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)

Tienilic acid--2,3-dichloro-4-(2-thienyl-carbonyl)phenoxyacetic acid--is a new diuretic with uricosuric properties. Nineteen patients with moderate arterial hypertension were treated for 5 consecutive weeks in a randomized fashion in a double-blind study with either tienilic acid or hydrochlorothiazide. Blood pressure was significantly reduced and to the same degree with both drugs. In 7 of the 11 patients receiving tienilic acid the daily dose was increased from 250 to 500 mg after 2 weeks, and in 2 of the 8 patients taking hydrochlorothiazide the daily dose was increased from 50 to 100 mg. Because of the potent uricosuric action of tienilic acid the mean serum urate concentration decreased from 6.3 to 3.3 mg/dL in the patients taking the drug. In contrast, the patients receiving hydrochlorothiazide the mean serum urate concentration increased from 6.1 to 7.8 mg/dL. Moderate hypokalemia of almost identical degree (mean serum potassium values 3.6 and 3.5 mmol/L) and mild metabolic alkalosis were observed in both groups. Tienilic acid had a marked hypocalciuric effect, which was of the same magnitude as the observed with hydrochlorothiazide. During the 5 weeks of treatment no significant change in renal or liver function was observed in either group. There were no hematologic complications and the drug was remarkably well tolerated. Tienilic acid, because of its unique character as a diuretic, hypouricemic and antihypertensive agent, should become the preferred drug for the treatment of arterial hypertension.
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PMID:Treatment of arterial hypertension with tienilic acid, a new diuretic with uricosuric properties. 2 7

Tienilic acid, a diuretic agent effective at the cortical diluting segment of the distal tubule, has been found to have equivalent antihypertensive action in a dose of 250 mg twice daily to hydrochlorothiazide in a dose of 50 mg twice daily. Tienilic acid reduced arterial pressure without diminishing renal plasma flow or endogenous creatinine clearance; moreover, it did so whilst achieving hypouricaemia through a uricosuric effect. Hypokalaemia was observed but corrected by supplemental potassium. A transient but reversible, slight elevation in serum creatinine concentration and significant hypertriglyceridaemia were also observed. In conclusion, tienilic acid seems to be a novel diuretic, well-suited for the patient with hypertension, particularly if there is coincidental gout or coexisting hyperuricaemia.
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PMID:Antihypertensive and renal effects of tienilic acid. 50 45

Ticrynafen is an orally administered diuretic that is similar to the thiazides in its therapeutic actions, but unlike the thiazides, it increases urate excretion and lowers serum uric acid levels. Ticrynafen is useful in the treatment of hypertension and in selected cases of chronic congestive heart failure. At present, it appears to be indicated primarily in patients with these disorders who have a history of gout. Patients who are currently receiving a thiazide should not have their therapy arbitrarily changed to ticrynafen because of asymptomatic hyperuricemia.
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PMID:Evaluation of a new uricosuric diuretic--ticrynafen. 51 60

Tienilic acid (TA) is a common new diuretic agent with a potent uricosuric action. In a double-blind cross-over study its antihypertensive effect was compared to that of hydrochlorothiazide (HCT). 20 patients with essential hypertension were studied: after I weeks of placebo wash-out 10 patients received TA (dose range 250-750 mg/die) and 10 HCT (dose range 50-150 mg/die), for 5 weeks. Systolic and diastolic blood pressures were significantly and equally reduced (p < 0.001) after the first week of treatment in both groups. While serum uric acid concentration increased after HCT, it was significantly reduced (p < 0.001) after TA treatment. Serum potassium was slightly reduced with both treatments. Serum tryglicerides, unchanged after HCT, showed a slight tendency to reduction on TA treatment. Ten patients with congestive heart failure, on full digitalis treatment, were given TA (dose range 250-1000 mg/die): in each patient a prompt diuretic effect was observed, associated to a significant reduction of body weight and to a marked improvement of the clinical signs of heart failure. Therefore, TA is an effective diuretic agent which may be conveniently used in the treatment of arterial hypertension and congestive heart failure, as it induces a diuretic effect comparable to that obtained with HCT, reducing at the same time, serum uric acid levels.
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PMID:[Tienilic acid in the treatment of arterial hypertension and congestive cardiac insufficiency]. 54 82

Diuretic therapy is usually accompanied by biochemical changes, such as hypokalemia, impaired glucose tolerance and hyperuricaemia. Tienilic acid is a new long-acting diuretic with antihypertensive effect, combined with uricosuric property. For the purpose of evaluating the effect of tienilic acid in patients with impaired renal function, eleven patients with hypertension and slight to moderate renal impairment were randomized to either hydrochlorothiazide or tienilic acid therapy. During eight weeks of treatment no changes occurred in serum-creatinine, creatinine-clearance, serum-sodium, or urea. Despite renal impairment, serum uric acid decreased during tienilic acid treatment. Compared with placebo, a significant decrease in uric acid was seen as early as after one week of treatment (p less than 0.01) and after 8 weeks the difference was still of the same order (p less than 0.01). During hydrochlorothiazide therapy, serum uric acid increased progressively. The difference was p less than 0.002 at 4 weeks and p less than 0.0005 at 8 weeks of treatment, compared with placebo. The results of this study show that the uricosuric effect of tienilic acid is maintained in patients with mild to moderate renal impairment.
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PMID:Tienilic acid in patients with impaired renal function. 676 7

This paper reports a clinical trial of tienilic acid, a new diuretic with uricosuric properties, in 23 patients with mild to moderate hypertension (standing diastolic blood pressure 90-120 mmHg). Tienilic acid was compared with hydrochlorothiazide in a variable-dose, double-blind cross-over study, and the duration of therapy was 8 weeks for each drug. The falls in blood pressure (systolic/diastolic) were: 11/11 mmHg supine and 17/11 mmHg standing for tienilic acid, and 8/12 mmHg supine and 9/17 mmHg standing for hydrochlorothiazide. There were no significant differences between the two drugs in their effect on blood pressure and heart rate, and regarding side-effects and laboratory results, except for serum uric levels (mean fall of 1,5 mg/dl with tienilic acid and mean increase of 1.1 mg/l with ydrochlorothiazide).
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PMID:The treatment of mild to moderate essential hypertension with tienilic acid (ticrynafen). 699 37

1. A double-blind crossover trial comparing the antihypertensive effect of tienilic acid and hydrochlorothiazide was conducted in thirty-eight patients with mild to moderate hypertension. 2. Tienilic acid was shown to be as effective as hydrochlorothiazide in controlling blood pressure. 3. Tienilic acid acid significantly lowered serum uric acid levels compared with both placebo and hydrochlorothiazide. 4. Tienilic acid was generally well tolerated but one patient developed acute renal failure due to acute allergic interstitial nephritis whilst taking the drug.
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PMID:Tienilic acid in the treatment of mild to moderate hypertension. 700 78

The efficacy of ticrynafen in the treatment of hypertension in patients with moderate renal impairment was compared with that of hydrochlorothiazide in a randomised, double-blind crossover trial in eleven subjects with renal insufficiency. Significant reductions in blood pressure occurred with both treatments, with the maximum responses occurring at different time intervals and to different degrees in individual patients. Thus, although ticrynafen caused a significant reduction in blood pressure in this group of hypertensive patients with renal insufficiency, it was not consistently different from that which could be achieved with hydrochlorothiazide. Ticrynafen also significantly reduced the serum uric acid concentration, compared with a significant rise with hydrochlorothiazide. No major biochemical abnormalities or side-effects were encountered in any subject. Thus, in these patients with renal insufficiency, ticrynafen still demonstrated a uricosuric effect as well as a useful anti-hypertensive action.
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PMID:Ticrynafen and hydrochlorothiazide. A comparison in hypertensive patients with renal impairment. 704 8

Tienilic acid (2,3-dichloro-4-(2-thienylcarbonyl) phenoxyacetic acid) is a new diuretic with uricosuric properties. Eighteen patients, aged between 37 and 67 years, with moderate arterial hypertension underwent a double-blind, within-patient, crossover study to compare the effects of tienilic acid (TNCF) and hydrochlorothiazide (HCTZ) on blood pressure, renal function, serum levels of uric acid and electrolytes, and liver function. Blood pressure was lowered similarly by TNCF and HCTZ. The prime advantage of TCNF over HCTZ was its profound hypouricaemic effect. Despite the possibility of hepatotoxicity of TNCF, it may still have a place in the treatment of hypertensive hyperuricaemic patients when the mechanism of hepatotoxicity of TNCF is elucidated.
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PMID:Comparison of the metabolic and antihypertensive properties of tienilic acid and hydrochlorothiazide. 723 15

Forty-nine patients with gout, many with hypertension and/or renal calculi, were given hydrochlorothiazide, furosemide, or ticrynafen. Diuresis and increased clearances of sodium (Na), potassium (K), chloride (Cl), and calcium (Ca) occurred after a single dose of hydrochlorothiazide, 100 mg, or furosemide, 40 mg, orally. There was very slight change in urate and phosphorus clearances. With prolonged use of hydrochloride or furosemide, diuresis and increased electrolyte excretion disappeared. Urate and Ca excretion fell with hydrochlorothiazide. With long-term use of furosemide, urate excretion was suppressed, but Ca excretion was sustained. Ticrynafen produced diuresis and increased clearances of Na, K, and Cl. Calcium excretion was increased after a single dose and minimally decreased after long-term use. Most striking was the severe and rather sustained uricosuria. Though ticrynafen is an effective uricosuric, natriuretic, and antihypertensive agent, its hepatotoxicity and nephrotoxicity mitigate against its clinical use.
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PMID:Effects of diuretics on urate and calcium excretion. 723 11


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