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Biomedical subjects

P Pörsti

Publications and source records attributed to P Pörsti.

10 recordsLinked to original sources
PubMed1988

Effects of the converting enzyme inhibitor quinapril (CI-906) on blood pressure, renin-angiotensin system, and prostanoids in essential hypertension.

Fourteen patients with mild to moderate essential hypertension were randomized, after a baseline placebo period of 4 weeks, to receive the angiotensin converting enzyme (ACE) inhibitor quinapril or a placebo. During a 12 week, double-blind phase, the dosage of quinapril was increased from 10 to 40 mg twice daily being doubled every 4 weeks. At the end of the baseline period and of each month of the double-blind phase, 12 h overnight urine collections were made and morning blood samples were taken about 12 h after the last dose of medication. During the double-blind phase, blood pressure in the quinapril group (n = 7) decreased from 159 +/- 3/105 +/- 1 to 141 +/- 6/94 +/- 2 mm Hg (mean +/- SEM). Serum ACE activity and plasma angiotensin II concentration were reduced to 4 +/- 1% and 14 +/- 1% of the pretreatment values, respectively. Neither the plasma concentrations nor the urinary excretions of prostaglandin E2, 6-keto-prostaglandin F1 alpha (a prostacyclin metabolite), or thromboxane B2 (a metabolite of thromboxane A2) were affected by quinapril. In the placebo group, blood pressure tended to decline but the biochemical variables remained essentially unchanged. These results indicate that prostanoids are not involved in the antihypertensive action of quinapril, the principal effect of which seems to be inhibition of the renin-angiotensin system.

Adult↗
PubMed1987

Serum lipid changes in a one-year, multicenter, double-blind comparison of doxazosin and atenolol for mild to moderate essential hypertension.

Proatherogenic changes in serum lipid concentrations have been implicated as one of the major risk factors in the development of coronary artery disease. In a double-blind study, the new alpha 1-adrenoceptor inhibitor, doxazosin, was compared with atenolol for effects on the serum lipid profile. Ninety-six hypertensive patients were treated for up to 1 year with either doxazosin or atenolol once daily. There were statistically significant differences (p less than or equal to 0.01) between doxazosin and atenolol after 20 to 52 weeks of treatment in changes from baseline total triglyceride levels, high density lipoprotein (HDL) cholesterol levels and HDL/total cholesterol ratio. The percentage of change from baseline and the statistical significance of the difference between treatment groups were: total triglycerides, doxazosin -5.9%, atenolol +32.4% (p = 0.01); HDL cholesterol, doxazosin +7.2%, atenolol -5.6% (p = 0.007) and HDL/total cholesterol ratio: doxazosin +8.7%, atenolol -6.2% (p = 0.006). All mean changes were in favor of doxazosin therapy. In addition, doxazosin treatment beneficially decreased total serum cholesterol levels (-1.6%) compared with atenolol (+0.6%), although not to a significant degree. The differences were maintained in the cohort of 67 patients treated for a full year. The favorable change exerted by doxazosin on the lipid profile suggests that it may have a beneficial influence on the lipid risk factor. These results, together with the sustained decrease in blood pressure achieved for up to 1 year of therapy, suggest that doxazosin may reduce the risk of coronary artery disease in susceptible patients.

Adrenergic alpha-Antagonists↗
PubMed1986

A long-term double-blind comparison of doxazosin and atenolol in patients with mild to moderate essential hypertension.

The efficacy and safety of doxazosin and atenolol were compared following once-daily administration for up to 1 year, with a minimum of 20 weeks' active treatment. According to response, patients received doxazosin 1-16 mg day-1 or atenolol 50-100 mg day-1. Mean daily doses at the final efficacy assessment (between 20 weeks and 1 year) were doxazosin 11.8 mg and atenolol 94.2 mg. Atenolol produced somewhat greater falls in blood pressure than doxazosin. The differences were statistically significant in the supine but not in the standing position. A small mean reduction in heart rate was produced by doxazosin whereas atenolol produced a marked bradycardia. Analysis of the same patient group at 20 weeks revealed similar overall profiles of activity except that atenolol produced greater falls in blood pressure than in the longer term analysis. Serum concentrations of HDL/total cholesterol ratio were raised in the doxazosin treatment group and lowered in the atenolol group. Triglyceride concentrations fell in the doxazosin group and rose in the atenolol group. Significant differences (P less than 0.001) were observed between treatment groups for these parameters, all differences being in favour of doxazosin. Pharmacokinetics of doxazosin, measured at steady state in 36 patients, showed dose-related plasma concentrations, a mean half-life of about 12 h and relatively low intersubject variation. The incidence of side-effects was slightly greater for patients in the doxazosin group. Drug-related side-effects were mostly mild to moderate in severity with no serious drug-related occurrences in either treatment group. No serious drug-related abnormalities in laboratory biochemistry and haematology tests were observed in either treatment group.

Adult↗
PubMed1982

Effect of pindolol and propranolol on renal function of patients with hypertension.

1 Pindolol and propranolol were administered orally in equipotent antihypertensive doses to 14 subjects with mild to moderate hypertension in an open cross-over study. 2 Pindolol caused a smaller decrease in plasma renin activity and heart rate than propranolol. 3 Glomerular filtration rate and effective renal plasma flow remained unchanged during therapy with either agent.

Adult↗
PubMed1981

Antihypertensive action of drug combination: Timolol, hydralazine, hydrochlorothiazide and triamterene.

A fixed combination tablet containing 5 mg of timolol, 25 mg of hydralazine, 25 mg of hydrochlorothiazide and 37.5 mg of triamterene was prepared and its antihypertensive effect compared with placebo in a randomized double-blind cross-over study lasting 16-20 weeks. 37 patients entered the study and 32 of them completed it. The trial drug caused a highly significant drop in blood pressure in both the supine and standing positions (from 172/112 to 142/91 mm Hg supine and from 168/17 to 136/100 mm Hg standing). There was also a highly significant fall in heart rate. Three patients were nonresponders with maximal dose used (4 tablets daily) and two patients had to withdraw from the trial because of complications. In general the side effects recorded were mild and equally common both on placebo and the trial drug. The serum potassium level was well maintained. The serum urate concentration was increased, but no signs of gout were observed. The conclusion was that this fixed combination of timolol, hydralazine, hydrochlorothiazide and triamterene is effective and well tolerated in the treatment of mild to moderate hypertension.

Adult↗
PubMed1978

Penbutolol, a new non-selective beta-adrenergic blocking compound in the treatment of hypertension. A comparision with propranolol.

The antihypertensive effect of a new non-selective beta-adrenergic blocking compound, penbutolol (40 mg b.i.d.), was compared with propranolol (160 mg b.i.d.) in a series of 20 hypertensive patients using a double-blind cross-over scheme. Both compounds reduced both the supine and the standing blood pressure significantly. The magnitude of the responses did not differ significantly and both compounds evoked a commensurate decrease in heart rate. No significant side-effects were noted and a series of laboratory tests did not disclose any biochemical changes.

Adrenergic beta-Antagonists↗
PubMed1976

Combined alpha- and beta-adrenoceptor blockade with labetalol in hypertension.

The antihypertensive effect of labetalol, a new alpha- and beta-adrenoceptor inhibiting agent, was studied in 20 patients in a double-blind crossover trial. A dose of 300 mg daily reduced blood pressure only moderately in the supine position, though in the sitting and standing positions the effect was more pronounced. A dose of 600 mg daily produced statistically significant and clinically relevant reductions in blood pressure in all positions studied. The effect on heart rate was small and of significance only in reducing the heart rate increment due to a change in posture. Side effects were mild: only one patient complained of postural dizziness with the higher dose. We conclude that labetalol is useful in the treatment of mild and moderately severe hypertension.

Adult↗
PubMed1976

A comparison of debrisoquine and methyldopa in hypertension.

Debrisoquine, an antihypertensive agent, was compared with methyldopa in a double-blind trial in the treatment of hypertension in 20 patients. The cross-over method was used to treat each patient with first one and then the other drug for two periods of six weeks each. Two placebo periods of two weeks each were also included, one before the trial, and the other between the two therapy periods. The maximum daily dose was 3 X 10 mg debrisoquine compared with 3 X 250 mg methyldopa. Hydrochlorothiazide, 50 mg daily, was added in all cases for the entire trial. Both preparations lowered blood pressure statistically significantly (p less than 0.005). Tablet for tablet, debrisoquine had a slightly more pronounced effect than methyldopa, but the difference was not statistically significant. Both drugs were well tolerated and in no case had treatment to be interrupted because of side effects. Debrisoquine produced less sedation and dizziness than methyldopa. The conclusion was that both drugs were equally effective in the doses studied and well tolerated and that debrisoquine is of value in the treatment of moderate hypertension.

Adult↗