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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 atenolol, a new beta 1 receptor blocking agent, was studied in a double blind non cross-over trial in 40 patients (pts) affected by mild to moderately severe essential hypertension with normal plasma renin activity. After a run-in period (15 days) of placebo treatment pts were assigned to two groups. The first (group A) continued placebo treatment for 30 days, the second (Group B) were given atenolol (ICI 66082) 100 mg daily for 30 days also. Atenolol significantly reduced systolic and diastolic blood pressure in recumbent and standing position and heart rate at rest. No significantly changes of the same parameters were observed in group A. Body weight and plasma renin activity was unchanged in both groups. Atenolol treatment never was discharged in order to side effects. These results seem to suggest that atenolol can be an useful drug in the treatment of systemic blood hypertension.
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PMID:[Efficacy and tolerability of a cardioselective beta-blocking drug (atenolol) in the treatment of essential hypertension. A double blind study (author's transl)]. 35 98

The antihypertensive action of beta-blocking agents has been suggested to be associated with the decrease in plasma renin activity (PRA) and can be antagonized by indomethacin, a prostaglandin (PG) synthesis inhibitor. We studied the acute and long-term effects of a beta 1-blocking agent, atenolol (50 mg b.i.d.), on blood pressure (BP), PRA and urinary PGF2 alpha excretion in 12 male patients (40 years old) with essential hypertension. BP was measured by means of a brachial cuff. PRA and PGF2 alpha were estimated radioimmunologically. One day after the initiation of atenolol treatment, BP fell significantly, the supine values from 159/114 to 143/104 mmHg and the erect from 158/118 to 140/106 mmHg. In six weeks BP decreased further to 135/94 and 134/96 mmHg, respectively. After the cessation of atenolol for three weeks BP rose to the pre-atenolol level. When the dose was readjusted (25-150 mg daily for 26 weeks), diastolic BP remained at 100 mmHg or higher in only two patients. During the atenolol treatment PRA declined to one-third of the pre-atenolol level in one day and to one-half in six weeks. The urinary excretion of PGF2 alpha was not affected by atenolol. Our results suggest that 1) the antihypertensive action of atenolol and the reduction of PRA are substantial already in one day, and 2) the decrease in BP or PRA is not associated with PGF2 alpha production.
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PMID:The effects of a beta 1-blocking agent, atenolol, on blood pressure, plasma renin activity and prostaglandin F2 alpha excretion in patients with essential hypertension. 48 51

The beneficial effects of beta-blockers on morbidity and mortality in both essential hypertension and diabetes mellitus have been demonstrated in several antihypertensive trial. Recently, negative side effects of beta-blockers on glucose metabolism have been suggested that could limit their wide-spread use. However, on detailed analysis, any side effects of beta 1-selective beta-blockers on glucose metabolism do not appear to be relevant for clinical practice and hence do not restrict the use of these agents as first-line antihypertensive drugs in diabetic and nondiabetic patients.
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PMID:Effects of antihypertensive treatment with beta-blockers on glucose metabolism. 128 43

The effects of six weeks of treatment with the selective peripheral alpha 1-adrenoceptor blocker terazosin, or the selective beta 1-adrenoceptor blocker atenolol on blood pressure, exercise performance and blood lipid profile were compared in a single-blind, randomized, crossover study of 17 patients with mild-to-moderate essential hypertension. Although both drugs significantly reduced blood pressure at rest, atenolol caused a larger fall in supine blood pressure (11/11 and 7.5/7.0 mmHg, atenolol and terazosin, respectively; p < 0.001). Both treatments controlled the pressor response to exercise, although a greater reduction in diastolic blood pressure was observed at the end of exercise on terazosin (74.0 +/- 5.7 and 91.6 +/- 4.0 mmHg, terazosin and atenolol, respectively; p < 0.01). Alpha 1-blocker therapy was not associated with any measurable improvement or deterioration in cardiopulmonary performance and exercise duration. Unlike atenolol, terazosin therapy had the potentially beneficial effect of reducing serum total cholesterol levels and increasing the high-density lipoprotein-cholesterol/low-density lipoprotein-cholesterol ratio.
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PMID:A comparison of the effects of the selective peripheral alpha 1-blocker terazosin with the selective beta 1-blocker atenolol on blood pressure, exercise performance and the lipid profile in mild-to-moderate essential hypertension. 129 Sep 20

Vascular formation of prostacyclin is increased by propranolol in patients with essential hypertension. However, the possible effect of beta-adrenoceptor blocking drugs in healthy subjects is, however, not known. We studied this issue by analysis of the urinary excretion of the prostacyclin metabolite, 2,3-dinor-6-keto-prostaglandin F1a during intake of a beta 1-selective (metoprolol) or a non-selective (propranolol) beta-adrenoceptor antagonist. After 14 days of metoprolol treatment (100 mg d-1) the urinary excretion of PGI-M did not differ from control (253 +/- 77 vs. 220 +/- 33 pg mg-1 creatinine, respectively). Five days of randomized cross-over treatment with propranolol (80 mg day-1) or placebo did not affect urinary PGI-M significantly either (177 +/- 11 vs. 202 +/- 11 pg mg-1 creatinine, respectively). Furthermore, a daily increasing dose of propranolol (80-480 mg) progressively lowered resting blood pressure and heart rate, but failed to influence urinary excretion of PGI-M. The data demonstrate that metoprolol and propranolol do not affect basal cardiovascular formation of prostacyclin in healthy subjects. Thus, the biosynthesis of prostacyclin does not appear to be regulated by beta-adrenoceptor activity under normal conditions.
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PMID:Formation of prostacyclin during administration of beta 1-selective and non-selective beta-adrenergic antagonists in healthy humans. 134 60

Acute, subacute, and chronic treatment with nebivolol, a novel beta 1-selective adrenergic antagonist, significantly lowered systolic and diastolic blood pressure and heart rate in patients with essential hypertension. No orthostatism and bradycardia were reported. A comparison between a normal control group and 23 hypertensive patients revealed that the ratio between the preejection period (PEP) and the left ventricular ejection time (LVET) of the systolic time intervals (STI) was significantly increased in the hypertensive patients, owing to a prolongation of the PEPc (PEP corrected for heart rate). Treatment with nebivolol 5 mg once a day significantly improved the PEP/LVET, in acute conditions from 0.42 +/- 0.023 to 0.39 +/- 0.018, after one month of treatment from 0.40 +/- 0.013 to 0.36 +/- 0.013 and after one year of treatment from 0.41 +/- 0.012 to 0.36 +/- 0.010, owing to a significant shortening of the PEPc. There was no correlation between changes of blood pressure and changes of STI. Diastolic dysfunction is an early finding in hypertension and may well be reflected in the prolongation of the PEPc. The improvement of left ventricular performance, as measured with STI, suggests that treatment with nebivolol may favorably influence the underlying diastolic dysfunction and be of therapeutic value for hypertensive patients with left ventricular damage.
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PMID:The antihypertensive and cardiac hemodynamic effects of nebivolol. 134 16

The cardinal hemodynamic disorder in established essential hypertension is increased total peripheral resistance. During exercise, the increase in stroke volume of the heart is abnormal. A 20-year follow-up study of the hemodynamics in essential hypertension demonstrated a progressive increase in total peripheral resistance and deterioration of the heart pump function. Long-term treatment with antihypertensive agents modifies the circulatory system in different ways. Vasodilators (angiotensin converting enzyme inhibitors, alpha 1-blockers, and calcium antagonists) all reduce total peripheral resistance, and in general, cardiac output, heart rate, and stroke volume remain unchanged. Calcium antagonists like verapamil and diltiazem reduce the heart rate approximately 10% during exercise, but since stroke volume increases, cardiac output is unchanged. Chronic treatment with conventional beta-blockers induces a permanent reduction in cardiac output and heart rate during exercise. In contrast, carvedilol--a beta 1,beta 2-blocker with alpha 1-blocking activity--prevents the immediate increase in total peripheral resistance during acute beta-blockade. In 19 patients followed by hemodynamic measurements over 6-9 months, blood pressure was well controlled by carvedilol. During exercise, total peripheral resistance decreased 6% (P less than 0.05), and the reductions in heart rate and cardiac index were less than on conventional beta-blockade. Echo-Doppler studies showed a significant reduction in the intraventricular septum of 13%.
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PMID:Long-term hemodynamic effects of antihypertensive treatment. 135 Apr 86

In a double-blind, randomized, placebo-controlled study, the authors investigated the effects of different beta-adrenoceptor blocking drugs on the peripheral circulation. A single intravenous injection of the nonselective beta-blocker propranolol (0.20 mg/kg), the beta 1-selective adrenoceptor blocker metoprolol (0.25 mg/kg), and the nonselective beta-blocker with partial agonistic activity (PAA) pindolol (0.04 mg/kg) and of placebo (saline) was given to eight patients with a primary Raynaud's phenomenon and to nine untreated patients with primary hypertension. The authors measured finger skin temperature (FST), and laser Doppler estimated finger skin blood flux (LDF) before, during, and after a standardized finger cooling test, performed 25 minutes after the administration of the drugs. In both patients groups propranolol, metoprolol, and pindolol had no significant effect on FST and LDF in the first 25 minutes after administration both in comparison to baseline value and to placebo. Also, no significant differences were found in the recoveries of FST and LDF after cold challenge between all drugs and placebo in both groups. The authors conclude that no adverse effect of any type of beta-adrenoceptor blocker in comparison to placebo could be detected after a single administration on both the baseline finger skin perfusion and the recovery after cold-induced vasoconstriction. In addition, the authors could not demonstrate a favorable effect of beta 1-selectivity or PAA in comparison to a nonselective beta-adrenoceptor blocker without PAA, in any group.
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PMID:The influence of different beta-blocking drugs on the peripheral circulation in Raynaud's phenomenon and in hypertension. 135 6

Nineteen men (mean age, 44 years) with moderately severe essential hypertension were studied invasively at rest and during exercise. After initial predrug recordings, patients received 25 mg carvedilol orally, and central hemodynamics at rest and during exercise were recorded 1 and 2 h after tablet intake to evaluate the immediate effects of carvedilol. Blood pressure decreased by 11% within 1 h, and the hemodynamic results indicated a combination beta-blocking and vasodilating effect. After 6-9 months of treatment (dose, 25-100 mg), supine hemodynamics were recorded, first 12-24 h after the last dose and then 1 and 2 h after an additional 25-mg dose. During chronic treatment (2 h after the last dose with the patient at rest and in the supine position), mean arterial pressure was reduced by 17% (p less than 0.001) and total peripheral resistance index was reduced by 6% (NS), whereas heart rate and cardiac index were reduced by 12%. Exercise hemodynamics demonstrated a decrease in blood pressure of 17% (p less than 0.001). Exercise stroke index increased by 5% (NS), in part compensating for the reduction in heart rate of 17%. Total peripheral resistance index was reduced by 5% (NS). Twenty-four-hour blood pressure monitoring (Accutracker II) demonstrated significant blood pressure reductions in awake as well as in asleep patients. Blood pressures decreased from 163/102 to 141/84 mm Hg in from 135/78 to 122/68 mm Hg in awake and asleep patients; respectively. Carvedilol is an effective antihypertensive agent, and the hemodynamic mode of action reflects alpha 1- and beta 1-blocking activities.
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PMID:Carvedilol in hypertension: effects on hemodynamics and 24-hour blood pressure. 137 46

An ideal antihypertensive drug should reduce blood pressure not only at rest but also during stressful situations. To test whether this criterion is fulfilled by celiprolol, a new beta 1-selective adrenergic blocker drug with peripheral vasodilating activity, we examined the effects of its oral administration on cardiovascular reactivity to laboratory stressors in 18 patients with essential hypertension, according to a placebo-controlled crossover design. In the 12 patients classified as "responders," celiprolol significantly reduced resting systolic and diastolic blood pressure (p less than 0.05 for both). Compared with placebo, celiprolol induced a blood pressure reduction from 179.4 +/- 16.9/119.5 +/- 12.4 mm Hg to 160.7 +/- 12.6/109.4 +/- 3.1 mm Hg during mental arithmetic; from 200.9 +/- 20.7/139.2 +/- 11.9 mm Hg to 184.1 +/- 16.4/127.6 +/- 12.1 mm Hg during handgrip test; from 212.8 +/- 18.5/126.2 +/- 14.2 mm Hg to 185.9 +/- 18.2/117.1 +/- 15.2 mm Hg during cycle ergometry. Our data suggest that in the majority of treated patients celiprolol is effective in reducing blood pressure not only at rest but also during a variety of stressful events, thereby ameliorating the impact of recurring stress-induced increases of blood pressure on the cardiovascular system.
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PMID:Effects of celiprolol on cardiovascular reactivity to laboratory stressors in patients with hypertension. 153 42


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