Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasma levels of cholesterol (C), triglycerides (TG), phospholipids (PL) (in total plasma, very low density [VLDL], low density (LDL), and high density [HDL] lipoproteins) and of two apolipoproteins (apo-B and apo-A) were studied in 13 hyperlipidemic patients suffering from hypertension and/or stable angina and treated by metoprolol or propranolol. Propranolol reduced the low density and high density lipoprotein phospholipids by 26% and 11%, respectively, and increased the very low density phospholipids by 24%. Metoprolol had only a transient effect on high density lipoprotein phospholipids. VLDL apolipoprotein-B was markedly increased by propranolol (67%), whereas apolipoprotein-A was slightly (8%) increased during metoprolol treatment. The reduced low density lipoprotein phospholipids and the increased high density lipoprotein apo-A correlated with the plasma concentration of propranolol and metoprolol, respectively. These results suggest that the comparative effects of beta-adrenoreceptor blocking agents on lipoprotein metabolism should be considered in their long-term use in patients with risk factors for hypertension and myocardial infarction.
 ...
PMID:Beta blockers and their effects on lipoproteins, phospholipids, apoproteins A and B, in whole plasma and the different fractions. 612 82

The long-term effects of metoprolol monotherapy, 100 mg b.i.d., for 16-18 months, were investigated in 8 previously untreated essentially hypertensive patients (resting blood pressure greater than 155/95 mmHg) and echocardiographic evidence of left ventricular hypertrophy (LVH) (left ventricular mass by Penn Cube formula greater than 215 g). Echocardiographic studies, according to the American Society of Echocardiography recording techniques and measurements criteria, were performed before starting treatment and at the end of follow-up. Metoprolol induced a decrease in systolic and diastolic blood pressure and heart rate, accompanied by a reduction of interventricular septum and posterior wall thickness (from 1.21 cm to 1.10 cm, and from 1.15 cm to 1.06 cm, respectively), left ventricular mass index and mean wall stress. All these changes were significant (p less than 0.01). Cardiac index decreased from 3017 ml/m2 to 2632 ml/m2 (p less than 0.01), mostly because of the reduction in the heart rate. In fact, stroke index, ejection fraction and fractional shortening all slightly increased during treatment in respect to pre-treatment values. Plasma renin activity fell from 1.45 ng/ml/h to 0.81 ng/ml/h (p less than 0.01), whereas both plasma noradrenaline and adrenaline concentration at rest did not change. Results indicate that in essentially hypertensive patients who have already developed LVH as a consequence of the hypertension, a long-term metoprolol therapy can successfully induce a reversal of LVH together with an effective blood pressure control, without noticeable adverse effects of changes in cardiac performance.
 ...
PMID:Left ventricular hypertrophy regression in hypertensive patients treated with metoprolol. 623 55

The antihypertensive effects of oral labetalol, a new alpha- and beta-adrenergic blocking agent, and metoprolol, a relatively beta1 selective adrenergic blocker, were evaluated in 91 patients with mild to moderate hypertension (standing diastolic blood pressure of 90 to 115 mm Hg) in a double-blind parallel group multicenter clinical trial. The effects of the two drugs on plasma lipids and lipoprotein fractions were also assessed. Following a four-week placebo phase, 44 patients were randomized to receive labetalol and 47 metoprolol. During a four-week titration phase, the labetalol dose was increased from 100 mg twice daily to a maximum of 600 mg twice daily to achieve a standing diastolic blood pressure of 90 mm Hg that was decreased by 10 mm Hg or more. Metoprolol was titrated from 50 mg to 200 mg twice daily. An eight-week maintenance period followed during which hydrochlorothiazide could be added. At the end of the maintenance phase, the doses of labetalol and metoprolol were tapered over a two to four day period after which patients received a placebo for one week. Blood pressure in the supine and standing position was measured at each visit. Labetalol and metoprolol both significantly (p less than 0.01) lowered the supine and standing blood pressure from baseline with no significant difference found between the two treatment groups. Both drugs lowered the heart rate; however, the rate-lowering effect was significantly greater with metoprolol (p less than 0.01). There were no significant effects of either drug on plasma lipids or lipoprotein fractions. Fatigue was the most frequently reported complaint with both drugs. Dizziness, dyspepsia, and nausea were more common with labetalol; bradycardia was more common with metoprolol. There was no blood pressure "overshoot" after withdrawing drug treatment; however, a heart rate "overshoot" was seen after metoprolol was tapered off and stopped. Labetalol is as safe and effective as metoprolol in the treatment of patients with mild to moderate hypertension.
 ...
PMID:Multiclinic comparison of labetalol to metoprolol in treatment of mild to moderate systemic hypertension. 635

Microelectrode recordings of multiunit sympathetic vasoconstrictor activity were made in muscle branches of the peroneal nerve in patients with essential hypertension before and during long-term treatment with the cardioselective beta-adrenergic receptor antagonist metoprolol. Nerve activity was quantified by counting the number of sympathetic bursts in the mean voltage neurogram. Metoprolol treatment lowered blood pressure and heart rate in all subjects. During long-term treatment, nerve activity was reduced both when compared to the level of activity after the first dose of the drug (p less than 0.01) and when compared to the control level before treatment (p less than 0.05). It is suggested that the reduction of sympathetic vasoconstrictor outflow to muscles contributed to the blood pressure reduction.
Hypertension
PMID:Sympathetic outflow to muscles during treatment of hypertension with metoprolol. 637 90

Metoprolol, a beta 1-adrenergic blocking agent, has been found effective in the treatment of hypertension. A death due to deliberate ingestion of metoprolol is described, including the case history, postmortem toxicologic findings, and identification and quantitation of the drug by high pressure liquid chromatography and gas chromatography/mass spectrometry. Metoprolol levels were found to be 4.7 mg/L in blood, 194 mg/L in urine, 3.3 mg/L in vitreous humor, 3.9 mg/L in pleural fluid, 254 mg/L in bile, 7.1 mg/kg in kidney, and 6.3 mg/kg in liver.
 ...
PMID:Fatal metoprolol overdose. 650 26

The effects of chlorthalidone and metoprolol on fasting plasma lipids and lipoprotein levels were compared in two similar nonrandomized groups of patients with mild hypertension. Chlorthalidone therapy was associated with an increase in serum cholesterol of 8.1% (17 mg/dl), mainly reflecting an increase in low-density lipoprotein (LDL)-cholesterol. High-density lipoproteins (HDL)-cholesterol decreased, but the difference between pre- and posttreatment levels did not reach statistical significance. Serum triglyceride (TG) concentration increased by 16% (20 mg/dl). Metoprolol therapy was not associated with changes in total, very low-density lipoprotein (VLDL)-, LDL- and HDL-cholesterol levels. Serum TG concentration increased by 22% (28 mg/dl), mainly due to an increase in VLDL-TG. Application of the Israel Ischemic Heart Disease Study data to these findings could predict only a very slight decrease in the 5-year estimated probability of myocardial infarction in the chlorthalidone-treated group. Metoprolol therapy has, theoretically, a more favorable influence on coronary heart disease risk status. These data suggest that the different forms of therapy for mild hypertension have a different effect on the theoretical coronary heart disease risk status, a fact that should be taken into consideration in the choice of medication.
 ...
PMID:Different effects of metoprolol and chlorthalidone on serum lipoprotein levels in mild hypertension. Possible implications for coronary heart disease risk status. 651 49

Treatment of hypertension with beta-adrenergic blockers may impair renal perfusion, perhaps because of beta 2-blockade in the renal vascular bed. We evaluated the effects of the cardioselective (beta 1 selective) beta-blocker metoprolol upon renal hemodynamics, intravascular volume, and renal electrolyte handling in nine essential hypertensive men. Metoprolol normalized systemic BP without significant acute or chronic changes in glomerular filtration rate, renal plasma flow, or renal blood flow. Overall renal sodium excretion and fractional sodium excretion increased on chronic metoprolol, without changes in intravascular volume or renal excretion of other electrolytes. Thus, cardioselective beta-blockade with metoprolol normalizes BP without renal hemodynamic impairment.
 ...
PMID:Renal perfusion is preserved during cardioselective beta-blockade with metoprolol in hypertension. 670 21

The effects of metoprolol and/or nifedipine on blood pressure were studied in 12 hypertensive males at rest and during standardized exercise on an ergometer bicycle. Metoprolol (100 mg X 2) and nifedipine (10 mg X 3) gave similar blood pressure reductions both at rest and during exercise. When the drugs were combined, the antihypertensive effect was potentiated. The PQ interval was not affected during any treatment period. No adverse reactions to the combined treatment were noted. The combination of a calcium blocker with vasodilating properties with a beta-blocker, which reduces cardiac output, thus seems a logical and promising therapeutic approach in the treatment of hypertension.
 ...
PMID:Antihypertensive effects at rest and during exercise of a calcium blocker, nifedipine, alone and in combination with metoprolol. 675 Oct 26

beta-Adrenoceptor blocking drugs are generally recognized as being effective in the treatment of hypertension. The mechanisms whereby these drugs reduce blood pressure are, however, not fully understood. In a double-blind, randomized study either metoprolol, 100--300 mg/day, or pindolol, 5--15 mg/day, was given for 6 months and the effects on blood pressure, heart rate and vascular resistance in the calf and forearm were investigated. Measurements were made at rest, during and after physical exercise, and during postischaemic hyperaemia. Both drugs reduced blood pressure to the same extent both at rest and during and after exercise. Metoprolol reduced heart rate to a greater extent than pindolol at rest and after exercise, whereas no difference was seen during physical exercise. Pindolol reduced the vascular resistance in the calf at rest by 14% (p less than 0.05), whereas metoprolol tended to increase vascular resistance, the difference in effect being highly significant (p less than 0.005). During and after leg exercise, there was no difference in forearm vascular resistance between the two drugs. It may be concluded that pindolol reduced resting blood pressure partly through peripheral vasodilatation. This was probably an effect of beta 2-adrenoceptor stimulation linked to the pronounced intrinsic sympathomimetic activity (ISA) of pindolol. Metoprolol on the other hand, acted mainly through cardiac mechanisms, as suggested by its pronounced reduction of heart rate.
 ...
PMID:Mode of action of beta-adrenoceptor blocking agents in hypertension. A comparison between metoprolol and pindolol with special reference to peripheral vascular effects. 676 Jun 78

The clinical efficacy of propranolol and metoprolol slow-release tablets (Durules) was compared in 20 patients with typical angina pectoris and concomitant hypertension. During a four-week run-in period all patients were given 80 mg propranolol b.i.d. in a single-blind fashion. Thereafter they were randomised in a double-blind fashion to treatment with either propranolol tablets, 80 mg b.i.d., or metoprolol Durules, 200 mg o.m. After four weeks, treatment was changed according to a cross-over design. The number of anginal attacks and nitroglycerin consumption were recorded by the patients in diary-cards. At the control visits, blood pressure was assessed in the supine and standing positions. No differences were found between the drugs as regards either antianginal or antihypertensive efficacy. Metoprolol Durules 200 mg o.m. are considered to be as effective as propranolol, 80 mg b.i.d. and may be preferred by some patients because of the simple dosage regimen.
 ...
PMID:Metoprolol in angina pectoris complicated by essential hypertension. A clinical comparison of the antianginal efficacy of metoprolol slow-release tablets (Durules) given once daily and propranolol tablets given twice daily. 679 20


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>