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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 ketanserin 40 mg b.d. in combination with a beta-adrenergic blocking agent or a diuretic was assessed in an open study in 35 patients with essential hypertension, who had not responded to treatment with beta-blockers, diuretics or their combination. The ketanserin/beta-blocker combination decreased mean sitting systolic/diastolic blood pressure (SBP/DBP) from 169/107 mmHg to 156/91 mmHg at the end of the 12-week active treatment period. The decrease in systolic blood pressure was significant only at Week 8, while the decrease in diastolic blood pressure was highly significant at all times. A significant reduction in heart rate by 10 beats.min-1 was observed with the ketanserin + beta-blocker combination. The ketanserin/diuretic combination led to a significant reduction in mean SBP/DBP from 164/106 mmHg to 146/92 mmHg after 12 weeks, with no significant change in heart rate. Body weight slightly increased in both groups. There were significantly fewer adverse reactions with the ketanserin/diuretic combination than with the ketanserin/beta-blocker combination. The results indicate a potentially useful therapeutic role for ketanserin in combination with beta-blockers or diuretics.
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PMID:Ketanserin combined with a beta-blocker or diuretic in essential hypertension. A multicentre study. 290 74

The relationship of continuous ambulatory intra-arterial blood pressure over a 24-hour period and awake resting hemodynamic parameters measured by echocardiography was studied in 21 patients with essential hypertension (WHO stage I & II): Left ventricular wall thickness at end-diastole correlated strongly with average SBP and weakly with average DBP during both waking and sleeping periods. Variability of blood pressure taken during waking and sleeping periods was not significantly correlated with any hemodynamic parameters measured by echocardiography. Variability of SBP during sleep had a significant correlation with age; however the fall of blood pressure during sleep had no significant correlation with age. Fall of blood pressure during sleep was significantly correlated to resting awake TPR. In patients with essential hypertension, the above results demonstrate that subjects with thicker left ventricular wall have higher average continuous blood pressure over 24-hours and suggest that there is a tendency for greater falls in blood pressure during sleep to occur in subjects with higher TPR and that older subjects have greater variabilities of SBP during sleep.
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PMID:Variability of direct arterial blood pressure in essential hypertension--relationships between the fall of blood pressure during sleep and awake resting hemodynamic parameters. 294 40

Beta blockers are often considered to be less effective for blood pressure control in elderly patients with essential hypertension than calcium antagonists. We therefore compared the efficacy and tolerability of the new beta blocker bisoprolol with those of nifedipine. Fifty-nine patients over 60 years of age with essential hypertension (supine diastolic blood pressure, DBP: 95-115 mmHg) took part in a randomized double-blind study. After 14 days on placebo the patients received either 10 mg bisoprolol o.d. or 20 mg nifedipine SR b.i.d. for 4 weeks. The doses were doubled in patients whose DBP remained greater than 90 mmHg, for a further 4 week period. Blood pressure was measured about 24 hours after bisoprolol and about 12 hours after nifedipine administration. Fifty-six patients were available for efficacy analysis. After 4 weeks there was a distinct decrease of SBP and DBP in both groups (bisoprolol: -22 +/- 16; -15 +/- 9 mmHg; nifedipine: -24 +/- 17; -17 +/- 7 mmHg) with no significant difference between the treatments. DBP was normalized in 22/28 (79%) patients on bisoprolol and in 24/28 (86%) patients on nifedipine (bisoprolol vs nifedipine: NS). There were 7/29 bisoprolol and 14/30 nifedipine patients who experienced at least one side-effect. Overall the tolerability of bisoprolol was considered to be better than that of nifedipine (P = 0.043). In conclusion, bisoprolol 10-20 mg o.d. proved to be as equally effective as nifedipine SR 20-40 mg b.i.d. for the treatment of essential hypertension in the elderly.
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PMID:Comparison of bisoprolol with nifedipine for treatment of essential hypertension in the elderly: comparative double-blind trial. 296 87

We investigated the effect of the calcium antagonist nifedipine upon the following parameters: systolic and diastolic blood pressure (SBP and DBP) heart rate (HR), electrocardiogram (ECG) and the relative rate of calcium uptake in platelets. The possible correlation between this rate and blood pressure was one of the main points we tried to establish. The subjects studied were 1) 26 patients with uncomplicated essential hypertension and 2) 13 healthy normotensive subjects. SBP and DBP were measured with the subject both in a recumbent and a sitting position. 10 mg of nifedipine were given orally. In the hypertensive patients SBP and DBP decreased significantly in both positions after receiving the drug, as expected, while HR increased significantly (P less than 0.001), also in both positions. In the normotensive subjects BP decreased too, after taking the drug, but was only significantly modified in some instances i.e. SBP recumbent, DBP recumbent and sitting. HR increased significantly in the sitting position but not in the recumbent position. The ECG post-nifedipine showed a negative depression of the ST segment in four patients from the hypertensive group. The relative rate of calcium uptake in platelets measured before the subjects had taken the drug decreased after it was administered. The difference was significant (P less than 0.05) in the hypertensive group, but not in the normotensive group. Some correlation was found between DBP and the rate of calcium uptake.
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PMID:[Effects of a calcium antagonist (nifedipine) in hypertensive and normotensive subjects]. 296 12

In a randomised double-blind study the effects on left ventricular mass (LV mass) and cardiac haemodynamics of urapidil, an antihypertensive agent with a vascular postsynaptic alpha 1-blocking action and a central antihypertensive effect, were compared with those of methyldopa in 29 patients with essential hypertension. During a 3-month period, urapidil was initially given at 120 mg/day and increased to 180 mg/day if a satisfactory antihypertensive response was not achieved. Methyldopa was started at 100 mg/day and increased to 1500 mg/day if an adequate blood pressure response was not achieved. Echocardiographic measurements were obtained at baseline and after 12 weeks' active treatment. The frequency rates of responders (DBP less than 95 mm Hg) on urapidil and methyldopa were 54% and 62%, respectively, after 12 weeks. In the group as a whole there was a nonsignificant tendency for decreased LV mass on both active drugs. However, the haemodynamic changes were difficult to interpret because of baseline differences between the 2 treatment groups.
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PMID:Comparison between the effects of urapidil and methyldopa on left ventricular hypertrophy and haemodynamics in humans. 296 99

The purpose of this study was to detect the anatomical and functional response of the left ventricle in essential, uncomplicated hypertension. Fifty outpatients, whose hypertension (DBP greater than 95 mmHg on three separate visits) had been documented from few weeks to a maximum of 5 years, showing neither electrocardiographic abnormalities nor other signs referable to target organ damage, underwent an M-mode, computerised echocardiographic study. Twenty-seven patients has never been treated, and 23 patients were withdrawn from previous treatments for at least one month. Echocardiographic data of the left ventricle were compared with those of 38 normals, matched by sex, age and body surface area. Hypertensives showed a significant increase in both LV mass index (p less than 0.001) and relative wall thickness (p less than 0.001), a pattern of concentric hypertrophy, which prevented an inappropriate rise in wall tension. Twenty-four patients, whose LV mass was above the mean normal value plus two standard deviations, were considered to have left ventricular hypertrophy. The remaining 26 patients were classified as non hypertrophic, for their mass resulted lower than the mean value of controls plus 2 SD: left ventricular mass was 152 +/- 32 g/m2 and 97 +/- 19 g/m2, respectively (p less than 0.001). Systolic performance was enhanced in both subgroups of hypertensives, since their values of fractional shortening and those of mean-Vcf were both above the line which represents the normal relationship with end-systolic stress. Diastolic relaxation, evaluated by means of time to peak filling rate, was impaired only in the hypertensive subjects with increased LV mass (p less than 0.001 vs. normotensive), being retained in the non-hypertrophic patients. In the whole hypertensive group, LV mass index poorly correlated with casual systolic blood pressure (r = 0.31; p less than 0.05), while time to peak filling rate showed a good correlation with LV mass index (r = 0.76; p less than 0.001). We conclude that: 1) in essential hypertension without electrocardiographic abnormalities or target organ damage, echocardiographic left ventricular hypertrophy is a rather frequent finding; 2) the pattern of concentric hypertrophy, by reducing the increase in wall tension due to pressure load, contributes to the retained, or enhanced, systolic performance seen in our series; 3) on the other hand, left ventricular filling seems to be impaired in relation to the degree of myocardial hypertrophy.
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PMID:[Left ventricular hypertrophy in hypertension: functional aspects]. 297 80

The antihypertensive efficacy of urapidil was compared with that of atenolol in a double-blind randomised parallel-group 10-week study. 44 patients with essential hypertension entered the study, and 43 with a supine DBP of 100 to 125 mm Hg after a 2-week placebo period were randomised either to urapidil (n = 22; 60 to 120 mg/day) or atenolol (n = 21; 50 to 100 mg/day) for 8 weeks. Blood pressure, heart rate, electrocardiogram (supine and standing) and side effects were recorded every week, and medical examinations and laboratory tests were done at the end of the placebo and active treatments. 36 patients completed the trial (17 on urapidil and 19 on atenolol). Patients' characteristics were similar in the two groups, and there were no differences between them in blood pressure and heart rate at the end of placebo period. Both drugs produced a significant fall in supine and standing blood pressure; urapidil decreased supine blood pressure from 164/109 to 150/96 (p less than 0.001), and atenolol decreased it from 167/111 to 146/94 mm Hg by week 8 (p less than 0.001). There were no differences in the blood pressure-reducing effects of the two drugs. There was no change in heart rate in the urapidil group, but a marked reduction occurred in the atenolol group, with significant differences from placebo and urapidil (p less than 0.001). Side effects were reported in 32% of the urapidil group and in 29% of the atenolol group; however, these were mild and transient in all but two patients (urapidil = 1, atenolol = 1) who were withdrawn.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of urapidil and atenolol in hypertension. 304 56

The acute hemodynamic effects of intravenous Nicardipine (N), a new calcium antagonist, were studied in 8 patients with moderate essential hypertension. The forearm arterial blood flow (ABF) was measured using plethysmography before and after N infusion: 1st step was obtained after infusion of 1 mg during 5 min then 1 mg during 25 min; a second step was obtained after the infusion of the same dose during the same time; thus a cumulative dosage of 4 mg was infused over a total duration of 60 mn. Systolic (SBP), diastolic (DBP) mean (MBP) blood pressure and heart rate (HR) were measured every minute using a non invasive device (Dinamap). Systemic vascular resistances (SVR) were calculated. Plasma concentration of N was determined at the beginning, in the middle and at the end of each step. Results are as follows: (table; see text) A 33% decrease in SVR was observed at the 2nd step whereas MBP decreased by 15% only. The date confirm the potent vasodilatory effect of intravenous N at low dosage; the BP alteration was moderate in relation to an increase in local blood flow. These results indicate that Nicardipine could be useful as part of the treatment of chronic arteriopathy and Raynaud disease.
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PMID:[Acute hemodynamic study of intravenous nicardipine in arterial hypertension]. 311 83

In arterial hypertension, hyperviscosity with hemorheological disturbances and platelet dysfunction may play a role in the prognosis and complications of the disease. We studied the effects of Nicardipine (NIC) on these blood disturbances in a group of 21 untreated patients with essential hypertension, aged 25 to 70 years (SBP/DBP = 185 +/- 28/105 +/- 17 mmHg). During one hour before and 4 hours after the IV injection of single doses of 5, 7.5 or 10 mg NIC over 5 min, blood pressure was recorded automatically (Dinamap). Hemorheological variables and platelet function were studied before and 30 min, 3 h and 24 hours after the injection. NIC lowered blood pressure and increased heart rate significantly (At 5 min, SBP = -24 mmHg; DBP = -18 mmHg; HR = +22 b/min). These effects were dose-dependent with rapid onset and short duration (less than 2 hrs). NIC decreased plasma viscosity from 1.36 +/- 0.08 to 1.30 +/- 0.07 Cst; p less than 0.01, whole blood viscosity from 22.4 +/- 2.8 to 20.7 +/- 1.5 mPas; p less than 0.05 for gamma = 0.512 s-1, and erythrocyte filterability with the Ca++ ionophore A 23187 from 16.3 +/- 3.8 to 13.5 +/- 3.1; p less than 0.01. Platelet aggregation with ADP was unchanged, but aggregation with A 23187 decreased from 46.9 +/- 21.2 to 31.3 +/- 25.6; p less than 0.05, as well as plasma levels of beta-thromboglobulin (71.2 +/- 29.8 to 55.4 +/- 24.3 ng/ml; p less than 0.02) and platelet generated malonaldehyde (7.2 +/- 1.8 to 6.7 +/- 1.4 nM/10(9) platelets; NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of intravenous nicardipine on blood pressure, hemorheology platelet function in arterial hypertension. Dose-effect relations]. 311 84

A dose titration study was performed using felodipine, a new calcium antagonist, in Chinese patients with essential hypertension inadequately controlled by metoprolol alone (DBP greater than 95 mmHg). BP and pulse rate were recorded at rest and during treadmill exercise. Nineteen patients completed the six weeks' dose titration phase (2.5-5-10 mg twice daily) of whom 17 were followed for one year. A single 2.5 mg dose of felodipine produced a rapid and pronounced antihypertensive response with pre-exercise supine BP falling from a mean 168/104 to 146/92 mmHg) (P less than 0.001). The SBP during exercise was reduced from 206 to 185 mmHg (P less than 0.001). After 6 weeks treatment the supine BP had fallen to 132/85 mmHg (P less than 0.001) and the SBP during exercise to 169 mmHg (P less than 0.001). Six patients received 2.5 mg twice daily, eight patients 5 mg twice daily and three patients 10 mg twice daily. The effects, both at rest and during exercise, were maintained for at least 12 hours after dosing. The pulse rate was unaffected by felodipine therapy apart from a small transient increase following the first dose. Sixteen patients achieved the target DBP of 90 mmHg measured 12 hours after dosing and only one patient still had a DBP greater than 95 mmHg. After one year the mean supine BP had fallen slightly further to 128/82 mmHg. One patient was withdrawn due to palpitations. Felodipine was otherwise well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The effects of combining felodipine and metoprolol in moderate to severe hypertension--a one year study. 323 15


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