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Current Medical Research and Opinion 2003The importance of blood pressure control in stroke prevention is supported by a large body of clinical evidence. However, it is not known which antihypertensive agents... (Review)
Review
The importance of blood pressure control in stroke prevention is supported by a large body of clinical evidence. However, it is not known which antihypertensive agents are most effective in preventing stroke. As stroke is characterised by vascular remodelling and dysfunction and by effects on the cerebral circulation, selecting an agent that has a direct vascular protective effect beyond blood pressure control may be desirable. Results with the angiotensin receptor blockers (ARBs) in clinical trials (LIFE and SCOPE) support the findings in animal models that ARBs may be a promising therapeutic option for prevention of stroke and possibly, cognitive decline.
Topics: Angiotensin Receptor Antagonists; Animals; Antihypertensive Agents; Benzimidazoles; Biphenyl Compounds; Cerebrovascular Circulation; Humans; Hypertension; Losartan; Rats; Rats, Inbred SHR; Stroke; Tetrazoles
PubMed: 13678484
DOI: 10.1185/030079903125001965 -
American Journal of Hypertension Jun 2000Rilmenidine is an antihypertensive agent with selectivity for I1 imidazoline receptors that acts both centrally by reducing sympathetic overactivity and in the kidney by... (Comparative Study)
Comparative Study Review
Rilmenidine is an antihypertensive agent with selectivity for I1 imidazoline receptors that acts both centrally by reducing sympathetic overactivity and in the kidney by inhibiting the Na+/H+ antiport. Rilmenidine provides antihypertensive efficacy comparable with that of diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. Experience from trials and clinical practice highlights rilmenidine's clinical and metabolic acceptability in hypertensive populations, including those at special risk because of old age, renal impairment, diabetes mellitus, or dyslipidemia. In the at-risk hypertensive, rilmenidine reduces left ventricular hypertrophy to a similar degree to other reference agents. New studies show a significant improvement in glucose metabolism in metabolic syndrome patients treated with rilmenidine, and a significant reduction in microalbuminuria during rilmenidine treatment of hypertensive type 2 diabetics. Thus the efficacy/tolerance ratio of rilmenidine supports its role as a first-line antihypertensive option for all groups of hypertensive patient, with specific advantages in some at-risk populations.
Topics: Albuminuria; Animals; Antihypertensive Agents; Diabetic Angiopathies; Humans; Hyperlipidemias; Hypertension; Hypertrophy, Left Ventricular; Insulin Resistance; Oxazoles; Rilmenidine; Treatment Outcome
PubMed: 10921529
DOI: 10.1016/s0895-7061(00)00226-0 -
The Senior Care Pharmacist Sep 2023Losartan is the only angiotensin II receptor blocker that has shown to significantly lower uric acid levels. The addition of or switch to losartan as an antihypertensive...
Losartan is the only angiotensin II receptor blocker that has shown to significantly lower uric acid levels. The addition of or switch to losartan as an antihypertensive agent for patients with gout is recommended by clinical guidelines because of its benefit as a uricosuric agent.
Topics: Humans; Hyperuricemia; Losartan; Gout; Antihypertensive Agents
PubMed: 37612850
DOI: 10.4140/TCP.n.2023.359 -
Best Practice & Research. Clinical... Dec 2001Fifty per cent of pregnancies are unplanned, and 1-6% of young women have pre-existing hypertension. However, no commonly used antihypertensive agent is known to be... (Review)
Review
Fifty per cent of pregnancies are unplanned, and 1-6% of young women have pre-existing hypertension. However, no commonly used antihypertensive agent is known to be teratogenic. ACE inhibitors (and angiotensin-receptor antagonists) should be discontinued due to fetotoxicity. Five to 10% of pregnant women have hypertension, of which pre-existing hypertension is but one type. There is consensus that severe maternal hypertension (blood pressure >or=170/110 mmHg) should be treated to minimize the risk of acute cerebrovascular complications. Parenteral hydralazine may be associated with a higher risk of maternal hypotension, and intravenous labetalol with neonatal bradycardia. There is no consensus that mild-to-moderate hypertension in pregnancy should be treated. Clinical trials indicate that transient severe hypertension, antenatal hospitalization, proteinuria at delivery and neonatal respiratory distress syndrome may be decreased by normalizing blood pressure, but intrauterine fetal growth restriction may be increased. Methodological problems with published trials warrant cautious interpretation of these findings. Methyldopa and beta-blockers have been used most extensively, although atenolol may impair fetal growth in particular and should be avoided.
Topics: Antihypertensive Agents; Female; Humans; Hypertension; Infant, Newborn; Infant, Small for Gestational Age; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Outcome
PubMed: 11800527
DOI: 10.1053/beog.2001.0232 -
The American Journal of Medicine Sep 1989Rilmenidine is a novel antihypertensive agent related to alpha 2-adrenoceptor agonist, used in the treatment of mild or moderate hypertension at the oral dose of 1 mg...
Rilmenidine is a novel antihypertensive agent related to alpha 2-adrenoceptor agonist, used in the treatment of mild or moderate hypertension at the oral dose of 1 mg once a day or 1 mg twice a day. The pharmacokinetic parameters were investigated after single or repeated administration in healthy subjects, using labeled and unlabeled compounds. Rilmenidine was rapidly and extensively absorbed, with an absolute bioavailability close to one and a time to peak plasma concentration of two hours. Rilmenidine was not subjected to presystemic metabolism. Distribution was independent of the free fraction since rilmenidine was weakly bound to plasma proteins (less than 10 percent). The volume of distribution was approximately 5 liters/kg (315 liters). Elimination was rapid, with a total body plasma clearance of approximately 450 ml/minute and an elimination half-life of approximately eight hours. Renal excretion was the major elimination process (two thirds of the total clearance); the parent drug in urine accounted for about 65 percent of the dose administered. Metabolism was very poor; few metabolites were found in urine and no metabolites were detected in plasma. Linear pharmacokinetics was demonstrated for rilmenidine from 0.5 to 2 mg; at 3 mg, a slight deviation from linearity was observed. In repeated administration, the linearity with dose of the pharmacokinetics of rilmenidine was confirmed.
Topics: Adult; Antihypertensive Agents; Biological Availability; Capsules; Carbon Radioisotopes; Female; Food; Humans; Male; Oxazoles; Rilmenidine; Solutions; Tablets
PubMed: 2782323
DOI: 10.1016/0002-9343(89)90500-7 -
MedGenMed : Medscape General Medicine May 2005The hypertensive patient with type 2 diabetes is especially at risk of adverse cardiovascular events. The United Kingdom Prospective Diabetes Study (UKPDS) and... (Review)
Review
The hypertensive patient with type 2 diabetes is especially at risk of adverse cardiovascular events. The United Kingdom Prospective Diabetes Study (UKPDS) and Hypertension Optimal Treatment (HOT) studies suggested that treatment to a lower target blood pressure resulted in better prevention of clinical disease in these patients. Most trials comparing antihypertensive drugs have shown only minimal differences between the various agents. The evidence from the trials suggests that diuretics, beta-blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors, and the angiotensin-receptor antagonists (ARBs) will all successfully reduce adverse clinical events. The largest of the comparative hypertensive drug trials, the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), demonstrated that a diuretic has a better hypotensive effect, and was more successful in preventing many aspects of cardiovascular disease compared with CCBs and ACE inhibitors. The importance of good blood pressure control and the general equivalence of antihypertensive drugs were again shown in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, which compared an ARB with a CCB. Choice of antihypertensive agent should be individualized and guided by the presence of concomitant clinical disease and the need to protect any specific target organ system in the diabetic hypertensive. Diuretics, being potent hypotensive drugs with clearly demonstrated clinical benefit, should form part of the antihypertensive regimen of most diabetic hypertensives. ACE inhibitors and ARBs are especially useful in preventing nephropathy. Most patients will require a combination of antihypertensive drugs to achieve tight blood pressure control of under 130/80 mm Hg in the diabetic hypertensive. The clinician should concentrate on seeking this lower target blood pressure rather than be excessively concerned about which is the best antihypertensive agent.
Topics: Antihypertensive Agents; Cardiovascular Diseases; Clinical Trials as Topic; Diabetes Mellitus, Type 2; Humans; Hypertension; Practice Guidelines as Topic; Practice Patterns, Physicians'; Treatment Outcome
PubMed: 16369452
DOI: No ID Found -
Journal of Medicinal Chemistry Dec 1980Starting with 2,6-dichlorophenyl isothiocyanate, 1-(2-aminoethyl)-2-cyano-3-(2,6-dichlorophenyl)guanidine (2) was prepared in three steps. In contrast to the...
Starting with 2,6-dichlorophenyl isothiocyanate, 1-(2-aminoethyl)-2-cyano-3-(2,6-dichlorophenyl)guanidine (2) was prepared in three steps. In contrast to the corresponding thiourea 1, this compound was essentially inactive as an antihypertensive agent.
Topics: Animals; Antihypertensive Agents; Heart Rate; Male; Rats; Thiourea
PubMed: 6779010
DOI: 10.1021/jm00186a027 -
Current Hypertension Reports Dec 2022To review the pathophysiology of hypertension in Alzheimer's disease and related dementias and explore the current landscape of clinical trials involving treatment of... (Review)
Review
PURPOSE OF REVIEW
To review the pathophysiology of hypertension in Alzheimer's disease and related dementias and explore the current landscape of clinical trials involving treatment of hypertension to improve cognition.
RECENT FINDINGS
Hypertension is increasingly recognized as a contributor to cognitive impairment. Clinical trials that explore blood pressure reductions with cognitive outcomes have been promising. Various antihypertensives have been evaluated in clinical trials, with growing interest in those agents that impact the renin-angiotensin-aldosterone system due to its own association with cognitive impairment. No antihypertensive agent has been found to be superior to others in reducing cognitive impairment risk or conferring neuroprotective benefits. In this review, the pathophysiology of and clinical trial data involving hypertension and dementia will be explored. Hypertension is a significant risk factor for the development of neurodegenerative dementias, and clinical trials have been overall favorable in improving cognition by reductions in blood pressure using antihypertensive agents.
Topics: Humans; Hypertension; Alzheimer Disease; Antihypertensive Agents; Renin-Angiotensin System; Blood Pressure
PubMed: 36125695
DOI: 10.1007/s11906-022-01221-5 -
Nihon Rinsho. Japanese Journal of... Aug 2014This clause explains a diuretic as an antihypertensive agent. A diuretic is a medicine used as a first-line agent also in the present. As an antihypertensive agent, a... (Review)
Review
This clause explains a diuretic as an antihypertensive agent. A diuretic is a medicine used as a first-line agent also in the present. As an antihypertensive agent, a thiazide-type diuretic drug is used in many cases. Use of furosemide is not recommended other than a chronic kidney disease patient. Considering future medical economics, it is desirable to use a diuretic drug positively.
Topics: Antihypertensive Agents; Diuretics; Humans; Hypertension; Mineralocorticoid Receptor Antagonists; Practice Guidelines as Topic; Renal Insufficiency, Chronic
PubMed: 25167755
DOI: No ID Found -
Stroke Jul 2018
Review
Topics: Antihypertensive Agents; Blood Pressure; Brain Ischemia; Humans; Hypertension; Stroke
PubMed: 29895536
DOI: 10.1161/STROKEAHA.118.021254