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)

Nicardipine, a new calcium antagonist, was tested in a 14-week double-blind trial including 15 outpatients with uncomplicated essential hypertension. They were randomly assigned to nicardipine (20-30 mg three times daily) or placebo as first-step treatment. When necessary but always after a minimum of 4 weeks, pindolol (15 mg/day) was combined with nicardipine or placebo. At the end of step 1 (85 +/- 6 days with nicardipine vs. 58 +/- 6 days with placebo, p less than 0.01), nicardipine induced larger drops in supine systolic and diastolic blood pressure (SBP and DBP) than the placebo (21 +/- 2.5 vs 1.4 +/- 3 mm Hg, p less than 0.001, and 13 +/- 2 vs. 3.5 +/- 1.5 mm Hg, p less than 0.001, respectively). In the nicardipine group (n = 57), 53% of patients had controlled blood pressure (SBP less than 160 mm Hg and DBP less than 95 mm Hg) versus 17% in the placebo group (n = 47), p less than 0.001. There was no significant correlation between the decrease in blood pressure and the age of patients. The most common side effects in the nicardipine group were flushes (12%), headache (8%), ankle edema (5%), and asthenia (4%). When blood pressure was not brought under control and pindolol was prescribed as the second-step treatment, the nicardipine group (n = 52) displayed larger drops in SBP and DBP than the placebo group (n = 40) (27 +/- 5 vs. 15 +/- 3 mm Hg, p less than 0.01, and 18 +/- 1 vs. 9 +/- 2 mm Hg, p less than 0.001, respectively). These results show that a calcium antagonist is useful for first-step treatment of hypertension.
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PMID:First-step treatment of mild to moderate uncomplicated essential hypertension by a new calcium antagonist: nicardipine. 241 2

In a double-blind crossover study, the influence of bisoprolol and placebo was tested in 20 noninsulin-dependent diabetics with concomitant essential hypertension. A 2-week washout placebo period was followed by two treatment periods of 2 weeks each with 10 mg bisoprolol or placebo. Compared with placebo, bisoprolol did not change blood glucose, haemoglobin A1 (HbA1), and glucosuria. No hypoglycaemia was observed. Serum cholesterol and triglyceride levels remained constant. Systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were significantly (p less than 0.01) reduced after 2 weeks of bisoprolol therapy, compared with placebo. It was concluded that bisoprolol, in a dose therapeutically effective in essential hypertension, has no influence on carbohydrate and lipid metabolism in noninsulin-dependent patients with diabetes mellitus; and 10 mg bisoprolol is effective for the normalisation of SBP and DBP in mildly hypertensive diabetics. Since bisoprolol was well tolerated in the dosage studied, it can be recommended for noninsulin-dependent diabetics with hypertension.
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PMID:Influence of bisoprolol on blood glucose, glucosuria, and haemoglobin A1 in noninsulin-dependent diabetics. 243 8

Despite their vasodilating action, calcium antagonists increase renal sodium excretion. To ascertain whether renal kallikrein plays a role in the renal effects of calcium antagonists, nifedipine (N) (10 mg orally) or placebo (P) was given to 17 male patients with mild to moderate essential hypertension during a 6-h infusion of either saline (S) or aprotinin (A) (2 X 10(6) KIU in 200 ml of saline). Blood pressure (BP) and heart rate (HR) were measured every 10 min, and blood samples were taken at -10, 0, 30, 60, 120, 240, 360 min for plasma renin activity (PRA), creatinine, and osmolarity determinations. Urinary kallikrein, aldosterone, creatinine, and electrolytes were measured in 6-h urine collections. The acute administration of N induced a significant systolic BP (SBP) and diastolic (DBP) fall and a transient PRA increase that peaked at 30 min and were not modified by A infusion. Urinary volume (+47%), Na+ (+54%) and Cl- (+58%) excretion were significantly enhanced by N. There were less pronounced and statistically not significant increases in urinary excretion of Ca2+ (+38%) and K+ (+29%). Infusion of A did not interfere with the natriuretic effect of N. Our data do not support the hypothesis that the kallikrein-kinin system plays an important role in mediating the renal effects of nifedipine in humans.
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PMID:Natriuretic effect of acute nifedipine administration is not mediated by the renal kallikrein-kinin system. 243 33

One thousand eleven patients with essential hypertension (H) were evaluated upon compliance with the following inclusion criteria: (a) mild to moderate uncomplicated H, with supine diastolic blood pressure (Su DBP) greater than 90 mm Hg at the end of the placebo period, with or without antihypertensive treatment; (b) greater than 20 years old. The dosage of ketanserin (K) was 20 mg b.i.d. up to the fourth week. Afterwards, if the patients normalized, we continued with the same schedule. If this did not occur, the dosage was increased (40 mg b.i.d.) up to the eighth week. Four hundred fifty-one men and 560 women were included, with a mean age of 56.6 years, mean body weight 74.8 kg, and mean height 166.30 cm. At the end of the eighth week, the percentage of normalization was 75.5% of the patients, and the percentage of partial responders was 5.6%. The decrease of the blood pressure (diastolic and systolic) was significant at the second week (paired t test, two-tailed probability, p less than or equal to 0.001). There were 62 dropouts: 10 due to inefficacy, 14 due to adverse reaction, and 38 due to other reasons. Laboratory examinations were performed before and after treatment and did not show statistical differences. Also, a 12-lead ECG was performed before and after treatment with K. The QTc was analyzed in a sample of 140 patients and did not show statistically significant changes. The incidence of side effects was minimal (24% of the patients, n = 224), mild, and transient; only 1% of the patients dropped out due to adverse reactions. In our experience, ketanserin was an effective and safe drug, to be used primarily for the treatment of mild to moderate H.
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PMID:Multicenter study with ketanserin in essential hypertension: an Argentine experiment. 244 62

Measurements of cerebrospinal fluid (CSF) catecholamines (CA) were made in an attempt to estimate the activity of central CA neurons in essential hypertension (EHT). CSF norepinephrine (NE), epinephrine (EPI), and dopamine (DA) levels were measured in 12 normotensive (age 36 +/- 3 years; SBP = 116 +/- 4 and DBP = 79 +/- 4 mm Hg) and in 12 EHT (age 41 +/- 2 years; CSF NE levels were twofold higher in EHT (240 +/- 23 pg/ml) than in normotensive subjects (127 +/- 28 pg/ml). Very low EPI and DA levels were observed in both groups of patients. The results suggest that central (spinal?) noradrenergic activity is increased in patients with EHT. In a second study we evaluated the effects of clonidine treatment for 2 weeks (150 micrograms t.i.d.) on CSF NE in EHT. Clonidine reduced pretreatment BP and CSF NE levels by 27% (p less than 0.05) and 39% (p less than 0.01), respectively. The results of the study indicate that central noradrenergic activity is reduced during clonidine treatment. A third group of experiments was designed to compare the effects of clonidine with those of propranolol treatment in patients with EHT. CSF NE measurements were made after 1 month of treatment with 0.36 +/- 0.07 mg of clonidine daily or 160 mg of propranolol daily. CSF NE levels were significantly lower in the clonidine group (p less than 0.01). Seventy-two hours after abrupt discontinuation of clonidine or propranolol treatment, BP returned to pretreatment levels. However, CSF NE showed a threefold increase after clonidine withdrawal, and no change after propranolol withdrawal. CSF EPI was not affected by either treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cerebrospinal fluid norepinephrine levels in essential hypertension: effects of drug treatment and withdrawal. 245 80

51 patients with mild essential hypertension (EH) were randomly divided into two groups; the first group (31 patients) was treated with 1 g. of oral calcium during a period of 8 weeks; the second group received a placebo. The treated with calcium showed a significant decrease in blood pressure (BP), the maximal reduction being of 6 mm Hg in the systolic pressure (SBP) and 3 mm in the diastolic (DBP) at the end of the 8th week. We found a substantial positive relationship between the decrease in SBP and seric renin activity (p less than 0.05), as well as a significant negative relationship (p less than 0.05) between DBP and the seric level of parathyroid hormone (PTH). During the administration of the oral calcium supplement, the BP decreased in an inverse proportion to the plasmatic renin and seric level of PTH.
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PMID:[Effect of an oral calcium supplement in the treatment of slight-to- moderate essential arterial hypertension]. 249 21

In a multi-center study, 188 patients with mild to moderate essential hypertension were treated with the beta-1 selective beta blocker bisoprolol. Treatment was started with 5 mg bisoprolol once a day; if the aim of therapy, namely normalising (less than or equal to 90 mmHg) the diastolic blood pressure at rest (DBP-R) 24 hours after drug intake was not achieved, the dose was increased every two weeks to a maximum of 20 mg. With the individual dose established in this way, the patients were admitted to long-term treatment that was scheduled to last one year. Prior to and during bisoprolol therapy, bicycle ergometry studies were carried out up to a maximum of 100 watts. After only two weeks on 5 mg bisoprolol, both resting and exercise blood pressures were clearly reduced. By means of success-related dose increments, normalisation of the DBP-R was achieved in 79% of the patients by the end of the 6th week. The percentage of patients manifesting load-positive blood pressure reactions during exercise was reduced from 63 to 18%. On conclusion of one year of treatment, 33%, 56% and 11% of the patients were receiving 5 mg, 10 mg and 20 mg bisoprolol, respectively. On the basis of subjective and objective parameters, including laboratory examinations, bisoprolol was seen to be well tolerated even over the long term.
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PMID:[The 24-hour-effect of bisoprolol on blood pressure at rest and during stress]. 252 5

This twenty-eight-week double-blind study in patients with mild to moderate essential hypertension showed quinapril (10, 20, and 40 mg/day) to be similarly effective to enalapril at the same doses in producing clinically significant reductions in sitting DBP. Hydrochlorothiazide could be safely added to quinapril therapy in nonresponders. Quinapril and enalapril were well tolerated. Both agents can safely be administered as first-line therapy.
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PMID:A comparison of the efficacy and safety of quinapril with that of enalapril in the treatment of mild to moderate essential hypertension. 253 63

The effectiveness and safety of cicletanine hydrochloride, the first representative of the furopyridine family, were evaluated in a 90-day double-blind study involving 120 patients with moderate essential hypertension poorly controlled after at least one month of treatment with a beta-blocker. After a 30-day pre-inclusion period during which a placebo capsule was given together with a stable dose of the beta-blocker, the patients were randomised to one of three therapeutic groups: group 1 (placebo, n = 40), group 2 (cicletanine 50 mg/day, n = 41), group 3 (cicletanine 100 mg/day, n = 39). All three groups were matched in every respect. Eight patients in group I were excluded (5 for ineffectiveness, 2 for unexpected effect, 1 for intercurrent disease) as was 1 patient in group 3 for unexpected effect. On entering the active phase of treatment, supine blood pressures were 171.3 +/- 13.6/103.9 +/- 6.1 mmHg in group 1, 173.5 +/- 12.7/103.6 +/- 5.2 mmHg in group 2 and 171.8 +/- 15.4/104.5 +/- 5.9 mmHg in group 3. A significant (p less than 0.0001) treatment effect on SBP was found in groups 2 and 3 and on DBP in all three groups. The improvement observed in both SBP and DBP was similar in groups 2 and 3 and highly significant when compared with group 1 (p 0.001). At the end of the trial, 5% of group 1 patients, 51.2% of group 2 patients and 74.4% of group 3 patients had normal blood pressure values. The drug was well tolerated clinically and biochemically.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the effectiveness and tolerance of cicletanine in patients with essential hypertension treated with beta-blockers]. 257 69

To study the relation of calcium channel blockade to calcium metabolism, we measured serum ionized calcium (Ca++i0), magnesium (Mg), calcitonin (CT), and 1,25-dihydroxyvitamin D (1,25-D) before and after short-term therapy with verapamil 120 mg three times daily in essential hypertensive subjects on low (10 mEq) and high (200 mEq) dietary sodium intakes. Salt-sensitive compared with salt-insensitive subjects on high v low dietary salt intake had lower Ca++i0 (P less than .05), higher 1,25-D (P less than .02), and a greater hypertensive responsive to verapamil (% delta DBP = 17.7 v -8.2, P less than .05). The % delta DBP was related to the initial CT (r = 0.68, P less than .05), initial 1,25-D (R = -0.89, P less than .01), and to the drug-induced % delta 1,25 D (R = .60, P less than .05). Thus, lower initial calcium and calcitonin levels, higher initial levels of 1,25-D, and a greater drug-induced suppression of 1,25-D were associated with an enhanced hypotensive response to verapamil. Verapamil elevated Ca++i0 (2.46 +/- 0.04 to 2.53 +/- 0.04 2.00 mEq/L, P less than .05), and suppressed Mg (2.00 +/- 0.03 to 1.84 +/- 0.03 mEq/L, P less than .01) and 1,25-D levels (66.7 +/- 8.1 to 51.6 +/- 5.7 pg/mL, P less than .05). These results suggest interactive effects of sodium and calcium metabolism in essential hypertension, especially among salt-sensitive individuals. We conclude that alterations of calcium metabolism may underlie the sensitivity to verapamil therapy and may contribute to its hypotensive effects.
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PMID:The effects of calcium channel blockade on blood pressure and calcium metabolism. 261 Sep 99


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