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

The antihypertensive effect and side-effects during 12 months' treatment with bendroflumethiazide and propranolol have been compared in two randomly selected, equally large groups (n= 53) of previously untreated male hypertensives. Systolic BP above 170 or diastolic BP above 105 mmHg on two occasions were defined as hypertension. The same BP reduction was achieved in both groups. During the 12 months' treatment one subject on bendroflumethiazide developed diabetes mellitus and one on propranolol developed cardiac decompensation. None developed gout. Contrary to what had been presumed, glucose tolerance improved during 12 months' treatment with both agents, while there were no changes in fasting blood sugar, insulin or triglyceride concentrations. No changes were found in serum potassium or total body potassium during 12 months' bendroflumethiazide treatment, while serum potassium increased during treatment with propranolol. Uric acid increased slightly during treatment with both agents. Prolongation of the follow-up to 24 months did not change any of the findings regarding metabolic changes during treatment. The frequency of subjective side-effects decreased to the same extent during treatment with both drugs. It is concluded that bendroflumethiazide and propranolol are equally useful as antihypertensive agents and that the risk of impariment of glucose metabolism and potassium balance seems to be very slight during treatment with bendroflumethiazide in mild hypertension.
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PMID:Antihypertensive effect and side-effects of bendroflumethiazide and propranolol. 93 76

From 1970 to 1974 in the dermatological clinic of Leipig University in 17 women and 3 men a necrobiosis lipoidica was established. Of these patients hitherto 12 female patients with histologally ascertained diagnosis underwent a clinico-angiological follow-up examination. Apart from this metabolic disturbances were thought for. In two thirds a disturbance of the carbohypdrate metabolism, in three fourths a disturbance of the lipometabolism was found; hyperlipoproteidaemia and diabetic change of the metabolism were simultaneously present in 7 out of 12 female patients. Uric acid level of the serum and rheumatic serology were, however, rarely pathological. A disturbance of the arterial blood supply of the legs could be ascertained in three fourths of the women who underwent a control examination. In these cases 15 to 19 extremities affected with necrobiosis had a disturbance of the blood supply. The microangiopathy histologically provable in foci of necrobiosis was to be seen only in one long-term diabetic also on the eye-ground. One third of the female patients suffered from hypertension. In all cases disturbances of the carbohydrate metabolism or of the lipometabolism and/or of the local blood supply could be proved. On the basis of these findings adequate examinations are recommendable in patients with necrobiosis lipoidical with regard to therapeutic consequences.
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PMID:[Studies on the relationship between diabetes mellitus and necrobiosis lipoidica]. 119 49

The fixed combination of lisinopril 20 mg and hydrochlorothiazide 12.5 mg (L/HCTZ) was compared with each of the monocomponents in a multicentre, double-blind, randomized, parallel-group study involving elderly patients with mild to severe hypertension. At the end of the trial, a total of 278 patients had completed 8 weeks of treatment. SBP reduction from baseline in the L/HCTZ group was significantly greater, sitting and standing, compared with both the monotherapy groups. Sitting DBP reduction from baseline in the L/HCTZ group was significantly greater than in the hydrochlorothiazide group. Uric acid levels were raised significantly more in the L/HCTZ group compared with the lisinopril group, and the fall in potassium levels were significantly smaller in the L/HCTZ group compared with the hydrochlorothiazide group. Safety and tolerability were equivalent for the three groups.
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PMID:Lisinopril-hydrochlorothiazide combination compared with the monocomponents in elderly hypertensive patients. 166 84

Nifedipine, in the gastrointestinal therapeutic system (GITS) formulation, a controlled-release formulation for once-a-day administration, was evaluated in the Modern Approach to the Treatment of Hypertension (MATH) trial. In this study conducted at 127 centers, 1155 patients with mild-to-moderate hypertension representative of the spectrum seen in practice were included in the analyses of effectiveness. After a 2 week placebo period, nifedipine GITS therapy was started at 30 mg/day and was titrated to a maximum dose of 180 mg/day over 6 weeks. Response criteria were a sitting diastolic blood pressure less than 90 mm Hg and a decrease of greater than or equal to 10 mm Hg. After titration, patients were observed for 12 weeks during treatment. At the final visit, nifedipine GITS significantly (P less than .0001) reduced sitting systolic blood pressure 17 +/- 14 mm Hg (mean +/- SD), and sitting diastolic blood pressure 14 +/- 8 mm Hg. Similar highly significant reductions in standing blood pressure were observed. For all subjects, 76% achieved goal blood pressure response during titration. More than 50% were controlled on doses of 30 to 60 mg/day. At the final visit blood pressure reductions in men and women were similar, except for a significantly greater decrease in sitting systolic pressure for women. A similar proportion of blacks responded compared with whites, and reductions in sitting systolic and diastolic blood pressure were also similar in the 2 groups. Nifedipine GITS had no effect on renal function, serum potassium, or total, HDL, or LDL cholesterol. Uric acid was reduced by 0.5 mg/dL (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nifedipine gastrointestinal therapeutic system in the treatment of hypertension. Results of a multicenter trial. The Modern Approach to the Treatment of Hypertension (MATH) Study Group. 207 18

Exploratory analyses were conducted in a nested case-control study of 1,031 incident cases of essential hypertension and 1,031 persistently normotensive controls from the Kaiser Permanente Multiphasic Health Checkup cohort in Northern California. Previous analyses have confirmed hypotheses that baseline weight, subsequent weight gain, alcohol consumption, parental history of hypertension, excessive use of salt, and centralized body fat distribution are predictive of developing hypertension. In the present study, pulmonary function tests, several serum chemistries, and heart rate were strongly predictive in univariate analyses. Adjusting for the risk factors mentioned above, forced vital capacity (p less than 0.001), serum uric acid (p = 0.003), serum cholesterol (p = 0.012), and heart rate (p = 0.014) remained independently predictive. Further adjustment for baseline blood pressure completely explained the association of heart rate with hypertension, and reduced the association with serum cholesterol to borderline significance. Forced vital capacity remained a strong, inverse predictor (odds ratio, fifth vs. first quintile = 0.22, 95% confidence interval (Cl) 0.11-0.46). Uric acid remained positively related to risk (odds ratio, fifth vs. first quintile = 2.19, 95% Cl 1.20-3.98). Although neither association is presently understood, both forced vital capacity and serum uric acid are closely linked to development of hypertension and may be markers of susceptibility or intermediate steps in pathways leading to hypertension.
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PMID:Precursors of essential hypertension: pulmonary function, heart rate, uric acid, serum cholesterol, and other serum chemistries. 201 30

The acute effects of buccal nifedipine 20 mg on blood pressure, renal haemodynamics and electrolyte excretion were compared in 16 untreated patients (HT) with uncomplicated arterial hypertension (WHO I-II), 11 normotensives (NT) and 6 normotensives given a placebo. Nifedipine caused a significant fall in the systolic and diastolic blood pressures (BP) of 25.7 +/- 12/26.5 +/- 10 mmHg in the hypertensives, and a minor but significant fall in diastolic BP in the normotensives. Renal vascular resistance fell significantly and renal plasma flow was increased non-significantly in the hypertensives. No changes in these parameters were seen in NT. Glomerular filtration rate remained constant in all groups, also in HT despite the marked haemodynamic changes. Natriuresis was significantly increased to the same degree in the HT and NT groups, in spite of their different haemodynamic responses. Uric acid excretion showed a parallel acute increase in both groups. The significant and close relationship between the acute changes in the excretion of sodium and uric acid provides evidence for a proximal tubular natriuretic effect of nifedipine.
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PMID:Acute natriuretic effect of nifedipine in hypertensive patients and normotensive controls--a proximal tubular effect? 355 92

The relationships between serum uric acid, serum glucose and diabetes have been examined in a survey of 7735 middle-aged men drawn at random from general practices in 24 British towns. There was a positive relationship between serum glucose and serum uric acid concentrations up to about 8.0 mmol/l; at higher levels of glucose, serum uric acid decreased. Uric acid levels were significantly reduced in insulin-dependent diabetics and in those on oral hypoglycaemics and also in 'non-diabetics' with casual glucose levels greater than 10 mmol/l. Both uric acid and glucose concentrations were positively related to body mass index; only uric acid was positively related to alcohol intake. Men on antihypertensive treatment had raised levels of uric acid (significant) and glucose (non-significant). The positive relationship between serum uric acid and serum glucose could not be explained by associations with body mass index, alcohol intake, age, social class, gout or treatment for hypertension. It probably reflects the biochemical interaction between serum glucose and purine metabolism, with increased excretion of uric acid during hyperglycaemia and glycosuria.
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PMID:Serum uric acid, serum glucose and diabetes: relationships in a population study. 362 42

The antihypertensive effect and patient tolerability during 12 weeks' treatment with atenolol and bendroflumethiazide were evaluated in an open, randomized, between-patient trial. Out of a total of 162 patients, aged 50-75 years, with previously untreated hypertension, 151 completed the trial. They were randomly allocated to two groups. Forty-nine patients, aged 50-64 years (middle-aged), and 23, aged 65-75 years (elderly), were treated with atenolol. Forty middle-aged and 39 elderly were treated with bendroflumethiazide. Significant reductions in blood pressure (BP) were observed during treatment with each drug (p less than 0.001). The change in diastolic BP in middle-aged patients was significant in favour of atenolol (p less than 0.01), but otherwise no difference was found between the two drugs. Uric acid increased during treatment with both drugs (p less than 0.001). Serum potassium decreased during bendroflumethiazide treatment (p less than 0.001). Subjective side-effects of both drugs were few and expected. The results of this study indicate that atenolol and bendroflumethiazide are equally effective in reducing BP in patients aged 50-75 years.
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PMID:Atenolol versus bendroflumethiazide in middle-aged and elderly hypertensives. 390 35

The effects of propranolol and prazosin on plasma lipoproteins in patients with essential hypertension were evaluated according to a crossover protocol of two 8-week periods with a washout of 4 to 6 weeks. Eleven patients with moderate hypertension (greater than 90 but less than or equal to 144 mm Hg, diastolic) and slightly overweight (+10% to +/- +30%, according to Metropolitan Life Insurance tables) were selected. No dietary changes were prescribed. Plasma cholesterol, triglycerides (TG), and lipoprotein changes were monitored at the beginning of each sequence and at 2-, 4- and 8-week intervals. Prazosin, when given first, did not essentially modify any of the metabolic parameters, except for a slight elevation in plasma apoprotein AI levels, i.e., the main protein component of high density lipoprotein (HDL); propranolol caused a significant rise in total TG and very low density lipoprotein TG (VLDL-TG) levels (+37.3% and +23.9%, respectively). Somewhat lower total TG (+19.6%) and vLDL (17.8%) TG elevations were noted when propranolol was given first; plasma glucose was also significantly raised (+12.8%). Triglyceride and glucose levels returned to normal upon changing to prazosin. Total plasma- and lipoprotein-associated cholesterol levels were essentially unchanged with either drug; similarly, no significant changes were detected in total plasma apoprotein B (the main protein component of LDL and also VLDL), a component of apoprotein AI levels. Uric acid levels were slightly raised on propranolol. There was an 8.8% reduction in uric acid levels when the medication changed from propranolol to prazosin.
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PMID:Plasma lipid and lipoprotein changes in hypertensive patients treated with propranolol and prazosin. 617 63

Several previous studies have demonstrated an increased prevalence of gout in New Zealand Maoris. The aetiology of the hyperuricaemia and its effect on morbidity, apart from gout, are unknown. A survey of 115 Maori men of working age revealed a history of gout in 10 (8%) and asymptomatic hyperuricaemia in 26 (23%). The relationship of hyperuricaemia with obesity was confirmed. Alcohol did not make an obvious contribution to the prevalence of hyperuricaemia. Hypertension was more common and creatinine clearance lower amongst those with gout, but not significantly so. The frequency of hypertension and mean creatinine clearance were similar to that seen in asymptomatic hyperuricaemia and normouricaemia. Urate clearance was lower in the gouty and hyperuricaemic subjects. The normouricaemic Maoris had a reduced fractional urate clearance compared with normal men elsewhere. They also excreted a relatively small proportion of hydrogen as ammonium. Both these features are characteristic of gout, and suggest that the Maoris' susceptibility to hyperuricaemia has a renal mechanism. Obesity is common amongst the Maoris and accentuates their natural tendency to hyperuricaemia.
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PMID:Hyperuricaemia, gout and kidney function in New Zealand Maori men. 648 33


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