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)

The antihypertensive effect of the following therapeutic regimens: diuretic alone (DA), diuretic plus sympathetic inhibitor (DSI), diuretic plus betablocker (DB) and diuretic plus, betablocker plus vasodilator (DBV) was studied for 34.1 +/- 5.4 months in 28 patients with resistant essential hypertension (REH). Depending of treatment tolerability and the optimal antihypertensive action of drugs 21, 24, 26 and 10 cases were treated continuously or alternately with DA (9.9), DSI (15.0), DB (4.8), and DBV (14.6), respectively (in paragraph average duration of treatment in months). On admission the 89.3% and 42.8% of population had electrocardiographic signs of left ventricular hypertrophy or past-history of cardio-vascular complications, respectively. Arithmethic average and standard deviation of individual changes of systolic and diastolic blood pressure obtained during DA, DSI, DB and DBV treatment were -32.4 +/- 31.8, -19.3 +/- 27.2, -18.9 +/- 15.9 and -18.2 +/- 21.3 for systolic and -35.8 +/- 20.2, -12.3 +/- 17.2, -15.1 +/- 16.9 and -15 +/- 13.1 (mm. de Hg.) for diastolic blood pressure respectively. Average blood pressure before treatment was 222.4 +/- 30.3/128.0 +/- 20.8 (mm of Hg) and under the most effective treatment was 175.5 +/- 21.8/106.5 +/- 12.1 with a p less than or equal to 0.001 for either sistolic and diastolic pressure. There were not significant regressive electrocardiographic changes during the therapeutic period, neither significant changes in urea and creatinine blood values. 46.4% and 25% of cases exhibited collateral drug symptoms and cardio-vascular no fatal complications, respectively. Three of the last group patients died outside of the Hospital (2 sudden deaths and 1 renal insufficiency death). RH still constitutes a challenge to medical therapy. Nevertheless individualized therapy may modify the natural history of this hypertensive variety.
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PMID:[Problem in the management of arterial hypertension resistent to drug treatment. Study of 28 cases]. 3 45

18-hydroxy 11-deoxycorticosterone (18-OH DOC), a weak mineralocorticoid, was estimated by a radioimmunoassay procedure after purification in 49 patients with hypertension and 38 normal control subjects. The sensitivity of the method was 2-4 pg; there was no detectable blank, and the precision was 9-10%. In normal subjects the absolute plasma levels were similar to those of aldosterone. ACTH administration produced a 23-fold increase, and sodium restriction resulted in a 4-fold increase (5.4+/-0.7-20.5+/-3.0 ng/dl). On the other hand, the plasma levels of 18-OH DOC declined by nearly 50% with upright posture or angiotensin II infusion. During both of these procedures, plasma aldosterone levels significantly increased. Patients with normal and low renin hypertension had similar changes in plasma 18-OH DOC levels with sodium restriction. However, the mean high sodium level in the normal renin essential hypertension group (11.6+/-1.6 ng/dl) was significantly greater (P is less than 0.001) than in the control group (5.4+/-0.7 ng/dl). In addition, at least 22% and perhaps as high as 37% of the hypertensive subjects had levels greater than the upper limits of normal on a high sodium intake. Differences between the groups were less impressive in the sodium-restricted studies. There were no significant differences in age, duration of hypertension, sodium balance, serum sodium, potassium, or blood urea nitrogen in those patients who had elevated levels of plasma 18-OH DOC. Patients with primary aldosteronism had levels within the normal range on both dietary intake. However, in contrast to the other groups there were no significant changes in the plasma levels with sodium restriction. Thus, a significant number of patients with essential hypertension presumably have an alteration in 18-OH DOC secretion.
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PMID:The regulation of plasma 18-hydroxy 11-deoxycorticosterone in man. 18 59

A salt-free diet is usually useless or dangerous in the elderly subject. It has at present only rare indications, such as after acute pulmonary oedema or congestive heart failure during initial treatment. In all other cases, it may be replaced by a reasonable diet; sodium intake remains permitted, but naturally one should not fall in the opposite extreme. As in younger subjects, and provided one takes into consideration the subjacent renal condition, properly prescribed diuretics have transformed the situation in the treatment of heart failure as in essential hypertension. Naturally the patient still requires regular clinical supervision and laboratory tests which may in practice be limited to periodical estimation of blood urea and serum potassium, less regularly, blood sugar and uric acid.
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PMID:[Salt-free diet and diuretics in the elderly (author's transl)]. 21 98

Endocrine activity in patients with essential hypertension was studied by measuring the urinary excretion of catecholamines, prostaglandin E (PGE) and cyclic adenosine monophosphate (cAMP). Simultaneously, plasma renin activity, concentrations of serum sodium, potassium, blood urea nitrogen (BUN) and creatinine were determined. Systolic blood pressure and BUN increased progressively with age until the sixth decade. Urinary excretion of norepinephrine was correlated with the systolic blood pressure. In contrast, plasma renin activity and urinary excretion of PGE decreased progressively with the increase in systolic blood pressure. Although the cause of essential hypertension is not known, it is suggested that hypertension accelerates the aging process in the kidney and thus decreases renal PGE synthesis. This decrease of PGE in turn causes a reduction of plasma renin activity, possibly either by accelerating the retention of sodium and water or by failing to stimulate renin synthesis. A decrease of PGE may also potentiate the vasopressor action of norepinephrine.
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PMID:Changes in hormonal activities relative to the severity of essential hypertension. 21 51

A double-blind, crossover, multicentre study of 98 previously untreated patients with mild to moderate essential hypertension was carried out in general practice to assess the effect of 50 mg, 100 mg, and 200 mg atenolol, given once daily, compared with that of placebo over a period of 4 weeks each. At the end of the double-blind phase, all patients took 100 mg atenolol daily for a further 8 weeks. All three doses of atenolol produced statistically significant falls in systolic and diastolic pressure and pulse rate (p less than 0.001). The lowest pressures were achieved with 100 mg daily; a difference of 22/15 mmHg at the end of the double-bling phase, and a difference of 25/16 mmHg at the final observation. Body weight, blood urea, blood uric acid, and serum electrolytes remained within normal limits throughout the study. The incidence of side-effects with 50 mg and 100 mg atenolol was not significantly different from that caused by placebo, but the incidence of tiredness at the 200 mg dose level was greater than that caused by placebo and by the lower doses. The incidence of possible side-effects elicited by a questionnaire was low, the greatest number being volunteered by patients taking placebo. It is concluded that the optimal dose of atenolol for treating patients with mild to moderate hypertension in general practice is 100 mg daily.
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PMID:A dose-response study of atenolol in mild to moderate hypertension in general practice. 34 Jan 36

In a double-blind study, 28 patients having mild to moderate essential hypertension were randomly assigned to a 6-week regimen of ticrynafen, hydrochlorothiazide, or placebo. Blood pressure fell after ticrynafen and hydrochlorothiazide. Serum uric acid fell strikingly with ticrynafen whereas it rose with hydrochlorothiazide. Serum potassium declined very little with ticrynafen; much less than with hydrochlorothiazide. Serum creatinine and blood urea nitrogen rose slightly more with ticrynafen than with hydrochlorothiazide. There were no clinical adverse effects to either of the medications. Ticrynafen appears to be an effective antihypertensive with a substantial hypouricemic effect.
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PMID:Ticrynafen and hydrochlorothiazide in hypertension. 34 80

1. Amiloride (40 mg/day) was given to nineteen patients with primary hyperaldosteronism. There were significant falls in systolic and diastolic blood pressure, in total exchangeable sodium and in serum sodium and bicarbonate, while total exchangeable potassium, total body potassium, serum potassium, chloride and urea, plasma renin, angiotensin II and aldosterone all increased significantly. Amiloride was effective in reducing the blood pressure in patients with and without adrenocortical adenoma. No carry-over effect was seen on withdrawing amiloride. Similar changes were associated with amiloride treatment in five patients with essential hypertension; hyperkalaemia was not observed. 2. Only negligible side effects were encountered in the entire series of 24 patients.
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PMID:Amiloride in the treatment of primary hyperaldosteronism and essential hypertension. 35 30

A new hypouricemic diuretic (tienilic acid) was compared with hydrochlorothiazide in a double-blind study in 8 patients with mild essential hypertension. After a two-week placebo period the patients received either 250 mg tienilic acid or 50 mg hydrochlorothiazide in a single daily dose for 3 weeks. After a second placebo period of 2 weeks the patients received, in a crossover design, either tienilic acid or hydrochlorothiazide for a further 3 weeks. The reduction of blood pressure and of body weight was similar for both drugs. When treatment was started diuresis and natriuresis increased with tienilic acid and with hydrochlorothiazide. Whereas serum sodium levels showed only minor variations, serum potassium levels fell with both diuretics and urinary potassium excretion increased. Urinary calcium excretion decreased and serum calcium levels slightly increased under both treatments. Both diuretics induced similar increases of plasma renin activity, plasma aldosterone concentration and aldosterone-18-glucuronide excretion. Blood urea nitrogen and, to a lesser extent, serum creatinine levels were raised slightly under both drug regimens. Whereas the serum uric acid level rose and remained elevated for the duration of hydrochlorothiazide treatment, it fell significantly and remained lowered during treatment with tienilic acid. Uric acid clearance was about twice as high with tienilic acid as with hydrochlorothiazide. Tienilic acid therefore appears to be a therapeutic alternative to thiazides and other hyperuricemic diuretics in hypertensive patients in whom hyperuricemia should be avoided or corrected.
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PMID:[Experiences with a new hypouricemic diuretic (tienilic acid): comparison with hydrochlorothiazide]. 37

526 patients with essential hypertension or congestive cardiac failure were treated with ticrynafen (250--500 mg/day) or hydrochlorothiazide (50--100 mg/day) for 6 weeks to 6 months. There was no appreciable effect on renal function, as measured by changes in blood urea nitrogen and serum creatinine levels. Both drugs exhibited similar antihypertensive activity and ability to control signs and symptoms of congestive cardiac failure. Side effects were mild and reversible. A notable difference is the marked reduction in serum uric acid in patients treated with ticrynafen, unlike the elevated urate levels occurring after treatment with hydrochlorothiazide.
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PMID:Renal function during ticrynafen therapy. 38 57

In a double-blind study, thirty patients having mild to moderate essential hypertension were randomly assigned to a six week regimen of either tienilic acid, hydrochlorothiazide, or placebo. Blood pressure was significantly reduced with tienilic acid and hydrochlorothiazide although more so with tienilic acid. Serum uric acid declined strikingly with tienilic acid and increased significantly with hydrochlorothiazide. Serum potassium declined slightly with tienilic acid but more so with hydrochlorothiazide. Serum creatinine and blood urea nitrogen increased slightly more with tienilic acid than with hydrochlorothiazide. There were no clinical adverse effects to any of the medications during this study. Twenty-four months of continuous administration of tienilic acid revealed maintenance of blood pressure effect, but with slight increases in blood urea nitrogen, serum creatinine and uric acid and slight decreases in serum potassium as compared to six weeks administration. Tienilic acid appears to be a useful new antihypertensive agent. The hypouricaemic effect is profound and strongly suggests the need for continuing evaluation of this compound because of its unique combination of diuretic, antihypertensive and hypouricaemic properties.
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PMID:A double-blind study of tienilic acid with two year follow-up of patients with mild to moderate essential hypertension. 38 95


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