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Biomedical subjects

E Vander Elst

Publications and source records attributed to E Vander Elst.

12 recordsLinked to original sources
PubMed1993

Short report: ramipril and hydrochlorothiazide combination therapy in hypertension: a clinical trial of factorial design. The East Germany Collaborative Trial Group.

OBJECTIVE: To identify appropriate dosages of ramipril and hydrochlorothiazide (HCT) when given in combination once a day for the treatment of essential hypertension. DESIGN: A 2- or 4-week placebo run-in followed by 6-week, double-blind, parallel-group phase: 4 x 3 factorial (2.5, 5 and 10 mg ramipril; 12.5 and 25 mg HCT; all six combinations; placebo). SETTING: Office practice (21 centres). PATIENTS AND PARTICIPANTS: Patients with mild-to-moderate essential hypertension (World Health Organization stage I-II; supine diastolic blood pressure 100-115 mmHg in last 2 weeks of run-in): 581 enrolled, 534 randomly assigned to double-blind therapy and 517 completed. MAIN OUTCOME MEASURES: Reduction in supine and standing blood pressure. RESULTS: In pairwise comparisons, the combinations of 5 mg ramipril with 12.5 and 25 mg HCT and 10 mg ramipril with 12.5 mg HCT consistently produced significantly greater blood pressure reductions than their respective components. Response surface analyses were performed, and a stairstep model was constructed to characterize the shape of the dose-response surface. The combinations involving 5 and 10 mg ramipril with 12.5 and 25 mg HCT were again more effective than their components. Withdrawals and adverse effects were minimal for all treatments. A large drop in serum potassium was observed on 25 mg HCT, but not on combination therapy. Addition of ramipril appeared to reduce the hyperuricaemic effect of HCT. CONCLUSIONS: Several dosage combinations of ramipril plus HCT produced significantly greater blood pressure reductions than the monotherapies at the same dosages. Overall, the combination of 5 mg ramipril and 25 mg HCT gave the best mean reduction. Combination therapy with ramipril plus HCT was safe and effective for patients with mild-to-moderate essential hypertension.

Double-Blind Method↗
PubMed1983

Penbutolol in hypertension, alone and in combination with furosemide. A long-term multicentre study.

Penbutolol is a new, potent and long-acting non-cardioselective beta-adrenergic blocker which has been evaluated in a 6-month open study of patients with moderate essential or renal hypertension. Eighty-two patients entered the study and 69 completed at least 3 months of treatment. Two-thirds of these showed a good response to penbutolol given alone as a single daily dose of either 40 mg or 80 mg. The major reduction in blood pressure occurred within the first 2 weeks of active therapy. This response was maintained for the entire study period. Blood pressure reduction after penbutolol did not correlate wtih the small reduction in heart rate observed. The remaining patients were treated with a combination of penbutolol and furosemide and most had achieved satisfactory control of their blood pressure by the end of the study. Penbutolol was well tolerated and produced no serious adverse effects. Some patients developed gastro-intestinal side-effects at the beginning of treatment which subsequently resolved. One patient with chronic glomerulonephritis showed a marked deterioration in renal function during the study. This may well have been related to disease progression. No other significant changes in biochemical or haematological parameters were observed.

Adult↗
PubMed1981

Controlled comparison of the effects of furosemide and hydrochlorothiazide added to propranolol in the treatment of hypertension.

Forty patients completed a double-blind parallel group study comparing furosemide (FUR) and hydrochlorothiazide (HCT) when added to a stable dose of beta blocker in the treatment of mild to moderate hypertension. Both diuretics caused a significant additional fall in blood pressure (BP) when added to propranolol, and there were no differences in the mean BP achieved. However, a higher proportion of patients achieved satisfactory control (BP less than 160/95 mm Hg) on FUR than on HCT and, in addition, there was a more marked dose-response effect with FUR. This study showed that FUR is at least as effective as HCT in the treatment of hypertension when added to propranolol, and appears to possess certain advantages in comparison to the thiazide.

Adult↗
PubMed1981

Penbutolol or hydrochlorothiazide once a day in hypertension. A controlled study with home measurements.

1 The hypotensive effect of single daily dosing with 80 mg penbutolol was compared to 100 mg hydrochlorothiazide and placebo in a double-blind cross-over controlled trial with daily home measurements in ten hypertensive patients. 2 Penbutolol, 80 mg once a day, reduced significantly the supine and standing blood pressure. 3 This hypotensive effect was more potent than hydrochlorothiazide 100 mg particularly in the evening. 4 The hypotensive effect remained for 24 h as shown by the evening (14 h after dose) and morning (24 h after dose) blood pressure readings. 5 No relevant subjective or physical side effects were recorded. There was no significant change nor individual noticeable variation in biochemical data during penbutolol treatment. However, during hydrochlorothiazide treatment, the expected electrolyte changes were observed (symptom-free hypokalemia and hyperuricemia). 6 Penbutolol serum concentration showed no cumulation after one month of treatment. 7 Sudden withdrawal of penbutolol after 1 month of therapy resulted in a slow return to baseline blood pressures over a 2-week period without rebound.

Blood Pressure↗
PubMed1975

[Studies on the bio-availability of tolbutamide (author's transl)].

Two different batches of Rastinon 1,0 Hoechst were administered, a year apart, to two groups of healthy subjects (ten and six men, respectively) without any difference in effect on blood sugar being found. The blood sugar concentration was measured in six healthy men before and after oral administration of 1,000 mg tolbutamide (as Rastinon 1,0 Hoechst or tolbutamid tablets Ratiopharm), in a blind test. After tolbutamide Ratiopharm, the area under the blood sugar concentration-time curves was only 29 percent (0-4 hafter medication) and 32 percent (4-8 h after medication) of that after Rastinon 1,0 (P 2alpha less than 0.01), with marked scatter between individuals. Maximal serum concentration was 80 percent below that after Rastinon. The first measurable value was reached 0.8 plus or minus 0.2 h after medication of Rastinon and 3.6 plus or minus 0.8 h after tolbutamide Ratiopharm. The areas under the serum concentration under the curves after tolbutamide Ratiopharm were only 16 percent (0-4 h after medication) and 19 percent (0-8 h after medication) of those after Rastinon (P 2alpha less than 0.05 and 0.01, respectively). The differences demonstrate that tolbutamide Ratiopharm tablets and Rastinon 1,0 Hoechst are not equivalent biologically and therapeutically.

Administration, Oral↗