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)

Retrospective experience with drug therapy in 747 patients with essential hypertension registered from 1972-1983 is reported. Five hundred patients were seen between 1972 to 1978 and 247 between 1979-1983; the latter group was characterised by the use of beta blockers as first line drugs. Hypertension was graded according to level of diastolic blood pressure as mild, moderate and moderately severe or severe in 423, 211, and 113 patients, respectively. The overall response to treatment at 6 months was satisfactory in 66.2% of mild, 50.2% of moderate and 58.4% of severe grades of hypertension. A large number of patients in both the groups having varying grades of severity needed at least 2 to 3 drugs for the control of hypertension. The side effects of drugs were generally mild which included general weakness with diuretics; skin rash, nasal congestion and pruritus with methyldopa; cold extremities with beta blockers and palpitations with prazosin.
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PMID:Experience with anti-hypertensive drug therapy in a hypertension clinic--1972-1983. A retrospective analysis. 198 Oct 83

In a multicentre open trial involving 229 investigators, cicletanine, a new antihypertensive agent, was administered orally in doses of 50 to 100 mg/day either alone (1,238 patients) or combined with another drug (430 patients). In this second group of patients with essential hypertension whose BP had not been normalized by a beta-blocker (n = 157), a calcium inhibitor (n = 67), an angiotensin-converting enzyme inhibitor (n = 134) or an alpha-blocker (n = 7), cicletanine normalized BP (less than 160/95 mmHg) in 48.8% of the patients and significantly lowered BP values which fell from 177.7 +/- 15.9/103.3 +/- 6.3 mmHg to 157.2 +/- 17.6/88.8 +/- 8.7 mmHg. The addition of cicletanine to treatments with beta-blockers, calcium inhibitors and angiotensin-converting enzyme inhibitors normalized BP in 48%, 52% and 47% of patients respectively. A significant reduction of symptoms was noted, notably as regards headache, dizziness, palpitations, lower limb oedema, asthenia, auditory disorders and dyspnoea. The side-effects reported (headache, dizziness, gastralgia, nausea, pruritus) were minor and non-specific; they accounted for the withdrawal of only 8 patients. The only significant, though moderate, biochemical variations observed were decreases in natremia and cholesterolaemia unconfirmed by qualitative analysis. Altogether, cicletanine proved to be effective and well tolerated when administered in combination with other antihypertensive drugs belonging to three main therapeutic classes.
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PMID:[Antihypertensive effectiveness and tolerance of cicletanine. Results obtained with bitherapy]. 257 67

In an eight-week, multicenter open-label study of enalapril monotherapy for mild-to-moderate essential hypertension, data for 115 of the 276 participants between the ages of 55 and 75 years (whites, n = 90; blacks, n = 25) were analyzed. These data were compared with similar data for the study subset of 92 younger patients between the ages of 21 and 45 years (whites, n = 58; blacks, n = 34). The most striking finding was the overall lack of significant differences in response between older and younger patients. There were, however, significant differences in response to therapy between the two racial groups studied. In the older group, normotension was achieved in 66% of white patients and 60% of black patients with a single daily dose of enalapril ranging from 5 to 40 mg; the group means, 13 +/- 1 mg in whites vs 22 +/- 2 mg in blacks, differed significantly (P less than 0.05). Thirty-one percent of older white patients attained normotension with a daily dosage of 5 mg, whereas only 4% of black patients in this age group did so. Only 4% of the older white patients but 24% of the older black patients reached the highest recommended daily dosage of 40 mg of enalapril. Adverse reactions occurred in 11% of the older white patients and 16% of the older black patients (a nonsignificant difference), consisting mostly of gastrointestinal discomfort, malaise, dizziness, and pruritus. There were no significant biochemical abnormalities, the only consistent change being a slight increase in mean plasma potassium from 4.34 to 4.45 mEq/L in older whites (P less than 0.05). Enalapril appeared to be generally effective and well tolerated in the management of mild-to-moderate hypertension in the older subset of patients in this study. Efficacy and tolerability data for older and younger patients were comparable.
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PMID:Efficacy and tolerability of enalapril monotherapy in mild-to-moderate hypertension in older patients compared to younger patients. 283 Sep 74

The therapeutic profile of enalapril in mild to moderate uncomplicated essential hypertension was assessed in 265 patients who participated in a multicenter, open-label, prospective study lasting eight weeks. There were 54 younger (aged 39 years or less), 136 middle-aged (40 to 59 years), and 75 older patients (60 years or over). Monotherapy with enalapril in a single daily dosage regimen ranging between 5 and 40 mg resulted in normotension (in the sitting position) in 73% of the younger, 50% of the middle-aged, and 56% of the older patients. Normotension was achieved with 5 mg/day of enalapril in 41%, 18%, and 37% of the subgroups, respectively. Both systolic and diastolic pressures at the end of eight weeks of treatment were significantly lower (P less than 0.01) in the younger patients than in the other two age groups. White patients had significantly greater (P less than 0.001) response of both systolic and diastolic blood pressures than did black patients and required significantly smaller (P less than 0.01) average daily dosages of enalapril (14 mg versus 22 mg, respectively). The overall incidence of side effects was 14% among all 276 patients enrolled in the study. Most were mild and transient, but six patients discontinued enalapril during the first week of therapy because of side effects. There were no cases of rash, dysgeusia, hematological disorders, or deterioration in renal function, but there were two cases of pruritus, one of glossitis associated with an upper respiratory infection, and three of dry cough or wheezing. Angioedema was not observed. Monotherapy with enalapril, usually in a single daily dose of 10 to 20 mg, was effective in inducing normotension in approximately half of the middle-aged and older hypertensive individuals and in nearly three fourths of those below age 40. In this study it was generally well tolerated, with a relatively small incidence of side effects.
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PMID:A multicenter trial of enalapril in the treatment of essential hypertension. 302 33

Labetalol, a new alpha- and beta-adrenergic blocking agent, was administered to 57 patients with essential hypertension whose standing diastolic blood pressure was 105 to 120 mm Hg after three and four weeks of placebo therapy and greater than 90 mm Hg after three to four weeks of therapy with hydrochlorothiazide, 25 mg twice a day. Patients were then randomly assigned on a double-blind basis to receive either labetalol, 100 mg twice a day, or placebo combined with hydrochlorothiazide. Thereafter, the dose of labetalol was titrated weekly in both groups to a maximum of 400 mg twice a day to achieve a standing diastolic blood pressure of less than 90 mm Hg that was also decreased from the hydrochlorothiazide baseline by 10 mm Hg or more (therapeutic goal). Labetalol was abruptly discontinued after four weeks of treatment and patients were given hydrochlorothiazide alone for two additional weeks. After one week of labetalol therapy, 100 mg twice a day (added to hydrochlorothiazide), there was a significantly greater reduction in supine systolic/diastolic blood pressure (6/5 mm Hg, p less than 0.04/less than 0.03) and standing blood pressure (9/7 mm Hg, p less than 0.01/less than 0.01) than with placebo therapy (3/0.5 and 3/1 mm Hg, respectively). The blood pressure reduction in the labetalol-treated group was associated with a 4 and 5 beats per minute reduction in the supine and standing heart rates, respectively. The median labetalol dose required to achieve the standing diastolic blood pressure goal was 400 mg twice a day. After four weeks of labetalol treatment, the mean reduction in blood pressure from the hydrochlorothiazide baseline was 12/13 mm Hg (p less than 0.01/0.01) in the standing position and 8/8 mm Hg (p less than 0.01/0.01) in the supine position. These blood pressure reductions were accompanied by a mean reduction in heart rate of 7 beats per minute. The most frequently reported complaints other than thiazide-induced nocturia included dizziness, fatigue, nausea, rash, and/or pruritus. Most of these complaints were reported at a similar incidence while patients were receiving placebo or hydrochlorothiazide alone as when receiving labetalol with hydrochlorothiazide. After abrupt withdrawal of labetalol, no evidence of rebound hypertension was observed. Labetalol is a safe and effective step II drug when added to hydrochlorothiazide for the treatment of patients with moderate to moderately severe hypertension.
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PMID:Step II treatment with labetalol for essential hypertension. 635 2

Skin patches of a clonidine transdermal therapeutic system (clonidine-TTS) with a constant release rate of either 0.1 or 0.2 mg clonidine/24 h continuously over 7 days were used in 32 essential hypertensives. These self-adhesive drug delivery systems (3.5 cm2), which were affixed to the upper outer arm, were changed by the patients at weekly intervals. During a mean observation period of 7 months (range 1-19 months) transdermal clonidine reduced the blood pressure from 162 +/- 15/107 +/- 5 mmHg to normal values (diastolic less than or equal to 95 mmHg) in 63% of our patients. However, chronic use of clonidine-TTS was accompanied by a high frequency of contact dermatitis (type IV allergy) in nearly half of our patients (n = 15, 47%). In 11 of these 15 patients transdermal clonidine administration had to be stopped because of intolerable local skin reactions (pruritus, erythema, vesiculation, and/or infiltration). Subsequent patch testing with all components of clonidine-TTS was performed in eight cases. Whereas in seven cases an allergic contact dermatitis to clonidine was found, only one patient showed an allergy to another component of clonidine-TTS (polyisobutylene). We conclude that this strikingly high incidence of local allergic skin reactions limits the use of clonidine-TTS in essential hypertension.
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PMID:Transdermal clonidine application: long-term results in essential hypertension. 650 14

The antihypertensive efficacy and side effects of a transdermal therapeutic system containing 2.5 mg clonidine (clonidine-TTS) was investigated in 21 patients with essential hypertension over a period of 10 weeks. The system was designed to release 0.1 mg clonidine/24 h. Mean systolic and diastolic blood pressure fell from 160 +/- 17/106 +/- 7 mm Hg to 139 +/- 16/91 +/- 8 mm Hg after 4 weeks and to 135 +/- 14/89 +/- 8 mm Hg after 10 weeks (p less than 0.001). Sufficient blood pressure control was achieved by one clonidine-TTS weekly in 24% and by 2 clonidine-TTS in 33% of the patients. 43% of all cases required additional oral therapy with 50 mg hydrochlorothiazide/day. However, antihypertensive action was accompanied by a high incidence of local skin reactions. These skin reactions with erythema, itching and red papules occurred in 6 of the 21 patients (29%) after treatment with TTS for at least 4 weeks. Patch testing with the various components of clonidine-TTS in 4 patients identified clonidine-allergy of delayed type in 3 cases. Typical clonidine side effects such as fatigue, dry mouth, constipation and sexual disturbances were moderate. It is concluded that clonidine-TTS has a good and continuous antihypertensive action. However, the high incidence of skin reactions limits its use in the treatment of essential hypertension.
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PMID:[Clonidine transdermal therapeutic system in essential hypertension: effect and tolerance]. 667 36

The angiotensin I-converting enzyme inhibitor, captopril (SQ 14225) was proposed as first treatment in 12 cases of uncomplicated essential hypertension maintained on unrestricted sodium intake (group I). Arterial pressure was normalized in 7 patients (subgroup Ia) whilst hydrochlorothiazide was added to captopril in 5 patients (subgroup Ib). A significant dose-response curve between the dose of captopril (range 75 to 450 mg/day) and the antihypertensive effect was obtained with a maximum at 300 mg/day. In 8 patients (group II) hydrochlorothiazide was proposed first and the addition of captopril was necessary in 4 cases. No relationship between pretreatment PRA and the maximum effect of captopril was observed (r = -0.34, NS). No disturbance of upright blood pressure regulation was noted. Adverse reaction consisted of 4 cases of benign and spontaneously regressive skin rash or pruritus.
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PMID:[Effect of captopril in essential hypertension (author's transl)]. 702 49

The objective of this study was to assess the efficacy and tolerability of transdermal clonidine in inner-city African-American and Hispanic-American patients with essential hypertension. A multiclinic open-label, prospective trial for 12 weeks was used. Dose titration was based on office blood pressure (BP) measurements of > 140/90 mm Hg. Clinical sites were community-based primary care centers. Untreated and treated hypertensive patients whose diastolic BP exceeded 90 mm Hg were administered transdermal clonidine at 0.1 mg or 0.2 mg delivery daily. The drug was titrated after 1 month if diastolic BP was greater than 90 mm Hg. At 12 weeks of treatment, change in blood pressure from baseline as well as adverse effects and patient satisfaction were assessed. A total of 357 patients entered the treatment phase of the study, and 315 patients (244 African-Americans, 67 Hispanic-Americans) had evaluable data. Transdermal clonidine significantly (P <.001) lowered BP in all patients by 15.7/12.8 +/- 18.1/9.6 mm Hg, and heart rate was reduced by 3 +/- 9 beats/min (P <.001). There were no differences in BP reduction according to race and ethnicity, gender, or age. The most common adverse effects were pruritus or discomfort at the patch site, dizziness, dry mouth, and fatigue. Eleven percent of the patients discontinued treatment because of one of these adverse effects. A large proportion of patients (67%) reported that transdermal clonidine was more convenient to use than oral therapy. Transdermal clonidine, alone or in combination with other antihypertensive therapies, significantly lowered BP and heart rate in inner-city hypertensive patients. The drug was generally well tolerated, with 89% of the patients remaining in the trial. Patient acceptability was high with the once-weekly treatment, which is an important feature for this particular hypertensive population.
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PMID:Clinical experience with transdermal clonidine in African-American and Hispanic-American patients with hypertension: evaluation from a 12-week prospective, open-label clinical trial in community-based clinics. 1042 43

In a survey including 2224 patients with essential hypertension we investigated efficacy and tolerability of the new ACE-inhibitor Imidapril. Mean blood pressure at baseline was 172 +/- 19/98 +/- 10 mmHg. Treatment with Imidapril 5-20 mg once daily caused a decrease in BP by 21 +/- 17/11 +/- 10 mmHg (p < 0.01/0.01). Systolic BP was reduced by > 15 mmHg in 71% diastolic BP by > 10 mmHg in 64% of patients. 29% of patients achieved the treatment goal of a blood pressure < or = 140/90 within an average of 26 days. Imidapril decreased pulse-pressure (one of the most important risk markers in hypertension) by 18% (74 +/- 17 to 61 +/- 11 mmHg, p < 0.01). ACE-inhibitor related adverse effects (cough, vertigo, headache, pruritus, tachycardia, orthostatic dysregulation or nausea) were observed in 38 patients (< 2%). Efficacy of treatment was graded by the physician in charge of the patient care by means of a questionnaire. Gradings were excellent or good in 96% of patients, moderate in 3% and poor in < 1%. In summary, the effects of Imidapril on blood pressure were comparable to those of other ACE-inhibitors. However, the frequency of adverse effects was low and similar to that of angiotensin-II-antagonists.
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PMID:[Efficiency and safety of ACE-inhibiting imidapril in patients with essential hypertension]. 1205 Sep 50


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