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

The aim of this 16-week trial was to determine the safety and efficacy of a step-care regimen of ramipril, an angiotensin converting enzyme inhibitor, from the minimal active dose (2.5 mg) in patients treated for mild to moderate hypertension. The trial was conducted by 102 general practitioners in 770 patients with mild to moderate hypertension. After a response rate to a 4-week placebo therapy of 9.1%, 57.0% of patients given active treatment with ramipril responded to daily doses of 2.5 mg. Ramipril 5 mg daily was effective in 55.6% of the remaining patients. There was no apparent statistically significant difference between the treatments with ramipril 10 mg or a combination of ramipril 5 mg + Lasix 20 mg daily (44.7% and 47.4% response respectively) in a 6-week double-blind arm of the study. In total, more than 90% of patients responded to treatment with ramipril by the end of the study. The incidence of adverse events was generally low, such as headache, cough, dizziness, asthenia, cramps and nausea. The incidence of cough appeared to be related both to the dosage of ramipril given and to outbreaks of influenza syndrome. Thirty-eight patients discontinued active treatment as a result of minor events such as cough, dizziness or diarrhoea, and one case each of myalgia and papular rash. There were no significant variations in laboratory parameters during the study, especially fasting blood glucose and apolipoprotein A1 and B. The results of this study provide evidence of the safety and efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The French multicentre study of ramipril in ambulatory patients with mild-to-moderate hypertension. 130 60

We studied the levels of cardiovascular risk factors in a population sample of 511 men and 920 women aged 65-74 years and living in East Finland. Altogether 312 men and 515 women had normal glucose tolerance, 84 men and 158 women impaired glucose tolerance (IGT), 33 men and 59 women newly diagnosed non-insulin-dependent diabetes (NIDDM) detected at the survey, and 82 men and 188 women previously diagnosed NIDDM. Subjects with IGT or newly diagnosed NIDDM had higher levels of total triglycerides and apolipoprotein B and lower levels of HDL cholesterol and apolipoprotein A1 than subjects with normal glucose tolerance, similarly as in previously diagnosed NIDDM. Furthermore, subjects with IGT or newly diagnosed NIDDM were more obese, had higher waist-hip ratio, and more frequently hypertension than subjects with normal glucose tolerance. Thus, asymptomatic hyperglycemia in the elderly is not a benign phenomenon, but is associated with similar adverse changes in cardiovascular risk factors as in middle-aged subjects.
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PMID:Asymptomatic hyperglycemia and cardiovascular risk factors in the elderly. 189 82

The levels of total cholesterol, triglyceride, LDL-C, HDL-C, apolipoprotein A1 and apolipoprotein B in the serum were measured in a selected series of 100 CAD patients (77 men and 23 women) who underwent coronary angiography and 141 non-CAD controls. Mean values of those variables differed significantly between the CAD and non-CAD groups matched in age, body weight, hypertension and smoking. There are significant difference in apolipoproteins A1, B and the ratio of apolipoprotein B to A1 between angina and myocardial infarction groups. Using stratified and multivariate stepwise regression analysis, it was shown that the apo A1, apoB/apoA1 are more sensitive and specific than the ordinary indices (e.g. total cholesterol, triglycerides, LDL-C and HDL-C) in estimating the degree of coronary artery stenosis and the differentiation of CAD from other diseases.
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PMID:[Serum apolipoprotein AI, B levels in patients with coronary diseases]. 212 69

Lowering blood pressure is not totally effective in preventing the atherosclerotic complications of systemic hypertension. In hypertensive patients both platelet hyperaggregation and dyslipidemia have been suggested as important risk factors. The effect of 8 weeks' treatment with ketanserin on blood pressure, serum lipid parameters (cholesterol, triglycerides, LDL, HDL-C, apolipoprotein A1 and B) and platelet aggregation, induced by collagen, ADP, arachidonic acid, was evaluated in 10 patients with essential hypertension. Ketanserin was effective in lowering blood pressure in all patients, 6 of whom became normotensive. Both CHOL and TG levels and APO B were significantly reduced, whereas HDL-C and APO A1 were significantly increased after treatment. These results might be attributed to the antagonistic activity of ketanserin on alpha-1 adrenoceptors with a consequent inhibition of phosphodiesterase. Platelet aggregation, after stimulation with collagen and arachidonic acid, was significantly reduced secondary to the inhibition of intraplatelet serotonin synthesis and release. These results suggest that keranserin is effective in reducing blood pressure and in achieving normal serum lipid pattern and platelet aggregation. Therefore, this drug might be helpful in controlling the main risk factors for cardiovascular damage.
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PMID:Effects of ketanserin administration on lipid metabolism and platelet aggregation in hypertensive patients. 227 4

The authors administered to ten patients with mild to medium severe hypertension and with a normal glucose tolerance and serum lipid spectrum bopindolol in amounts of 0.5 to 2 mg/day in the course of 12 months. They revealed: a) bopindolol reduced effectively the blood pressure with a maximum decline already during the first month, b) It reduced significantly the heart rate, c) it did not cause deterioration of the glucose tolerance and did not interfere with the response of immunoreactive insulin (IRI) after a glucose load, d) it did not influence significantly the levels of lipoprotein cholesterol, total cholesterol, VLDL cholesterol, HDL cholesterol; within the reference range a slight increase of LDL cholesterol was recorded during the 12th month; e) it did not influence the concentration of triglycerides, apolipoprotein A1 and apolipoprotein B.
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PMID:[Bopindolol does not affect normal glucose and lipid metabolism in hypertensive patients]. 257 94

This study evaluated the effect of prazosin in controlled mild hypertension and evaluated select metabolic changes that occurred with prazosin monotherapy. Various aspects of glucose, insulin, and lipid metabolism were studied before and after approximately 10 weeks of prazosin treatment in 12 patients with mild hypertension. Prazosin was well tolerated and induced a significant decrease (p less than 0.001) in both systolic and diastolic blood pressures, without any change in body weight. Plasma concentrations of glucose, free fatty acid, and lactate, which were measured hourly from 8 A.M. to 4 P.M. following meals consumed at 8 A.M. and noon, did not change with prazosin treatment. However, the plasma insulin response from 8 A.M. to 4 P.M. decreased significantly (p less than 0.001) following prazosin treatment. In addition, fasting plasma triglyceride and cholesterol concentrations were significantly lower (p less than 0.05) in prazosin-treated persons, as were postprandial triglyceride concentrations (p less than 0.001). Lower total plasma triglyceride and cholesterol concentrations were accounted for by decreases in very low-density lipoprotein cholesterol and triglyceride and low-density lipoprotein cholesterol and triglyceride, whereas both high-density lipoprotein triglyceride and high-density lipoprotein cholesterol concentrations increased following prazosin treatment. Finally, although both apolipoprotein A1 and apolipoprotein B concentrations decreased in association with prazosin treatment, the decrease in apolipoprotein B was much greater in magnitude, leading to an increase in the ratio of apolipoprotein A1 to apolipoprotein B. In this study, treatment of mild hypertension with prazosin led to lower blood pressures and changes in insulin and lipoprotein metabolism that are important in this patient population.
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PMID:Effect of prazosin treatment on carbohydrate and lipoprotein metabolism in patients with hypertension. 264 61

High-density lipoprotein (HDL) cholesterol, an independent coronary heart disease (CHD) risk factor, is inversely associated with CHD. Whether interventions to increase concentrations of HDL--particularly the HDL2, HDL3, and apolipoprotein A1 subfractions--will reduce the incidence of CHD in high-risk patients is thus an area of intense speculation. Both nonpharmacologic and pharmacologic regimens will raise HDL concentrations. Nonpharmacologic approaches include habitual high-level aerobic exercise and weight loss--both of these somewhat more effective in men than in women--cessation of cigarette smoking, and changing of dietary habits. A number of drugs have been found to elevate HDL cholesterol. These include the bile acid-binding resin cholestyramine, nicotinic acid, gemfibrozil, phenytoin, exogenous estrogens, and alcohol. Terbutaline has also been reported to raise HDL cholesterol. It is not yet known whether, and to what degree, pharmacologic and nonpharmacologic elevation of HDL cholesterol will retard or reverse the progression of atherosclerosis. Conversely, HDL cholesterol is lowered by a broad variety of drugs, including anabolic--androgenic steroids, exogenous progestins, and probucol, which are used therapeutically to reduce low-density lipoprotein (LDL) cholesterol. Some agents used to treat hypertension also reduce HDL cholesterol, especially thiazide diuretics and the beta blockers, with the possible exception of pindolol. In the antiadrenergic class of antihypertensive agents, reserpine and methyldopa lower HDL cholesterol, but the alpha blocker prazosin does not appear to affect HDL cholesterol. The alpha agonist guanabenz has no effect on HDL cholesterol, and the vasodilator carprazidil has been reported to raise HDL cholesterol. In light of these facts, investigations should be undertaken to determine whether the metabolic effects of antihypertensive agents blunt their beneficial effects on CHD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nonpharmacologic and pharmacologic alteration of high-density lipoprotein cholesterol: therapeutic approaches to prevention of atherosclerosis. 286 87

Ketanserin is a serotonin S2 receptor antagonist with antihypertensive activity. Its effects on blood pressure, glucose metabolism and serum lipids were assessed in 24 patients with diabetes mellitus and mild arterial hypertension in a double blind, placebo-controlled trial. Ketanserin in doses up to 80 mg daily caused a slight decrease of supine BP (from 159/97 +/- 19/11 to 153/90 +/- 20/9 mm Hg; NS/P less than 0.01) and upright BP (from 160/102 +/- 18/13 to 151/93 +/- 12/12 mm Hg; P less than 0.05/NS). However, these pressures did not differ significantly from the levels observed in the placebo group. Supine and upright heart rate, body weight, plasma sodium and potassium, serum creatinine, glucose, C-peptide, glycosylated haemoglobin, serum cholesterol and triglycerides, their lipoprotein fractions, apolipoprotein A1, A2 and B concentrations and the responses of serum glucose and insulin to a standard oral glucose loading test did not change. These findings indicate that the selective S2 receptor antagonist ketanserin did not unfavourably influence glucose and lipid metabolism in diabetic patients with arterial hypertension.
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PMID:Antihypertensive and metabolic effects of ketanserin in diabetic patients with mild hypertension. 307 19

To compare the effects of prazosin and atenolol on plasma lipid concentrations, 60 patients with arterial hypertension (diastolic 90 to 120 mm Hg, systolic 160 to 200 mm Hg) were allocated at random to one of two treatment groups. The lipid profile included the determination of total cholesterol and triglyceride levels by ultracentrifugation, and assays of apoproteins A1 and B by laser immunonephelometry. Determinations were performed 30 days before and on the first, 90th, and 180th days of treatment. Both drugs had similar reducing effects on blood pressure. A significant decrease in total cholesterol, low-density lipoprotein cholesterol, and apoprotein B, and an increase in high-density lipoprotein cholesterol and apolipoprotein A1 were observed in patients receiving prazosin, whereas patients receiving atenolol exhibited opposite changes in plasma lipids. Although the clinical significance of these findings is uncertain, such metabolic effects should be taken into account when evaluating the risk/benefit ratio of antihypertensive treatments.
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PMID:Effects of two antihypertensive agents on lipids, lipoproteins, and apoproteins A and B. Comparison of prazosin and atenolol. 351 89

In order to investigate comparatively the effects of prazosin and atenolol on plasma lipid concentrations, 60 patients from two centres, presenting with arterial hypertension (diastolic 90-120 mmHg, systolic 160-200 mmHg), were allocated at random to one or the other of these drugs. The lipid profile, stable during the period of observation, included total cholesterol and triglycerides, study by ultracentrifugation, and assays of apoproteins A1 and B by laser immunonephelometry. Determinations were performed 30 days before, and on the 1st, 90 th and 180 th days of treatment. Both drugs had similar lowering effects on blood pressure. A significant decrease in total cholesterol, LDL cholesterol and apoprotein B and an increase in HDL cholesterol and apolipoprotein A1 were observed in patients under prazosin, whereas patients under atenolol exhibited opposite variations in plasma lipids. Although the clinical significance of these findings is uncertain, such metabolic effects should be taken into account when evaluating the risk/benefit ratio of antihypertensive treatments.
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PMID:[Comparative study of the effects of prazosin and atenolol on plasma lipids of hypertensive patients]. 389 49


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