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Hypertension Causes

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34721. Hydrochlorothiazide-amiloride versus hydrochlorothiazide alone for essential hypertension: effects on blood pressure and serum potassium level. (PubMed)

Hydrochlorothiazide-amiloride versus hydrochlorothiazide alone for essential hypertension: effects on blood pressure and serum potassium level. In a double-blind randomized controlled trial the effects on the blood pressure and the serum potassium concentration of hydrochlorothiazide-amiloride hydrochloride (Moduret) and hydrochlorothiazide alone were compared in 266 adults who were normokalemic and had a diastolic blood pressure greater than 95 mm Hg at the time of entry into the study (...) /99 to 138/87 mm Hg and the potassium level from 4.16 to 3.69 mmol/L. The proportions of patients in the two groups with hypokalemia (14% and 29% respectively), defined as a serum potassium level below 3.5 mmol/L, differed significantly (p = 0.0026), whereas the proportions with a potassium level exceeding 4.5 mmol/L (4.5% and 3.9% respectively) were similar. Thus, the combination drug reduced the blood pressure to the same extent as hydrochlorothiazide alone but significantly less often caused

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1985 Canadian Medical Association journal Controlled trial quality: uncertain

34722. Effect of pindolol and propranolol on renal function of patients with hypertension. (PubMed)

Effect of pindolol and propranolol on renal function of patients with hypertension. 1 Pindolol and propranolol were administered orally in equipotent antihypertensive doses to 14 subjects with mild to moderate hypertension in an open cross-over study. 2 Pindolol caused a smaller decrease in plasma renin activity and heart rate than propranolol. 3 Glomerular filtration rate and effective renal plasma flow remained unchanged during therapy with either agent.

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1982 British journal of clinical pharmacology Controlled trial quality: uncertain

34723. A comparison of minoxidil and hydralazine in non-azotemic hypertensives. (PubMed)

A comparison of minoxidil and hydralazine in non-azotemic hypertensives. In 36 patients with normal renal function receiving hydrochlorothiazide and propranolol, lying diastolic blood pressure remained above 95 mmHg. In a double-blind trial, Step 3 therapy with 5-40 mg/day of minoxidil reduced blood pressure somewhat more effectively than 25-200 mg/day of hydralazine. The percentage of patients with lying diastolic blood pressure below 90 mmHg was 69 versus 35% at four weeks, and 55 versus 40 (...) % at 28 weeks. Transient falls in blood pressure within 4 h of any dose were greater with hydralazine which usually needed to be given in divided daily doses. Minoxidil caused tachycardia, and more adverse effects. Minoxidil is more effective, produces more consistent blood pressure control throughout the day, and may often be administered once daily.

1983 Journal of hypertension Controlled trial quality: uncertain

34724. Comparison of beta-adrenoceptor blockers and calcium antagonists in hypertension. (PubMed)

Comparison of beta-adrenoceptor blockers and calcium antagonists in hypertension. The calcium antagonist drug, verapamil, was compared in double-blind, double-dummy, crossover studies with two beta-adrenoceptor blocking drugs, pindolol and labetalol. All were equally effective as antihypertensive drugs in patients with mild-to-moderate hypertension. Verapamil caused a fall in blood pressure by reducing total peripheral resistance, as judged by echocardiographic studies, and had no adverse (...) effects on airways resistance in patients with obstructive airways disease. The favorable hemodynamic effects and absence of serious side effects suggest that verapamil may be an important advance in the treatment of hypertension.

1983 Hypertension Controlled trial quality: uncertain

34725. Haemodynamic effects of carvedilol, a new beta-adrenoceptor blocker and precapillary vasodilator in essential hypertension. (PubMed)

Haemodynamic effects of carvedilol, a new beta-adrenoceptor blocker and precapillary vasodilator in essential hypertension. Carvedilol (BM 14190) is a new antihypertensive compound which combines beta-adrenoceptor blocking and precapillary vasodilating properties but is devoid of intrinsic sympathomimetic activity. The acute and long-term effects on blood pressure and regional haemodynamics (forearm plethysmography) were studied with carvedilol 25 mg b.i.d. or 50 mg b.i.d. Comparisons were made (...) with propranolol 80 mg b.i.d. in a randomized double-blind placebo controlled trial comprised of 30 patients with essential hypertension. After a four-week placebo period active therapy was given for four weeks. Carvedilol administered acutely reduced blood pressure at both doses, delta 13/6 mmHg (P less than 0.001/P less than 0.01) and 17/10 mmHg (P less than 0.001/P less than 0.01). Resistance in the forearm fell significantly with the higher dose. This was in contrast to propranolol which only reduced heart

1984 Journal of hypertension Controlled trial quality: uncertain

34726. The effects of treatments with labetalol and hydrochlorothiazide on ventilatory function of asthmatic hypertensive patients with demonstrated bronchosensitivity to propranolol. (PubMed)

The effects of treatments with labetalol and hydrochlorothiazide on ventilatory function of asthmatic hypertensive patients with demonstrated bronchosensitivity to propranolol. Fifty-two asthmatic patients with mild to moderate hypertension were screened for bronchosensitivity to propranolol in a double-blind randomized fashion after a 2-week minimum placebo run-in period. Thirty-five patients qualified on the basis of a decrease in 1-second forced expiratory volume FEV1 by greater than (...) or equal to 20% after 80 mg of propranolol with no more than a +/- 15% change after placebo. Of these patients, 18 were then randomly assigned to antihypertensive treatment with labetalol at doses that were increased at weekly intervals (100, 200, 400, 600 mg BID) and 17, with hydrochlorothiazide (HCTZ) (25 or 50 mg BID) as needed for control of hypertension. At each placebo washout visit and at each of the four active drug-treatment phase visits, spirometric measurements were obtained just prior

1985 Journal of clinical hypertension Controlled trial quality: uncertain

34727. Detection and treatment of hypertension in older individuals. (PubMed)

) had a 17.2% reduction in all-cause mortality over five years compared to Referred Care, which was primarily due to a reduction in deaths attributed to cardiovascular causes. Thus, antihypertensive treatment can be safely and beneficially administered to individuals in this age range with diastolic hypertension, including those with mild hypertension. (...) Detection and treatment of hypertension in older individuals. The Hypertension Detection and Follow-up Program screened 34,012 individuals aged 60-69 years old in their homes in 14 communities around the United States during 1972 and 1973. The prevalence of hypertension, defined as diastolic blood pressure greater than or equal to 90 mmHg or on antihypertensive medication, was 42.1%. After a second clinic screen, 2,376 hypertensives were identified and randomized into Stepped Care, a special

1985 American journal of epidemiology Controlled trial quality: uncertain

34728. Plasma noradrenaline concentration in essential hypertension during long-term beta-adrenoceptor blockade with oxprenolol. (PubMed)

Plasma noradrenaline concentration in essential hypertension during long-term beta-adrenoceptor blockade with oxprenolol. 1. Chronic beta-adrenoceptor blockade with oxprenolol causes elevation of plasma noradrenaline levels, as compared with placebo, despite a significant fall in blood pressure and pulse rate. 2. The plasma noradrenaline concentration is not influenced by the frequency of administration or the formulation of the drug. 3. Plasma noradrenaline levels are not correlated

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1980 British journal of clinical pharmacology Controlled trial quality: uncertain

34729. The effects of bromocriptine in methyldopa treated hypertension. (PubMed)

The effects of bromocriptine in methyldopa treated hypertension. 1. The effects of treatment with the dopaminergic agonist bromocriptine were studied in nine patients with essential hypertension receiving methyldopa as sole therapy. 2. In Phase 1 of the study, the addition of bromocriptine on a single-blind basis caused a significant fall in lying and standing blood pressures. Plasma prolactin fell significantly but there was no significant change in the other biochemical parameters measured

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1980 British journal of clinical pharmacology Controlled trial quality: uncertain

34730. Verapamil in the treatment of hypertension. (PubMed)

Verapamil in the treatment of hypertension. A randomized, double-blind, crossover trial was carried out in 17 hypertensive patients to evaluate the hypotensive efficacy and safety of verapamil. Verapamil in doses of 120 mg thrice daily was compared with pindolol in doses of 7.5 mg twice daily. A thiazide diuretic was given with both drugs. Blood pressure fell about 14/11 mm Hg during treatment with either drug compared to the placebo period, and neither drug caused significant side effects

1981 Journal of cardiovascular pharmacology Controlled trial quality: uncertain

34731. Ticrynafen and hydrochlorothiazide. A comparison in hypertensive patients with renal impairment. (PubMed)

in individual patients. Thus, although ticrynafen caused a significant reduction in blood pressure in this group of hypertensive patients with renal insufficiency, it was not consistently different from that which could be achieved with hydrochlorothiazide. Ticrynafen also significantly reduced the serum uric acid concentration, compared with a significant rise with hydrochlorothiazide. No major biochemical abnormalities or side-effects were encountered in any subject. Thus, in these patients with renal (...) Ticrynafen and hydrochlorothiazide. A comparison in hypertensive patients with renal impairment. The efficacy of ticrynafen in the treatment of hypertension in patients with moderate renal impairment was compared with that of hydrochlorothiazide in a randomised, double-blind crossover trial in eleven subjects with renal insufficiency. Significant reductions in blood pressure occurred with both treatments, with the maximum responses occurring at different time intervals and to different degrees

1982 European journal of clinical pharmacology Controlled trial quality: uncertain

34732. Response of blood pressure and plasma norepinephrine to propranolol, metoprolol and clonidine during isometric and dynamic exercise in hypertensive patients. (PubMed)

Response of blood pressure and plasma norepinephrine to propranolol, metoprolol and clonidine during isometric and dynamic exercise in hypertensive patients. The effects of metropolol (beta 1-selective), propranolol (nonselective) and clonidine (central alpha-stimulant) on plasma norepinephrine, blood pressure and heart rate were assessed at rest, during isometric work and dynamic exercise in 15 patients with moderate hypertension. Metroprolol resulted in a lower diastolic blood pressure during (...) tended to be lowest following clonidine, especially during dynamic work. The findings support the hypothesis that the central action of clonidine inhibits peripheral release of norepinephrine, but is insufficient to attenuate cardiac stimulation by physical exercise. The fact that propranolol caused higher plasma norepinephrine concentrations than metoprolol during exercise may explain the difference in the blood pressure responses during exercise.

1982 European journal of clinical pharmacology Controlled trial quality: uncertain

34733. Comparison of labetalol and clonidine in hypertension. (PubMed)

Comparison of labetalol and clonidine in hypertension. The antihypertensive effect of labetalol (L) was compared with that of clonidine (C) in a randomized cross-over study in 17 hypertensive outpatients on bendrofluazide (B). After treatment for two weeks with B(5 mg qd), either L (100 mg tid) or C (0.1 mg tid) was given and their doses were titrated at 2-weekly visits until normotension was achieve, or intolerable side-effects occurred. The treatment with B and L or C was than continued (...) ), respectively. The mean daily doses required were L 476 mg and C 0.335 mg. On a weight basis, labetalol had about 1/1400 of the potency of clonidine. 12 patients complained of tiredness and dry mouth on clonidine and 2 patients of unsteadiness on labetalol. Labetalol caused a psoriasiform rash on the hands in one patient and limb weakness in one patient.

1982 European journal of clinical pharmacology Controlled trial quality: uncertain

34734. Antihypertensive and metabolic effects of increasing doses of atenolol and labetalol. A comparative study in primary hypertension. (PubMed)

Antihypertensive and metabolic effects of increasing doses of atenolol and labetalol. A comparative study in primary hypertension. Thirty-two patients with primary hypertension were studied in a double-blind cross-over comparison between the cardioselective beta 1-blocking agent atenolol and the combined alpha- and beta-blocking agent labetalol. The doses used were atenolol 50--150 mg twice daily and labetalol 200--600 mg twice daily. Both drugs effectively reduced blood pressure and heart rate (...) . Dose increments every second week resulted in a higher proportion of patients with normal blood pressure (les than or equal to 150/90 mm Hg) with both drugs. Labetalol was somewhat more effective in lowering upright blood pressure while atenolol caused a more pronounced heart-rate reduction. Both agents decreased plasma renin activity and urinary aldosterone excretion. Scalp tingling on labetalol (2 patients) and cold fingers with atenolol (1 patient) caused withdrawal of the drugs. Cold fingers

1982 Acta medica Scandinavica. Supplementum Controlled trial quality: uncertain

34735. Potassium conservation with amiloride/hydrochlorothiazide ("Moduret') in thiazide-induced hypokalaemia in hypertension. (PubMed)

Potassium conservation with amiloride/hydrochlorothiazide ("Moduret') in thiazide-induced hypokalaemia in hypertension. A double-blind study was carried out in 24 hypertensive patients with thiazide-induced hypokalaemia (serum potassium less than 3.2 mmol/l) to compare the effects of treatment with an amiloride/hydrochlorothiazide combination or hydrochlorothiazide alone. The study was divided into three phases: (i) potassium repletion (Weeks 0 to 4) with oral potassium chloride (40 mmol/day (...) ), (ii) stabilization (Weeks 4 to 6) of normokalaemia, and (iii) active drug treatment (Weeks 6 to 14), patients being allocated at random to receive one or other of the two treatments. Dosage was 2 tablets per day of the 5 mg amiloride plus 50 mg hydrochlorothiazide combination or of 50 mg hydrochlorothiazide alone. The results showed that blood pressure control was comparable in both treatment groups but hydrochlorothiazide alone caused a statistically significant reduction in serum potassium

1982 Current medical research and opinion Controlled trial quality: uncertain

34736. Evaluation of guanabenz added to hydrochlorothiazide therapy in hypertension. (PubMed)

Evaluation of guanabenz added to hydrochlorothiazide therapy in hypertension. Guanabenz, a centrally acting alpha-adrenergic antihypertensive agent, produces neither the sodium retention seen with other centrally acting agents nor the metabolic abnormalities characteristic of diuretics. In this study, which involved 204 hypertensive out-patients, the additive effects of guanabenz and hydrochlorothiazide were compared with the effects of hydrochlorothiazide therapy alone. Before randomization (...) dose, 24 mg/day) caused a further decrease in mean SDBP to 88 mm Hg (p less than 0.01), an increase in the response rate to 86%, and no weight change. Pulse rates in both groups were unchanged. The principal side-effects in both groups were dry mouth, drowsiness, weakness, and dizziness, with a greater incidence of each during the combination therapy. The usual laboratory abnormalities were associated with hydrochlorothiazide. Guanabenz was found to enhance the antihypertensive efficacy

1982 The Journal of international medical research Controlled trial quality: uncertain

34737. Effects of treatment with nifedipine and metoprolol in essential hypertension. (PubMed)

Effects of treatment with nifedipine and metoprolol in essential hypertension. In a double-blind trial 26 patients with essential hypertension were treated with nifedipine or placebo for 8 weeks, following a 4-week run-in-placebo period in all patients. The daily dosage of nifedipine during this phase was 10 mg 3 times daily. Metoprolol was then added to the therapeutic regimen of both groups for a further 12 weeks. Both nifedipine and metoprolol used as mono-therapy caused statistically (...) with vasodilation properties, such as nifedipine, offers a theoretically interesting approach in the treatment of hypertension, even though the practical outcome in the present study probably suffered from an inadequate dose of nifedipine during the period of combined therapy.

1982 European journal of clinical pharmacology Controlled trial quality: uncertain

34738. Treatment of hypertension with beta-blockers with and without intrinsic sympathomimetic activity. (PubMed)

Treatment of hypertension with beta-blockers with and without intrinsic sympathomimetic activity. In a randomized double-blind trial 36 patients with essential hypertension were treated with either metoprolol or pindolol for 6 months following a 6-week placebo period. At the end of the placebo period and after 6 weeks and 6 months of active therapy peripheral hemodynamics at rest and during maximal vasodilatation were studied. Exercise heart rate was reduced to the same extent with both (...) metoprolol and pindolol, indicating that the doses used (metoprolol average 179 mg/day; pindolol average 12 mg/day) were equipotent as regards beta-adrenoceptor blocking effect. The antihypertensive effect was identical with both compounds. However, metoprolol caused a significant reduction of heart rate at rest both at 6 weeks and 6 months. With pindolol the reduction in heart rate was not significant at 6 weeks, and it was clearly much less than with metoprolol. On the other hand, no change in calf

1983 Journal of cardiovascular pharmacology Controlled trial quality: uncertain

34739. Absence of an effect of mianserin on the actions of clonidine or methyldopa in hypertensive patients. (PubMed)

Absence of an effect of mianserin on the actions of clonidine or methyldopa in hypertensive patients. The concurrent administration of tricyclic antidepressants has been shown in man to result in a clinically significant impairment of the antihypertensive effect of clonidine. This interaction is thought to be related to competition for central alpha 2 receptors where clonidine acts as an agonist and the tricyclics act as antagonists. Although it seems to cause less cardiovascular effects than (...) tricyclic antidepressants, the tetracyclic antidepressant, mianserin also has been reported to be an alpha receptor antagonist and may, therefore, also interfere with the antihypertensive activity of centrally-acting drugs. This study investigates the effects of acute and chronic mianserin administration in patients with essential hypertension established on long term treatment with either clonidine or methyldopa. The first dose of mianserin was not associated with an increase in blood pressure

1983 European journal of clinical pharmacology Controlled trial quality: uncertain

34740. A comparative study of atenolol and penbutolol in hypertensive patients. (PubMed)

A comparative study of atenolol and penbutolol in hypertensive patients. In a randomized controlled, double-blind clinical trial with 45 patients with moderate hypertension atenolol 100 mg and penbutolol 40 mg were equally effective in lowering the blood pressure. During the 6 weeks of treatment there was no change in body weight and serious side-effects were not observed, but bradycardia occurred more frequently with atenolol than with penbutolol. Withdrawal of medication during the final week (...) of the study did not cause any adverse reaction.

1983 European heart journal Controlled trial quality: uncertain

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