The Addition of Visken to Methyldopa Therapy in Hypertension: A Multicentre Study

1976 ◽  
Vol 4 (2) ◽  
pp. 128-131 ◽  
Author(s):  
J E Murphy
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Multicentre Study ◽  
Treatment Regimen ◽  
Sleep Disturbances ◽  
Supine Blood Pressure ◽  
Blood Pressures

Forty-one patients completed the study where Visken was added to the treatment regimen of patients whose blood pressures were poorly controlled on methyldopa or who were experiencing side-effects with methyldopa. Supine blood pressure was reduced from 177/108 mm Hg before Visken therapy to 159/96 mm Hg after twelve weeks of taking Visken. The dose of methyldopa was reduced from a mean 921 mg at the start to 445 mg at the end. Fourteen patients were able to stop methyldopa therapy. The number of side-effects reported was reduced as the study continued and fifteen patients commented that they felt better on Visken. Nine patients did not complete the trial, three of these because of side-effects, viz insomnia, lethargy and sleep disturbances.

The Value of Portably Recorded Blood Pressures in the Initiation of Treatment of Moderate Hypertension

1973 ◽  
Vol 45 (s1) ◽  
pp. 195s-198s ◽  
Author(s):  
Maurice Sokolow ◽  
Dorothee Perloff ◽  
Ronald Cowan
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Arterial Pressure ◽  
Antihypertensive Therapy ◽  
Moderate Hypertension ◽  
Vascular Involvement ◽  
Pressure Elevation ◽  
Blood Pressures ◽  
Hypotensive Therapy ◽  
Reduce Risk

1. The value of making portable-recorder measurements of blood pressure has been studied. 2. The danger associated with mild arterial pressure elevation is not immediate, but almost any reduction in pressure is likely to reduce risk. 3. Patient and doctor together must decide what burden of side effects of hypotensive therapy is tolerable. 4. Such decisions will become rational only when the probability of vascular involvement can be accurately assessed in a given patient. 5. The likelihood of arresting the disease through antihypertensive therapy must similarly be assessed.

Prazosin and Hydrallazine in the Treatment of Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 617s-619s ◽  
Author(s):  
Priscilla Kincaid-Smith ◽  
A. S. P. Hua ◽  
J. B. Myers ◽  
Ileene Macdonald ◽  
P. Fang
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Diastolic Blood Pressure ◽  
Blocking Agent ◽  
Base Line ◽  
Double Blind ◽  
Supine Diastolic Blood Pressure ◽  
Treatment Of Hypertension ◽  
Blood Pressures

1. Two vasodilators, prazosin and hydrallazine, have been compared in three double-blind cross-over studies designed to test their effect when used in combination with a β-adrenoceptor-blocking agent and a thiazide. 2. Single doses of 3 mg of prazosin or 75 mg of hydrallazine were administered to patients whose blood pressures remained uncontrolled on a thiazide and a β-adrenoceptor-blocking agent. Both agents produced significant falls in systolic and diastolic blood pressure apparent at 1 h. The effects of prazosin persisted for 6–7 h and those of hydrallazine for 4–6 h. Tachycardia was more marked and more prolonged after hydrallazine and continued after the blood pressure had risen to base-line levels or above. 3. In 6 week and 12 week double-blind cross-over studies, mean falls in blood pressure were similar with prazosin and hydrallazine. Similar falls in the supine diastolic blood pressure were achieved with 1 mg of prazosin and 20 mg of hydrallazine, but for a given fall in supine diastolic blood pressure, prazosin produced a significantly lower standing diastolic blood pressure. 4. Severe side effects were more pronounced after hydrallazine, which necessitated withdrawal of seven patients, whereas only one patient on prazosin withdrew from the trial because of side effects.

Lormetazepam (Lorámet®): A Multicentre Assessment of its Efficacy and Acceptability as a Hypnotic in Out-Patients with Sleep Disturbances

1983 ◽  
Vol 11 (6) ◽  
pp. 325-332 ◽  
Author(s):  
R C Hill ◽  
T V A Harry
Keyword(s):  
Side Effects ◽  
Multicentre Study ◽  
Sleep Disturbances ◽  
Prior Experience ◽  
Sleep Pattern ◽  
Diary Card ◽  
Short Acting ◽  
Visual Analogue Scales ◽  
Time To Onset ◽  
Analogue Scales

In an open, multicentre study, the short-acting benzodiazepine hypnotic lormetazepam (Loramet®) was administered nightly (1–2 mg p.o.) for a period of 7 nights to 665 out-patients with various types of sleep disturbances. The patients assessed the efficacy and acceptability of lormetazepam with the aid of a simple diary card and a set of visual analogue scales. The results showed that about 75% of the patients reported a significant improvement in their sleep pattern. The time to onset of sleep was decreased, the number of nocturnal wakings was reduced and the patients reported waking in the morning more refreshed and co-ordinated. The effects were significant after the first night and there were further significant improvements by the seventh night on the drug. In patients who had prior experience of other hypnotics, twice as many preferred lormetazepam to temazepam and three times as many preferred lormetazepam to nitrazepam. Nine patients withdrew from the study due to lack of efficacy and only fifteen patients dropped out following the occurrence of side-effects, mainly drowsiness and lightheadedness. It was concluded that lormetazepam is an effective and highly acceptable hypnotic in patients with sleep disturbances.

Quality-by-Design Enabled Chitosan Nanoparticles for Antitubercular Therapy: Formulation, Statistical Optimization, and In vitro Characterization

2020 ◽  
Vol 15 ◽  
Author(s):  
Manasi M. Chogale ◽  
Sujay S. Gaikwad ◽  
Savita P. Kulkarni ◽  
Vandana B. Patravale
Keyword(s):  
Side Effects ◽  
Treatment Regimen ◽  
Research Work ◽  
Chitosan Nanoparticles ◽  
In Vitro Release ◽  
Antitubercular Therapy ◽  
Prolonged Treatment ◽  
High Dose ◽  
Average Size

Background: Tuberculosis (TB) continues to be among the leading causes for high mortality among developing countries. Though a seemingly effective treatment regimen against TB is in place, there has been no significant improvement in the therapeutic rates. This is primarily owing to the high drug doses, their associated sideeffects, and prolonged treatment regimen. Discontinuation of therapy due to the severe side effects of the drugs results in the progression of the infection to the more severe drug-resistant TB. Objectives: Reformulation of the current existing anti TB drugs into more efficient dosage forms could be an ideal way out. Nanoformulations have been known to mitigate the side effects of toxic, high-dose drugs. Hence, the current research work involves the formulation of Isoniazid (INH; a first-line anti TB molecule) loaded chitosan nanoparticles for pulmonary administration. Methods: INH loaded chitosan nanoparticles were prepared by ionic gelation method using an anionic crosslinker. Drugexcipient compatibility was evaluated using DSC and FT-IR. The formulation was optimized on the principles of Qualityby-Design using a full factorial design. Results: The obtained nanoparticles were spherical in shape having an average size of 620±10.97 nm and zeta potential +16.87±0.79 mV. Solid state characterization revealed partial encapsulation and amorphization of INH into the nanoparticulate system. In vitro release study confirmed an extended release of INH from the system. In vitro cell line based safety and efficacy studies revealed satisfactory results. Conclusion: The developed nanosystem is thus an efficient approach for antitubercular therapy.

scholarly journals Beyond the high: Mapping patterns of use and motives for use of cannabis as medicine

2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Sleep Disturbances ◽  
Online Survey ◽  
Cannabis Use ◽  
Health Conditions ◽  
Convenience Sample ◽  
Mental Health Conditions ◽  
Patient Organisations ◽  
Patterns Of Use

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.

scholarly journals Baroreflex activation therapy for resistant hypertension: results from mid-term prospective ambulatory blood pressure registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Sindt ◽  
T Madej ◽  
S Grimm ◽  
M Knaut
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Pressure Drop ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Drug Resistant ◽  
Baroreflex Activation Therapy ◽  
Activation Therapy ◽  
Resistant Arterial Hypertension

Abstract Objectives First generation baroreflex activation therapy (BAT) devices showed clinical efficacy in patients with drug-resistant arterial hypertension (AHT), but the safety profile was insufficient. Data regarding efficacy of second-generation devices were generated mostly from office blood pressure (BP) measurements or short-term 24-hour ambulatory blood pressure measurements (ABPM). We present a mid-term prospective registry to evaluate the efficacy and safety of recent BAT devices. Purpose The purpose of our study was to find a method that helps patients with drug-resistant arterial hypertension to control their blood pressure. Further we sought to reduce the overall amount of antihypertensive drugs to lessen side effects, as well as the effects of polypharmacy. Methods All patients receiving Barostim neo between November 2013 and June 2019 for resistant AHT were prospectively included into this observational study. ABPM was performed at baseline, in 3-month intervals in the first year after BAT implantation and in 6-month intervals afterwards for up to 42 months. Patients were assigned into two groups of responders and non-responders. Non-responders had a mean blood pressure drop (BPD) below 5mmHg. Responders in turn were categorized into 3 sub-groups (low-BPD between 5–9 mmHg, medium-BPD between 10–19 mmHg and high-BPD ≥20 mmHg). The primary efficacy end-points were changes in systolic and diastolic BP and number of antihypertensive medications. The primary safety end point was BAT-related major adverse events (MAE). Results 64 patients (mean age 63 years, 67% males) were included. Only patients who completed a 24-hour ABPM during a follow up were counted in the statistical analysis. We had an overall responder rate of 67.8%. Out of those 15.4% had low-BPD, 38.4% medium-BPD and 46.2% had a high-BPD. Systolic BP decreased over the 3.5-years period from 168±17 mmHg to 149±19 mmHg (n=19, mean change −18.8 mmHg; 95% confidence interval [CI]: −29.32 to −8.36; p<0.0007). Diastolic BP decreased from 97±16 to 85±12 mmHg (n=19, mean change −11.7 mmHg; 95% CI: −19.2 to −4.2; p<0.0021). The mean number of antihypertensive drugs was reduced from 6.9±1.3 to 5.2±1.5 (n=19, mean change −1.7; 95% CI: −0.8 to −0.27; p<0.0009). The time course of primary end-points is shown in Fig.1. Freedom from BAT-related MAE was 93.5%. 4 perioperative complications (1 pocket bleeding, 1 pocket infection, 1 N. hypoglossus palsy, 1 hoarseness) resolved without residual side effects. There were five non BAT related deaths (7,8%) in the follow up period. Conclusion Systolic and diastolic ABP, as well as number and dosage of antihypertensive drugs decreased significantly during 3.5-years follow-up after Barostim neo implantation in 64 consecutive patients (of whom 62 completed at least one follow-up). No MAE associated with BAT were observed after the perioperative period. However, further controlled trials are needed to confirm the long-term efficacy of BAT. Figure 1. Mean blood pressure drop Funding Acknowledgement Type of funding source: None

Role of Autonomic Nervous System in Maintenance of Cerebral and Renal Hypertension

1957 ◽  
Vol 188 (2) ◽  
pp. 371-374 ◽  
Author(s):  
Sol Rothman ◽  
Douglas R. Drury
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Renal Hypertension ◽  
The Other ◽  
Peripheral Vasculature ◽  
Blood Pressures ◽  
Sympathetic Nervous ◽  
Blood Pressure Responses

The blood pressure responses to various drugs were investigated in renal hypertensive, cerebral hypertensive and normotensive rabbits. Hexamethonium bromide and Dibenamine reduced the blood pressures of renal and cerebral hypertensives. Effects in the normal were insignificant. The cerebral hypertensive's blood pressure was slightly affected by benzodioxane. Blood pressure was not reduced at all in the other groups. Blood pressure of the renal hypertensive rabbit was greatly reduced by Veriloid and dihydroergocornine. Blood pressures of cerebral and normal animals were affected to a lesser degree. The results suggest that maintenance of hypertension in the cerebral hypertensive rabbit depends on an overactive sympathetic nervous system, possibly due to the release of medullary pressor centers from inhibitory impulses originating in higher centers; whereas, the maintenance of hypertension in the renal hypertensive rabbit may be attributed to an increased reactivity of the peripheral vasculature to a normal sympathetic tone.

Physical exercise and blood pressure with reference to the angiotensinogen M235T polymorphism

2002 ◽  
Vol 10 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Rainer Rauramaa ◽  
Raimo Kuhanen ◽  
Timo A. Lakka ◽  
Sari B. Väisänen ◽  
Pirjo Halonen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Reference Group ◽  
Controlled Trial ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Blood Pressures ◽  
Agt Gene ◽  
M235t Polymorphism

We investigated the role of the angiotensinogen (AGT) gene M235T polymorphism in determining blood pressure (BP) response to moderate intensity exercise in a 6-yr randomized controlled trial in 140 middle-aged men. Sitting, supine, and standing blood pressures were measured annually. Of the randomized men, 86% participated in the trial for 6 yr. Submaximal cardiorespiratory fitness increased by 16% in the exercise group. In the M homozygotes, sitting systolic BP decreased by 1.0 mmHg in the exercise but increased by 14.6 mmHg in the reference group ( P = 0.007 for net effect). Sitting and supine diastolic BP decreased by 6.2 and 3.3 mmHg in the exercise but increased by 2.8 and 3.2 mmHg in the reference group ( P = 0.026 and 0.024 for net effects), respectively. Regular moderate intensity exercise attenuates aging-related increase in systolic BP and decreases diastolic BP among the M homozygotes of the AGT gene M235T polymorphism.

scholarly journals The diagnostic value of supine blood pressure in hypertension

2016 ◽  
Vol 2 ◽  
pp. 310-318 ◽  
Author(s):  
Paweł Krzesiński ◽  
Adam Stańczyk ◽  
Grzegorz Gielerak ◽  
Katarzyna Piotrowicz ◽  
Małgorzata Banak ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diagnostic Value ◽  
Supine Blood Pressure

Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children

2000 ◽  
Vol 98 (2) ◽  
pp. 137-142 ◽  
Author(s):  
L. W. DOYLE ◽  
G. W. FORD ◽  
N. M. DAVIS ◽  
C. CALLANAN
Keyword(s):  
Blood Pressure ◽  
Corticosteroid Therapy ◽  
Animal Species ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids ◽  
Preterm Children ◽  
Clinical Hypertension ◽  
Blood Pressures ◽  
The Relationship ◽  
Mercury Sphygmomanometer

Antenatal corticosteroid therapy substantially improves the survival rate of preterm infants, with few side effects. Higher blood pressure in adulthood has been described in several animal species after exposure to antenatal corticosteroids, but there are no similar reports in humans. The objective of the present study was to determine the relationship between exposure to antenatal corticosteroid therapy and blood pressure at 14 years of age. This was a cohort study of 210 preterm survivors with birthweights of < 1501 g born in the Royal Women's Hospital, Melbourne, between 1 January 1977 and 31 March 1982. Blood pressure was measured in 177 subjects (84.3%) at 14 years of age with a standard mercury sphygmomanometer. Children exposed to antenatal corticosteroids (n = 89) had higher systolic and diastolic blood pressures than those not exposed to corticosteroids (n = 88) [mean difference (95% confidence interval) (mmHg): systolic, 4.1 (0.1–8.0); diastolic, 2.8 (0.05–5.6)]. However, few had blood pressure in the hypertensive range. It is concluded that antenatal corticosteroid therapy is associated with higher systolic and diastolic blood pressures in adolescence, and might lead to clinical hypertension in survivors well beyond birth.

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