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)

Brachial artery diameter (pulsed Doppler method), forearm vascular resistance, and venous tone (plethysmographic method) were studied in 18 patients with sustained essential hypertension. Hemodynamic parameters were reevaluated after 3 months of treatment by propranolol (9 patients) or pindolol (9 patients). For the same decrease in pressure, propranolol decreased heart rate significantly while pindolol did not, indicating the role of intrinsic sympathomimetic activity. After pindolol, forearm vascular resistance and venous tone significantly decreased while brachial artery cross-sectional area significantly increased. After propranolol, forearm vascular resistance and brachial artery cross-sectional area did not change significantly, while forearm venous tone increased markedly. The study shows that, in the long term, pindolol dilates small and large arteries and veins of the forearm circulation whereas Propranolol apparently does not.
 ...
PMID:Comparative effects of propranolol and pindolol on small and large arteries and veins of the forearm circulation in hypertensive man. 242 54

beta-Adrenoceptor sensitivity after abrupt withdrawal of long-term therapy (5-12 months) with bopindolol (1-2 mg/day), a long-acting beta-adrenoceptor blocking agent with intrinsic sympathomimetic activity, was assessed in five patients with uncomplicated essential hypertension. The chronotropic dose 25 of isoproterenol (CD 25), plasma concentrations of catecholamines, triiodothyronine and thyroxin, plasma renin activity and aldosterone, hemoglobin, hematocrit and oxyhemoglobin dissociation were measured on the last day of bopindolol administration and 1, 2, 3, 6, and 13 days after abrupt replacement by placebo tablets. The chronotropic dose 25 of isoproterenol (microgram/m2) was greater than 25.6 in all patients on the last day of bopindolol therapy. On day 1 in patients who had been taking 2 mg/day of bopindolol, CD 25 remained greater than 25.6 but fell to 12.1 in the one patient who had been taking 1 mg/day. On day 2, CD 25 was 10.19 +/- 2.97 and felt gradually to the lowest value of 3.76 +/- 1.19 on day 13. Throughout the study, plasma concentrations of catecholamines, triiodothyronine and thyroxin, and oxyhemoglobin dissociation remained unchanged. Plasma renin activity and plasma aldosterone, which were suppressed during bopindolol therapy, rose during placebo, coinciding with a fall in hemoglobin and hematocrit. No subjective symptoms of increased beta-adrenoceptor-mediated functions were reported by the patients throughout the whole study period. Therefore, hypersensitivity of beta-adrenoceptor-mediated responses was not demonstrated within the first 13 days after sudden withdrawal of bopindolol.
 ...
PMID:Withdrawal of the long-acting beta blocker bopindolol is not associated with beta-adrenoceptor supersensitivity. 243 24

Essential hypertension is associated with increased intrarenal resistance that may go undetected unless the fractional distribution of cardiac output to the kidney is measured. Several hypotensive drugs induce a transient reduction of renal blood flow and glomerular filtration rate due to the reduction in renal perfusion. This may represent an untoward effect especially in subjects already presenting a clinically relevant reduction of renal function. Loop diuretics, cardioselective and intrinsic sympathomimetic activity (ISA) beta-blockers, calcium entry-blockers, and angiotensin-converting enzyme (ACE) inhibitors either do not significantly reduce or even increase renal perfusion. This is one more reason for considering these agents as first choice drugs for the treatment of hypertension.
 ...
PMID:Renal hemodynamic changes induced by hypertension and its treatment. 264 11

The pharmacologic therapy of mild primary hypertension (diastolic blood pressure less than 105 mm Hg) has effectively reduced hypertensive arteriolar end organ disease such as cerebrovascular accidents, congestive heart failure, and nephropathy, but there has been no convincing evidence that coronary heart disease (CHD) or its complications, acute myocardial infarction or angina, have been reduced. The risks of therapy with certain antihypertensive drugs may outweigh their treatment benefits as it relates to CHD. The optimal treatment strategy should be to reduce all CHD risk factors, reverse the hemodynamic abnormalities present by lowering the systemic vascular resistance (SVR), preserving cardiac output (CO) and perfusion, and to select the best antihypertensive drug for concomitant medical diseases or problems while maintaining a good quality of life. Antihypertensive drugs that have favorable or neutral effects on CHD risk factors include alpha blockers, calcium channel blockers, central alpha agonists, and angiotensin-converting enzyme inhibitors. On the other hand, diuretics and beta blockers without intrinsic sympathomimetic activity have unfavorable effects on many CHD risk factors. Baseline and serial evaluation of the effects of these drugs on serum lipids, lipid subfractions, glucose, uric acid, electrolytes, exercise tolerance, left ventricular hypertrophy, blood pressure, SVR, CO, perfusion, concomitant diseases, and side effects is necessary to evaluate overall cardiovascular risk.
 ...
PMID:New insights and new approaches for the treatment of essential hypertension: selection of therapy based on coronary heart disease risk factor analysis, hemodynamic profiles, quality of life, and subsets of hypertension. 238 95

The acute effects of propranolol and acebutolol on blood pressure, heart rate and hormonal changes during graded treadmill exercise were studied in patients with essential hypertension. Both of propranolol (2 mg i.v.) and acebutolol (10 mg i.v.) lowered the pre-exercise hemodynamic parameters and suppressed the elevation of systolic blood pressure, heart rate and pressure-rate product during exercise, but did not show any significant effect on diastolic blood pressure. Although these drugs increased plasma norepinephrine concentration (PNE) at rest and during moderate exercise, they failed to affect PNE at submaximal exercise. Plasma renin activity at rest and during exercise were more strongly suppressed by propranolol than acebutolol. Plasma aldosterone concentration was not affected by these drugs. Propranolol and acebutolol showed similar acute effects on blood pressure, heart rate and hormonal profiles at rest and during exercise within the doses used in this study. These results indicate that beta 1 adrenoceptor selectivity and intrinsic sympathomimetic activity may not play an important role in the acute antihypertensive effect at rest and during exercise and that both beta blockers have beneficial antihypertensive effects during exercise on patients with essential hypertension.
 ...
PMID:Comparison of the acute effects of acebutolol and propranolol on blood pressure, heart rate and hormonal changes during graded treadmill exercise in patients with essential hypertension. 265 44

During 10 years of clinical use involving almost 3 million patient-years, acebutolol has become established as a remarkably safe and well-tolerated beta-blocking agent, effective in treating essential hypertension and cardiac arrhythmias. The existence of a long-lived active metabolite (diacetolol) confers a 24-hour duration of action, which permits effective use of a once-daily regimen, particularly for hypertension. Acebutolol has low lipid solubility and low protein binding; the former property reduces the risk of central side effects, and the latter means that displacement interactions with other drugs are unlikely. Because acebutolol and its metabolite normally have both renal and hepatic excretion pathways, an alternative pathway is available should either be compromised through disease. Acebutolol is cardioselective, and clinical use has borne out the low incidence of bronchospasm in patients with impaired lung function. The possession of intrinsic sympathomimetic activity (ISA) leads to only modest reductions in cardiac output, which in turn reduces the chance of excessive bradycardia and the likelihood of precipitating heart failure. A combination of selectivity and ISA may be responsible for the low incidence of tiredness and cold extremities observed with acebutolol compared with other beta blockers. The unique pharmacologic and pharmacokinetic profile of acebutolol confers several therapeutic advantages and may be responsible for the generally low level of side effects experienced in clinical use.
 ...
PMID:Acebutolol: ten years of experience. 285 85

Betaxolol is a relatively cardioselective beta-adrenoceptor blocking drug, with no partial agonist (intrinsic sympathomimetic) activity and weak membrane-stabilising (local anaesthetic) activity. Its pharmacokinetic properties of most interest include high bioavailability after oral administration, and a long elimination half-life. It has a narrow dose-response range, which obviates the need for dose titration, with 10 to 20 mg once daily being the usual dosage. This dose reduces systolic and diastolic blood pressures by about 15 mm Hg in most patients with mild to moderate hypertension. In a few comparative studies betaxolol 20 mg daily was as effective as atenolol and moderate doses of propranolol, and more effective than acebutolol, in reducing blood pressure in such patients. Betaxolol has been well tolerated in most patients. Thus, betaxolol is an effective alternative to other beta-blocking drugs in patients with essential hypertension, with properties that may offer advantages in some patients.
 ...
PMID:Betaxolol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in hypertension. 286 47

Several antihypertensive drugs have an adverse effect on glucose tolerance that may partially or completely negate the beneficial effects of reducing blood pressure as it relates to the incidence of coronary heart disease and its complications. Diuretics (particularly high doses) and beta-blockers without intrinsic sympathomimetic activity have the greatest adverse effect on glucose intolerance. Central alpha-agonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, and alpha-blockers do not adversely affect glucose and are preferred in diabetic hypertensive patients, selected hypertensive patients at risk for developing glucose intolerance, and probably most other patients with mild essential hypertension as initial and/or monotherapy compared with diuretics and beta-blockers.
 ...
PMID:Adverse effects of antihypertensive drug therapy on glucose intolerance. 287 31

The antihypertensive effects of indenolol, a new not-cardioselective beta-blocking agent, were evaluated in patients with WHO grades I and II essential hypertension (range 160/95 to 200/115 mm Hg) in a double-blind, placebo-controlled study after acute (12 patients) and 2-week treatment (seven patients). Indenolol (30 to 120 mg) reduced blood pressure in a dose-dependent fashion. Maximum reduction was 26 mm Hg for systolic and 17 mm Hg for diastolic pressure. Hypotensive activity commenced within 10 minutes, peaked in 60 minutes, and persisted for about 7 hours. Lower limb vascular resistance (strain-gauge plethysmography) was significantly lowered, thus suggesting an intrinsic sympathomimetic activity. Heart rate was progressively reduced at 30 and 60 mg without any additional effect at 120 mg. Indenolol did not alter adrenergic reflexes (standing, cold application, and hand-grip) and did not induce any side effect. In conclusion, indenolol possesses an antihypertensive activity associated with reduction of vascular resistance.
 ...
PMID:Effects of indenolol on blood pressure, lower limb blood flow, adrenergic reflexes, and plasma renin activity. 288 Jun 89

The effect on plasma lipids of a new beta-blocker bucindolol, which possesses weak alpha-adrenergic blocking property and intrinsic sympathomimetic activity, given orally over a 3-month period as a monotherapy or with a thiazide diuretic to 44 patients with essential hypertension was studied. The mean level of plasma HDL cholesterol concentration increased significantly during 3 months monotherapy with bucindolol or with bucindolol and diuretic. This increase was due to the increase of HDL3 subfraction. There were no significant changes in the concentrations of plasma triglycerides or total cholesterol during treatment. The ratio of HDL cholesterol to total cholesterol increased significantly. The concentration of apoprotein A-I decreased significantly in both treatment groups, but the level of apoprotein B remained constant among treatment groups. The results support the earlier observations that beta-adrenergic blocking agents with different pharmacologic properties differ as regard to their effects on plasma lipids and lipoproteins.
 ...
PMID:Effect of bucindolol on plasma HDL cholesterol subfractions and other plasma lipids in essential hypertensive patients. 288 37


<< Previous 1 2 3 4 5 6 7 Next >>