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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 of the combined use of the new calcium channel blocker nicardipine and atenolol was assessed in a double-blind, placebo-controlled trial involving twenty hypertensive patients. Atenolol 100 mg once daily was given to all patients. In addition, either placebo or nicardipine, in increasing doses (5-20 mg three times daily), was allocated randomly to the patients. Compared with placebo, nicardipine had an additional dose-dependent, blood-pressure-lowering effect in the hypertensive patients who had been pretreated with atenolol. An increase in the heart rate was not observed, suggesting that atenolol prevented reflex activation of sympathetic nerve tone caused by the vasodilating properties of nicardipine. The combination of both atenolol and nicardipine was well tolerated by all patients; side effects were minor and did not cause discontinuation of the treatment. No effects on A-V conduction were observed. It is concluded that the combined administration of nicardipine and atenolol is a useful treatment for hypertension that is well accepted by the patients.
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PMID:Blood pressure, heart rate and A-V conduction responses to nicardipine in hypertensive patients receiving atenolol. 402 46

It is difficult for the physician to choose the therapeutic method and the remedy when a plethora is caused by antihypertensive drugs. Apart from the efficacy in the planning of a life-long treatment the compatibility and the simplicity shall increasingly be taken into consideration, for only thus the best possible therapy discipline is to be achieved. Three components--beta-blockers, diuretic and vasodilator--were systematically--alone and combined--applied. Of 188 patients 44% reacted on a beta-blocker alone, 22% on a diuretic alone, other 15% on the combination of the two as well as further 10% only on the triple combination with an addition of vasodilators. The beta-blocker-monotherapy was more successful in younger patients, frequently with high renin content, and in patients up to 60 years. In older patients, more frequently with low renin content, a diuretic or addition of vasodilators was necessary. The blood pressure before the treatment was, however, not decisive for the success of the therapy. In the remaining 9% the beta-blocker was either contraindicated, or even the triple combination did not decrease the diastolic pressure below the desirable aim of 95 Torr. A scheme of therapy, which is based on a beta-blocker, may besides be further simplified by long-acting substances allowing a single daily dosage. This fact is confirmed in a double comparison of Atenolol and Oxprenolol (slow release) in 13 patients. Apart from the favourable relation of effect and compatibility of the beta-blockers these substances antagonize disadvantageous effects of the diuretics and vasodilators. Moreover, they promise a protection of the heart also in the patient with hypertension, which could not be proved with the antihypertensive therapy performed up to now.
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PMID:[Long-term therapy with beta receptor blockaders]. 611 98

Atenolol was compared with placebo in a randomised and double-blind prospective study of 120 women with mild to moderate pregnancy-associated hypertension who were also initially managed conventionally by bed rest. Atenolol given once daily significantly reduced blood-pressure, prevented proteinuria, and reduced the number of hospital admissions. Loss of blood-pressure control leading to withdrawal from the study was commoner among the placebo group, whose babies had a high morbidity. Respiratory distress syndrome occurred only in the placebo group. Intrauterine growth retardation, neonatal hypoglycaemia, and hyperbilirubinaemia occurred with the same frequency in the two groups. Neonatal bradycardia was more common after atenolol but the systolic blood-pressure of the babies was the same in both groups. There was no difference between the groups in maternal symptoms which could have been attributed to beta-blocker therapy. Thus atenolol is more effective than conventional obstetric management in this form of hypertension and does not adversely affect mother or baby.
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PMID:Placebo-controlled trial of atenolol in treatment of pregnancy-associated hypertension. 613 Nov 64

Over a period of 4 years, a team of obstetricians and nephrologists have used beta-blockers in the treatment of hypertension in high risk pregnancies. One hundred and twenty one patients (125 pregnancies) were treated with this new therapeutic approach: Acebutolol (56 cases), Pindolol (38 cases) and Atenolol (31 cases) were used. In our group of patients, 56% (70/121) had a previous record of hypertension. Treatment was started when diastolic pressure reached 90 mmHg. The mothers showed excellent tolerance and in 95% of cases blood pressure was controlled in a satisfactory manner. Three groups of new-born infants were defined. In 20 infants, the weight was less than 2.5, in 15 infants between 2.5 and 2.8 kg, and in 90 infants more than 2.8 kg. There was no evidence of low Apgar scores, bradycardia or hypotension in the infants. The importance of team management of the patient is emphasised.
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PMID:Beta blocker therapy in 125 cases of hypertension during pregnancy. 613 22

A complex study of changes of hemodynamics and myocardial performance was conducted while treating 215 hypertensive patients with obsidan (propranolol), corgard, a cardioselective beta-blocker tenormine and alpha- and beta-blocker trandate. Different hypotensive efficiency and varying hemodynamic mechanisms of its action were found. Obsidan and corgard were mainly efficient in moderate hypertension and marked hypersympathicotonia. Tenormine and trandate produce the most marked hypotensive effect (due to reduction in the vascular tone). The signs of increase in venous blood return to the heart during trandate and obsidan therapy and decrease in venous return after long-term tenormine therapy were established. Myocardial contractility indices decreased after obsidan therapy to the more extent than after corgard and tenormine, and they did not change after trandate. The possibility of myocardial hypertrophy regression was shown (especially in the long-term treatment with tenormine and trandate). A reduction in intramyocardial tension has been stated to depend mainly on hemodynamic factors (reduction in volume or pressure overload on the myocardium) whereas the diminution of the myocardial mass also depends on neurohumoral effects.
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PMID:[Comparative evaluation of the therapeutic effect of various classes of beta-blockaders in patients with hypertension]. 613 17

Although the mechanism of antihypertensive action of beta-adrenergic blocking drugs (beta-blockers) is not known, a theoretical advantage of cardioselective beta-blockers over nonselective ones has been proposed in the treatment of hypertension. To study this hypothesis, we examined cardiovascular responses to handling stress in spontaneously hypertensive (SHR) rats after a single (100 mg/kg) and multiple oral treatments (100 mg/kg per day for 17 d) with either atenolol or propranolol. Atenolol and propranolol markedly suppressed the tachycardia induced by handling stress after acute and chronic administration. Resting mean arterial pressure (MAP) was reduced by acute and chronic atenolol treatment, but not by propranolol. Stress-induced increase in MAP was significantly reduced by chronic treatment with propranolol, whereas no consistent effects were observed with atenolol. Acute treatment with guanethidine (30 mg/kg) markedly reduced the rise in MAP induced by stress. These results suggest that suppression of cardiac function by beta-blockers does not always attenuate the rise in MAP induced by stress, thus cardioselective beta-blockers might not confer any further reduction of the blood pressure increase due to sympatho-adrenal excitation. Inhibition of stress-induced MAP rise by propranolol could be mediated by a modulation of the catecholamine release.
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PMID:Effects of acute and chronic treatments with atenolol and propranolol on cardiovascular responses to handling stress in spontaneously hypertensive rats. 614 Dec 34

A therapeutic game plan is important for the management of hypertension in the runner. Participation in physical training programs may result in lower resting blood pressure in mild hypertensives. Maximal exercise tests can be used to identify those hypertensive patients with a dangerously high exercise blood pressure. Most antihypertensive drugs can be used for the treatment of hypertension which is refractory to exercise training. Atenolol, a cardioselective beta blocker has minimal side effects and the least risk of impairing performance. Calcium channel blockers effectively lower exercise blood pressure and should be used when side effects of beta blockers contraindicate their use in patients.
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PMID:Hypertension in the runner. 615 80

The effects on blood lipids and uric acid of six different antihypertensive drugs used alone, and of five different combinations of two antihypertensive drugs, are reported here. Prazosin significantly lowered serum low density lipoprotein and very low density lipoprotein (LDL + VLDL) cholesterol and total triglycerides while maintaining high density lipoprotein (HDL) levels. Atenolol lowered LDL + VLDL cholesterol slightly. Both pindolol and hydrochlorothiazide (HCTZ) were neutral, while oxprenolol increased total triglycerides. Propranolol lowered HDL cholesterol and increased total triglycerides and uric acid. The combination of prazosin plus pindolol has a direct favorable lipid profile, while the combination of propranolol plus HCTZ lowered HDL cholesterol and increased total triglycerides. The combination of propranolol plus prazosin lowered HDL cholesterol, but to a lesser degree than propranolol alone, which suggests that prazosin was not able to completely counteract the negative effects of propranolol on HDL. Methyldopa plus HCTZ, and HCTZ plus amiloride were neutral with regard to effects on blood lipids. It is suggested that the metabolic effects of antihypertensive drugs could be of special importance in the long-term treatment of mild hypertension.
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PMID:Antihypertensive drugs and blood lipids: the Oslo study. 617 60

Atenolol 100 mg once daily and metoprolol SA 200 mg once daily were compared in 20 patients with mild to moderate hypertension, in a randomised, double-blind cross-over trial. Blood pressure and heart rate were compared at rest and during maximal exercise on a bicycle ergometer at 2 and 24 h post-dose. Blood pressure control was similar with both drugs, except at 2 h when systolic blood pressure was significantly lower with atenolol. Blood pressure and heart rate were less well controlled at 24 h than at 2 h with both drugs, but the majority of patients were still considered adequately controlled at 24 h. Atenolol and metoprolol SA can be considered equally effective in the treatment of mild to moderate hypertension and can be recommended as a once daily regime.
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PMID:A comparison of once daily atenolol and metoprolol SA in mild to moderate hypertension. 634 29

The relationship between the oral dosage and plasma concentration of the long-acting cardioselective beta-adrenoceptor blocker atenolol and the antihypertensive response to the the degree of beta-adrenoceptor blockade and change in plasma renin activity (PRA) was evaluated in patients with mild-to-moderate essential hypertension in a double-blind, randomized, between-patient, dose-ranging (25, 50 or 100 mg once daily for 4 weeks) study. The optimum, or minimum, daily dose of atenolol to treat patients with mild-to-moderate hypertension was not clearly identified in this study. A between-treatment comparison did not demonstrate that all blood pressure falls were always less in the 25 mg group than in the other two groups. Calculation of beta-error or the power for the negative results between doses suggested that a large sample size is required to draw a conclusion that no dose-antihypertensive relationship of atenolol exists in the treatment of mild-to-moderate hypertension. A relatively flat plasma concentration-antihypertensive response relationship was observed. Steady-state plasma concentrations of atenolol were dose-related and renal drug clearance was well correlated with individual creatinine clearance. beta-adrenoceptor blockade was better correlated with plasma atenolol concentration. Correlations which were less strong were between plasma drug concentration and change in various blood pressures and between blood pressure falls and beta-adrenoceptor blockade. There was no relationship between the fall in blood pressure and change in PRA. Atenolol appeared to suppress PRA in an all-or-none fashion.
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PMID:A dose ranging study of atenolol in hypertension: fall in blood pressure and plasma renin activity, beta-blockade and steady-state pharmacokinetics. 634 68


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