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)

Prazosin has been used as an antihypertensive drug in the treatment of 93 patients in Dunedin since 1971-1972, mainly those whose previous control was unsatisfactory. It has led to very significant improvement of control in many cases; 48 patients now receiving the drug have taken it for an average of 30 months. Forty-five patients have stopped taking the drug for various reasons, such as failure to respond (11-8%), side effects (20-4%), myocardial infarction (8-6%) or unrelated reasons (7-5%). This reflects to some extent the use ofa new drug in patients who are difficult to control, and its use initially without concomitant diuretic and beta-blocker therapy. We believe that the place of praxosin is primarily as a third drug for patients whose hypertension does not respond satisfactorirly to a diuretic and a beta-blocker. The first dose must be kept small, preferably 0-25 mg, and even with this dose a small proportion of patients receiving diuretic and beta-blocker therapy seem to become hypotensive; patients should be warned about this. The plasma half-life in normal volunteers was 3-8 hours but in some patients it seems to be considerably longer.
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PMID:Use of prazosin at the dunedin hypertension clinic controlled and open studies and pharmacokinetic observations. 2 40

This paper reports the findings of an open evaluation of 100 patients treated with prazosin. When prazosin was added to existing hypotensive regimens in 50 patients whose blood pressure was poorly controlled, 36 (72 percent) became normotensive. Treatment was initiated with prazosin in a further 50 patients. Satisfactory control was achieved with prazosin alone in 24 and 20 of these became normotensive. The remaining 26 patients received in addition a beta-adrenoreceptor blocking agent together with a thiazide diuretic in 14. While prazosin alone caused a mean fall of 26/14mmHg in this group, the enchanced efficacy of combined therapy achieved a normal blood pressure in 19 (73 percent) and a total mean fall in pressure of 42/28mmHg. The most frequent side effect was dizziness or faintness at the start of therapy or, less often, when the dose was increased. This is minimised by using a low initial dose of 0.5mg two or three times daily. Prazosin is an effective hypotensive agent, used alone or in combination, in most patients with hypertension of all degrees of severity.
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PMID:Prazosin in hypertension. Part I. Clinical experience in 100 patients. 2 93

Twenty-two chronic hemodialysis patients with hypertension were treated with prazosin. Eight patients had volume-responsive hypertension, 11 volume-indpendent, and 3 high-renin hypertension. Blood pressure fell in all volume-responsive patients from a predialysis level of 175 +/- 5/100 +/- 3 to 148 +/- 4/75 +/- 3 mm Hg (p less than 0.001) after 3 months of therapy. Prazosin alone was effective in volume responsive patients at a dose of 5 +/- 1.0 mg daily. The blood pressure fell in volume-indpendent patients from 192 +/- 7/105 +/- 2 mm Hg predialysis to 155 +/- 6/80 +/- 3 after 3 months (p less than 0.001). Two were controlled on prazosin alone at a dose of 12 +/- 2 mg daily. Nine required 27 +/- 5 mg of prazosin daily as well as additional antihypertensive treatment. The blood pressure fell from 183 +/- 3/109 +/- 6 mm Hg predialysis to 173 +/- 17/85 +/- 3 mm Hg in high-renin patients after 3 months. One patient was controlled on 40 mg of prazosin daily. Two required 40 mg of prazosin daily as well as additional antihypertensive medication. Eleven patients described transient dizziness within the first month of therapy. One patient had recurrent syncope necessitating prazosin withdrawal; Prazosin is an effective antihypertensive agent which can be used in all types of hypertensive dialysis patients either alone or in combination with minimal side effects.
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PMID:Effects of prazosin in the control of blood pressure in hypertensive dialysis patients. 9 39

Experience in a hypertension clinic attended by 591 patients over a 13-year period has shown marked changes in the pattern of use of hypotensive agents. Thiazides have been used throughout the period in almost all cases. Methyldopa was used for most patients for almost a decade. Since 1967 there has been a steady increase in the use of beta adrenergic blocking agents, and these are now used for over 60% of patients attending the clinic. Combination beta adrenergic blocking agents with peripheral vasilodators such as hydrallazine and prazosin have provided a very effective means of controlling the blood pressure in moderate and severe hypertension. Prazosin, a new peripheral vasodilator, has been used in the treatment of 295 patients. In most cases it has been used in combination with a thiazide diuretic and beta adrenergic blocking agent. Open studies have demonstrated that this is an effective hypot .ensive agent. Side effects are few and are counteracted by combination with a beta adrenergic blocking agent. Prazosin and hydrallazine are being compared in double-blind studies.
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PMID:Changing concepts in the management of hypertension. 24 Jan 12

Prazosin (Minipress; Pfizer), a new antihypertensive agent, was investigated in 24 outpatients with uncontrolled hypertension. In 12 patients a single-blind placebo-controlled trial was conducted and in 12 patients an open trial with treatment for a minimum of 16 weeks. Three patients developed postural hypotension and were withdrawn from the trial. Fifteen patients responded to treatment with prazosin and normotensive levels were reached in 9. Ten patients had renal impairment at the start of the study; renal function remained static in 9 and serum urea and creatinine values increased in 1. Prazosin maintains renal function well in severely hypertensive patients and has a relatively low incidence of side-effects, related mainly to postural hypotension which develops unpredictably in some patients. In addition to its extensively documented beneficial effect in mild and moderate forms of hypertension, prazosin is of use in the therapy of patients with severe and uncontrolled hypertension.
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PMID:Prazosin in the therapy of uncontrolled hypertension. 33 73

Among the newer antihypertensive agents are the beta-blocking drugs, such as propranolol. These agents are useful as second-step drugs to be used if diuretic therapy alone is not effective. In mild to moderately severe hypertension, propranolol, in does of up to 480 mg/day in combination with a thiazide diuretic, has been found to be effective in over 80% of patients on long-term therapy. This degree of response is essentially similar to that noted with a combination of reserpine and a diuretic agent. Although some observers believe that propranolol produces many fewer side effects than the other step 2 drugs (reserpine and alpha-methyldopa), there are some patients who do experience restlessness, insomnia, and depression. Clonidine may be substituted for another step 2 drug, is of moderate potency, but may not be tolerated by a large number of patients because of the severe dry mouth and drowsiness that it produces. Prazosin appears to be a suitable substitute for hydralazine as an effective vasodialator if thiazides plus propranolol or thiazides plus reserpine or alpha-methyldopa are not effective. In some instances, it many be an acceptable second-step drug because of its alpha-adrenoreceptor-blocking properties. The angiotensin II competitive inhibitors or converting enzyme inhibitors may in the future have some place in the management of hypertension.
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PMID:Propranolol and newer antihypertensive drugs in the management of hypertension. 42 60

Prazosin was used in combination with other antihypertensive drugs in the successful management of hypertension in seven patients with chronic renal failure and six renal transplant recipients, also with chronic renal failure. The addition of small doses of prazosin (mean 3 mg/day) to the antihypertensive regimen produced significant falls in systolic and diastolic blood pressures in both the lying and standing positions. The standing blood pressures were significantly lower than the lying blood pressures during prazosin treatment. Neither the mean blood urea concentrations nor the mean plasma creatinine concentrations changed significantly during prazosin administration. Chromium-51 edetic acid clearances did not change significantly during prazosin treatment in the seven patients in whom it was measured. Severe symptomatic postural hypotension occurred in one patient a week after starting prazosin 3 mg/day. This hypotensive episode was associated with a transient and reversible deterioration in renal function. Another patient developed a rash while on prazosin but it was probably related to propranolol rather than prazosin. Prazosin is thus an effective antihypertensive drug in patients with chronic renal failure, and it may be used with a variety of other drugs. It should be used cautiously, however, since patients with chronic renal failure may respond to small doses, and significant postural falls in blood pressure may result. There was no evidence that the use of prazosin resulted in progressive deterioration in the residual renal function of the patients with chronic renal failure.
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PMID:Use of prazosin in management of hypertension in patients with chronic renal failure and in renal transplant recipients. 81 12

We conducted an uncontrolled study of the efficacy of prazosin in the treatment of hypertension in 45 patients. In 25 patients only prazosin was used and in 20 patients prazosin was combined with a thiazide diuretic. Control of blood pressure was obtained in 22 of the 25 patients (88%) on prazosin alone, and in all the patients on the combined treatment. Adverse effects occurred in 15 of 25 patients (60%) on prazosin alone, and in 13 of the 20 patients (65%) on combined treatment. However, in 18 patients (40%) adverse effects disappeared or were tolerated with continued therapy. In 10 patients (22%) therapy was stopped because of the adverse effects. The median dose of prazosin was 5,73 mg twice a day. Prazosin is a useful alternative to hydralazine in the treatment of hypertension.
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PMID:Prazosin alone and combined with a thiazide diuretic in the treatment of hypertension. 86 Jan 71

Prazosin was used as an additional antihypertensive agent for treating 38 patients with hypertension and renal functional impairment. The drug was effective in 29 of these patients at a mean daily dose of 7 mg. The mean blood pressure fall in these 29 patients was 28/22 mm Hg. The most frequent (10 patients) and important side effect of prazosin treatment was dizziness, which occurred on standing of after exertion and was seen either after the first dose or after a large dose increase. The "first-dose phenomenon" was a result of severe postural hypotension and was eliminated by using a starting dose of 0-5 mg every 12 hours, with the first dose being given before retiring to bed. Dosage increments were limited to 0-5 mg, beginning late in the evening. Eleven patients had a significant improvement in renal function, while a further eight patients had stable renal function. In no patient was there a deterioration in renal function which could be attributed to prazosin.
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PMID:Prazosin in the treatment of patients with hypertension and renal functional impairment. 91 33

1. The effects of intravenous (i.v.) administration of the vasodilator drugs prazosin or diazoxide on blood pressure and plasma renin activity were evaluated in the anaesthetized dog. 2. Prazosin and diazoxide both induced a rapid reduction in the mean arterial pressure to 73% and 75% of control values respectively. 3. Prazosin lowered plasma renin activity to 62% (P less than 0-025) of the control value whereas diazoxide raised plasma renin activity to 178% (P less than 0.05) of the control value. 4. The combination of vasodilatation and low renin activity observed following the administration of prazosin is unique, and may have clinical significance if these factors reduce the vascular complications of hypertension.
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PMID:Differing effects of the vasodilator drugs, prazosin and diazoxide on plasma renin activity in the dog. 97 13


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