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Biomedical subjects

F A Finnerty

Publications and source records attributed to F A Finnerty.

At least 19 recordsLinked to original sources
PubMed1987

Hypertension.

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Antihypertensive Agents↗
PubMed1986

A multicenter, randomized, double-blind dose-response evaluation of step-2 guanfacine versus placebo in mild to moderate hypertension.

Guanfacine, an alpha-adrenoceptor agonist, may exhibit distinct dose-related curves for efficacy and adverse effects in the step-2 therapy of essential hypertension. To determine the lowest clinically effective safe dose, 462 newly or previously diagnosed subjects were admitted to a 5-week prerandomization phase at 8 centers. Patients were weaned from any current antihypertensive drugs and placed on 25-mg chlorthalidone, daily, in the morning. At the end of the 5-week weaning period, 362 patients with seated diastolic blood pressures (BPs) between 95 and 114 mm Hg qualified for the 12-week postrandomization phase. Subjects were randomized to receive either an indistinguishable placebo or 0.5, 1, 2 or 3 mg of guanfacine. Chlorthalidone was changed to bedtime administration and taken with the study medications. Guanfacine was started at the lowest dose in all subjects and increased (if scheduled, according to the randomization code) to the next higher dose at biweekly intervals. Of the 362 randomized patients, 278 completed the study. The 1-mg guanfacine dosage produced a 14/13 mm Hg decrease in BP (p less than 0.0125 compared with placebo). Doses of guanfacine at 2 and 3 mg/day were not more effective than the 1 mg/day dose; 0.5 mg/day was not better than placebo. There was an increase in the frequency of side effects possibly or probably associated with 2 and 3 mg/day guanfacine. Only 3.2% of the patients in the 1 mg/day group dropped out of the study because of side effects. We conclude that when added to a diuretic, 1 mg/day guanfacine at bedtime is the lowest safe and therapeutically effective dose.

Administration, Oral↗
PubMed1985

Guanadrel. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in hypertension.

Guanadrel sulphate is an orally active peripheral sympathetic inhibitor (adrenergic neuron-blocking drug). In comparative studies, guanadrel was comparable in efficacy with guanethidine or methyldopa in mild to moderately severe hypertension, although generally it caused fewer central nervous system side effects than methyldopa and less orthostatic dizziness and diarrhoea than guanethidine. However, its efficacy in patients whose blood pressure remains inadequately controlled by other drugs (except diuretics alone) has yet to be adequately demonstrated. Guanadrel has a rapid onset of action and a half-life of about 10 hours, thus dose titration can be achieved more rapidly than with guanethidine, and twice daily administration is appropriate. Generally, guanadrel has been well tolerated, withdrawal of treatment due to adverse effects seldom being necessary. Thus, guanadrel appears to be a suitable alternative to methyldopa for the treatment of mild to moderately severe hypertension not controlled adequately by diuretics alone.

Antihypertensive Agents↗
PubMed1984

Step-down treatment of mild systemic hypertension.

Previous studies have shown that controlling the diastolic blood pressure (BP) for 6 months frequently permits the use of fewer drugs in lower doses in most patients with moderately severe and severe systemic hypertension. Prompted by these observations, the dosage of chlorthalidone (monotherapy) was decreased in a stepwise fashion and then discontinued after the diastolic BP had been maintained below 85 mm Hg for 6 months in 67 patients with mild systemic hypertension (diastolic BP 92 to 104 mm Hg). These patients have been followed for 48 months. Initially, a dose of 25 mg/day of chlorthalidone was just as effective as 50 mg in controlling the diastolic BP in all patients, and it was not until the dose was reduced to 12.5 mg/day that the diastolic BP increased in 8 patients. Annoying symptoms and metabolic side effects were decreased or eliminated. Chlorthalidone therapy was discontinued in 36 of the 67 patients. The ability to discontinue therapy in these patients suggests the possibility of intermittent, rather than continuous, lifelong therapy.

Adult↗
PubMed1983

Multicenter clinical evaluation of long-term efficacy and safety of labetalol in treatment of hypertension.

The long-term efficacy and safety of labetalol, an antihypertensive agent with combined beta- and alpha-blocking activity, were evaluated alone (number = 193) and in combination with a diuretic (number = 144) in an open-label multicenter trial of 337 hypertensive patients aged 21 to 75 years, including initially 205 (61 percent) men and 219 (65 percent) Caucasians. There were 219 (65 percent) mild, 85 (25 percent) moderate, and 33 (10 percent) severe hypertensive patients. Labetalol (100 to 1,200 mg twice a day) alone or in combination with a diuretic reduced the mean standing blood pressure by 13/11 and 25/16 mm Hg to 135/88 and 130/91 mm Hg, respectively (p less than 0.01), and supine blood pressure by 6/7 and 18/13 mm Hg to 141/86 and 138/90 mm Hg (p less than 0.01), respectively. Blood pressure reductions observed at one month were maintained after one year; 206 (62 percent) patients had 10 mm Hg or greater reductions and 184 (56 percent) patients were maintained at diastolic blood pressures less than 90 mm Hg. Most frequently reported drug-related side effects included fatigue (14 percent), dizziness (12 percent), nausea (11 percent), nasal stuffiness (8 percent), headache (4 percent), and male sexual dysfunction (14 percent). Side effects were generally of mild to moderate intensity and often transient. In addition, in 27 (8 percent) patients reversible asymptomatic transaminase elevations to greater than twice normal developed at some time during the study. In 13 (4 percent) patients these alterations resolved during continued labetalol therapy, but in five (2 percent) patients these marked elevations led to discontinuation of the drug. A total of 32 (9.5 percent) patients were terminated prematurely due to side effects (most commonly genitourinary or gastrointestinal) possibly attributable to the drug. These findings indicate that labetalol with or without a diuretic is a potentially effective, safe, and relatively well-tolerated long-term antihypertensive therapy.

Adult↗
PubMed1983

Hypertension.

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Humans↗
PubMed1981

Step-down therapy in hypertension. Importance in long-term management.

To determine the minimum amount of therapy needed to control arterial pressure, the amount of one drug was reduced, then use of one or more drugs was discontinued after the diastolic pressure had been lower than 90 mm Hg for six months in 51 hypertensive patients. By six months, one drug had been eliminated in 38 patients, and the dose of another had been decreased in 49 patients. By 12 months, stepping up therapy was necessary in 13 patients; thus, one drug therapy had been eliminated in only 27 patients, and the dose was decreased in another 43 patients. No further therapeutic changes were necessary during the next six months. Originally, 161 complaints of side effects were noted. After step-down therapy, 18% of the side effects were reported unchanged, 26% were significantly decreased, and 56% were completely absent.

Antihypertensive Agents↗
PubMed1980

Initial therapy of essential hypertension: diuretic or beta blocker?

The ability of hydrochlorothiazide or a long-acting beta adrenergic blocker, nadolol, to reduce the blood pressure was compared in 55 patients with mild to moderately severe essential hypertension. A randomized crossover study design was employed, with 43 patients completing both legs of the study. The mean sitting diastolic blood pressures after one month of therapy were reduced by 13.6 and 14.9 mmHg with hydrochlorothiazide and nadolol, respectively. After hydrochlorothiazide therapy, the diastolic blood pressure was 90 mmHg or lower in 51 percent of the patients, and after nadolol, in 56 percent of the same patients. The results suggest that diuretics and beta adrenergic blockers are equally effective in lowering the blood pressure. Nadolol's long duration of beta adrenoreceptor blockade justifies a simplified, once daily dosage schedule.

Adrenergic beta-Antagonists↗
PubMed1979

Step 2 regimens in hypertension. An assessment.

A single-blind clinical trial compared step 2 combination therapy consisting of 50 or 100 mg of hydroflumethiazide plus either 0.125 to 0.250 mg of reserpine, 500 to 2,000 mg of methyldopa, or 80 to 320 mg of propranolol hydrochloride, in 59 patients whose elevated blood pressure (BP) failed to respond adequately to the thiazide alone. After nine weeks of treatment, diastolic BP was reduced below 90 mm Hg in all 20 patients treated with the reserpine-hydroflumethiazide combination, in 13 of the 19 patients treated with methyldopa and hydroflumethiazide, and in 16 of the 20 patients treated with propranolol and hydroflumethiazide. Changes in laboratory values were not substantial; adverse reactions occurred only in the methyldopa group. Although the three treatment regimens were similar with respect to safety and efficacy, the reserpine-hydroflumethiazide combination offers the advantages of more convenient dosage at lower cost.

Adult↗
PubMed1979

Hypertension in the elderly: special considerations in treatment.

The goal of antihypertensive therapy in the elderly should be to reduce systolic blood pressure to 140 mm Hg and diastolic pressure to 100 mm Hg without disturbing cerebral or coronary blood flow or depressing cerebral function. This goal can usually be accomplished by using half doses of thiazide diuretics alone or in combination with half doses of hydralazine. Drugs which produce postural hypotension or depress cardiac output and cerebral function should not be used.

Aged↗
PubMed1979

Diuretics as initial treatment for essential hypertension.

1 In the United States, the thiazide diuretics are considered the cornerstone of all antihypertensive regimens for four reasons: by themselves, they are capable of controlling the blood pressure in 60-70% of the hypertensive population; they prevent the sodium retention produced by all other antihypertensive agents; they can be given once a day; and they are inexpensive. 2 Despite these advantages, the thiazide do cause hypokalaemia hyperuricaemia and hyperglycaemia. The incidence of hypokalaemia (K less than 3.0 mEq/l) is only 2-4%; the incidence of hyperuricaemia (uric acid greater than 10 mg per cent is 3-4%; and the incidence of hyperglycaemia is 1-2%. 3 The possibility that a beta-blocking agent combined with a thiazide diuretic might produce better BP control, prevent thiazide-induced abnormalities and exert a coronary prevention action with once daily administration would suggest that such a combination should be the ideal initial therapy for most patients with hypertension.

Adrenergic beta-Antagonists↗