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

The authors relate the data on the hypotensive effect and procedure of cranial electric stimulation (CES). The method was applied to the treatment of 66 patients aged 20-40 years suffering from stage I essential hypertension (EH) (WHO classification). To provide clinical and physiological evidence for CES, the EEG and ECG were recorded. In addition, computer was employed to average out and to design the histograms of the R-R intervals as was echocardiography to examine central hemodynamics. Before the treatment of SAP (179.2 +/- 4.3 mm Hg), DAP (104.2 +/- 2.6 mm Hg) the patients manifested cephalgia, cardialgia, pronounced vegetative dysfunction. The EEG showed phenomena of irritation in the upper stem structures of the brain. The histograms of R-R intervals distribution demonstrated the signs of a decrease of the tonic influence of the parasympathetic nervous system. The hyperkinetic type of hemodynamics was revealed. After CES the patients manifested an improvement of subjective symptomatology: headache attacks ceased in 85% of the patients, heart pains in 76%; AP got stabilized within normal, which correlated with normalization of central hemodynamics. The histograms of R-R intervals distribution demonstrated an increase of the model value, a decline of the mode, and a rise of the variation range, attesting to the changes in vegetative regulation of heart activity, with a reduction of sympathetic regulation and a simultaneous increment of parasympathetic effects. The authors hold that CES is an effective and prospective method of the treatment of the initial stage of EH.
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PMID:[Cranial electrostimulation--a new nondrug method of treating the initial stage of hypertension]. 152 56

Short-term fluctuations in blood pressure (BP) and heart rate (HR) were analyzed in a group of eight men with essential hypertension. Indirect finger BP was measured by a Finapres device. Analog-to-digital conversion of the BP was used to determine systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) and HR every second. The equidistant sampling allowed a direct spectral analysis using a fast Fourier transform algorithm. The effects of an oral dose of clonidine (150 micrograms) were studied in a double-blind, crossover, placebo-controlled study. Clonidine markedly reduced the variability of BP and HR after 90 min as indicated by a reduction in the standard deviations of BP by 36.7% for SAP, 21.0% for DAP, 22.1% for MAP, and 26.0% for HR. At this time clonidine reduced the average BP by 19.7 mm Hg for SAP, 10.6 mm Hg for DAP, 16.0 mm Hg for MAP, and 1.0 beat/min for HR. Spectral profiles of BP and HR illustrated the alterations in the spontaneous oscillations underlying the standard deviation changes. Clonidine dramatically reduced the amplitude of BP and HR oscillations in the mid-frequency region 66-129 mHz, which depends on the activity of the autonomic nervous system. We suggest that an increased sensitivity of the baroreflex is responsible for the apparent better control of BP and HR with clonidine.
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PMID:Clonidine reduces blood pressure and heart rate oscillations in hypertensive patients. 171 18

The effectiveness and acceptability of perindopril (P) as an antihypertensive agent were compared with those of captopril (C), atenolol (A) and a combined hydrochlorothiazide + amiloride diuretic (D) in three simultaneous multicentre double-blind trials involving 165, 173 ans 165 patients respectively. After a 1 month placebo period, 3 groups of patients with essential hypertension whose DAP in supine position ranged from 95 to 125 mmHg (means: 103.9, 106.2 and 105.2 mmHg respectively) were allocated at random to treatment with either P (4 mg once a day) or C (25 mg b.d.) or A (50 mg once a day) or D (hydrochlorothiazide 50 mg + amiloride 5 mg once a day) during 3 months. The patients were re-examined monthly and their treatment was modified if their BP was insufficiently controlled (DAP greater than 90 mmHg): first, the dosage of the drug was doubled, then another antihypertensive agent was added, which was either a diuretic (studies with C or A) or a beta-blocker (studies with D). After 3 months, in the monotherapy group BP was controlled in 49 p. 100 of patients on P versus 49 p. 100 on C; 55 p. 100 on P versus 48 p. 100 on A and 72 p. 100 on P versus 72 p. 100 on D. The majority of patients who received P alone were controlled with 4 mg, and only 15 p. 100 required 8 mg. In cases where BP control necessitated a therapeutic combination, the addition of a diuretic was more effective with P than with C (26 p. 100 versus 8 p. 100) or A (23 p. 100 versus 10 p. 100), whereas the addition of a beta-blocker was less effective with P than with D (5 p. 100 versus 13 p. 100). The total percentage of controlled patients was greater with P than with C (75 p. 100 versus 57 p. 100, p = 0.016) or with A (78 p. 100 versus 58 p. 100, p = 0.006); there was non significant difference between P and D (78 p. 100 versus 84 p. 100). The percentages of patients who discontinued treatment were similar with P (6 p. 100 at most), C (4 p. 100), A (5 p. 100) and D (5 p. 100). Most of the side-effects reported with P were minor and unspecific, and their incidence was close to that observed with the other drugs.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Perindopril: first-line treatment of arterial hypertension]. 250 15

In connection with a mass screening of the Bergen population 93 patients with essential hypertension and 48 normotensive controls were studied in 1965-66. Blood pressure (BP) was recorded intraarterially, cardiac output (CO), by dilution method, heart rate (HR) by ECG and oxygen consumption (VO2) by Douglas bag/Scholander technique. Studies were performed during rest and 50, 100 and 150 watt steady state exercise. The most important initial findings were: Although CO and HR were higher in the youngest hypertensive group (17-29 yrs) than in normotensive age matched controls VO2 was also increased and no true luxury perfusion was demonstrated. Exercise stroke index (SI) did not increase to the same level as in normotensives and total peripheral resistance index (TPRI) during exercise was increased. Cross-sectional data showed a reduction in SI and CI and an increase in TPRI with increasing age - at rest as well as during exercise. 10-year follow-up: 28 subjects initially below 40 years were completely untreated. During the first 10 years there was a fall in CI and SI of approximately 15% and TPRI increased by 20%. The same changes were seen at rest as well as during exercise. Resting blood pressure was practically unchanged. Nearly all patients greater than 40 yrs were treated. 20-year follow-up: Between the 10 year and 20 year follow-up DAP rose to 100 mmHg or more in most of the subjects less than 40 yrs and treatment had to be started. Generally diuretics, betablockers or a combination of the 2 were used. Before the 20 year follow-up, treatment was withdrawn for 2 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hemodynamics in essential hypertension at rest and during exercise--a 20-year follow-up study. 325 Mar 16

The effect on systolic (SAP) and diastolic (DAP) arterial blood pressure of 5 mg mepindolol daily vs 12.5 mg hydrochlorothiazide daily vs 5 mg mepindolol plus 12.5 mg hydrochlorothiazide daily was evaluated in this multicenter study. After a 2-week washout period with placebo, 138 patients with mild to moderate essential hypertension (WHO Class I and II), homogeneous for age and blood pressure values, were randomly allocated to one of the three treatment groups. Arterial blood pressure and heart rate were obtained at the beginning and at the end of the washout placebo period, and after 2, 4, and 6 weeks of active treatment. At the beginning and at the end of the study, all patients underwent a thorough clinical and laboratory evaluation, including blood chemistry, electrocardiogram, and chest roentgenogram. A trend toward normalization of blood pressure was defined as a lowering of DAP to 90 mmHg or at least a 10-mmHg decrease from the control value. Statistical analysis was performed on all the data. After 6 weeks of treatment, SAP and DAP values were significantly reduced in 67% of the patients in all groups. In 71% of patients on mepindolol plus hydrochlorothiazide a particularly more marked decrease in DAP was observed. Mepindolol was well tolerated: side effects were generally mild and inconsequential. The results show that mepindolol, given as a single oral dose of 5 mg, is an effective agent in the treatment of mild to moderate essential hypertension. Because of its efficacy, the advantage of single daily administration, and lack of important side effects, it can increase compliance to therapy. Moreover the association of mepindolol plus hydrochlorothiazide appears to be safe and effective.
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PMID:Multicenter evaluation of mepindolol and of mepindolol plus hydrochlorothiazide in essential hypertension. 675 52

the autonomic sympathetic reflexes to sustained handgrip, upright tilt and the Valsalva maneuver, were tested in 26 patients with labile and 26 with fixed essential hypertension. Sustained handgrip increased systolic (SAP), diastolic (DAP) and mean arterial (MAP) pressure, heart rate (HR), cardiac index (CI), tension time index (TTI) (p less than .01), and had no effect on total peripheral resistance index (TPRI) and left ventricular ejection rate index (LVERI) in both groups of patients. However, the response to upright tilt and the Valsalva maneuver was different in the two groups. Upright tilt in labile hypertensives increased DAP, MAP, HR, and TPRI (p less than .001); decreased CI, stroke index (SI) and LVERI (p less than .01) and had no effect on SAP. In fixed hypertensives, it decreased SAP, MAP, CI, SI and LVERI (p less than .001); increased HR (p less than .01) and had no effect on DAP, and TPRI. The diastolic pressure overshoot of the Valsalva maneuver was attenuated in fixed hypertensives compared to labile (p less then .001). Additionally, when the percent changes from control in DAP, MAP, HR and TPRI to sustained handgrip and upright tilt between the two groups were compared, only differences to upright tilt between the two groups were observed. The results of this investigation suggest that upright tilt and the Valsalva maneuver might serve as better predictors of autonomic reflexes in hypertensive patients than the grip test.
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PMID:Hemodynamic correlates of autonomic reflexes in patients with labile and fixed hypertension. 733 96

This article analyses the changes of arterial blood pressure and heart rate (HR) in 120 patients with essential hypertension during two successive exercise tests. Before and during the tests, the patients did not take any hypertensive drugs. The obtained measuring results at exercise tests and restitution were the basis for the calculating regression equations. Then the results were analyzed statistically (p < 0.05) and clinically (drop or increase of arterial systolic blood pressure value (SAP) or/and diastolic (DAP) by 5 mmHg, and HR by 5 beats per minute). The HR response was comparable in both test for all tested groups both in exercise and restitution periods. For the additional sex division the HR value in all subgroups women was lower in the second test and satisfies the condition of statistic and clinical significance. In the second test SAP was lower only in the group of mild pressure and in the group without organ changes (stage I WHO) during exercise. At restitution periods the SAP values were lower in all the tested groups with the exception of the group with borderline hypertension. DAP was lower in the second test in all the tested groups both in exercise test and in the restitution period. It is also shown that the quantity of DAP difference in the second test is the greater, the higher value of DAP at restitution is.
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PMID:[Evaluation of arterial blood pressure and heart rate during exercise tests in patients with essential hypertension in different stages of hypertension]. 875 38

Although it is well-known that quantitative trait loci (QTLs) influence blood pressure (BP) in male Dahl salt-sensitive rats (DSS), few studies have been carried out to ascertain the BP effect of these QTLs in females. In the current work, we analyzed BP of seven selected congenic strains constructed in the DSS background. One QTL, C8QTL2, exhibited similar effects on systolic (SAP), diastolic (DAP), and mean arterial (MAP) pressures in females as previously shown in males. In contrast, six QTLs that previously demonstrated influences on SAP, DAP, and MAP in males did not have effects in females. These male-specific QTLs are likely regulated differently in males than in females and emphasize the necessity of identifying female-specific QTLs for diagnosing and treating hypertension in women. Current findings may have implications in genetic research of essential hypertension, and association and linkage analyses should be performed in separate genders. Men and women may possess distinctive as well as shared genetic determinants for SAP, DAP, and MAP. The data on a single gene or marker might be pooled from both genders only when evidence favors the sex-independence in a study.
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PMID:Sexual dimorphism on hypertension of quantitative trait loci entrapped in Dahl congenic rats. 1885 55