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

In 14 patients with essential hypertension, left ventricular function was assessed echocardiographically before and after 4 and 8 weeks of treatment with the betablocking agent atenolol. Atenolol was given orally in a dose of 100 mg/day. After 4 weeks of treatment systolic blood pressure decreased from 160 to 138 mm Hg(p less than 0.001) and diastolic pressure from 105 to 91 mm Hg(p less than 0.001). Heart rate decreased from 76 to 64 beats/min (p less than 0.05). Systolic shortening of the left ventricular transverse diameter declined from 41 to 36% (p less than 0.01), though in no instance did it fall below the lower limit of normality (30%). After 8 weeks of betablocking therapy, blood pressure and heart rate remained essentially unchanged. Systolic shortening increased slightly but insignificantly to 38%. The left ventricular enddiastolic diameter did not change throughout the study. It is concluded that longterm betablocking therapy is associated with a significant reduction of left ventricular function which improves in the later stage of treatment. Since the diminution of left ventricular function is slight, the induction of left heart decompensation is unlikely, at any rate in patients with initially normal left ventricular function.
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PMID:[Left ventricular function in hypertension treated with beta blockers]. 3 Sep 95

Recent research shows that the renin-angiotensin-aldosterone axis either maintains or causes some or all of the high blood pressure of most patients and demonstrates anew that renin-sodium profiling defines this involvement. Performed with a serum potassium measurement, this now reliable test is useful for primary screening and then, in conjunction with renal vein renin studies or an aldosterone profile, for diagnosis or exclusion of surgically curable renovascular or adrenocortical hypertensions. For the remaining majority with essential hypertension, renin profiling exposes the relative participation of either vasoconstriction or volume factors, thereby guiding simpler, more specific, and predictably effective antirenin or antivolume treatments. Renin profiling identifies those in whom treatment should begin with a beta-blocker as opposed to a diuretic while not infrequently also providing baseline information about severity and prognosis in individual patients.
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PMID:Renin profiling for diagnosis and treatment of hypertension. 3 92

The antihypertensive effect of the following therapeutic regimens: diuretic alone (DA), diuretic plus sympathetic inhibitor (DSI), diuretic plus betablocker (DB) and diuretic plus, betablocker plus vasodilator (DBV) was studied for 34.1 +/- 5.4 months in 28 patients with resistant essential hypertension (REH). Depending of treatment tolerability and the optimal antihypertensive action of drugs 21, 24, 26 and 10 cases were treated continuously or alternately with DA (9.9), DSI (15.0), DB (4.8), and DBV (14.6), respectively (in paragraph average duration of treatment in months). On admission the 89.3% and 42.8% of population had electrocardiographic signs of left ventricular hypertrophy or past-history of cardio-vascular complications, respectively. Arithmethic average and standard deviation of individual changes of systolic and diastolic blood pressure obtained during DA, DSI, DB and DBV treatment were -32.4 +/- 31.8, -19.3 +/- 27.2, -18.9 +/- 15.9 and -18.2 +/- 21.3 for systolic and -35.8 +/- 20.2, -12.3 +/- 17.2, -15.1 +/- 16.9 and -15 +/- 13.1 (mm. de Hg.) for diastolic blood pressure respectively. Average blood pressure before treatment was 222.4 +/- 30.3/128.0 +/- 20.8 (mm of Hg) and under the most effective treatment was 175.5 +/- 21.8/106.5 +/- 12.1 with a p less than or equal to 0.001 for either sistolic and diastolic pressure. There were not significant regressive electrocardiographic changes during the therapeutic period, neither significant changes in urea and creatinine blood values. 46.4% and 25% of cases exhibited collateral drug symptoms and cardio-vascular no fatal complications, respectively. Three of the last group patients died outside of the Hospital (2 sudden deaths and 1 renal insufficiency death). RH still constitutes a challenge to medical therapy. Nevertheless individualized therapy may modify the natural history of this hypertensive variety.
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PMID:[Problem in the management of arterial hypertension resistent to drug treatment. Study of 28 cases]. 3 45

1. Active and acid-activable inactive renin were measured in renal venous and arterial plasma of 18 patients with essential hypertension (EHT) and 19 patients with renovascular hypertension (RVHT). In seven patients with EHT and in 11 patients with RVHT measurements were made before and 25-35 min after an intravenous injection of 300 mg of diazoxide. 2. Under basal conditions the renal vein to artery ratios for active and inactive renin in EHT ranged from 0.71 to 1.96 and from 0.68 to 1.44 respectively. In 14 patients with RVHT the renal vein to artery ratio for active renin on the affected side was above the range found in EHT and in six of them the renal vein to artery ratio for inactive renin was also elevated. 3. The diazoxide-induced release of active renin from kidneys, which had a stenotic artery but were not seriously contracted, was associated with a fall of the renal vein to artery ratio for inactive renin to a value below 1.00. 4. The results indicate that changes in the release of active and inactive renin do not always run in parallel. The findings are compatible with the hypothesis that circulating inactive renin can be activated in the kidney.
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PMID:Renal release of active and inactive renin in essential and renovascular hypertension. 3 2

1. Chlorothiazide twice a day plus atenolol, metoprolol, pindolol and propranolol in single daily doses administered to patients with essential hypertension achieved effective control of blood pressure. 2. Each beta-adrenoreceptor-blocking drug was associated with small, but significant, increases in plasma triglyceride concentrations and suppression of fasting immuno-reactive glucagon concentrations.
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PMID:beta-Adrenoreceptor-blocking agents and lipid metabolism. 3 7

1. Plasma adrenaline and noradrenaline were measured in supine and upright positions in 27 essential hypertensive patients and in 12 age-matched control subjects. 2. Plasma adrenaline was markedly increased in a large proportion of patients, compared with control subjects, either in supine or in upright positions, whereas no significant differences were found in plasma noradrenaline. 3. Six hypertensive patients were chronically treated with beta-adrenoreceptor-blocking agents (five with propranolol and one with pindolol). Plasma noradrenaline was not significantly changed in the supine position but was markedly increased on standing in four out of six patients. Plasma adrenaline was decreased in five out of six patients either in suprine or upright positions. 4. These findings support the view that the adrenergic system participates in the mechanism of essential hypertension.
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PMID:Plasma adrenaline and noradrenaline in essential hypertension and after long-term treatment with beta-adrenoreceptor-blocking agents. 3 10

The appropriateness of hypertrophy was analyzed in 64 patients with essential hypertension during diagnostic cardiac catheterization and left ventriculography. The degree of hypertrophy may be described by the relationships between peak systolic pressure, mass to volume ratio and peak systolic wall stress. The peak systolic wall stress represents an important determinant of the appropriateness of hypertrophy and has great influence on left ventricular function and myocardial energy demand. The hypertrophy in essential hypertension may be subdivided into 3 different types of hypertrophy: (a) inappropriate hypertrophy associated with increased mass-to-volume ratio and decreased systolic wall stress, (b) appropriate hypertrophy with normal systolic wall stress and (c) inappropriate hypertrophy with normal or decreased mass-to-volume ratio, however with significantly increased systolic wall stress. On the basis of the appropriateness or degree of left ventricular hypertrophy in essential hypertension the therapeutical consequences are being discussed with special reference to beta receptor blockade and digitalis glycosides.
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PMID:[The heart in hypertension. V. Systolic and diastolic wall stress and degree of hypertrophy as determinants of diagnostic and therapeutical consequences (author's transl)]. 3 78

Nadolol, a new beta-blocker that is not metabolized and has a uniquely long pharmacological half-life (up to 24 hours) was employed as the sole drug therapy for thirty-one patients with mild to moderately severe essential hypertension. Twenty-two patients had a reduction over 3 months of 10% or more in supine diastolic pressure, including twelve who became normotensive. Daily dosage, administered in two divided doses, ranged up to 640 mg; however, twenty patients required 160 mg or less. Twenty-three patients continued therapy for a median additional period of 15 months, during which satisfactory control was maintained in seventeen patients. Side-effects of nadolol caused termination of therapy in only one patient.
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PMID:Initial experience with a new long-acting beta-blocker, nadolol, in hypertensive patients. 3 62

Nadolol, a new beta-adrenergic blocking agent, was administered orally in gradually increasing single daily doses to 13 hospitalized patients with essential hypertension. Maximal doses ranged from 200 to 480 mg/day. Blood pressure was reduced in nine patients and heart rate was decreased in 11 patients. The decrease in blood pressure was either partial or temporary in five of the nine patients who responded. Concomitant administration of the diuretic chlorthalidone decreased blood pressure in a previously unresponsive patient. Nadolol effectively inhibited isoproterenol-induced tachycardia and decreased cardiac output by 18 per cent. Plasma renin activity and plasma aldosterone concentration were not changed significantly by the treatment. Body weight was not altered significantly. Blood pressure response was independent of the pretreatment renin levels or the change in renin induced by nadolol; it was also independent of the changes in cardiac output and heart rate but was more pronounced in patients with milder baseline hypertension. The decline in serum concentration of nadolol was consistent with the drug's reported half-life of 12.2 hours. The results indicate that single daily doses of nadolol alone can reduce blood pressure significantly with minimal cardiodepressant effects and no important side effects. The effectiveness of nadolol may be enhanced by the addition of a diuretic.
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PMID:Effect of nadolol in treatment of hypertension. 3 98

To investigate the effect of chronic alpha-adrenergic receptor blockade on renin release, plasma renin activity (PRA) was determined overnight at short intervals in 9 patients with essential hypertension before and after 7 days medication with phenoxybenzamine (20 mg orally/day). Inhibition of basal (supine) renin secretion in response to alpha-adrenergic receptor blockade was more apparent in patients with elevated PRA (n = 3) than in those with normal PRA. On the other hand, patients with low PRA (n = 2) even showed an increase in renin release. In addition, night-day variations with secretory episodes in PRA were blunted during drug administration. It is suggested that alpha-adrenergic receptor blockade inhibits renin secretion distal to its blockade of specific adrenergic receptors. However, the increase in renin release during phenoxybenzamine observed in patients with low PRA indicates that the responsiveness of renin secretion to stimulatory effects (most probably induced by the lowered blood pressure in our patients) remained intact during alpha-adrenergic receptor blockade.
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PMID:[Effect of a chronic alpha adrenergic receptor blockade on basal secretion of renin in essential hypertension]. 3 76


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