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Biomedical subjects

S G Chrysant

Publications and source records attributed to S G Chrysant.

At least 19 recordsLinked to original sources

Antihypertensive and metabolic effects of concomitant administration of terazosin and methyclothiazide for the treatment of essential hypertension.

The efficacy and safety of once-daily 2.5- or 5.0-mg methyclothiazide (MCTZ) added to once-daily 5.0-mg terazosin (TRZ) versus 5.0-mg TRZ alone was evaluated in this double-blind, multicenter study. All patients received TRZ during a 6-week titration period. Hypertensive patients (222) (mean blood pressure of 159/104 mm Hg) were randomized to one of three treatment groups: TRZ alone (N = 76); TRZ+MCTZ-2.5 mg (N = 74); and TRZ+MCTZ-5.0 mg (N = 72) for the 8-week double-blind period. Changes in the supine and standing SBP/DBP from preTRZ period were: TRZ alone (-4.8/-8.1 and -2.6/-6.1 mm Hg); TRZ+MCTZ-2.5 mg (-17.3/-12.4 and -16.0/-11.2 mm Hg); and TRZ+MCTZ-5.0 mg (-20.6/-14.4 and -23.3/-14.6 mm Hg). Blood pressure changes in the combination groups were significantly greater than those in the TRZ alone group. However, there were no statistically significant differences between the TRZ+MCTZ-2.5-mg and TRZ+MCTZ-5.0-mg groups. The combination of TRZ and MCTZ tends to mitigate the adverse effects on serum glucose, uric, potassium and lipids usually associated with thiazide diuretics. Thus, combination treatment that begins with TRZ and adds MCTZ is effective in lowering blood pressure without any significant adverse metabolic effects.

Adrenergic alpha-Antagonists

Effects of high salt intake and meclofenamate on arterial pressure and renal function in the spontaneously hypertensive rat.

1. The effects of prolonged high sodium intake (duration 3 months) and meclofenamate were studied in two groups of male spontaneously hypertensive (SH) rats. 2. Group 1 (eight rats) received 1% NaCl in water and served as controls, and group 2 received 1% NaCl in water plus meclofenamate (3.5-4.0 mg daily). 3. Group 2 rats developed higher arterial pressure, renal vascular resistance and left ventricular weight and greater renal histological changes, with lower effective renal plasma flow, renal blood flow and glomerular filtration rate, than group 1. No differences were observed between the two groups in heart rate, body weight, fluid intake, urine volume, UNaV, UKV and right ventricular weight. 4. The results suggest that the combination of high sodium intake and meclofenamate exerts a greater damaging effect on the arterial presssure and renal function of SH rats than salt alone.

Animals

Antihypertensive and renal effects of tienilic acid.

Tienilic acid, a diuretic agent effective at the cortical diluting segment of the distal tubule, has been found to have equivalent antihypertensive action in a dose of 250 mg twice daily to hydrochlorothiazide in a dose of 50 mg twice daily. Tienilic acid reduced arterial pressure without diminishing renal plasma flow or endogenous creatinine clearance; moreover, it did so whilst achieving hypouricaemia through a uricosuric effect. Hypokalaemia was observed but corrected by supplemental potassium. A transient but reversible, slight elevation in serum creatinine concentration and significant hypertriglyceridaemia were also observed. In conclusion, tienilic acid seems to be a novel diuretic, well-suited for the patient with hypertension, particularly if there is coincidental gout or coexisting hyperuricaemia.

Glycolates

Ticrynafen: a novel uricosuric antihypertensive natriuretic agent.

Interest in new diuretics with less side effects has led to the synthesis of ticrynafen, an uricosuric diuretic. This agent was compared with hydrochlorothiazide in a crossover design study involving 12 hypertensive men. Both agents significantly decreased mean arterial pressure from 8% to 18% in eight of the 12 patients. In addition to reducing body weight, these diuretics induced reversible changes in BUN and carbon dioxide content (increased) and plasma concentration of potassium and chloride ions (decreased). The most important change in renal function was a 2.5-fold increase in fractional urate clearance by ticrynafen associated with reduction of serum uric acid by 62%. Thus, ticrynafen is a promising therapeutic agent in hypertension, adding a unique uricosuric effect that should improve patient compliance.

Blood Pressure

Abrupt cessation of clonidine administration: a prospective study.

In 20 patients with mild to moderate hypertension, the effects of abrupt cessation of clonidine therapy on blood pressure, heart rate and catecholamine excretion were evaluated. In a double blind, crossover study, placebo was substituted for clonidine after 3 days of therapy and again after 30 days. The results demonstrated no instances of clinically significant symptoms or overshoot in blood pressure or heart rate. There was an overshoot in norepinephrine excretion that approached the upper limits of normal. Thus, a clinical withdrawal syndrome associated with abrupt cessation of clonidine was not seen in this study of patients without severe hypertension who were given the drug without a diuretic agent.

Adult

Hemodynamic correlates of saralasin-induced arterial pressure changes.

Angiotensin antagonists have proved useful in elucidating the clinical role of the renin-angiotensin system; and their diagnostic and therapeutic efficacy in hypertension has been the subject of many reports but the hemodynamic effects remain unknown. Therefore, saralasin was infused intravenously (1.3 mg/min for 30 min) in 26 sodium-depleted patients with hypertension. Systemic hemodynamic alterations were determined before, during, and after infusion. On the basis of mean arterial pressure (MAP) changes, patients were classified as responders, nonresponders, or pressorresponders (MAP changes greater than or equal to 10 mm Hg). MAP fall in responders was achieved through reduced cardiac output and/or total peripheral resistance, with minimal or absent reflexive heart rate increase. In nonresponders, despite no change in MAP, output fell in parallel with stroke index and left ventricular ejection rate, In pressorresponders, saralasin increased vascular resistance. Thus, in addition to variable effects on vascular receptors, saralasin produced inhibitory cardiac effects either through altered venous return or inhibition of contractility.

Adult

Hemodynamic changes induced by prolonged NaCl and DOCA administration in spontaneously hypertensive rats.

The results of this study demonstrate that the spontaneously hypertensive rat is sensitive to salt excess. The hypertensinogenic effect of salt was mediated through elevation of peripheral vascular resistance. The addition of DOCA aggravated the hypertension, mainly be elevating the cardiac output without appreciably decreasing peripheral vascular resistance. SHR'S EXPOSED TO 1% NaCl consumed more fluids and excreted more sodium and urine than control rats. Those exposed to 1% NaCl and DOCA had higher fluid consumptions and excreted more sodium than the other two groups. These effects of sodium in a neurogenic strain of hypertensive rats suggest a possible interplay between the neurogenic and salt-dependent components in the development and maintenance of hypertension. They also suggest that SHRs, like other hypertensive rat models, are salt sensitive.

Animals

Hemodynamic effects of isometric exercise in normotensive and hypertensive subjects.

Isometric exercise increases arterial pressure and heart rate in normotensive individuals and also in patients with labile and fixed essential hypertension. The hypertensinogenic effect of isometric exercise is mediated through an increase in cardiac output because the peripheral vascular resistance is usually not affected. The cardioaccelerating effects of isometric exercise are mediated through an initial vagal withdrawal and a later stimulation of the sympathetic system. However hypertensive patients with defective sympathetic adjustments are not immune to the hypertensinogenic and cardioaccelerating effects of isometric exercise. Since isometric exercises are performed several times during daily activities, they may result in dangerous elevations in arterial pressure in patients with already increased arterial pressure, and this may eventually lead to cerebrovascular accidents and/or cardiac decompensation. It is therefore recommended that patients with elevated arterial pressure, or persons prone to hypertension, should refrain from such activities.

Blood Pressure

Action of Nitroglycerin and amyl nitrite in labile and essential hypertension: hemodynamic differences.

Seventeen patients with labile hypertension received nitroglycerin and 18 received amyl nitrite. Twelve patients with established essential hypertension received nitroglycerin and 12 received amyl nitrite. Nitroglycerin reduced the systolic and mean arterial pressures and cardiac output in both groups, but had no effect on diastolic pressure and total peripheral resistance. Amyl nitrite decreased systolic, diastolic, and mean arterial pressures and peripheral vascular resistance and increased heart rate and cardiac output in labile hypertensives. In established hypertensive patients, amyl nitrite decreased systolic, diastolic, and mean arterial pressures and cardiac output, and had little effect on peripheral vascular resistance. Nitroglycerin reduced arterial pressure in labile and established hypertensives through venodilation and peripheral venous pooling. Amyl nitrite and effects similar to nitroglycerin in established hypertensives; in labile hypertensives it reduced arterial pressure through arterial dilation and a decrease in peripheral vascular resistance.

Adult

Systemic and renal hemodynamic effects of bupicomide: a new vasodilator.

The systemic and renal hemodyanmic effects of bupicomide were studied in 10 male patients with uncomplicated essential hypertension of moderate severity. Bupicomide significantly reduced systolic, diastolic, and mean arterial pressure and peripheral vascular resistance and this hypotensive effect was associated with a reflexive increase in heart rate, left ventricular ejection rate, and cardiac index; it had no effect upon other reflexive sympathetic adjustments induced by upright tilt and the Valsalva maneuver. Bupicomide also increased renal blood flow and decreased renal vascular resistance, but it had no effect upon the glomerular filtration rate. The hypotensive mechanism of bupicomide therefore is mediated by peripheral arteriolar dilation, through vascular smooth muscle relaxation. The more immediate clinical side effects of bupicomide are related to its strong vasodialting action and include headaches, cutaneous flushing, and tachycardia.

Clinical Trials as Topic