Archive for the ‘Hypertension’ Category


Treatment of Severe Hypertension with Atenolol and Betaxolol with Once-Daily Regimens  Hemodynamic Aspects: ConclusionThe lack of significant weight gain at the end of our study is misleading, because most patients required major increases in the dosage of furosemide during the drug titration period. Thus, long-term administration of minoxidil in both hypertensive animals and man causes volume overload and ventricular dilatation. Although these changes may lead to congestive heart failure and pulmonary edema in patients with compromised myocardium, there are to date no data on whether similar complications develop eventually in patients with normal myocardium. For the six-month duration of this study, none of our patients developed dyspnea or pulmonary edema, and the indices of myocardial contractility, such as myocardial fiber shortening and ejection fraction, remained unchanged from baseline. (more…)

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  • Triple therapy of severe hypertension with the long-acting cardioselective (3-blockers atenolol and betaxolol in combination with furosemide and minoxidil were effective and well tolerated by most patients in our study. The drug regimens exerted similar, smooth, sustained antihypertensive effects, as demonstrated by clinical and 24-h ambulatory arterial pressure measurements. Although these regimens were effective and convenient, they were associated with several side effects, the most important of which were edema and cardiac enlargement. The cardiac enlargement was probably due to a preloading effect on the left ventricle from sodium and water retention. It was not likely to be an afterloading effect, since the arterial pressure was significantly decreased with treatment and remained within normal limits during the tripletherapy phase of the study. mycanadianfamilypharmacy.net
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  • Treatment of Severe Hypertension with Atenolol and Betaxolol with Once-Daily Regimens  Hemodynamic Aspects: ResultsThe baseline clinical characteristics of the two groups of patients are listed in Table 1. The patients were male, predominantly white, and there were no significant differences with respect to age, weight, arterial pressure, and heart rate, both supine and upright, between the two groups.
    Antihypertensive Effects
    The addition of atenolol or betaxolol to diuretic baseline therapy resulted in significant and similar decreases in arterial pressure (p<.001) by both clinic visits and ambulatory measurements (Tables 2 and 3, Fig 1 to 4), and this effect was further enhanced with the addition of the vasodilator. In addition to lowering the arterial pressure, both atenolol and betaxolol significantly decreased the heart rate (p<.001), and the addition of the vasodilator had no appreciable effect (Tables 2 and 3). read more
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  • They were seen in the morning 24 ±2 h after receiving the last dose of medication. Arterial pressure was taken in triplicate in the supine (5 min) and the upright positions (2 min) and the values were averaged. The heart rate was taken once. After a two- to four-week baseline period of only diuretic monotherapy (furosemide 40 mg/day), patients were randomized to either betaxolol (20 mg/day) or atenolol (50 mg/day) if their supine diastolic arterial pressure (SDAP) was 105 to 125 mm Hg inclusive. Patients with severe hypertension (SDAP^ 116 mm Hg) were randomized after two weeks of baseline observation. However, this was considered week 4 for the purposes of analysis of results. At week 6 of the treatment period, if the SDAP was >95 mm Hg or greater, minoxidil, 2.5 mg/ day, was added. Depending on arterial pressure response (SDAP>90 mm Hg), the dosages were increased to 80 mg/day for betaxolol, 200 mg/day for atenolol, and 20 mg/day for minoxidil up to week 16. Thereafter no changes were permitted. Increases in the dosage of furosemide, only for edema, were also allowed during this titration period. Click Here
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  • Treatment of Severe Hypertension with Atenolol and Betaxolol with Once-Daily Regimens  Hemodynamic Aspectsβ-blockers, in combination with minoxidil and a diuretic, are very effective in the treatment of severe hypertension, and their effectiveness lies in their ability to suppress the reflexive tachycardia and renin release produced by minoxidil. However, prolonged administration of minoxidil has been associated with cardiomegaly and pulmonary hypertension. Most of these studies were not prospective, studied small numbers of patients, relied mostly on cardiothoracic ratios, and used patients with renal failure and compromised myocardium. There are no studies reported so far using the echocardiogram to evaluate ventricular size in a sequential manner in these patients. Of the two reported studies that used echocardiography, one had only four patients with repeated observations and the other did not evaluate ventricular chambers. fully
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