Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Measurements of cerebrospinal fluid (CSF) catecholamines (CA) were made in an attempt to estimate the activity of central CA neurons in essential hypertension (EHT). CSF norepinephrine (NE), epinephrine (EPI), and dopamine (DA) levels were measured in 12 normotensive (age 36 +/- 3 years; SBP = 116 +/- 4 and DBP = 79 +/- 4 mm Hg) and in 12 EHT (age 41 +/- 2 years; CSF NE levels were twofold higher in EHT (240 +/- 23 pg/ml) than in normotensive subjects (127 +/- 28 pg/ml). Very low EPI and DA levels were observed in both groups of patients. The results suggest that central (spinal?) noradrenergic activity is increased in patients with EHT. In a second study we evaluated the effects of clonidine treatment for 2 weeks (150 micrograms t.i.d.) on CSF NE in EHT. Clonidine reduced pretreatment BP and CSF NE levels by 27% (p less than 0.05) and 39% (p less than 0.01), respectively. The results of the study indicate that central noradrenergic activity is reduced during clonidine treatment. A third group of experiments was designed to compare the effects of clonidine with those of propranolol treatment in patients with EHT. CSF NE measurements were made after 1 month of treatment with 0.36 +/- 0.07 mg of clonidine daily or 160 mg of propranolol daily. CSF NE levels were significantly lower in the clonidine group (p less than 0.01). Seventy-two hours after abrupt discontinuation of clonidine or propranolol treatment, BP returned to pretreatment levels. However, CSF NE showed a threefold increase after clonidine withdrawal, and no change after propranolol withdrawal. CSF EPI was not affected by either treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cerebrospinal fluid norepinephrine levels in essential hypertension: effects of drug treatment and withdrawal. 245 80

The aim of our study was to evaluate the antihypertensive effectiveness of verapamil slow-release (SR), administered once a day. We studied 11 patients, 7 male and 4 female, with an average age of 53.6 +/- 12.86 years, who had essential hypertension. After a drug washout period of at least 15 days, placebo was administered (one tablet per day), and then patients received verapamil SR 240 mg/day at 8:00 a.m. for at least 2 weeks. At the end of the washout, placebo, and active drug treatment periods we performed ambulatory intermittent blood pressure monitoring for 24 h using a Squibb Spacelabs pressurometer. After verapamil treatment, in comparison to placebo, a significant reduction of systolic (SBP) and diastolic blood pressure (DBP) (154.91 +/- 13.34/94.29 +/- 9.48 vs. 143.73 +/- 11.39/84.6 +/- 7.99 mm Hg; p less than 0.005), was observed without significant changes of the circadian blood pressure pattern. Moreover, we observed a significant reduction of SBP and DBP variability mainly during daytime, whereas this behavior was not evident for heart rate. In conclusion, verapamil SR seems useful to obtain a constant and significant reduction of 24-h blood pressure values with a significant reduction of SBP and DBP variability.
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PMID:Noninvasive blood pressure monitoring evaluation of verapamil slow-release 240-mg antihypertensive effectiveness. 247 83

This randomized, double blind study compared the antihypertensive effects of enalapril to hydrochlorothiazide (HCTZ) in the elderly. One hundred seventy-four patients with diastolic blood pressures (DBP) of 90-120 mm Hg or isolated systolic hypertension (ISH) (systolic BP greater than 160 mm Hg and diastolic BP less than 90 mm Hg) were studied. After four weeks of placebo, patients received either enalapril 10 mg or HCTZ 12.5 mg once daily. If the BP was uncontrolled (DBP greater than 85 mm Hg or SBP greater than 140 mm Hg) after 4 weeks, the dose was doubled. At 8 weeks, if necessary, the other drug could be added at the lower dose, then doubled 4 weeks later. Two-thirds of the patients had essential hypertension (EH), the rest ISH; 68% were male and 80% Caucasian. The baseline BPs were 167/94 mm Hg in both groups, at 8 weeks the mean BPs were 148/85 mm Hg in both groups (p less than or equal to 0.01), and at the end of the study the BPs with enalapril were 144/83 mm Hg and with HCTZ they were 145/83 mm Hg (p less than or equal to 0.01). The Caucasians showed greater BP falls on enalapril than HCTZ after 4 weeks (p less than or equal to 0.05). The SBP falls for the ISH (-22 mm Hg) and EH (-23 mm Hg) groups were similar at the end of the study. Both drugs were generally well tolerated. Laboratory adverse experiences (AEs) were 9% more common in the HCTZ patients (n.s.). Enalapril and HCTZ both seem to be effective antihypertensive agents in the elderly.
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PMID:Enalapril and hydrochlorothiazide as antihypertensive agents in the elderly. 248 56

51 patients with mild essential hypertension (EH) were randomly divided into two groups; the first group (31 patients) was treated with 1 g. of oral calcium during a period of 8 weeks; the second group received a placebo. The treated with calcium showed a significant decrease in blood pressure (BP), the maximal reduction being of 6 mm Hg in the systolic pressure (SBP) and 3 mm in the diastolic (DBP) at the end of the 8th week. We found a substantial positive relationship between the decrease in SBP and seric renin activity (p less than 0.05), as well as a significant negative relationship (p less than 0.05) between DBP and the seric level of parathyroid hormone (PTH). During the administration of the oral calcium supplement, the BP decreased in an inverse proportion to the plasmatic renin and seric level of PTH.
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PMID:[Effect of an oral calcium supplement in the treatment of slight-to- moderate essential arterial hypertension]. 249 21

The effectiveness and safety of cicletanine hydrochloride, the first representative of the furopyridine family, were evaluated in a 90-day double-blind study involving 120 patients with moderate essential hypertension poorly controlled after at least one month of treatment with a beta-blocker. After a 30-day pre-inclusion period during which a placebo capsule was given together with a stable dose of the beta-blocker, the patients were randomised to one of three therapeutic groups: group 1 (placebo, n = 40), group 2 (cicletanine 50 mg/day, n = 41), group 3 (cicletanine 100 mg/day, n = 39). All three groups were matched in every respect. Eight patients in group I were excluded (5 for ineffectiveness, 2 for unexpected effect, 1 for intercurrent disease) as was 1 patient in group 3 for unexpected effect. On entering the active phase of treatment, supine blood pressures were 171.3 +/- 13.6/103.9 +/- 6.1 mmHg in group 1, 173.5 +/- 12.7/103.6 +/- 5.2 mmHg in group 2 and 171.8 +/- 15.4/104.5 +/- 5.9 mmHg in group 3. A significant (p less than 0.0001) treatment effect on SBP was found in groups 2 and 3 and on DBP in all three groups. The improvement observed in both SBP and DBP was similar in groups 2 and 3 and highly significant when compared with group 1 (p 0.001). At the end of the trial, 5% of group 1 patients, 51.2% of group 2 patients and 74.4% of group 3 patients had normal blood pressure values. The drug was well tolerated clinically and biochemically.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the effectiveness and tolerance of cicletanine in patients with essential hypertension treated with beta-blockers]. 257 69

The magnitude and duration of the antihypertensive effect of slow-release nicardipine (SR-Nicardipine) have been compared with placebo in 36 uncomplicated essential hypertensives (diastolic BP 95 to 115 mm Hg after 1-month placebo washout). According to a double-blind, randomized, cross-over design they received SR-Nicardipine 40 mg b.d. and placebo for 1 month. At the end of each treatment period, blood pressure and heart rate were measured 12 h after the evening dose and 1, 2, 3 and 4 h after the morning dose. SR-Nicardipine significantly reduced systolic (SBP) and diastolic (DBP) blood pressure at each time after dosing. The absolute decrements peaked 4 h after dosing (-18.3 and -11.7 mm Hg, respectively) and more than 90% of the peak effect persisted 12 h after dosing, both for SBP and DBP. The heart rate was slightly increased by SR-Ni-cardipine. Adverse effects monitored with a check-list occurred in 31% of patients during SR-Nicardipine treatment and in 28% on placebo. Thus, SR-Nicardipine 40 mg b.d. has a maintained and significant antihypertensive effect lasting up to 12 h in essential hypertension.
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PMID:Antihypertensive effect of slow-release nicardipine. A placebo-controlled cross-over study. 266 39

The long-term antihypertensive efficacy of a combination of ketanserin (20 mg), an S2 antagonist with alpha 1 blocking activity, and chlorthalidone (25 mg), given o.d., was evaluated in fifteen patients with primary hypertension of mild to moderate degree, aged 45-65 years, up to a 12-month observation period. Systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were measured by an automatic recorder (Sentron Bard Biomedical) twice at rest after 5 min in a supine position and after 2 and 5 min in an upright position, 24 h after the last antihypertensive dose. Thirteen patients completed the study whilst two were lost to the follow-up. A significant reduction was observed in both SBP and DBP at rest. In particular, SBP was reduced from 167 +/- 17 mmHg to 152 +/- 21 mmHg (p less than 0.01) after 1 month of therapy and was kept constant at this level throughout the observation period. DBP was also reduced from the first control [99 +/- 7 vs. 90 +/- 9 mmHg (p less than 0.01)] without any increase during the follow-up. HR was unchanged throughout the study. Four patients had dizziness and orthostatic hypotension after the first dose of the drug combination but were able to continue the study without further adverse reactions. These data support the conclusion that long-term treatment with the combination of a small dose of ketanserin and chlorthalidone is able to reduce systolic and diastolic blood pressure, without remarkable untoward side-effects.
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PMID:Long-term antihypertensive efficacy of ketanserin plus chlorthalidone. 270 Mar 22

Differences in cardiovascular responses to mental stress, psychological factors, and self-determined home blood pressure between black individuals with and without a family history of essential hypertension (EH) may suggest mechanisms responsible for the high incidence of EH in blacks. In this study, 12 black male students with a parental history of EH and 12 without a parental history of EH participated in a laboratory session during which two mental challenge tasks (anagrams and mental arithmetic) were presented. Following the laboratory session all subjects made daily recordings of their morning and evening blood pressure for four weeks (28 days) after the laboratory session. The results showed that sons of hypertensive parents had higher systolic (SBP) and diastolic (DBP) than sons of normotensive parents at rest and during mental challenge; no reliable differences in heart rate were observed. Sons of hypertensive parents had higher self-determined home blood pressure (SBP and DBP) and scored significantly higher on psychological measures of Trait-Anger/Temperament, Anger-Out, and Submissiveness. Apparently there was no significant change in SBP or DBP over the four weeks prior to final examinations in either of the groups. Although the resting blood pressure level, weight, and family history predicted a large proportion of the variance in home SBP and DBP, the amount of explained variance, particularly for DBP, was significantly increased by the inclusion of psychological variables and the level of cardiovascular responses (and not the delta change) to mental challenge in the regression equation. These findings indicate that the degree to which self-determined home blood pressures can be predicted is enhanced significantly by considering both the level of cardiovascular responses to stress and psychological measures of the experience and expression of anger. The implications of these results are discussed in light of current research demonstrating that average home blood pressures are a better predictor of cardiac complications than casual (office) blood pressures.
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PMID:Cardiovascular reactivity, emotional factors, and home blood pressures in black males with and without a parental history of hypertension. 277 4

In a double blind cross-over drug trial, antihypertensive effects (resting and after dynamic exercise) of atenolol and of labetalol were studied in 20 patients of mild to moderate essential hypertension. Both drugs exhibited almost equal antihypertensive response, and were well tolerated. Haemodynamic variables (HR, SBP, DBP and RPP), both at rest and after maximal tread mill exercise, were significantly altered (P less than 0.001) by both drugs. Exercise capacity was observed to be marginally improved by atenolol. Although the antihypertensive effect, when compared between the two drugs, was not statistically significant, individual suitability or comparison revealed a preference for atenolol in 17 patients and for labetalol in 3 patients.
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PMID:Comparative efficacy of atenolol and labetalol in essential hypertension--a double blind cross over trial. 280 62

Cardiac performance, as judged by preload, afterload, and myocardial contractility, was evaluated by non-invasive M-mode echocardiography before and after acute oral administration of calcium entry blockers (nitrendipine and verapamil), angiotensin converting enzyme (ACE) inhibitors (captopril and lisinopril), and a dopamine receptor agonist (fenoldopam) in patients with mild to moderate essential hypertension. Left ventricular end diastolic volume was taken as an index of preload, end systolic stress as an index of afterload, and the ratio of systolic pressure to end systolic volume (SBP:ESV), ejection fraction (EF), and mean velocity of circumferential fibre shortening (Vcf) as indices of contractility. Reductions of afterload and mean arterial pressure were achieved with all antihypertensive agents involved (mean percentage change +/- s.e.m.: 15 +/- 2% and 10 +/- 1%, respectively, P < 0.05) but the afterload reduction with lisinopril was greatest (21 +/- 9%; P < 0.01). The dopamine receptor agonist fenoldopam decreased by preload 24% (P < 0.05) and increased all of the three parameters of myocardial contractility (SBP:SV 66%; EF 17%, Vcf 19%; P < 0.01). In contrast, no effect on these parameters was observed with either calcium entry blocker or either ACE inhibitor.
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PMID:Disparate cardiac effects of afterload reduction in hypertension. 285 42


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