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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The changes in plasma renin activity (PRA) during short-term salt depletion (and peroral furosemide on the first day) and after bolus injection of propranolol were compared to the change during long-term treatment with diuretic and with propranolol in 19 patients with benign primary hypertension. A highly significant correlation was found between PRA on short-term and long-term salt depletion (r=0.02). A highly significant correlation was likewise found between initial PRA and decrement of PRA after bolus injection of or long-term treatment with propranolol. Only a weak inverse correlation was found between PRA reached during short-term salt depletion or long-term diuretic treatment and the fall in diastolic BP during long-term treatment (r=0.60). No significant correlation was found between decrease in PRA on propranolol (bolus/long-term) and diastolic BP reduction. It is concluded that the short-term PRA response to salt depletion and propranolol in the individual patient gives a good prediction of the PRA level on long-term diuretic or propranolol treatment, but is of no value in predicting the BP reduction during treatment.
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PMID:Acute and long-term salt depletion and beta-blockade: plasma renin activity response and its relation to blood pressure reduction in long-term treatment. 2 64

The antihypertensive effects on metoprolol and pindolol were compared in 50 patients with essential hypertension belonging to WHO stage 1 or 2. After four weeks of placebo treatment the patients were randomly allocated to treatment with metoprolol or pindolol. During the initial dose-titration period of six weeks the dose was individually adjusted, aiming at a diastolic blood pressure in the seated position less than 95 mm Hg. The maximum possible dosage for metoprolol was 50, 100 and 150 mg b.i.d. and for pindolol 5, 10 and 15 mg b.i.d. Thereafter followed a fixed-dose period of 20 weeks. Six patients did not complete the study. At the end of the study satisfactory blood pressure control, defined as a diastolic blood pressure in the seated position less than 95 mm Hg, was achieved in 15 of the 20 patients (75%) in the metroprolol group and in 13 out of 24 patients (54%) in the pindolol group. The average reduction in diastolic blood pressure was more pronounced with metoprolol than with pindolol, while no difference was found between the two beta-blockers with regard to the reduction of the systolic blood pressure. Generally, metoprolol and pindolol were both well tolerated by the patients.
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PMID:A comparison between metoprolol and pindolol in the treatment of essential hypertension. 2 70

Atenolol was compared with five other beta-blockers and a thiazide diuretic in a randomised cross-over trial of once-daily treatment of essential hypertension. Atenolol was significantly better at reducing resting and exercise blood pressures at 24 hours than any of the other drugs and had a low incidence of side effects. Both timolol and acebutolol had a significant hypotensive effect at 24 hours and a low incidence of side effects, suggesting that further increases in dosage might be effective and well tolerated. Labetalol proved ineffective when given once daily, and the high incidence of side effects, equalled only by pindolol, would probably prohibit further increases in dosage. Bendrofluazide was equal or superior to all the beta-blockers except atenolol at reducing resting blood pressure, and its cheapness still makes it an agent of first choice in mild or moderate essential hypertension.
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PMID:Randomised study of six beta-blockers and a thiazide diuretic in essential hypertension. 2 10

1. In seventeen patients with untreated essential hypertension the sodium and water contents of leucocytes were significantly increased, whereas the rate constant for ouabain-sensitive sodium efflux was significantly reduced. 2. These abnormalities were not found in fourteen other patients with well-controlled hypertension. 3. Preliminary observations in accelerated hypertension suggest a different pattern of abnormality in leucocyte sodium metabolism.
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PMID:Abnormal sodium transport in leucocytes from patients with essential hypertension and the effect of treatment. 2 75

1. A clinical study of pyratrione, a tyrosine hydroxylase inhibitor, has been carried out in essential hypertension. 2. Out of thirty-nine patients who received pyratrione, twenty-eight showed a significant decrease in blood pressure.
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PMID:Effect of pyratrione (a tyrosine hydroxylase inhibitor) in essential hypertension. 2 76

To investigate the initial potassium loss and development of hypokalaemia during the administration of an oral diuretic, metabolic balance studies were performed in ten patients with essential hypertension who had shown hypokalaemia under prior oral diuretic treatment. Chlorthalidone (50 mg daily) was given for 14 days. Six patients received a normal-sodium diet and four a low-sodium (17 mmol/day) diet. All patients had a normal initial total body potassium (40K). The electrolyte balances, weight, bromide space, plasma renin activity, and aldosterone secretion rate were measured. In both groups a potassium deficit developed, with proportionally larger losses from the extracellular than from the intracellular compartment. In the normal-sodium group the highest mean potassium deficit was 176 mmol on day 9, after which some potassium was regained; in the low-sodium group the highest deficit was 276 mmol on day 13. The normal-sodium group showed an immediate but temporary rise of the renin and aldosterone levels; in the low-sodium group renin and aldosterone increased more slowly but remained elevated. It is concluded that dietary sodium restriction increases diuretic-induced potassium loss, presumably by an increased activity of the renin-angiotensin-aldosterone system, while sodium delivery to the distal renal tubules remains sufficiently high to allow increased potassium secretion.
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PMID:Initial potassium loss and hypokalaemia during chlorthalidone administration in patients with essential hypertension: the influence of dietary sodium restriction. 2 52

1. The antihypertensive effect of a new beta-adrenoceptor blocking agent, trimepranol (10--14 mg/twice daily), chlorthalidone (50 mg every second day) and their combination was studied in eighteen patients with mild to moderate essential hypertension. In a controlled randomized cross-over study the drugs were given for 6 week periods. 2. A significant and equal decrease in blood pressure was achieved both with trimepranol and chlorthalidone, whereas their combination was significantly more effective. 3. Trimepranol significantly antagonized the chlorthalidone-induced hypokalemia. 4. The results favor the use of diuretic or diuretic-beta-adrenoceptor blocker combination over beta-adrenoceptor blocker monotherapy in the treatment of mild to moderate hypertension.
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PMID:Effect of diuretic, beta-adrenoceptor blocking agent and their combination on elevated blood pressure and serum potassium: a cross-over study. 2 53

Within the last 10 years the indications for a therapeutic regimen with beta-blocking-agents have been differentiated: coronary heart disease with angina pectoris (interval regimen), essential hypertension, especially in younger persons; hyperkinetic heart syndrome; thyreotoxikosis, symptomatic therapy; heart rhythm disorders, extrasystolic or tachysystolic; neurologic-psychiatric diseases. The development of the newer beta-blocking-agents has effected different kinetic data (f.i. long acting effects of Tenormin) and a increased cardioselectivity. The recommendations for the therapeutic regimen have to be outlined to the underlying diseases. The sensitivity against the drugs depends on remarkable individual differences, with the consequence of a careful and low dosage in the beginning in each case. The side-effects of beta-blocking-agents are presumably: bradycardia, bronchospasm, fatigue, adynamia, myocardial insufficiency, gastrointestinal symptoms, hypoglycemia, hypotension.
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PMID:[Therapy with beta-blocking-agents (author's transl)]. 3 43

Measurement of the blood volume in cases of essential hypertension has shown a negative correlation with increase in blood pressure. We have been able to distinguish a group of moderate hypertensives who are hypervolemic, and whose systemic effect is more marked than in the moderate hypovolemic type. Such cases respond poorly to single drug therapy with beta blockers, but well to diuretics. The authors propose a general treatment scheme for essential hypertension: single therapy (beta blockers or diuretics) in mild cases of hypertension; single therapy by diuretics in the moderate types with the increased volume; single therapy by beta blockers in the moderate types with low volume, multiple treatment with the drugs together in cases of severe hypertension.
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PMID:[Importance of measuring blood volume by an isotope method in essential hypertension]. 3 Apr 25

In 22 patients with essential hypertension plasma levels and urine excretions of sodium and noradrenaline were studied before, during and after long-term beta-blockade with pindolol. The relation between mean blood pressure and the quotient of sodium-/noradrenaline-excretion changed during treatment (placebo r=-0.34; pindolol r=+0.31). During placebo there existed a significant (p is less than 0.03) correlation between blood pressure and sodium-excretion which disappeared during beta-blockade. No correlation between blood pressure and noradrenaline was seen during placebo, whereas during beta-blockade a significant (p is less than 0.003) correlation was observed. In contrast to the placebo period there was a significant positive correlation between sodium- and noradrenaline-excretion during long-term treatment with pindolol. It is concluded that whole-body balance of sodium and noradrenaline is an important factor in essential hypertension.
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PMID:[The importance of changes in whole-body balance of sodium and noradrenaline in essential hypertension (author's transl)]. 3 Aug 56


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