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)

When mean arterial pressure exceeds 140 mmHg (equivalent to 180/120), there is a significant risk of maternal cerebral vascular damage. Therefore it is recommended that blood pressures greater than 170/110 should be treated with urgency, aiming to maintain the blood pressure at all times at less than 170/110 but not lower than 130/90. Parenteral hydralazine is effective and safe therapy. Labetalol (intravenously or orally) appears to be as effective and as safe, and causes fewer troublesome side effects; however, clinical experience of its use is more limited, particularly in relation to its safety for the fetus and neonate. Delivery of the fetus is usually the definitive management of severe hypertension in pregnancy. However, this action may not reduce the blood pressure immediately. After initial treatment with rapid-acting agents, it is often advantageous to maintain control of arterial pressure with ongoing oral therapy (methyldopa, labetalol). In addition to the protective effect on the mother, such therapy may allow delivery of the fetus to be deferred; this should be considered only if the fetus is significantly premature (e.g., less than 34 weeks), there is no other evidence of maternal or fetal distress, and there can be meticulous monitoring of the maternal and fetal state proceeding to prompt delivery if deterioration occurs. The indications for treatment of mild or moderate hypertension in pregnancy are less clear. Severe hypertensive episodes can be reduced by several drugs (methyldopa, labetalol, beta-blockers). Methyldopa appears to reduce the small risk of mid-trimester abortions seen in association with early hypertension. Other benefits may be possible with other individual drugs; however, none of these have been found consistently in controlled studies to date. There seems, therefore, to be no definite indication for treatment of mild hypertension in pregnancy; treatment of moderate hypertension may be reasonable but its value is unproved at present. Antihypertensive drugs are valuable in pregnancy to reduce the risks directly due to elevated blood pressure. These drugs are not expected to affect the evolution of preeclampsia nor to treat the other complications of this condition.
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PMID:Antihypertensive drugs in pregnancy. 286 23

In the control of chronic disease no therapeutic regimen is successful unless it is complied with. A number of studies have indicated that compliance with tablet-taking may be as low as 40%. Patients with hypertension are frequently on a number of different anti-hypertensive agents, and if they have other chronic disorders they may take as many as 10 different drugs and up to 40 tablets per day. It is therefore not surprising that compliance is poor. To achieve compliance requires education of the patient, reduction in the number of drugs and simplification of the drug regimen. Methyldopa was used in a crossover study on a once- or twice-daily basis. Blood pressure was measured at the same time each day 2 hours after the morning dose. Compliance was assessed by tablet count and by blood pressure control, which was better on once-a-day therapy. Over a 6-week period 95% of medication was taken on the once-daily compared with 84% on the twice-daily regimen. In a subsequent study atenolol once per day replaced propranolol given 3 times per day. Blood pressure was lower on atenolol and tablet compliance was 94% compared with 74% on thrice-daily propranolol therapy. In addition, many patients admitted not taking the midday dose. The effect of dietary advice was then monitored by 24-hour urine electrolytes. When advice was given superficially by the doctor, urine sodium fell from 186 mmol/day to 165 mmol/day. When seen on one occasion by a dietitian and given diet sheets, it fell from 182 to 135 mmol/day. When seen at repeated visits by the dietitian and the advice modified according to sodium excretion, urine sodium excretion fell from 188 to 83 mmol/day. Supplemental oral potassium is often given as antihypertensive medication and up to 6 tablets per day may be administered. Compliance decreased as the number of tablets increased. Compliance was 92% on 1 tablet, 83% on 2 tablets, 68% on 3 tablets, 75% on 4 tablets (usually taken as 2 tablets twice a day) and 58% when on 6 tablets per day. The compliance with diuretic-taking was 96%. When given amiloride/hydrochlorothiazide the compliance was 93% and this elevated plasma potassium more than high dose supplemental potassium. In a recent study people on 3 or more drugs for blood pressure control were placed on a low salt diet and their drugs replaced with enalapril.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Compliance and the elderly hypertensive. 287 9

Twenty-five patients whose pregnancies were complicated by chronic hypertension were entered in a double-blind study and randomly allocated to treatment with methyldopa (Aldomet) or placebo. Thirteen patients were in the treatment group and 12 in the placebo group. The two groups showed no significant difference in demographic and pretreatment laboratory profiles. Methyldopa-treated patients registering in the first trimester had a significant reduction in the mean arterial pressure (MAP) during the second and third trimesters (P less than 0.025). No significant differences in birth weight (BW), ponderal index (PI) were found when results were corrected for gestational age (GA), race, and sex. The mean GA was significantly prolonged in the methyldopa-treated group by 10.3 days (P less than 0.05). The frequency of superimposed pre-eclampsia was similar in both groups (33.3% vs. 38.4%). However, 75% of the superimposed pre-eclampsia occurred antepartum in the placebo group, while 80% of the methyldopa-treated group developed superimposed pre-eclampsia intrapartum. The results of this small study suggest that the treatment of hypertension in pregnancy may reduce MAP and possibly delay the occurrence of superimposed pre-eclampsia and thus afford a prolongation of the pregnancy.
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PMID:Treatment of hypertension in pregnancy with methyldopa: a randomized double blind study. 288 43

Bioavailability of alpha-methyldopa from a film coated tablet Dopegyt (EGIS Pharmaceutical Works, Budapest, Hungary) and from Aldometil (MSD, Sharp and Dohme GmbH, Munich, FRG) containing 250 mg of effective substance, was investigated in a crossover study in six patients with mild hypertension having normal renal and liver functions. Alpha-methyldopa was determined in plasma by fluorometry. There was no difference in the pharmacokinetic parameters calculated (Cl, Vd, AUC, t1/2) indicating that the two preparations are bioequivalent.
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PMID:Comparative bioavailability study of two preparations of alpha-methyldopa after single, oral doses. 367 24

Among 509 patients referred to our Institute for Holter monitoring, between 1st September, 1982-30th October, 1983, 28 patients aged 65-90 (mean 76) were referred for dizziness and syncope. There were 17 men and 11 women. Seven patients had a M.I. in their past, 4 angina pectoris, 5 hypertension, 4 aortic stenosis or aortic insufficiency or both, hemodynamically significant, one had mitral valve prolapse (MVP) and one transient ischemic attacks (TIA). In our series 16 out of 28 patients received digoxin and antiarrhythmic drugs (quinidine, propranolol, procainamide, Neo-gilurythmal, amiodarone), 2 of them digoxin and quinidine in full doses and one digoxin and amiodarone. Other drugs administered to our patients included Aldomin, Isordil, Lasix, aminophylin, cromoglycate etc. In 10 patients (35.7%) we found complex ventricular arrhythmias (7 with M.I., 3 patients of 4 with significant aortic valve lesion, 2 patients of 2 with left anterior hemiblock (LAH), 1 patient with MVP, 1 patient with TIA). In another 5 patients (17.8%) we found atrial fibrillation, fast rhythm (2 with chronic obstructive lung disease, 2 with hypertension and 1 in post M.I.) which explained their symptomatology. From our data we conclude that the pluripathology found in old age as well as the multimedication administered, cause a plurietiology of syncope, arrhythmias playing an important role in its determination, in this particular age group.
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PMID:Holter monitoring for dizziness and syncope in old age. 387 98

Methyldopa therapy for hypertension after renal transplantation could affect graft outcome adversely, since methyldopa inhibits suppressor cells. To study effects of methyldopa on transplant outcome, we analyzed prospective data on 1,648 hypertensive, first-allograft recipients; 545 patients used methyldopa and 1,103 patients did not. One-year graft functional survival was 66% and 67% for all patients using and not using methyldopa respectively. No increased acute rejection occurred related to methyldopa. During the one to six years of follow-up, no adverse effects on graft survival could be attributed solely to methyldopa except that graft survival among white recipients using methyldopa was diminished late after transplantation (P less than .05). Patient survival was not affected by methyldopa. Azathioprine and prednisone therapy may avert the suppressor cell inhibition by methyldopa. Its effect on kidney transplant outcome is not significant except in whites late in the course of graft function; methyldopa use when clinically indicated appears safe.
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PMID:Methyldopa therapy and outcome in cadaveric renal transplantation. 389 1

The effects of prazosin and alphamethyldopa on blood lipids and lipoproteins were assessed in 20 patients with mild or moderate arterial hypertension. Parameters measured included serum cholesterol (CHO), triglycerides (TG), high density lipoprotein-cholesterol (HDL-CHO), insulin (I), glucose (G), and non-esterified fatty acids (NEFA). Prazosin -4 mg/day for 6 weeks in hydrochlorothiazide-treated patients lowered blood pressure by 18.6/17.2 (systolic/diastolic pressure) mmHg. There was a significant decrease in CHO (-5.8%), in I (-16.5%), and in NEFA (-3.0%), and a significant increase in HDL-CHO (+15.5%). Alphamethyldopa 250-750 mg/day for 6 weeks in hydrochlorothiazide-treated patients lowered blood pressure by 18.8/14.6 (systolic/diastolic pressure) mmHg, accompanied by a non-significant decrease in CHO and TG, and significant increases in HDL-CHO (+10.3%), G (+8.5%) and NEFA (+6.4%). Thus, prazosin appears to have a more beneficial effect on blood lipids and lipoproteins than alphamethyldopa.
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PMID:Effects of prazosin and alphamethyldopa on blood lipids and lipoproteins in hypertensive patients. 389 72

Forty-three patients hospitalised for chronic hypertension or superimposed toxemia in late pregnancy were treated with Dopegyt-orally in constant dosage. Blood pressure dropped at the beginning of therapy. In the further course of treatment blood pressure re-increased in 14 patients, that other antihypertensive drugs had to be administered additionally. alpha-methyldopa alone is sufficient only in a part of the hypertensive patients.
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PMID:[Effect of alpha-methyldopa (Dopegyt) on blood pressure in hypertensive pregnant patients]. 400 21

A self-administered symptom questionnaire was completed by 477 patients in a hypertension clinic. The complaints of the patients were analysed according to the type of therapy being given and the dose of drug taken. Methyldopa therapy was associated with sleepiness, weakness of the limbs, sleeping longer at night, and rising more frequently at night to pass urine. Diarrhoea, impotence, failure of ejaculation, blurred vision, depression, and the symptoms of postural hypotension were not related to methyldopa therapy. Bethanidine administration was related to postural hypotension, impotence, and failure of ejaculation but not to weakness of the limbs, blurred vision, depression, or diarrhoea. Patients receiving guanethidine complained of postural hypotension, failure of ejaculation, and had their bowels open more frequently. Similarly, patients receiving propranolol had an increased frequency of defaecation but also tended to complain of weakness of the limbs.Considering each drug individually, 5% of patients failed to take the prescribed dose of diuretic whereas
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PMID:Side effects of hypotensive agents evaluated by a self-administered questionnaire. 472 58

During the study of an inbred strain of Wistar rats which spontaneously develop hypertension when they reach a weight of approximately 150 g, it was found that these animals also develop an erythrocytosis. A significant increase in red cell count was observed in spontaneously hypertensive (SH) rats (8-11 x 10(6) RBC/mm(3)) when compared with normotensive rats (6-7 x 10(6) RBC/mm(3)) of the same strain. This increase in red cell count paralleled the increase in body weight and the rise in blood pressure. Since the plasma volume, as measured with labeled albumin was normal, there was an absolute increase in red cells. The hematocrit and hemoglobin content of the blood measured in SH rats were only slightly greater than those found in normotensive rats. However, the mean cell volume (MCV) of the red cells in the SH rats was 45-47 mu(3) as compared with 51-53 mu(3) in normotensive rats.A fourfold increase in 24 hr (59)Fe incorporation into the red cells was found in the SH rats when compared with normotensive controls. The bone marrow of the SH rats showed erythroid hyperplasia. When the SH rats were treated with alpha-methyldopa (Aldomet 200 mg/kg daily, i.p.) the red cell count fell in parallel with the drop in blood pressure. No change in red cell count or blood pressure was observed in normotensive rats treated in the same manner. The erythropoietin titer was high in SH rats, and was undetectable in normotensive rats. These observations suggest a direct relationship between the hypertension and the erythrocytosis mediated by erythropoietin; both are genetically controlled.
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PMID:Erythrocytosis in spontaneously hypertensive rats. 501 Nov 7


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