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)

The efficacy and safety of terazosin were compared with those of other antihypertensive drugs in three parallel-group, randomized, double-blind studies in which 133 patients with mild to moderate hypertension participated. In two studies, terazosin monotherapy was compared with placebo and prazosin (study M79-073), or with hydrochlorothiazide (study M80-012). In a third study (M80-013), the combination of terazosin plus hydrochlorothiazide was compared with the combination of prazosin plus hydrochlorothiazide. Doses of study medications were administered twice daily and were increased at weekly intervals until the average supine diastolic blood pressure was 90 mm Hg or less, with a decrease from baseline of at least 10 mm Hg, or until the maximum specified dosage of a given study drug was reached. In general, all active treatments resulted in significant decreases from baseline in supine and standing blood pressures. There was no significant difference between terazosin- and prazosin-treated patients for changes from baseline to the final visit in supine or standing blood pressure measurements (study M79-073). Hydrochlorothiazide had a significantly greater effect on supine diastolic blood pressure when compared with terazosin (study M80-012). Otherwise, there were no significant differences between active treatment groups. Overall, no regimen caused clinically important changes in pulse rates, body weights, laboratory test results, physical examinations, or electrocardiograms. The incidence of side effects was approximately the same for all drugs; the most common side effects were headache, dizziness, malaise, asthenia, and nasal congestion. The results of these studies suggest that terazosin exhibits antihypertensive activity that is quantitatively similar to that of prazosin in patients with mild to moderate hypertension, and that a dose of 1 to 10 mg twice daily is well tolerated.
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PMID:Comparative trials of terazosin with other antihypertensive agents. 287 6

Although the value of treating all degrees of hypertension has been clearly established, a substantial percentage of patients fail to comply with drug therapy and thus do not receive the long-term benefits of blood pressure reduction. Antihypertensive drugs can have a negative impact on the patient's overall quality of life, as judged by their physical state, emotional well-being, cognitive acuity, and sexual and social functioning. These effects can be quite troubling to patients with a seemingly symptomless disease. In order to examine more closely the effects of different antihypertensive agents on quality of life, a double-blind, multicenter trial was conducted in which male patients were assigned to treatment with either methyldopa, propranolol or captopril for six months. Hydrochlorothiazide was added to the primary drug in patients whose blood pressure was not adequately controlled after eight weeks. Quality of life was evaluated using a battery of validated psychological assessment scales and indexes. Captopril was favored over methyldopa and propranolol on a number of the quality of life measures, including general well-being, physical symptoms, and sexual dysfunction. Addition of a diuretic negatively affected quality of life in all three primary drug groups, but captopril was still favored over the other primary drugs even when the effect of the diuretic was considered. The study demonstrated that quality of life is relevant and assessable and can be influenced by the choice of drug therapy. Greater attention by physicians to quality of life issues can hopefully improve patient compliance and extend the benefits of long-term antihypertensive therapy to more patients.
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PMID:Beyond blood pressure control. Effect of antihypertensive therapy on quality of life. 305 45

In this study, 953 patients (48 percent men) more than 60 years old with mild to moderate hypertension (class I or II) were included. After a two-week wash-out period, a starting dosage of captopril--12.5 mg twice a day--was given. Patients were examined after one and three weeks and, subsequently, at monthly intervals for a total period of four months. The dosage was adjusted to a maximum of 50 mg twice a day plus, when needed, 25 mg of hydrochlorothiazide per day. Thirty-two patients were lost to follow-up, 10 withdrew because of inadequate control of blood pressure, and only 21 (2 percent) dropped out because of side effects. Mean blood pressure decreased from 184/104 to 152/87 mm Hg. The lowest dosage (25 mg a day) was sufficient to control blood pressure in 15 percent of patients, 31 percent needed 50 mg a day, and 24 percent required 100 mg a day. Hydrochlorothiazide was added to the captopril regimen in 30 percent. No substantial changes in biochemical variables or electrocardiographic results were observed. "Quality of life" (judged as physical fitness, positive well being, mood, and sexual desire) remarkably improved.
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PMID:Captopril in elderly hypertensive patients. Results from a multicenter Italian trial. 306 94

Twenty-seven patients with mild to moderate essential hypertension were randomized to receive therapy with either hydrochlorothiazide or diltiazem. After a placebo run-in period of 2 weeks, patients received increasing doses of either drug for 14 weeks. Those in whom hypertension was effectively controlled continued for 26 weeks of total treatment. Those not controlled, i.e. blood pressure greater than 140/90 mm Hg or less than 10 mm Hg reduction of pressure, were unblinded and crossed over to therapy with both drugs. Eleven of 14 patients (79%) were effectively treated with diltiazem alone, and 8 of 13 patients (62%) were effectively treated with hydrochlorothiazide alone. Supine blood pressures fell from 152 +/- 5/97 +/- 1 to 142 +/- 4/87 +/- 3 mm Hg in the 11 patients treated with diltiazem, from 152 +/- 2/99 +/- 1 to 134 +/- 3/88 +/- 2 mm Hg in the 8 patients treated with hydrochlorothiazide, and from 151 +/- 4/104 +/- 3 to 140 +/- 5/92 +/- 1 mm Hg in the 8 patients who received both drugs (p less than 0.01 for each group). Diltiazem patients had significant increases in alkaline phosphatase and urinary magnesium. Hydrochlorothiazide patients had increases in serum uric acid, serum globulin, CO2 content, and plasma renin activity. Serum potassium, serum chloride, urinary osmolality, and urinary calcium decreased after treatment with hydrochlorothiazide. Patients receiving both drugs had increases in serum glucose, serum BUN, serum uric acid, serum globulin, and CO2 content. These patients had decreased serum chloride and urinary calcium. Diltiazem monotherapy was comparable to hydrochlorothiazide in efficacy of lowering blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal-metabolic consequences of antihypertensive therapy with diltiazem versus hydrochlorothiazide. 332 Jul 20

After three weeks' administration of placebo, three groups of eight patients with moderate hypertension were randomly assigned to single daily dose, double-blind treatment with either pindolol 15 mg, hydrochlorothiazide 50 mg, or a combination of both for eight weeks. All determinations were made 24 hours after ingestion of a dose. Reductions in supine, sitting, and standing systolic and diastolic blood pressure were greater in patients receiving hydrochlorothiazide than in those administered pindolol; however, the greatest reductions were registered in individuals receiving combination therapy. Mean basal plasma renin activity rose significantly from 0.45 +/- 0.44 to 1.42 +/- 1.31 ng/mL/hr and from 0.67 +/- 0.46 to 1.27 +/- 0.83 ng/mL/hr in patients receiving hydrochlorothiazide and combination therapy, respectively, but there was no change in those administered pindolol. Hydrochlorothiazide and combination therapy increased mean total cholesterol levels from 247 +/- 25 to 263 +/- 37 mg/dL and 198 +/- 36 to 211 +/- 33 mg/dL, respectively, at eight weeks, and both increased mean triglyceride concentrations at two weeks. Pindolol did not show any tendency to alter lipid levels. Pindolol should be given twice daily. At 15 mg daily, it has little or no effect on basal plasma renin activity or plasma lipid levels.
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PMID:The influence of pindolol and hydrochlorothiazide on blood pressure, and plasma renin and plasma lipid levels. 351 76

We conducted a multicenter randomized double-blind clinical trial among 626 men with mild to moderate hypertension to determine the effects of captopril, methyldopa, and propranolol on their quality of life. Hydrochlorothiazide was added if needed to control blood pressure. After a 24-week treatment period, all three groups had similar blood-pressure control, although fewer patients taking propranolol required hydrochlorothiazide. Patients taking captopril alone or in combination with a diuretic were least likely to withdraw from treatment because of adverse effects (8 percent vs. 20 percent for methyldopa and 13 percent for propranolol). The treatment groups were similar in scores for sleep dysfunction, visual memory, and social participation. However, patients taking captopril, as compared with patients taking methyldopa, scored significantly higher (P less than 0.05 to less than 0.01) on measures of general well-being, had fewer side effects, and had better scores for work performance, visual-motor functioning, and measures of life satisfaction. Patients taking propranolol also reported better work performance than patients taking methyldopa. Patients taking captopril reported fewer side effects and less sexual dysfunction than those taking propranolol and had greater improvement (P less than 0.05 to less than 0.01) on measures of general well-being. Our findings show that antihypertensive agents have different effects on the quality of life and that these can be meaningfully assessed with available psychosocial measures.
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PMID:The effects of antihypertensive therapy on the quality of life. 352 Mar 18

The safety and efficacy of sustained-release diltiazem, 120 to 180 mg twice daily, was compared with those of hydrochlorothiazide, 25 to 50 mg twice daily, in 207 patients with mild-to-moderate hypertension (supine diastolic blood pressure [BP] 95 to 114 mm Hg) using a baseline, placebo, parallel-design study protocol. All patients received placebo for 2 to 4 weeks, followed by either study drug during the double-blind phase, titrated over 8 weeks to achieve a goal of supine diastolic BP reduction of at least 10 mm Hg and/or a diastolic BP of less than 90 mm Hg. Patients not achieving the treatment goal with either drug alone received the other drug in combination. Both drugs produced significant decreases in supine and upright BP throughout the 26-week study. The magnitude of decrease in mean supine diastolic BP was similar for both drugs as monotherapy at week 14 (-11.4 and -12.1 mm Hg, respectively). Hydrochlorothiazide produced significantly greater reductions at week 14 in mean supine systolic BP than sustained-release diltiazem (-19.5 and -12.7 mm Hg, respectively). The difference in mean supine diastolic BP reduction with the 2 drugs diminished when hydrochlorothiazide (50 mg/day) was compared with sustained-release diltiazem. The BP effects were sustained for 6 months with both drugs. The 2 drugs appeared to lower BP more in patients older than 60 years and more in black than in white patients. The combination of the 2 drugs decreased supine diastolic BP to goal levels in about 56% of the patients not achieving goal with either drug alone. Adverse effects were minimal with either drug alone and in combination, except for hypokalemia, which increased with thiazide alone and in combination.
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PMID:Comparison of hydrochlorothiazide and sustained-release diltiazem for mild-to-moderate systemic hypertension. 354 1

Nitrendipine is a new nifedipine-like calcium antagonist antihypertensive agent. In this study, nitrendipine 5-40 mg orally bid was administered for up to three months to 16 patients with severe essential hypertension (untreated supine diastolic blood pressure greater than or equal to 115 mm Hg). Hydrochlorothiazide or propranolol or both were also given to patients who did not achieve goal blood pressure with nitrendipine alone. Five patients achieved goal blood pressure (supine less than or equal to 90 mm Hg) with nitrendipine alone and six more after the addition of a second drug, and only four required triple-drug therapy. One patient was terminated from the study because of headaches, a common nitrendipine side effect. This study demonstrates that nitrendipine is an effective and well-tolerated agent in the treatment of severe hypertension.
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PMID:Effectiveness of a new calcium antagonist in severe hypertension. 379 49

In a randomised double blind study in patients with mild to moderate hypertension, piretanide 6 mg once and twice daily significantly reduced both supine and erect blood pressure. This was seen after only 2 weeks and a further progressive reduction was evident over the ensuing 12-week trial period. The higher dose produced a mean maximal fall of 29% in supine diastolic pressure, compared with 23% after the lower dose; the difference is not significant. Hydrochlorothiazide 50 mg/amiloride 5 mg twice daily (HCT/A) also reduced supine blood pressure significantly after 2 weeks, but the reduction in erect diastolic blood pressure did not achieve statistical significance until 8 weeks. The maximal effect (a 13% fall in supine diastolic blood pressure) was significantly less than that of either piretanide regimen. Blood pressures in this group also returned more rapidly to pretreatment levels during the placebo washout phase at the end of the study. HCT/A produced a significant sustained rise in serum potassium and a reduction in serum sodium and chloride. Piretanide had minimal effects on serum electrolytes.
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PMID:Single and divided daily dose piretanide in the treatment of uncomplicated essential hypertension: a double-blind comparison with a combination of hydrochlorothiazide and amiloride. 390 25

To evaluate the efficacy of acebutolol, 400-600 mg/day in elderly hypertensive patients, and to compare it with hydrochlorothiazide 25-50 mg/day, 45 patients with mild-moderate uncomplicated hypertension were treated for 6 weeks in a multicentre, single-blind, randomized, crossover trial. Acebutolol decreased supine systolic blood pressure from 186.5 to 162.7 mmHg and diastolic blood pressure from 107.4 to 92.4 mmHg. Hydrochlorothiazide decreased systolic blood pressure from 185.0 to 166.4 and diastolic blood pressure from 107.2 to 96.4. There was no difference between the effects of acebutolol and hydrochlorothiazide on blood pressure during the trial. Both drugs proved to be safe and effective antihypertensive agents, provided the major contraindications for their use were taken into account. Beta-blockade by acebutolol was highly effective in treating mild-moderate arterial hypertension in the elderly.
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PMID:Multicentre comparison of the antihypertensive effect of acebutolol and hydrochlorothiazide in uncomplicated mild-moderate hypertension in the elderly. 390 26


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