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

Two hundred twenty-six patients with mild to moderate hypertension were treated with terazosin in an open, multicenter study to determine the drug's long-term efficacy and safety. All patients had previously received terazosin in a short-term study; 66 patients entered from later short-term studies and had experienced a 7 mm Hg decrease in supine diastolic blood pressure in response to terazosin. Terazosin was administered once or twice daily either alone or in combination with a diuretic and/or a beta blocker. Supine systolic and diastolic blood pressures were significantly decreased from baseline during time intervals ending at 90, 180, 360, and 720 days of long-term therapy. No clinically significant trends were observed in pulse rate, clinical laboratory test results, physical examinations, or electrocardiograms. Patients had a tendency toward a slight weight gain. The most common adverse experiences attributed to terazosin monotherapy were dizziness and asthenia (9.7 percent and 6.6 percent, respectively). Adverse experiences were usually of mild or moderate severity. Of the 226 patients who underwent long-term therapy, 29 (13 percent) withdrew because of adverse experiences, and three (1 percent) withdrew because of uncontrolled blood pressure. This study demonstrates that terazosin is effective and safe for long-term treatment of hypertension.
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PMID:Long-term experience with terazosin for treatment of mild to moderate hypertension. 287 10

The effect of terazosin administration on serum lipid profiles was assessed in four multicenter, randomized, controlled, double-blind studies in which patients were treated for mild to moderate hypertension. Three studies were placebo-controlled, fixed-dose studies in which the dose of terazosin was gradually increased to a fixed level of 5, 10, or 20 mg once daily, and remained fixed for four weeks. The remaining study was a placebo-controlled, dose-titration study designed to compare the antihypertensive effects of once-daily administration of terazosin with those of twice-daily administration of prazosin. In this study, the dosage of medication was titrated until a satisfactory decrease in supine diastolic blood pressure was obtained, or until the maximum daily dosage (20 mg) was reached. When data from the three fixed-dose studies were pooled, analysis of fasting blood samples revealed that mean serum cholesterol and the low-density lipoprotein plus very-low-density lipoprotein cholesterol fraction were significantly (p less than or equal to 0.05) decreased during terazosin monotherapy (-5.4 mg/dl and -6.1 mg/dl, respectively) in comparison with placebo (-0.2 mg/dl and -1.0 mg/dl, respectively). Terazosin therapy was also associated with a significant within-group increase in the cholesterol ratio. In the dose-titration, comparative study, both terazosin- and prazosin-treated patients experienced significant within-group increases in the cholesterol ratio (1.8 and 2.3, respectively). Although changes in lipid parameters in the dose-titration comparative study were not significantly different between the three treatment groups, all changes in the tetrazosin and prazosin groups were in a beneficial direction, and were greater in magnitude than those observed in the placebo group. Observations from the four studies suggest that terazosin may exert a positive effect on the lipid profile.
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PMID:Effect of terazosin on serum lipids. 287 13

Terazosin, a new selective long-acting alpha1-adrenergic blocking agent, has been shown to be an effective once-daily antihypertensive agent in four of five randomized double-blind placebo-controlled studies of patients with mild to moderate hypertension. In one trial, 24-h monitoring revealed that terazosin produced a sustained blood pressure lowering effect throughout the day. In three fixed-dose trials, steady patterns of blood pressure response during maintenance therapy indicated that tolerance to terazosin did not develop. Favourable changes in the plasma lipid profile were observed, while laboratory data suggested the development of haemodilution. Overall, terazosin was well tolerated. Asthenia, dizziness and peripheral oedema were significantly more common in patients treated with terazosin than with placebo.
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PMID:Terazosin: a new alpha 1-blocker for the treatment of hypertension: a review of randomized, controlled clinical trials of once-daily administration as monotherapy. 288 73

Terazosin is a new long-acting, selective alpha 1-adrenergic antagonist. Its pharmacokinetic and pharmacodynamic profiles are similar to those of prazosin, but terazosin has a half-life three to four times longer. This allows once daily dosing of terazosin and a potential advantage in ensuring patient compliance to treatment. Terazosin has been evaluated alone and in combination with other drugs for the treatment of mild to moderate hypertension. Terazosin has been shown to have favorable lipid and side effect profiles. Unlike prazosin, the drug is available (but not yet marketed) in parenteral form. Its gradual onset of action with intravenous use would limit its potential application in hypertensive emergencies. Other possible uses for terazosin might include treatment of congestive heart failure and Raynaud's phenomenon, but definitive studies are needed.
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PMID:Terazosin: a new long-acting alpha 1-adrenergic antagonist for hypertension. 289 88

The purpose of this study was to evaluate the effects of the alpha 1-blocking agent terazosin on blood pressure (BP) and blood lipids in a large, variant population of patients with hypertension. A total of 16,917 patients with hypertension were evaluated at 2214 primary and community care facilities; 7808 of these patients had not been treated previously for hypertension; 3928 were switched to terazosin from another antihypertensive agent; and 5181 received terazosin in addition to an agent that had not controlled their hypertension. Terazosin produced highly significant reductions in systolic (-18.2 +/- 0.2 mm Hg) and diastolic (-13.2 +/- 0.1 mm Hg) BP when used as monotherapy (mean dose, 3.1 mg; range, 2 to 10 mg) without causing a significant increase in heart rate. Equal antihypertensive efficacy was demonstrated in men, women, blacks, and whites of all ages, with particular benefit to elderly patients (> or = 65 years of age) with systolic hypertension. Comparative studies indicated that terazosin had equal antihypertensive efficacy in combination with diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. Patients who had not responded to monotherapy with one of these classes of antihypertensive drugs showed significant reductions of BP after terazosin, in the following average doses, was added to diuretics, 3.1 mg; beta-blockers, 3.4 mg; calcium channel blockers, 3.3 mg; and ACE inhibitors, 3.4 mg. Terazosin produced highly significant reductions in blood levels of total cholesterol (-5.0%), triglycerides (-6.1%), and low-density lipoprotein cholesterol (-7.6%) without change in high-density lipoprotein cholesterol when used as monotherapy. Similar favorable effects on blood lipid levels were demonstrated when terazosin was used in combination with all other classes of antihypertensive drugs. The greatest reductions in blood cholesterol (-9.2%) were observed among patients with hyperlipidemia (total cholesterol > or = 240 mg/dL). Terazosin maintained its antihypertensive efficacy and was well tolerated by patients with a variety of concomitant diseases, including congestive heart failure, peripheral vascular disease, chronic obstructive pulmonary disease, benign prostatic hyperplasia, diabetes, and obesity. Adverse effects occurred in 17.9% of patients and caused 2.2% to drop out of the study. The most frequent adverse effects were dizziness (4.8%), headache (2.5%), and asthenia (2.4%). Only 0.4% suffered syncope and 0.2% impotence. These data demonstrate the usefulness of terazosin as monotherapy or add-on therapy for treatment of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alpha 1-blockade for the treatment of hypertension: a megastudy of terazosin in 2214 clinical practice settings. 792 16

Emerging consensus indicates that the goal of antihypertensive therapy is not merely a reduction in the level of systemic arterial blood pressure; rather, it is prevention of target organ damage and reversal of complications. Among the clinical consequences of hypertension, left ventricular hypertrophy (LVH) is a prominent manifestation. Initially the left ventricle (LV) hypertrophies as an adaptive physiological response to an increase in afterload. However, persistence of LVH can cause a number of cardiac complications. Reversal of LVH is, therefore, likely to be of immense therapeutic benefit. A number of clinical and experimental observations have shown a close correlation between level of adrenergic activity and the development of LVH; adrenergic blockade has been shown to cause regression of LVH. Recent studies have demonstrated that post-synaptic alpha-blockers cause a reduction of LV mass. Terazosin, by virtue of its long duration of action, may attenuate the pathologic adrenergic pathways in the myocardium. These observations suggest the possible role of adrenergic mechanisms in the complex multifactorial pathogenesis of LVH and suggest the therapeutic impact of alpha-adrenergic blockade in promoting regression of LVH.
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PMID:Adrenergic mechanisms in left ventricular hypertrophy: significance and clinical implications. 810 6

To examine the contribution of the sympathetic nervous system to the development of hypertension, we injected spontaneously hypertensive rat (SHR) pups and normotensive Wistar-Kyoto rat (WKY) pups twice daily with saline (1.0 mL/kg SC) or terazosin (0.5 mg/kg SC), an alpha 1-adrenoceptor antagonist, from postnatal day 1 through 21. We determined the effectiveness and duration of action of this terazosin dose in pilot studies with adult SHR and WKY. Body weights of WKY pups were greater than body weights of SHR pups from postnatal day 1 through 21. In addition, body weights of terazosin-treated pups of both strains were comparable to body weights of saline-injected littermate controls. Indirectly measured systolic pressures of terazosin-treated SHR were reduced significantly at 60 and 90 days of age but not at 30 days of age compared with saline-injected littermate controls. Terazosin did not affect systolic pressures of WKY, measured at 30, 60, and 90 days of age. At 100 days of age, in chronically catheterized rats, mean arterial pressures of terazosin-treated SHR were reduced significantly compared with those of saline-injected littermate controls. In contrast, terazosin did not affect mean arterial pressures of WKY at 100 days of age. Finally, preweanling treatment with terazosin did not alter patterns of open field behavior of adult SHR or WKY. SHR were significantly more active and reared more frequently compared with WKY. These findings indicate that the time between birth and weaning at 21 days of age is critical for the full expression of the hypertensive phenotype in SHR. Chronic blockage of alpha 1-adrenoceptors during the preweanling period in SHR may reduce vascular hypertrophy, leading to long-term reductions in arterial pressure.
Hypertension 1996 May
PMID:Preweanling administration of terazosin decreases blood pressure of hypertensive rats in adulthood. 862 Dec 5

Terazosin is a selective alpha1-adrenoceptor antagonist. A double-blind, randomized, placebo-controlled, two-period study evaluated the effects of posture and of oral and intravenous administration of terazosin on blood pressure and heart rate in patients with hypertension. At least one week after withdrawal of all antihypertensive medications, 31 patients with sitting diastolic blood pressure of 95 to 114 mmHg were enrolled in the study. After a 24-hour, single-blind, placebo lead-in phase, the patients were randomized to receive either oral terazosin (1 mg on day 1, 2 mg on day 2, and 5 mg on days 3 and 4), a 12-hour intravenous infusion of terazosin (2.5 mg, 5 mg, or 7.5 mg), or placebo for 4 consecutive days. Head-up tilt (60 degrees for 20 minutes) evaluations were performed before and 0.5, 1.5, 2.5, 6, 12, and 16 hours after start of administration during the placebo lead-in phase and on each of the 4 days of the double-blind treatment phase. Blood pressure and heart rate were monitored every 2 minutes during the 20-minute tilt. Statistically significantly larger mean changes in blood pressure and heart rate were observed with the 7.5-mg intravenous dose of terazosin compared with those after oral terazosin or placebo. With respect to intravenous terazosin, the orthostatic changes were maximal on the first day of the 4-day treatment and increased with increasing doses of terazosin. Maximum orthostatic changes in blood pressure after oral administration of terazosin were not significantly different from those observed with placebo. The most common treatment-emergent adverse events during tilt were dizziness and nausea. Dizziness occurred more frequently with intravenous terazosin than with oral terazosin. The results of this study indicate that oral dose titration of terazosin rather than a slower rate of terazosin infusion minimized the postural effects on blood pressure and associated symptoms during head-up tilt.
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PMID:Effects of oral and intravenous terazosin and head-up tilt on blood pressure responses in patients with hypertension. 965 May 45

Terazosin (TE) and tamsulosin (TA) were allocated randomly to 38 patients who had urinary disturbance accompanying prostatic hypertrophy, and the efficacy and safety of the drugs were examined. Subjective symptoms due to I-PSS were improved significantly in both TE and TA groups. On the other hand, objective symptoms such as the maximum urinary flow and mean urinary flow were improved more in the TE group. TE showed hypotensive and cholesterol-decreasing effects in patients who also had hypertension and hyperlipemia. No unknown adverse reactions were observed in either groups, and the drugs were shown to be highly safe. TE was considered to be useful as the first choice drug for the patients with hypertension and or hyperlipemia and those with severe objective symptoms. TA was considered to be useful for the patients with impaired drug compliance or those with severe subjective symptoms though objective symptoms were not so severe.
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PMID:[The efficacy and safety of terazosin and tamsulosin in patients with urinary disturbance accompanying prostatic hypertrophy]. 1123 15

Norepinephrine receptors have been studied in emotion, memory, and attention. However, the role of alpha1-adrenergic receptors in fear conditioning, a major model of emotional learning, is poorly understood. We examined the effect of terazosin, an alpha1-adrenergic receptor antagonist, on cued fear conditioning. Systemic or intra-lateral amygdala terazosin delivered before conditioning enhanced short- and long-term memory. Terazosin delivered after conditioning did not affect consolidation. In vitro, terazosin impaired lateral amygdala inhibitory postsynaptic currents leading to facilitation of excitatory postsynaptic currents and long-term potentiation. Since alpha1 blockers are prescribed for hypertension and post-traumatic stress disorder, these results may have important clinical implications.
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PMID:Antagonism of lateral amygdala alpha1-adrenergic receptors facilitates fear conditioning and long-term potentiation. 2087 Jul 45


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