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

Hypertension associated with ciclosporin A may be mediated by sodium and volume retention. Therefore, the effects of an antihypertensive therapy (6 weeks) with nitrendipine (10-20 mg twice daily) or lisinopril (10-20 mg once daily) on office blood pressure, 24-hour ambulatory blood pressure, and left ventricular function were evaluated in a randomised, double-blind cross-over trial in patients after heart transplantation. Nitrendipine and lisinopril were equally effective in lowering office and ambulatory systolic and diastolic blood pressures. After an acute sodium load (210 mval/2 h i.v.), sodium excretion was significantly increased during therapy with lisinopril but only slightly during nitrendipine, indicating that angiotensin-converting enzyme inhibition may improve the sodium-retaining state of heart transplant recipients associated with ciclosporin A.
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PMID:Effects of nitrendipine and lisinopril on blood pressure and sodium excretion in ciclosporin-associated hypertension after heart transplantation. 828 28

We have recently shown that treatment with the calcium channel blocker nitrendipine may aggravate albuminuria and glomerular injury in rats with two-kidney, one clip renovascular hypertension if arterial blood pressure is not reduced. To test whether nitrendipine also exerts its adverse renal effects when normotension is achieved, we examined the effect of combined therapy with nitrendipine and the converting enzyme inhibitor enalapril on blood pressure, albuminuria, glomerular filtration rate, and morphology of the nonclipped kidney. Rats treated with enalapril alone or in combination with the diuretic hydrochlorothiazide or rats treated with nitrendipine alone served as controls. Therapy was started 6 weeks after clipping of one renal artery. Nitrendipine alone did not reduce blood pressure but significantly increased albuminuria, diuresis, glomerular filtration rate, and glomerular volume and injury compared with untreated hypertensive controls. Increase of glomerular filtration rate, diuresis, and albuminuria was reversible after withdrawal of nitrendipine. Treatment with enalapril alone decreased blood pressure significantly but not to normotensive levels and was without significant effect on albuminuria and glomerular morphology. The combination of nitrendipine and enalapril reduced blood pressure to normotensive levels and not only prevented the increase of glomerular volume, glomerular filtration rate, diuresis, and albuminuria caused by nitrendipine alone but furthermore improved glomerular injury and albuminuria to levels not significantly different from normotensive controls. Enalapril in combination with the diuretic had similar beneficial effects on blood pressure, albuminuria, and glomerular injury. These data demonstrate that the adverse effects of nitrendipine monotherapy on glomerular structure and function can be prevented by the combination of nitrendipine and enalapril when blood pressure is normalized.
Hypertension 1994 Jan
PMID:Combination treatment of enalapril with nitrendipine in rats with renovascular hypertension. 828 22

Calcium antagonists exert several characteristic effects on the kidney that potentiate their antihypertensive effect. The objective of the present study was to investigate the effectiveness of nitrendipine in the presence of different degrees of renal impairment. Two groups of hypertensive patients were included in the study. Group 1:10 patients with arterial hypertension secondary to chronic renal parenchymatous disease and adequately controlled with a diuretic and/or a beta-blocker who were switched to nitrendipine. These patients were then followed monthly for 1 year. Group 2:24 patients diagnosed as having essential hypertension who presented values of urinary albumin excretion above 30 mg/day after a minimum of 3 years of adequate blood pressure control with a diuretic and/or a beta-blocker. Patients were randomly assigned to continue with the same therapy or to switch to nitrendipine for 1 year. In both groups nitrendipine was as efficacious as standard therapy for controlling blood pressure and did not induce changes in renal hemodynamics. Nitrendipine did not modify the level of proteinuria in group 1, nor the urinary excretion of albumin in group 2. These results seem to indicate that nitrendipine can be safely used in patients with arterial hypertension and different degrees of renal function impairment.
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PMID:Antihypertensive effect of nitrendipine in the hypertensive patient with renal impairment. 851 91

A model to investigate the functional capacity (psychomental performance) under stressful conditions was developed. Twenty eight patients with mild hypertension receiving Nitrendipine (20 mg) for 30 days were tested under hypoxic (16% oxygen) and/or orthostatic (-30 mmHg lower body negative pressure) conditions using a subset of the AGARD battery. The main effect was a decreasing performance of the grammatical reasoning task (GRT) under hypoxia or the combination of hypoxia and orthostasis. A simultaneous application of stressors while performing psychometric test batteries may be useful to reveal pharmaceutical influences on human performance and may help to recommend the use of drugs in occupational medicine.
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PMID:Effects of an antihypertensive medication on functional capacity under simulated flight-typical stress-conditions. 1047 4

(1) In trials involving hypertensive non diabetic patients under 65, some diuretics and betablockers have prevented strokes, without conferring protection from coronary events or death. In one trial captopril had an effect comparable to that of diuretics or betablockers in terms of overall cardiovascular prevention, but was a little less effective in preventing strokes. (2) In trials involving hypertensive subjects over 65, some diuretics and betablockers have reduced the risk of stroke, coronary events, heart failure, and death. In one trial a diuretic was superior to a betablocker in terms of preventive efficacy and adverse effects. Nitrendipine, in combination with other antihypertensive drugs, prevented strokes in one trial. (3) In a trial involving hypertensive diabetic patients, captopril and atenolol reduced the risk of stroke, heart failure and worsening of retinal disease, without preventing coronary events or death. In two trials coronary events were more frequent on dihydropyridine than on an angiotensin-coverting-enzyme (ACE) inhibitor. (4) In one trial a diuretic reduced the risk of relapse after stroke, even in patients without severe hypertension.
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PMID:Antihypertensive drugs: diuretics and betablockers are the best assessed. 2118 12

The present study investigated the development of hypertension and the functional and morphological changes in the kidney in Dahl salt-sensitive (Dahl S) rats fed with a normal salt diet during aging. Furthermore, the effects of calcium channel antagonists nitrendipine and nicardipine on these changes were examined. The rats showed proteinuria from 6 weeks of age and gradually developed hypertension accompanied by the decrease in the glomerular filtration rate during aging. Glomerular screlosis and degeneration of the renal tubule were found by histological examinations at 17 weeks of age. Nitrendipine (20 mg/kg chow), given from 7 weeks of age for 10 weeks, inhibited the elevation in systolic blood pressure from 3 weeks after the dosing, whereas nicardipine (20 mg/kg chow) inhibited it only at 5 weeks after dosing. Both drugs decreased glomerular sclerosis, but did not affect the glomerular filtration rate, urine volume, urinary excretion of protein and N-acetyl-beta-D-glucosaminidase and serum concentrations of creatinine and urea nitrogen. These results demonstrated that Dahl S rats fed with a normal salt diet spontaneously developed the renal disorder in the early stage of hypertension and reinforce the validity of nitrendipine for the treatment of hypertensive patients with renal failure.
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PMID:[Effects of nitrendipine on the development of hypertension and renal failure in Dahl salt-sensitive rats]. 1067 98

There are many reports on the efficacy of Ca-antagonists for treatment of elderly essential hypertension. In particular, many studies have noted the beneficial effects of antihypertensive therapy on the quality of life (QOL). Nevertheless, there are no reports on antihypertensive therapy regarding the relationship between brain blood flow (BBF) and QOL. Therefore, we examined the efficacy of nitrendipine, a Ca-antagonist, on the brain blood flow and QOL, and its side effects in elderly essential hypertensive patients. The subjects were 17 (males: 4, females: 13) patients with untreated hypertension of WHO stage I or II, aged 70 years or older. The mean dose of nitrendipine was 9.4 +/- 0.4 mg daily. Before and 6 months after treatment, we examined blood pressure (BP), heart rate (HR), echocardiography (left ventricular mass index [LVMI], % fractional shortening [% FS]), plasma noradrenaline (Nad), plasma renin activity (PRA), BBF using the IMP-ARG method with BBF scintigraphy, and QOL was examined with a questionnaire. Two patients were excluded from this study because 1 had no decrease in BP, and another was moved to a different hospital. BP significantly decreased from 178/93 to 137/77 mmHg, but HR was not changed after treatment. BBF significantly increased from 37.0 +/- 4.9 to 41.0 +/- 4.9 ml/dl/min, but % FS, Nad, and PRA did not significantly change. The degree of QOL was improved by 4.2 +/- 1.2 points and there was a significant positive correlation between the changes of BBF and of QOL (r = 0.66, p = 0.04). However, moderate pharmacotherapy for BP seems to be necessary because there were 2 patients whose BBF decreased accompanied by excessive drop in BP after treatment. In conclusion, it is possible to safely use nitrendipine for elderly essential hypertensive patients. Nitrendipine has beneficial effects on BBF, and it was suggested that the increase of BBF is one of the most important factors in improvement of QOL.
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PMID:[Usefulness of nitrendipine and its effects on quality of life and brain blood flow in elderly hypertensive patients]. 1091 29

Diabetes mellitus without previous myocardial infarction carries the same risk of a future myocardial infarction as someone who has had one. Intense glucose, lipid, and blood pressure control in diabetic patients is advocated to reduce cardiovascular events and decrease the incidence of end-stage renal disease, retinal damage, and peripheral vascular disease. Recent studies, including the Systolic Hypertension in the Elderly Program, indicate that low-dose diuretics, compared with placebo, reduce fatal and nonfatal myocardial infarctions but not fatal and nonfatal strokes in diabetic patients. Similarly, captopril (and diuretics) compared with diuretics and beta-blockers decreased fatal and nonfatal myocardial infarctions but not fatal and nonfatal strokes in the Captopril Prevention Project. Intense blood pressure therapy with captopril and intense blood pressure therapy with atenolol equally lowered macrovascular and microvascular events compared with less intense blood pressure treatment in the United Kingdom Prospective Diabetes Study. Fewer myocardial infarctions were seen with enalapril than with nisoldipine in the Appropriate Blood Pressure Control in Diabetes trial. Intense blood pressure control with felodipine, enalapril, and hydrochlorothiazide reduced overall cardiovascular events and mortality but not myocardial infarction and strokes in the Hypertension Optimal Treatment trial. Nitrendipine alone or together with enalapril and hydrochlorothiazide decreased fatal and nonfatal strokes and cardiovascular mortality but not myocardial infarctions in the Systolic Hypertension in Europe trial. These trials, in aggregate, reinforce the importance of intense blood pressure control, which can be achieved only with combination drug therapy rather than a specific monotherapy drug class recommendation.
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PMID:Controversies surrounding the treatment of the hypertensive patient with diabetes. 1098 Nov 15

We investigated whether an angiotensin-converting enzyme (ACE) inhibitor increases the production of nitric oxide (NO) in exhaled air in normotensive and hypertensive subjects. In study 1, 8 normotensive male subjects received a single oral dose of enalapril (5 mg) or nitrendipine (10 mg) in a crossover manner. Exhaled air was collected at baseline, and at 2, 4, and 8 hours after administration of the drug. In study 2, 10 normotensive subjects (6 men and 4 women) and 10 hypertensive subjects (6 men and 4 women) received a single oral dose of enalapril (5 mg). Exhaled air was collected at baseline and at 2 and 4 hours after administration of the drug. In study 1, enalapril significantly increased the NO release rate from the lung in normotensive subjects (36.9+/-5.1 pmol/s at baseline versus 58.3+/-7.3 pmol/s at 4 hours, P<0.01). Nitrendipine did not change the NO release rate. In study 2, enalapril significantly increased the release of NO from the lung in normotensive subjects (40.4+/-6.0 pmol/s at baseline versus 70. 3+/-11.4 pmol/s at 4 hours, P<0.01) but not in hypertensive subjects. ACE inhibition increased NO production from the lung in normotensive subjects but not in hypertensive patients. The reduction of angiotensin II production and/or the accumulation of bradykinin in the pulmonary tissue may be responsible for increased NO production in components of the lung, such as the pulmonary vascular endothelium, bronchial epithelial cells, macrophages, nasopharyngeal cells, and neurons. However, the effects of ACE inhibition on NO production from the lung differ between hypertensive subjects and normotensive subjects.
Hypertension 2000 Dec
PMID:Effect of enalapril on exhaled nitric oxide in normotensive and hypertensive subjects. 1111 3

One hundred and sixteen patients with isolated systemic hypertension were treated with Nitrendipine for five years. The result showed that it was effective, persistent and stable. There was no influence on lipid and glucose metabolism. The incidence of stroke was decreased and it could protect the renal function.
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PMID:[A report of the treatment of isolated systemic hypertension in the elderly patients (5 years follow up)]. 1118 2


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