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)

The various aspects of the sexual life of 100 female patients aged 40-60 with acute myocardial infarction were compared with those of a control group of 100 female patients of the same age, hospitalized for other diseases. Sexual frigidity and dissatisfaction were found among 65% of the coronary patients as compared with 24% of the controls. The commonest cause for sexual dissatisfaction was premature ejaculation or impotence in the husband. The incidence of premarital sexual relations was greater among the frigid patients when compared with those who achieved orgasm. The coronary patients had an earlier menopausal age than the controls. The number of coronary patients who underwent artificial abortions in the past was lower than in the control group. All these findings were statistically significant at a level of P less than 0.05. No connection was found between extramarital relations and sexual frigidity. There was no relation found between sexual frigidity and diabetes, essential hypertension, marital status, pathological gynecological findings, or localization of the infarction. Until now, sexual frigidity and dissatisfaction appear to have been a neglected aspect in the female coronary patient.
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PMID:Sexual life and sexual frigidity among women developing acute myocardial infarction. 100 33

The efficacy and safety of enalapril and hydrochlorothiazide was investigated in a multicenter study of 81 patients with mild to moderate essential hypertension. The subjects were randomly assigned to one of three groups and, following a placebo period, given enalapril maleate (20 mg), hydrochlorothiazide (12.5 mg), or a combination of the two drugs (32.5 mg). A significant decrease in blood pressure was observed after only 2 weeks in the enalapril and enalapril-hydrochlorothiazide groups. A double dose was required to achieve a satisfactory response in one-third of the patients in both the enalapril (9 of 27) and the enalapril-hydrochlorothiazide groups (8 of 27). Adverse reactions included cough in one patient and mild hyperkalemia in another, both of whom received enalapril. Two patients on the drug combination developed side effects--symptomatic orthostatic hypotension in one and impotence in the second. Enalapril alone and in combination with hydrochlorothiazide appears to be effective and well tolerated.
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PMID:Treatment of hypertension by enalapril and hydrochlorothiazide separately and together: a multicenter study. 231 14

We have treated 128 patients aged 40 +/- 9 years (60 males and 68 females), all with essential hypertension (W.H.O. I and II), over a period of 10 yr. The treatment was performed with clonidine at a dose that ranged from 0.150 to 1,200 mg (twice daily). Forty-two patients also received a diuretic (HCTZ 25 mg daily). Mean blood pressure decreased significantly from 169 +/- 10 mm Hg systolic, 107 +/- 3 diastolic to 145 +/- 6 mm Hg (p less than 0.001) 90 +/- 3 mm Hg diastolic (p less than 0.001). Side effects occurred during the first month. These were drowsiness 28%, dry mouth 35%, constipation 13%, dizziness 9%, postural hypotension 2%, and male impotence 3.3% (2/60). Side effects still present after 120 months of treatment were drowsiness 11.7%, dry mouth 26.6%, constipation 14.1%, dizziness 4.7%, and male impotence 1.7% (1/59). The number of patients who discontinued treatment resulting from side effects were 3.34%, all of them within the first 6 months. There were no changes in renal or liver function or in serum electrolytes or lipids. Retinopathy improved in most patients. Electrocardiogram (ECG) improved in 45 patients with LVH. It is concluded that clonidine provided sustained blood pressure control with minimum side effects during 10-year therapy for hypertension.
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PMID:Safety aspects of long-term antihypertensive therapy (10 years) with clonidine. 245 59

Selective alpha 1 adrenergic receptor blocking agents lower blood pressure by reducing the increased peripheral vascular resistance that characterizes essential hypertension. Prazosin and terazosin have been shown to be well tolerated in clinical practice and seldom cause impotence or metabolic abnormalities. The most common adverse effects--dizziness, headache, and asthenia--are generally well tolerated and infrequently lead to discontinuation of therapy. First-dose syncope can usually be avoided by initiating therapy with low doses administered at bedtime. Finally, the alpha 1 receptor antagonists do not adversely affect such cardiovascular risk factors as hypokalemia, serum lipid profile, and left ventricular hypertrophy. In fact, alpha 1 antagonists reduce total cholesterol and low-density-lipoprotein plus very-low-density-lipoprotein cholesterol and thus may contribute to the overall management of cardiovascular risk by blood pressure reduction and improvement of the serum lipid profile. Since the goal of treating chronic essential hypertension is to improve morbidity and mortality, the choice of therapy should be influenced by the agent's ability to modify as many risk factors as possible. Alpha 1 adrenoreceptor antagonists beneficially impact several cardiovascular risk factors and thus merit consideration as first-line antihypertensive therapy.
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PMID:New perspectives on selective alpha 1 blockade. 257 43

Electronic data collection was used in this open study to survey the safety and efficacy of nifedipine when used in the treatment of 3972 patients with mild to moderate essential hypertension. The safety and efficacy results are presented and discussed as well as the advantages, disadvantages and reliability of electronic data collection. The validity of data collected electronically has not previously been tested, such data having been assumed to be reliable. The pattern of adverse events reported in this study is compared with the pattern of reports to the Committee on Safety of Medicine (CSM), to Bayer UK and in a large paper-based study of nifedipine, in order to test these assumptions. Reported adverse medical events pre-treatment, prior to entry to the study and noted at visit 1, were compared with reports during treatment in the study at visits 2 and 3. The expected incidence of flushing and headache was seen which diminished with continued treatment. Reductions were seen in dyspnoea and impotence. Ankle oedema was observed and was not reduced by time alone. After one month of treatment with nifedipine 20 mg tablets twice daily, 66.5% of patients had a sitting phase V diastolic blood pressure of 90 mmHg or below and 79% of 95 mmHg or below.
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PMID:Safety and efficacy of nifedipine 20 mg tablets in hypertension using electronic data collection in general practice. 275 81

The side-effect profile of labetalol was assessed in 34 patients with mild to moderate essential hypertension who had previously experienced side effects during beta-blocker therapy. The most frequently reported beta-blocker side effects were fatigue, impotence, cold extremities, and depression. After discontinuing their previous beta-blocker for 4 weeks, labetalol was titrated (100-400 mg b.i.d.) to achieve blood pressure control. Twenty-seven of 34 patients did not have a recurrence of a beta-blocker related side effect while receiving labetalol. The most common new side effect with labetalol was dizziness (3 patients). As judged by the attending physician and the patient, labetalol was better tolerated than conventional beta-blocker therapy in 30 of 34 patients (88%). Twenty-four of 34 patients (71%) preferred labetalol over previous therapy. Labetalol controlled blood pressure in 30 of 34 patients (88%). At equal antihypertensive doses, some side effects common to beta-blockers are seen less frequently with labetalol.
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PMID:Comparative tolerability of labetalol versus propranolol, atenolol, pindolol, metoprolol, and nadolol. 287 65

Thiazide diuretics have been the 'mainstay' of antihypertensive therapy for three decades. They reduce arterial pressure, initially through a fall in plasma volume and cardiac output. However, in time, output returns towards pretreatment levels, thereby accounting for a long-term fall in pressure through decreased vascular resistance. At present, the precise mechanism for this reduced resistance remains unknown. Although the fall in arterial pressure is not due to direct vasodilation, it is not unlikely that it may operate, in part, indirectly through reduced vascular responsiveness, induced prostacyclins and other mechanisms. Attendant unwanted biochemical effects include hypokalaemia, hyperuricaemia, hyperglycaemia, reduced renal excretory function and hyperlipidaemia. Orthostatic hypotension and, of more recent emphasis, sexual impotence are among the more common side effects. A question has been raised as to whether hyperlipidaemia might explain the failure of some multicentre studies to prevent myocardial infarction or progression of coronary heart disease but this is more a 'non issue' although it must be considered. The present data continue to support the conclusion that diuretics are safe, effective and economical for the treatment of hypertension, and they remain a major cornerstone of initial as well as multipharmacological therapy, particularly in volume-dependent forms of essential hypertension, steroid-dependent hypertensions, renal parenchymal disease and in special patient groups (black, obese and elderly.
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PMID:Diuretics in hypertension. 331 27

The efficacy and tolerability of the new ACE-inhibitor enalapril (MK 421) and the beta 1-selective adrenoceptor blocker atenolol for the treatment of primary hypertension were compared in a double blind parallel study. 12 patients were randomized to each drug. The doses of enalapril were 20 and 40 mg o.d. and of atenolol 50 and 100 mg o.d. for 4 weeks each, whereafter hydrochlorothiazide (HCTZ) 25 or 50 mg o.d. was added if necessary to achieve a supine diastolic blood pressure (BP) less than 90 mm Hg 24 hours after drug intake. Supine BP was reduced from 160 +/- 7/111 +/- 4 mm Hg to 153 +/- 13/101 +/- 9 mm Hg (p less than 0.05/p less than 0.005) with enalapril and from 163 +/- 17/109 +/- 6 mm Hg to 145 +/- 11/95 +/- 7 mm Hg (p less than 0.005/p less than 0.001) with atenolol. The addition of HCTZ caused a profound additive BP reduction to 132 +/- 7/88 +/- 6 mm Hg with enalapril and to 130 +/- 10/88 +/- 7 mm Hg with atenolol. There was no significant difference between the efficacy of enalapril and atenolol alone or combined with HTCZ. The reduction in mean arterial pressure with enalapril tended to correlate with pre-treatment stimulated plasma renin activity and 24 hours urinary kallikrein excretion. Both drugs tended to reduce serum and urinary aldosterone and kallikrein excretion to the same extent. There was one drop-out in each group, one due to impotence on the combination of enalapril and HCTZ and one due to peripheral coldness during atenolol treatment. Other side effects were mild. No toxic adverse effects were registered.
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PMID:Enalapril and atenolol in primary hypertension--a comparative study of blood pressure lowering and hormonal effects. 608 25

Ten patients with adult-onset diabetes in whom diabetes antedated the appearance of hypertension were evaluated. These patients had evidence of diabetic autonomic neuropathy, including significant orthostatic hypotension (four patients), impotence (three patients), and evidence of diabetic peripheral sensorimotor neuropathy (nine patients) in clinical testing and nerve conduction study results. Baroreflex function was evaluated by multiple hemodynamic tests, including inhalation of amyl nitrite and intravenous administration of phenylephrine, before and after parasympathetic blockade with atropine, and the cold pressor test; results were compared with results in normal control subjects, patients with essential hypertension, and two subgroups of uremic patients undergoing maintenance hemodialysis. Baroreflex function was significantly abnormal in the diabetic patients and was consistent with combined parasympathetic and sympathetic motor nerve (efferent) dysfunction in the baroreflex arc. There was a significant inverse correlation between the degree of orthostatic hypotension in the diabetic patients and their baroreflex response to phenylephrine (r = -0.680, p less than 0.05). There was no significant correlation between supine hypertension in the patients with diabetes and any of the hemodynamic or biochemical parameters examined. The results suggest that orthostatic hypotension in these patients is related to baroreflex dysfunction. However, baroreflex dysfunction does not appear to be a factor in the development of hypertension in these patients, although more studies with normotensive diabetic patients are needed to confirm this point.
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PMID:Baroreflex dysfunction in patients with adult-onset diabetes and hypertension. 613 Jul 1

Labetalol is a combined alpha- and beta-adrenoceptor blocking agent for oral and intravenous use in the treatment of hypertension. It is a nonselective antagonist at beta-adrenoceptors and a competitive antagonist of postsynaptic alpha 1-adrenoceptors. Labetalol is more potent at beta that at alpha 1 adrenoceptors in man; the ratio of beta-alpha antagonism is 3:1 after oral and 6.9:1 after intravenous administration. Labetalol is readily absorbed in man after oral administration, but the drug, which is lipid soluble, undergoes considerable hepatic first-pass metabolism and has an absolute bioavailability of approximately 25%. There are no active metabolites, and the elimination half-life of the drug is approximately 6 hours. Unlike conventional beta-adrenoceptor blocking drugs without intrinsic sympathomimetic activity, labetalol, when given acutely, produces a decrease in peripheral vascular resistance and blood pressure with little alteration in heart rate or cardiac output. However, like conventional beta-blockers, labetalol may influence the renin-angiotensin-aldosterone system and respiratory function. Clinical studies have shown that the antihypertensive efficacy of labetalol is superior to placebo and to diuretic therapy and is at least comparable to that of conventional beta-blockers, methyldopa, clonidine and various adrenergic neuronal blockers. Labetalol administered alone or with a diuretic is often effective when other antihypertensive regimens have failed. Studies have shown that labetalol is effective in the treatment of essential hypertension, renal hypertension, pheochromocytoma, pregnancy hypertension and hypertensive emergencies. In addition, preliminary studies indicate that labetalol may be of value in the management of ischemic heart disease. The most troublesome side effect of labetalol therapy is posture-related dizziness. Other reported side effects of the drug include gastrointestinal disturbances, tiredness, headache, scalp tingling, skin rashes, urinary retention and impotence. Side effects related to the beta-adrenoceptor blocking effect of labetalol, including asthma, heart failure and Raynaud's phenomenon, have been reported in rare instances.
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PMID:Labetalol: a review of its pharmacology, pharmacokinetics, clinical uses and adverse effects. 631 May 29


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