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

Nadolol, a new beta-adrenergic blocking agent, was administered orally in gradually increasing single daily doses to 13 hospitalized patients with essential hypertension. Maximal doses ranged from 200 to 480 mg/day. Blood pressure was reduced in nine patients and heart rate was decreased in 11 patients. The decrease in blood pressure was either partial or temporary in five of the nine patients who responded. Concomitant administration of the diuretic chlorthalidone decreased blood pressure in a previously unresponsive patient. Nadolol effectively inhibited isoproterenol-induced tachycardia and decreased cardiac output by 18 per cent. Plasma renin activity and plasma aldosterone concentration were not changed significantly by the treatment. Body weight was not altered significantly. Blood pressure response was independent of the pretreatment renin levels or the change in renin induced by nadolol; it was also independent of the changes in cardiac output and heart rate but was more pronounced in patients with milder baseline hypertension. The decline in serum concentration of nadolol was consistent with the drug's reported half-life of 12.2 hours. The results indicate that single daily doses of nadolol alone can reduce blood pressure significantly with minimal cardiodepressant effects and no important side effects. The effectiveness of nadolol may be enhanced by the addition of a diuretic.
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PMID:Effect of nadolol in treatment of hypertension. 3 98

Chronic treatment of spontaneously hypertensive rats (SHR) and Kyoto-Wistar normotensive rats (WKY) with nadolol was carried out from gestation until 28 weeks of age. Nadolol treatment caused some lowering of blood pressure but did not prevent the development of hypertension or cardiac hypertrophy in the SHR, in spite of significant beta-blockade. The lumen of large mesenteric arteries from control SHR was smaller than from WKY, and nadolol treatment increased the lumen size in the SHR. An increased number of smooth muscle cell layers present in the control SHR as compared with WKY was reduced slightly by nadolol treatment. However, the changes produced by nadolol did not reach the levels of control and treated WKY. In the aorta, the incidence of polyploid smooth muscle cells was higher in the SHR than the WKY in the control group. Nadolol treatment reduced the percentage of polyploid cells in both SHR and WKY, so that the difference between these two groups of animals was eliminated in the treated groups. The tissue level of norepinephrine in the plasma, heart, mesenteric arteries, and adrenal glands in the SHR and WKY was not affected by the treatment. We suggest that the ineffectiveness of nadolol in preventing hypertension development may be due to its lack of effect in preventing primary changes in the resistance arteries, and that the development of polyploidy of smooth muscle cells may be mediated by beta-receptors.
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PMID:Influence of chronic nadolol treatment on blood pressure and vascular changes in spontaneously hypertensive rats. 149 93

We review the pharmacology, pharmacokinetics, and relative costs of beta-blockers, as well as indications for and therapeutic controversies surrounding their use. It is hoped that this discussion will assist clinicians in making informed decisions when choosing a drug for a hospital formulary or a particular patient. Beta-blockers are indicated for a variety of noncardiovascular and cardiovascular conditions, including hypertension, ischemic heart disease, arrhythmias, and prophylaxis of myocardial infarction (MI). These agents compete with catecholamines at beta-adrenoreceptors. They have different ancillary properties, including intrinsic sympathomimetic activity (ISA), cardioselectivity, and membrane stabilizing-activity, and vary in their duration of action, route of elimination, and lipophilicity. Beta-blocking agents decrease oxygen demand by exerting a negative inotropic and chronotropic effect. They also reduce blood pressure and possess antiarrhythmic effects. Beta-blockers penetrate the central nervous system (CNS) to different degrees and can cause a wide variety of CNS adverse effects. Nonselective beta-blockers have been noted to slightly reduce renal blood flow. Nadolol is an exception in that either no change, or even a small increase in renal blood flow, is observed upon initiation of therapy. Beta-blockers also act on the pulmonary bed by preventing beta 2-mediated bronchodilation, thereby exacerbating bronchospastic disease in some patients. Beta-adrenergic blocking agents can potentiate both hypoglycemia and hyperglycemia in diabetic patients. Their effects on total peripheral resistance (TPR) are controversial. Initially it appears that beta-blockade increases TPR. After chronic therapy, however, TPR decreases to or below baseline values. These agents appear to be equally efficacious in the treatment of hypertension, arrhythmias, and ischemic heart disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Around the beta-blockers, one more time. 168 78

The paper concerns a cooperative open study with participation of 10 centers of the USSR. After receiving placebo 419 men aged 30-59 years suffering from arterial hypertension (diastolic arterial pressure in the sitting position greater than or equal to 95 mm Hg) were given antihypertensive drugs after randomization. The treatment was provided in accordance with a stepped scheme and was started from monotherapy with the beta-adrenoblockers nadolol or propranolol (PP), or with the indirect vasodilator prazosin (PS) or the diuretic. If monotherapy failed, the patients were administered combinations of the indicated drugs. The treatment lasted one year, with a monthly control being exercised. 356 patients completed the studies. Of these, 131 patients (36.8%) had received monotherapy toward the end of the year. During the entire year, monotherapy was provided to 48.9% of the patients who started treatment from nadolol and completed the studies, to 34.1% who started treatment from PP, to 35.5% who started treatment from PS, and only to 14.4% of the patients who started treatment from the diuretic. Comparison of the patients' group given the diuretic with all the remaining groups demonstrate the difference to be significant. By the end of the treatment with nadolol, PP and PS, the diastolic arterial pressure reduced 10-11%, whereas toward the end of monotherapy with the diuretic, it dropped 6%, with the difference being significant. In patients on monotherapy, the negative chronotropic effect of nadolol exceeded that in patients given PP. Nadolol is an effective long-acting beta-blocker. By the intensity of the antihypertensive effect the drug is not inferior to PP or PS and compares very favourably with the diuretic.
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PMID:[The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped-plan treatment (cooperative research). The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. I. The research protocol and results of monotherapy]. 179 12

A comparative study was undertaken to examine the long-acting beta-blocker nadolol without intrinsic sympathomimetic activity and reference agents such as anapriline, a beta-blocker, hypothiazide, a diuretic, and pratsiol, a postsynaptic alpha-adrenoblocker in 361 patients with sustained arterial hypertension (diastolic blood pressure, 95 mm Hg or more) in the randomized groups. The therapy was started with monotherapy of one of these drugs; if ineffective, a combination of two or, if necessary, three agents of different groups was given. The patients' status was monitored at least once monthly for 6 months. Monotherapy with beta-blockers or pratsiol was found to be more effective than that with diuretics. Addition of the second agent was required by 48% of the patients, that of the third agent, by 13%. Nadolol in combination with diuretics and/or pratsiol showed the same effects as did anapriline. The agent possessed a more pronounced negative chronotropic action than did anapriline when it was given alone or in combination. Nadolol caused a decrease in middle and small-sized bronchial patency as did anapriline. A 6-month nadolol therapy resulted in regression of left ventricular hypertrophy.
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PMID:[Role of a beta adrenergic blocking agent nadolol (corgard) in prevention of arterial hypertension: a 6-month treatment (cooperative study)]. 220 53

Response to Nadolol (Corgard) tablets has been studied in newly diagnosed Nigerian patients with essential hypertension attending the hypertension clinic of the University College Hospital, Ibadan. 21 out of 26 recruited patients completed the study. The mean age was 47.3 +/- 9.5 SD years. The mean supine systolic blood pressure post placebo was 177.6 +/- 13.3 SD mm Hg, while the diastolic blood pressure was 101.7 +/- 11.7 SD mm Hg. After 8 weeks, the mean readings were 126.2 +/- 11.2 SD mm Hg supine systolic and 81 +/- 8.9SD mm Hg supine diastolic. In the erect position, the corresponding mean readings post placebo and at 8 weeks 168.8 +/- 21.9 SD mm Hg and 125.2 +/- 15.4 SD mm Hg systolic, and 107.4 +/- 12.2 SD mm Hg and 86 +/- 8 SD mm Hg diastolic respectively. There was a significant difference (P less than .001) between the mean readings post placebo and at 8 weeks in both systolic and diastolic blood pressures in the supine and erect positions). The mean supine pulse rate per minute post placebo was 80 +/- 7, and at 8 weeks 70 +/- 3. There was a significant difference (P less than .001) between the two pulse rates. 2 of the 26 patients were taken off the trial at 4 weeks because of poor response, but were included in the determination of effectiveness, toleration and side effects. Nadolol was found highly effective in 15 patients (65.2%) moderately effective in 6 patients (26%) and ineffective in 2 patients (8.6%). Side effects were not a problem in this study and toleration was excellent in most cases.
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PMID:Clinical experience with nadolol in Nigerian patients with essential hypertension. 248 67

The short-term continuous treatment with propranolol and nadolol, a long-acting nonselective beta-adrenoblocker without own sympathomimetic activity, conducted in two randomized groups of men with stable arterial hypertension (the diastolic AP greater than or equal to 95 mm Hg) has shown that by its hypotensive and negative chronotropic effects nadolol given in the mean dose 87 mg/day compared very favourably with propranolol administered in a dose of 144 mg/day. At the same time nadolol is more fit for patients since it may be taken once a day. The influence of both beta-blockers on the hemodynamic, metabolic parameters and external respiratory function was similar. Nadolol in doses of less than 200 mg/day did not lower the rate of glomerular filtration. On the use of the drug in doses of 240 and 280 mg/day the rate of glomerular filtration slightly decreased.
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PMID:[The comparative results of a short course of nadolol and propranolol treatment of arterial hypertension patients (cooperative research). The Working Group of the Cooperative Program for the Study of New Preparations in Preventing Arterial Hypertension]. 269 55

Chronic administration of nadolol has been reported to reduce blood pressure either without or with a concomitant fall of renal blood flow. We therefore studied the effects of nadolol 80 mg once daily on ambulatory blood pressure, renal and systemic haemodynamics in patients with mild to moderate essential hypertension. Ten patients took part in this randomized, double-blind, placebo-controlled, crossover study, each phase of which lasted 4 weeks. Nadolol significantly reduced ambulatory blood pressure and heart rate, but had no effect on blood pressure variability. Cardiac output was significantly reduced by nadolol and total peripheral resistance increased but without reaching statistical significance. Despite the fall in blood pressure and cardiac output, renal blood flow and glomerular filtration rate remained unchanged. The fraction of cardiac output reaching the kidneys rose significantly and renal vascular resistance was significantly reduced. Body weight, urinary sodium excretion and urine flow rate remained unchanged. We conclude that nadolol 80 mg once daily lowers ambulatory blood pressure in patients with mild to moderate hypertension without impairment of renal blood flow, indicating a redistribution of cardiac output to the kidneys. The mechanism of the renal vasodilator effect of nadolol remains to be determined.
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PMID:Nadolol in essential hypertension: effect on ambulatory blood pressure, renal haemodynamics and cardiac function. 286 51

Propranolol is a commonly used drug; of new and refilled prescriptions, it ranked no. 1 in 1984 and no. 2 in 1985. Medical conditions for its use include angina pectoris, myocardial infarction, hypertension, cardiac dysrhythmias, hypertrophic subaortic stenosis, migraine headache, hyperthyroidism, and pheochromocytoma. Almost all dental practitioners will treat a patient receiving propranolol for one of these conditions. The following recommendations seem appropriate at this time: The patient should continue to receive propranolol during dental treatment. Sudden withdrawal of the beta-blocker will cost the patient the benefit of propranolol therapy and may lead to acute myocardial ischemia. Acute stress should be minimized, as hypertensive responses may also be caused by endogenously released epinephrine. Short appointments scheduled in the morning, possibly with conscious sedation, should be considered. The dosage of adrenergic vasoconstrictors should be limited and gingival retraction cord containing epinephrine avoided entirely. The blood pressure should be taken approximately 5 minutes after local anesthesia is administered to determine if a systemic response has occurred. In the unlikely event of a hypertensive emergency, a rapidly acting, short-duration antihypertensive drug, such as the alpha-blocker phentolamine (Regitine, 5 mg intravenously) should be administered. Sublingual nitroglycerin (Nitrostat, 0.4 mg) may be useful as a nonparenteral alternative. These recommendations apply to other nonselective beta-blockers, including nadolol (Corgard) and timolol (Blocadren). They may also apply to labetalol (Normodyne, Trandate), a nonselective beta-antagonist with some alpha-blocking activity and to pindolol (Visken), a beta-blocker with some intrinsic beta 2-agonistic activity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hypertensive response to levonordefrin in a patient receiving propranolol: report of case. 327 28

Nadolol is a nonselective beta-adrenergic receptor antagonist used on a long-term basis for therapy of angina and hypertension. It has been reported to increase renal blood flow in humans. Theoretically, this could lead to an increase in glomerular filtration rate and improved renal sodium handling. The present study was designed to test whether patients receiving long-term nadolol therapy exhibited changes in whole-body composition that might arise as a consequence. Nine nadolol recipients with angina were followed for up to one year, and serial assessments were made of glomerular filtration rates and whole-body composition using in vivo neutron activation analysis to assess nitrogen, oxygen, sodium, potassium, chlorine, phosphorous, and calcium. No significant changes in these elements were observed. We conclude that any effect of nadolol on renal blood flow in short-term studies is not associated with significant changes in body composition measured over a period of one year.
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PMID:Whole-body composition in patients with angina pectoris receiving long-term treatment with the nonselective beta-receptor blocking drug nadolol. 379 51


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