Drugs online research references
BMJ. 1996 Aug 17;313(7054):404-6.
Predictive value of ambulatory blood pressure shortly after withdrawal of antihypertensive drugs in primary care patients.
Beltman FW, Heesen WF, Kok RH, Smit AJ, May JF, de Graeff PA, Havinga TK, Schuurman FH, van der Veur E, Lie KI, Meyboom-de Jong B.
Department of General Practice, University of Groningen, Netherlands.
OBJECTIVE: To determine whether ambulatory blood pressure eight weeks after withdrawal of antihypertensive medication is a more sensitive measure than seated blood pressure to predict blood pressure in the long term. DESIGN: Patients with previously untreated diastolic hypertension were treated with antihypertensive drugs for one year; these were withdrawn in patients with well controlled blood pressure, who were then followed for one year. SETTING: Primary care. SUBJECTS: 29 patients fulfilling the criteria for withdrawal of antihypertensive drugs. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive value of seated and ambulatory blood pressure eight weeks after withdrawal of antihypertensive drugs. RESULTS: Eight weeks after withdrawal of medication, mean diastolic blood pressure returned to the pretreatment level on ambulatory measurements but not on seated measurements. One year after withdrawal of medication, mean diastolic blood pressure had returned to the pretreatment level both for seated and ambulatory blood pressure. For ambulatory blood pressure, the sensitivity and the positive predictive value eight weeks after withdrawal of medication were superior to those for seated blood pressure; specificity and negative predictive value were comparable for both types of measurement. Receiver operating characteristic curves showed that the results were not dependent on the cut off values that were used. CONCLUSION: Ambulatory blood pressure eight weeks after withdrawal of antihypertensive drugs predicts long term blood pressure better than measurements made when the patient is seated.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8761232&dopt=Abstract
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Exp Nephrol. 1996 Jan-Feb;4(1):19-25.
Comparison of the effects of angiotensin-converting enzyme inhibition and angiotensin II receptor blockade on the evolution of spontaneous glomerular injury in male MWF/Ztm rats.
Remuzzi A, Malanchini B, Battaglia C, Bertani T, Remuzzi G.
Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
The mechanism by which angiotensin-converting enzyme (ACE) inhibitors prevent proteinuria and glomerulosclerosis in experimental nephropathies is not yet clear. Experimental evidence is available that the effect of ACE inhibitors on the glomerular function depends on the inhibition of angiotensin II generation, but it is possible that inhibition of the bradykinin breakdown also plays a relevant role. To establish the mediators of the effects of ACE inhibitors in glomerular injury, we compared the effects of the ACE inhibitor lisinopril with those of a specific angiotensin receptor (AT1) antagonist (ZD7155) on the renal function in male MWF/Ztm rats. After 4 months (end of the study), the untreated animals developed hypertension and proteinuria (160 +/- 10 mm Hg and 214 +/- 92 mg/24 h, respectively). In the lisinopril- and in the ZD7155-treated rats, a comparable systolic pressure control was achieved (121 +/- 12 and 118 +/- 14 mm Hg, respectively), and proteinuria was significantly prevented (averaging only 38 +/- 23 and 30 +/- 8 mg/24h, respectively) at the end of the study. The glomerular filtration rate was comparable in control and lisinopril-treated rats and significantly increased in ZD7155-treated rats. Both treatments significantly reduced the glomerular capillary pressure and significantly increased the ultrafiltration coefficient (Kf) as compared with untreated animals. In ZD7155-treated rats the Kf was also significantly higher than in untreated animals glomerular sclerosis and tubulointerstitital damage developed. Structural changes were absent in lisinopril- and ZD7155-treated animals. These results show that the antihypertensive and renal protective effects of ACE inhibitors are shared by the angiotensin receptor antagonist. Thus, angiotensin II is the likely mediator of proteinuria and glomerulosclerosis which develop spontaneously with age in this model.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8788596&dopt=Abstract
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Acad Radiol. 1996 Apr;3(4):294-9.
Regression of increased left ventricular masses in elderly hypertensive patients on lisinopril as assessed by magnetic resonance imaging.
Handa S, Hamada M, Ura M, Yoshida S, Nishio I.
Department of Medicine, Wakayama Medical College, Japan.
RATIONALE AND OBJECTIVES: We investigated, using magnetic resonance imaging, whether the addition of lisinopril could reduce increased left ventricular (LV) masses in hypertensive patients whose blood pressure was well controlled with nifedipine. METHODS: Fourteen hypertensive patients being treated with nifedipine and having an interventricular septum thickness of more than 12 mm were studied. Half of them were given 5 mg lisinopril, and the others were not. Short-axis images of the left ventricle from the base to the apex were obtained by a standard spin-echo pulse sequence. The entire LV mass was calculated from the area of short-axis slices of the left ventricle multiplied by slice thickness. RESULTS: Blood pressure fell slightly and almost equally in both groups. The LV mass and LV mass index showed a significant decrease in the lisinopril-treated group but not in the control group. CONCLUSION: Results demonstrate the effectiveness of lisinopril in reducing increased LV masses, at least in combination with nifedipine.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8796677&dopt=Abstract
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