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)

The antihypertensive efficacy and side effects of a transdermal therapeutic system containing 2.5 mg clonidine (clonidine-TTS) was investigated in 21 patients with essential hypertension over a period of 10 weeks. The system was designed to release 0.1 mg clonidine/24 h. Mean systolic and diastolic blood pressure fell from 160 +/- 17/106 +/- 7 mm Hg to 139 +/- 16/91 +/- 8 mm Hg after 4 weeks and to 135 +/- 14/89 +/- 8 mm Hg after 10 weeks (p less than 0.001). Sufficient blood pressure control was achieved by one clonidine-TTS weekly in 24% and by 2 clonidine-TTS in 33% of the patients. 43% of all cases required additional oral therapy with 50 mg hydrochlorothiazide/day. However, antihypertensive action was accompanied by a high incidence of local skin reactions. These skin reactions with erythema, itching and red papules occurred in 6 of the 21 patients (29%) after treatment with TTS for at least 4 weeks. Patch testing with the various components of clonidine-TTS in 4 patients identified clonidine-allergy of delayed type in 3 cases. Typical clonidine side effects such as fatigue, dry mouth, constipation and sexual disturbances were moderate. It is concluded that clonidine-TTS has a good and continuous antihypertensive action. However, the high incidence of skin reactions limits its use in the treatment of essential hypertension.
 ...
PMID:[Clonidine transdermal therapeutic system in essential hypertension: effect and tolerance]. 667 36

Thirty-two patients with primary hypertension were studied in a double-blind cross-over comparison between the cardioselective beta 1-blocking agent atenolol and the combined alpha- and beta-blocking agent labetalol. The doses used were atenolol 50--150 mg twice daily and labetalol 200--600 mg twice daily. Both drugs effectively reduced blood pressure and heart rate. Dose increments every second week resulted in a higher proportion of patients with normal blood pressure (les than or equal to 150/90 mm Hg) with both drugs. Labetalol was somewhat more effective in lowering upright blood pressure while atenolol caused a more pronounced heart-rate reduction. Both agents decreased plasma renin activity and urinary aldosterone excretion. Scalp tingling on labetalol (2 patients) and cold fingers with atenolol (1 patient) caused withdrawal of the drugs. Cold fingers were reported in another four patients during treatment with atenolol and in one when on labetalol. Tiredness and postural symptoms were more common during intake of labetalol.
 ...
PMID:Antihypertensive and metabolic effects of increasing doses of atenolol and labetalol. A comparative study in primary hypertension. 676 Jun 79

Estulic (guanfacine), a new centrally acting antihypertensive agent derived from guanidine, was administered to 13 patients with established essential hypertension. Therapeutic effect and safety were evaluated in all patients during the first year. Blood pressure normalization was elicited in 6 patients and a good therapeutic response in 5. Two patients did not respond to the monotherapy. Dryness of the mouth was observed in 11 patients during the first year and tiredness in 4. At the end of the first year, 3 patients out of 7 who completed the 1-year treatment still complained of dry mouth. Five patients continued for a second year of treatment. In all of them the blood pressure was normalized and only one patient suffered from dryness of the mouth. Estulic was usually given once daily in the evening; in some patients it was given twice daily. At the end of the first year, doses between 2 and 7 mg were used (mean 3.4 mg); during the second year 2 mg/day was administered to 2 patients, 3 mg/day to 2 patients and 5 mg to 1 patient. No impairment of laboratory values was seen during long-term treatment. In one patient with renal insufficiency the treatment had to be discontinued owing to deterioration of the underlying disease. After withdrawal of the drug, no rebound hypertension was observed.
 ...
PMID:[Estulic in the long-term treatment of hypertension]. 678 68

40 patients with essential hypertension were subjected to an analysis of efficacy and safety of the three-component-combination Briserin (Reserpine, Clopamide, Dihydroergocristine). After double-blind and randomized allocation, one group received the two constituents Reserpine/Clopamide, another the full combination Briserin and a third first Reserpine/Clopamide and Briserin afterwards. Both types of treatment proved equi-effective in terms of blood pressure reduction with the blood pressure values falling below 150/90 mm Hg within one week. The most important finding resided in the improved orthostatic tolerance due to Briserin. Maximal systolic pressure drop during standing and the tachycardia associated were significantly reduced by Briserin, i.e. by the influence of Dihydroergocristine. In addition, there was a corresponding difference in terms of subjective complaints due to orthostasis. The same held true for general symptoms related to hypertension such as headache, dizziness, undue tiredness and sleeplessness. Patients preferred treatment with Briserin as compared to the other regimen. The discussion deals with the clinical-pharmacological impact of the orthostatic regulation quality within the framework of antihypertensive treatment.
 ...
PMID:[Hypertension therapy with Briserin: what role do dihydroergocristine components play?]. 679 82

Twenty-eight patients with mild essential hypertension were treated with placebo for six weeks and then with active medication for a further 32 weeks. Twelve patients were well-controlled with 160-320 mg/day of slow release oxprenolol alone, 12 required oxprenolol and chlorthalidone, and four also required hydrallazine. beta-adrenergic blockade reduced the basal level of plasma free fatty acid (FFA) by 41%. A sub-maximal exercise test reduced the level of FFA by 34% during placebo treatment. The same exercise test during beta-blockade reduced the already lowered basal FFA level by a further 45%. Only female subjects experienced exercise-induced leg fatigue during beta-blockade. They always had higher FFA levels than males, but the relative changes in FFA concentration were similar in both sexes. Exercise testing induced a 52 mmHg rise in systolic blood pressure, but this was reduced to only 14 mmHg during treatment. Patients controlled on oxprenolol alone showed no significant change in plasma lipid and lipoprotein levels. Those patients ultimately requiring combination drug therapy experienced a statistically significant rise in plasma triglycerides and a significant fall in high density lipoprotein cholesterol. The biological importance of these changes is uncertain.
 ...
PMID:Long-term treatment with slow release oxprenolol alone, or in combination with other drugs: effects on blood pressure, lipoproteins and exercise performance. 696 9

1. Twenty-two patients with moderately severe essential hypertension were treated for a period of 12 months with guanfacine (BS 100-141), a new centrally-acting antihypertensive agent. A twice daily schedule was followed and the dose range of guanfacine was 1-8 mg daily. 2. In twenty patients satisfactory blood pressure responses (diastolic pressure below 95 mmHg) were achieved in both the supine and the standing position. Pulse rate decreased slightly, though not significantly. 3. Tolerance to the pressure-lowering effect of the drug developed during the third or fourth month of therapy. This could be overcome by either increasing dosage or adding a diuretic. 4. All patients reported side-effects, mainly dryness of the mouth and fatigue. These side-effects became less or disappeared at the end of 3 months. Rebound hypertension on discontinuation of therapy occurred in two patients. 5. Plasma concentrations of noradrenaline and adrenaline as well as plasma renin activity were decreased after 1 week of treatment with the drug. 6. Guanfacine in conjunction with a diuretic is a useful drug in the long-term treatment of hypertension. Reduced central sympathetic outflow may be the major mechanism underlying the antihypertensive effect of the drug.
 ...
PMID:Evaluation of long-term treatment of essential hypertension with guanfacine. 699 80

1. Prizidilol (SKF 92657), a new antihypertensive drug with combined precapillary vasodilator and non-selective beta-adrenoceptor-blocking actions, was given to 24 patients with essential hypertension in a placebo-controlled, dose-titration study, Incremental doses from 200 to 800 mg were given once daily. Supine and standing blood pressure measured 24--27 h after drug intake was reduced during treatment with prizidilol (400--800 mg/day). Slight but significant decreases in heart rate were seen after moderate doses (mean: 447 mg once daily) of prizidilol. A more pronounced blood pressure reduction was noticed 2--7 h after drug administration. 2. Maximal blood pressure reduction coincided with peak plasma concentration of prizidilol, which was measured by a newly developed assay. 3. Plasma renin activity and 24 h urinary excretion of aldosterone and methoxycatecholamines were reduced after the highest doses (mean: 700 mg once daily) of prizidilol. 4. Prizidilol was well tolerated, although dizziness and tiredness were reported by four patients and oedema by two.
 ...
PMID:Prizidilol (SKF 92657) in primary hypertension. 718 85

Although essential hypertension is usually defined as a hemodynamic disorder, it is expressed differently among individuals and varies during progression of the disease state. Therefore, various types of treatment can be envisioned. The use of selective I1-imidazoline-receptor agonists to modulate I1-imidazoline receptors involved in the central regulation of blood pressure has led to the introduction of a novel class of centrally acting antihypertensive drugs. Moxonidine, a representative molecule of this class, dissociates between a 10% alpha 2-adrenoceptor-agonist action linked with side effects such as fatigue or dry mouth, and a 90% specific antihypertensive action resulting from its selective agonistic action at I1-imidazoline receptors. Clinical experience is based on more than 2,000 patients and volunteers, and long-term efficacy has been demonstrated in about 500 patients who received a daily dose of moxonidine 0.2-0.4 mg. Moxonidine produces a pronounced reduction in peripheral vascular resistance without reflex tachycardia, accompanied by reduced plasma norepinephrine concentration and plasma-renin activity. Cardiovascular responses to exercise and standing remain nearly normal, and serious or life-threatening side effects, particularly the sympathetic overactivity that can occur on sudden withdrawal of other centrally acting agents, are never observed. In addition, moxonidine behaves neutrally with respect to plasma levels of cholesterol, potassium and glucose, glucose and lipid metabolism, and renal function, and can be administered without complication to patients with asthma or certain other diseases. Studies with magnetic resonance imaging have shown that moxonidine significantly reduces left ventricular mass, an indicator of left ventricular hypertrophy (LVH), within a 6-month treatment period, an effect that coincided with decreased plasma concentrations of catecholamines and renin. Comparisons between moxonidine and other well-established antihypertensive drugs such as nifedipine, atenolol, or angiotensin-converting enzyme inhibitors showed equal effectiveness in lowering blood pressure, whereas the adverse events profile always favored moxonidine. Considering its efficacy, safety, and specific effects (e.g., its ability to reduce LVH), moxonidine meets the criteria satisfied by other currently prescribed antihypertensive drugs. Because of its especially favorable benefit-to-risk ratio, moxonidine should be recommended as first-line treatment of hypertension and may also be useful in treating related problems such as LVH, coronary artery disease, and ventricular premature beats.
 ...
PMID:I1-imidazoline-receptor agonists in the treatment of hypertension: an appraisal of clinical experience. 753 26

Carvedilol is a beta-adrenoceptor antagonist which also causes peripheral vasodilation primarily via alpha 1-adrenergic blockade. Carvedilol produces its antihypertensive effect partly by reducing total peripheral resistance by blocking alpha 1-adrenoceptors and by preventing beta-adrenoceptor-mediated compensatory mechanisms. This combined action avoids many of the unwanted effects associated with traditional beta-blocker or vasodilator therapy. In clinical trials published to date, most of which enrolled small numbers of patients, the antihypertensive efficacy of carvedilol administered once daily was similar to that of atenolol, labetalol, pindolol, propranolol, metoprolol, nitrendipine (in elderly patients), slow release nifedipine or captopril in patients with mild-to-moderate essential hypertension. Combined therapy with carvedilol 25 mg and hydrochlorothiazide 25 mg, nicardipine 60 mg or slow release nifedipine 20 mg has an additive antihypertensive effect. Carvedilol and atenolol at similar doses were equally effective at reducing blood pressure in patients who had previously not responded adequately to hydrochlorothiazide monotherapy. As a result of its multiple mechanisms of action, carvedilol is suited for the management of specific groups of hypertensive patients, such as those with renal impairment. In patients with non-insulin-dependent or insulin-dependent diabetes mellitus carvedilol does not appear to affect glucose tolerance or carbohydrate metabolism. Initial studies have demonstrated that carvedilol and slow release nifedipine have similar efficacy in patients with stable angina pectoris and there is evidence that carvedilol has a beneficial haemodynamic effect in patients with congestive heart failure (NYHA class II or III) secondary to ischaemic heart disease. A postmarketing surveillance study has shown that carvedilol is generally well tolerated with only 7% (164/2226) of patients (83% of the total number received 25mg daily for 12 weeks) withdrawing from treatment because of adverse events. Vertigo, headache, bronchospasm, fatigue and skin reactions were the most common events causing withdrawal. Thus, clinical experience to date suggests that carvedilol is likely to be a valuable addition to the options currently available for treating patients with mild-to-moderate essential hypertension, and may offer particular benefit in specific populations of hypertensive patients.
 ...
PMID:Carvedilol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. 768 74

The nifedipine gastrointestinal therapeutic system (GITS) is a recently developed controlled-release formulation for once-a-day dosing. We evaluated the influence of morning versus evening administration of the drug in a randomized double-blind cross-over study including 15 essential hypertensives. Five patients had to be excluded from blood pressure analysis because of noncompliance (three cases) or intolerable side effects (two cases). To assess the exact duration of the antihypertensive efficacy noninvasive automatic ambulatory blood pressure monitoring was performed. After a placebo period patients were given 30 mg nifedipine GITS either at 1000 or 2200 hours. Twenty-four-hours systolic and diastolic blood pressure profiles documented a sustained antihypertensive effect of both nifedipine regimens throughout the whole period without affecting the circadian rhythm. Statistical analysis revealed no significant difference between morning and evening administration. Two patients stopped their medication because of intolerable side effects (fatigue and muscle cramps, respectively). Two more cases suffered from mild reversible headache which provoked no discontinuation of the drug. In conclusion our results document a sustained antihypertensive efficacy of 30 mg nifedipine GITS in patients with moderate essential hypertension. Time of administration has no impact on day- and nighttime blood pressure control.
 ...
PMID:Morning versus evening administration of nifedipine gastrointestinal therapeutic system in the management of essential hypertension. 789 13


<< Previous 1 2 3 4 5 6 7 8 9 Next >>