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)

In order to compare the medium term antihypertensive effectiveness and tolerability of atenolol with those of bopindolol (LT 31-200), a new non-selective beta-blocker with slight PAA (partial agonist activity), a randomized double-blind study was performed. Thirty-one outpatients with mild-to-moderate essential hypertension (WHO stage I-II) were enrolled and after a placebo run-in randomly allocated to bopindolol (1 to 4 mg/day) or atenolol (50 to 200 mg/day). The dose was titrated according to the individual pressor responses, and thereafter it was kept constant until the end of the treatment (12 weeks). Both drugs induced statistically significant decreases in SBP, DBP and HR, both in resting conditions and during an ergometric test. Accordingly, most patients achieved the main goal of the therapy, i.e., supDBP less than or equal to 90 mmHg, 11/15 (74%) with bopindolol versus 8/13 (62%) with atenolol. There were no significant differences between the effects of the two compounds. Resting airway resistance (expressed as Peak Expiratory Flow) was not influenced by the treatments. The antihypertensive efficacy was still evident after 12 months in 8 patients who were evaluated for non-comparative long-term effectiveness of bopindolol monotherapy, and improvements in plasma lipid profiles were also observed. Side effects were relatively mild and transient, with two patients in the atenolol group discontinuing therapy (one for inefficacy and one because of undesirable reactions) and one dropped out in the bopindolol group (late evidence of not fulfilling inclusion criteria).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Double-blind comparison of once-daily bopindolol and atenolol for mild-to-moderate hypertension. 288 20

Beta blocker monotherapy is often considered to be inadequate in essential hypertension. It was the aim of this study to compare the antihypertensive activity of the new betablocker bisoprolol with the diuretic combination: hydrochlorothiazide plus amiloride. Forty hypertensive patients (DBP 95-120 mmHg) were enrolled in the study, of which 34 were evaluable for efficacy. The patients were, under double-blind conditions, randomly allocated to receive 10 mg bisoprolol (B) or 50 mg hydrochlorothiazide plus 5 mg amiloride (HA) as single daily doses for 30 days. Patients whose DBP had been normalized (less than or equal to 90 mmHg) after 30 days (D 30) continued the monotherapy for another 30 days. Patients whose DBP remained over 90 mmHg were, under single-blind conditions, kept on their initial treatment but received in addition the alternative drug for another 30 days (D 60). Blood pressure measurements were performed 24 hours after drug intake. The two groups comprising 17 patients each were comparable with regard to the patients' characteristics and baseline blood pressure values. After 30 days of treatment supine SBP, DBP and HR were significantly more reduced with B than with HA. The mean reduction of DBP was 16.8 +/- 8.0 mmHg with B and 8.4 +/- 6.4 mmHg with HA (P less than 0.002). After 30 days of monotherapy, blood pressure was within the normal range in 15/17 (88.2%) patients treated with B but in only 4/17 (23.5%) patients treated with HA (B vs HA: P less than 0.001). In the B group, there was a further slight decrease in SBP, DBP and HR during the second 30 day period.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bisoprolol versus hydrochlorothiazide plus amiloride in essential hypertension, a randomized double-blind study. 289 5

The antihypertensive effect of ketanserin 40 mg b.d. in combination with a beta-adrenergic blocking agent or a diuretic was assessed in an open study in 35 patients with essential hypertension, who had not responded to treatment with beta-blockers, diuretics or their combination. The ketanserin/beta-blocker combination decreased mean sitting systolic/diastolic blood pressure (SBP/DBP) from 169/107 mmHg to 156/91 mmHg at the end of the 12-week active treatment period. The decrease in systolic blood pressure was significant only at Week 8, while the decrease in diastolic blood pressure was highly significant at all times. A significant reduction in heart rate by 10 beats.min-1 was observed with the ketanserin + beta-blocker combination. The ketanserin/diuretic combination led to a significant reduction in mean SBP/DBP from 164/106 mmHg to 146/92 mmHg after 12 weeks, with no significant change in heart rate. Body weight slightly increased in both groups. There were significantly fewer adverse reactions with the ketanserin/diuretic combination than with the ketanserin/beta-blocker combination. The results indicate a potentially useful therapeutic role for ketanserin in combination with beta-blockers or diuretics.
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PMID:Ketanserin combined with a beta-blocker or diuretic in essential hypertension. A multicentre study. 290 74

Ketanserin (K), a selective and specific S2-receptor antagonist, has been compared with metoprolol (M), a cardioselective beta-blocker, in a double-blind study in order to assess its efficacy and safety in the treatment of essential hypertension. After a placebo run-in period of 4 weeks, hypertensive patients [supine diastolic blood pressure (DBP) greater than or equal to 100 mmHg] were treated with K, 40 mg twice daily (n = 18), or with M, 100 mg twice daily (n = 14). Systolic pressure (SBP) and DBP, both supine and standing, were significantly reduced from the first month of treatment by both drugs and remained stable for the whole study period (12 weeks). About two-thirds of the patients treated with K responded to the therapy (drop in DBP of at least 10%) and half were normalized (DBP less than or equal to 90 mmHg). In the M group, 50% of patients responded and 30% were normalized. A significant decrease in the heart rate was observed with M, but not with K. Ten patients treated with K were followed for 1 year. The antihypertensive effect of K was maintained throughout the study with evidence of tolerance. No serious adverse reaction was observed.
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PMID:Clinical experience with ketanserin in the treatment of hypertension. 293 19

The relationship of continuous ambulatory intra-arterial blood pressure over a 24-hour period and awake resting hemodynamic parameters measured by echocardiography was studied in 21 patients with essential hypertension (WHO stage I & II): Left ventricular wall thickness at end-diastole correlated strongly with average SBP and weakly with average DBP during both waking and sleeping periods. Variability of blood pressure taken during waking and sleeping periods was not significantly correlated with any hemodynamic parameters measured by echocardiography. Variability of SBP during sleep had a significant correlation with age; however the fall of blood pressure during sleep had no significant correlation with age. Fall of blood pressure during sleep was significantly correlated to resting awake TPR. In patients with essential hypertension, the above results demonstrate that subjects with thicker left ventricular wall have higher average continuous blood pressure over 24-hours and suggest that there is a tendency for greater falls in blood pressure during sleep to occur in subjects with higher TPR and that older subjects have greater variabilities of SBP during sleep.
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PMID:Variability of direct arterial blood pressure in essential hypertension--relationships between the fall of blood pressure during sleep and awake resting hemodynamic parameters. 294 40

Beta blockers are often considered to be less effective for blood pressure control in elderly patients with essential hypertension than calcium antagonists. We therefore compared the efficacy and tolerability of the new beta blocker bisoprolol with those of nifedipine. Fifty-nine patients over 60 years of age with essential hypertension (supine diastolic blood pressure, DBP: 95-115 mmHg) took part in a randomized double-blind study. After 14 days on placebo the patients received either 10 mg bisoprolol o.d. or 20 mg nifedipine SR b.i.d. for 4 weeks. The doses were doubled in patients whose DBP remained greater than 90 mmHg, for a further 4 week period. Blood pressure was measured about 24 hours after bisoprolol and about 12 hours after nifedipine administration. Fifty-six patients were available for efficacy analysis. After 4 weeks there was a distinct decrease of SBP and DBP in both groups (bisoprolol: -22 +/- 16; -15 +/- 9 mmHg; nifedipine: -24 +/- 17; -17 +/- 7 mmHg) with no significant difference between the treatments. DBP was normalized in 22/28 (79%) patients on bisoprolol and in 24/28 (86%) patients on nifedipine (bisoprolol vs nifedipine: NS). There were 7/29 bisoprolol and 14/30 nifedipine patients who experienced at least one side-effect. Overall the tolerability of bisoprolol was considered to be better than that of nifedipine (P = 0.043). In conclusion, bisoprolol 10-20 mg o.d. proved to be as equally effective as nifedipine SR 20-40 mg b.i.d. for the treatment of essential hypertension in the elderly.
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PMID:Comparison of bisoprolol with nifedipine for treatment of essential hypertension in the elderly: comparative double-blind trial. 296 87

We investigated the effect of the calcium antagonist nifedipine upon the following parameters: systolic and diastolic blood pressure (SBP and DBP) heart rate (HR), electrocardiogram (ECG) and the relative rate of calcium uptake in platelets. The possible correlation between this rate and blood pressure was one of the main points we tried to establish. The subjects studied were 1) 26 patients with uncomplicated essential hypertension and 2) 13 healthy normotensive subjects. SBP and DBP were measured with the subject both in a recumbent and a sitting position. 10 mg of nifedipine were given orally. In the hypertensive patients SBP and DBP decreased significantly in both positions after receiving the drug, as expected, while HR increased significantly (P less than 0.001), also in both positions. In the normotensive subjects BP decreased too, after taking the drug, but was only significantly modified in some instances i.e. SBP recumbent, DBP recumbent and sitting. HR increased significantly in the sitting position but not in the recumbent position. The ECG post-nifedipine showed a negative depression of the ST segment in four patients from the hypertensive group. The relative rate of calcium uptake in platelets measured before the subjects had taken the drug decreased after it was administered. The difference was significant (P less than 0.05) in the hypertensive group, but not in the normotensive group. Some correlation was found between DBP and the rate of calcium uptake.
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PMID:[Effects of a calcium antagonist (nifedipine) in hypertensive and normotensive subjects]. 296 12

The acute hemodynamic effects of intravenous Nicardipine (N), a new calcium antagonist, were studied in 8 patients with moderate essential hypertension. The forearm arterial blood flow (ABF) was measured using plethysmography before and after N infusion: 1st step was obtained after infusion of 1 mg during 5 min then 1 mg during 25 min; a second step was obtained after the infusion of the same dose during the same time; thus a cumulative dosage of 4 mg was infused over a total duration of 60 mn. Systolic (SBP), diastolic (DBP) mean (MBP) blood pressure and heart rate (HR) were measured every minute using a non invasive device (Dinamap). Systemic vascular resistances (SVR) were calculated. Plasma concentration of N was determined at the beginning, in the middle and at the end of each step. Results are as follows: (table; see text) A 33% decrease in SVR was observed at the 2nd step whereas MBP decreased by 15% only. The date confirm the potent vasodilatory effect of intravenous N at low dosage; the BP alteration was moderate in relation to an increase in local blood flow. These results indicate that Nicardipine could be useful as part of the treatment of chronic arteriopathy and Raynaud disease.
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PMID:[Acute hemodynamic study of intravenous nicardipine in arterial hypertension]. 311 83

In arterial hypertension, hyperviscosity with hemorheological disturbances and platelet dysfunction may play a role in the prognosis and complications of the disease. We studied the effects of Nicardipine (NIC) on these blood disturbances in a group of 21 untreated patients with essential hypertension, aged 25 to 70 years (SBP/DBP = 185 +/- 28/105 +/- 17 mmHg). During one hour before and 4 hours after the IV injection of single doses of 5, 7.5 or 10 mg NIC over 5 min, blood pressure was recorded automatically (Dinamap). Hemorheological variables and platelet function were studied before and 30 min, 3 h and 24 hours after the injection. NIC lowered blood pressure and increased heart rate significantly (At 5 min, SBP = -24 mmHg; DBP = -18 mmHg; HR = +22 b/min). These effects were dose-dependent with rapid onset and short duration (less than 2 hrs). NIC decreased plasma viscosity from 1.36 +/- 0.08 to 1.30 +/- 0.07 Cst; p less than 0.01, whole blood viscosity from 22.4 +/- 2.8 to 20.7 +/- 1.5 mPas; p less than 0.05 for gamma = 0.512 s-1, and erythrocyte filterability with the Ca++ ionophore A 23187 from 16.3 +/- 3.8 to 13.5 +/- 3.1; p less than 0.01. Platelet aggregation with ADP was unchanged, but aggregation with A 23187 decreased from 46.9 +/- 21.2 to 31.3 +/- 25.6; p less than 0.05, as well as plasma levels of beta-thromboglobulin (71.2 +/- 29.8 to 55.4 +/- 24.3 ng/ml; p less than 0.02) and platelet generated malonaldehyde (7.2 +/- 1.8 to 6.7 +/- 1.4 nM/10(9) platelets; NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of intravenous nicardipine on blood pressure, hemorheology platelet function in arterial hypertension. Dose-effect relations]. 311 84

A dose titration study was performed using felodipine, a new calcium antagonist, in Chinese patients with essential hypertension inadequately controlled by metoprolol alone (DBP greater than 95 mmHg). BP and pulse rate were recorded at rest and during treadmill exercise. Nineteen patients completed the six weeks' dose titration phase (2.5-5-10 mg twice daily) of whom 17 were followed for one year. A single 2.5 mg dose of felodipine produced a rapid and pronounced antihypertensive response with pre-exercise supine BP falling from a mean 168/104 to 146/92 mmHg) (P less than 0.001). The SBP during exercise was reduced from 206 to 185 mmHg (P less than 0.001). After 6 weeks treatment the supine BP had fallen to 132/85 mmHg (P less than 0.001) and the SBP during exercise to 169 mmHg (P less than 0.001). Six patients received 2.5 mg twice daily, eight patients 5 mg twice daily and three patients 10 mg twice daily. The effects, both at rest and during exercise, were maintained for at least 12 hours after dosing. The pulse rate was unaffected by felodipine therapy apart from a small transient increase following the first dose. Sixteen patients achieved the target DBP of 90 mmHg measured 12 hours after dosing and only one patient still had a DBP greater than 95 mmHg. After one year the mean supine BP had fallen slightly further to 128/82 mmHg. One patient was withdrawn due to palpitations. Felodipine was otherwise well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of combining felodipine and metoprolol in moderate to severe hypertension--a one year study. 323 15


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