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Hypertension Causes

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34761. Effects of the new calcium entry blocker isradipine (PN 200-110) in essential hypertension. (PubMed)

Effects of the new calcium entry blocker isradipine (PN 200-110) in essential hypertension. In this double-blind cross-over study 16 patients with mild-to-moderate hypertension were treated with placebo and the dihydropyridine derivative, isradipine 5-10 mg twice daily. In the supine position isradipine reduced systolic (-18 mm Hg; p less than 0.002) and diastolic (-15 mm Hg; p less than 0.001) pressures, while heart rate was not changed; in the standing position, systolic (-15 mm Hg; p less (...) than 0.002) and diastolic (-14 mm Hg; p less than 0.001) pressures decreased, whereas heart rate increased (+6 bpm; p less than 0.05). Body weight and lower leg volumes remained unaltered, suggesting that isradipine did not cause fluid retention. On IS plasma angiotensin I (+40 pg/ml), angiotensin II (+ 14 pg/ml), and aldosterone (+4.1 ng/dl) rose. The intracellular Na+ and K+ concentrations and the transmembrane cation transport activities (Na+-K+ pump, Na+-K+ cotransport, Na+-Li+ countertransport

1989 Journal of cardiovascular pharmacology

34762. Morbidity and mortality in the Systolic Hypertension in the Elderly Program (SHEP) pilot study. (PubMed)

Morbidity and mortality in the Systolic Hypertension in the Elderly Program (SHEP) pilot study. The pilot study of the Systolic Hypertension in the Elderly Program was a randomized, double-blind, placebo-controlled trial of drug therapy for isolated systolic hypertension. It followed 551 elderly participants with untreated blood pressures of greater than 160/less than 90 mm Hg for an average of 34 months. Mean age of the participants was 72 years; 63% were women, and 82% were white (...) . Pretreatment blood pressures averaged 172/75 mm Hg. Participants were randomly assigned to treatment with chlorthalidone or placebo as Step I medication. Blood pressures at annual visits averaged 141/68 and 157/73 mm Hg for the drug-treated and placebo-treated groups, respectively, with 60% and 33% of the survivors on blinded medication having systolic blood pressures of less than 160 mm Hg at their last annual visit. All-cause mortality rates for the drug-treated and placebo-treated groups were 25.4

1989 Stroke

34763. Efficacy and safety of isradipine in hypertension. (PubMed)

Efficacy and safety of isradipine in hypertension. Of the calcium channel blocking drugs, only verapamil is approved in the United States for treatment of hypertension. Isradipine is a 1,4-dihydropyridine calcium blocker that may be given on a twice-daily basis. It causes peripheral vasodilation with minimal cardiodepressant activity. We undertook a double-blind, parallel group randomized, multicenter study of 203 hypertensive subjects to examine the efficacy and safety of isradipine (...) in treatment of hypertension. Subjects were given 0, 2.5, 5, 7.5, or 10 mg isradipine twice daily for up to 5 weeks. There was a significant dose-response relationship between isradipine dose and decrease in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Isradipine 15 mg/day reduced supine pressure by 16/15 mm Hg in patients with starting DBP less than 105 mm Hg and by 38/22 mm Hg in those with starting DBP greater than or equal to 105 mm Hg. There was no significant orthostatic fall

1989 Journal of cardiovascular pharmacology

34764. Comparison of enalapril and atenolol in mild to moderate hypertension. (PubMed)

Comparison of enalapril and atenolol in mild to moderate hypertension. Short-term therapy with angiotensin converting enzyme (ACE) inhibitors for hypertension is effective and well tolerated, and compared with beta blockers, may cause fewer adverse reactions. Furthermore, enalapril has been observed to have a greater effect on systolic blood pressure than beta blockers. We therefore decided to compare the ACE inhibitor enalapril and the beta blocker atenolol as monotherapy in a double-blind

1989 The American journal of medicine

34765. Comparative renal effects of intravenous administration of fenoldopam mesylate and sodium nitroprusside in patients with severe hypertension. (PubMed)

hypertensive patients while lowering BP with nitroprusside does not predictably alter renal function and causes a moderate expansion in volume. (...) Comparative renal effects of intravenous administration of fenoldopam mesylate and sodium nitroprusside in patients with severe hypertension. We studied the renal effects of intravenous administration of fenoldopam mesylate, a dopamine-1 agonist, vs sodium nitroprusside following acute reduction of blood pressure (BP) in 11 patients with severe hypertension (supine BP, 168/124 to 252/135 mm Hg). Following randomization (open-label), timed urinary and plasma samples for clearance of urea

1989 Archives of internal medicine

34766. Calcium-channel blockade (nitrendipine) in combination with ACE inhibition (captopril) in the treatment of mild to moderate hypertension. (PubMed)

and tolerability of monotherapy with nitrendipine (20 mg) or captopril (100 mg), and of their combination (nitrendipine 10 mg plus captopril 50 mg), in patients suffering from mild to moderate primary hypertension, according to a single-blind, randomized, placebo-controlled design. After the first 4-week monotherapy period, both nitrendipine and captopril induced a significant decrease in systolic and diastolic blood pressure (BP) (p less than 0.001). Furthermore, nitrendipine caused a significant increase (...) Calcium-channel blockade (nitrendipine) in combination with ACE inhibition (captopril) in the treatment of mild to moderate hypertension. The antihypertensive efficacy of a combination of calcium-channel blockers and angiotensin-converting-enzyme (ACE) inhibitors in severe primary hypertension is well known, but a synergistic action of this drug combination in mild to moderate primary hypertension is still not established. Therefore, the aim of the present study was to evaluate the efficacy

1989 Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy

34767. Comparison of felodipine extended release and conventional tablets in essential hypertension using ambulatory blood pressure monitoring. (PubMed)

Comparison of felodipine extended release and conventional tablets in essential hypertension using ambulatory blood pressure monitoring. Two formulations of felodipine, conventional and extended release (ER) tablets, were compared in a double-blind, crossover study of patients whose blood pressure was not being controlled using metoprolol 100 mg once daily. Nineteen patients with a supine diastolic blood pressure greater than or equal to 95 mmHg after 4 weeks of taking metoprolol and placebo (...) and the heart rate were monitored over 24 h using an Accutracker (Suntech Medical Instruments, Raleigh, North Carolina, USA). During the final treatment, both felodipine formulations caused similar substantial falls in supine blood pressure compared with pressures prior to randomized treatment. The falls in clinic blood pressures (systolic/diastolic) were similar with the conventional and ER formulations at all time points, i.e. 0 h (21/13; 19/11 mmHg), 2 h (39/18; 36/18 mmHg) and 5 h (30/12; 35/11 mmHg

1989 Journal of hypertension

34768. Acute hemodynamic (systemic and renal) and humoral effects of three increasing doses of iloprost in essential hypertensives. (PubMed)

Acute hemodynamic (systemic and renal) and humoral effects of three increasing doses of iloprost in essential hypertensives. To evaluate the acute hemodynamic, both systemic and renal, and humoral effect of three increasing doses of Iloprost, a prostacyclin analogue, eight uncomplicated untreated hospitalized patients with mild to moderate essential hypertension, while on a constant sodium and potassium intake, received, after oral hydration, three doses of Iloprost (1,2 or 4 ng/kg/body weight (...) greater on the 4 ng dose. Glomerular filtration rate and adrenaline showed a dose-dependent increase; urinary sodium excretion and fractional sodium excretion were similarly increased by the three doses. No correlation was found between urinary sodium excretion and either glomerular filtration rate or renal plasma flow. The data obtained indicate that Iloprost causes reduction of blood pressure with a reflex activation in the sympathetic nervous system and stimulation of renin secretion, renal

1989 American journal of hypertension

34769. Intravenous labetalol versus sodium nitroprusside for treatment of hypertension postcoronary bypass surgery. (PubMed)

Intravenous labetalol versus sodium nitroprusside for treatment of hypertension postcoronary bypass surgery. Hypertension is common following coronary artery bypass surgery. The safety of labetalol, a recently released combined alpha-1 and beta-adrenergic blocking agent for treatment of hypertension in this clinical situation is controversial. The authors compared the hemodynamic effects of labetalol with those of sodium nitroprusside (SNP) in 91 patients with good left ventricular function (...) and equally severe coronary artery disease and in whom coronary artery bypass surgery had been just completed. They were anesthetized using fentanyl, diazepam, and enflurane. If hypertension developed postoperatively, patients were randomized to receive labetalol, 2 mg/min to a maximum of 300 mg (20 patients) or sodium nitroprusside in 0.5 micrograms.kg-1.min-1 increments by infusion (20 patients) to return blood pressure to normal. Compared with control values, labetalol brought about significant (P less

1989 Anesthesiology

34770. Carvedilol and atenolol once daily in the treatment of hypertension. (PubMed)

Carvedilol and atenolol once daily in the treatment of hypertension. Fifty milligrams of carvedilol and 100 mg atenolol were administered in a random order once a day for 2 months to 43 patients with mild to moderate hypertension, in a double-blind crossover study. Blood pressure, heart rate and peripheral blood flow parameters (n = 11) were recorded 2 and 24 h after the drug administration. Supine blood pressure was the same 2 h after both carvedilol and atenolol administration, but carvedilol (...) caused a greater decrease in standing systolic blood pressure 2 h after the administration (P less than 0.05). The heart rate decreased less with carvedilol (P less than 0.01). There was no difference in the effects exerted by the two therapies on systolic blood pressure and the heart rate 24 h after drug administration, but the diastolic blood pressure was higher in patients given carvedilol (92 versus 88 mmHg; P less than 0.05). Forearm blood flow, forearm vascular resistance and calf blood flow

1989 Journal of hypertension. Supplement : official journal of the International Society of Hypertension

34771. Potassium channel stimulation in normal subjects and in patients with essential hypertension: an acute study with cromakalim (BRL 34915). (PubMed)

with essential hypertension but not in normotensive subjects. This may be due to a greater reflex response in the normal subjects or to specific effects of cromakalim on mechanisms causing the high blood pressure. (...) Potassium channel stimulation in normal subjects and in patients with essential hypertension: an acute study with cromakalim (BRL 34915). We studied the acute effects of the potassium channel opener cromakalim on blood pressure, the renin-angiotensin-aldosterone system and renal function in eight patients with essential hypertension and five normal subjects. In the hypertensive patients, blood pressure decreased significantly from 2 to 6 h after treatment with cromakalim 1.5 mg compared

1989 Journal of hypertension. Supplement : official journal of the International Society of Hypertension

34772. Comparison of the renal effects of dilevalol and carteolol in patients with mild to moderate essential hypertension. (PubMed)

to the carteolol phase. The results suggest that dilevalol may cause a greater decrease in TRR and less reduction in GFR when compared to carteolol in patients with mild-to-moderate essential hypertension. The difference in the renal effects might be due to the difference in the potency of vasodilatory properties of both drugs at the doses applied. (...) Comparison of the renal effects of dilevalol and carteolol in patients with mild to moderate essential hypertension. The effects of 6 weeks of treatment with dilevalol 100 mg once daily, or carteolol 10 mg once daily, on renal blood flow (RBF), glomerular filtration rate (GFR) and total renal vascular resistance (TRR) were studied in 10 patients with mild-to-moderate essential hypertension in a randomised cross-over experiment. Both drugs lowered the systolic and diastolic blood pressures

1990 European journal of clinical pharmacology

34773. Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy. (PubMed)

Beta-blockers vs. angiotensin-converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy. Both beta-blockers and angiotensin-converting enzyme (ACE) inhibitors have been shown to cause left ventricular hypertrophy regression in hypertensive patients. So far, no study allowed a true comparison of these drugs in this regard. Therefore, 56 hypertensive patients (38 newly recognized and 18 without any antihypertensive drugs for more than 2 months, mean of 9.5+/-14 months (...) between the reductions in 24-h BP and in LVM index. Bisoprolol and enalapril were similarly effective in lowering blood pressure (BP) in the office and during 24-h monitoring and in reducing the left ventricular mass index in hypertensive patients.

1990 Journal of cardiovascular pharmacology

34774. Effect of bisoprolol and acebutolol on resting blood pressure and on exercise blood pressure profile in hypertensive patients: a comparative, single-blind study. (PubMed)

Effect of bisoprolol and acebutolol on resting blood pressure and on exercise blood pressure profile in hypertensive patients: a comparative, single-blind study. The objective of this study was to compare the efficacy and the safety of bisoprolol (B) and acebutolol (A) on blood pressure at rest and during exercise in hypertensives. The design was a comparative, single-blind study with two phases following a 10-day washout period for pretreated patients: a 15 day-placebo phase and an 8-week (...) therapeutic phase. Forty-six outpatients suffering from mild to moderate essential hypertension [diastolic blood pressure (DBP) ranging between 95 and 120 mm Hg] were randomly given either 10 mg of bisoprolol or 400 mg of acebutolol once a day for 8 weeks; this dosage was doubled after 4 weeks if DBP was still above 90 mm Hg. Blood pressure measurements were made 24 h after drug intake at rest and during exercise stress tests and were performed at the end of the placebo period and after 1 and 2 months

1990 Journal of cardiovascular pharmacology

34775. Effects of nifedipine versus hydralazine on sympathetic activity and cardiac function in patients with hypertension persisting on diuretic plus beta-blocker therapy. (PubMed)

Effects of nifedipine versus hydralazine on sympathetic activity and cardiac function in patients with hypertension persisting on diuretic plus beta-blocker therapy. In patients with hypertension persisting on combined diuretic and beta-blocker therapy, the effects of an additional 9-week therapy with a calcium antagonist (nifedipine) versus a classical arterial vasodilator (hydralazine) were compared for changes in blood pressure (BP), plasma catecholamines (n = 15), and left ventricular (LV (...) . In contrast, LV diastolic function was not affected by nifedipine, whereas hydralazine improved the peak filling rate. We conclude that arterial vasodilation by a calcium antagonist causes less sympathetic activation than caused by a classical arterial vasodilator. However, during short-term therapy in patients already on a diuretic and a beta blocker, nifedipine appears not to improve decreased LV diastolic function.

1990 Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy

34776. [Comparative prospective randomized multicenter study of 2 dosage protocols of nitrendipine in patients with mild to moderate hypertension]. (PubMed)

[Comparative prospective randomized multicenter study of 2 dosage protocols of nitrendipine in patients with mild to moderate hypertension]. 134 patients with mild to moderate hypertension received nitrendipine during 6 months in an increasing fashion. Therapeutic goal was achieved in 92% of the patients (DBP less than 95 mmHg) in which BP decreased from 168.4 +/- 13.7/105.0 +/- 1.1 to 140.9 +/- 12.7/84.4 +/- 6.6 (p less than 0.001). In patients whose BP was not controlled with a single initial (...) doses of 20 mg/day, the degree of control was similar with 40 mg single dose and 20 mg twice a day. The most frequently encountered undesirable effects were those caused by the vasodilator action of the drug. No changes in blood glucose and plasma lipid levels were found.

1989 Revista clínica española

34777. Use of esmolol during anesthesia to treat tachycardia and hypertension. (PubMed)

Use of esmolol during anesthesia to treat tachycardia and hypertension. We evaluated the clinical effectiveness of esmolol, an ultra-short-acting, cardioselective beta-adrenergic receptor blocker, in controlling sinus tachycardia and increased systolic blood pressure occurring perioperatively in 30 ASA physical status II or III patients having elective, non-cardiac surgery. Esmolol 80 mg I.V. bolus (N = 15) or placebo (N = 15) followed by 12 mg/min or placebo were infused in 30 isoflurane (...) -anesthetized patients using a randomized double-blind study design. The bolus plus infusions were given when surgical stimuli caused heart rate to exceed 95 bpm or systolic blood pressure 140 mm Hg. Esmolol significantly decreased heart rate (107 +/- 4, mean +/- SEM to 99 +/- 4, mean +/- SEM bpm) within 45 sec after starting the bolus plus infusion; the placebo had no effect, heart rate being 105 +/- 4 before and 106 +/- 3 bpm after the bolus plus infusion. Patients given esmolol continued to have heart

1989 Anesthesia and analgesia

34778. Cardiovascular-risk reduction: initial diuretic therapy compared with calcium-antagonist (felodipine) therapy for primary hypertension. (PubMed)

Cardiovascular-risk reduction: initial diuretic therapy compared with calcium-antagonist (felodipine) therapy for primary hypertension. Drug therapy for hypertension has failed to demonstrate a significant reduction in coronary mortality. We compared a calcium-antagonist agent, felodipine, with diuretic therapy as a first-line antihypertensive treatment in a randomized study, to assess the effects of six months of each regimen on over-all cardiovascular risk. Both regimens lowered blood (...) ) by three months. Felodipine did not influence these measurements, but caused a 43% increase in plasma noradrenaline levels by one month of therapy (P less than 0.025). In both groups, a significant fall occurred in the risk percentile score at six months, as calculated from the Multiple Risk Factor Intervention Trial data. However, the decrease was significantly greater in the felodipine group at six months (45% compared with 29%; P less than 0.05). Thus, when doses were titrated to achieve equivalent

1989 The Medical journal of Australia

34779. The nifedipine gastrointestinal therapeutic system in the treatment of hypertension. (PubMed)

The nifedipine gastrointestinal therapeutic system in the treatment of hypertension. As the number of antihypertensive agents increases, the choice of optimal therapy becomes more difficult. Certainly, hemodynamic derangements caused by the disease state as well as therapy must be considered. Patient convenience and quality of life are also issues that must be addressed. Preliminary experience suggests that the gastrointestinal therapeutic system (GITS) push-pull osmotic pump formulation (...) of nifedipine is safe and efficacious in the treatment of hypertension. In 1 study, nifedipine GITS was compared with sustained-release propranolol in patients with mild to moderate hypertension already receiving diuretics. Using a 2-week placebo run-in, double-blind study design, patients were randomly assigned to receive nifedipine GITS (n = 31) in doses of 30, 60 or 90 mg once daily, or sustained-release propranolol (n = 32) in doses of 80, 160 or 240 mg once daily. Previous diuretic therapy

1989 The American journal of cardiology

34780. Nicorandil, a new vasodilator drug, in patients with essential hypertension. (PubMed)

Nicorandil, a new vasodilator drug, in patients with essential hypertension. In 12 mild to moderate hypertensive patients we investigated the acute antihypertensive efficacy of three different doses of nicorandil, a new vasodilating agent which probably acts by increasing the potassium efflux from smooth muscle cells and causing a cellular hyperpolarization. After a 3-day placebo period the patients were given, according to a double-blind Latin-square randomized design, 10, 20 and 30 mg (...) , though reduced, after 24 h; no change in the heart rate was observed. The results from the upright position were similar. There were no significant changes in urine volume and electrolyte excretion during the nicorandil administration. The three different doses of nicorandil caused similar acute blood pressure reductions without change in the heart rate, nor in the urine volume and urinary sodium.

1989 Journal of hypertension. Supplement : official journal of the International Society of Hypertension

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