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Hypertension Causes

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34861. [Controlled study on the treatment of hypertension with verapamil in retard form]. (PubMed)

[Controlled study on the treatment of hypertension with verapamil in retard form]. The antihypertensive effect of an oral slow release (retard) formulation of verapamil was evaluated in a negative (placebo) and positive (nifedipine) controlled study. After a run-in period of one week without antihypertensive therapy, 54 patients were classified as having mild to moderate hypertension (diastolic blood pressure 95-115 mm Hg) and assigned randomly to one of three groups (n = 18 each (...) the values before treatment. After two weeks of treatment, 13 of 18 patients on verapamil and 9 of 18 patients on nifedipine had resting diastolic pressures less than or equal to 90 mm Hg. Also systolic pressure and blood pressures during exercise were significantly lowered by both active drugs. Verapamil caused a fall in heart rate during rest and under maximal exercise. Undesired side effects from verapamil were constipation (6 of 18) and headache (1 of 18); those from nifedipine were flush or headache

1985 Zeitschrift für Kardiologie Controlled trial quality: uncertain

34862. [Rebound hypertension after controlled hypotension and its prevention by captopril]. (PubMed)

and NTG can cause rebound hypertension, the extent of which depends on the level of hypotension previously achieved and the infusion rate of the vasodilator. Pretreatment with captopril prevents the rebound and reduces the dosage of vasodilator required and, therefore, may be considered an alternative to the well-documented beta-adrenergic blockers. (...) [Rebound hypertension after controlled hypotension and its prevention by captopril]. In 27 patients undergoing ear, nose and throat surgery, the problem of post-hypotensive hypertension (rebound hypertension) following vasodilator-induced controlled hypotension was studied, together with prevention by the ACE inhibitor captopril. Hypotension was induced by sodium nitroprusside (SNP) in seven patients (group 1) and by nitroglycerin (NTG) in ten patients (group 3). Ten patients (group 2) received

1986 Der Anaesthesist Controlled trial quality: uncertain

34863. Diltiazem as monotherapy for systemic hypertension: a multicenter, randomized, placebo-controlled trial. (PubMed)

to be more effective in older patients, but caused no increase in orthostatic BP drop. There were no statistically significant changes in BP in the placebo group. Two patients receiving placebo and 1 patient receiving diltiazem discontinued therapy as a result of adverse effects, and overall, side effects were only slightly more common with diltiazem treatment. Thus, diltiazem was effective and well tolerated single therapy for mild to moderate systemic hypertension and appears to compare favorably (...) Diltiazem as monotherapy for systemic hypertension: a multicenter, randomized, placebo-controlled trial. A multicenter, randomized, placebo-controlled, parallel group study of diltiazem in essential hypertension was carried out in 77 patients (40 diltiazem, 37 placebo) with stable supine diastolic blood pressure (BP) between 95 and 110 mm Hg. Patients were withdrawn from previous antihypertensive therapy for at least 4 weeks, titrated to the optimal dose, and followed for a total of 12 weeks

1986 The American journal of cardiology Controlled trial quality: uncertain

34864. Hemodynamics of metoprolol and pindolol in systemic hypertension with particular reference to reversal of structural vascular changes. (PubMed)

Hemodynamics of metoprolol and pindolol in systemic hypertension with particular reference to reversal of structural vascular changes. In a double-blind, comparative study metoprolol (100 to 300 mg/day) or pindolol (5 to 15 mg/day) was given in randomized order to 39 patients with uncomplicated essential hypertension. Peripheral hemodynamics were studied by noninvasive means after an initial 6-week placebo period and again after 6 weeks and 6 months of active treatment. Three patients withdrew (...) sympathomimetic activity acts as a partial agonist causing active stimulation of vascular beta 2 adrenoceptors and relaxation of resistance vessels.

1986 The American journal of cardiology Controlled trial quality: uncertain

34865. Twice-daily verapamil for hypertension: a comparison with propranolol. (PubMed)

Twice-daily verapamil for hypertension: a comparison with propranolol. Recent reports have confirmed that some slow calcium channel inhibitors have useful antihypertensive properties because they produce dilatation of the peripheral arterioles without reflex tachycardia. Verapamil is such a drug, but its clinical role in the management of hypertension is not clear. An open crossover trial was performed to compare the 24-hour profiles of blood pressure reduction after long-term therapy (...) and dynamic exercise were also examined. The drugs produced a uniform and comparable reduction in blood pressure throughout the 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. Thus, oral verapamil given 2 times a day shows a degree of efficacy similar to that of propranolol and provides 24-hour blood pressure control. This slow

1986 The American journal of cardiology Controlled trial quality: uncertain

34866. The relationship between diuretics and serum cholesterol in Hypertension Detection and Follow-up Program participants. (PubMed)

The relationship between diuretics and serum cholesterol in Hypertension Detection and Follow-up Program participants. The effect of diuretics, mainly chlorthalidone, on serum cholesterol was studied in 7,006 of the Hypertension Detection and Follow-up Program (HDFP) hypertensive patients not on antihypertensive medication at baseline. Several investigators have reported that diuretic therapy increases serum cholesterol in treated subjects. However, data from two long-term studies indicated (...) that no increase in cholesterol occurred after two years of diuretic treatment. In the present study, yearly changes in serum cholesterol in hypertensives treated with diuretics were observed. The results were in agreement with those reported from both short-term and long-term studies, in that a significant increase in cholesterol was observed in six months to one year into the study but not from the second to the fifth year of therapy. In fact, the serum cholesterol levels were the same as baseline values

1988 American journal of preventive medicine Controlled trial quality: uncertain

34867. The unsuitability of minoxidil for the treatment of moderate hypertension. (PubMed)

The unsuitability of minoxidil for the treatment of moderate hypertension. Minoxidil is very effective in the treatment of severe or resistant hypertension but fluid retention and hypertrichosis have been side-effects. This study examines the suggestion that the use of small doses of minoxidil may be effective in the treatment of moderate hypertension without causing these adverse effects. Sixteen patients with an elevated blood pressure level that was suboptimally controlled by combination (...) agent to substantial doses of frusemide. Low doses of minoxidil do not appear to be effective in the treatment of moderate hypertension, and the drug cannot be recommended for this indication.

1986 The Medical journal of Australia Controlled trial quality: uncertain

34868. Evaluation of verapamil in the treatment of hypertension. (PubMed)

of labetalol in hypertensive patients with coexisting chronic obstructive lung disease. Blood pressure fell equally with these drugs, and neither of the drugs caused significant side effects. Labetalol significantly reduced both forced expiration volume at 1s (FEV1) and forced vital capacity (FVC), suggesting a bronchoconstrictor effect. Verapamil was devoid of any such effect. Verapamil did not affect plasma renin concentration. (...) Evaluation of verapamil in the treatment of hypertension. Two separate randomized double-blind, crossover trials were carried out in hypertensive patients to evaluate the antihypertensive efficacy and safety of verapamil. In the first study, verapamil, in doses of 120 mg three times daily, was compared with pindolol, in doses of 7.5 mg twice daily. A thiazide diuretic was given with both drugs. In another study, verapamil, in doses of 160 mg twice daily, was compared with 200 mg twice daily

1986 Journal of clinical hypertension Controlled trial quality: uncertain

34869. Hemodynamic changes of local dental anesthesia in normotensive and hypertensive subjects. (PubMed)

the changes of blood pressure and heart rate were nearly similar. The most remarkable alteration (rise in blood pressure, lowering of heart rate) was caused by norepinephrine. The vasoactive concentration of norepinephrine 1:20,000-1:30,000 as a component of local anesthetic preparations is contraindicated in hypertensive patients. (...) Hemodynamic changes of local dental anesthesia in normotensive and hypertensive subjects. Hypertensive patients are an important group in dental treatment. In a prospectively randomised study the influence of 4 ml lidocaine 2% plain or with epinephrine 1:100,000 or norepinephrine 1:20,000 on heart rate and blood pressure before, during and after a small surgical intervention (tooth extraction) was investigated in a normotensive (n = 39) and a hypertensive group (n = 36). In both groups

1986 International journal of clinical pharmacology, therapy, and toxicology Controlled trial quality: uncertain

34870. Comparison of the effects of penbutolol and propranolol on glomerular filtration rate in hypertensive patients with impaired renal function. (PubMed)

Comparison of the effects of penbutolol and propranolol on glomerular filtration rate in hypertensive patients with impaired renal function. Penbutolol and propranolol were administered orally in a dosage of 40 mg once daily and 80 mg twice daily, respectively to 12 patients with hypertension and impaired renal function. Both drugs caused a significant decrease in mean arterial pressure and heart rate. Serum creatinine concentration increased significantly by 10% during therapy with propranolol

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1986 British journal of clinical pharmacology Controlled trial quality: uncertain

34871. Responses to mental stress and physical provocations before and during long term treatment of hypertensive patients with beta-adrenoceptor blockers or hydrochlorothiazide. (PubMed)

Responses to mental stress and physical provocations before and during long term treatment of hypertensive patients with beta-adrenoceptor blockers or hydrochlorothiazide. 1 Cardiovascular and sympatho-adrenal responsiveness to mental stress (CWT; a colour word test), orthostatic testing (ORT) and a cold pressor test (CPT) were examined in three groups of hypertensive patients (n = 14-16) before and after 6 months treatment with metoprolol (243 +/- 26 mg daily), propranolol (149 +/- 16 mg daily (...) ) or hydrochlorothiazide (50 +/- 8 mg daily) in an open trial design. 2 Treatment reduced outpatient blood pressures in the three groups similarly (from approximately 155/102 to 135/90 mm Hg). During treatment resting blood pressures in the laboratory were clearly reduced by beta-adrenoceptor blockade but not by thiazide treatment. Metoprolol and propranolol caused similar reductions of basal heart rates and plasma glycerol levels, whereas only propranolol reduced cyclic AMP concentrations in plasma. 3 Before

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1987 British journal of clinical pharmacology Controlled trial quality: uncertain

34872. Haemodynamic effects of atenolol, labetalol, pindolol and captopril: a comparison in hypertensive patients with special reference to changes in limb blood flow, heart rate and left ventricular function. (PubMed)

Haemodynamic effects of atenolol, labetalol, pindolol and captopril: a comparison in hypertensive patients with special reference to changes in limb blood flow, heart rate and left ventricular function. 1 To compare the haemodynamic effects of secondary characteristics of beta-adrenoceptor blockers with an angiotensin converting enzyme inhibitor forty patients with previously untreated mild to moderate hypertension were prescribed either atenolol 50-100 mg day-1, labetalol 200-800 mg day-1 (...) , pindolol 10-30 mg day-1 or captopril 25-100 mg day-1 and observed for 6 months. 2 Over this period: (a) All four drugs produced similar reductions in blood pressure at rest (P less than or equal to 0.01) and after exercise (P less than or equal to 0.01). (b) All four drugs significantly decreased resting forearm (P less than or equal to 0.01) and calf blood flow (P less than or equal to 0.01). They all also caused a significant reduction in the increased calf blood flow following exercise (P less than

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1987 British journal of clinical pharmacology Controlled trial quality: uncertain

34873. [Hemodynamic effects of labetalol on the humeral artery of the hypertensive patient. A double-blind study versus placebo]. (PubMed)

[Hemodynamic effects of labetalol on the humeral artery of the hypertensive patient. A double-blind study versus placebo]. Forearm arterial hemodynamics, including measurements of brachial artery diameter and compliance with pulsed Doppler velocimetry were determined before and after acute administration of labetalol in patients with sustained essential hypertension. Labetalol caused a significant and rapid drop in blood pressure with a decrease in forearm vascular resistance and an increase (...) in brachial blood flow. Brachial artery diameter did not change while arterial compliance significantly increased. The study provided evidence that labetalol caused a shift of the pressure-brachial artery diameter curve toward lower values of blood pressure, indicating a pharmacological effect of alpha and beta blockade on the hypertensive arterial wall.

1987 Annales de cardiologie et d'angéiologie Controlled trial quality: uncertain

34874. [Acute treatment of arterial hypertension using calcium antagonists: comparison between diltiazem and nifedipine]. (PubMed)

hypertension; nifedipine (10 mg sublingually) in 10 patients or 5% glucose (placebo) in 4 patients was used as a control. As compared with the 5% glucose group, diltiazem caused a persistent fall in diastolic pressure during 60 minutes, but only a transient decrease in systolic arterial pressure and heart rate; plasma renin activity was unchanged. Nifedipine caused a persistent fall in both systolic and diastolic pressure and a slight but significant increase in plasma renin activity, but did not modify (...) heart rate. The diltiazem-induced decrease in systolic pressure was significantly smaller than the pressure changes caused by nifedipine. Variations in plasma renin activity between the two calcium antagonists were not significant. These findings suggest that in patients with hypertension diltiazem exerts a less marked acute antihypertensive effect than nifedipine.

1987 Schweizerische medizinische Wochenschrift Controlled trial quality: uncertain

34875. Comparative study on the antihypertensive efficacy of torasemide and indapamide in patients with essential hypertension. (PubMed)

Comparative study on the antihypertensive efficacy of torasemide and indapamide in patients with essential hypertension. In a double-blind randomized multicenter study the antihypertensive efficacy of 2.5 mg torasemide (1- isopropyl-3-([4-(3-methyl-phenylamino)pyridine]-3-sulfony)urea) and 2.5 mg indapamide was compared in patients with essential hypertension, known as responders to diuretic therapy. After a wash-out period of 4 weeks patients with a sitting diastolic blood pressure of 100-115 (...) mmHg were included in the 12-weeks active treatment period. After 4 weeks of treatment with a once daily 2.5 mg dose of each drug, doses could once be doubled if blood-pressure decrease was considered to be insufficient. 66 patients qualified for the statistical evaluation, 32 in the torasemide group and 34 in the indapamide group. In these patients both drugs caused a similar fall in blood pressure leading to a normalization of blood pressure in most of the patients. Serum parameters remained

1988 Arzneimittel-Forschung Controlled trial quality: uncertain

34876. Effect of oral salt loading on blood pressure and lymphocyte sodium metabolism in borderline hypertension. (PubMed)

Effect of oral salt loading on blood pressure and lymphocyte sodium metabolism in borderline hypertension. A randomized double-blind cross-over trial was performed to test the effects of oral salt loading (normal diet + 200 mmol NaCl/day for 4 weeks followed by normal diet + 400 mmol/day for 1 week) against placebo on blood pressure and lymphocyte sodium homeostasis in 10 young borderline hypertensive men, genetically predisposed for essential hypertension. Salt loading caused no significant

1986 Acta medica Scandinavica. Supplementum Controlled trial quality: uncertain

34877. Comparison of the efficacy of an ACE-inhibitor and a calcium channel blocker in hypertensive asthmatics. A preliminiary report. (PubMed)

Comparison of the efficacy of an ACE-inhibitor and a calcium channel blocker in hypertensive asthmatics. A preliminiary report. A series of 8 adult patients with stable bronchial asthma and an established diagnois of essential hypertension (WHO I and II) was studied in a randomized double-blind cross-over study to assess the effect of captopril (50-100 mg/day) and verapamil (160-240 mg/day) on blood pressure, lung function and asthmatic symptoms. The effect of the medication on blood pressure (...) was significant with a mean of 137/86 mmHg and 148/90 mmHg after 4 weeks on captopril and verapamil, respectively, with fewer orthostatic changes caused by captopril. There were no marked changes of asthmatic symptoms or peak expiratory flow (PEF) measurements during the trial.

1986 Postgraduate medical journal Controlled trial quality: uncertain

34878. Pharmacodynamics and pharmacokinetics of three different doses of urapidil infused in hypertensive patients. (PubMed)

Pharmacodynamics and pharmacokinetics of three different doses of urapidil infused in hypertensive patients. The study was designed to follow the haemodynamic effects and pharmacokinetics under steady-state conditions of three different doses of urapidil infused continuously. Nine male hypertensive patients received three randomly assigned intravenous infusions of 32.5, 65 and 130 mg urapidil, over 14 h during 6 consecutive days, in a change-over fashion. Blood pressure and heart rate were (...) measured over a period of 28 h after the infusion began and were compared with a reference profile obtained prior to the treatment periods. Urapidil and its main metabolite, parahydroxylated urapidil, were also determined for 28 h after the infusion began using HPLC. The 32.5 mg dose of urapidil caused a maximum decrease in systolic blood pressure of 33 +/- 8 mmHg, the 65 mg dose a maximum decrease of 39 +/- mmHg and the 130 mg dose a maximum decrease of 50 +/- 12 mmHg. The 32.5 and 65 mg doses

1986 European journal of clinical pharmacology Controlled trial quality: uncertain

34879. Cadralazine and chlorthalidone as a second-step drug with atenolol in hypertensive patients: differences in blood pressure control during exercise. (PubMed)

Cadralazine and chlorthalidone as a second-step drug with atenolol in hypertensive patients: differences in blood pressure control during exercise. The long-term efficacy of a new vasodilator, cadralazine (ISF 2469), and chlorthalidone have been compared in 20 hypertensive patients not adequately controlled by atenolol. After 4 weeks of treatment with atenolol 100 mg once daily, patients whose diastolic blood pressure was greater than 95 mmHg were randomly divided into two groups to receive (...) in addition to atenolol, either cadralazine 15 mg once daily or chlorthalidone 25 mg once daily. Both treatments were administered for 6 months. At the end of treatment with atenolol and after 3 and 6 months of combination therapy, blood pressure and heart rate were measured at rest and during bicycle exercise 24 h after the last dose. Compared to atenolol alone, both cadralazine and chlorthalidone caused a significant and similar reduction in resting blood pressure. Both groups showed an increase

1986 European journal of clinical pharmacology Controlled trial quality: uncertain

34880. Postoperative hypertension after repair of coarctation of aorta in children: protective effect of propranolol? (PubMed)

Postoperative hypertension after repair of coarctation of aorta in children: protective effect of propranolol? The effects of the nonselective beta blocker, propranolol, on coarctectomy-induced hypertension were evaluated relative to changes in cardiac function, sympathetic tone, and plasma renin activity (PRA). A randomized, placebo-controlled, double-blind, age-stratified design was employed. Propranolol (n = 11, mean age 9.4 years) or placebo (n = 12, mean age 10.2 years) was started 2 days (...) , systolic blood pressure, heart rate, cardiac index and PRA showed only negligible increases. However, diastolic blood pressure, increased even faster with propranolol than with placebo but to the same extent. Plasma catecholamines showed similar increases on the two treatments. Only in the placebo group was the code broken in the intensive care unit because of hypertension uncontrolled by sodium nitroprusside; this occurred in 6 of 12 patients. We conclude that nonselective beta blockade ameliorates

1987 American heart journal Controlled trial quality: uncertain

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