Ambulatory systolic blood pressure patterns in elderly hypertensives.

In a recent study we found that patients with isolated systolic hypertension (ISH) had two patterns of systolic blood pressure (SBP) elevations by ambulatory BP monitoring (ABPM), sustained (S) and intermittent (I), the prognostic significance of which seems to be different. In the present study we tried to determine whether such patterns of SBP elevations may be detected among other hypertensives as well. Twenty-eight elderly patients (mean age 65.

[Cerebral blood flow in elderly hypertensives after enalapril of calcium channel blockers].

25 elderly hypertensive patients (mean age 66.5 +/- 5.0 years) were given enalapril (E) 20-40 mg daily, or calcium channel blockers (CCB): either slow-release nifedipine (40 mg) or long-acting verapamil (120-360 mg) daily, 6 weeks each, in a single-blind crossover study.

[Effect of captopril on pulmonary function].

During the past few years, dry cough has been described as a possible adverse effect of treatment with angiotensin converting enzyme (ACE) inhibitors. There have been several studies of the effect of long-term administration of ACE inhibitors on pulmonary function. We examined spirometrically the effect of a single oral dose of captopril (25 mg) on bronchial tonus in those who had not received the drug previously, in 4 patients who had previously had dry cough during ACE inhibitor therapy, in 20 patients with obstructive pulmonary disease and in 20 control subjects without pulmonary disease.

Massive hepatic infarction in systemic lupus erythematosus.

Liver disease in systemic lupus erythematosus, as demonstrated by abnormal histopathology, is rare and usually mild; typically, this hepatic disease is of chronic nature and not related to a hypercoagulable state. A patient is described in whom life-threatening hypercoagulability in association with systemic lupus erythematosus resulted in extensive liver infarction. Follow-up radionuclide liver scintigraphy suggested that regenerative recovery in the infarcted areas of the liver may be delayed or absent, but there was no evident functional hepatic impairment.

Comparison of the acute effects of captopril and of nifedipine on left ventricular diastolic function in elderly hypertensive patients.

The acute effects of single doses of captopril (C) 12.5 mg, of nifedipine (N) 10 mg, or of their combination (C + N) on parameters of left ventricular (LV) function were assessed in 18 elderly hypertensive subjects using radionuclide ventriculography. Blood pressure (BP) was lowered by C from 177/100 to 164/92 mmHg, by N from 177/100 to 161/91 mmHg (p less than 0.

Comparative effects of captopril and nifedipine on diastolic and systolic cardiac function in elderly hypertensive patients.

Both nifedipine and captopril are effective in the treatment of systemic hypertension in the elderly, but their effects on cardiac function in this age group have not been evaluated. We studied the effects of acute oral administration of 20 mg nifedipine and 12.5 mg captopril on systolic and diastolic cardiac function, as evaluated by a radionuclide method, in 14 elderly hypertensives, mean age 73.

Patient characteristics and their influence on therapy and its outcome in hypertension of the elderly.

A retrospective study was undertaken to analyze the effects of various patient factors on therapy and its outcome in elderly hypertensive subjects. Two hundred and three male hypertensives with a mean age of 63.1 years at entry, were followed in a special hypertension clinic by nurse practitioners under physician supervision, for 2 years or more (mean 3.

Comparison of oxprenolol vs methyldopa as second-line antihypertensive agents in the elderly.

Direct within-patient comparisons of the effects of centrally acting sympathetic inhibitors and beta-blockers on blood pressure (BP) of the elderly have not been done. In the present study, 32 elderly hypertensive patients were treated with a diuretic. Methyldopa (500 mg/d) (16 patients, subgroup A) or slow-release oxprenolol (80 mg/d) (subgroup B) was added as a second-step antihypertensive agent for a period of eight weeks, after which the second-step agents were switched, respectively, for another period of eight weeks.

Once-a-day triple therapy with low-dose minoxidil for moderate hypertension.

Minoxidil was given to 16 men with hypertension of various degrees of severity, in conjunction with a diuretic and atenolol. Mean supine and standing blood pressures (BP) on diuretic + atenolol were 172/106 and 162/104 mm Hg, respectively. Minoxidil was added and the dose titrated to lower the diastolic pressure to less than 90 mm Hg.

Comparison of low-dose captopril and propranolol as second-line drugs in mild and moderate hypertension.

Captopril in low doses has been used recently with success in the treatment of mild to moderate hypertension. In the present study we compared the effects of captopril, 50 mg/day, to propranolol, 80 mg/day, as second-line antihypertensive agents. By administering each of these drugs together with hydrochlorothiazide, the mean blood pressure was lowered from 156/99 to 140/84 and from 15/98 to 140/85 mm Hg, respectively.

Hypertension and renal failure (scleroderma renal crisis) in progressive systemic sclerosis. Review of a 25-year experience with 68 cases.

This paper reports the experiences of our group with 68 patients with progressive systemic sclerosis (PSS) admitted to hospitals of the University of Pittsburgh Health Center between 1955 and 1981 with scleroderma renal crisis (SRC). The onset of SRC was characterized by four features, namely, onset or aggravation, usually abrupt, of arterial hypertension; appearance of Grade III or IV retinopathy; elevations of peripheral renin activity to at least twice the upper limit of normal; and rapid deterioration of renal function within a period of less than one month. Over 90% of our patients in whom these criteria could be determined had at least three of them present with the onset of SRC.

Combined treatment with minoxidil and captopril in refractory hypertension.

The BP of four patients with severe hypertension could not be controlled by treatment with a variety of drugs including minoxidil and captopril. Satisfactory responses were obtained only when minoxidil and captopril were given in combination (along with diuretic and beta-adrenergic blocking agents). The doses of minoxidil could be reduced by the addition of captopril and adverse effects were thus minimized.

Cerebral blood flow changes with diuretic therapy in elderly subjects with systolic hypertension.

It has been feared that lowering the blood pressure (BP) of elderly patients with systolic hypertension (SH) may compromise cerebral perfusion. To test this hypothesis, BP, cerebral blood flow (CBF), plasma renin activity (PRA), blood counts, urinary and serum electrolytes and other blood chemistries were measured in fifteen elderly patients (ages 61-76 years) with SH (systolic BP greater than 170 and diastolic BP less than 100 mmHg). Gray matter flow (Fg) was calculated from clearance curves of inhaled 133-Xenon.

Complications of antihypertensive therapy.

Effective use of modern antihypertensive agents requires an intimate understanding of the various side effects associated with each of the drugs. Some of the undesirable side effects are unavoidable because they are inherent in the action of the drug. For example, hypokalemia and hyperuricemia are inherent side effects of diuretic therapy.

Elevation of serum potassium during beta blockade: absence of relationship to the renin-aldosterone system.

Eighteen patients with essential hypertension were treated in a single-blind, crossover study with pindolol and with propranolol. The two drugs were compared because of known differences between them on renin secretion. We noted that plasma renin activity and plasma aldosterone concentration were suppressed by propranolol but not by pindolol.