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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 oral labetalol and propranolol were evaluated in 65 black and 75 white patients with mild to moderate hypertension (standing diastolic blood pressure (StDBP) of 90-115 mmHg) in a double-blind multicenter clinical trial. Following a 4-week placebo phase, labetalol (n = 70) or propranolol (n = 70) was randomly assigned. During a 5-week titration phase, labetalol could be increased from 100 mg BID to 600 mg BID to achieve a StDBP of less than 90 mmHg and a decrement of greater than or equal to 10 mmHg. Propranolol could be titrated from 40 to 240 mg BID. A 3-month maintenance phase was followed by an optional 8-month maintenance phase. Hydrochlorothiazide (HCTZ) could be added at any time during the maintenance phase. Supine and standing blood pressures were measured at each visit. Statistical analysis revealed significant (ANOVA, p less than 0.05) treatment by race effects. Therefore, the treatment groups were stratified retrospectively by race. This study demonstrated that labetalol is equally effective in white and black patients, whereas, propranolol is significantly (p less than 0.05) more effective in white than in black patients. Moreover, labetalol is significantly more effective than propranolol in lowering the standing systolic/diastolic blood pressure of black patients (p less than 0.02/p less than 0.001). These blood-pressure effects were accompanied by a significantly greater (p less than 0.04) reduction in heart rate with propranolol. Furthermore, significantly more (p less than 0.05) black patients treated with propranolol compared to those treated with labetalol required the addition of a diuretic for control of their blood pressure.
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PMID:Monotherapy with labetalol compared with propranolol. Differential effects by race. 391 17

A case of thrombocytopenic purpura caused by hydrochlorothiazide is reported. A 65-year-old man received hydrochlorothiazide 50 mg/d to control his mild hypertension. Approximately one year after initiation of therapy, the patient developed epistaxis and generalized malaise with anorexia. A peripheral blood smear showed a reduction in platelets. The drug was discontinued; two weeks later the patient's symptoms resolved completely and his platelet count returned to normal. The results of several experiments suggest a mechanism of sensitivity, i.e., an antigen-antibody type of reaction. Hydrochlorothiazide therapy should be stopped if thrombocytopenic purpura develops. If recognized early, the symptoms will resolve spontaneously. The use of corticosteroids may aid in shortening the duration of thrombocytopenia.
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PMID:Hydrochlorothiazide-induced thrombocytopenic purpura. 394 58

A comparative study of changes in plasma lipids, apo-A1 and apo-B under the effect of 2-week, 2-month and 6-month treatments with hydrochlorothiazide and pratsiol was conducted in 48 patients with arterial hypertension. Hydrochlorothiazide caused a significant increase in total cholesterol (CH), LDL cholesterol, apo-A1 and apo-B, and a decrease in cholesterol load of HDL particles as compared to placebo effects. Increased levels of HDL cholesterol were only noted in the early days of hydrochlorothiazide treatment. Pratsiol therapy produced a significant reduction of total triglycerides (TG), VLDL cholesterol, the cholesterol atherogenic coefficient, the apo-B/apo-A1 ratio, and increased HDL cholesterol. The activity of post-heparin lipoprotein lipase was not basically affected by hydrochlorothiazide, while pratsiol evoked a significant increase in its activity. The pratsiol-associated TG decrease was more pronounced in patients with elevated TG baseline, and the rise in HDL cholesterol, in those with initial hypo-alphacholesterolemia. Therefore unlike hydrochlorothiazide, pratsiol is associated with a favorable antiatherogenic trend of changes in the lipoprotein spectrum.
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PMID:[Change in the spectrum of lipids and apoproteins A1 and B as affected by hypothiazide and pratsiol in patients with hypertension]. 406 53

1. The responses of the mean arterial pressure to (-)-noradrenaline, tyramine, angiotensin II-val(5)-amide, vasopressin and rat renin have been contrasted in renal hypertensive and in salt plus desoxycorticosterone hypertensive rats. The responses were measured in rats both unanaesthetized and rats anaesthetized with pentobarbitone.2. Responses of unanaesthetized, ganglion blocked renal hypertensive rats to noradrenaline, tyramine and vasopressin markedly exceeded, and to angiotensin II and renin were markedly smaller than, those of unanaesthetized ganglion blocked salt + DOC hypertensive animals. Responses to angiotensin and to renin were apparently enhanced in the latter animals.3. Hydrochlorothiazide and frusemide markedly reduced mean arterial pressure in salt + DOC hypertensive rats before and after ganglionic blockade.4. Neither diuretic caused significant reduction in the mean arterial pressures of unanaesthetized, renal hypertensive rats in the absence of ganglionic blockade: frusemide did so in anaesthetized and unanaesthetized rats after ganglionic blockade.5. Whereas the diuretics did not affect the responses of the renal hypertensive rats to pressor agents, frusemide and to a lesser extent hydrochlorothiazide tended to depress the responses to pressor agents in salt induced hypertension.6. Hydrochlorothiazide did not influence mean arterial pressure in unanaesthetized rats with neurogenic hypertension.
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PMID:Responses of mean arterial pressure to pressor agents and diuretics in renal hypertensive and salt hypertensive rats. 432 21

Adrenal-enucleated, mononephrectomized rats given a high salt diet rapidly develop malignant hypertension, characterized by the presence of necrotizing vascular lesions in a number of organs and tissues. If a normal salt intake is provided, or if hydrochlorothiazide is given together with a high salt diet, there is, instead, the delayed onset of benign hypertension which either stabilizes or increases in intensity extremely slowly; Such animals display few, if any, pathologic vascular changes other than occasional focal glomerular hyalinization, show insignificant cardiac enlargement, and do not exhibit alterations in the serum sodium or potassium. Occasional animals behave atypically and develop malignant hypertension despite normal salt consumption, demonstrating that in susceptible rats excess salt is not essential to this disorder. Hydrochlorothiazide given to rats that imbibed distilled water postoperatively prevented hypertension entirely for 97 days, when one of eight rats developed mild hypertension and some others reached what is regarded as a prehypertensive range. It is concluded that adrenal regeneration provides a physiological milieu favorable to the development of benign hypertension, which is not, as a rule, manifest until regeneration is complete. Salt excess converts the response into one in which malignant hypertension begins during regeneration and worsens rapidly thereafter until death. The course and findings are compared with those of the benign and malignant phases of clinical essential hypertension, and the implications of the similarities are discussed.
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PMID:Benign and malignant hypertension after adrenal enucleation in the rat. Relationship to salt intake, response to hydrochlorothiazide, and similarity to essential hypertension. 602 46

In this study, the relation between renin activity and therapeutic response to hydrochlorothiazide or propranolol was studied. Patients with a diastolic blood pressure of 95 to 114 mm Hg were treated with propranolol (40 to 320 mg twice daily) or hydrochlorothiazide (25 to 100 mg twice daily). The initial renin profiles were: low, 56 percent (n = 300); normal, 33 percent (n = 174); high, 11 percent (n = 60). A greater incidence of low and fewer high renin profiles (p less than 0.001) were observed in blacks. After furosemide administration (40 mg intravenously), 55 percent of patients (n = 291) had a low renin response and 45 percent (n = 240) had a normal renin response. No correlation between renin profile and renin response was observed, although low renin response and low renin profile occurred more frequently in older patients. Hydrochlorothiazide administration resulted in a greater decrement in diastolic blood pressure (p less than 0.05) in the total group. Irrespective of renin activity, both hydrochlorothiazide and propranolol reduced diastolic blood pressure. When renin profile was considered, no significant variation in response to hydrochlorothiazide therapy was observed, and there was a greater reduction in diastolic blood pressure in the patients with a high renin profile receiving propranolol. In comparing therapeutic response, patients with a low renin profile had a better response to hydrochlorothiazide, and propranolol was more effective in patients with a high renin profile. The anticipated effect of therapy on plasma renin activity was observed. Although these results are consistent with a volume-vasoconstrictor analysis of hypertension, the results of therapy could not have been prejudged from renin profile or responsivity. The slight differences observed do not warrant the expense of renin determinations when a simple determination of therapeutic response is sufficient.
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PMID:Comparison of propranolol or hydrochlorothiazide alone for treatment of hypertension. III. Evaluation of the renin-angiotensin system. 634 19

The treatment of hypertension has failed to achieve a reduction of the incidence of coronary heart disease. Recently, attention has been drawn to the effects of antihypertensive drugs on the metabolism of lipoproteins. Of the beta-blockers only pindolol was lipid neutral while propranolol, atenolol and oxprenolol lowered cholesterol and increased serum triglycerides. Hydrochlorothiazide did not influence blood lipids. Prazosin lowered serum LDL + VLDL cholesterol and total triglycerides. The combination of pindolol + prazosin lowered LDL + VLDL cholesterol and increased triglycerides. Propranolol + prazosin lowered HDL cholesterol, methyldopa + hydrochlorothiazide and hydrochlorothiazide + amiloride had no effect on blood lipids.
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PMID:Blood lipids and antihypertensive drugs. The Oslo study. 663 18

We compared hydrochlorothiazide and propranolol hydrochloride for monotherapy of hypertension by a double-blind study of 683 men who were titrated to less than 90 mm Hg diastolic BP or to 640 mg of propranolol or 200 mg of hydrochlorothiazide. Propranolol reduced systolic BP from 146.0 +/- 14.4 (SD) to 134.8 +/- 16.3 mm Hg and diastolic BP from 101.6 +/- 4.6 to 90.5 +/- 7.5 mm Hg. Hydrochlorothiazide lowered both systolic BP more effectively from 146.5 +/- 15.8 to 128.8 +/- 12.2 mm Hg and diastolic BP from 101.3 +/- 4.5 to 89.4 +/- 6.5 mm Hg. In blacks, hydrochlorothiazide lowered systolic BP 20.3 +/- 14.3 mm Hg v 8.2 +/- 12.2 mm Hg for propranolol; hydrochlorothiazide reduced diastolic BP 13.0 +/- 7.0 mm Hg v 9.5 +/- 7.0 for propranolol. In whites, the systolic BP reductions were 15.3 +/- 12.0 mm Hg for hydrochlorothiazide v 13.2 +/- 13.1 mmn Hg for propranolol; diastolic BPs were 10.9 +/- 5.7 mm Hg for hydrochlorothiazide and 12.6 +/- 6.6 mm Hg for propranolol. In blacks treated with hydrochlorothiazide, 71.3% achieved diastolic BP of less than 90 mm Hg, v 53.5% with propranolol. There was no racial difference in dose response to propranolol, but blacks required much less hydrochlorothiazide to achieve control. We conclude that in this short-term study propranolol was as efficacious as hydrochlorothiazide in whites, but the latter was more effective than propranolol in blacks.
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PMID:Comparison of propranolol and hydrochlorothiazide for thr initial treatment of hypertension. I. Results of short-term titration with emphasis on racial differences in response. Veterans Administration Cooperative Study Group on Antihypertensive agents. 675 Jan 66

The antihypertensive effect of once and twice daily hydrochlorothiazide administration was compared in 24 ambulatory patients with essential hypertension. Hydrochlorothiazide 100 mg daily taken as a single morning dose or as a twice daily divided dose was administered to 24 previously diagnosed hypertensive patients in a double-blind cross-over fashion for 12 weeks. No patient received other antihypertensive agents or medications known to influence blood pressure. Sitting and standing blood pressure, weight, pulse, tablet count, and subjective complaints of side effects were obtained at study weeks 3 and 6 on each treatment schedule. There was no significant difference between the mean sitting systolic (133 and 131 mm Hg) or diastolic (85 and 84 mm Hg) blood pressure measurements at study weeks 3 and 6 for each treatment schedule. Comparison of standing mean systolic and diastolic blood pressure and mean arterial pressure produced similar results. Subjective complaints of medication side effects, including orthostasis or urinary frequency, did not differ between treatment schedules. This study suggests that hydrochlorothiazide may be effectively administered once daily for the treatment of hypertension.
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PMID:Antihypertensive effect of hydrochlorothiazide administered once or twice daily. 676 88

1 In a placebo-controlled study, the respective anti-hypertensive effects of hydrochlorothiazide and hydrochlorothiazide plus the beta-adrenoceptor blocker acebutolol were assessed in 18 patients with moderately severe essential hypertension. 2 Hydrochlorothiazide 100 mg daily decreased the mean supine blood pressures from 163/107 mmHg to 150/103 mmHg. Addition of acebutolol in a single-blind fashion in doses up to 800 mg daily reduced mean supine pressure to 137/95 mmHg. Further increases in acebutolol dosage to a maximum of 2000 mg daily in 13 patients whose hypertension was not well controlled on lower doses resulted in a mean supine blood pressure of 132/92 mmHg.
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PMID:Antihypertensive action of acebutolol (Sectral) when used concomitantly with hydrochlorothiazide. 705 18


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