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)

We assessed the long-term effects of carvedilol on renal function in 10 patients with mild-to-moderate essential hypertension. After a 2- to 4-week placebo run-in period, all patients received 5 mg carvedilol once daily. If the effect was insufficient, the dosage was successively increased to 10 or 20 mg once daily. The mean +/- SEM duration of treatment was 17.3 +/- 1.0 weeks, and the final mean daily dosage was 13.5 +/- 2.2 mg/day. With treatment, systolic and diastolic blood pressures decreased significantly from 159.7 +/- 1.3 to 140.5 +/- 3.2 mm Hg (p less than 0.001) and from 98.3 +/- 1.0 to 88.2 +/- 2.7 mm Hg (p less than 0.001), respectively. Carvedilol did not cause significant changes in glomerular filtration rate, effective renal plasma flow, blood urea nitrogen, or serum creatinine. Renal vascular resistance decreased significantly from 12.7 +/- 1.4 to 11.2 +/- 1.2 dyne.s.cm-5/1.48 m2 x 10(3) (p less than 0.05). Thus, long-term carvedilol therapy was effective in reducing blood pressure in essential hypertension without causing impairment of renal function.
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PMID:Effect of long-term carvedilol therapy on renal function in essential hypertension. 137 58

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The efficacy and tolerability of enalapril--hydrochlorothiazide combination as a first line therapy in black patients with mild to moderate arterial hypertension: a clinical study in Kenya. 162 42

The aim of this 3-month double-blind multicenter trial was to compare the antihypertensive efficacy and tolerability of the ACE inhibitor perindopril with those of a diuretic combination. After 1 month of receiving placebo, 165 patients with essential hypertension were randomised to perindopril 4 mg (n = 82) or to 50 mg hydrochlorothiazide + 5 mg amiloride (n = 83). The patients were treated for 3 months with monthly assessments, "uncontrolled" patients (DBP greater than 90 mm Hg) had their dosage doubled and then, if necessary, atenolol 50 mg was added. At the end of the 3-month study, mean decreases in supine and standing systolic and diastolic blood pressures were similar in both groups. In the perindopril group, BP control was obtained in 56% of the patients with the 4 mg dosage and required an increase to 8 mg alone in 16% and with atenolol in 5%. The corresponding percentages in the diuretic group were 48, 23 and 13%. The overall percentage of "controlled" patients was similar in the 2 groups, respectively 78 and 84%. The nature and incidence of complaints were comparable in the 2 groups. Adverse laboratory changes were more frequent in the diuretic group: decrease in blood sodium (140.5 vs 139.1 mmol/l; P less than 0.01), potassium (4.2 vs 3.9 mmol/l; P less than 0.01) with 10 patients having significant hypokalemia, increase in blood urea, triglycerides and uric acid. By contrast, a transient increase in blood potassium with a decrease in triglycerides was observed in the perindopril group.
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PMID:A double-blind comparison of perindopril and hydrochlorothiazide-amiloride in mild to moderate essential hypertension. 168 28

Osler's maneuver which makes it possible to detect phenomenon of pseudo-hypertension was performed in 64 patients with elevated blood pressure when measured by Korotkoff's method. In 14 patients with essential hypertension and 14 patients with pseudo-hypertension the effect of 9 days hypotensive treatment with furosemide on renal function was compared. 22% of studied patients revealed pseudo-hypertension. The drop in arterial pressure caused a significant increase in the plasma urea, as well as a significant decrease in creatinine clearance and uric acid clearance in patients with pseudo-hypertension. These changes were not observed in patients with essential hypertension. Antihypertensive treatment of patients with pseudo-hypertension is hazardous due to the possibility of adverse effects caused by diminished tissue flow. Before starting the hypotensive therapy in elderly patients it is advisable to exclude pseudo-hypertension by means of Osler's maneuver.
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PMID:[Effect of hypotensive treatment on renal function in patients with pseudo-hypertension]. 188 32

The safety and efficacy of labetalol and hydrochlorothiazide (HCTZ) were compared in a group of 34 patients aged 65 years or older with mild to moderate essential hypertension. After a 4-week placebo run-in period, during which all previous antihypertensive medication was discontinued, patients were randomized to receive either labetalol (100 mg bid) or HCTZ (25 mg bid). The patients' blood pressure and heart rate were evaluated biweekly and drug dosage was titrated (up to 400 mg and 50 mg bid of labetalol and HCTZ, respectively) to achieve a standing diastolic blood pressure less than 90 mm Hg. Patients underwent 24-hour ambulatory blood pressure monitoring at the end of the placebo run-in period and again after the 6-week titration period. Both labetalol and HCTZ significantly (P less than .01) reduced standing systolic (-19.4 vs -27.7 mm Hg) and diastolic (-14.0 vs -15.2 mm Hg) blood pressures following 12 weeks of treatment. Both antihypertensives effectively controlled the 24-hour ambulatory blood pressure, however, the labetalol group experienced a significantly lower rate of rise in diastolic blood pressure (P = .02) and mean arterial pressure (P = .02) during the acceleration period (400-1200) compared to the HCTZ group. HCTZ caused significant decreases in serum potassium (P less than .01) and alkaline phosphatase (P less than .05) and increases in uric acid (P less than .01) and urea nitrogen (P = .07). These results indicate that labetalol may offer some unique advantages over thiazide diuretics that may be particularly important in the treatment of elderly patients with hypertension.
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PMID:Comparison of labetalol and hydrochlorothiazide in elderly patients with hypertension using 24-hour ambulatory blood pressure monitoring. 235 3

Blood plasma uric acid and urea content and aspartate aminotransferase activity were studied in 177 patients with ischemic heart disease and essential hypertension. It was established that the blood uric acid level did not depend essentially on the transamination processes in patients with ischemic heart disease but was closely connected with transamination processes and amino acid metabolism in patients with essential hypertension.
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PMID:[The relation of uric acid metabolism to transferase activity in patients with ischemic heart disease and hypertension]. 239 37

We administered diltiazem HCl i.v. (0.05 mg/kg in bolus followed by 0.01 mg/kg/min for 45 min), and determined the changes in blood pressure (BP), glomerular filtration rate (GFR), renal blood flow (RBF), total renal resistance, urinary volume (UV), urinary sodium (UNa) and potassium excretion, urea and osmolar clearance, and tubular reabsorption ratio of sodium (TRNa%). The serum concentration of diltiazem achieved was similar to the maximum level after a single oral dose of 120 mg. GFR and RBF were measured by i.v. infusion of sodium thiosulfate and sodium rho-amino-hippurate, respectively, as indicators. The subjects included 12 cases of essential hypertension (EH), 10 of chronic glomerular nephritis (CGN) with hypertension, 12 of CGN without hypertension, 12 of ischemic heart disease (IHD), and 10 of normotensive controls. BP decreased in hypertensives but not in normotensives. In patients with EH, GFR and RBF increased markedly (by 25.3 +/- 33.8% and 30.7 +/- 39.5%, respectively). In patients with IHD, GFR increased slightly by 9.8 +/- 17.6%, whereas in patients with CGN with hypertension, GFR decreased by -4.3 +/- 14.3%. No significant change of these indices was observed in normal subjects and in patients with CGN without hypertension. UV and UNa increased and TRNa% decreased in all groups. Urea and osmolar clearance increased in almost every group.
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PMID:Clinical effects of intravenous diltiazem hydrochloride on renal hemodynamics. 243 98

Perindopril is a new inhibitor of converting enzyme activity with a prolonged half-life. Thirty-two patients with essential hypertension and a diastolic blood pressure greater than 95 mm Hg were stratified into two groups according to their 24 h urine sodium excretion. They were randomized in a double-blind fashion to placebo or perindopril and a dose titration made in steps of 2, 4, 6, and 8 mg given once daily at weekly intervals. The goal diastolic blood pressure was 90 mm Hg. Goal blood pressure was achieved in 11 of 16 patients on perindopril and 3 of 6 patients on placebo. Perindopril caused a fall in BP of 22/11 (supine) and 27/14 (erect) mm Hg while the placebo group had falls of 3/2 (supine) and 3/0 (erect) mm Hg. Most of the blood pressure fall occurred in the first week of therapy with 2 mg/day. Side effects were few and occurred mainly in the placebo phase. There was no alteration in urine protein, white cell count, plasma urea, or creatinine. The fall in blood pressure achieved at the end of the titration or with 2 mg did not differ between the two groups. There was no correlation between blood pressure response and 24 h urine sodium or plasma renin activity. These results indicate that perindopril is an effective antihypertensive drug that appears to work equally well in patients on high or low sodium intake.
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PMID:The effect of perindopril on blood pressure in humans on different sodium intakes. 248 43

Malignant hypertension developed in an 18-year-old man whose primary hypertension had been diagnosed by chance. Standing blood pressure was 290/170 mmHg. Tests of renal function revealed high blood urea nitrogen and creatinine levels and low levels of both effective renal plasma flow and the glomerular filtration rate. Plasma renin activity and levels of angiotensin II and aldosterone were greatly elevated. Severe concentric left ventricular hypertrophy was noted. The patient received standard antihypertensive treatment with furosemide, propranolol, nifedipine, and prazosin, but his blood pressure did not decrease and there was no improvement in the clinical or biochemical measures. The patient was then given 20 mg of enalapril daily for one year. The inhibition of angiotensin converting enzyme immediately reduced blood pressure. Angiotensin II and aldosterone levels became normal, kidney function and hemodynamics improved, and echocardiograms revealed that the left ventricular hypertrophy had regressed. The results confirm the pathogenetic role of angiotensin II in the development of the malignant phase of hypertension.
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PMID:Treatment of malignant hypertension with an angiotensin converting enzyme inhibitor. 255 Jan 35

Sixteen nonhospitalized men, average age 41.3 years with essential hypertension (WHO I-II) were given nifedipine slow-release tablets of 20 mg twice daily for 48 weeks. Both supine and standing blood pressure values were significantly reduced, but heart rate was not significantly changed by the drug. A significant decrease in serum sodium and potassium was found. A slight increase in serum magnesium throughout the study became statistically significant at 48 weeks (p less than 0.05). It is suggested that a possible diuretic activity, and the increase in magnesium, may add to the direct nifedipine-induced blood pressure reduction. Serum creatinine increased significantly after 24 and 48 weeks of nifedipine administration; serum urea, cholesterol, triglycerides, uric acid, and blood glucose remained essentially unchanged. Most of the patients had low plasma renin activity (PRA) in the control period, and nifedipine significantly increased PRA. Body weight was kept constant. Side effects were few and of no clinical significance. The slow-release preparation of nifedipine seems to be a potent and effective drug in treating essential hypertension of a mild to moderate degree.
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PMID:Antihypertensive and metabolic effects of long-term therapy with nifedipine slow-release tablets. 258 Jan 30


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