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

Hydrochlorothiazide (HCT) and spironolactone (SP), alone and in combination, were utilized in the treatment of 79 adult men with mild to moderate essential hypertension. Comparative effects were determined with regard to anti-hypertensive action, serum potassium homeostasis and BUN. Both HCT and SP, alone and in combination, produced significant anti-hypertensive effects. Anti-hypertensive response to SP was clearly dose-related. All medications produced a moderate and transient elevation of BUN. The most marked differences were observed with regard to serum potassium levels (K). HCT produced a marked decrease in K which persisted through 12 weeks of therapy. SP produced moderate dose-related elevations of K which reverted toward baseline levels between the 4th and 12th weeks of treatment. The "safety advantage" of SP is discussed relative to its role in producing K homeostasis due to its unique mechanism of action.
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PMID:Antihypertensive effect and serum potassium homeostasis: comparison of hydrochlorothiazide and spironolactone alone and in combination. 33 51

A double-blind study of hydrochlorothiazide and spironolactone, alone and in combination, was conducted in 49 patients with mild-to-moderate essential hypertension after a 4-wk placebo washout period. In the whole group mean arterial blood pressure fell to levels of less than or equal to 107 mm Hg or declined by more than 15 mm Hg in 78% of the patients after twelve weeks of treatment. Sixty-nine percent of patients receiving hydrochlorothiazide alone developed serum potassium levels lower than 3.5 mEq/L; serum potassium levels were above 5.5 mEq/L in 2 patients (5.5%) receiving spironolactone 400 mg/day. Uric acid levels rose in all patients, more in those on hydrochlorothiazide, but clinical gout did not develop in any subject. Hydrochlorothiazide, spironolactone, and the combination of the two are effective antihypertensives. Spironolactone in doses of 200 and 400 mg/day was associated with side effects but did not induce a greater antihypertensive effect than doses of 100 mg/day. Our data suggest that when hydrochlorothiazide is associated with potassium loss, when gout or elevated uric acid levels are of concern, or when carbohydrate tolerance is abnormal, supplementation or replacement with spironolactone (up to 100 mg/day) may be useful in controlling blood pressure while reducing side effects.
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PMID:Hydrochlorothiazide and spironolactone in hypertension. 36 34

1. Blood pressure, systemic haemodynamics, plasma volume, renin and aldosterone were measured during placebo treatment and after 1, 4 and 12 weeks of hydrochlorothiazide in 13 patients with uncomplicated essential hypertension. Nine of these patients were also studied after 24 and 36 weeks of treatment. 2. Mean arterial pressure was lowered significantly during hydrochlorothiazide treatment. In seven patients the fall in mean arterial pressure was lowered significantly during hydrochlorothiazide treatment. In seven patients the fall in mean arterial pressure was greater than 10% (responders); four of these were studied for 36 weeks. The remainder were considered non-responders. 3. Hydrochlorothiazide lowered cardiac output. The maximal decrease was observed after 12 weeks of treatment (P less than 0.01). In responders this was followed by a return to pretreatment values and a significant decrease in total peripheral resistance, whereas in non-responders cardiac output remained reduced and total peripheral resistance was permanently elevated. 4. Changes in plasma volume, renin and aldosterone were not significantly different in responders and non-responders although non-responders tended to show a greater degree of plasma volume depletion and a more pronounced increase in plasma aldosterone. 5. Thus it is unlikely that the initial decrease in cardiac output is an important determinant of the long-term haemodynamic effect of thiazide diuretics.
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PMID:Haemodynamics during long-term thiazide treatment in essential hypertension: differences between responders and non-responders. 39 81

A clinical and laboratory examination was conducted with a hypotensive drug Katapresan used alone and in combinations with Reserpine and saluretics in 30 patients with stage II and III of essential hypertension. Katapresan was shown to be an active hypotensive agent, often effective in patients resistant to other drugs. For long-term therapeutic courses the most effective combination is Katapresan with Hypothiazide and Reserpine. Katapresan may result in a deceleration of atrioventricular conduction, a slowing down of the electric systole, a reduction of the contractile function of the myocardium. The drug does not affect the metabolism of potassium and sodium ions.
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PMID:[Clinical evaluation of the hypotensive drug catapresan]. 88 32

In 36 patients with essential hypertension the action and side effects of hydrochlorothiazide (25 mg/d), hydrochlorothiazide-triamterene (25 and 50 mg/d) and propranolol (160 mg/d) were investigated. Hydrochlorothiazide and hydrochlorothiazide-triamterene led to an average decrease of the systolic blood pressure by 21 and 30 mm Hg and of the diastolic pressure by 11 and 18 mm Hg. Propranolol alone decreased the systolic pressure by 35 mm Hg on average in 8 out of 16 patients. The diastolic pressure was lowered by 20 mm Hg. In the remaining 8 patients the systolic pressure, when propranolol was used alone, decreased by 21.3 mm Hg, the diastolic pressure by 11.3 mm Hg. Addition of hydrochlorothiazide-triamterene lowered pressures by a further 22.5 (systolic) and 10.6 (diastolic) mm Hg. No disturbances of the potassium or acid-base balance were observed using hydrochlorothiazide-triamterene.
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PMID:[Triamterene in the treatment of hypertension with hydrochlorothiazide and propranolol (author's transl)]. 91 94

The author observed 76 patients with Stage II essential hypertension undergoing combined therapy with Rauwolfia serpentaria, Isobarine and Hypothiazid, 37 patients treated with Dopegit, and 44--with Obsidan. The examined patients demonstrated pulmonary arterial hypertension or a tendency towards its development, an increasing lung-ear time interval, and a reduced functional capacity of the right ventricular myocardium. A direct correlation was established between the level of blood pressure in the general circulation and the pressure in the pulmonary artery and the degree of blood flow deceleration in the lung-ear interval. Combined therapy results in a reduction of the elevated blood pressure not only in the general, but also in the pulmonary circulation.
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PMID:[Changes in the hemodynamic indices of the pulmonary circulation and in the functional state of the right ventricular myocardium in stage II hypertension under certain types of hypotensive therapy]. 101 33

Background data revealed that some American and Japanese patients with essential hypertension, including many who were not being treated with any anti-hypertensive drug, had a deficiency of coenzyme Q10. Eight clinically used anti-hypertensive drugs have now been tested for inhibition of two mitochondrial coenzyme Q10-enzymes of heart tissue, succinoxidase and NADH-oxidase. Diazoxide and propranolol significantly inhibited the CoQ10-succinoxidase and CoQ10-NADH-oxidase, respectively. Metoprolol did not inhibit succinoxidase, and was one-fourth as active as propranolol for inhibition of NADH-oxidase. Hydrochlorothiazide, hydralazine, ans clonidine also inhibited CoQ10-NADH-oxidase. Reserpine did not inhibit either CoQ10-enzyme, and methyldopa was a very eak inhibitor of succinoxidase. The internationally recognized clinical side-effects of propranolol may be due, in part, to inhibition of CoQ10-enzymes which are indispensable in the bioenergetics of cardiac function. A pre-existing deficiency of coenzyme Q10 in the myocardium of hypertensive patients could be augmented by subsequent treatment with propranolol, possibly to the "life-threatening" state described by others.
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PMID:Bioenergetics in clinical medicine. III. Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive drugs. 119 30

This study was designed to obtain information under general practice conditions on the efficacy and tolerability of a fixed combination of the beta-blocking agent oxprenolol 80 mg (Trasicor 80) and hydrochlorothiazide + KCl (Esidrex-K) in the treatment of moderate essential hypertension. Patients with a diastolic pressure of 100 to 130 mm Hg were covered by the study. The dosage of Trasicor was kept relatively low and at a constant level, i.e. one tablet twice daily throughout. In the group of 370 patients whose record had been completed according to the treatment plan, the systolic and diastolic pressures fell on the average by 28 and 17 mm Hg respectively. After 10 weeks of therapy, the diastolic pressure was normalized (i.e. below 95 mm Hg) in 226 patients. The mean decreases in pressure were statistically significant after two weeks' treatment. The mean pulse rate fell from 79 to 73. Tolerance of the regimen was very good in 75% of patients; 57 patients were withdrawn from the study for various reasons.
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PMID:[Treatment of essential hypertension with Transicor 80 and Esidrex K under medical practice conditions]. 125 Nov 51

Eye-ground-photos were taken in twenty-eight previously untreated men with mild to moderate essential hypertension. The same eye was evaluated before and after 26 weeks of double-blind treatment with Enalapril or Hydrochlorothiazide. The vascular changes were assessed by using a more elaborate and refined grading than the Keith-Wagener-Barker scale. All photos were examined by the same observer without knowledge of blood pressure, type of treatment or the order in which the photos had been taken. There were significant positive correlations between the vascular alterations in the retina in the untreated state and left ventricular wall thickness (echocardiography), minimal vascular resistance in the calf (plethysmography) and blood pressure respectively. Treatment with Enalapril decreased the reflection of the retinal arterial wall significantly and reduced the narrowing of arteries and arterio-venous crossing phenomena non-significantly. Hydrochlorothiazide did not affect any of the retinal vascular changes. It can be concluded that this relatively simple technique of evaluating eye-ground-photos with a new grading scale, when used in non-malignant hypertension, gives a useful assessment of the degree of hypertensive target organ damage in the retina as well as in other important target organs, i.e. the heart and vascular beds. In addition, Enalapril positively affects hypertensive retinopathy in contrast to Hydrochlorothiazide, reflecting what happens to structural cardiovascular changes in the rest of the body.
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PMID:Hypertensive retinal vascular changes: relationship to left ventricular hypertrophy and arteriolar changes before and after treatment. 134 41

A double-blind trial of hydrochlorothiazide, timolol and enalapril was carried out in Ethiopians with essential hypertension at the Tikur Anbessa Hospital, Addis Abeba, between 1987 and 1990. Patients with a supine diastolic blood pleasure of 95-120 mmHg after a washout period of 2 weeks were randomized to receive hydrochlorothiazide 25 mg daily, timolol 10 mg daily or enalapril 10 mg daily. Doses were doubled at 4 weeks if the diastolic blood pressure remained above 95 mmHg. At the end of 8 weeks of treatment, there were 9 patients taking hydrochlorothiazide, 10 patients taking timolol and 7 patients taking enalapril. Hydrochlorothiazide significantly lowered both systolic and diastolic blood pressure at 4 and 8 weeks compared with pre-treatment levels. Timolol and enalapril did not significantly lower the systolic blood pressure, but each lowered the diastolic blood pressure at 4 weeks and 8 weeks respectively. More patients on hydrochlorothiazide attained a diastolic blood pressure of less than 90 mmHg while less patients required doubling of dosage compared to timolol and enalapril. It is concluded that Ethiopian hypertensives may respond better to diuretics than to beta-blockers or angiotensin converting enzyme inhibitors, as found in other black populations.
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PMID:The efficacy of hydrochlorothiazide, timolol and enalapril in Ethiopians with essential hypertension. 139 19


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