 of the study, if office DBP > 90 mm Hg, the dose was doubled to 10 mg daily. At the end of the study (day 84), 24 h ABPM was done again. Side effects were noted throughout the study. Four patients dropped out during the study (two due to headache, one due to pedal edema and one rejected further participation). Of the remaining 28 patients, at day 28, 12 required an increased dose of 10 mg/day. At the end of the study, office BP was below 140 90 mm Hg in 71% of the patients. In the whole group BP decreased from 158 +/- 15/101 +/- 8.4 to 138 +/- 9/85 +/- 5 mm Hg, P < 0.001. ABPM showed that BP was normalized in 82% of the patients. It decreased from 146.8 +/- 9.56/94.8 +/- 7.4 to 130.2 +/- 10.6/83 +/- 6.3 mm Hg, P < 0.001. BP was similarly reduced in working and sleeping hours, with preservation of the circadian rhythm. Heart rate was unaffected by the drug. Five patients showed persistently elevated SBP on office measurements while on ABPM, the values were within normal limits. This finding confirms the existence of a white coat effect in patients with proven hypertension and the superiority of ABPM over office BP measurements in clinical investigations. In summary, ABPM showed that the antihypertensive effect of felodipine was sustained throughout normal 24 h, including the critical (as regards cardiovascular morbidity) awakening hours.
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PMID:Efficacy of low felodipine dose monotherapy in mild-to-moderate hypertension: a comparison between office and ambulatory blood pressure monitoring. 887 49

The safety and efficacy of Amlodipine (AML) for mild to moderate hypertension was evaluated in a "real life" setting. This open non-comparative trial included 123 men and 143 women (age 30-91 years, mean 59.4). All had sitting diastolic blood pressure (DBP) between 95 and 115 mmHg, confirmed in most by 2 baseline measurements, 2 weeks apart. Eligible patients were given AML 5 mg daily as add-on or monotherapy and were evaluated 4 weeks later. If DBP was then > 90 mmHg, the daily dose was raised to 10 mg; those with < 90 mmHg remained on 5 mg. AML was continued for 8 weeks. Other BP-lowering drugs were unchanged. Of the original 266 patients 22 (8.2%) withdrew due to adverse events (AE), and others were protocol violators, lost to follow-up or withdrew, leaving 211 available for efficacy analysis. In this major group BP was reduced from 165 +/- 15/101 +/- 4 to 139 +/- 11/83 +/- 5 after 12 weeks of AML (p < 0.05). The reduction was greater in those under 70 years, from 173 +/- 12/100 +/- 5 to 142 +/- 12/80 +/- 4 (p < 0.05). In those with BMI > 30 kg/m2, BP decreased from 165 +/- 15/101 +/- 5 to 140 +/- 12/83 +/- 5 (p < 0.05). Mean change in heart rate was -1.5 bpm (p < 0.05). Mean final AML dose was 5.5 mg/day. The most common AML-related AE requiring cessation of the drug was pedal edema in 2.6% of the 266 patients; in 3.7% it persisted during therapy. Other AE occurring in > 1% were dizziness in 1.8%, headache 1.5%, flushing 1.1% and fatigue 1.1%. We conclude that AML is an effective and well-tolerated antihypertensive suitable for most hypertensive patients.
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PMID:[Multicenter community-based trial of amlodipine in hypertension in Israel]. 1095 90


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