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)

Thirty adults with essential hypertension (systolic BP greater than 150 mmHg or diastolic BP greater than 100 mmHg) were treated with 5-20 mg of enalapril to study its anti-hypertensive efficacy and safety. Ten patients had mild hypertension (diastolic BP greater than 90 mmHg and less than 105 mmHg), 10 had moderate hypertension (diastolic BP greater than 105 mmHg and less than 115 mmHg) and 6 had severe hypertension (diastolic BP greater than 115 mmHg). Of the 20 patients who completed the trial, 9 (45%) showed optimum reduction of BP to less than 130/90 mmHg) and a further 7 (35%) showed significant reduction. The mean fall in systolic BP was 32.5 mmHg (0-80 mmHg) and in diastolic BP was 18.5 mmHg (0-50 mmHg). The peak fall in BP was achieved in 3.5 weeks (1-6 weeks) with a mean dose of 7.2 mg of enalapril daily (5-15 mg/day). Mild side effects not needing drug withdrawal were seen in 8/20 patients (40%). Monotherapy with enalapril appears to be effective and safe as step one therapy for patients with essential hypertension.
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PMID:Enalapril monotherapy in essential hypertension. 162 42

In 51 patients with stage II essential hypertension (mild and moderate arterial hypertension), a cross-over study was carried out to estimate the efficacy of the use of ketanserin (KS), an antagonist of serotonin receptors, as compared to the efficacy of placebo, the beta-adrenoblocker propranolol (PP), the diuretic triampur and the beta 1-adrenoblocker prazosin. When administered in the daily dose 40-80 mg, KS produced an antihypertensive effect in 43.7% of the patients. The efficacy of KS administered once or twice a day did not practically differ. The side effects of the monotherapy were unmarked and required the drug withdrawal only in 2 patients (4%). KS produced no material shifts in the biochemical parameters with the exception of a slight increase of the activity of alanine transferase and led to a certain reduction of carbohydrate tolerance. In patients who responded to KS, the drugs belonging to the other three groups appeared effective as well. Both KS combined with triampur and KS combined with PP provided a higher antihypertensive effect than monotherapy with each of those drugs. The combination of KS and prazosin produced the same effect as monotherapy with prazosin.
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PMID:[A cross-over study of ketanserin compared to placebo, beta-adrenergic blockader, diuretic and alpha 1-adrenergic blockader. Cooperative research in the USSR (the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension). Working Group (4)]. 168 78

A group of 205 patients with mild to moderate essential uncomplicated hypertension was chosen from 3,183 hypertensive patients referred to a hypertension clinic for the first time, and was asked to participate in a six-month double-blind parallel trial. A single physician was in charge of all the patients. After a two-week single-blind placebo period, the patients were randomly assigned to regimens of either enalapril (20 mg per day) or placebo. Both groups were then followed up every two weeks, and increasing doses of hydrochlorothiazide (25 and 50 mg), oxprenolol (160 and 320 mg), and dihydralazine (50 and 100 mg) were added until the diastolic blood pressure was lower than 90 mm Hg. After a six-month follow-up, the enalapril group showed lower systolic and diastolic blood pressures than the control group (129/82 +/- 12/6 mg Hg versus 135/86 +/- 10/5 mm Hg; p less than 0.001). The number of daily tablets of active drugs was 2.7 +/- 1.8 in the enalapril group and 4.4 +/- 2.4 in the control group (p less than 0.01). The mean plasma potassium level was 4.16 +/- 0.4 mmol/liter in the enalapril group versus 3.92 +/- 0.4 mmol/liter in the control group (p less than 0.001), despite more frequent use of amiloride (p less than 0.001). This difference is explained by the lower dose of hydrochlorothiazide used in the enalapril group by comparison to the control group, and a lower excretion of urinary aldosterone in the enalapril group than in the control group (11.6 +/- 7.4 versus 19.8 +/- 11.8 micrograms per 24 hours, p less than 0.001). Drug withdrawal was necessary in eight patients in the enalapril group and in 16 patients in the control group (p less than 0.05). These results show that first-step treatment of mild to moderate uncomplicated essential hypertension with enalapril permits better blood pressure control than the standard treatment, requires fewer tablets to be taken daily, and involves a smaller risk of hypokalemia.
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PMID:Treatment of mild to moderate hypertension with or without the converting enzyme inhibitor enalapril. Results of a six-month double-blind trial. 303 42

Guanfacine, 1 to 3 mg/day, and clonidine, 0.1 to 0.3 mg twice a day, were compared in a 24-week double-blind, randomized, parallel study of 42 patients with hypertension that was inadequately treated by chlorthalidone, 25 mg/day. Mean reduction of blood pressure was 18/9 mm Hg after guanfacine and 14/8 mm Hg after clonidine. To determine the incidence of rebound hypertension, subjects were hospitalized for 7 days during chlorthalidone therapy for collection of baseline data and once again immediately after abrupt withdrawal of the alpha-agonist after 24 weeks of dosing. Although blood pressure and heart rate rose significantly in both groups, the changes after clonidine withdrawal were greater and occurred earlier (day 2) than those after guanfacine withdrawal (day 4). Forty percent of the subjects receiving guanfacine and 64% of subjects receiving clonidine had diastolic blood pressure elevations greater than or equal to 10 mm Hg from baseline. There were increases in urinary norepinephrine levels in both groups after drug withdrawal, but these correlated poorly with blood pressure rise. Side effects after guanfacine were much the same as those after clonidine. Guanfacine taken once a day provides an effective and safe alternative to clonidine in the management of essential hypertension.
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PMID:Clonidine and guanfacine in hypertension. 388 7

Previous studies provide conflicting conclusions concerning the consequences of abrupt withdrawal of guanabenz therapy for essential hypertension. In the present study, 10 patients were treated for mild to moderate essential hypertension for 12 weeks, following which the drug was abruptly withdrawn. Blood pressure, pulse rate, and plasma catecholamine levels were obtained before, at 4 and 12 weeks after starting therapy, and 48-96 h and 4 and 8 weeks post-therapy. At the end of 12 weeks of therapy, the mean dose of guanabenz was 22.2 +/- 4.4 mg/day (range, 16-48 mg/day) and supine blood pressure was 140 +/- 5.5/88 +/- 2.4 mm Hg. Two to 4 days after drug withdrawal, supine and standing diastolic blood pressure remained significantly reduced compared to control (p less than 0.01). Standing systolic blood pressure also remained significantly reduced compared to control (p less than 0.01). Mean plasma catecholamine level was less than baseline after 4 weeks of therapy, but the change was not significant. No increase in plasma catecholamine concentration was observed at any time during the withdrawal period. No patient had symptoms of sweating, nervousness, palpitations, or insomnia after guanabenz withdrawal. In one patient with pretreatment systolic pressure of 150 mm Hg, systolic pressure 48 h after drug withdrawal was 160 mm Hg. These studies, together with previous reports, suggest that guanabenz therapy for mild to moderate essential hypertension in doses of 32 mg/day or less can be safely withdrawn on an outpatient basis with a very low incidence of withdrawal phenomena.
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PMID:Effect of guanabenz withdrawal on blood pressure and plasma catecholamines. 608 34

Guanfacine (BS 100-141) (N-amidino-2-(2,6-dichlorophenyl)-acetamide hydrochloride) is a centrally acting alpha-adrenergic receptor agonist. A comparison of its anti-hypertensive effect with that of methyldopa was made in patients with essential hypertension. After a wash-out period of 8-10 days, 33 patients with hypertension of different degrees of severity were treated with guanfacine or methyldopa, both combined with clorexolone, in a randomized double-blind study extending over 8 weeks. Blood pressure was reduced significantly by both drug treatments, compared with the placebo. The incidence of side-effects with both drugs was low. Those that did occur decreased after adjustment of dosage. Guanfacine was clinically effective in all patients with various degrees of hypertension, but treatment with methyldopa was inadequate in 30% of patients even at maximum dosage. Up to 40 hours after abrupt drug withdrawal, no rebound hypertension was noted in the guanfacine group.
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PMID:The antihypertensive effect of guanfacine compared with methyldopa. 610 13

Captopril was used in primary and long-term treatment of 40 treatment-resistant hypertensive patients. Of these, 21 had renovascular hypertension, seven unilateral and fourteen bilateral, and 19 had essential hypertension, 10 with high-renin and 9 with normal-renin profiles. All patients were off treatment when started on captopril therapy and were treated for at least 12 months, on the average for more than 2 years. The strategy of systematic drug withdrawal used to find the lowest effective dose of captopril led to average doses of 150 to 300 mg/day. A diuretic agent was added in 17 of the 40 patients when diastolic pressure remained greater than 105 mm Hg and a beta-adrenergic blocking agent was added for tachycardia or additional pressure control in 16 patients. Captopril alone was effective in 14 of the 40 patients. In all groups, mean supine and standing blood pressure levels were maintained at less than 140/90 mm Hg without evidence of decreased effectiveness over time. Control and treatment systolic pressures were higher in patients older than 50 years. For patients of all ages, systolic but not diastolic pressure during captopril treatment was higher in the supine position than standing. Plasma renin activity remained significantly elevated over time and aldosterone excretion usually decreased despite concurrent diuretic therapy. Captopril alone or in combination with a diuretic or beta-adrenergic blocking agent is effective in long-term treatment of drug-resistant renovascular and essential hypertension.
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PMID:Long-term efficacy of captopril in renovascular and essential hypertension. 680 61

1 Labetalol, an alpha- and beta- adrenoceptor blocking drug, was compared with acebutolol, alone or associated with dihydralazine in forty patients with moderate essential hypertension. 2 Labetalol (400--800 mg daily) seemed to have a slightly higher potency than acebutolol alone (400--800 mg daily). 3 Labetalol (1200--1600 mg daily) had the same potency as the combination of acebutolol (400--800 mg daily) and dihydralazine (50--100 mg daily). 4 Contrarily to acebutolol, the drop in blood pressure with labetalol was not correlated with initial plasma renin activity. 5 Labetalol side effects were minor and did not lead to drug withdrawal.
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PMID:Comparative trial of labetalol and acebutolol, alone or associated with dihydralazine, in treatment of essential hypertension. 699 23

The effect of both administration and withdrawal of doxazosin on patients with essential hypertension was evaluated by twenty-four-hour ambulatory blood pressure (BP) monitoring. Six hypertensive men were treated with doxazosin starting at 1 mg/day, and the dosage was titrated at weekly intervals up to a maximum of 8 mg/day. The twenty-four-hour BP profile was monitored noninvasively before treatment, in the fourth week of treatment, and on days 2 and 7 after the discontinuation of doxazosin. The average twenty-four-hour systolic and diastolic BPs (SBP and DBP) were lowered by doxazosin treatment and returned to the pretreatment levels within two days of doxazosin withdrawal. Doxazosin treatment produced a significant decrease in the daytime SBP and DBP but not in the nighttime BP values. The daytime BP decrease was no longer detected on days 2 and 7 after drug withdrawal. The twenty-four-hour pulse rate was not influenced by either doxazosin administration or discontinuation. The plasma norepinephrine concentration and plasma renin activity were increased by doxazosin treatment and were decreased by drug withdrawal. There was no rebound hypertension following doxazosin withdrawal. Thus, the present study using twenty-four-hour BP monitoring showed that doxazosin treatment reduced the daytime BP in patients with essential hypertension and that this reduction was abolished within two days after doxazosin discontinuation.
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PMID:Effect of administration and withdrawal of doxazosin on ambulatory blood pressure in patients with essential hypertension. 781 52

Cilazapril [correction of Silazapril], a new inhibitor of long-acting angiotensin-converting enzyme, was given to 39 hypertensive subjects aged 24-68 with initial diastolic pressure 95-120 mm Hg. Of them 16 were females and 23 were males. The course of the treatment lasted 8 weeks, the drug being taken daily in a single dose 2.5 mg in the morning. Checkups, measurements of arterial pressure (AP), blood counts, urinalyses were made before the treatment, on the treatment week 4 and 8. In one patient the drug was discontinued 4 weeks after the treatment start because the AP fall to 110/63, in 23 patients the dose was raised to 5 mg, the rest continued on 2.5 mg/day. The treatment ended in the systolic pressure decrease by 14.9% (from 161.0 +/- 2.9 to 137.8 +/- 2.8 mm Hg, p < 0.0001) and diastolic pressure fall by 13.5% (from 104.5 +/- 1.4 to 90.1 +/- 1.7 mm Hg, p < 0.005). No side effects causing the drug withdrawal were registered. It is concluded that the drug is effective in essential hypertension stage IIA-IIB as monotherapy.
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PMID:[Evaluation of the efficacy and tolerance of the new delayed-action angiotensin-converting enzyme inhibitor cilazapril in patients with hypertension (preliminary report)]. 830 91


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