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

Two hundred and thirty-eight patients with essential hypertension from 39 general practice centres were treated in a double-blind trial with either oxprenolol 160 mg in a slow-release (SR) formulation with cyclopenthiazide 0,25 mg and potassium chloride 600 mg given once daily, or methyldopa 250 mg 3 times daily. After a 2-week placebo washout period, each patient was treated for 10 weeks. Both treatments significantly reduced blood pressure. Oxprenolol SR plus cyclopenthiazide-KCl was shown to possess significantly superior antihypertensive activity to methyldopa. Pulse rate, as expected, was significantly decreased by the beta-blocker and virtually unaffected by methyldopa. The overall incidence of side-effects was low. The incidence of sleepiness and dry mouth was significantly higher in the methyldopa group, and erythema in the oxprenolol group. The principle of general practitioners conducting multi-centre double-blind trials for research purposes, on drugs which are predominantly given to ambulatory patients, has been established for the first time in South Africa. Virtually no difficulty was encountered in getting patients' consent in the general practice milieu.
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PMID:Oxprenolol slow-release with cyclopenthiazide-KCl compared with methyldopa in the treatment of essential hypertension. A multicentre general practice trial. 37 Oct 21

1. The aim of the study was to compare the efficacy and the tolerability of treatment with atenolol (50-100 mg once daily), nitrendipine (20-40 mg once daily) and their combination (atenolol 50 mg + nitrendipine 20 mg) once daily in patients with mild to moderate essential hypertension. 2. The study was a randomised, double-blind, placebo controlled parallel groups design: blood pressures were measured at 'trough' effect (i.e. 24 h after dosing) to assess the adequacy of once-daily treatment. 3. Mean blood pressures (mm Hg) recorded on four occasions over 12 weeks of treatment were significantly lower both with atenolol (155/97 sitting: 155/104 standing) and with the combination of atenolol plus nitrendipine (153/96 sitting: 152/104 standing) than with placebo (169/108 sitting: 169/114 standing). Nitrendipine alone had no significant effect on blood pressure 24 h after dosing (165/104 sitting: 165/110 standing). 4. Withdrawals due to adverse effects were more common during treatment with nitrendipine: 7/32 of the patients experienced adverse effects attributable to intense systemic vasodilatation (e.g., flushing, erythema, headache). 2/37 patients taking atenolol were withdrawn: one because he developed a psoriatic rash and the other because of impaired peripheral circulation. Of the 35 patients taking combination treatment, two were withdrawn: one developed headaches and dyspnoea, and the other asthma. 5. The results suggest that once daily dosing with nitrendipine does not control blood pressure throughout the 24 h period in the majority of patients, and is associated with a considerable burden of adverse effects. Combination treatment was better tolerated but appeared to offer no advantages over atenolol alone in terms either of blood pressure control or adverse effects.
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PMID:Comparison of once daily atenolol, nitrendipine and their combination in mild to moderate essential hypertension. 218 68

In this double-blind cross-over study 16 patients with mild-to-moderate hypertension were treated with placebo and the dihydropyridine derivative, isradipine 5-10 mg twice daily. In the supine position isradipine reduced systolic (-18 mm Hg; p less than 0.002) and diastolic (-15 mm Hg; p less than 0.001) pressures, while heart rate was not changed; in the standing position, systolic (-15 mm Hg; p less than 0.002) and diastolic (-14 mm Hg; p less than 0.001) pressures decreased, whereas heart rate increased (+6 bpm; p less than 0.05). Body weight and lower leg volumes remained unaltered, suggesting that isradipine did not cause fluid retention. On IS plasma angiotensin I (+40 pg/ml), angiotensin II (+ 14 pg/ml), and aldosterone (+4.1 ng/dl) rose. The intracellular Na+ and K+ concentrations and the transmembrane cation transport activities (Na+-K+ pump, Na+-K+ cotransport, Na+-Li+ countertransport), measured ex vivo in the erythrocytes of eight male patients, were not significantly influenced by isradipine. Hot flushes and facial erythema occurred more frequently (p less than 0.05) on isradipine than on placebo. In conclusion, the new calcium entry blocker isradipine at a dose of 5-10 mg twice daily lowers blood pressure and is well tolerated in most patients with essential hypertension.
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PMID:Effects of the new calcium entry blocker isradipine (PN 200-110) in essential hypertension. 246 57

The antihypertensive effect of clonidine hydrochloride delivered at a constant rate for seven days by transdermal disks was evaluated in seven patients with essential hypertension. Blood pressure values measured at the physician's office were not significantly decreased by one month of treatment with one (n = 2) or two (n = 5) once-weekly applied clonidine transdermal disks. In contrast, blood pressure values recorded during patients' customary daily activities by means of a portable blood pressure recorder were considerably reduced, from 159/97 +/- 2/2 to 136/76 +/- 7/5 mm Hg. Plasma drug concentration at the end of the fourth week averaged 1.22 +/- 0.24 ng/mL. Plasma renin, vasopressin, and epinephrine levels were not modified by clonidine, whereas plasma norepinephrine level was significantly reduced. Local skin erythema developed in three patients and dry mouth in six. These findings suggest that clonidine transdermal disks lower blood pressure in hypertensive patients, but produce local skin lesions and general side effects.
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PMID:Transdermal clonidine therapy in hypertensive patients. Effects on office and ambulatory recorded blood pressure values. 396 74

Skin patches of a clonidine transdermal therapeutic system (clonidine-TTS) with a constant release rate of either 0.1 or 0.2 mg clonidine/24 h continuously over 7 days were used in 32 essential hypertensives. These self-adhesive drug delivery systems (3.5 cm2), which were affixed to the upper outer arm, were changed by the patients at weekly intervals. During a mean observation period of 7 months (range 1-19 months) transdermal clonidine reduced the blood pressure from 162 +/- 15/107 +/- 5 mmHg to normal values (diastolic less than or equal to 95 mmHg) in 63% of our patients. However, chronic use of clonidine-TTS was accompanied by a high frequency of contact dermatitis (type IV allergy) in nearly half of our patients (n = 15, 47%). In 11 of these 15 patients transdermal clonidine administration had to be stopped because of intolerable local skin reactions (pruritus, erythema, vesiculation, and/or infiltration). Subsequent patch testing with all components of clonidine-TTS was performed in eight cases. Whereas in seven cases an allergic contact dermatitis to clonidine was found, only one patient showed an allergy to another component of clonidine-TTS (polyisobutylene). We conclude that this strikingly high incidence of local allergic skin reactions limits the use of clonidine-TTS in essential hypertension.
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PMID:Transdermal clonidine application: long-term results in essential hypertension. 650 14

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.
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PMID:[Clonidine transdermal therapeutic system in essential hypertension: effect and tolerance]. 667 36

Anaphylactoid reaction to Syntocinon is rare, but has been described in the literature. The reactions described include patchy erythema, hypotension, bronchospasm and oxygen desaturation, but pulseless electrical activity following Syntocinon has not been reported. We present the case of a 34-year-old primigravida with essential hypertension, gestational diabetes and hypothyroidism with a twin pregnancy following in vitro fertilization. During elective caesarean delivery she developed a severe anaphylactic reaction to Syntocinon leading to pulseless electrical activity.
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PMID:Pulseless electrical activity during caesarean delivery under spinal anaesthesia: a case report of severe anaphylactic reaction to Syntocinon. 2021 47