Antihypertensive Agents: Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS.Hypertension: Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Hydrochlorothiazide: A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It is used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism.Diuretics: Agents that promote the excretion of urine through their effects on kidney function.Atenolol: A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility.Amlodipine: A long-acting dihydropyridine calcium channel blocker. It is effective in the treatment of ANGINA PECTORIS and HYPERTENSION.Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cellular membranes.Hydralazine: A direct-acting vasodilator that is used as an antihypertensive agent.Methyldopa: An alpha-2 adrenergic agonist that has both central and peripheral nervous system effects. Its primary clinical use is as an antihypertensive agent.Sodium Chloride Symporter Inhibitors: Agents that inhibit SODIUM CHLORIDE SYMPORTERS. They act as DIURETICS. Excess use is associated with HYPOKALEMIA.Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.Minoxidil: A potent direct-acting peripheral vasodilator (VASODILATOR AGENTS) that reduces peripheral resistance and produces a fall in BLOOD PRESSURE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p371)Bendroflumethiazide: A thiazide diuretic with actions and uses similar to those of HYDROCHLOROTHIAZIDE. It has been used in the treatment of familial hyperkalemia, hypertension, edema, and urinary tract disorders. (From Martindale, The Extra Pharmacopoeia, 30th ed, p810)Rats, Inbred SHR: A strain of Rattus norvegicus with elevated blood pressure used as a model for studying hypertension and stroke.Doxazosin: A prazosin-related compound that is a selective alpha-1-adrenergic blocker.Angiotensin II Type 1 Receptor Blockers: Agents that antagonize ANGIOTENSIN II TYPE 1 RECEPTOR. Included are ANGIOTENSIN II analogs such as SARALASIN and biphenylimidazoles such as LOSARTAN. Some are used as ANTIHYPERTENSIVE AGENTS.Captopril: A potent and specific inhibitor of PEPTIDYL-DIPEPTIDASE A. It blocks the conversion of ANGIOTENSIN I to ANGIOTENSIN II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the RENIN-ANGIOTENSIN SYSTEM and inhibits pressure responses to exogenous angiotensin.TetrazolesLisinopril: One of the ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACE inhibitors), orally active, that has been used in the treatment of hypertension and congestive heart failure.Nordefrin: A norepinephrine derivative used as a vasoconstrictor agent.Glutamyl Aminopeptidase: A ZINC-dependent membrane-bound aminopeptidase that catalyzes the N-terminal peptide cleavage of GLUTAMATE (and to a lesser extent ASPARTATE). The enzyme appears to play a role in the catabolic pathway of the RENIN-ANGIOTENSIN SYSTEM.Dihydropyridines: Pyridine moieties which are partially saturated by the addition of two hydrogen atoms in any position.Angiotensin Receptor Antagonists: Agents that antagonize ANGIOTENSIN RECEPTORS. Many drugs in this class specifically target the ANGIOTENSIN TYPE 1 RECEPTOR.Clonidine: An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat HYPERTENSION and HEART FAILURE.Indapamide: A benzamide-sulfonamide-indole derived DIURETIC that functions by inhibiting SODIUM CHLORIDE SYMPORTERS.Labetalol: A salicylamide derivative that is a non-cardioselective blocker of BETA-ADRENERGIC RECEPTORS and ALPHA-1 ADRENERGIC RECEPTORS.Blood Pressure Monitoring, Ambulatory: Method in which repeated blood pressure readings are made while the patient undergoes normal daily activities. It allows quantitative analysis of the high blood pressure load over time, can help distinguish between types of HYPERTENSION, and can assess the effectiveness of antihypertensive therapy.Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Guanfacine: A centrally acting antihypertensive agent with specificity towards ADRENERGIC ALPHA-2 RECEPTORS.Perindopril: An angiotensin-converting enzyme inhibitor. It is used in patients with hypertension and heart failure.Hypertension, Renal: Persistent high BLOOD PRESSURE due to KIDNEY DISEASES, such as those involving the renal parenchyma, the renal vasculature, or tumors that secrete RENIN.Blood Pressure Determination: Techniques for measuring blood pressure.Renin-Angiotensin System: A BLOOD PRESSURE regulating system of interacting components that include RENIN; ANGIOTENSINOGEN; ANGIOTENSIN CONVERTING ENZYME; ANGIOTENSIN I; ANGIOTENSIN II; and angiotensinase. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming ANGIOTENSIN I. Angiotensin-converting enzyme, contained in the lung, acts on angiotensin I in the plasma converting it to ANGIOTENSIN II, an extremely powerful vasoconstrictor. Angiotensin II causes contraction of the arteriolar and renal VASCULAR SMOOTH MUSCLE, leading to retention of salt and water in the KIDNEY and increased arterial blood pressure. In addition, angiotensin II stimulates the release of ALDOSTERONE from the ADRENAL CORTEX, which in turn also increases salt and water retention in the kidney. Angiotensin-converting enzyme also breaks down BRADYKININ, a powerful vasodilator and component of the KALLIKREIN-KININ SYSTEM.Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure.Benzimidazoles: Compounds with a BENZENE fused to IMIDAZOLES.Imidazoline Receptors: Receptors of CLONIDINE and other IMIDAZOLINES. Activity of the ligands was earlier attributed to ADRENERGIC ALPHA-2 RECEPTORS. Endogenous ligands include AGMATINE, imidazoleacetic acid ribotide, and harman.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Propanolamines: AMINO ALCOHOLS containing the propanolamine (NH2CH2CHOHCH2) group and its derivatives.Losartan: An antagonist of ANGIOTENSIN TYPE 1 RECEPTOR with antihypertensive activity due to the reduced pressor effect of ANGIOTENSIN II.Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of CALCIUM ion on membrane functions.Renin: A highly specific (Leu-Leu) endopeptidase that generates ANGIOTENSIN I from its precursor ANGIOTENSINOGEN, leading to a cascade of reactions which elevate BLOOD PRESSURE and increase sodium retention by the kidney in the RENIN-ANGIOTENSIN SYSTEM. The enzyme was formerly listed as EC 3.4.99.19.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Prazosin: A selective adrenergic alpha-1 antagonist used in the treatment of HEART FAILURE; HYPERTENSION; PHEOCHROMOCYTOMA; RAYNAUD DISEASE; PROSTATIC HYPERTROPHY; and URINARY RETENTION.Rats, Inbred WKY: A strain of Rattus norvegicus used as a normotensive control for the spontaneous hypertensive rats (SHR).Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Chlorthalidone: A benzenesulfonamide-phthalimidine that tautomerizes to a BENZOPHENONES form. It is considered a thiazide-like diuretic.Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen.Adrenergic alpha-Antagonists: Drugs that bind to but do not activate alpha-adrenergic receptors thereby blocking the actions of endogenous or exogenous adrenergic agonists. Adrenergic alpha-antagonists are used in the treatment of hypertension, vasospasm, peripheral vascular disease, shock, and pheochromocytoma.Fumarates: Compounds based on fumaric acid.Systole: Period of contraction of the HEART, especially of the HEART VENTRICLES.Biphenyl CompoundsMedication Adherence: Voluntary cooperation of the patient in taking drugs or medicine as prescribed. This includes timing, dosage, and frequency.Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.Imidazoles: Compounds containing 1,3-diazole, a five membered aromatic ring containing two nitrogen atoms separated by one of the carbons. Chemically reduced ones include IMIDAZOLINES and IMIDAZOLIDINES. Distinguish from 1,2-diazole (PYRAZOLES).Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Clinical Trials as Topic: Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.Desoxycorticosterone: A steroid metabolite that is the 11-deoxy derivative of CORTICOSTERONE and the 21-hydroxy derivative of PROGESTERONE.Hypertension, Renovascular: Hypertension due to RENAL ARTERY OBSTRUCTION or compression.Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway.Kidney Failure, Chronic: The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.Kidney: Body organ that filters blood for the secretion of URINE and that regulates ion concentrations.Phenylacetates: Derivatives of phenylacetic acid. Included under this heading are a variety of acid forms, salts, esters, and amides that contain the benzeneacetic acid structure. Note that this class of compounds should not be confused with derivatives of phenyl acetate, which contain the PHENOL ester of ACETIC ACID.Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Diabetic Nephropathies: KIDNEY injuries associated with diabetes mellitus and affecting KIDNEY GLOMERULUS; ARTERIOLES; KIDNEY TUBULES; and the interstitium. Clinical signs include persistent PROTEINURIA, from microalbuminuria progressing to ALBUMINURIA of greater than 300 mg/24 h, leading to reduced GLOMERULAR FILTRATION RATE and END-STAGE RENAL DISEASE.Benzopyrans: Compounds with a core of fused benzo-pyran rings.Cardiovascular Diseases: Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Trichlormethiazide: A thiazide diuretic with properties similar to those of HYDROCHLOROTHIAZIDE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p830)Proteinuria: The presence of proteins in the urine, an indicator of KIDNEY DISEASES.Arteries: The vessels carrying blood away from the heart.Delayed-Action Preparations: Dosage forms of a drug that act over a period of time by controlled-release processes or technology.Cardiovascular System: The HEART and the BLOOD VESSELS by which BLOOD is pumped and circulated through the body.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Diabetes Mellitus, Type 2: A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY.Diabetes Complications: Conditions or pathological processes associated with the disease of diabetes mellitus. Due to the impaired control of BLOOD GLUCOSE level in diabetic patients, pathological processes develop in numerous tissues and organs including the EYE, the KIDNEY, the BLOOD VESSELS, and the NERVE TISSUE.Thiazides: Heterocyclic compounds with SULFUR and NITROGEN in the ring. This term commonly refers to the BENZOTHIADIAZINES that inhibit SODIUM-POTASSIUM-CHLORIDE SYMPORTERS and are used as DIURETICS.Administration, Oral: The giving of drugs, chemicals, or other substances by mouth.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Kidney Diseases: Pathological processes of the KIDNEY or its component tissues.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Aorta: The main trunk of the systemic arteries.CreatinineBenzothiadiazines: Heterocyclic compounds of a ring with SULFUR and two NITROGEN atoms fused to a BENZENE ring. Members inhibit SODIUM-POTASSIUM-CHLORIDE SYMPORTERS and are used as DIURETICS.Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Hypertrophy, Left Ventricular: Enlargement of the LEFT VENTRICLE of the heart. This increase in ventricular mass is attributed to sustained abnormal pressure or volume loads and is a contributor to cardiovascular morbidity and mortality.Stroke: A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Felodipine: A dihydropyridine calcium antagonist with positive inotropic effects. It lowers blood pressure by reducing peripheral vascular resistance through a highly selective action on smooth muscle in arteriolar resistance vessels.Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat.Cilazapril: One of the ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACE inhibitors) used for hypertension. It is a prodrug that is hydrolyzed after absorption to its main metabolite cilazaprilat.Nicardipine: A potent calcium channel blockader with marked vasodilator action. It has antihypertensive properties and is effective in the treatment of angina and coronary spasms without showing cardiodepressant effects. It has also been used in the treatment of asthma and enhances the action of specific antineoplastic agents.Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Albuminuria: The presence of albumin in the urine, an indicator of KIDNEY DISEASES.Hypertension, Malignant: A condition of markedly elevated BLOOD PRESSURE with DIASTOLIC PRESSURE usually greater than 120 mm Hg. Malignant hypertension is characterized by widespread vascular damage, PAPILLEDEMA, retinopathy, HYPERTENSIVE ENCEPHALOPATHY, and renal dysfunction.Nitrendipine: A calcium channel blocker with marked vasodilator action. It is an effective antihypertensive agent and differs from other calcium channel blockers in that it does not reduce glomerular filtration rate and is mildly natriuretic, rather than sodium retentive.Pulse: The rhythmical expansion and contraction of an ARTERY produced by waves of pressure caused by the ejection of BLOOD from the left ventricle of the HEART as it contracts.Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.Azetidinecarboxylic Acid: A proline analog that acts as a stoichiometric replacement of proline. It causes the production of abnormal proteins with impaired biological activity.Apium graveolens: A plant species of the family APIACEAE. The stalks are a food source.ThiazepinesReserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use.Peptidyl-Dipeptidase A: A peptidyl-dipeptidase that catalyzes the release of a C-terminal dipeptide, -Xaa-*-Xbb-Xcc, when neither Xaa nor Xbb is Pro. It is a Cl(-)-dependent, zinc glycoprotein that is generally membrane-bound and active at neutral pH. It may also have endopeptidase activity on some substrates. (From Enzyme Nomenclature, 1992) EC 3.4.15.1.Fosinopril: A phosphinic acid-containing angiotensin-converting enzyme inhibitor that is effective in the treatment of hypertension. It is a prodrug that is converted to its active metabolite fosinoprilat.Drug Chronotherapy: The adaptation of drug administration to the known variations in biological RHYTHMICITY, such as CIRCADIAN RHYTHMS. The treatment is aimed at supporting normal rhythms, or modifying the timing of therapy to achieve maximal efficacy and minimal adverse effect.Diastole: Post-systolic relaxation of the HEART, especially the HEART VENTRICLES.Celiprolol: A cardioselective beta-1 adrenergic antagonist that has intrinsic symopathomimetic activity. It is used in the management of ANGINA PECTORIS and HYPERTENSION.
Effects of amlodipine on sympathetic nerve traffic and baroreflex control of circulation in heart failure. (1/6648)
Short-acting calcium antagonists exert a sympathoexcitation that in heart failure further enhances an already elevated sympathetic activity. Whether this is also the case for long-acting formulations is not yet established, despite the prognostic importance of sympathetic activation in heart failure. It is also undetermined whether in this condition long-acting calcium antagonists favorably affect a mechanism potentially responsible for the sympathetic activation, ie, the baroreflex impairment. In 28 heart failure patients (NYHA functional class II) under conventional treatment we measured plasma norepinephrine and efferent postganglionic muscle sympathetic nerve activity (microneurography) at rest and during arterial baroreceptor stimulation and deactivation induced by stepwise intravenous infusions of phenylephrine and nitroprusside, respectively. Measurements were performed at baseline and after 8 weeks of daily oral amlodipine administration (10 mg/d, 14 patients) or before and after an 8-week period without calcium antagonist administration (14 patients). Amlodipine caused a small and insignificant blood pressure reduction. Heart rate, left ventricular ejection fraction, and plasma renin and aldosterone concentrations were not affected. This was the case also for plasma norepinephrine (from 2.43+/-0.41 to 2.50+/-0.34 nmol/L, mean+/-SEM), muscle sympathetic nerve activity (from 54.4+/-5.9 to 51.0+/-4.3 bursts/min), and arterial baroreflex responses. No change in the above-mentioned variables was seen in the control group. Thus, in mild heart failure amlodipine treatment does not adversely affect sympathetic activity and baroreflex control of the heart and sympathetic tone. This implies that in this condition long-acting calcium antagonists can be administered without untoward neurohumoral effects anytime conventional treatment needs to be complemented by drugs causing additional vasodilatation. (+info)Irbesartan reduces QT dispersion in hypertensive individuals. (2/6648)
Angiotensin type 1 receptor antagonists have direct effects on the autonomic nervous system and myocardium. Because of this, we hypothesized that irbesartan would reduce QT dispersion to a greater degree than amlodipine, a highly selective vasodilator. To test this, we gathered electrocardiographic (ECG) data from a multinational, multicenter, randomized, double-blind parallel group study that compared the antihypertensive efficacy of irbesartan and amlodipine in elderly subjects with mild to moderate hypertension. Subjects were treated for 6 months with either drug. Hydrochlorothiazide and atenolol were added after 12 weeks if blood pressure (BP) remained uncontrolled. ECGs were obtained before randomization and at 6 months. A total of 188 subjects (118 with baseline ECGs) were randomized. We analyzed 104 subjects who had complete ECGs at baseline and after 6 months of treatment. Baseline characteristics between treatments were similar, apart from a slight imbalance in diastolic BP (irbesartan [n=53] versus amlodipine [n=51], 99.2 [SD 3. 6] versus 100.8 [3.8] mm Hg; P=0.03). There were no significant differences in BP normalization (diastolic BP <90 mm Hg) between treatments at 6 months (irbesartan versus amlodipine, 80% versus 88%; P=0.378). We found a significant reduction in QT indexes in the irbesartan group (QTc dispersion mean, -11.4 [34.5] milliseconds, P=0.02; QTc max, -12.8 [35.5] milliseconds, P=0.01), and QTc dispersion did not correlate with the change in BP. The reduction in QT indexes with amlodipine (QTc dispersion, -9.7 [35.4] milliseconds, P=0.06; QTc max, -8.6 [33.2] milliseconds, P=0.07) did not quite reach statistical significance, but there was a correlation between the change in QT indexes and changes in systolic BP. In conclusion, irbesartan improved QT dispersion, and this effect may be important in preventing sudden cardiac death in at-risk hypertensive subjects. (+info)Late referral of end-stage renal failure. (3/6648)
We studied all new patients accepted for renal replacement therapy (RRT) in one unit from 1/1/96 to 31/12/97 (n = 198), to establish time from nephrology referral to RRT, evidence of renal disease prior to referral and the adequacy of renal management prior to referral. Sixty four (32.3%, late referral group) required RRT within 12 weeks of referral. Fifty-nine (29.8%) had recognizable signs of chronic renal failure > 26 weeks prior to referral. Patients starting RRT soon after referral were hospitalized for significantly longer on starting RRT (RRT within 12 weeks of referral, median hospitalization 25.0 days (n = 64); RRT > 12 weeks after referral, median 9.7 days (n = 126), (p < 0.001)). Observed survival at 1 year was 68.3% overall, with 1-year survival of the late referral and early referral groups being 60.5% and 72.5%, respectively (p = NS). Hypertension was found in 159 patients (80.3%): 46 (28.9%) were started on antihypertensive medication following referral, while a further 28 (17.6%) were started on additional antihypertensives. Of the diabetic population (n = 78), only 26 (33.3%) were on an angiotensin-converting-enzyme inhibitor (ACEI) at referral. Many patients are referred late for dialysis despite early signs of renal failure, and the pre-referral management of many of the patients, as evidenced by the treatment of hypertension and use of ACEI in diabetics, is less than optimal. (+info)PST 2238: A new antihypertensive compound that modulates Na,K-ATPase in genetic hypertension. (4/6648)
A genetic alteration in the adducin genes is associated with hypertension and up-regulation of the expression of renal Na, K-ATPase in Milan-hypertensive (MHS) rats, in which increased ouabain-like factor (OLF) levels are also observed. PST 2238, a new antihypertensive compound that antagonizes the pressor effect of ouabain in vivo and normalizes ouabain-dependent up-regulation of the renal Na-K pump, was evaluated for its ability to lower blood pressure and regulate renal Na,K-ATPase activity in MHS genetic hypertension. In this study, we show that PST 2238, given orally at very low doses (1 and 10 microg/kg for 5-6 weeks), reduced the development of hypertension in MHS rats and normalized the increased renal Na,K-ATPase activity and mRNA levels, whereas it did not affect either blood pressure or Na,K-ATPase in Milan-normotensive (MNS) rats. In addition, a similar antihypertensive effect was observed in adult MHS rats after a short-term treatment. In cultured rat renal cells with increased Na-K pump activity at Vmax due to overexpression of the hypertensive variant of adducin, 5 days of incubation with PST 2238 (10(-10-)-10(-9) M) lowered the pump rate to the level of normal wild-type cells, which in turn were not affected by the drug. In conclusion, PST 2238 is a very potent compound that in MHS rats reduces blood pressure and normalizes Na-K pump alterations caused by a genetic alteration of the cytoskeletal adducin. Because adducin gene mutations have been associated with human essential hypertension, it is suggested that PST 2238 may display greater antihypertensive activity in those patients carrying such a genetic alteration. (+info)Blocking angiotensin II ameliorates proteinuria and glomerular lesions in progressive mesangioproliferative glomerulonephritis. (5/6648)
BACKGROUND: The renin-angiotensin system is thought to be involved in the progression of glomerulonephritis (GN) into end-stage renal failure (ESRF) because of the observed renoprotective effects of angiotensin-converting enzyme inhibitors (ACEIs). However, ACEIs have pharmacological effects other than ACE inhibition that may help lower blood pressure and preserve glomerular structure. We previously reported a new animal model of progressive glomerulosclerosis induced by a single intravenous injection of an anti-Thy-1 monoclonal antibody, MoAb 1-22-3, in uninephrectomized rats. Using this new model of progressive GN, we examined the hypothesis that ACEIs prevent the progression to ESRF by modulating the effects of angiotensin II (Ang II) on the production of transforming growth factor-beta (TGF-beta) and extracellular matrix components. METHODS: We studied the effect of an ACEI (cilazapril) and an Ang II type 1 receptor antagonist (candesartan) on the clinical features and morphological lesions in the rat model previously reported. After 10 weeks of treatment with equihypotensive doses of cilazapril, cilazapril plus Hoe 140 (a bradykinin receptor B2 antagonist), candesartan, and hydralazine, we examined systolic blood pressure, urinary protein excretion, creatinine clearance, the glomerulosclerosis index, and the tubulointerstitial lesion index. We performed a semiquantitative evaluation of glomerular immunostaining for TGF-beta and collagen types I and III by immunofluorescence study and of these cortical mRNA levels by Northern blot analysis. RESULTS: Untreated rats developed massive proteinuria, renal dysfunction, and severe glomerular and tubulointerstitial injury, whereas uninephrectomized control rats did not. There was a significant increase in the levels of glomerular protein and cortical mRNA for TGF-beta and collagen types I and III in untreated rats. Cilazapril and candesartan prevented massive proteinuria, increased creatinine clearance, and ameliorated glomerular and tubulointerstitial injury. These drugs also reduced levels of glomerular protein and cortical mRNA for TGF-beta and collagen types I and III. Hoe 140 failed to blunt the renoprotective effect of cilazapril. Hydralazine did not exhibit a renoprotective effect. CONCLUSION: These results indicate that ACEIs prevent the progression to ESRF by modulating the effects of Ang II via Ang II type 1 receptor on the production of TGF-beta and collagen types I and III, as well as on intrarenal hemodynamics, but not by either increasing bradykinin activity or reducing blood pressure in this rat model of mesangial proliferative GN. (+info)Trigeminal and carotid body inputs controlling vascular resistance in muscle during post-contraction hyperaemia in cats. (6/6648)
1. In anaesthetized cats, the effects of stimulation of the receptors in the nasal mucosa and carotid body chemoreceptors on vascular resistance in hindlimb skeletal muscle were studied to see whether the responses were the same in active as in resting muscle. The measurements of vascular resistance were taken, first, in resting muscle, and second, in the immediate post-contraction hyperaemic phase that followed a 30 s period of isometric contractions. 2. Stimulation of the receptors in the nasal mucosa caused reflex apnoea and vasoconstriction in muscle. The latter response was attenuated when the test was repeated during post-contraction hyperaemia. 3. Stimulations of the carotid bodies were made during a period of apnoea evoked reflexly by electrical stimulation of both superior laryngeal nerves. This apnoea prevented any effects of changes in respiration on the carotid body reflex vascular responses. Stimulation of the carotid bodies evoked hindlimb muscle vasoconstriction. In the post-contraction hyperaemic period, the response was reduced or abolished. A similar attenuation of the reflex vasoconstrictor responses occurred in decentralized muscles stimulated through their motor roots in the cauda equina. 4. Evidence is presented that the attenuation of the vasoconstrictor responses evoked by the two reflexes is a phenomenon localized to the contracting muscles themselves resulting from an interaction between sympathetic neuronal activity and the local production of metabolites. 5. The results are discussed in relation to the metabolic needs of tissues in relation to asphyxial defence mechanisms such as occur in the diving response. (+info)Inhibition of endothelium-dependent hyperpolarization by endothelial prostanoids in guinea-pig coronary artery. (7/6648)
1. In smooth muscle of the circumflex coronary artery of guinea-pig, acetylcholine (ACh, 10(-6) M) produced an endothelium-dependent hyperpolarization consisting of two components. An initial component that occurs in the presence of ACh and a slow component that developed after ACh had been withdrawn. Each component of the hyperpolarization was accompanied by an increase in membrane conductance. 2. Indomethacin (5 x 10(-6) M) or diclofenac (10(-6) M), both inhibitors of cyclooxygenase, abolished only the slow hyperpolarization. The initial hyperpolarization was not inhibited by diclofenac nor by nitroarginine, an inhibitor of nitric oxide synthase. 3. Both components of the ACh-induced hyperpolarization were abolished in the presence of atropine (10(-6) M) or high-K solution ([K+]0 = 29.4 mM). 4. The interval between ACh-stimulation required to generate an initial hyperpolarization of reproducible amplitude was 20 min or greater, but it was reduced to less than 5 min after inhibiting cyclooxygenase activity. Conditioning stimulation of the artery with substance P (10(-7) M) also caused a long duration (about 20 min) inhibition of the ACh-response. 5. The amplitude of the hyperpolarization generated by Y-26763, a K+-channel opener, was reproducible within 10 min after withdrawal of ACh. 6. Exogenously applied prostacyclin (PGI2) hyperpolarized the membrane and reduced membrane resistance in concentrations over 2.8 x 10(-9)M. 7. At concentrations below threshold for hyperpolarization and when no alteration of membrane resistance occurred, PGI2 inhibited the initial component of the ACh-induced hyperpolarization. 8. It is concluded that endothelial prostanoids, possibly PGI2, have an inhibitory action on the release of endothelium-derived hyperpolarizing factor. (+info)Nitric oxide limits the eicosanoid-dependent bronchoconstriction and hypotension induced by endothelin-1 in the guinea-pig. (8/6648)
1. This study attempts to investigate if endogenous nitric oxide (NO) can modulate the eicosanoid-releasing properties of intravenously administered endothelin-1 (ET-1) in the pulmonary and circulatory systems in the guinea-pig. 2. The nitric oxide synthase blocker N(omega)-nitro-L-arginine methyl ester (L-NAME; 300 microM; 30 min infusion) potentiated, in an L-arginine sensitive fashion, the release of thromboxane A2 (TxA2) stimulated by ET-1, the selective ET(B) receptor agonist IRL 1620 (Suc-[Glu9,Ala11,15]-ET-1(8-21)) or bradykinin (BK) (5, 50 and 50 nM, respectively, 3 min infusion) in guinea-pig isolated and perfused lungs. 3. In anaesthetized and ventilated guinea-pigs intravenous injection of ET-1 (0.1-1.0 nmol kg(-1)), IRL 1620 (0.2-1.6 nmol kg(-1)), BK (1.0-10.0 nmol kg(-1)) or U 46619 (0.2-5.7 nmol kg(-1)) each induced dose-dependent increases in pulmonary insufflation pressure (PIP). Pretreatment with L-NAME (5 mg kg(-1)) did not change basal PIP, but increased, in L-arginine sensitive manner, the magnitude of the PIP increases (in both amplitude and duration) triggered by each of the peptides (at 0.25, 0.4 and 1.0 nmol kg(-1), respectively), without modifying bronchoconstriction caused by U 46619 (0.57 nmol kg(-1)). 4. The increases in PIP induced by ET-1, IRL 1620 (0.25 and 0.4 nmol kg(-1), respectively) or U 46619 (0.57 nmol kg(-1)) were accompanied by rapid and transient increases of mean arterial blood pressure (MAP). Pretreatment with L-NAME (5 mg kg(-1); i.v. raised basal MAP persistently and, under this condition, subsequent administration of ET-1 or IRL 1620, but not of U-46619, induced hypotensive responses which were prevented by pretreatment with the cyclo-oxygenase inhibitor indomethacin. 5. Thus, endogenous NO appears to modulate ET-1-induced bronchoconstriction and pressor effects in the guinea-pig by limiting the peptide's ability to induce, possibly via ET(B) receptors, the release of TxA2 in the lungs and of vasodilatory prostanoids in the systemic circulation. Furthermore, it would seem that these eicosanoid-dependent actions of ET-1 in the pulmonary system and on systemic arterial resistance in this species are physiologically dissociated. (+info)HypertensionDiureticsImpact of antihypertensive drugsChoice of antihypertensiveMedicationsDrugTreatmentMedicationEffectPatientsGuidelinesHypertensionDrugsCardiovascularHypertensiveTherapeuticClass of antihypertensive agentsEffect of Antihypertensive AgentsInhibitorsTherapyPharmacologicalCentral-acting antihyperImpact of antihypertensiveClasses of antihypertensiveEffective antihypertensiveAlternative antihypertensiveTreatmentsPotentAldosteroneAntagonistsMyocardialCardiacCommonlyAntihyperlipidemicAdherence2000MedicationActionsEffectivenessPreventionT2DMStudyBlood
- Recent large hypertension trials have shown great differences in incidence of new-onset diabetes mellitus among patients receiving different antihypertensive drug therapies. (elsevier.com)
- In this review, the results from some of the large hypertension trials are discussed, and the hypotheses on how different antihypertensive drug regimens can affect glucose homeostasis are considered. (elsevier.com)
- Dr. Wright is an internationally renowned luminary in hypertension, one of the primary investigators of the NHLBIsponsored* ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), which concluded that thiazide-type diuretics are superior in preventing cardiovascular disease and should be preferred for first-step antihypertensive therapy. (uhhospitals.org)
- Approximately 10 percent of patients with hypertension have resistant hypertension, defined as a blood pressure that remains above goal in spite of the concurrent use of three antihypertensive agents of different classes, including a diuretic at an appropriate dose. (uhhospitals.org)
- Beta-blockers are less beneficial than other antihypertensive drugs in the elderly with hypertension. (ices.on.ca)
- Some hypertension treatment guidelines published in the late 1990's recommended that diuretics and β-blockers be used as 1st line drugs for treating uncomplicated hypertension, reserving new antihypertensive drugs for special indications. (elsevier.com)
- If the incidence of de novo diabetes is indeed higher with diuretics and cost-analysis confirm long-term savings with using a more expensive but less diabetogenic drug to treat hypertension, then the recommendation may shift to using an antihypertensive that acts on the renin-angiotensin axis. (elsevier.com)
- In the intensive-therapy arm, patients were treated with three or more antihypertensive medications, including diuretics, calcium channel blockers and ACE inhibitors. (uhhospitals.org)
- This recommendation is predicated on the fact that large trials showing cardiovascular protection with antihypertensive drugs used β-blockers and diuretics. (elsevier.com)
- Objective: Evaluate the impact of antihypertensive drugs (AHD) on stroke and acute myocardial infarction (AMI) and death for 3 cohorts of patients: diabetics, high risk, and hypertensive. (scirp.org)
- The question now is whether the results from these recent trials should affect the choice of antihypertensive treatment, particularly for special groups. (elsevier.com)
- What is your second medication of choice, recognizing that most patients require at least two antihypertensive medications for adequate control? (uhhospitals.org)
- It is important to titrate antihypertensive medications to maximally tolerated recommended dosages and to strongly consider the addition of spironolactone, which is particularly effective in helping patients achieve blood pressure treatment goals. (uhhospitals.org)
- SPRINT was designed as a target-based study, which gave physicians flexibility in selecting antihypertensive medications to achieve the assigned blood pressure target. (uhhospitals.org)
- For a second agent, I would recommend a drug that has been shown to reduce cardiovascular events, such as a calcium channel blocker, ACE inhibitor or ARB. (uhhospitals.org)
- Other guidelines suggested all antihypertensives are equal and that drug selection should be individualized. (elsevier.com)
- In clinical practice, under-treatment of high BP and poor adherence to antihypertensive drugs (AHD) cause suboptimal BP control and, ultimately, preventable CV morbidity and mortality. (scirp.org)
- The main purpose of our survey was to identify uncomplicated hypertensive patients as well as hypertensive patients with associated CV disease or diabetes using data from administrative database, and to evaluate the relationship between the antihypertensive treatment and the incidence of stroke, acute myocardial infarction (AMI) and death in the three cohorts of patients. (scirp.org)
- What antihypertensive medication do you recommend as first agent? (uhhospitals.org)
- The effect of antihypertensive agents on new-onset diabetes mellitus: Time to amend the guidelines? (elsevier.com)
- Of the 194,761 patients in the cohort, 25,485 (13%) were prescribed a beta-blocker as their first antihypertensive agent. (ices.on.ca)
- These disparate guidelines arise from the controversy over "are all antihypertensives created equal? (elsevier.com)
- The mechanism of action of prazosin hydrochloride, a new antihypertensive agent was studied in 14 patients with essential hypertension. (ahajournals.org)
- These agents control severe hypertension. (medscape.com)
- K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. (nih.gov)
- Reliable and easy-to-use LC-MS/MS-method for simultaneous determination of the antihypertensives metoprolol, amlodipine, canrenone and hydrochlorothiazide in patients with therapy-refractory arterial hypertension. (bioportfolio.com)
- In retrospective analyses of the Veterans Affairs Single-Drug Therapy for Hypertension Study, we compared changes in pulse pressure with 6 classes of antihypertensive agents: 1292 men with diastolic blood pressure of 95 to 109 mm Hg on placebo were randomized to receive hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem, prazosin, or placebo. (ahajournals.org)
- This led to the development of potent, systematically active APA inhibitors, such as RB150, as a prototype of a new class of centrally acting antihypertensive agents for the treatment of certain forms of hypertension. (inserm.fr)
- 1 outlines the steps for the use of rapid-acting antihypertensive agents for acute-onset severe hypertension during pregnancy and the postpartum period. (freethesaurus.com)
- Comparative effectiveness of fourth-line anti-hypertensive agents in resistant hypertension: A systematic review and meta-analysis. (qmul.ac.uk)
- Aim We assessed the effectiveness of fourth-line mineralocorticoid receptor antagonists in comparison with other fourth-line anti-hypertensive agents in resistant hypertension. (qmul.ac.uk)
- We included randomised and non-randomised studies that compared mineralocorticoid receptor antagonists with other fourth-line anti-hypertensive agents in patients with resistant hypertension. (qmul.ac.uk)
- Conclusion On the basis of this meta-analysis, mineralocorticoid receptor antagonists reduce blood pressure more effectively than other fourth-line agents in resistant hypertension. (qmul.ac.uk)
- Sarah-Jo Sinnott, Laurie A Tomlinson, Adrian A Root, Rohini Mathur, Kathryn E Mansfield, Liam Smeeth, Ian J Douglas, Comparative effectiveness of fourth-line anti-hypertensive agents in resistant hypertension: A systematic review and meta-analysis, European Journal of Preventive Cardiology, 24 (3) pp. 228-238. (qmul.ac.uk)
- Morus alba extract exerts antihypertensive action in an experimental model of arterial hypertension. (greenmedinfo.com)
- Generally speaking, the primary agents for initial monotherapy to treat uncomplicated hypertension are diuretics and beta blockers. (mussenhealth.us)
- Antihypertensive drugs, also known as anti hypertension drugs, is a kind of medicine which can control blood pressure and be used for the treatment of hypertension. (china-sinoway.com)
- It has been suggested that a randomized controlled trial comparing specific antihypertensive agents to one another is required to determine if one agent demonstrates superior efficacy with respect to cardiovascular outcomes in patients on hemodialysis with hypertension (Jindal et al. (freethesaurus.com)
- Subjects (n=39) with chronic renal disease accompanied by mild to moderate hypertension and varying degrees of proteinuria were divided into 3 groups based on UAE values and placed on nonpharmacological and/or treatment with an antihypertensive drug regimen (consisting of one or more antihypertensive drugs [beta blocker, ACE inhibitor or calcium-channel blocker]) to achieve a target blood pressure ≤ 130/85 mmHg. (edu.pl)
- In conclusion, in patients with hypertension, changes in UAE depend on initial UAE values and administered antihypertensive treatment. (edu.pl)
- We propose to identify genetic predictors of the antihypertensive and adverse metabolic responses to two preferred and pharmacodynamically contrasting drugs, a beta-blocker (atenolol) and a thiazide diuretic (hydrochlorothiazide) given initially as monotherapy, and subsequently in combination, to 800 individuals with uncomplicated hypertension. (clinicaltrials.gov)
- Children with symptomatic hypertension, secondary hypertension, target organ damage, diabetes, or persistent hypertension despite nonpharmacologic measures should be treated with antihypertensive medications. (aafp.org)
- Ambulatory blood pressure monitoring can be used to rule out white coat hypertension or to monitor the effects of antihypertensive treatment. (aafp.org)
- Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. (nih.gov)
- To assess the effect of low-dose, diuretic-based antihypertensive treatment on major cardiovascular disease (CVD) event rates in older, non-insulin-treated diabetic patients with isolated systolic hypertension (ISH), compared with nondiabetic patients. (nih.gov)
- Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure). (rug.nl)
- Antihypertensive effects of hydroalcoholic extract of Crataegus Azarolus subspecies Aronia fruit in rats with renovascular hypertension. (greenmedinfo.com)
- Antihypertensive Effects of Hydroalcoholic Extract ofFruit in Rats with Renovascular Hypertension: An Experimental Mechanistic Study. (greenmedinfo.com)
- This study aimed at examining the antihypertensive effect and related mechanisms of hydroalcoholic extract offruit in rats with renovascular hypertension. (greenmedinfo.com)
- We conclude that antihypertensive also minimize the inflammation associated hypertension but not completely, as inflammation was reversed only in 67.5% population who were using beta-blocker. (zibelinepub.com)
- Chronic Hypertension (as determined by current antihypertensive therapy and/or an average of diastolic blood pressure greater than 90 mmHg or greater or systolic blood pressure of 140 mmHg confirmed on at least two subsequent visits over one week or more). (clinicaltrials.gov)
- Losartan is an angiotensin-receptor blocker (ARB) that may be used alone or with other agents to treat hypertension. (rcsb.org)
- May be used as a first line agent to treat uncomplicated hypertension, isolated systolic hypertension and left ventricular hypertrophy. (rcsb.org)
- Recent large hypertension trials have shown great differences in incidence of new-onset diabetes mellitus among patients receiving different antihypertensive drug therapies. (elsevier.com)
- In this review, the results from some of the large hypertension trials are discussed, and the hypotheses on how different antihypertensive drug regimens can affect glucose homeostasis are considered. (elsevier.com)
- In the ongoing effort to improve outcomes of CKD, the National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (K/DOQI) appointed a Work Group and an Evidence Review Team in 2001 to develop clinical practice guidelines on hypertension and use of antihypertensive agents in CKD. (elsevier.com)
- The aim of the study is to calculate the cost-effectiveness of the reduction and control of hypertension using antihypertensive active ingredients. (udg.edu)
- Few comparative effectiveness studies of treatment strategies using antihypertensive therapeutic classes in hypertension control have been assessed in a primary care environment. (jabfm.org)
- The objectives are to compare the effectiveness of common antihypertensive therapeutic classes initiated as monotherapy and of fixed-dose combinations (FDCs), free-equivalent combinations (FECs), and monotherapy on hypertension control. (jabfm.org)
- Antihypertensive drugs are medicines that help lower blood pressure. (encyclopedia.com)
- A retrospective study evaluating the tolerability and effectiveness of adjunctive antihypertensive drugs in patients with inadequate response to initial treatment. (bioportfolio.com)
- Since the original reports suggesting that the antihypertensive action of beta-adrenoreceptor blocking drugs is related to their inhibitory action on renin release, much evidence has been put forward both to refute and support this hypothesis. (biomedsearch.com)
- ICD-9 code E942.6 for Other antihypertensive agents causing adverse effects in therapeutic use is a medical classification as listed by WHO under the range -DRUGS, MEDICINAL AND BIOLOGICAL SUBSTANCES CAUSING ADVERSE EFFECTS IN THERAPEUTIC USE (E930-E949). (aapc.com)
- Moreover, it has not been established whether the impact of antihypertensive drugs on insulin sensitivity, lipids, thrombosis and fibrinolysis adds to or attenuates vascular risk reduction. (eurekaselect.com)
- This review discusses the differential effects of antihypertensive drugs on insulin sensitivity, lipids and haemostasis and considers their association with vascular risk. (eurekaselect.com)
- Dual-acting combination drugs have been developed because of the frequent need for two different types of antihypertensive agents to control blood pressure. (freethesaurus.com)
- uncertainty about when to initiate therapy, which drugs to choose if a second antihypertensive agent is needed, and when (or whether) a patient is too old to benefit from treatment. (freethesaurus.com)
- These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including this drug. (rxlist.com)
- Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. (rxlist.com)
- Antihypertensive drugs mainly take effects through influencing systems which play an important role in regulating blood pressure physiologically, such as the sympathetic nervous system, the renin-angiotensin-aldosterone system, the endothelin system and so on. (china-sinoway.com)
- There are five categories of common first-line antihypertensive drugs including diuretic drugs (Hydrochlorothiazide and Furosemide), beta blockers (such as Metoprolol), angiotensin-converting enzyme inhibitor (ACEI) (such as Captopril), angiotensin II receptor blockers (ARB), and calcium antagonists (CCB). (china-sinoway.com)
- The common effect of these antihypertensive drugs is to reduce blood pressure, but because of differences of hypotensive mechanism, different kinds of antihypertensive drugs have their emphasis which doctors depend on to choose antihypertensive drugs for different patients. (china-sinoway.com)
- Antihypertensive drugs in very old people: a subgroup meta-analysis of randomised controlled trials. (nih.gov)
- Beneficial clinical effects of treatment with antihypertensive drugs have been shown in middle-aged patients and in those hypertensive patients over 60 years old, but whether treatment is beneficial in patients over 80 years old is not known. (nih.gov)
- We collected data from all participants aged 80 years and over in randomised controlled trials of antihypertensive drugs through direct contact with study investigators. (nih.gov)
- Keep antihypertensive drugs away from very old people. (nih.gov)
- Wolf S. and Risler T., Are all antihypertensive drugs renoprotective? (edu.pl)
- The placebo group received placebo and any active antihypertensive drugs prescribed by patient's private physician for persistently high BP. (nih.gov)
- In facts, antihypertensive drugs have gone through a series of evolution with practitioners switching up different classes of the medication for their patients according to trends of recommendation to assist with achieving a lower risk target blood pressure . (journal-pharm.com)
- There are over hundreds of types of antihypertensive drugs in the current market, but only one-third of the patients that are currently diagnosed have their blood pressure successfully controlled via a monotherapy while the other two-thirds require multiple drug therapy courses to assist them in achieving the same effect. (journal-pharm.com)
- With these pushing factors being revealed, there will be a wider structure-activity profile on vasorelaxant activity available on hands, thus more promising vasorelaxant agents could be synthesized and lead to more options in novel antihypertensive drugs creation that to be applied in current medical practices. (journal-pharm.com)
- Drug interactions to be aware of include lithium, agents increasing serum levels of potassium, and the use of hydrochlorothiazide with antidiabetic drugs both oral agents and insulin. (wikipedia.org)
- Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina , heart failure, or diabetic kidney disease). (rxlist.com)
- How Do Antihypertensive Drugs Work? (frontiersin.org)
- Though antihypertensive drugs have been in use for many decades, the mechanisms by which they act chronically to reduce blood pressure remain unclear. (frontiersin.org)
- Here we review the long-term renal actions of antihypertensive agents in human studies and find three different mechanisms of action for the drugs investigated. (frontiersin.org)
- These findings provide insights into the actions of antihypertensive drugs, and challenge misconceptions about the mechanisms underlying the therapeutic efficacy of many of the agents. (frontiersin.org)
- Given that the therapeutic activity of antihypertensive drugs is to a large extent empirical and may itself be associated with a variety of adverse effects, clear targeting of relevant tissue components in whatever organ system does regulate arterial pressure over long periods of time, would be highly desirable. (frontiersin.org)
- There are only few studies comparing the efficacy and/or effectiveness of the most commonly used antihypertensive drugs. (udg.edu)
- Results This work compares the effectiveness and cost-effectiveness of different antihypertensive drugs commonly used in clinical practice. (udg.edu)
- Angiotensin II receptor blockers (ARBs) are antihypertensive real estate agents with considerable proof efficacy and protection for the reduced amount of cardiovascular (CV) disease risk in various patient populations over the CV continuum. (exposed-skin-care.net)
- CONCLUSIONS: Individuals aged 65 years and older or 75 years and older who receive antihypertensive therapy have statistically significant reduction in the risk of all-cause and cardiovascular mortality, heart failure, and stroke. (elsevier.com)
- Thus, the finding of microalbuminuria is an indication for screening for possible vascular disease and aggressive intervention to reduce all cardiovascular risk factors (e.g., lowering of LDL cholesterol, antihypertensive therapy, cessation of smoking, institution of exercise, etc. (diabetesjournals.org)
- Our studies of the acute and chronic effects of treatment with propranolol in hypertensive patients showed that the antihypertensive action of the drug was of later onset than the initial cardio-depressant and renin-suppressive effects and had little relationship to the pre-treatment levels of treatment-induced changes in plasma renin activity (PRA). (biomedsearch.com)
- 1. The changes in plasma volume, haemodynamic variables, plasma renin activity and plasma aldosterone were studied in forty-one hypertensive patients after administration of adrenergic-blocking agents. (clinsci.org)
- Because it was unexpectedly found that the anti-hypertensive agent, ifenprodil, has neuroprotective activity through results to GluN2B and GluN1-4b ATDs (Supplementary Fig. (grey) and Ro 25-6981 (lime) in stereoview. (exposed-skin-care.net)
- Results of a large-scale specific trial are needed for definite conclusion that antihypertensive treatment is beneficial in very elderly hypertensive patients. (nih.gov)
- The blood pressure-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications. (greenmedinfo.com)
- 4 This landmark analysis reaffirmed the benefit of BP-lowering medication in preventing CV events across hypertensive populations, establishing these agents as risk modifying treatments for all patients at elevated risk. (emedinexus.com)
- This report presents the results after one year of follow-up of 759 hypertensive patients who were begun on one of a number of randomized, double blind treatment regimens using various antihypertensive agents. (jamanetwork.com)
- Review the properties, dosages, and precautions of the 28 new therapeutic agents marketed in the United States in 1999. (drugster.info)
- The overall class of antihypertensive agents lowers blood pressure, although the mechanisms of action vary greatly. (encyclopedia.com)
- Losartan is the first of a class of antihypertensive agents called angiotensin II receptor blockers (ARBs). (rcsb.org)
- The effect of antihypertensive agents on new-onset diabetes mellitus: Time to amend the guidelines? (elsevier.com)
- Aminopeptidase A inhibitors as centrally acting antihypertensive agents. (inserm.fr)
- Classes of antihypertensive combinations include ACE inhibitors with calcium channel blocking agents, ACE inhibitors with thiazides, angiotensin II inhibitors with calcium channel blockers, angiotensin II inhibitors with thiazide, antiadrenergic agents (central) with thiazide, antiadrenergic agents (peripheral) with thiazide, beta blockers with calcium channel blockers, beta blockers with thiazides and potassium sparing diuretics with thiazides. (drugs.com)
- Losartan may be also used as a second line agent in the treatment of congestive heart failure, systolic dysfunction, myocardial infarction and coronary artery disease in those intolerant of ACE inhibitors. (rcsb.org)
- This review describes the rationale for this combination therapy and the clinical trials that have demonstrated that these two agents can be combined without the loss of efficacy for either agent or an increase in the incidence of adverse events. (dovepress.com)
- Real-world observational studies have demonstrated that patients are more adherent to SPAA than co-administered antihypertensive and lipid-lowering therapy, and this improved adherence translated to reduced CV events. (dovepress.com)
- Novel agonists of melatonin receptors as promising hypotensive and neuroprotective agents for therapy of glaucoma. (greenmedinfo.com)
- The proposed work should help move toward the long-term goal of selection of antihypertensive drug therapy based on a patient's genetic make-up. (clinicaltrials.gov)
- Responses to antihypertensive drug therapy exhibit considerable interpatient variability, contributing to poor rates of HTN control (currently 34% in the US), and frequent nonadherence and dropout from therapy. (clinicaltrials.gov)
- As in Aim 1, Aim 2 will include testing for associations with antihypertensive and adverse metabolic responses to monotherapy and combination therapy. (clinicaltrials.gov)
- The proposed research will substantially increase our understanding of the pharmacogenetics of mono- and combination antihypertensive drug therapy. (clinicaltrials.gov)
- The proposed research is significant because genetically-targeted antihypertensive therapy could lead to dramatically higher response rates and fewer adverse effects than the usual trial-and-error approach. (clinicaltrials.gov)
- Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction . (rug.nl)
- The antihypertensive effects of Verelan are evident within the first week of therapy. (rxlist.com)
- Similarly, data is frugal on the effects of antihypertensive therapy on safety and non-vascular outcomes. (emedinexus.com)
- The study population consisted of 8,676 patients with an incident prescription for an antihypertensive agent of a total of 79,176 patients receiving antihypertensive therapy in 33 geographically diverse primary care clinics. (jabfm.org)
- To determine if the combined incidence of nonfatal myocardial infarction and coronary heart disease death differs between diuretic-based and each of three alternative antihypertensive pharmacological treatments. (clinicaltrials.gov)
- While all interventional cardiologists have access to pharmacopeial texts and databases and are aware of the growing number of pharmacological agents in the armamentarium, questions arise as to the ideal agent or combination of agents in differing patient situations. (routledge.com)
- The metabolism and pharmacokinetics of moxonidine, a potent central-acting antihypertensive agent, were studied in four healthy subjects after a single oral administration of approximately 1 mg (∼60 μCi) of [ 14 C 3 ]moxonidine. (aspetjournals.org)
- In this study, we evaluated the prognostic impact of antihypertensive agents in patients with CRPC treated with androgen receptor axis-targeting (ARAT) agents or docetaxel chemotherapy. (elsevier.com)
- Little is known, however, of the comparative effects of various classes of antihypertensive agents on pulse pressure. (ahajournals.org)
- These data show that classes of antihypertensive agents differ in their ability to reduce pulse pressure. (ahajournals.org)
- Prazosin hydrochloride appears to be an effective antihypertensive agent which acts by peripheral vasodilatation. (ahajournals.org)
- It follows that the kidney is the most likely target for the action of most effective antihypertensive agents used chronically in clinical practice today. (frontiersin.org)
- Despite blindly searching and testing for the potential vasorelaxant effects of an unknown compound, we strongly believe that the opinions elaborated above could serve better insights for those researching similar topics in the future and potentially lead to at least in the advancement for an alternative antihypertensive study. (journal-pharm.com)
- Captopril and atenolol were equally effective in reducing blood pressure to a mean of 144/83 mm Hg and 143/81 mm Hg respectively, with a similar proportion of patients (27% and 31%) requiring three or more antihypertensive treatments. (bmj.com)
- Increased number of individuals with SAH in populations has contributed to increase of treatments, both for nondrug treatments and for treatments based on use of antihypertensives 26 . (scielo.br)
- Also, it has been proven that the results of the study are in agreement with the antihypertensive treatments prescribed in the current clinical practice in the sanitary region of Girona. (udg.edu)
- In the present study, QSAR model was developed by using linear and nonlinear methodology that may be helpful in development of potent antihypertensive agents. (ijddr.in)
- 5. This study suggests that the decrease in plasma renin activity was related to the lowering of the heart rate rather than to sodium retention and that adrenergic-blocking agents can impair the normal relationship between stroke index and plasma volume, between plasma volume and plasma renin activity, and between plasma renin activity and plasma aldosterone. (clinsci.org)
- Comparative fourth-line agents included bisoprolol, doxazosin, furosemide and additional blockade of the renin angiotensin-aldosterone system. (qmul.ac.uk)
- 3. Analgesics, Narcotic antagonists, and agents used to treat arthritis: Agents used to treat gout. (worldcat.org)
- Some patients, particularly those with severe and active comorbid conditions, such as an acute myocardial infarction, require inotropic agents and vasopressors. (medscape.com)
- 6. Cardiac, vascular, and renal agents: Agents used to treat migraine. (worldcat.org)
- The investigators found no such association between breast cancer and any of the other commonly used antihypertensive agents , even if they were taken for long durations. (freethesaurus.com)
- Participants include patients 18 years of age or older with electronic portal access, GHS primary care physicians, and Geisinger health plan insurance, and taking at least one antihypertensive or antihyperlipidemic agent from March 2009 to June 2011. (jmir.org)
- Our study sought to extend previous knowledge of adherence by determining the rate of first-fill failure for antihypertensive agents prescribed by electronic means, as well as identifying the clinical and demographic factors most closely associated with that failure. (freethesaurus.com)
- We observed increased proportion of use of antihypertensive, from 48.7% in 2000 to 61.3% in 2006, reaching 65.7% in 2010. (scielo.br)
- Both intensive schedules in the Frequent Hemodialysis Network reduced antihypertensive medication use, relative to three sessions per week. (advancingdialysis.org)
- Intensive Hemodialysis, Blood Pressure, and Antihypertensive Medication Use. (advancingdialysis.org)
- Conclusions The effectiveness analysis and the pharmacoeconomic study provide new information about antihypertensive active ingredients, with the objective of being able to apply it in the usual clinical practice. (udg.edu)
- Oral Anti-Neoplastic Agents For Prevention of Restenosis. (routledge.com)
- Therefore, the risk of developing T2DM should be considered when selecting an antihypertensive agent. (eurekaselect.com)
- Prescription pattern of antihypertensive agents in T2DM patients visiting tertiary care centre in North India. (freethesaurus.com)
- Nearly 16% of antihypertensive prescriptions in this study went unfilled. (freethesaurus.com)
- Patients and methods: This study included 156 Japanese men with CRPC who were treated with ARAT agents (n = 85) or docetaxel (n = 71) at our hospital between 2008 and 2017. (elsevier.com)
- Double Blind Control Study of Antihypertensive Agents: II. (jamanetwork.com)
- antihypertensive /an·ti·hy·per·ten·sive/ (-ten´siv) counteracting high blood pressure, or an agent that does this. (drugster.info)
- Conversely, lowering the blood pressure with antihypertensive agents may also worsen neurological function by reducing cerebral perfusion. (freethesaurus.com)
- The large variability between individuals in the observed blood pressure response to these agents cannot be attributed to the polymorphisms analysed at the ACE and AGT loci. (nih.gov)
- 8. Agents affecting blood formation and coagulability: Agents used to treat deficiency anemias. (worldcat.org)
- Antihypertensive combinations have agents that control blood pressure. (drugs.com)
- agent that reduces high blood pressure. (fpnotebook.com)