The effectiveness of differentiated treatment of patients with essential hypertension

1982 ◽  
Vol 63 (2) ◽  
pp. 19-21
Author(s):  
Yu. A. Panfilov ◽  
N. N. Kryukov ◽  
E. D. Baibursyan

Abstract. Depending on the hemodynamic type and state of the kallikreinkinin 'blood system, differential treatment of 246 hypertensive patients was carried out using the beta-blocker anaprilin and the peripheral arteriolar vasodilator apressin. A pronounced hypotensive effect was observed in 82.5% of patients. In patients who underwent differential treatment, a decrease in blood pressure was observed 3.2 days earlier than in patients who were treated empirically; hospitalization terms were reduced by an average of 2.5 bed-days.

1973 ◽  
Vol 1 (2) ◽  
pp. 462-464
Author(s):  
Ann Dawson ◽  
Ian Smith ◽  
Brian F Johnson

In seven hypertensives receiving beta-blocker drugs, an additional reduction in standing blood pressure occurred between 60 and 90 minutes after 40 mg phentolamine by mouth. The occurrence of the postural hypotensive effect was delayed in relation to the reported time of peak plasma concentration of unchanged phentolamine. Supine blood pressure and heart rate were unaffected. Phentolamine has no clinically useful anti-hypertensive effect in conjunction with beta-blockers in patients with essential hypertension.


1974 ◽  
Vol 48 (s2) ◽  
pp. 77s-79s
Author(s):  
G. Leonetti ◽  
G. Mayer ◽  
A. Morganti ◽  
L. Terzoli ◽  
A. Zanchetti ◽  
...  

1. Stepwise increases of oral doses of propranolol produced both a significant lowering of blood pressure and suppression of plasma renin activity in sixteen patients with mild or moderate normal-renin essential hypertension. 2. The hypotensive and the renin-suppressive actions of propranolol were differently related to plasma propranolol concentrations. At the lowest propranolol concentrations (15–40 nmol/l), there was almost no decrease in blood pressure whereas plasma renin activity and responsiveness to renin-releasing stimuli (standing, intravenous frusemide) were already strongly depressed (greater than 50%). Therefore in a large number of normal-renin hypertensive patients under small doses of propranolol, the renin-suppressive action of the drug can be dissociated from the hypotensive effect. Dissociation of the two effects, though in the opposite way, was also observed in three of four low-renin hypertensive patients, whose blood pressure was decreased by propranolol without further reduction of the already suppressed plasma renin activity. 3. It is concluded that in patients with mild and moderate hypertension and low or normal plasma renin activity, the hypotensive effect of propranolol cannot be attributed to suppression of renin activity. These conclusions do not necessarily apply to high-renin hypertensive patients.


2020 ◽  
pp. 3753-3778
Author(s):  
Bryan Williams ◽  
John D. Firth

Essential hypertension is invariably symptomless and usually detected by routine screening or opportunistic measurement of blood pressure. However, once a patient has been labelled as ‘hypertensive’ it is not uncommon for them to associate preceding symptoms to their elevated blood pressure. Some patients will claim that they can recognize when their blood pressure is elevated, usually on the basis of symptoms such as plethoric features, palpitations, dizziness, or a feeling of tension. Screening surveys have demonstrated that these symptoms occur no more commonly in untreated hypertensive patients than they do in the normotensive population. However, there are two important caveats to the symptomless nature of essential hypertension: (1) symptoms may develop as a consequence of target organ damage, (2) headache may be a feature of severe hypertension.


Author(s):  
Pradeep Kumar Pal ◽  
Neera Saini ◽  
Mishra Vn ◽  
Awasthi Hh

Objective: Essential hypertension is the most frequent kind of hypertension and also known as primary hypertension or idiopathic, affecting 95% of hypertensive patients. This study was conducted to see the effect of Yogic practices as Nadi Shodhana Pranayama (NSP = cleaning of subtle energy channel along with regulation of rhythm of breathing) and Dhyana (meditation) on the symptoms of Raktagata Vata (essential hypertension), blood pressure, and Hamilton’s anxiety rating scale.Methods: This clinical study was conducted on 50 cases of Raktagata Vata, and these were randomly divided into two subgroups: (1) Control and (2) intervention consisting of 25 cases in each subgroup. Yogic practices were done regularly for 3 months by the registered cases in both subgroups. Light medication of first order initially was also prescribed to intervention subgroup.Result: In both subgroups, significant results (p<0.001) were observed and most of the symptoms of Raktagata Vata improved better in the intervention than control subgroup. Significant results (p<0.001) were also observed in blood pressure along with Hamilton’s anxiety scale scoring.Conclusion: Yogic practices impact positive effects on Agya Chakra (hypothalamus-cerebral system), control autonomic nervous system and improve the quality of life of Raktagata Vata patients by improving symptoms and regulating the blood pressure.


2019 ◽  
Vol 20 (3) ◽  
pp. 147032031986889 ◽  
Author(s):  
Piotr Ruszkowski ◽  
Anna Masajtis-Zagajewska ◽  
Michał Nowicki

Background: The aim of this study was to compare the influence of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors on endothelial function and blood pressure in patients with essential hypertension on long-term angiotensin-converting enzyme inhibitor therapy. Method: The study was designed as a prospective, double-blind, randomised, placebo controlled, crossover clinical trial. Twenty patients with essential hypertension were treated with an angiotensin-converting enzyme inhibitor; the control group included 10 healthy subjects. Hypertensive patients received in random order 80 mg of fluvastatin daily or placebo for 6 weeks. The following parameters were assessed at baseline and after each treatment period: serum lipids, flow-mediated vasodilation, activity of von Willebrand factor, concentration of vascular endothelial growth factor, C-reactive protein and 24-hour blood pressure profile. Results: Hypertensive patients did not differ from healthy subjects with respect to age, body mass and biochemical parameters, with the exception of C-reactive protein, which was higher in hypertensive patients ( P=0.02). After statin therapy, low-density lipoprotein cholesterol ( P<0.0001), C-reactive protein ( P=0.03), von Willebrand factor ( P=0.03) and vascular endothelial growth factor ( P<0.01) decreased and flow-mediated vasodilation improved ( P<0.001). Statins had no significant effect on blood pressure. Conclusions: Statins added to angiotensin-converting enzyme inhibitors may improve endothelial function and ameliorate inflammation independently of blood pressure.


1976 ◽  
Vol 51 (s3) ◽  
pp. 513s-515s
Author(s):  
L. Hansson ◽  
B. E. Karlberg ◽  
H. Åberg ◽  
A. Westerlund ◽  
N. C. Henningsen ◽  
...  

1. Atenolol (ICI 66.082, Tenormin) is a new β-adrenoreceptor-blocking agent, devoid of intrinsic sympathomimetic and membrane-stabilizing properties. It does not cross the blood—brain barrier. 2. Atenolol given to hypertensive patients in initial open trials reduced arterial blood pressure significantly. 3. A double-blind comparison between atenolol and placebo in forty-five patients with essential hypertension demonstrated that atenolol gave a statistically significant reduction of blood pressure (Δ 28/15 mmHg, P < 0·005). 4. The optimum anti-hypertensive dose of atenolol in patients with mild to moderately severe essential hypertension was 200 mg daily. 5. Atenolol was compared with propranolol in thirty patients with essential hypertension. No statistically significant differences of anti-hypertensive effect were observed between the two drugs. 6. Long-term results (up to 2 years) in 117 hypertensive patients indicate that drug tolerance is good. No serious toxic effects were observed. 7. In four of twelve hypertensive patients with obstructive airways disease atenolol had to be withdrawn owing to deterioration of ventilatory function.


1981 ◽  
Vol 60 (5) ◽  
pp. 483-489 ◽  
Author(s):  
W. Kiowski ◽  
F. R. Bühler ◽  
P. Vanbrummelen ◽  
F. W. Amann

1. Plasma noradrenaline concentrations and blood pressure were measured in 45 patients with essential hypertension and 34 matched normotensive subjects. Plasma noradrenaline was similar in both groups, but in the hypertensive patients plasma noradrenaline correlated with blood pressure. 2. The increase in forearm flow in response to an intra-arterial infusion of phentolamine was determined in 12 of the hypertensive and 14 of the normotensive subjects to assess the α-adrenoceptor-mediated component of vascular resistance. Although the dilator response to phentolamine was similar in both groups, in the hypertensive patients it was correlated with the control plasma noradrenaline (r = 0.83, P<0.01) as well as the height of mean blood pressure (r = 0.73, P<0.01). 3. These results suggest that in hypertensive patients plasma noradrenaline can be a marker for both sympathetic activity and the α-adrenoceptor-mediated component of vascular resistance.


1977 ◽  
Vol 52 (3) ◽  
pp. 319-323 ◽  
Author(s):  
R. F. Bing ◽  
J. Harlow ◽  
A. J. Smith ◽  
M. M. Townshend

1. The 24 h urinary excretion of adrenaline, noradrenaline, normetadrenaline, metadrenaline and vanilloylmandelic acid has been compared in 17 male normotensive subjects and 25 age-matched male hypertensive patients studied under similar in-patient conditions. 2. 24 h urinary metadrenaline was significantly lower in the hypertensive patients. With this exception, no significant differences were found between the two groups when the total 24 h excretion of free catecholamines and their metabolites was analysed. 3. Diurnal variation in free catecholamine excretion was found in both normotensive and hypertensive subjects. There was no corresponding variation in metabolite excretion. 4. No correlation could be established between systolic or diastolic blood pressure and the amounts of the catecholamines or their metabolites in the urine of either group. 5. The results are considered in the light of recent work demonstrating high plasma catecholamine concentrations in hypertension. They lend no support to the concept that excessive circulating catecholamines are responsible for the elevated blood pressure in essential hypertension.


1976 ◽  
Vol 51 (s3) ◽  
pp. 211s-213s
Author(s):  
M. Ulrych ◽  
Z. Ulrych

1. Relationships between labelled albumin disappearance rate (LADR), plasma volume, blood volume, plasma renin activity (PRA) and blood pressure (BP) were studied in normotensive control subjects and patients with hypertension of different aetiology and severity. In essential hypertensive patients without complications an inverse linear relationship was found between blood pressure and plasma or blood volume. 2. Very close inverse correlations were found between LADR and PRA in both normotensive subjects and patients with uncomplicated essential hypertension. LADR appears to be an excellent reference standard for PRA. 3. It is postulated that LADR mainly reflects the relation between circulating fluid and vascular capacitance tone. LADR is increased in hypertension and blood volume may still be inappropriately high.


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