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Hypertension Causes

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34841. Neural control of circulation before and after intravenous urapidil in essential hypertension. (PubMed)

the results of a study in which we examined the effects of urapidil on the arterial baroreflex and the cardiopulmonary reflex in 6 essential hypertensive patients given 25 mg of the drug intravenously. The dose of the drug used caused a marked reduction in arterial blood pressure (direct measurement). However, pressor and depressor responses to carotid baroreceptor deactivation and stimulation (neck chamber device), respectively, were not modified when compared with those observed in the placebo period (...) Neural control of circulation before and after intravenous urapidil in essential hypertension. Drugs interfering with sympathetic influences on the cardiovascular system have been shown to effectively lower blood pressure in hypertension. However, sympathetic cardiovascular control is involved in blood pressure homeostasis, which means that these drugs may produce potential adverse haemodynamic effects that may reduce the benefit of their antihypertensive action. This paper summarises

1988 Drugs Controlled trial quality: uncertain

34842. An open study to compare the efficacy and tolerability of two diuretic combinations, frusemide plus amiloride and hydrochlorothiazide plus amiloride, in patients with mild to moderate essential hypertension. (PubMed)

An open study to compare the efficacy and tolerability of two diuretic combinations, frusemide plus amiloride and hydrochlorothiazide plus amiloride, in patients with mild to moderate essential hypertension. Forty-four patients with mild to moderate essential hypertension were entered in an open study to compare the efficacy and tolerability of the two diuretic combinations, frusemide (40 mg) plus amiloride (5 mg) and hydrochlorothiazide (50 mg) plus amiloride (5 mg), as first-line treatment (...) assessed (18 in each group), both treatments were found to reduce blood pressure effectively in a high percentage of patients treated. Hydrochlorothiazide/amiloride, however, caused a significant reduction in both plasma potassium and sodium levels whereas frusemide/amiloride did not. More adverse events were reported by patients taking frusemide/amiloride, but the majority of these were trivial.

1988 Current medical research and opinion Controlled trial quality: uncertain

34843. Paranormal healing and hypertension. (PubMed)

Paranormal healing and hypertension. A prospective randomised trial was carried out to see whether paranormal healing by laying on of hands might reduce blood pressure in essential hypertension and whether such an effect might be due to a paranormal, psychological, or placebo factor. Patients were randomised to three treatment groups: paranormal healing by laying on of hands (n = 40), paranormal healing at a distance (n = 37), and no paranormal healing (controls; n = 38). Healing at a distance (...) these differences were not significant. Probably week to week variations among the groups accounted for any differences noted. In this study no treatment was consistently better than another and the data cannot therefore be taken as evidence of a paranormal effect on blood pressure. Probably the fall in blood pressure in all three groups either was caused by the psychosocial approach or was a placebo effect of the trial itself.

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1988 British medical journal (Clinical research ed.) Controlled trial quality: uncertain

34844. A comparison of long acting nifedipine and enalapril in elderly hypertensives: a randomised, single-blind, cross-over study. (PubMed)

A comparison of long acting nifedipine and enalapril in elderly hypertensives: a randomised, single-blind, cross-over study. The effects of nifedipine and enalapril on blood pressure (BP), heart rate, plasma and urine electrolyte, plasma renin activity (PRA), aldosterone and catecholamines, were studied in ten elderly hypertensive subjects in a randomised, single-blind, cross-over trial. Both nifedipine and enalapril were effective in lowering supine and erect systolic and diastolic BP (...) , with nifedipine causing a significant (P less than 0.05) rise in heart rate. Arterial pressure rose to pre-treatment levels on withdrawal of both drugs. Plasma glucose fell significantly (P less than 0.02) on enalapril therapy, whilst no other biochemical changes were observed. PRA, aldosterone and adrenaline rose on nifedipine therapy whereas PRA showed a greater rise on enalapril with a fall in plasma aldosterone and no change in plasma adrenaline. Plasma noradrenaline was not altered by either agent

1988 Journal of human hypertension Controlled trial quality: uncertain

34845. Bevantolol vs propranolol: a double-blind controlled trial in essential hypertension. (PubMed)

Bevantolol vs propranolol: a double-blind controlled trial in essential hypertension. Bevantolol is a novel beta 1-selective beta-adrenoceptor antagonist. The Study Group evaluated its therapeutic utility (100-300 mg bid) compared with propranolol (80-240 mg bid) in 266 patients with mild to moderate essential hypertension (WHO Grades I and II, sitting diastolic blood pressure (DBP) greater than or equal to 95 mmHg). There was no difference in their antihypertensive efficacy over six months, 77 (...) % being controlled (DBP less than or equal to 90 mmHg) on bevantolol and 81% on propranolol. Hydrochlorothiazide 25-50 mg bid added later improved BP control in those incompletely controlled on bevantolol monotherapy. Both beta-adrenoceptor antagonists also reduced intraocular pressure. Bevantolol caused significantly fewer adverse effects than propranolol with many fewer withdrawals during long-term therapy. This unique clinical pharmacologic profile of bevantolol enhances its therapeutic usefulness

1988 Angiology Controlled trial quality: uncertain

34846. Antihypertensive and metabolic effects of ketanserin in diabetic patients with mild hypertension. (PubMed)

Antihypertensive and metabolic effects of ketanserin in diabetic patients with mild hypertension. Ketanserin is a serotonin S2 receptor antagonist with antihypertensive activity. Its effects on blood pressure, glucose metabolism and serum lipids were assessed in 24 patients with diabetes mellitus and mild arterial hypertension in a double blind, placebo-controlled trial. Ketanserin in doses up to 80 mg daily caused a slight decrease of supine BP (from 159/97 +/- 19/11 to 153/90 +/- 20/9 mm Hg (...) and insulin to a standard oral glucose loading test did not change. These findings indicate that the selective S2 receptor antagonist ketanserin did not unfavourably influence glucose and lipid metabolism in diabetic patients with arterial hypertension.

1988 Journal of human hypertension Controlled trial quality: uncertain

34847. Propranolol increases prostacyclin synthesis in patients with essential hypertension. (PubMed)

Propranolol increases prostacyclin synthesis in patients with essential hypertension. We tested the hypothesis that vascular prostacyclin synthesis is increased by propranolol and could account for some of the drug's antihypertensive effect. We studied 10 white patients with mild essential hypertension in a randomized, double-blind design to assess the effects of indomethacin with or without the addition of propranolol on blood pressure and vascular prostacyclin biosynthesis, as assessed (...) volunteers. Indomethacin caused a significant rise in mean arterial blood pressure and a significant fall in 2,3-dinor-6-keto-PGF1 alpha excretion, and it blocked the rise in urinary 2,3-dinor-6-keto-PGF1 alpha associated with propranolol therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

1988 Hypertension Controlled trial quality: uncertain

34848. Combined beta 1-adrenoceptor blockade and/or beta 2- or beta 1/2 adrenoceptor stimulation as treatment of essential hypertension. (PubMed)

Combined beta 1-adrenoceptor blockade and/or beta 2- or beta 1/2 adrenoceptor stimulation as treatment of essential hypertension. Single and combined therapy with terbutaline (10 mg/day) and metoprolol (200 mg/day) and single therapy with orciprenaline (30 mg/day) were assessed over 8 weeks in a total of 45 patients with essential hypertension. Blood pressure at rest was comparably reduced by metoprolol + terbutaline and metoprolol alone, but with terbutaline and orciprenaline only after 4 (...) weeks. The responder rates (greater than or equal to 10% reduction in diastolic blood pressure) at rest were 58% (metoprolol + terbutaline), 63% (metoprolol) and significantly lower with terbutaline alone at 42% and orciprenaline alone at 45%. The heart rate was affected only by metoprolol monotherapy, which caused a significant decrease. The beta-adrenoceptor stimulators terbutaline and orciprenaline in the chosen doses slightly decreased blood pressure and did not increase the heart rate

1988 Journal of hypertension. Supplement : official journal of the International Society of Hypertension Controlled trial quality: uncertain

34849. Effects of angiotensin converting enzyme inhibition and beta-blockade on exercise responses in hypertensive patients. (PubMed)

Effects of angiotensin converting enzyme inhibition and beta-blockade on exercise responses in hypertensive patients. We compared exercise responses in two groups of hypertensive patients treated with an angiotensin converting enzyme (ACE) inhibitor (lisinopril, 20-80 mg/day, n = 17) or a cardioselective beta-blocker (atenolol, 50-200 mg/day, n = 9). Measurements were made at rest and during exercise at 25 W (2.7 mets) and at 50 W (3.8 mets) on a bicycle ergometer (where mets is exercising (...) oxygen consumption/resting oxygen consumption) after 4 weeks of placebo, and again after 12 weeks of drug administration. Both drugs reduced (P less than 0.05) mean arterial pressure. Atenolol caused significant decreases in the heart rate (approximately 25%) and cardiac output (approximately 26%; Defares CO2 rebreathing), and significant increases in total peripheral resistance (approximately 30%) and arteriovenous O2 content (approximately 20%). Lisinopril decreased (P less than 0.05) stroke volume

1988 Journal of hypertension. Supplement : official journal of the International Society of Hypertension Controlled trial quality: uncertain

34850. Changes in calcium metabolic indices during long-term treatment of patients with essential hypertension. (PubMed)

Changes in calcium metabolic indices during long-term treatment of patients with essential hypertension. 1. Disturbances of calcium metabolism, mimicking mild, compensated secondary hyperparathyroidism, accompany essential hypertension, but it is not known whether these alterations are primary or only secondary to the elevated blood pressure. 2. Indices of systemic calcium metabolism were followed prospectively during 6 months' treatment with either propranolol, bendroflumethiazide or verapamil (...) in 35 patients with essential hypertension. Multivariate statistical methods were employed to study the effects of blood pressure reduction upon the metabolic indices with adjustment for the effects of the different antihypertensive agents. 3. Propranolol treatment increased the plasma ionized calcium and serum phosphate concentrations, and reduced the serum levels of parathyroid hormone, free fatty acids and glycerol. Neither the total nor the total albumin-modified serum calcium concentration

1988 Clinical science (London, England : 1979) Controlled trial quality: uncertain

34851. Effects of l-tryptophan and various diets on behavioral functions in essential hypertensives. (PubMed)

Effects of l-tryptophan and various diets on behavioral functions in essential hypertensives. The effects of tryptophan in combination with two different diets (high-carbohydrate and high-protein diet) on behavioral parameters such as mood, sleep and performance were chronically studied in a group of 34 hypertensive patients undergoing a trial of testing the antihypertensive properties of l-tryptophan. While no major changes in mood were observed, there was a tendency for sleep latency (...) to decrease and sleep duration to increase following tryptophan intake in the intragroup analysis. The administration of tryptophan caused a significant improvement on performance in a concentration task. No significant dietary effects were observed either in combination with tryptophan or in the placebo group. These data again demonstrate behavioral relevance of the precursor amino acid l-tryptophan and suggest a long-term improvement in partial aspects of performance behavior.

1989 Neuropsychobiology Controlled trial quality: uncertain

34852. Effect of calcium carbonate on blood pressure in normotensive and hypertensive people. (PubMed)

Effect of calcium carbonate on blood pressure in normotensive and hypertensive people. Forty-seven patients with mild hypertension and 48 normotensive patients entered a blinded, parallel study in which they received a placebo, 10 mmol/day calcium carbonate (CaCO3), or 20 mmol/day CaCO3. There were no significant differences in blood pressure changes among the groups. In the hypertensive group and in patients with the highest blood pressure there were individual falls in systolic pressure (...) , particularly in the group receiving 10 mmol daily CaCO3. In the hypertensive group the changes were: with placebo, -3 +/- 2/-2 +/- 2 mm Hg; with CaCO3 (10 mmol), -7 +/- 3/-2 +/- 2 mm Hg; and with CaCO3 (20 mmol), -2 +/- 3/1 +/- 2 mm Hg. No change was significant, and no pressure changes of patients taking CaCO3 differed significantly from changes of patients taking placebo. Ten of 33 patients taking placebo, 11 of 31 taking 10 mmol/day CaCO3, and nine of 31 taking 20 mmol/day CaCO3 were classified

1989 Hypertension Controlled trial quality: uncertain

34853. 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 Controlled trial quality: uncertain

34854. 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 Controlled trial quality: uncertain

34855. 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 Controlled trial quality: uncertain

34856. A comparison of the acute effects of cicletanine and bendrofluazide on urinary electrolytes and plasma potassium in essential hypertension. (PubMed)

A comparison of the acute effects of cicletanine and bendrofluazide on urinary electrolytes and plasma potassium in essential hypertension. The acute effects on urinary electrolyte excretion and plasma potassium were compared of the anti-hypertensive dihydrofuropyridine cicletanine with the thiazide bendrofluazide in 6 patients with uncomplicated essential hypertension. Cicletanine 50 mg or 100 mg and bendrofluazide 5 mg caused no acute decrease in blood pressure compared to placebo for 24 h

1990 European journal of clinical pharmacology Controlled trial quality: uncertain

34857. Monotherapy of hypertension with darodipine: a new calcium-channel blocker. (PubMed)

Monotherapy of hypertension with darodipine: a new calcium-channel blocker. Calcium-channel blockers are increasingly used as single agents for the treatment of essential hypertension. Following three weeks of single-blind placebo therapy, 43 patients with essential hypertension were randomized into four groups. Group 1 (10 patients) received placebo twice a day, Group 2 (13 patients) received darodipine (PY 108-068) 50 mg twice a day, Group 3 (9 patients) received darodipine 100 mg twice a day (...) , and Group 4 (11 patients) received darodipine 150 mg twice a day. Patients were seen in the clinic weekly for 4 weeks. Clinical and laboratory evaluations were done on each patient. Darodipine caused a sustained decrease in the supine and standing systolic and diastolic blood pressure (p less than .001) and there were no significant pressure differences between the three drug dosages. The effects of the drug on heart rate were not consistent. Placebo had no effect on either blood pressure or heart rate

1988 Clinical cardiology Controlled trial quality: uncertain

34858. Diuretics--a risk in the long-term treatment of hypertensive patients? (PubMed)

Diuretics--a risk in the long-term treatment of hypertensive patients? The trial of the European Working Party on High blood pressure in the Elderly (EWPHE) revealed an overall decrease in cardiovascular mortality and morbidity in the actively treated patients. They received as first-line drugs a combination of hydrochlorothiazide and triamterene; methyldopa was added as necessary. The present post hoc analysis examined the effect of the diuretic treatment on cardiovascular events, both when (...) was not significant (RHR, 0.84; 95% CI, 0.56-1.25). The effect of treatment in the latter combined group became significant (RHR, 0.62; 95% CI, 0.40-0.95) when all cardiovascular study terminating events were considered; they were reduced by 38%. No effect of treatment on mortality from all causes was detected.

1988 Journal of hypertension Controlled trial quality: uncertain

34859. Efficacy of once daily nitrendipine in essential hypertension--a study using ambulatory blood pressure monitoring. (PubMed)

Efficacy of once daily nitrendipine in essential hypertension--a study using ambulatory blood pressure monitoring. To determine if the calcium channel blocking agent, nitrendipine, is effective as monotherapy we have performed a double-blind placebo-controlled crossover trial using 20 mg once daily or twice daily in 19 mild to moderate hypertensive patients. Blood pressure was measured by a random zero (RZ) sphygmomanometer and at home using the Remler semiautomatic BP recorder. The BP (RZ (...) ) was significantly reduced by twice daily nitrendipine compared to placebo (from 163/99 +/- 20/6 mmHg to 140/90 +/- 15/9 mmHg). Once daily drug administration reduced systolic BP only (163 +/- 20 to 144 +/- 17 mmHg). Remler BP confirmed that the maximum systolic and diastolic BP lowering effect was in the twice daily group while once daily drug did produce a significant lowering of BP but less than the twice daily dosage. This study suggests that twice daily nitrendipine caused a greater decrease in BP

1988 Journal of human hypertension Controlled trial quality: uncertain

34860. Efficacy and tolerance of nifedipine retard vs acebutolol in patients with essential hypertension treated for 26 weeks. (PubMed)

Efficacy and tolerance of nifedipine retard vs acebutolol in patients with essential hypertension treated for 26 weeks. Patients with essential hypertension were given calcium channel antagonist, Nifedipine Retard or Acebutolol for 26 weeks in a single blind, randomised trial. Both drugs reduced mean systolic and diastolic blood pressure, but side effects were less frequent and caused less drop-outs in Nifedipine than in Acebutolol group of patients. We conclude that both Nifedipine Retard (...) and Acebutolol were equally effective in essential hypertension but side effects were considerably milder in patients treated with Nifedipine Retard.

1990 Materia medica Polona. Polish journal of medicine and pharmacy Controlled trial quality: uncertain

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