Drugs online research references
J Cardiovasc Pharmacol. 1992 Aug;20(2):216-22.
Comparison of the cardiac and hemodynamic effects of lisinopril and atenolol in patients with hypertension: therapeutic implications.
Zusman RM, Christensen DM, Higgins J, Boucher CA.
Division of Hypertension and Vascular Medicine, Massachusetts General Hospital, Boston 02114.
The antihypertensive and hemodynamic effects of lisinopril and atenolol were evaluated in 21 patients with mild-to-moderate essential hypertension. Left ventricular systolic and diastolic performances were assessed prior to and following treatment by first-pass radionuclide cineangiography at rest and during peak upright bicycle exercise. Both lisinopril and atenolol treatment significantly reduced the blood pressure. Lisinopril therapy was associated with a reduction in systemic vascular resistance and left ventricular end-diastolic and end-systolic volumes but no change in stroke volume, cardiac output, peak ejection rate, peak filling rate, time to peak ejection rate, or time to peak filling rate. In contrast, atenolol therapy was associated with an increase in end-diastolic volume and stroke volume but no change in cardiac output; the left ventricular peak ejection and peak filling rates were decreased by atenolol treatment. Although both lisinopril and atenolol each significantly reduced the blood pressure, lisinopril had no effect on left ventricular systolic or diastolic performance; in contrast, atenolol decreased both systolic and diastolic parameters of ventricular performance. Left ventricular function may be affected in significantly different ways despite apparent similarities in blood pressure control in patients who respond to angiotensin converting enzyme inhibition or beta-adrenergic receptor blockade. Differences in hemodynamic response to an antihypertensive agent may be important in the selection of a drug for the treatment of subsets of patients with cardiac function abnormalities.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1381012&dopt=Abstract
Drugs. 1986;31 Suppl 4:174-83.
Compliance and the elderly hypertensive.
Morgan TO, Nowson C, Murphy J, Snowden R.
In the control of chronic disease no therapeutic regimen is successful unless it is complied with. A number of studies have indicated that compliance with tablet-taking may be as low as 40%. Patients with hypertension are frequently on a number of different anti-hypertensive agents, and if they have other chronic disorders they may take as many as 10 different drugs and up to 40 tablets per day. It is therefore not surprising that compliance is poor. To achieve compliance requires education of the patient, reduction in the number of drugs and simplification of the drug regimen. Methyldopa was used in a crossover study on a once- or twice-daily basis. Blood pressure was measured at the same time each day 2 hours after the morning dose. Compliance was assessed by tablet count and by blood pressure control, which was better on once-a-day therapy. Over a 6-week period 95% of medication was taken on the once-daily compared with 84% on the twice-daily regimen. In a subsequent study atenolol once per day replaced propranolol given 3 times per day. Blood pressure was lower on atenolol and tablet compliance was 94% compared with 74% on thrice-daily propranolol therapy. In addition, many patients admitted not taking the midday dose. The effect of dietary advice was then monitored by 24-hour urine electrolytes. When advice was given superficially by the doctor, urine sodium fell from 186 mmol/day to 165 mmol/day. When seen on one occasion by a dietitian and given diet sheets, it fell from 182 to 135 mmol/day. When seen at repeated visits by the dietitian and the advice modified according to sodium excretion, urine sodium excretion fell from 188 to 83 mmol/day. Supplemental oral potassium is often given as antihypertensive medication and up to 6 tablets per day may be administered. Compliance decreased as the number of tablets increased. Compliance was 92% on 1 tablet, 83% on 2 tablets, 68% on 3 tablets, 75% on 4 tablets (usually taken as 2 tablets twice a day) and 58% when on 6 tablets per day. The compliance with diuretic-taking was 96%. When given amiloride/hydrochlorothiazide the compliance was 93% and this elevated plasma potassium more than high dose supplemental potassium. In a recent study people on 3 or more drugs for blood pressure control were placed on a low salt diet and their drugs replaced with enalapril.(ABSTRACT TRUNCATED AT 400 WORDS)
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2874009&dopt=Abstract
Cardiology. 1979;64(2):97-109.
Hemodynamic adjustments in hypertensive patients developing circulatory congestion during beta-adrenergic blockade.
Reybrouck T, Amery A, Billiet L, Fagard R.
In the course of chronic treatment with a cardioselective beta-blocking agent (atenolol) 6 patients out of a series of 38 hypertensives developed signs of circulatory congestion. In spite of this, maximal exercise capacity was maintained. This resulted from hemodynamic readjustments at rest and exercise, where an increase in stroke volume played a major role.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=436128&dopt=Abstract
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