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

Overall, the worldwide experience on enalapril to date is very encouraging. The drug produces good to excellent responses in 54 to 66 percent of patients with essential hypertension and is at least as effective as either diuretics or beta blockers. The effects of enalapril compared with those of diuretics confirm that patients more dependent upon the renin-angiotensin system respond better. When hydrochlorothiazide is administered concomitantly with enalapril, almost all patients respond, with good long-term maintenance. In patients with severe hypertension, Blocadren or Aldomet may be added in addition to hydrochlorothiazide and will produce additional benefit. Enalapril attenuates the adverse metabolic effects of hydrochlorothiazide, particularly hypokalemia. Overall, although the efficacy of enalapril and that of captopril are similar, enalapril is better tolerated and does not appear to be associated with any significant occurrence of captopril-type side effects, particularly the skin rash and loss of taste. As expected, enalapril and other converting inhibitors may be associated with azotemia in patients with bilateral renovascular hypertension.
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PMID:Enalapril worldwide experience. 608 56

Serial blood samples were obtained throughout pregnancy from 11 women with essential hypertension (EHT). Seven were treated with labetalol (Trandate) and 4 with alpha -methyl dopa (Aldomet). Nine patients were well-controlled throughout pregnancy. Their mean plasma renin concentrations (PRC) followed the profile determined in 18 normal patients studied serially. They remained in the upper normal range until the last month, when both treatment groups showed a fall in PRC. Mean plasma aldosterone (ALD) also followed a normal profile until late gestation when it too showed a sharp fall. Of the two patients who developed superimposed PIH, one, who received labetalol, developed severe hypertension at 35 weeks, requiring delivery. Although PRC increased early in this pregnancy, ALD did not, remaining low throughout. Serum potassium [K+] measurements were also very low in this patient. The second patient only became hypertensive at 40 weeks and had PRC and ALD profiles resembling those in the successfully treated EHTs. There was a strong positive correlation throughout between serum potassium and ALD measurements (p less than 0.001) but none between PRC and ALD. This latter agrees with the known lack of correlation between PRC and ALD in normal pregnancy and may suggest that changes in electrolyte balance are more important stimuli to ALD secretion during pregnancy.
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PMID:Renin and aldosterone concentrations in pregnant essential hypertensives - a prospective study. 634 44

The incidence, pathogenesis and management of hypertension in 1600 pregnant women admitted to El-Hussein University Hospital, Cairo, in 1980 was studied. A total of 100 women had pregnancy related hypertension, e.g.: 67 or 4.18% had pre-eclampsia, 7 or .44% had eclampsia, 25 or 1.56% had essential hypertension, and 1 or .06% had chronic nephritis. Total fetal mortality was 18%. Maternal mortality was 2% in all cases. Maternal complications or morbidity was 14: 10 in pre-eclampsia; 1 in eclampsia; and 3 in essential hypertension. From all pathological states 54 patients ended with spontaneous vaginal delivery. Termination of pregnancy occurred only in 2 patients, one with severe pre-eclampsia and the other with severe essential hypertension. Induction of labor was done in different weeks of gestation according to the severity or complications discovered. Caesarean section was done in 12 patients, 7 of them for hypertension and in the remaining 5 for other reasons. Management of hypertension at the hospital consisted of 3 approaches: 1) rest in bed and sedation such as pethidine, valium or Algafan; 2) a combination of sedatives and hypotensives such as Brinerdin, Serpasil and Aldomet; and 3) a combination of sedatives, hypotensives and diuretics.
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PMID:Al-Azar experience in pregnancy associated hypertension. 1226 17