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

Recent evidences suggest that the sympathetic nervous system plays a major role in the pathogenesis and maintenance of several clinical forms of hypertensive disease. The clonidine suppression test allows us to uncover the subtle changes in neuronal noradrenaline release in essential hypertension. To prove this possibility, we selected 16 patients: 7 borderline hypertensives (BH) (4 males and 3 females), mean age: 24 years; and 9 established hypertensives (EH) (6 males and 3 females), mean age: 25 years. In both groups, the heart rate (HR) and blood pressure (BP) were registered every 30 min and by intravenous catheter plasma catecholamines (PCA) and plasma renin activity (PRA) were measured before and after (180 and 240 min) one oral dosis of clonidine (300 mcg) had been administered. Patients remained in clinostatism for 180 and and orthostatism for 60 min. HR and BP diminished in BH and EH after clonidine during clinostatism in comparison to preclonidine period. PCA also showed reduction in 180 min with respect to the basaline period. PRA did not present change in 180 min in either groups in relation to time O. During orthostatism, HR increased in both groups with respect to the baseline period. BP remained low in relation to baseline time. PCA were increased with respect to preclonidine period. PRA showed a slight tendency to increase in relation to time O in both groups. CAP baseline level are not reliable indexes of the role of the sympathetic tone in maintenance of high BP values in hypertensive disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of sympathetic tone in essential hypertension by the clonidine suppression test]. 294 90

Nitric oxide (NO) production is reduced in patients with essential hypertension and in some experimental models. We have investigated the effect of trichlormethiazide and captopril on NO synthase (NOS) activity and glomerular damage in the kidney of deoxycorticosterone acetate (DOCA)-salt hypertensive rats. DOCA-salt rats were induced with weekly injections of DOCA (30 mg/kg body weight (BW) and 1% saline in drinking water after right nephrectomy. As antihypertensive therapies, CAP (captopril, 40 mg/kg BW) and TCM (trichlormethiazide, 10 mg/kg BW) were given after induction of DOCA-salt hypertension. The increased blood pressure was significantly lowered by TCM, but not by CAP after 5 weeks. Nitrite production in kidney slices was suppressed in DOCA-salt rats, and immunoreactivity for both brain-type NOS (B-NOS) in macula densa and endothelial-type NOS (EC-NOS) in renal vessels was decreased. TCM significantly increased the nitrite production in the kidney slices and B-NOS immunoreactivity, whereas these changes were less in CAP. Glomerulosclerosis score was significantly higher in DOCA-salt rats, and TCM ameliorated renal damage more effectively than CAP. These results indicate that the reduced nitrite production in the kidney of DOCA-salt hypertensive rats was increased more effectively by trichlormethiazide than by captopril, via increased immunoreactivity for B-NOS in the macula densa, and prevented renal damage.
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PMID:Effect of trichlormethiazide and captopril on nitric oxide synthase activity in the kidney of deoxycorticosterone acetate-salt hypertensive rats. 867 52

A double-blind, randomized, parallel-group study was performed to compare the efficacy and tolerability of captopril-thiazide and enalapril-thiazide combinations. After a 3-week placebo run-in period, 47 Black patients with mild to moderate essential hypertension (mean 24-hour diastolic blood pressure (BP) > 90 mmHg and < 115 mmHg) were randomized to receive 1 of 2 combination tablets: captopril 50 mg plus hydrochlorothiazide 25 mg (CAP, n = 24) or enalapril 20 mg plus hydrochlorothiazide 12.5 mg (COR, n = 23) once daily. After 12 weeks of active treatment the mean 24-hour ambulatory BP was reduced from 152 +/- 11/99 +/- 6 to 133 +/- 13/86 +/- 7 mmHg (p < 0.005) in the CAP group and 157 +/- 15/100 +/- 6 to 141 +/- 18/90 +/- 12 in the COR group (p < 0.005). Target BP (24-hour diastolic BP < 90 mmHg) was achieved in 75% (18/24) of patients on CAP and 48% (11/23) on COR (p = n.s.). 24-hour BP load fell significantly with both CAP (from 69% to 34%, p < 0.001) and COR (from 67% to 37%, p < 0.001). Left ventricular mass index decreased by 7% with CAP and 11% with COR. Cardiac index and fractional shortening remained essentially unchanged in both groups. Both treatments were well tolerated and overall incidence of side effects was very low. It is concluded that both CAP and COR are effective, safe first-line antihypertensive choices in Black patients with mild to moderate hypertension with the former showing a trend towards greater efficacy than the latter.
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PMID:Comparison of captopril-thiazide and enalapril-thiazide combinations in the management of mild to moderate black hypertensive patients: how important is diuretic dose and duration of action of the ACE-inhibitor? 879 12