Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

A randomised double-blind crossover trial was done to assess the efficacy of chlorothiazide as an antihypertensive drug in patients with severe renal failure. There was a significant reduction in standing (mean drop 13/6 mm Hg) and supine (mean drop 13/5 mm Hg) blood-pressure, without postural hypotension. Chlorothiazide has a place in the management of hypertension in patients with severe renal failure and its antihypertensive effect is probably due to a change in peripheral vascular resistance and not to volume contraction.
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PMID:Double-blind trial of antihypertensive effect of chlorothiazide in severe renal failure. 9 80

A new beta-adrenoreceptor blocking drug (timolol) was used in two clinical studies. In the first double blind study administration of hydrochlorothiazide and timolol reduced the mean (formula: see text) blood pressure by 23 mm Hg, compared with a fall of nine mm Hg with administration of hydrochlorothiazide and a placebo. Plasma potassium (K+) levels fell with the administration of hydrochlorothiazide alone, but rose back to control values when patients were given timolol. In the second study (patient blind), Moduretic (hydrochlorothiazide, 50 mg and amiloride, 5 mg) and timolol were given once daily. The mean blood pressure fell by 20 +/- 2 mm Hg allowing hypertension to be controlled by this once-daily regimen; the control persisted throughout the day. Plasma potassium (K+) levels fell slightly after treatment with Moduretic, but the fall was not as great as with hydrochlorothiazide. Of the 65 patients who entered these studies, 35 had not been previously treated and had diastolic blood pressure between 105 mm Hg and 130 mm Hg. In 18 patients the diastolic blood pressure was reduced below 95 mm Hg after treatment with a diuretic alone, in 15 patients treatment with a diuretic and timolol (5 mg to 20 mg) reduced the diastolic blood pressure below 95 mm Hg. In two patients, the diastolic blood pressure was between 95 mm Hg and 100 mm Hg. The response achieved with a relatively simple therapeutic regimen that can be administered once daily suggests that the therapy of most hypertensive patients could be supervised by paramedical personnel.
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PMID:A simplified approach to the treatment of hypertension. 60 Jan 90

This study was undertaken to evaluate the effect of chronic diuretic therapy with chlorothiazide on the course of salt hypertension in hypertension-resistant (R) and hypertension-sensitive (S) strains of rats. Investigation of the effects of chlorothiazide on blood pressure, 24-hour urinary 24Na and aldosterone excretion, and plasma renin activity (PRA) produced the following observations: (1) Chlorothiazide failed to prevent the development of salt hypertension in S rats. (2) After 12 weeks, S rats on high salt puls chlorothiazide exhibited a rapid fall in blood pressure to levels indistinguishable from those of S rats on low salt. (3) Chlorothiazide significantly increased urinary 24Na excretion only in S rats on high salt (P less than 0.01). (4) Chlorothiazide significantly increased PRA and urinary aldosterone excretion in both strains on low or high salt diets (P less than 0.001). (5) Morbidity and mortality of salt hypertension were alleviated by chlorothiazide treatment. The unique aspect of this study is the finding that chlorothiazide did not abolish the hypertensiogenic action of salt in S rats.
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PMID:Influence of thiazide on salt hypertension. 85 74

Antihypertensive agents may modify the renal effects of angiotensin converting enzyme inhibition (ACEI). This potential interaction, which is important in the diagnosis of renovascular hypertension was studied in two rat models with and without diuretic treatment prior to ACEI. Acute intravenous administration of furosemide or hydrochlorothiazide in one-kidney, one-clamp animals (1K1C) did not change glomerular filtration rate (GFR) or effective renal plasma flow (ERPF). ACEI administration after furosemide and hydrochlorothiazide decreased GFR (p less than 0.001, p less than 0.01) but not ERPF. Chlorothiazide administered to 1K1C prior to ACEI, decreased GFR (p less than 0.02) but not ERPF captopril administration to 1K1C which received hydrochlorothiazide intraperitoneally for 7-10 days decreased GFR (p less than 0.007) and ERPF (p less than 0.02), while two-kidney, one-clamp animals (2K1C) decreased GFR only in the clamped kidney (p less than 0.005). ERPF in 2K1C increased only in the contralateral kidney (p less than 0.01). Without diuretic 1K1C animals decreased GFR and ERPF after ACEI (p less than 0.005, P less than 0.001). In the clamped kidney of 2K1C rats, GFR and ERPF decreased significantly (p less than 0.0005, p less than 0.004) and contralateral kidney ERPF increased (p less than 0.001), but GFR did not. The consequences of ACEI on GFR are similar with or without diuretic. These data suggest that diuretic therapy may not significantly interfere with ACEI evaluation of renovascular hypertension.
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PMID:Renal functional response to captopril during diuretic therapy. 156 84

Several studies have shown that antihypertensive drugs therapy could reduce morbidity and mortality of hypertension related complication such as stroke, congestive heart failure and renal failure, but there was no significant reduction of coronary heart disease. The benefit of the treatment on morbidity and mortality may be counterbalanced by adversed metabolic effects of long-term therapy. The purpose of this study is to evaluate the blood pressure-lowering and adverse metabolic effects of chlorothiazide and propranolol monotherapy. A double-blind, cross-over design clinical trial was performed for 42 cases (22 males and 20 females) with the mean age of 52 (from 30 to 59 years old). After 2 weeks run-in period, the patients were assigned to group A and B with age and sex stratification. Chlorothiazide and propranolol were given for 12 weeks in alternative with 2 weeks placebo washout period. Our studies have shown that, chlorothiazide and propranolol could reduce both systolic and diastolic blood pressure significantly. But they also associated with adverse metabolic effects. Serum uric acid and triglyceride increased and decreased the concentration of high density lipoprotein cholesterol (HDL-C). Those changes could counterbalance the benefit of blood pressure-lowering effect of antihypertension. Carefully monitoring the adverse metabolic effects closely is necessary in therapy with these drugs.
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PMID:[Metabolic effects of chlorothiazide and propranolol on essential hypertension--a double-blind, cross-over design clinical trial]. 184 31

No adverse effect upon cognitive function has been detected during the first 9 months of treatment by a thiazide diuretic (Moduretic; Merck Sharp & Dohme, Hoddesdon, UK) or a beta-blocking agent (atenolol) of moderately elevated blood pressure in a cohort of 2630 men and women aged between 65 and 74 years. Furthermore, no association was discovered between levels of systolic or diastolic blood pressure at outset and responses to standard tests of cognitive function. This study was carried out in general practices as part of the current Medical Research Council Treatment Trial of Mild Hypertension in the Elderly.
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PMID:Treating hypertension in the older person: an evaluation of the association of blood pressure level and its reduction with cognitive performance. 216 77

Increasing information on the potentially serious risks of potassium and magnesium depletion associated with diuretic therapy demands a clinical focus on understanding the factors involved and on methods for preventing these electrolyte deficiencies. Data suggest that serum potassium and magnesium levels may be normal in the presence of tissue depletion, but decreases in serum levels are almost always associated with tissue and whole-body depletion of these electrolytes in patients in whom such depletion cannot be risked. Ventricular ectopy has also been associated with depletion of potassium and magnesium, which may explain the increased risk of sudden unexpected death in hypertensive patients. Any clinician who treats hypertension or congestive heart failure must consider whether to replete potassium and magnesium in patients already receiving diuretic therapy, or, better still, consider how to prevent depletion of these electrolytes in patients in whom such depletion cannot be risked. If prevention is selected, the clinician must then evaluate the data on available diuretic combinations for efficacy in electrolyte conservation, bioavailability, and dosage convenience. The combination of triamterene and hydrochlorothiazide (Maxzide, 75 mg triamterene/50 mg hydrochlorothiazide) has demonstrated electrolyte conservation, with bioavailability and dosage convenience.
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PMID:Magnesium depletion, diuretics, and arrhythmias. 243 74

Treating older hypertensive patients presents special challenges. The physiological effects of aging result in hemodynamic and pharmacokinetic changes. Geriatric patients are more likely to have concomitant diseases than younger patients. Treatment regimens should be individualized; monotherapy should be the goal. While most antihypertensive agents can be used, each class of drugs has advantages and disadvantages. Diuretics are both effective and inexpensive but their metabolic side effects (especially hypokalemia) may be quite serious in the geriatric population. Sympatholytics, beta-blockers, alpha-blockers, and direct vasodilators may not be tolerated. The angiotension-converting enzyme inhibitors, captopril and enalapril, are good choices because they have favorable hemodynamics, renin and nonrenin-dependent mechanisms of action and are associated with minimal biochemical alterations. In a recent multicenter study, captopril (25 mg twice daily) was given to 99 geriatric patients with seated diastolic blood pressure (BP) of 92-110 mm Hg. Patients whose blood pressures were not controlled after two weeks of therapy were randomized to either Capozide (captopril, 25 mg with 15 mg hydrochlorothiazide) or captopril, 50 mg twice daily. The average decrease in BP was 16.9/11.9 mm Hg; 75.8% of patients responded to treatment. Black and white patients had equal responses. Only five patients withdrew from the study due to adverse reactions, none of which was serious. Geriatric hypertensives should be treated. Because captopril and Capozide are well-tolerated, effective medications in elderly patients with mild, moderate, or severe hypertension, they should be considered as initial therapy for geriatric hypertension.
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PMID:Challenges in therapy of hypertension in the elderly. 305 47

To study the effect of a combination of amiloride, 5 mg, and hydrochlorothiazide, 50 mg (Moduretic), on plasma and skeletal muscle electrolytes in patients on long-term diuretic therapy (greater than 1 year) for arterial hypertension and/or congestive heart failure, 58 patients were recruited. Fifty-five patients completed the study, 27 controls and 28 in the treatment group. The Moduretic group demonstrated a significant increase in skeletal muscle potassium and magnesium values and a significant decrease in systolic blood pressure after 6 months on therapy. There was no significant change in these parameters in the control group. It is concluded that this combination of amiloride and hydrochlorothiazide is capable of preserving the internal and external balance of potassium and magnesium on a long-term basis in the patient categories studied.
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PMID:Amiloride prevents thiazide-induced intracellular potassium and magnesium losses. 341 6

A comparative study was made of the effects of a new therapeutic agent consisting of 50 mg captopril and 25 mg hydrochlorothiazide (Capozide) with an already existing agent Moduretic (50 mg hydrochlorothiazide and 5 mg amiloride). In the Capozide group (32 patients), 20 achieved normal blood pressure, 8 responded but were not brought under control, and 3 were non-responders. In the Moduretic group (31 patients), 17 achieved normal blood pressure, 10 were partially controlled and 4 were non-responders. Moduretic appeared to be most effective in patients previously untreated or who had been taking only one drug, while Capozide controlled patients who had been taking 1 or 2 antihypertensive drugs which had been either ineffective or poorly tolerated. The long-acting effect of a single dose of Capozide was demonstrated by blood pressure measurements taken at least 10 hours later. Both drugs were generally well tolerated and no significant changes were observed in the laboratory measurements. The combination of an angiotensin converting enzyme inhibitor with a diuretic proved more effective than single agents in lowering raised blood pressure. We therefore conclude that Capozide is an effective alternative to traditional medication in the treatment of moderate hypertension.
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PMID:Comparative study of the efficacy and tolerance of capozide and moduretic administered in a single daily dose for the treatment of chronic moderate arterial hypertension. 353 48


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