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

The morbidity and mortality due to cardiovascular complications of chronic arterial hypertension are distinctly reduced by persistent and successful antihypertensive therapy. The principal emphasis is on drug therapy. Diet and psychotherapy should be used as supportive measures. Examples of antihypertensive drugs available for general practice: saluretics, beta-receptor blockers, dihydralazine (Nepresol), alpha-methyldopa, clonidine (Catapresan), reserpine and guanethidine (Ismelin). With mild hypertension (diastolic blood pressure up to 105 mm Hq), monotherapy with a beta-receptor blocker or a saluretic is indicated first. Contrary to the medical rule never to use a combination preparation if it can possibly be avoided fixed combinations have proved valuable in hypertensive therapy and facilitate therapy for the hypertensive patient and for the doctor.
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PMID:[Therapy of hypertension in general practice. Comments on the recommendations of the German Antihypertension League (author's transl)]. 30 37

Fifty patients with arterial hypertension of various causes were treated with a combination consisting of Nepresol, a beta-adrenergic receptor-blocking agent and a diuretic. Duration of treatment ranged between 3 months and 5 years. A significant reduction of blood pressure was attained in all of the cases, with a return of the values to the normal range in a high proportion of the patients. The renal function did not deteriorate during therapy, but owing to potassium loss regular potassium replacement was required in the majority of the cases. Allergic reactions appeared in two cases. Neither SLE nor rheumatoid arthritis was encountered. Positive ANF reaction and a significant elevation of the Rose-Waaler titre were demonstrated in a number of cases. The benefits as well as the hazards of the therapeutic use of hydrazine derivatives are pointed out.
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PMID:Nepresol in the treatment of hypertension of major severity. 39 42

The course of the illness in a six-year-old boy is reported. His recurrent headaches led to the detection of arterial hypertension (170/135 mmHg). Clinical and histological examination revealed neurofibromatosis von Recklinghausen. A bilateral paraumbilical murmur hinted at a renovascular form. Arteriography showed an aneurysm of the right renal artery and multiple bilateral intrarenal stenoses and aneurysmatic dilatations. Under conservative treatment with Propranolol and Dihydralazine blood pressure remained almost normal over two years. 38 paediatric cases of renovascular hypertension in childhood reported in the literature are analyzed with regard to clinical manifestation, morphology and localisation of the renovascular lesions.
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PMID:[Renovascular hypertension in neurofibromatosis von Recklinghausen (author's transl)]. 41 39

Dihydralazine treatment which lowered blood pressure in young rats from the Lyon Hypertensive Strain (LHS), did not change phenylethanolamine-N-methyltransferase (PNMT) activity, but decreased tyrosine hydroxylase and dopamine-beta-hydroxylase activities in the C2 medullary region. These data suggest that the increase in PNMT activity, previously described for this strain, is not a consequence of the developing hypertension and that hypotensive treatment could inactivate some catecholaminergic neurons of the medulla oblongata.
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PMID:Dihydralazine and catecholamine-synthesizing enzymes in spontaneous hypertension. 49 52

Dihydralazine, given in small i.v. doses, has been of great value in diagnostic tests for unilateral renovascular hypertension, where it enhances renin release on the affected side. The acute hemodynamic effects of an i.v. dose of 0.1 mg/kg b.wt. were studied in 14 patients with essential hypertension, using a quantitative renographic technique for determination of effective renal plasma flow and radiocardiographic technique for determination of the parameters in systemic circulation. Cardiac index increased from 4.040 to 6.423 1/min.m2 (p less than 0.01), stroke index from 59 to 66 ml/beat.m2 (p less than 0.05), heart rate from 70.4 to 96.6 beats/min (p less than 0.01) and left ventricular work index from 1.04 to 1.49 W/m2 (p less than 0.01), while mean arterial B decreased from 125 to 110 mmHg (p less than 0.01) and total peripheral resistance index from 2927 to 1534 10(5).N.s.m(-3) (p less than 0.01). Effective renal plasma flow and pulmonary plasma volume were unchanged. Peripheral renin activity increased from 0.5 to 1.6 nmol A1/1.h (p less than 0.02). It is concluded that even a small test dose of 0.1 mg/kg of dihydralazine elicits a considerable additional work load on the heart, a circumstance that must be taken into consideration in studies of patients with coronary heart diseases.
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PMID:The cardiac response to a small i.v. dose of dihydralazine, a safe drug for diagnostic tests? 66 11

The validity of invasive preoperative diagnostic procedures in patients with unilateral renovascular hypertension was assessed. A significant lowering of blood pressure following reconstructive surgery can be predicted if following stimulation with Dihydralazine the renal-venous renin ratio of the involved to the noninvolved kidney is at least 2.0. Furthermore, it is of importance to determine the renal perfusion rate in the contralateral non-stenotic kidney which should be within normal limits. If these two criteria are met then in the majority of cases surgical intervention in unilateral hypertension is meaningful.
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PMID:Relevant diagnostic procedures in renovascular hypertension. 102 67

The anti-hypertensive effect of propranolol is studied in 35 essential permanent hypertensive patients. The decrease in blood pressure in higher in the presence (p is less than 0.01) than in the absence of diuretic therapy. The anti-hypertensive effect is higher in severe than in moderate hypertension. No side effect was observed except the decrease in heart rate (p is less than 0.001). Dihydralazine was added in 4 severe hypertensive patients and induced in 2 of them anginal attacks.
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PMID:[Use of propranolol in permanent essential hypertension]. 121 99

Data on the influence of antihypertensive drug treatment on mortality of hypertensive rats are reviewed. Dihydropyridine calcium antagonists, verapamil, the angiotensin-converting enzyme (ACE) inhibitor captopril, and a triple combination of reserpine, hydralazine, and chlorothiazide normalized or markedly prolonged survival. Captopril was less effective in sodium chloride-induced, low-renin Dahl rat hypertension. Dihydralazine prolonged but did not nearly normalize survival. The K(+)-channel activator minoxidil was relatively ineffective. Data on diuretics or beta-blockers are insufficient or unavailable. Calcium antagonists nitrendipine and nimodipine and the ACE inhibitor captopril improved survival and prevented vascular lesions and calcinosis even at doses that failed to achieve normotension. All drugs that normalized survival also reduced heart weights. Minoxidil invariably increased heart weights and failed to improve survival. (Di)hydralazine assumed an intermediate position.
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PMID:Effects of different antihypertensive drug classes on survival in animal models. 171 94

This report is on a 35-year-old II-para (status post-Caesarean Section due to breech presentation, at that time normal pregnancy) progress, who was hospitalized with hypertension and proteinuria during the 40th week of pregnancy. Both symptoms occurred initially three days before hospitalization. Blood pressure was within the high normal range (140/90 mmHg) as a result of medication with Dihydralazine (50 mg/die). After induction of labour with prostaglandin (PGE2), the patient delivered normally, and the highest blood pressure measured was 140/90 mmHg, following a subsequent curettage under general anaesthesia, which had to be performed due to incomplete deliver of the placenta. Two hours post delivery, sudden epigastric pain occurred, followed by nausea and vomiting. Blood chemistry showed the development of a severe post-partal HELLP-Syndrome with acute renal failure. The case demonstrates, that the life threatening picture of the HELLP-Syndrome may develop without preexistent severe hypertension or proteinuria. For this reason a post-delivery screening of blood chemistry should be mandatory in cases of severe epigastric or right-upper-quadrant pain.
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PMID:[HELLP syndrome--postpartum]. 174 78

Reduced aortic distensibility and compliance may participate in the genesis of cardiac hypertrophy in patients with hypertension. In these patients the increase in end-systolic stress, a determinant factor contributing to the development of cardiac hypertrophy, is influenced not only by the geometric properties of the ventricle but also by the level of systolic pressure. In patients with sustained essential hypertension, the degree of cardiac hypertrophy correlates significantly with the increase in aortic rigidity, which is assessed by the calculation of the characteristic impedance, by the measurement of carotid-femoral pulse-wave velocity, or by the calculation of the Peterson elastic modulus at the level of the aortic arch. Dihydralazine-like substances are unable to modify arterial stiffness, whereas calcium-entry blockers and converting-enzyme inhibitors improve arterial stiffness when achieving the same degree of blood pressure reduction. Modifications in the stiffness of the aorta and other large arteries must be considered to understand reversion of cardiac hypertrophy as a result of antihypertensive treatment.
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PMID:Arterial distensibility and left ventricular hypertrophy in patients with sustained essential hypertension. 183 66


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