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Hypertension Causes

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34781. 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

34782. 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

34783. 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

34784. Beta-adrenoceptor blockade and vasodilatation in essential hypertension. Hemodynamic studies at rest and during exposure to stress. (PubMed)

to propranolol (80 mg) which did not lower blood pressure acutely and caused an increase in regional resistance. In a long-term double-blind, randomized comparison, both propranolol (80 mg X 2) and carvedilol (25 mg X 2 and 50 mg X 2) showed a useful antihypertensive effect. After 29 days, however, it was still possible to demonstrate an acute decrease in resistance with carvedilol (50 mg) after tablet intake, indicating the vasodilating activity of this compound. When patients with essential hypertension (...) Beta-adrenoceptor blockade and vasodilatation in essential hypertension. Hemodynamic studies at rest and during exposure to stress. The purpose of this study was to evaluate the acute and long-term effects on blood pressure and hemodynamics both at rest and during acute exposure to loud noise of drugs with beta-adrenoceptor blocking and vasodilating properties. Prizidilol and carvedilol both act as nonselective beta-blocking and precapillary vasodilating compounds. Prizidilol (200 mg X 2

1984 Acta medica Scandinavica. Supplementum Controlled trial quality: uncertain

34785. Does increasing potassium intake lower blood pressure in essential hypertension? (PubMed)

supine blood pressure had fallen by 4% with potassium supplementation compared with placebo. In a separate metabolic study the effect of 12 slow release potassium tablets (98 mmol/day) was studied in 12 patients with mild essential hypertension who had a fixed sodium and potassium intake. The increase in potassium intake caused immediate natriuresis with an average cumulative sodium loss of 110 mmol per patient. In spite of this loss of sodium there was no rise in plasma renin activity (...) , but there was a significant increase in plasma noradrenaline level. On an average western diet containing approximately 150 mmol of sodium/day, potassium chloride supplementation causes a small but worthwhile fall in blood pressure in many patients with essential hypertension. It is likely that part of the mechanism of this fall in blood pressure is related to the increase in potassium intake causing a loss of sodium with no compensatory rise in renin release.

1984 Journal of cardiovascular pharmacology Controlled trial quality: uncertain

34786. Pharmacodynamics and kinetics of etozolin/ozolinone in hypertensive patients with normal and impaired kidney function. (PubMed)

Pharmacodynamics and kinetics of etozolin/ozolinone in hypertensive patients with normal and impaired kidney function. The effect on urinary electrolyte excretion, renin release and plasma norepinephrine of single oral doses of 400 mg etozolin (E) and of 40 mg furosemide (F) were studied in hypertensive patients with normal (n = 6) and impaired kidney function (n = 6). E caused a marked saluresis up to 24 hours, showing its long duration of action. F, however, displayed a brief, brisk peak (...) diuresis, followed by a rebound from the 4th to the 24th hours. The brisk peak diuresis induced by F was associated with pronounced release of renin, almost twice that induced by E. In chronic renal failure the renin release in relation to the magnitude of the diuresis was increased, i.e. the sensitivity of these patients to changes in water homeostasis was increased. E and F stimulated the sympathetic system to roughly the same extent. Patients with essential hypertension had higher plasma levels

1984 European journal of clinical pharmacology Controlled trial quality: uncertain

34787. A double-blind multicentre study of piretanide and hydrochlorothiazide in patients with essential hypertension. (PubMed)

A double-blind multicentre study of piretanide and hydrochlorothiazide in patients with essential hypertension. In a randomized double-blind parallel group study conducted in three centres the hypotensive activity of piretanide 6 mg b.i.d. was compared with that of hydrochlorothiazide (HCT) 25 mg b.i.d. and HCT 50 mg b.i.d. Ninety-three patients entered the study and sixty-one completed a 16-week trial period. All three treatments produced a significant reduction in supine diastolic (...) generally mild and transient, except for polyuria which was noted in all three groups but more commonly in the piretanide group. Two patients were withdrawn because of side-effects: one patient in the high dose HCT group developed severe postural symptoms; and one patient in the low dose HCT group was withdrawn because of restlessness, nausea, weakness, dizziness and somnolence. All three treatments caused a significant increase in serum uric acid concentrations. Four patients in each of the HCT groups

1984 The Journal of international medical research Controlled trial quality: uncertain

34788. Propranolol versus verapamil for the treatment of essential hypertension. (PubMed)

Propranolol versus verapamil for the treatment of essential hypertension. Recent reports have confirmed that slow calcium channel inhibitors have useful antihypertensive properties because they produce dilatation of the peripheral arterioles without reflex tachycardia. Their clinical place in the management of hypertension has yet to be clearly defined, and thus we have performed an open crossover trial to compare the 24-hour profiles of blood pressure reduction after chronic therapy (...) shown to produce a uniform and comparable reduction in blood pressure throughout the whole day, together with a reduction in heart rate, which was greater with propranolol. Comparable effects were also seen on the pressor responses to exercise. Both drugs were equally well tolerated and caused no patient withdrawals. We conclude that oral verapamil given twice daily showed a similar degree of efficacy to propranolol and provided 24-hour blood pressure control. This slow calcium channel inhibitor may

1984 American heart journal Controlled trial quality: uncertain

34789. Role of nifedipine in the treatment of resistant hypertension. Comparison with hydralazine in hospital outpatients. (PubMed)

. A survey of 122 patients with resistant hypertension treated long-term with nifedipine and a control group of 102 similar patients treated with hydralazine revealed that nifedipine at an average dose of 40 mg daily caused a fall in blood pressure similar to that achieved with hydralazine in a dose of 86 mg daily. The side effect profile of both drugs was also similar. Nifedipine may be a useful alternative to existing step-three antihypertensive drugs. (...) Role of nifedipine in the treatment of resistant hypertension. Comparison with hydralazine in hospital outpatients. In a double-blind, randomized crossover study, the daily administration of 30 to 90 mg of nifedipine lowered blood pressure in a dose-related fashion in 14 patients already taking a beta receptor blocker and diuretic. The duration of the hypotensive response to 20 mg of nifedipine in capsule form, giving as a "step-three" drug to five of these patients, was six to eight hours

1984 The American journal of medicine Controlled trial quality: uncertain

34790. Blood pressure, heart rate and A-V conduction responses to nicardipine in hypertensive patients receiving atenolol. (PubMed)

to the patients. Compared with placebo, nicardipine had an additional dose-dependent, blood-pressure-lowering effect in the hypertensive patients who had been pretreated with atenolol. An increase in the heart rate was not observed, suggesting that atenolol prevented reflex activation of sympathetic nerve tone caused by the vasodilating properties of nicardipine. The combination of both atenolol and nicardipine was well tolerated by all patients; side effects were minor and did not cause discontinuation (...) Blood pressure, heart rate and A-V conduction responses to nicardipine in hypertensive patients receiving atenolol. The antihypertensive effect of the combined use of the new calcium channel blocker nicardipine and atenolol was assessed in a double-blind, placebo-controlled trial involving twenty hypertensive patients. Atenolol 100 mg once daily was given to all patients. In addition, either placebo or nicardipine, in increasing doses (5-20 mg three times daily), was allocated randomly

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1985 British journal of clinical pharmacology Controlled trial quality: uncertain

34791. Metabolic consequences of long-term thiazide-based antihypertensive treatment of renal hypertension. (PubMed)

Metabolic consequences of long-term thiazide-based antihypertensive treatment of renal hypertension. In 72 outpatients with early stage disease and mild to moderate hypertension, metabolic parameters were evaluated before and during 6 years of treatment with two different thiazide diuretic-based antihypertensive therapy regimens. Compared to the untreated state, chronic diuretic treatment caused a persisting increase in serum lipids in men or postmenopausal women. The high incidence

1985 Cardiology Controlled trial quality: uncertain

34792. Effects of the dopaminergic agonist cianergoline on blood pressure, the renin-angiotensin-aldosterone axis and the sympathetic nervous system in patients with essential hypertension. (PubMed)

Effects of the dopaminergic agonist cianergoline on blood pressure, the renin-angiotensin-aldosterone axis and the sympathetic nervous system in patients with essential hypertension. Cianergoline is a new dopaminergic agonist with a predominant cardiovascular action. Its effects on blood pressure, the renin-angiotensin-aldosterone axis, the sympathetic nervous system and lipid metabolism were assessed in 20 patients with benign essential hypertension. Cianergoline given in increasing doses (...) for 4 weeks (maximum daily dose 12 +/- 2 mg (SD)) and placebo both caused a slight decrease in arterial pressure, (from 159/104 to 152/98 mm Hg and from 154/104 to 149/103 mm, respectively; difference not significant). Supine and upright plasma renin activity, plasma aldosterone, norepinephrine, epinephrine and dopamine levels, urinary catecholamine excretion rates as well as serum prolactin, low and high density cholesterol and triglyceride concentrations were not changed after cianergoline

1985 European journal of clinical pharmacology Controlled trial quality: uncertain

34793. Comparison of labetalol and propranolol in hypertension. (PubMed)

Comparison of labetalol and propranolol in hypertension. 1 Labetalol has been compared with propranolol in a double-blind, double-dummy study of 24 patients with mild or moderate essential hypertension. 2 Two patients were unable to tolerate propranolol and five labetalol, because of symptom side effects; this difference was not significant (P greater than 0.1). 3 On a self-administered questionnaire, labetalol was associated with a greater number of side effects per patient than propranolol (...) , but no individual side effect was significantly more common with either drug. 4 There was no difference in the number of spontaneously reported side effects between the two drugs. 5 Both drugs impaired pulmonary function, but propranolol caused a greater reduction than labetalol after 8 weeks of treatment. 6 We conclude that labetalol and propranolol are similarly effective and acceptable to the patient.

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1980 British journal of clinical pharmacology Controlled trial quality: uncertain

34794. Captopril, an orally active converting enzyme inhibitor, in the treatment of primary hypertension. A controlled long-term study with reference to initial plasma renin activity. (PubMed)

Captopril, an orally active converting enzyme inhibitor, in the treatment of primary hypertension. A controlled long-term study with reference to initial plasma renin activity. Captopril (SQ 14 225), an orally active inhibitor of angiotensin converting enzyme, was evaluated in the treatment of primary (essential) hypertension in a placebo-controlled long-term study. In 24 patients allocated to captopril treatment, mean supine BP fell from 174 +/- 18/110 +/- 7 to 151 +/- 22/96 +/- 12 mmHg. Ten (...) patients achieved a supine diastolic BP of less than or equally 90 mmHg with a mean BP fall of 28/22 mmHg after 4 weeks' captopril dose titration (75-450 mg daily). In 14 patients, BP fell 19/9 mmHg. When hydrochlorothiazide (50-100 mg daily) was subsequently added, a total supine BP reduction of 51/20 mmHg was noted. In the placebo control group (n = 16), BP changed +1/-2 mmHg from 171/110 mmHg while addition of hydrochlorothiazide caused a mean supine BP fall of 19/10 mmHg. During long-term follow-up

1981 Acta medica Scandinavica Controlled trial quality: uncertain

34795. Do carbohydrates promote hypertension? (PubMed)

sucrose as a 50 per cent solution dissolved in water. BAY g 5421 caused a significant decrease of plasma insulin after a 100 g sucrose tolerance test as compared to placebo. Blood pressure after four weeks of treatment with placebo was 135 +/- 5.7 systolic and 92 +/- 6.6 diastolic (mmHg, mean +/-s.d.) and after four weeks of treatment with BAY g 5421 was not significantly different. There was no change in weight. The question whether carbohydrates promote hypertension has to be further investigated. (...) Do carbohydrates promote hypertension? Several earlier studies indicate an association between plasma insulin level and blood pressure independent of weight. A short review summarizes evidences showing: (a) the association between a high carbohydrate content of diet and hyperinsulinemia; (b) effect of insulin on renal reabsorbation of sodium; and (c) effects of carbohydrate intake on sympathetic activity and blood pressure. A pilot study examined the effect of a glycoside-hydrolase inhibitor

1981 International journal of obesity Controlled trial quality: uncertain

34796. Circulatory effects of stress in essential hypertension. (PubMed)

Circulatory effects of stress in essential hypertension. Hemodynamics and plasma catecholamines were studied during mental arithmetics and cold pressor test in thirteen patients with essential hypertension. Blood pressure was significantly increased by both forms of "stress". Cold pressor test caused a significant increase in total peripheral resistance, while mental arithmetics increased heart rate and cardiac output significantly. Thus, different forms of "stress" can increase blood pressure (...) arithmetics after both cardioselective and non-selective beta-blockade compared to placebo. During cold pressor test there was a significant increase in noradrenalin only after non-selective beta-blockade. Adrenalin in plasma was significantly increased only during mental arithmetics after cardioselective beta-blockade. The pathogenesis of essential hypertension is complex and still not fully understood. Both hereditary (1) and environmental factors such as salt intake (2) and stress (3,4,5) are probably

1981 Acta medica Scandinavica. Supplementum Controlled trial quality: uncertain

34797. Effect of prazosin and oxprenolol on plasma renin activity and blood pressure in patients with essential hypertension. (PubMed)

Effect of prazosin and oxprenolol on plasma renin activity and blood pressure in patients with essential hypertension. 48 patients with normal-renin essential hypertension were treated with prazosin alone or in combination with oxprenolol. 1 h after a single dose of 2 mg prazosin tachycardia and a decrease in blood pressure developed. Renin activity in the peripheral plasma (PRA) increased from 1.04 +/- 0.15 to 2.64 +/- 0.20 ng AgT/ml/h. A 3-day treatment with 2 mg t.i.d. prazosin of 11 (...) patients caused no further decrease in blood pressure, while PRA returned to the baseline level. Treatment for 3 days with 2 mg prazosin t.i.d. and 40 mg oxprenolol t.i.d. of 37 patients further decreased blood pressure as well as PRA. The increase in PRA after a single dose of prazosin could be related to the enhanced sympathetic activity. The decreased PRA after prazosin + oxprenolol therapy may be one of the factors responsible for the greater antihypertensive response to the combined therapy.

1981 Cardiology Controlled trial quality: uncertain

34798. Captopril and atenolol combined with hydrochlorothiazide in essential hypertension. (PubMed)

Captopril and atenolol combined with hydrochlorothiazide in essential hypertension. 1 Fifty-seven patients with mild or moderate essential hypertension, mean age 50 (range 31-69) were randomised to treatment with either captopril or atenolol. Twenty-six patients in each group completed the study. 2 Captopril (25-50 mg three times daily) and atenolol (50-100 mg once daily) caused a highly significant fall in blood pressure both supine and standing. 3 When hydrochlorothiazide (25-50 mg once daily (...) ) was added a further fall in blood pressure was observed in both groups. 4 Captopril as single drug caused no significant change in heart rate, while atenolol significantly reduced heart rate both supine and standing. 5 Two patients were excluded from the captopril group, one because of a reversible loss of taste and the other because of dizziness. Three patients were excluded from the atenolol group, two because of bradyarrhythmias and one because of inadequate blood pressure response. 6 Both captopril

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1982 British journal of clinical pharmacology Controlled trial quality: uncertain

34799. A double-blind comparison of verapamil and labetalol in hypertensive patients with coexisting chronic obstructive airways disease. (PubMed)

A double-blind comparison of verapamil and labetalol in hypertensive patients with coexisting chronic obstructive airways disease. A randomized, double-blind, cross-over trial was carried out in nine hypertensive patients with coexisting chronic obstructive lung disease to evaluate the hypotensive efficacy and safety of verapamil and labetalol. The effects on respiratory function were also assessed. Verapamil in doses of 160 mg twice daily was equally effective as 200 mg twice daily (...) of labetalol. Labetalol significantly reduced both forced expiration volume at 1 s (FEV1) and forced vital capacity (FVC), suggesting a bronchoconstrictor effect. Verapamil was devoid of any such effect. Neither drug caused significant side effects.

1982 Journal of cardiovascular pharmacology Controlled trial quality: uncertain

34800. No effect of propranolol and metoprolol on tolbutamide-stimulated insulin-secretion in hypertensive diabetic and non-diabetic patients. (PubMed)

No effect of propranolol and metoprolol on tolbutamide-stimulated insulin-secretion in hypertensive diabetic and non-diabetic patients. In a double-blind cross-over study, we compared the effects of placebo, propranolol and metoprolol on tolbutamide-stimulated insulin-secretion in 10 non-insulin-dependent hypertensive diabetics and in 10 hypertensive non-diabetic patients. The patients were randomly allocated to two weeks each of treatment with placebo, propranolol 80 mg or metoprolol 100 mg (...) b.i.d. At the end of each period, an intravenous tolbutamide tolerance test (IVTT, 200mg of tolbutamide i.v.) was performed, which caused a significant rise in peripheral insulin levels, leaving blood glucose concentrations unchanged. Tolbutamide-induced insulin-secretion was unaffected by pretreatment with beta-blockers when blood glucose concentrations were unchanged during the test. Since the serum-concentrations achieved with 200 mg of tolbutamide i.v. are similar to those reported during oral

1982 Annals of clinical research Controlled trial quality: uncertain

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