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 effects on blood lipids and uric acid of six different antihypertensive drugs used alone, and of five different combinations of two antihypertensive drugs, are reported here. Prazosin significantly lowered serum low density lipoprotein and very low density lipoprotein (LDL + VLDL) cholesterol and total triglycerides while maintaining high density lipoprotein (HDL) levels. Atenolol lowered LDL + VLDL cholesterol slightly. Both pindolol and hydrochlorothiazide (HCTZ) were neutral, while oxprenolol increased total triglycerides. Propranolol lowered HDL cholesterol and increased total triglycerides and uric acid. The combination of prazosin plus pindolol has a direct favorable lipid profile, while the combination of propranolol plus HCTZ lowered HDL cholesterol and increased total triglycerides. The combination of propranolol plus prazosin lowered HDL cholesterol, but to a lesser degree than propranolol alone, which suggests that prazosin was not able to completely counteract the negative effects of propranolol on HDL. Methyldopa plus HCTZ, and HCTZ plus amiloride were neutral with regard to effects on blood lipids. It is suggested that the metabolic effects of antihypertensive drugs could be of special importance in the long-term treatment of mild hypertension.
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PMID:Antihypertensive drugs and blood lipids: the Oslo study. 617 60

The effects of propranolol and prazosin on plasma lipoproteins in patients with essential hypertension were evaluated according to a crossover protocol of two 8-week periods with a washout of 4 to 6 weeks. Eleven patients with moderate hypertension (greater than 90 but less than or equal to 144 mm Hg, diastolic) and slightly overweight (+10% to +/- +30%, according to Metropolitan Life Insurance tables) were selected. No dietary changes were prescribed. Plasma cholesterol, triglycerides (TG), and lipoprotein changes were monitored at the beginning of each sequence and at 2-, 4- and 8-week intervals. Prazosin, when given first, did not essentially modify any of the metabolic parameters, except for a slight elevation in plasma apoprotein AI levels, i.e., the main protein component of high density lipoprotein (HDL); propranolol caused a significant rise in total TG and very low density lipoprotein TG (VLDL-TG) levels (+37.3% and +23.9%, respectively). Somewhat lower total TG (+19.6%) and vLDL (17.8%) TG elevations were noted when propranolol was given first; plasma glucose was also significantly raised (+12.8%). Triglyceride and glucose levels returned to normal upon changing to prazosin. Total plasma- and lipoprotein-associated cholesterol levels were essentially unchanged with either drug; similarly, no significant changes were detected in total plasma apoprotein B (the main protein component of LDL and also VLDL), a component of apoprotein AI levels. Uric acid levels were slightly raised on propranolol. There was an 8.8% reduction in uric acid levels when the medication changed from propranolol to prazosin.
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PMID:Plasma lipid and lipoprotein changes in hypertensive patients treated with propranolol and prazosin. 617 63

Seventeen patients with newly diagnosed hypertension, or with hypertension not optimally controlled by previous treatment, completed an open, noncomparative study on the effects of prazosin on plasma lipids. Patients with diabetes mellitus, raised triglycerides, or alcohol consumption of over 250 g/week, and patients on concomitant treatment with drugs known to affect lipid levels were excluded. Diastolic blood pressure varied between 90 and 115 mm Hg. Prazosin was given initially in a dose of 1 mg three times a day for the first 2 weeks. If the drug was well tolerated but the blood pressure response was not satisfactory, the dose was increased at fortnightly intervals to 2 mg t.i.d., 4 mg t.i.d., and to a maximum of 6 mg t.i.d. Patients were reviewed twice before the start of prazosin treatment, the intervals between visits being not less than 2 weeks, and after 2, 4, 6, 8, and 12 weeks of prazosin treatment. Patients attended in the morning after an overnight fast of 12-16 h. Duplicate measurements of blood pressure and heart rate were recorded after 5 min lying down and after 2 min standing. Blood was taken for measurements of triglycerides, total cholesterol, and high density lipoprotein (HDL) cholesterol, as well as other hematological and biochemical parameters. Prazosin reduced systolic and diastolic blood pressures significantly. There was a slight tendency to increase HDL and reduce total cholesterol, but in neither case were these changes statistically significant. Triglyceride levels did not change significantly either.
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PMID:Open assessment of the effect of prazosin on plasma lipids. 617 64

Prazosin is an orally active post-synaptic selective alpha 1-adrenoreceptor antagonist that has been widely used in treating hypertension and congestive heart failure (CHF). Its role in the treatment of hypertension has previously been reviewed in this journal. Subsequent reports confirm its efficacy in treating mild to severe hypertension as a single agent or, more frequently, in combination with another antihypertensive agent and/or a diuretic. Recent studies of the metabolic effect of prazosin indicate that the drug may have a favourable effect on plasma lipids in hypertensive patients. Its recent use in treatment of congestive heart failure has shown prazosin to be comparable with nitroprusside in producing balanced arterial and venous dilation with generally sustained haemodynamic and clinical effects during long term therapy. Initial studies in Raynaud's phenomenon and in patients with aortic regurgitation or aortic stenosis or with mitral regurgitation are promising, but require confirmation from wider clinical experience. The drug has generally been well tolerated. The primary side effect of orthostatic hypotension can be largely avoided by beginning treatment with a low dose.
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PMID:Prazosin update. A review of its pharmacological properties and therapeutic use in hypertension and congestive heart failure. 630 44

A total of 75 male Wistar rats with one-kidney, one-clip renal hypertension was maintained on either a regular (RNa) or a low-salt (LNa) diet for 3 wk after clipping. Blood pressure in the unanesthetized rats was equally elevated independent of sodium intake. Plasma renin activity was higher in LNa animals, and blood pressure was renin dependent only in this group, as evidenced by the blood pressure response to 10 mg/kg captopril iv. There was no significant difference in plasma catecholamines between RNa and LNa rats, although in the former the sympathetic nervous system is believed to play a major role in sustaining high blood pressure. The acute intravenous administration of 0.5 mg/kg prazosin did not induce a more pronounced blood pressure fall in the RNa rats. Prazosin enhanced plasma norepinephrine levels similarly in both groups, but epinephrine levels only rose in the LNa animals. Prazosin also markedly stimulated plasma renin activity rendering blood pressure renin dependent even in RNa rats. Thus, using alpha 1-adrenoceptor blockade, it has not been possible to demonstrate that the blood pressure elevation of salt-repleted one-kidney, one-clip renal hypertensive rats is due to an enhanced sympathetic nerve activity. Data obtained with sympatholytic agents must be interpreted with great caution if renin activity cannot be kept unchanged.
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PMID:Alpha 1-adrenoceptor blockade in renal hypertensive rats with low and high renin levels. 632 98

The introduction of the western diet and lifestyle to Japan has been associated with changes in body build, lipid levels, and disease pattern. An increased incidence of coronary heart disease parallels increased fat intake. Thiazide diuretics and beta blockers may have adverse effects on blood lipids in man leading to an increase in the risk of coronary heart disease; therefore, for many patients these drugs may not offer the optimum treatment strategy. Hence, prazosin, a drug that effectively lowers blood pressure without adversely affecting lipid metabolism, has been evaluated in nine studies within Japan. Prazosin showed adequate antihypertensive effects even at doses as low as 1 to 3 mg per day. Sustained constant blood pressure reductions were achieved with maintenance doses of 3 to 6 mg per day without significant side effects. Even when given in low doses, prazosin increased high-density lipoprotein cholesterol while inhibiting elevations of total cholesterol and decreasing triglycerides. In view of these findings, prazosin as a single agent can be considered for monotherapy of hypertension.
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PMID:Studies on the effect of prazosin on blood pressure and serum lipids in Japanese hypertensive patients. 636 47

The antihypertensive action of prazosin and propranolol, as well their effect on serum lipid levels, were evaluated in a crossover study in 20 men with untreated mild to moderate hypertension in a general practice environment. Both prazosin (7.5 +/- 0.5 mg/day) and propranolol (270 +/- 26 mg/day) produced a similar reduction in blood pressure over an eight-week period. The administration of propranolol also led to a reduction of the mean fasting high-density lipoprotein cholesterol concentration by 10.5% (P less than 0.01) and this effect was dose-related (r = -0.414; P less than 0.05). Prazosin treatment produced no changes either in the total or in the high-density lipoprotein cholesterol levels, but led to a reduction of the total triglyceride levels by 9.5% (P less than 0.05). These results suggest that the value of blood pressure reduction produced by high doses of beta-adrenoceptor blocking agents, such as propranolol, may be diminished by a potentially adverse effect of these agents on serum lipid levels. Conversely, alpha-adrenoceptor blocking agents may confer an added benefit in the treatment of hypertension.
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PMID:Changes in serum lipid levels during antihypertensive therapy. 636 95

A metabolite of prazosin was detected in serum from hypertensive patients treated with prazosin. Its structure as 2-(1-piperazinyl)-4-amino-6,7-dimethoxyquinazoline was established by UV, IR, and mass-spectrometry. An assay method for simultaneous determination of prazosin and its metabolite in serum, urine and saliva is described. Preliminary data about the kinetics of prazosin and the metabolite after a single oral dose of prazosin 1 mg, and after multiple doses of 1 to 5 mg t.i.d. for 6-82 days in 7 patients with hypertension, are presented. After the single dose the metabolite level was much lower than that of intact drug, even though the former was eliminated much more slowly than the latter. The slow elimination of the metabolite led to its eventual accumulation in serum during multiple administration. The mean accumulation ratio of the metabolite was estimated to be at least 5.5 (from 3.0 to 7.9). Prazosin itself had a low accumulation ratio, so the mean steady-state level of the intact drug on multiple administration was several times lower than that of metabolite. As this metabolite has some hypotensive effect in animals, it may account for part of the therapeutic activity of parzosin in patients. The mean steady-state concentration of intact prazosin during the course of treatment were found to be significantly lower than that predicted from a single dose study.
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PMID:Identification of a prazosin metabolite and some preliminary data on its kinetics in hypertensive patients. 651 Apr 54

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

The disposition and effect of orally administered prazosin have been studied in eight women with hypertension which was uncontrolled by beta-adrenoceptor blockade during the last trimester of pregnancy. Results were compared with healthy men of similar age. The median time to peak concentration was 165 min during pregnancy and 120 min in the men (P less than 0.04). Area under the concentration vs time curve was 3914 ng l-1 min in pregnancy and 2439 ng l-1 min in the men (P less than 0.06). Mean elimination half-life was 171 min in the pregnant women and 130 min in the men (P less than 0.01). Blood pressure was lowered by prazosin in both supine and standing positions. Blood pressure control remained satisfactory in six of the eight women and the median prolongation of pregnancy was 22 days. Neonatal outcome was satisfactory and all babies are developing normally. We conclude that prazosin is more slowly, but apparently more completely, absorbed during pregnancy and that its half-life is slightly prolonged. Prazosin appears to be both effective and safe when used during the last trimester to control blood pressure.
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PMID:Clinical pharmacological studies with prazosin during pregnancy complicated by hypertension. 663 40


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