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

Urapidil is an antagonist of postsynaptic alpha 1 receptors, which leads to a diminution of the increased blood pressure by reducing the peripheral vascular resistance. With this pilot study we examined, whether it is possible to reduce the pregnancy-induced-hypertension with urapidil postpartum. The postpartum dosage of dihydralazine was diminished step by step and finally discontinued. We started i.v. treatment with urapidil at a diastolic blood pressure of more than 100 mm Hg. We observed a declining blood pressure in all cases without any tachycardia or serious side effects. Further studies will have to classify the rank of urapidil in the treatment of hypertension in preeclampsia.
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PMID:[Anti-hypertensive therapy in pregnancy-induced hypertension with urapidil]. 802 22

Urapidil (Ebrantil), a new antihypertensive agent with central and peripheral sites of action, has proven effective in the management of both chronic and acute hypertension. This study investigates its effects on cardiovascular responses during intubation and extubation under general anesthesia. Thirty normotensive patients (ASA I-II) were randomized into control (I, without urapidil, n = 10); lower dose (II, 0.4 mg/kg, n = 10); and higher dose (III, 0.6 mg/kg, n = 10) groups. A significant fall of blood pressure was observed in all patients within 1 min after urapidil administration (P < 0.05), and the magnitude of the decrease was related to blood pressure before treatment. However, no transient drop of blood pressure to hypotensive values was observed. The results suggest that urapidil could be used under general anesthesia in patients to control fluctuating blood pressure during intubation and extubation. The increased heart rate (P < 0.05) seen for several minutes after urapidil administration may have been due to the patients' hypovolemic state.
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PMID:Preliminary report on cardiovascular responses to urapidil during intubation and extubation. 803 72

Pregnancy-induced hypertension (PIH) is a frequent cause of maternal and neonatal morbidity and mortality. In the present study we focused on the pathophysiology of PIH, mainly on the role of mineralocorticoids, reversed blood pressure patterns, and the resulting necessity of continuous monitoring of the preeclamptic mother. Problems of antihypertensive therapy are discussed and the first results of a pilot study with Urapidil are presented. To examine the role of mineralocorticoids in the pathophysiology of PIH, we studied plasma aldosterone and 18-hydroxy-corticosterone (18-OH-B) levels in 25 women with PIH and in 25 healthy pregnant women. Furthermore, we evaluated the mineralocorticoid receptor (MR) count in mononuclear leukocytes in the 2 groups. The MR-count was significantly decreased in the PIH-group. The values of plasma aldosterone and 18-OH-B were also low. These results cannot be explained by receptor down-regulation due to higher level of mineralocorticoids of the zona glomerulosa. Perhaps deoxycorticosterone or a hitherto unknown mineralocorticoid is responsible for the hypertension and altered MR-status. The first results of continuous blood pressure measurements with a noninvasive, real-time blood pressure monitor (Finapres) are presented. The comparison of the obtained values with intraarterial measurements demonstrates a good correlation between the two methods. We also report on the first experiences with Urapidil in the treatment of hypertension in severe preeclampsia. The data show that hypertension in preeclamptic women can be treated by Urapidil without side effects or reflex-tachycardia. Further studies will have to prove if Urapidil is suited for prepartal treatment of PIH as well.
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PMID:Hypertension in pregnancy. 838 33

Urapidil, an antihypertensive agent with dual action (alpha 1-adrenergic antagonist and 5HT1A agonist) is well established in the treatment of arterial hypertension. The present brief review deals specifically with data obtained with urapidil in the treatment of elderly hypertensive patients. Some of these data, dealing with 245 patients aged > or = 65 years, have previously been published, but additional data from more than 5000 hypertensive patients in this age group on file will be reviewed as well. This unique and large data base clearly indicates that urapidil is an effective antihypertensive agent also when used in the treatment of elderly patients. Moreover, urapidil is well tolerated in this age group and has, in addition, a potentially favourable lipid profile. It may therefore be concluded that urapidil is well suited for the treatment of hypertension in the elderly.
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PMID:Review of studies with urapidil in elderly hypertensives. 853 38

Stroke is a partly preventable neurological disease associated with excessive economic cost. Adequate prevention of stroke and sufficient therapy in the acute phase will help to reduce the heavy burden of morbidity and severe economic impact. Hypertension as such, and even more so stroke itself, are known to influence cerebral autoregulation in a negative sense. With respect to the prevention of stroke, antihypertensive therapy should be accompanied by attempts to inhibit of atherogenesis, for instance via improvements of the lipid profile (lowering of LDL, elevation of HDL) or via inhibition of platelet aggregation. In conditions of acute stroke, a pharmacologically induced rise in intracranial pressure should be avoided, whereas cerebral perfusion pressure must be maintained. If possible, ischaemic tolerance should be increased. Also with respect to the secondary prevention of stroke, antihypertensive therapy should be aiming at maintaining cerebral blood flow, whereas the progression of atherosclerotic lesions should be impaired as much as possible. Urapidil may be characterised as a peripheral alpha 1-adrenoceptor blocker with additional sympathoinhibitory effect, triggered by the stimulation of central 5HT1A-receptors. Urapidil, well documented as an effective antihypertensive agent in short- and long-term trials, also showed beneficial influence in the acute phase of stroke. After 3 years of treatment with urapidil (60 mg b.i.d.), the total cardiovascular risk proved reduced by 26%. In addition, urapidil influenced lipid profile, glucose metabolism, and platelet aggregation favourably in hypertensive patients. In animal experiments, urapidil improved the ischaemic tolerance of the brain. Taken together it would seem worthwhile to investigate urapidil as a possibly beneficial agent in the treatment of acute stroke, as well as in secondary prevention of this condition.
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PMID:Potential beneficial effects of urapidil in primary and secondary prevention of stroke. 853 45

Hypertension and tachycardia are frequently encountered in the perioperative setting. Aim of this study was to evaluate the efficacy and safety of Urapidil when used for prevention of perioperative blood pressure elevations. 348 patients, at risk for hypertensive crises, were randomly administered either Urapidil or "no treatment". Blood pressure and heart rate were measured the day before as well as immediately before intervention and were continuously monitored during the intraoperative period. This study has shown a pronounced and well tolerated antihypertensive effect of Urapidil during anaesthesia in these patients. The effect on diastolic values was specific for Urapidil, since systolic pressure was lowered also in the control group as a consequence of anaesthesia. Urapidil treatment resulted to be effective in preventing hypertensive reactions following algogenic stimulation. This becomes particularly evident towards the end of the operative period, when the hypotensive effect attributable to the anesthetic itself progressively decreases.
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PMID:[Prevention of hypertensive crises in the perioperative period. Efficacy and safety of the use of urapidil]. 892 72

This review aims to describe the pharmacological bases for using urapidil, a recently introduced hipotensor, and to survey the literature on its therapeutic possibilities. The anesthesiologist often sees hypertension during surgery and must apply hypotensive treatment to prevent complications. Urapidil works mainly by antagonizing postsynaptic alpha-1-adrenergic receptors and stimulating 5-HT1A receptors, a double mechanism that provides vasodilation with moderate decrease in blood pressure without reflex tachycardia. Adverse side effects are rare and clinically unimportant. Onset is rapid after intravenous administration and duration of action is short; dose can be easily adjusted based on response and patient requirements. While urapidil has been used successfully in a variety of diseases and surgical procedures, its pharmacological characteristics make it particularly useful in patients at high cardiovascular risk or undergoing neurosurgery, in which results are good. Although the oral form is not sold in Spain, it is used in other countries to treat chronic high blood pressure. Urapidil is a hypotensor with a wide range of indications (critical hypertension, prophylaxis for hypertensive peaks and treatment of hypertension during surgery) and few side effects.
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PMID:[Urapidil in anesthesiology: pharmacology and indications]. 964 68

Urapidil effects on oxidant stress were studied in 36 patients with hypertension stage I-III running with crises. Acute hypertensive crisis was managed by intravenous injections of urapidil (20-50 mg) for 5 min. After that for a week they received urapidil monotherapy followed by combined treatment for another week (quinapril--25 mg/day or ramipril--5-10 mg/day in combination with hypothiaside--25 mg/day; lokren--20 mg/day or atenolol--50-100 mg/day and diltiazem--180-360 mg/day) to stabilize arterial pressure finally. Oxidant stress was estimated by lipid peroxidation (LPO) and state of antioxidant system (AOS). Catabolism and anabolism were evaluated by blood levels of hydrocortisone and insulin. LPO, AOS, the blood hormones were measured before management of hypertensive crisis, immediately after it and 1, 3, 7 and 14 days after. Before the crisis treatment LPO was found high. Urapidil administration reduced levels of hydrocortisone, dienic conjugates, lipid peroxidation, oxidant stress rate (OSR). Later, LPO and OSR slowly increased. It is concluded on validity of the antioxidants use in hypertensive patients with crises.
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PMID:[Urapidil effects on oxidative stress in hypertensive crises]. 1097 42

Hypertensive crises are situations when arterial hypertension shows its immediate damaging potential, and in such circumstance, antihypertensive therapy provides its life-saving effectiveness. Among these situations are hypertensive emergencies, hypertensive urgencies, hypertensive encephalopathy, and also accelerated-malignant hypertension characterised by the presence of grade 3 or grade 4 Keith-Wagener retinopathy and numerous complications (acute renal failure, heart failure, haemorrhagic brain stroke or acute coronary events). Despite of antihypertensive therapy, the mortality rate of accelerated-malignant hypertension is about 25% after the 5th year. We present the case of a thirty-three years old male, with a five-year history of non-treated hypertension, who develops accelerated- hypertension with heart failure, microangiopathic haemolytic anaemia and renal failure that requires renal replacement therapy. After a strict control of blood pressure; initially using parenteral agents such as Solinitrin and Urapidil, followed by angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-adrenergic receptor blockers, calcium channel blockers and Hydralazine, the patient partially recovers his renal function, resulting in the withdrawal of haemodialysis.
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PMID:[Accelerated arterial hypertension in a young male]. 1521 76

Despite the availability of a wide range of effective blood pressure (BP)-lowering agents, a substantial proportion of patients with hypertension fail to achieve target BP levels. The majority of patients with hypertension need a combination of two or more drugs to achieve BP targets and choice of second-line or subsequent-line therapy is an important consideration in hypertension management. Alpha-1-adrenoreceptor antagonists (alpha-blockers) have a BP-lowering effect broadly similar to the other antihypertensive drug classes and are effective as add-on therapy in patients with inadequately controlled hypertension. Alpha-blockers may also have therapeutic benefits that go beyond BP control, including improvements in lipid profile and glucose metabolism, as well as reducing the symptoms of benign prostatic hyperplasia. Urapidil has an alpha-blocking effect but, unlike other alpha-blockers, also has a central sympatholytic effect mediated via stimulation of serotonin 5HT(1A) receptors in the central nervous system. Several studies have suggested that oral urapidil is effective and well tolerated when used as second-line therapy in patients with BP inadequately controlled with other agents. Urapidil has also been shown to improve glucose and lipid metabolism in hypertensive patients with concomitant diabetes and/or hyperlipidemia. Intravenous urapidil is effective in the treatment of hypertensive crises, perioperative hypertension, and pre-eclampsia and may have a potential role in the management of acute stroke. In this review, the use of alpha-blockers in hypertension is discussed, with particular focus on urapidil for the lowering of BP in a variety of clinical settings.
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PMID:Urapidil, a dual-acting antihypertensive agent: Current usage considerations. 2065 59


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