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)

Infiltrative dermatitis and marked alopecia of the scalp appeared shortly after a new beta-blocker, nadolol (Corgard), was prescribed for the treatment of a patient with hypertension. Cessation of the beta-blocker therapy, after four months of therapy, was followed by a dramatic involution of the eruption, and total regrowth of scalp hair occurred within three months. The associated eruption and rapid regrowth of hair upon discontinuation of nadolol distinguish this alopecia from the telogen effluvium previously associated with other beta-blocker drugs, such as propranolol (Inderal) and metoprolol (Lopressor).
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PMID:Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol. 397 99

Nadolol and propranolol were compared in seventy-five hypertensive patients in a double-blind randomized study conducted at Ain-Shams Hospital. After an initial wash-out period of 5 weeks, including 3 weeks of placebo administration, forty-five patients were given nadolol once daily and thirty patients received propranolol four times per day for 12 weeks, followed by a tapering-off period of 2 weeks. Both beta-blocking agents were effective in controlling hypertension with final daily doses ranging from 80 to 320 mg. Of statistical significance, however, were the better responses of supine systolic blood pressure elicited by nadolol. The only adverse reactions that occurred in this series were slight weight gains in two patients treated with nadolol and moderate dizziness in one patient treated with propranolol. Nadolol was proved to be a safe antihypertensive drug, at least comparable to propranolol in efficacy, with the advantages of a once-daily dose and a lack of direct depressant action on the heart.
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PMID:Nadolol and propranolol in the treatment of hypertension: a double-blind comparison. 610 14

Nadolol is a nonselective beta-adrenoceptor blocking drug without intrinsic sympathomimetic or membrane stabilising activity. Its inherently long duration of activity makes it suitable for once daily administration in both hypertension and angina pectoris, and in these conditions it has been as effective as propranolol given in a traditional regimen 4 times daily. However, other beta-blocking drugs can also be given with reduced frequency, especially in hypertension; and some, such as atenolol (a longer acting 'cardioselective' agent) or long-acting preparations of other beta-blockers, have also been given once daily in angina prophylaxis. Nevertheless, nadolol is one of a few beta-blocking drugs which have clearly been shown to be effective in both hypertension and angina with once daily administration. Other specific properties of nadolol, such as its excretion entirely in unmetabolised form, may offer advantages over other existing beta-blocking drugs in specific patients, while some properties (such as lack of 'cardioselectivity') may be disadvantageous in others. The choice of a beta-blocking drug should thus be based on a knowledge of the pharmacodynamic and pharmacokinetic properties of the different beta-blocking drugs, and a careful consideration of how such properties can best be applied to benefit the individual patient.
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PMID:Nadolol: a review of its pharmacological properties and therapeutic efficacy in hypertension and angina pectoris. 610 67

First, blood pressure and heart rate variability was studied in 89 normotensive and hypertensive ambulatory subjects with the use of an intra-arterial monitoring device. Short- and long-term variabilities were analyzed by computer. Absolute variabilities (standard deviations) were greatest in patients with hypertension, but relative variabilities (variation coefficients, i.e., standard deviations as percent of means) were slightly lower in the subjects with more severe hypertension. Second, the effect of nadolol on 24-hour blood pressure and heart rate values and on their variability was assessed in seven ambulatory patients with essential hypertension by means of the same intra-arterial device and computer analysis. Two recording sessions were performed (1) without treatment and (2) after 10 days' administration of nadolol once a day (dose range, 80 to 320 mg). Nadolol, given once a day, was shown to reduce blood pressure uniformly throughout the 24-hour period without loss of activity in the hours farthest from administration. The lack of alteration in relative blood pressure variability suggests that nadolol lowers blood pressure without interfering with the mechanisms involved in cardiovascular homeostasis. Reduction in heart rate variability after nadolol suggests less chance of tachycardia episodes in patients with angina and/or arrhythmias receiving nadolol.
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PMID:Twenty-four-hour blood pressure profile and blood pressure variability in untreated hypertension and during antihypertensive treatment by once-a-day nadolol. 614 66

A series of studies on various therapeutic aspects of beta-adrenergic-blocking drugs was carried out by the Veterans Administration Cooperative Study Group on Antihypertensive Agents. In one study the diastolic blood pressures of 49% of 132 men with mild to moderate hypertension were controlled (less than 90 mm Hg) with once-daily nadolol. In a similar group, 85% were controlled with nadolol plus bendroflumethiazide, both given once daily. Nadolol alone was as effective as diuretic alone, although in another study comparing propranolol and hydrochlorothiazide, the latter was somewhat more effective. In both trials black patients tended to respond better to the diuretic, whereas white patients responded better to the beta blocker. Although high-renin hypertensive patients tended to respond better to the beta blocker and low-renin patients to the diuretic, the relationships were not close enough to provide a dependable guide to treatment. Sixty percent of patients whose blood pressure was not controlled on the nadolol-containing regimens reached goal blood pressure (less than 90 mm Hg) with the addition of hydralazine, 25 to 100 mg twice daily.
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PMID:Veterans Administration cooperative study on nadolol as monotherapy and in combination with a diuretic. 614 68

Two-hundred ninety-one patients with hypertension and 313 patients with angina pectoris were enrolled and treated with nadolol for up to 2 years. The efficacy of nadolol in hypertension and angina was maintained over the 2-year period. Discontinuation because of an adverse reaction occurred with 8.3% of the hypertensive patients and 8.6% of the angina patients. The observed reactions were typical of those which occur with beta-blocking drugs. Serum creatinine levels fell significantly (p less than 0.05) after 12 months of treatment for both the angina and hypertensive patients. After 24 months of treatment the serum creatinine levels had decreased 20% from baseline (p less than 0.001). Blood urea nitrogen levels fell in the angina patients after 12 months of treatment but not in the hypertensive patients. Nadolol is safe and effective for the long-term treatment of both hypertension and angina. Renal function, as measured by serum creatinine levels, improved with long-term treatment.
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PMID:Long-term experience with nadolol in treatment of hypertension and angina pectoris. 614 74

Nadolol (N) titrated from 80 to 240 mg or bendroflumethiazide (B) 5 to 10 mg, or the combination (B + N), were randomly assigned double-blind to 365 men with pretreatment diastolic blood pressures (BP) of 95 to 114 mm Hg. After 12 weeks of treatment, a diastolic BP of less than 90 mm Hg was achieved in 49% who received N, 46% who received B and 85% who received B + N. With N, the diastolic BP decreased more in whites than in blacks; with B, this racial trend was reversed. Side effects were infrequent; the most common were impotence, lethargy, weakness and postural dizziness, which occurred more often with B than with N. Addition of hydralazine, 25 to 100 mg twice daily, controlled diastolic BP at a level of less than 90 mm Hg in approximately 60% of those previously uncontrolled. N, and especially B + N, provided an efficacious once-daily treatment for systemic hypertension, and addition of hydralazine was effective in most nonresponders.
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PMID:Efficacy of nadolol alone and combined with bendroflumethiazide and hydralazine for systemic hypertension. 635 51

Heart rate and blood velocity are major determinants of flow disturbances at arterial bifurcations. Since endothelial damage due to flow disturbances is thought to be significant in the pathogenesis of atherosclerosis, the effects of drugs on these parameters have to be considered in the selection of medications to prevent atherosclerosis. To determine the effects of antihypertensive drugs on heart rate and blood velocity 15 patients with hypertension were treated with placebo, hydrochlorothiazide, nadolol, propranolol and hydralazine in sequence. The doses given produced significant changes in heart rate and blood pressure, and Doppler ultrasonographic recording of aortic blood velocity showed that there were significant changes in peak blood velocity. Nadolol and propranolol produced significantly lower values of heart rate x blood velocity than placebo, hydralazine and hydrochlorothiazide.
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PMID:Effects of antihypertensive agents on blood velocity: implications for atherogenesis. 713 86

Although beta-adrenergic blocking agents are known to reduce the risk of myocardial infarction, the mechanism of this protective effect is not well understood. The recent demonstration that beta blockers selectively blunt the increased morning risk of myocardial infarction suggests that these agents block the pathophysiologic consequences of stressors concentrated in the morning. We determined the effect of nadolol on the hemodynamic and hemostatic responses to mental stress and isometric exertion (handgrip), 2 potential triggers of infarction. The study was conducted in 15 subjects with mild systemic hypertension, using a placebo-controlled, double-blind, crossover design. Nadolol reduced systolic pressure and heart rate after mental stress. Poststress systolic pressure was 139 +/- 4 mm Hg during therapy with nadolol versus 161 +/- 4 mm Hg during placebo administration (p < 0.05). Heart rate increased to 61 +/- 2 during nadolol therapy versus 89 +/- 5 beats/min during placebo therapy (p < 0.05). The systolic pressure increase was similar during therapy with nadolol and placebo (29 +/- 2 vs 33 +/- 2 beats/min, p = NS); however, heart rate increase was less during nadolol therapy (4 +/- 1 vs 12 +/- 4 vs beats/min, p < 0.01). The responses to handgrip and their modification during nadolol therapy were similar to those observed after mental stress. Neither platelet aggregability nor fibrinolytic potential was altered by nadolol. Thus, nadolol modified hemodynamic indexes without altering the hemostatic indexes measured. This hemodynamic effect may contribute to the decrease in morning cardiovascular events by beta-adrenergic blockers and their well-documented cardioprotective effect.
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PMID:Effects of nadolol on hemodynamic and hemostatic responses to potential mental and physical triggers of myocardial infarction in subjects with mild systemic hypertension. 851 27

Nadolol, a beta-blocker used in the management of hypertension and angina pectoris, has three chiral centers and is currently marketed as an equal mixture of its four stereoisomers. Enantiomeric separation of nadolol by high-performance liquid chromatography was studied on a column packed with novel heptakis (6-azido-6-deoxy-2, 3-di-O-phenylcarbamolyted) beta-cyclodextrin bonded chiral stationary phase. The retention behavior and resolution of nadolol enantiomers were investigated and discussed with respect to the mobile phase composition and flow rate, pH, ionic strength, and temperature. The optimal separation condition was found; the mobile phase contained 80% buffer solution (1% triethylamine acetate, pH 5.5) and 20% methanol with 0.3 ml/min mobile phase flow rate at a temperature of 20 degrees C. At the optimal conditions, resolution of three stereoisomers of nadolol was obtained with a complete separation of the most active enantiomer, (RSR)-nadolol. Thermodynamic properties including enthalpy and entropy change of binding to the CSP for the enantiomeric separation were also determined.
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PMID:Liquid chromatographic retention behavior and enantiomeric separation of three chiral center beta-blocker drug (nadolol) using heptakis (6-azido-6-deoxy-2, 3-di-O-phenylcarbamolyted) beta-cyclodextrin bonded chiral stationary phase. 1239 97


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