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

An assessment was made of the efficacy of Sotalol, a beta1 selective beta blocker, in the management of essential arterial hypertension. A single 160 mg dose per diem was administered per os to 34 patients over a period of 14 weeks. Arterial pressure and heart rate were checked periodically. In addition, SAP, DAP and heart rate were evaluated before and during the third week of treatment in 8 subjects under maximum ergometric test conditions. Excellent tolerance was observed. Under basal conditions, all subjects displayed good reduction of SAP and DAP. This was highly significant. During exercise, it was less evident, and the results were only significant for low work loads. It is nevertheless felt that the simple dose protocol of the drug, its good tolerance and its effectiveness under basal conditions suggest that more extensive ergometric studies should be conducted.
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PMID:[Hypotensive effect of sotalol under basic conditions and during exercise. Clinical cases]. 665 6

The effects of a herbal drug, Ajmaloon (Hamdard, India), on the arterial blood pressure, heart rate (HR) and baroreceptor-heart rate reflex were studied in anesthetized rabbits and monkeys. Intravenously administered Ajmaloon produced a dose-dependent hypotensive response in both the species without any significant effect on the heart rate. Only in high doses (200 mg/kg or more). Ajmaloon produced a bradycardia response in rabbits. Even the highest dose (300 mg/kg) of Ajmaloon used in the present investigation did not cause arrhythmia or any other conduction disorder or respiratory distress. Baroreflex SAP-HR curve was shifted to the left of the control following treatment with 100 mg/kg intravenous Ajmaloon in both the species. Loss of tachycardia response to fall in arterial pressure in Ajmaloon treated animals indicated the drug induced suppression of normally existing sympathetic excitatory influence in response to hypotension. Baroreflex regulatory HR response to hypertension remains intact after intravenous administration of 100 mg/kg Ajmaloon, a dose much higher than the prescribed highest oral dose for humans. Intact baroreflex regulation of arterial blood pressure in response to hypertension in Ajmaloon treated mammals suggests that in patients besides lowering the blood pressure. Ajmaloon might not interfere with the normal blood pressure regulatory mechanism through arterial baroreceptors during hypertension.
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PMID:Effect of Ajmaloon on the baroreceptor-heart rate reflex in anaesthetized rabbits and monkeys. 764 95

Interrelationships between arterial pressure (AP), physical performance (PP) and arterial hypertension (AH) risk factors were studied in two representative samples of hypertensive subjects using multivariate stepwise regression analysis in the preexercise, exercise and postexercise periods and two exercise tests. Test 1 (standard continuous bicycle ergometry) allowed PP estimation by the work performed and double product (HRmax x SAP/100 max). Test 2 (stepwise intermittent bicycle ergometry by PWCx) estimated PP according to a special formula. Test 1 is standard and therefore is able to provide significant diagnostic, prognostic and rehabilitation information. Test 2 is standard only at its first step, while the second step varies with cardiovascular response to the initial step. This is convenient for definition of permissible exercise dynamic control over exercising subjects, assessment of training efficacy in different regimens and programs. It is concluded that both methods are fit for estimating relations between AP, PP and AH risk factors in exercise and are comparable by the main parameters.
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PMID:[A comparative evaluation of 2 physical loading tests in arterial hypertension]. 801 18

In this prospective, randomized study, two regimens of total intravenous anaesthesia (TIVA), with propofol and S(+)-ketamine (S-ketamine) and with propofol and alfentanil, were compared with reference to endocrine stress response, circulatory effects and recovery. METHODS. The investigation was conducted in two groups of 20 ASA I-III patients over 60 years of age who were scheduled for endoprothetic orthopaedic surgery. After oral premedication with midazolam, patients received a TIVA with body-weight-adjusted doses of propofol, and S-ketamine or alfentanil as the analgesic component. For CPPV (PEEP 5 mbar), air and oxygen (FiO2 33%) were used. For muscle relaxation, patients of both groups received vecuronium in body-weight-adjusted doses. Blood samples were taken through a central venous line at seven time points before induction of anaesthesia and on the first morning after the operation also for analysis of epinephrine, norepinephrine (by HPLC/ECD), and ADH, ACTH and cortisol (by RIA). In addition, SAP, HR, arterial oxygen saturation, recovery from anaesthesia and side effects were observed. RESULTS. The two groups had comparable group mean values for age (S-ketamine group 71 years, alfentanil-group 70 years), other biometric data, and duration of anaesthesia and operation (Table 1). Plasma levels of epinephrine, norepinephrine (Table 2, Fig. 1), ADH (Table 2, Fig. 2) ACTH and cortisol (Table 2, Fig. 3) were higher in the S-ketamine-group (P < 0.05) owing to the intraoperative course of these endocrine parameters. Before induction, and on the first morning after the operation, levels were comparable between the groups. 5 min after the induction of anaesthesia, SAP and HR (Table 3) were significantly lower in the alfentanilgroup (P = 0.001). Recovery from anaesthesia (orientation with respect to person and location) was faster in the alfentanilgroup (16 vs 39 min, P = 0.001). An arterial oxygen saturation below 90% was observed in 7 patients in the S-ketamine- and 13 patients in the alfentanilgroup (P = 0.03). Four patients with S-ketamine reported dreams, and 1 dream was judged negative. Postoperative emesis was found in 6 patients in the S-ketaminegroup and 12 patients in the alfentanilgroup (P = 0.03). All patients said they would agree to undergo the same anaesthetic technique again. CONCLUSIONS. Considerable differences were found in the endocrine stress response of the two groups. With respect to endocrine response and circulation, TIVA with propofol and S-ketamine had sympathomimetic properties with positive circulatory effects and led to moderate endocrine stimulation. This should be kept in mind in patients with hypotension, hypothyrosis, or adrenocortical insufficiency; because "eustress" might be beneficial in this group of patients. On the other hand, TIVA with propofol and alfentanil showed sympatholytic properties, with negative circulatory effects and a remarkable reduction of endocrine stress response. This might be beneficial in patients with hypertension and states of endocrine hyperfunction. Both regimens were accompanied by such typical side effects as dreams, delayed recovery, reduced ventilation, and emesis, which should also be considered.
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PMID:[Total intravenous anesthesia (TIVA) in geriatric surgery. S-(+)-ketamine versus alfentanil]. 859 65

KT3-671, a nonpeptide AT1 receptor antagonist, was administered to 20-week-old stroke-prone spontaneously hypertensive rats (SHRSP) daily for 3 weeks. Its effects on systolic, mean, and diastolic arterial blood pressure (SAP, MAP, DAP), heart rate and locomotor activity were investigated with radiotelemetry. A clear diurnal variation in blood pressure, heart rate, and locomotor activity was observed in synchrony with the light cycle. KT3-671 at a daily dose of 10 mg/kg orally (p.o), produced a significant and consistent reduction in blood pressure, preventing the development of hypertension. KT3-671 reduced SAP more than DAP, suggesting that it may affect both vascular tone and cardiac output. Although KT3-671 did not affect diurnal rhythms in heart rate and locomotor activity, it did cause a slight but significant reduction in heart rate. The MAP determined 23 h after the administration of KT3-671 showed a significant reduction from the day 2 of therapy to the day 3 after discontinuation of therapy, suggesting a long duration of antihypertensive action. There was no rebound increase in blood pressure after discontinuation of KT3-671 therapy. These results suggest that KT3-671 may be potentially useful in the therapy of hypertension.
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PMID:Effect of repeated administration of KT3-671, a nonpeptide AT1 receptor antagonist, on diurnal variation in blood pressure, heart rate, and locomotor activity in stroke-prone spontaneously hypertensive rats as determined by radiotelemetry. 890 3

The placement of pointed cranial pins into the periosteum is a recognized acute noxious stimulation during intracranial surgery which can result in sudden increases in blood pressure and heart rate, causing increases in intracranial pressure. A skull block (blockade of the nerves that innervate the scalp, including the greater and lesser occipital nerves, the supraorbital and supratrochlear nerves, the auriculotemporal nerves, and the greater auricular nerves) may be effective in reducing hypertension and tachycardia. Twenty-one patients were allocated in a prospective, double-blind fashion to a control group or a bupivacaine group. After a standardized induction and 5 min prior to head pinning, a skull block was performed. Patients in the control group received a skull block of normal saline, while the bupivacaine group received a skull block with 0.5% bupivacaine. Systolic (SAP), diastolic (DAP), mean arterial pressure (MAP), heart rate (HR), and end-tidal isoflurane were recorded at the following times: 5 min after the induction of anesthesia, during performance of the skull block, during head pinning, and 5 min after head pinning. Significant increases in SAP of 40 +/- 6 mm Hg, DAP of 30 +/- 5 mm Hg, MAP of 32 +/- 6 mm Hg, and HR of 22 +/- 5 bpm occurred during head pinning in the control group, while remaining unchanged in the bupivacaine group. These results demonstrate that a skull block using 0.5% bupivacaine successfully blunts the hemodynamic response to head pinning.
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PMID:The effect of bupivacaine skull block on the hemodynamic response to craniotomy. 908 97

YM358 2,7-diethyl-5-[[2'-(1H-tetrazole-5-yl)biphenyl-4-yl]methyl]-5H-pyrazolo[ 1,5-b][1,2,4]-triazole potassium salt), a novel nonpeptide angiotensin AT1-receptor antagonist, was administered daily for 4 weeks to 24-week-old stroke-prone spontaneously hypertensive rats (SHRSP). Its effects on systolic, mean and diastolic arterial pressure (SAP, MAP and DAP), heart rate and locomotor activity were investigated by using radiotelemetry. A clear diurnal variation in blood pressure, heart rate and locomotor activity was observed in synchrony with the light cycle. YM358 at a daily oral dose of 10 or 30 mg/kg produced a reduction of blood pressure in a dose-dependent manner. Although a mild attenuation of the antihypertensive effect of YM358 was observed during the early stage of therapy, YM358 at 30 mg/kg per day produced a significant and consistent decrease in 24-hr MAP and DAP, and it prevented the further development of hypertension. YM358 did not affect either heart rate or locomotor activity or their diurnal variations. After the discontinuation of therapy with YM358, the blood pressure recovered promptly to the control level while there was no sign of a rebound increase in blood pressure. These results suggest that YM358 may be potentially useful for the treatment of hypertension.
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PMID:Antihypertensive effect of repeatedly administered YM358, an angiotensin AT1-receptor antagonist, in stroke-prone spontaneously hypertensive rats. 903 37

The aim of the study was to evaluate the effect of angiotensin converting enzyme inhibition on blood pressure and plasma renin activity (PRA) in patients with essential (EH) and renovascular (RVH) hypertension. Forty patients with RVH and sixty four with EH were studied. All patients underwent renal digital subtraction angiography in order to find out renal artery stenosis. Blood pressure was measured before and 15, 30, 45, 60 and 90 minutes after captopril administration in the captopril test. PRA was determined before and 60 minutes after captopril. It was shown that fall of systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure after captopril was significant in each time period both in EH and RVH. Hypotensive effect was significantly higher (p < 0.001) in RVH. Basic PRA did not differ in the studied groups. 60 minutes after captopril administration PRA was significantly higher (p < 0.001) in patients with RVH. Absolute and percentage rise of PRA also differentiated studied groups (p < 0.001). Significant correlations were found between the change of PRA after captopril and fall of SAP, DAP and MAP in both groups. These relationships were stronger in RVH.
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PMID:[Usefulness of converting enzyme inhibitors in diagnosis of renovascular hypertension. I. Comparison of the effect of angiotensin converting enzyme inhibition on blood pressure and plasma renin activity in patients with primary hypertension and renovascular hypertension]. 938 Aug 5

The aim of the study was to evaluate the effect of angiotensin converting enzyme inhibition on renoscintigraphic curves using DTPA as a tracer in patients with essential (EH) and renovascular (RVH) hypertension. Twenty four patients with EH and sixteen with RVH were studied. Protocol consisted of control renoscintigraphy with DTPA and the second one after captopril administration in dose 25 mg performed after three days. Relative DTPA uptake of the single kidney was calculated from the curve time-activity between 120 and 180 second after tracer administration. Results were expressed as a quotient of the relative DTPA uptake of ischemic or "weaker" kidney to the DTPA uptake of both kidneys (coefficient A) or contralateral one (coefficient B). Coefficient A in basic renoscintigraphy did not differ in patients with EH and RVH and was 45.81 +/- 3.02% and 44.66 +/- 6.17% respectively. In renoscintigraphy with captopril coefficient A decreased significantly (P < 0.001) in patients with RVH and was significantly lower (p < 0.05) than in patients with EH. Change (delta) of coefficient B after captopril was significantly higher in patients with RVH (p < 0.001). Significant correlations were found between delta coefficient A and delta diastolic (DAP) and mean (MAP) arterial pressure as well as delta plasma renin activity (PRA) after captopril in patients with RVH. Similarly, relationships were shown between percentage change (% delta) of coefficient B and % delta of systolic (SAP), DAP and MAP as well as delta PRA after captopril in patients with RVH.
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PMID:[Usefulness of angiotensin converting enzyme inhibitors in the diagnosis of renovascular hypertension. II. Comparison of the effect of angiotensin converting enzyme inhibition on reno-scintigraphic curves with DTPA in patients with essential and renovascular hypertension]. 948 Apr 62

We have measured the effect of a bolus dose of esmolol 80 mg i.v. on heart rate, and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures during electroconvulsive therapy (ECT). We also assessed seizure duration using both the cuff method and two-lead EEG. We studied 20 patients in a double-blind, placebo-controlled, within-patient blocked randomized study. No patient was receiving psychotherapeutic drugs or had cardiovascular disease. Esmolol significantly reduced heart rate, SAP and MAP before the stimulus, and also significantly reduced the increases in these variables during the convulsion, compared with placebo. However, seizure duration was also significantly reduced, possibly making ECT less effective. The reduction in seizure duration was 5.83 s when monitored clinically and 9.9 s when measured by the EEG. Because of the reduction in seizure duration, routine administration of esmolol is not advisable because it may interfere with the efficacy of ECT, but administration of esmolol during ECT could be useful to reduce tachycardia and hypertension in high-risk patients.
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PMID:Low-dose esmolol bolus reduces seizure duration during electroconvulsive therapy: a double-blind, placebo-controlled study. 1061 42


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