Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amlodipine, a novel dihydropyridine calcium-antagonist, was compared to slow-release nifedipine in a short-term study on 40 patients with mild to moderate essential hypertension, in order to assess the efficacy and tolerability of two different dihydropyridine calcium-antagonists with short and long half-life. After a two-week single-blind placebo period, patients were given, in a randomized sequence, amlodipine (5 or 10 mg/day od, 20 patients) or nifedipine s.r. (20 or 40 mg BID, 20 patients). At the end of treatment (12 weeks) a significant lowering of arterial pressure was obtained after 24h from the administration of amlodipin (-34/-17 mmHg) and after 12h from the administration of nifedipine s.r. (-33/-16 mmHg). Furthermore, with both drugs, no significant changes in heart rate and ECG have been reported. Amlodipine was better tolerated than nifedipine, as shown by the lower incidence of side effects. Therefore amlodipine proved to be an effective and well tolerated drug in the therapy of mild to moderate hypertension.
 ...
PMID:[A comparison between amlodipine and nifedipine retard in patients with essential arterial hypertension]. 153 44

Labetalol was evaluated in a multicenter, placebo-controlled study of elderly patients (greater than or equal to 60 years) with mild to moderate essential hypertension. After a placebo-washout period, doses were titrated from 100 mg BID to a maximum of 400 mg BID over a 6-week period. Once blood pressure control (standing diastolic blood pressure [SDBP] less than 90 mm Hg and greater than or equal to 10 mm Hg reduction from baseline) was achieved or the maximum allowable dosage had been given, the dosage remained the same until the end of the study. The titration phase was followed by a 4-week maintenance period. Blood pressure control was achieved in 37/54 (69%) of the patients who were treated with labetalol compared with 21/58 (36%) of the patients who received placebo (P less than .001). Twenty-nine (78%) of those controlled on labetalol responded to doses of 200 mg or less BID, and there was no significant difference between groups with respect to orthostatic blood pressure changes. Adverse experiences were generally mild and occurred with similar frequency in the labetalol and placebo groups; six patients who received labetalol and five who received placebo withdrew from the study due to adverse experiences, but in only one case (labetalol) was the adverse experience considered drug-related. In summary, labetalol effectively and safely lowered diastolic blood pressure in the elderly without producing significant orthostatic changes.
 ...
PMID:Evaluation of labetalol in elderly patients with essential hypertension. 188 Feb 21

The effects of enalapril alone and in combination with the cyclooxygenase inhibitors sulindac and indomethacin on blood pressure (BP), plasma aldosterone, renin activity and converting enzyme activity were evaluated in 29 patients with mild to moderate essential hypertension, 26 of whom had low plasma renin activity. Patients were randomly assigned to one of three treatment groups. All patients underwent a 4-week placebo phase (phase I), then received enalapril (20 mg BID) for 4 weeks (phase II). In phase III, group I (n = 10) continued on enalapril alone; group II (n = 9) received sulindac 200 mg BID plus enalapril, and group III (n = 10) received indomethacin 50 mg BID plus enalapril, all for 4 weeks. Enalapril lowered BP significantly (mean supine BP 149/100 in phase I vs. 134/90 in phase II, p less than 0.05) without inhibiting aldosterone production. The BP effect was not blunted by concomitant administration of sulindac or indomethacin. Enalapril lowered converting enzyme activity to 25% to 30% of baseline and tended to increase renin activity. In the 10 patients who received indomethacin (group III), the effects of enalapril alone and enalapril plus indomethacin on urinary excretion of 6-keto prostaglandin F1 alpha (PGF1 alpha), a stable metabolite of prostacyclin (PGI2), were examined. Enalapril increased urinary 6-keto PGF1 alpha in group III from 118 +/- 23 to 194 +/- 38 ng/g creatinine (p less than 0.05), while addition of indomethacin reduced 6-keto PGF1 alpha to basal levels (138 +/- 26 ng/g creatinine).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Antihypertensive effect of enalapril in essential hypertension: role of prostacyclin. 282 71

The antihypertensive effect of labetalol was evaluated in 18 adult black patients with mild to moderate essential hypertension previously controlled with a combination of a diuretic and a beta blocker. After a 4-week washout period, standing blood pressure had increased from 138 +/- 2.2/85 +/- 1.5 mmHg, (mean +/- SEM) to 154 +/- 1.9/100 +/- 0.6 mmHg. Labetalol was then titrated to a maximum of 600 mg BID to obtain a standing diastolic blood pressure of less than or equal to 90 mmHg and/or a decrease of greater than or equal to 10 mmHg from baseline (end of washout period). By the end of the labetalol titration period, standing blood pressure had decreased to 140 +/- 2.0/84 +/- 1.5 (p less than 0.01). Following a 2-week maintenance period, standing blood pressure was 136 +/- 1.6/80 +/- 1.5 mmHg (NS vs. titration). Labetalol therapy was well tolerated and reduced diastolic blood pressure to less than or equal to 90 mmHg in 17 of 18 patients, 13 of whom required dosages less than or equal to 300 mg BID. The average reduction in standing heart rate while on labetalol was 4 bpm (p less than 0.01). Side effects were limited to skin rash in one patient and possible mild urinary retention in another. These data indicate that labetalol is an effective antihypertensive for black patients with mild to moderate essential hypertension.
 ...
PMID:Labetalol as monotherapy in hypertensive black patients. 287 8

Two hundred and one patients with essential hypertension, whose supine diastolic blood pressure (SDBP) was greater than or equal to 95 mmHg following 2 weeks of treatment with the optimal dose of a beta blocker-diuretic combination (Phase 1), were randomly assigned to the addition of either 25 or 50 mg captopril BID for 6 weeks (Phase 2). At the end of Phase 2, the dose of captopril was doubled in the patients not normalized (SDBP greater than or equal to 95 mmHg) and maintained in the others (SDBP less than 95) for an additional 4 weeks (Phase 3). At the end of Phase 3, the beta blocker was withdrawn in the normalized (SDBP less than 95 mmHg) patients, and captopril plus diuretic was given for 4 weeks (Phase 4). The addition of captopril at either dose level led to a significant fall (p less than 0.01) in standing and supine diastolic and systolic blood pressure after the first 2 weeks of treatment. There was no significant difference in response between the two dose levels of captopril. At the end of Phase 2, 59.4% and 55.8% of patients, respectively, assigned to 25 and 50 mg captopril BID, were normalized. Doubling the dose of captopril (Phase 3) led to approximately an additional 30% of patients being normalized. At the end of Phase 4 (captopril plus diuretic) the SDBP was still less than 95 mmHg in 63% of patients, whereas it was increased in the others. Side effects were noted in 10 patients (5%). The incidence was similar in each treatment group, and a total of four patients (2%) were withdrawn due to side effects.
 ...
PMID:A multicenter trial of low dose captopril administered twice daily in patients with essential hypertension unresponsive to beta blocker-diuretic treatment. 288 60

Eight hypertensive patients with moderate renal insufficiency were treated with gradually increasing oral doses of guanabenz acetate to a maximum dose of 8 mg BID. Patients' medications were titrated over 8 weeks. Once blood pressure control was achieved (seated diastolic blood pressure, 90 mmHg, or decrease of 10 mmHg from baseline values), drug dosages were maintained for up to a 12-week total treatment phase. Patients had significant reductions of blood pressure during treatment with guanabenz as compared to that during pretreatment levels. No changes in body weight or creatinine clearance were evident, as compared to baseline values. Our data suggest that guanabenz, in relatively small doses, can be used as safe and effective monotherapy of essential hypertension in patients with moderate renal insufficiency.
 ...
PMID:Safety and efficacy of guanabenz in hypertensive patients with moderate renal insufficiency. 383 1

Twelve patients with essential hypertension (diastolic blood pressure, greater than 90 mmHg) after four weeks of treatment with captopril (50 mg BID) were randomly divided into two groups and treated with 12.5 mg and 25 mg of hydrochlorothiazide OD, in addition to captopril, in a crossover experimental design. Each dosage of hydrochlorothiazide was given for four weeks, with a two-week placebo washout period intervening. Both dosages of hydrochlorothiazide caused significant reductions in blood pressure. Eighty percent of patients achieved a diastolic blood pressure less than 90 mmHg during combination therapy, independent of the dose of diuretic. None of the patients reported significant side effects, and no changes were observed in routine biochemical analysis during treatment. In patients not completely controlled by captopril alone, a once-daily dosage of 12.5 mg of hydrochlorothiazide proved as effective as a 25-mg once-daily dosage. The smaller dosage could result in fewer unwanted metabolic effects induced by diuretic administration.
 ...
PMID:Antihypertensive efficacy of two low dosages of hydrochlorothiazide in patients treated with captopril. 390 43

The efficacy of a propranolol-hydralazine combination tablet was compared with that of each of its two components in the twice-daily treatment of mild to moderate essential hypertension (diastolic blood pressure: 100 to 125 mmHg). After a three-week, single-blind, placebo period, a 9- to 18-week, single-blind, dose-finding phase with the combination was performed. The daily doses of propranolol/hydralazine were 40 mg/25 mg, 80 mg/25 mg, 80 mg/50 mg, 120 mg/50 mg, 160 mg/50 mg, and 160 mg/100 mg. Of 83 patients, 73 (88%) had decreases in diastolic blood pressure equal to or greater than 10 mmHg. Thirty-eight (46%) patients had a diastolic blood pressure equal to or less than 90 mmHg while taking 80 mg propranolol/50 mg hydralazine or less given BID. Mean systolic and diastolic pressures were reduced by 16.8 mmHg (10.9%) and 17.6 mmHg (16.7%), respectively (P less than 0.001). A ten-week, double-blind, parallel-treatment phase followed in which patients were randomly assigned to the combination tablet or to propranolol or hydralazine. There were significantly larger increases in mean systolic (P less than 0.01) and mean diastolic (P less than 0.03) blood pressure when the components were taken alone than with the combination from the mean of the last three weekly dose-finding visits to the mean of the last four biweekly parallel-treatment visits. The changes in systolic/diastolic blood pressures were: hydralazine (n = 30), 14.43/8.62 mmHg; propranolol (n = 24), 9.87/6.09 mmHg; and the combination (n = 27), 1.47/1.53 mmHg. During the parallel-treatment phase, the proportions of patients with new complaints were: hydralazine, 16/31 (52%); propranolol, 10/25 (40%); and the combination, 11/27 (41%). In the hydralazine group, three patients had cardiovascular events (severe tachycardia, mild palpitations, and skipped heart beats) and two patients had mild anxiety; no such occurrences were noted in the propranolol or combination group. The mean change (increase) in heart rate from the end of dose-finding to the end of the double-blind period was significantly larger for patients taking hydralazine than for patients taking propranolol or the combination. Mean changes for these groups were: hydralazine, 12.4 beats/min; propranolol, 2.9 beats/min; and the combination, 1.8 beats/min (P = 0.0001). This study found the combination of propranolol plus hydralazine to be safe and more effective than either component.
 ...
PMID:Propranolol-hydralazine combination in essential hypertension. 635 36

After receiving placebo for two weeks, 20 patients with essential hypertension were randomly divided into two groups. Those in group 1 received a combination of 25 mg of captopril (CPT) and 25 mg of hydrochlorothiazide (HCT) BID. Those in group 2 received a combination of 80 mg of oxprenolol (OXP) and 10 mg of chlorthalidone (CHLT) BID. Patients whose recumbent diastolic blood pressure was less than 95 mmHg after four weeks of treatment continued with the same regimen for six more weeks, while the dosages were doubled for nonresponders. All the patients in group 1 had satisfactory blood pressure readings after the first four weeks of therapy; six patients in group 2 required double dosages to control their blood pressure. Both drug combinations reduced patients' recumbent systolic blood pressure, but CPT + HCT reduced their diastolic and standing systolic blood pressure more effectively. Doubling the dosages of OXP + CHLT was only slightly more effective in controlling patients' blood pressure. In addition, patients who received CPT + HCT showed a significant decrease in serum sodium level, whereas patients who received the double dosages of OXP + CHLT showed a significant increase in serum cholesterol and creatinine levels. The data suggest that low dosages of CPT + HCT control blood pressure more effectively than high dosages of OXP + CHLT and, in addition, do not have any negative metabolic effects.
 ...
PMID:Captopril and oxprenolol in a fixed combination with thiazide diuretics: comparison of their antihypertensive efficacy and metabolic effects. 638 15

The rate of recovery of the renin-angiotensin-aldosterone axis after stopping diuretic administration was examined in 18 male patients with essential hypertension. Upright plasma renin activity (PRA) and plasma aldosterone (PA) were measured during sodium restriction (10 mEq sodium intake), after three days of furosemide administration (40 mg BID po) and for five days following cessation of the diuretic. After diuretic administration, the mean PRA level (8.2 +/- 1.7 ng/ml/hr) was significantly elevated compared to the level on low sodium diet (4.2 +/- 0.5 ng/ml/hr). However, the major finding was that PRA levels continued to increase significantly compared to levels during diuresis on days 1 (11.3 +/- 1.7 ng/ml/hr) and 2 (10.8 +/- 1.5 ng/ml/hr) of the postdiuretic period. Mean PA values paralleled PRA responses in the study. Infusion of normal saline on postdiuretic day 1 failed to suppress PRA to levels seen in subjects not receiving diuretics. The postdiuretic period was accompanied by increased urinary sodium reabsorption and decreased urinary potassium excretion and by significant decreases in creatinine, PAH and free water clearance. The mechanism of this sustained renin response several days after cessation of diuretic therapy may be best explained by a prolonged action of furosemide or by partial ongoing volume depletion with reduced sodium load to the distal nephron. Since all patients demonstrated a marked and consistent PRA response after diuretic withdrawal, this time period represents a potent stimulatory challenge for monitering renin responses.
 ...
PMID:Enhanced renin levels after discontinuation of furosemide: additional effects of loop diuretics on renin release. 674 46


1 2 Next >>