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

1. Effects of treatment with piretanide (10 and 30 mg/kg per day p.o.) for 9 weeks on blood pressure, urinary excretion of electrolytes, and vascular reactivities to pressor substances were investigated in 10-week-old spontaneously hypertensive (SHR) rats. 2. Piretanide (30 mg/kg) prevented development of hypertension and produced a significant reduction in blood pressure from the 2nd week of the treatment. A slight decrease in blood pressure was observed in rats treated with the lower dose of piretanide. 3. Piretanide produced significant and dose-dependent diuresis throughout the experiment. Although significant natriuresis was observed in the 1st and 4th week of the treatment, natriuresis disappeared in the 8th week. Urinary excretion of potassium was decreased significantly by piretanide throughout the experiment. 4. Attenuation of pressor responses to phenylephrine and angiotensin II was observed after chronic administration of piretanide (30 mg/kg). 5. These data demonstrate the contribution of attenuated vascular reactivities to pressor substances as well as a diuretic action to the antihypertensive effect of piretanide during its long-term administration in SHR rats.
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PMID:Reduction in blood pressure and vascular reactivities to pressor substances by chronic treatment with piretanide in spontaneously hypertensive rats. 265 50

Piretanide is a potent 'loop' diuretic whose principal site of action is in the thick ascending limb of the loop of Henle. When administered orally or intravenously to healthy volunteers it rapidly increases diuresis and electrolyte excretion, and the effects are short-lived. In comparative studies, piretanide has generally been found to be 5 to 7 times more potent than frusemide (furosemide) but only one-tenth as potent as bumetanide, on a weight-for-weight basis. Piretanide 6 to 12 mg/day, in conventional or sustained release formulations, has been shown to significantly lower elevated blood pressure in a large proportion of patients with mild to moderate hypertension. Comparative trials of up to 3 months duration indicate that at this dosage piretanide is of comparable antihypertensive efficacy as hydrochlorothiazide 50 to 100 mg/day, but has significantly less effect on serum potassium levels. Short term studies in patients with oedema caused by renal, hepatic or cardiac failure demonstrated that piretanide 6 to 9 mg is of similar diuretic potency as frusemide 40 mg and bumetanide 1 mg. In medium term trials in patients with congestive heart failure piretanide 6 mg/day produced equivalent symptomatic improvement as frusemide 40 mg/day. When used to treat oedema caused by liver disease, piretanide 12 to 24 mg/day was successful in only about 50% of patients, but spironolactone added to the treatment regimen greatly increased the response rate. Generally, piretanide has been well-tolerated in clinical trials, although the conventional tablet formulation has caused a relatively high incidence of acute adverse effects--these were greatly reduced with the introduction of the sustained release formulation. Serum concentrations of most electrolytes have not shown any consistent adverse trends and hyperuricaemia and hypokalaemia have been encountered infrequently. Thus, piretanide appears to offer an effective alternative to other 'loop' diuretics for the treatment of oedematous diseases and to hydrochlorothiazide for the management of mild to moderate hypertension. However, its relative place in therapy remains to be clarified with wider clinical experience.
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PMID:Piretanide. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. 389 5

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

Piretanide is a high-ceiling, loop-active diuretic that has been developed for treatment of congestive heart failure, hypertension and edematous states caused by renal and hepatic diseases. Piretanide is structurally related to furosemide and bumetanide; when administered orally, 6 mg of piretanide is as effective as 40 mg of furosemide, and when administered intravenously, 12 mg of piretanide is as effective as 40 mg of furosemide. Piretanide enhances water and sodium excretion in patients with congestive heart failure, with nephrotic syndrome and with cirrhosis and ascites. Adverse effects reported to date are limited to those attributable to excess loss of fluid and electrolytes. Under some conditions, piretanide appears to be less potassium wasting than thiazide diuretics or other loop-active diuretics.
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PMID:Piretanide: a loop-active diuretic. Pharmacology, therapeutic efficacy and adverse effects. 638 44

Piretanide presented in 6 mg sustained-release capsules was administered twice daily for 12 weeks as antihypertensive monotherapy to 16 patients with mild-to-moderate hypertension. No steady or monotonic statistically significant decrease in blood pressure occurred during piretanide treatment, and the drug was therefore not found to be an effective antihypertensive agent. Statistically significant falls in serum potassium values were found at the ends of weeks 4 (P less than 0.01) and 8 (P less than 0.01), but these had no clinical importance. Serum magnesium values had decreased significantly (P less than 0.02) by the end of week 12. Mean blood glucose values did not change significantly, but 4 patient developed diabetic hyperglycaemia.
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PMID:Piretanide in the treatment of hypertension. Effects on arterial blood pressure and several blood variables. 730 76