Antihypertensive efficacy, tolerance, and safety of ramipril in young vs. old patients: a retrospective study.

The efficacy, tolerance, and safety of ramipril, an angiotensin-converting enzyme inhibitor, were assessed in 502 patients from five multicenter, double-blind studies who had mild-to-moderate essential hypertension. Each study was designed with a 4-week placebo run-in phase followed by 6 weeks of treatment with ramipril or one of five other antihypertensive treatments. A total of 412 young patients (17-65 years of age) and 90 old patients (66-87 years) in these studies received single daily doses of 5 or 10 mg of ramipril. At the end point of treatment, mean reductions in supine systolic blood pressure (19.4 mm Hg in young patients, 17.8 mm Hg in old) were significantly different, whereas mean reductions in supine diastolic blood pressure (13.3 mm Hg in young patients, 12.5 mm Hg in old) showed no significant difference. The number of responders was similar in both age groups: 68.6% and 71.1% of young and old patients respectively. No clinically relevant trends were observed in biochemical and hematological variables. Ramipril was well tolerated by both young and old patients, and there was little evidence that it was less safe in the elderly.

Tratamento da hipertensäo arterial: monoterapia da hipertensäo leve a moderada com dose única diária de prazosina cápsulas de liberaçäo gradual (SR) / Treatment of essential hypertension: monoterapy of mild and moderate forms with single daily doses of sustained-release prazosin

A eficácia e a tolerabilidade de uma nova formulaçäo de liberaçäo gradual do bloqueador do receptor pós-dináptico alfa, prazosina, foram investigadas em um estudo clínico multicêntrico aberto de pacientes ambulatoriais portadores de hipertensäo essencial leve e moderada. Com a posologia de dose única diária, as pressöes arteriais sistólica e diastólica foram significativamente reduzidas logo ao início do tratamento e durante as 12 semanas da duraçäo do estudo. Em média, a freqüência cardíaca permaneceu constante inicialmente e durante os três meses do período de tratamento. A dose inicial de prazosina de liberaçäo gradual (1mg) proporcionou uma reduçäo suave e regular da pressäo arterial, com mínimos efeito colaaterais. Além disso, a eficácia da droga permaneceu inalterada após os três meses de tratamento

A single-blind study of doxazosin in the treatment of essential hypertension when added to nonresponders to angiotensin-converting enzyme inhibitor therapy.

Doxazosin, a selective alpha 1-inhibitor, was assessed in hypertensive patients with sitting diastolic blood pressures (DBPs) of 95 to 114 mm Hg while receiving a stable dose of captopril or enalapril. Fifty-six patients were entered into the study that involved three phases: (1) a 2-week baseline period, (2) a 10-week period in which patients received doxazosin, 1 to 8 mg, once daily, and (3) a 4-week maintenance period. After 14 weeks of doxazosin treatment, 95% of the patients were therapy successes (sitting DBP either less than or equal to 90 mm Hg with greater than or equal to 5 mm Hg reduction or greater than or equal to 10 mm Hg reduction) at a mean daily dose of 2.4 mg. Ninety-three percent achieved blood pressure control (sitting DBP less than or equal to 90 mm Hg) at a mean dose of 2.3 mg once daily. By the final treatment visit, systolic/diastolic sitting blood pressures for efficacy evaluable patients were reduced by 16/17 mm Hg from a mean baseline of 158/101 mm Hg to a final value of 143/84 mm Hg. Throughout the study (2 to 14 weeks), all blood pressure reductions from baseline were significant (p less than 0.05). There was only one side effect (vertigo) that warranted dose reduction, and only one patient was withdrawn from therapy (nausea). Most side effects were mild or moderate and disappeared or were tolerated with continued therapy. No clinically significant laboratory changes were apparent, and no trends were observed with regard to organ systems or correlations with dose or duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term safety and efficacy of ketanserin in essential hypertension: ketanserin versus or in combination with metoprolol.

The long-term safety and efficacy of ketanserin in the treatment of essential hypertension was assessed in monotherapy or in combination with the beta-blocker, metoprolol. In an initial double-blind phase, 40 patients were randomized and treated for 12 weeks with either ketanserin or metoprolol. When compared with baseline placebo values, both drugs were significantly effective in reducing blood pressure levels. The antihypertensive action of ketanserin was more gradual than that of metoprolol. The incidence of side-effects was lower with ketanserin: six cases of mild bradycardia were noted with the beta-blocker. Following this phase, all patients received ketanserin therapy during a 12-month period in an open study. Those patients not controlled by monotherapy [i.e. diastolic blood pressure (DBP) greater than 90 mmHg] were treated by a combination of both drugs. Twenty-two patients receiving ketanserin monotherapy were successfully controlled for all of the period of observation [mean supine systolic blood pressure (SBP)/DBP = 142/88]. Side-effects were minimal, with no significant changes observed in biochemical or haematological measurements during the year-long open phase. The results of this study document the efficacy and safety of long-term treatment of essential hypertension with ketanserin.

[Comparative study of 2 diuretic-containing combination preparations in patients with edematous heart failure]. / Vergleichende Untersuchung zweier diuretikahaltiger Kombinationspräparate bei Patienten mit hydropischer Herzinsuffizienz.

The efficacy and tolerability of two combinations, namely 50 mg spironolactone + 20 mg furosemide (SF) or 50 mg spironolactone + 5 mg butizide (SB), were compared in a randomised intraindividual trial in 22 patients with congestive heart failure. The parameters used were: weight, ankle- and calf-circumference, blood pressure, resting pulse, resting ECG, spirometry and blood chemistry. The physicians' judgement of the success of treatment was also recorded. Clinical symptoms improved clearly in both groups and in most cases there was significant improvement of the various parameters. The trend towards improvement was more apparent with SF. The physicians considered SF to be more effective in 12 cases compared to one case with SB. In all other cases both treatments were considered equally effective. The blood chemistry data showed relevant differences: serum-potassium levels were less scattered with SF and showed a - desirable - shift into the upper normal range. The number of patients with elevated serum-creatinin-levels increased during SB-treatment whereas the opposite was noted with SF. This could be due to furosemide's positive effects on renal functions.

Effect of prazosin on blood pressure and plasma lipids in patients receiving a beta-blocker and diuretic regimen.

When prazosin was added to a beta-blocker/diuretic regimen, there was a further and statistically significant (p less than 0.05) reduction in blood pressure (12.7 percent supine diastolic pressure) but no significant change in heart rate. Mean high-density lipoprotein cholesterol increased by 10.8 percent (p less than 0.05) during prazosin treatment whereas very low-density lipoprotein and low-density lipoprotein cholesterol decreased. Together these changes contributed to a significant (p less than 0.05) increase in the ratio of high-density lipoprotein: low-density lipoprotein plus very low-density lipoprotein cholesterol of 13.3 percent. The reduction in total cholesterol was more marked in patients with elevated cholesterol levels (260 mg/100 ml or greater); in this group, total cholesterol and triglyceride levels were significantly reduced (p less than 0.05) during prazosin treatment.