UMLS:C0085580 - FACTA Search

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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 amiloride was compared to that of the calcium antagonist nitrendipine in 12 patients (8 males), aged 34-62 years, with essential hypertension WHO grade I-II (mean supine blood pressure 158/103, standing 155/106 mmHg) in a double-blind placebo-controlled cross-over study design. Amiloride was given 5 mg once daily for one month followed by 20 mg twice daily for another month. Amiloride 5 mg once daily significantly reduced supine and standing DBP but not SBP (supine 151/94, standing 149/97 mmHg), whereas 10 mg once daily decreased SBP as well as DBP (supine 145/98, standing 145/101 mmHg). Nitrendipine 20 mg once daily significantly reduced supine and standing SBP and standing DBP (supine 150/97, standing 148/98 mmHg), but on 20 mg twice daily only supine SBP was significantly reduced (supine 150/99, standing 151/106 mmHg). Heart rate was transiently increased by nitrendipine 20 mg once daily and unchanged following amiloride. Plasma noradrenaline was unaltered following amiloride 10 mg once daily as well as nitrendipine 20 mg twice daily, whereas plasma renin activity and aldosterone were elevated following amiloride. Serum electrolytes, blood glucose, plasma lipids and body weight were not altered by any of the drugs. Amiloride 5-10 mg daily has a mild to moderate BP lowering effect in patients with essential hypertension. The BP reduction following nitrendipine 20 mg once daily was comparable to that of amiloride 5 mg daily. Nitrendipine 20 mg twice daily gave no additional BP decrease.
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PMID:Amiloride compared with nitrendipine in treatment of essential hypertension. 323 18

In the present study, effects of angiotensin on the adrenal steroidogenesis were studied in essential hypertension, primary aldosteronism and renovascular hypertension (RVH). Angiotensin III(A III), an analogue of angiotensin II, was administered to 17 normal volunteers (9 male and 8 female), 44 patients with essential hypertension (EH) (15 with high renin; HREH, 15 with normal renin; NREH and 14 with low renin; LREH), 8 patients with primary aldosteronism (5 with adrenal adenoma; APA and 3 with bilateral adrenocortical hyperplasia; IHA) and 5 patients with renovascular hypertension. In all the patients with hypertension and normal subjects, blood pressure (BP) and plasma concentrations of progesterone (P), corticosterone (B), aldosterone (Aldo), 17 alpha-hydroxyprogesterone(17-OHP) and cortisol(F) were measured before and after intravenous administration of A III (0.1, 0.5, 1.0, 10, 20 and 40 ng/kg/min, for 15 min, respectively). 1) BP rose from 164 +/- 19/88 +/- 8 to 180 +/- 19/112 +/- 10 mmHg [systolic BP(SBP); P less than 0.01, diastolic BP(DBP); P less than 0.01] in HREH, from 162 +/- 12/96 +/- 7 to 186 +/- 11/118 +/- 8 mmHg in NREH(SBP; P less than 0.01, DBP; P less than 0.01), 165 +/- 12/94 +/- 8 to 202 +/- 12/126 +/- 9 mmHg in LREH(SBP; P less than 0.001, P less than 0.001) and 118 +/- 8/72 +/- 7 mmHg to 136 +/- 11/88 +/- 8 mmHg in controls (SBP; P less than 0.01, DBP; P less than 0.01). The elevation in NREH and LREH was greater than that in HREH and controls. The elevations of BP both in APA and IHA were remarkably greater than that in controls and as similar as LREH(APA; 174 +/- 21/103 +/- 12 to 204 +/- 18/136 +/- 8 mmHg, IHA; 176 +/- 10/104 +/- 4 to 206 +/- 17/138 +/- 10 mmHg). The elevation in RVH was similar to that in NREH(173 +/- 9/108 +/- 8 to 194 +/- 13/132 +/- 10 mmHg). 2) Plasma P increased from 25.5 +/- 7.5 to 39.5 +/- 13.8 ng/100 ml(P less than 0.001) in HREH, from 28.0 +/- 7.7 to 45.3 +/- 12.7 ng/100 ml(P less than 0.001) in NREH, from 23.8 +/- 8.2 to 47.2 +/- 19.4 ng/100 ml(P less than 0.001) in LREH and 26.6 +/- 11.0 to 43.4 +/- 14.6 ng/100 ml in controls. The increment in HREH or NREH was similar to that in controls(P less than 0.1, respectively), whereas greater than controls in LREH(P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Studies on abnormalities of adrenal steroidogenesis in essential hypertension, primary aldosteronism and renovascular hypertension: responses of plasma steroids to angiotensin III]. 341 Jan 45

We have previously reported on a high prevalence of high renin essential hypertension in psoriasis. Since angiotensin-converting enzyme (ACE) was also reported to be increased in some psoriatics, we found it rational to treat 10 patients with hypertension and diffuse psoriasis with captopril at a dose of 25 mg t.i.d. Five patients had high PRA levels and in 1 of them serum ACE was also increased. Serum creatinine, BUN and urinalysis were normal in all of them. SPB fell from 163 +/- 3 to 138 +/- 3 and DBP from 107 +/- 3 to 86 +/- 2 mm Hg after 1 month of captopril treatment. A surprising clinical improvement of the cutaneous lesions occurred in 3 patients previously resistant to every local or systemic treatment. Unfortunately, however, 3 patients developed heavy proteinuria (greater than 2 g/day) which disappeared after captopril discontinuation. The unexpected incidence of reversible proteinuria induced by low doses of captopril in our patients recommends a careful monitoring of the renal function every time this drug is employed in the treatment of hypertension in a psoriatic.
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PMID:Captopril-induced proteinuria in hypertensive psoriatic patients. 354 Jun 94

The antihypertensive effects of verapamil over 24 hours were assessed on twice and thrice daily dose regimens on 12 patients (25-65 years of age; mean age 50) with essential hypertension (WHO stages I-II) in a randomised, double-blind, cross-over trial. After a dose titration period starting with either verapamil 80 mg tid or 120 mg bid the patients kept their maintenance dose (240, 360 or 480 mg daily) for 4 weeks before crossing over to the other administration schedule. Repeated ambulatory blood pressure (BP) curves were recorded in 10 patients with a non-invasive portable device (Pressurometer III, Del Mar Avionics). The BP reductions (causal BP values) obtained by 2- and 3-dose regimens were of similar magnitude (from 170 +/- 19/105 +/- 8 on placebo to 140 +/- 17/87 +/- 7 and to 146 +/- 14/88 +/- 8 by 2-and 3-dose respectively). Analyses of BP curves revealed close similarity in profiles on the two dose regimens, although DBP was significantly (p less than 0.05) lower by 3-dose as compared to 2-dose regimen during the period 0.00-2.59 a.m. Long-term (circadian rhythm) and short-term variability did not differ between the regimens. Despite the slight difference in DBP curves after midnight, the overall impression is that verapamil given both twice and thrice daily provides adequate BP control throughout 24 hours.
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PMID:Variability of blood pressure in ambulatory hypertensive patients: effects of verapamil on twice and thrice daily dose regimens. 354 89

116 patients from 4 clinics participated in a double blind study to assess the efficacy of (BAY l 5240), a nifedipine-acebutolol fixed combination (10 mg + 100 mg), as compared to nifedipine 20 mg in essential hypertension. During the 10 week study, the mean recumbent blood pressure decreased 1 to 3 h after treatment from 175.5/105.2 to 148.3/88.0 mmHg in the BAY l 5240 group and from 174.3/102.9 to 150.3/86.5 mmHg in the nifedipine group. The results also showed a comparable decrease in the mean systolic (SBP) and diastolic (DBP) blood pressures before treatment (24 h after last tablet) and after physical exertion before and after either drug given for 4 weeks. Doubling of the dose for 4 additional weeks produced a moderate and similar additional decrease in blood pressure. The results show the possibility of treating essential hypertension with a low dose of a beta-adrenergic blocking agent in combination with 10 mg nifedipine. Both regimens were well tolerated. One patient in the BAY l 5240 group and 2 in the nifedipine group, all treated by the same investigator, were withdrawn from the study because of headache during the nifedipine pre-period.
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PMID:Effects of BAY l 5240, a fixed combination of low dose nifedipine and acebutolol on hypertension: comparison with standard dose nifedipine. 388 99

The dose-response effects of oral nicardipine on the systemic blood pressure were examined in 54 patients with uncomplicated essential hypertension (DBP greater than or equal to 100 mm Hg). The study was designed in four sequential stages. A 2 week single-blind placebo run-in period was followed by dose titration with nicardipine at 2 week intervals. Patients achieving the target DBP less than or equal to 95 mm Hg were then crossed over to placebo for 2 weeks, following which the previous dose of nicardipine was readministered for 6 weeks. Forty-eight patients completed the dose-titration phase. The target DBP 95 mm Hg was achieved in 33; in eight after 10 mg three times daily, in 21 after 20 mg three times daily, in three after 30 mg three times daily and in one after 40 mg three times daily. In the 48 patients, systolic blood pressure was reduced from 188 +/- 25 to 158 +/- 21 mm Hg (P less than 0.001) and diastolic blood pressure from 111 +/- 9 to 93 +/- 13 mm Hg (P less than 0.001); heart rate increased from 81 +/- 7 to 87 +/- 13 beats min-1 (P less than 0.01). Thirty-one of the 33 patients completed the crossover to placebo, which was accompanied by a significant increase towards pretreatment blood pressure levels. Reinstitution of nicardipine at the previous dose resulted in a reduction of SBP and DBP to levels not significantly different from those at the end of the dose-titration stage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Anti-hypertensive dose-response effects of nicardipine in stable essential hypertension. 389 80

The antihypertensive effect of carteolol, a new potent nonselective beta-adrenergic antagonist, was investigated in a double-blind, parallel study of 35 patients with mild-to-moderate, essential hypertension whose blood pressures were not adequately controlled with a diuretic. Patients were randomly assigned to receive placebo, carteolol 5 mg, or carteolol 20 mg once a day in addition to hydrochlorothiazide 50 mg for six weeks. Thirty-four patients completed the study: 11 patients received placebo (group 1), 12 patients received carteolol 5 mg (group 2), and 11 patients received carteolol 20 mg (group 3). After six weeks of treatment, the two groups that received carteolol had significant reductions in systolic (SBP) and diastolic (DBP) blood pressure from baseline in both the supine and standing positions. In group 2, mean SBP decreases for supine and standing positions were 11 +/- 2.1 and 11 +/- 1.9 mm Hg, respectively (P less than .01) and 8 +/- 1.2 and 9 +/- 1.3 mm Hg, respectively, for DBP (P less than .01); whereas in group 3, values were 8 +/- 2.8 and 12 +/- 3.0 mm Hg for SBP, in 5 +/- 1.9 and 9 +/- 3.1 mm Hg, respectively, for DBP (P less than .01). The hypotensive effect was associated with slight but significant decreases in heart rate (P less than .01 in group 2 and P less than .05 in group 3). Reductions in SBP and DBP with the 20-mg dose were not significantly different from those with the 5-mg dose.2+ moderate hypertension.
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PMID:Antihypertensive effect of carteolol in thiazide-treated hypertensive subjects. 390 1

A controlled multicentre trial was organised to compare the effects of 20 mg Nifedipine tablets (N) and 2,5 mg Indapamide tablets (I) during a 4 months' treatment period after a placebo period, in 59 patients with moderate essential hypertension (n = 59). The results of blood pressure measurements of 18 patients treated by nifedipine (1 tablet twice daily) and 22 patients treated by indapamide (1 tablet every morning) were compared. The systolic blood pressure, after 10 minutes recumbency, fell from 165 +/- 10 mmHg to 148 +/- 13 mmHg (p less than 0.01), and the diastolic pressure from 104 +/- 6 mmHg to 86 +/- 7 mmHg (p less than 0.01) in the patients treated with nifedipine. In the indapamide group, the SBP fell from 164 +/- 13 mmHg to 152 +/- 15 mmHg (p less than 0.01) and the DBP from 100 +/- 4 mmHg to 87 +/- 6 mmHg (p less than 0.01). There were no significant changes of heart rate with either drug; plasma creatinine, potassium and uric acid concentrations were also unchanged. There was a higher incidence of headaches and tiredness in the nifedipine group, whilst patients treated with indapamide complained more often of muscular cramps. Flushing was observed in nearly a quarter of the patients in both groups. These results confirm that both nifedipine and indapamide induce significant and persistant falls in systolic and diastolic blood pressure. Although the fall was greater with nifedipine than with indapamide, the difference was not statistically significant. The tolerance was satisfactory in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparative effects of nifedipine and indapamide in the treatment of arterial hypertension]. 393 9

Among the first screened 2439 males born in 1926 and 1927, aged 48-49 years at the time of screening and representing 76% of these age cohorts, uncontrolled or partly controlled hypertension was found in 7.5%. Of these individuals, 30% preferred to remain with their physicians, regardless of the degree of control they had achieved. Among those who were referred to the Hypertension Unit (5.2% of the screened population), elevated S-GT levels (greater than or equal to 1.10 mukat/l) were found in 38.3%, against 18.5% in the two cohorts. During 24 months of treatment and follow-up only two men among the entire group of hypertensives referred dropped out, both were heavy drinkers (greater than 80 g alcohol daily). The mean BP after treatment was significantly lower among men with normal than high S-GT values or in those who admitted to heavy drinking. Of the 99 males treated for more than two years, 82 (83%) were responders (supine DBP less than or equal to 95 mmHg). Of the non-responders, 70% were either heavy drinkers or had abnormal S-GT values. The possible role of alcohol in the pathogenesis of essential hypertension in middle-aged males is discussed.
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PMID:Hypertension, levels of serum gamma glutamyl transpeptidase and degree of blood pressure control in middle-aged males. 610 14

Sixteen patients (11 M, 5 F), median age 41 years, with essential hypertension insufficiently controlled on hydrochlorothiazide 75 mg/day (DBP greater than or equal to 100 mmHg) were investigated. Plasma renin concentration (PRC), angiotensin II concentration (PA II), aldosterone concentration (PAC), plasma noradrenaline concentration (PNAC), plasma volume (PV) and exchangeable sodium (NaE) were determined and a saralasin-infusion (5.4 nmol/kg/min) was carried out while the patients were on thiazide alone, and in fourteen cases, repeated 3 months later after addition of a beta-blocker (propranolol 6, metoprolol 6 and atenolol 2 patients). On thiazide alone PRC, PA II and PAC was higher than normal in the group as a whole and the angiotensin II-inhibitor, saralasin, caused a significant decrease in MAP in twelve out of sixteen patients. After addition of a beta-blocker SBP and DBP decreased from 164/109 mmHg to 136/94 mmHg. PRC and PA II decreased by 40% and 58%, respectively. At this point saralasin caused no significant change in MAP. No close correlation was found between changes in BP on beta-blocker treatment and either PRC, PA II or saralasin response on thiazide treatment. PV, NaE, PAC and PNAC did not change sigificantly. It is concluded that in pts with thiazide-induced stimulation of the renin-angiotensin system (RAS) addition of a beta-blocker leads to suppression of RAS and the angiotensin II dependence of the blood pressure is nearly abolished. This mechanism might well contribute to the antihypertensive effect of beta-blockade in this particular situation. However, the pharmacological changes induced by beta-blockade are very complex, and most likely other factors are involved in the antihypertensive effect of beta-blocking drugs.
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PMID:Angiotensin II blockade during combined thiazide-beta-blocker treatment. 610 82

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