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Biomedical subjects

E D Freis

Publications and source records attributed to E D Freis.

At least 91 records · Page 5Linked to original sources
PubMed1980

Informed consent: how much does the patient understand?

Comprehension and recall of the information contained in the informed consent statement was tested in clinically hypertensive patients entering a controlled trial comparing hydrochlorothiazide and propranolol. The consent statement was the primary vehicle for conveying the information to the patient. The average of correct answers to a multiple-choice quiz was 71.6% at 2 hr and 61.2% at 3 mo after the consent procedure. The effectiveness of recall did not correlate with level of education. Patients exhibited greater comprehension of the action of the drugs than of their side effects. Nearly all patients indicated their belief that they would receive the best possible care. While 95% wanted to be informed about the trial, 75% stated they would have given their consent even without this information.

Adult↗
PubMed1979

Treatment of hypertension: state of the art in 1979.

1. The results of the Veterans Administration Co-operative Study have been extended by the subsequent clinical trials, which included patients of both sexes and with less vascular disease. The later studies confirm the effectiveness of treatment in preventing most complications except myocardial infarction and sudden death. Furthermore, the lower diastolic blood pressure in which treatment has been shown to have a significant beneficial effect has been lowered from 105 mmHg as indicated by the Veterans Study to 100 mmHg as shown by the much larger Australian trial. The possibility of reducing the incidence of sudden death and fatal myocardial infarction has been suggested by other recent control trials using beta-adrenoreceptor-blocking drugs, an approach that needs further exploration. 2. A number of interesting and useful new drugs have appeared which include tienilic acid, minoxidil, saralasin and captopril, and in addition recent controlled trials have re-emphasized the effectiveness of the old drug, reserpine, when combined with a diuretic. The art of treatment of hypertension therefore appears to be in a healthy state and we should expect more advances in the future.

Adrenergic alpha-Antagonists↗
PubMed1979

Double-blind assessment of tienilic acid in essential hypertension.

The antihypertensive effectiveness of tienilic acid in doses of 250 mg once and twice daily was compared to hydrochlorothiazide 50 mg once and twice per day in a randomized double-blind trial lasting six weeks. Blood pressure fell significantly and to a similar extent with the larger dose of both drugs. This was accompanied by a slight decrease in body weight and serum potassium concentration and a slight increase in serum creatinine and blood urea nitrogen. The magnitude of these changes was similar with both drugs. Unlike hydrochlorothiazide, however, the administration of tienilic acid was associated with a marked drop in the concentration of serum uric acid. No disturbing side effects or evidence of serious toxicity were noted during treatment with the new drug.

Adult↗
PubMed1978

Furosemide compared with hydrochlorothiazide. Long-term treatment of hypertension.

In a double-blind crossover study, the effectiveness of furosemide, 40 mg twice daily, was compared with hydrochlorothiazide, 50 mg twice daily, in hypertensive patients. Both hydrochlorothiazide and furosemide significantly reduced blood pressure (BP) during three months of therapy. However, the fall in BP was consistently greater with hydrochlorothiazide than with furosemide, although the difference was significant only with respect to systolic BP. The somewhat greater antihypertensive effectiveness of hydrochlorothiazide may be related to its longer action permitting a more continuous diuretic effect and, hence, maintenance of reduced extracellular fluid volume throughout the 24-hour period.

Blood Pressure↗
PubMed1978

Mechanism of antihypertensive effect of thiazide diuretics.

Hemodynamic studies were carried out before and during 8 weeks of treatment with hydrochlorothiazide 50 mg. twice daily in 11 hypertensive patients. Forty-eight hours after beginning treatment there was a significant reduction in blood pressure, cardiac output, plasma volume, and extracellular fluid volume (thiocyanate space) while total peripheral resistance increased. After 6 and 8 weeks of treatment, the blood pressure and the plasma and extracellular volumes remained reduced. However, total peripheral resistance fell while cardiac output rose to control levels. These results were consistent with the "reverse autoregulation" theory of the action of the thiazides as proposed by Tobian. The present evidence discussed below makes it appear unlikely that the thiazides have an important direct vasodilator effect.

Antihypertensive Agents↗
PubMed1977

Clinical study of ticrynafen. A new diuretic, antihypertensive, and uricosuric agent.

In a double-blind study, 20 hypertensive patients were randomly assigned to a six-week regimen of either ticrynafen or hydrochlorothiazide. Blood pressure was significantly reduced with both medications, although most patients required an increase in dosage from 250 to 500 mg ticrynafen daily. Whereas the serum uric acid level rose moderately in the hydrochlorothiazide-treated patients, it fell strikingly to less than half of the pretreatment level in patients treated with ticryafen. Body weight decreased slightly in both groups, as did serum potassium levels. Blood urea nitrogen and serum creatinine levels rose slightly in both groups. The magnitude of these changes was not significantly different between the two groups. Use of ticryafen was well tolerated. Ticryafen appears to be a useful new antihypertensive agent because of its unique combination of diuretic, antihypertensive, and hypouricemic effects.

Adult↗