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Biomedical subjects

R Fagard

Publications and source records attributed to R Fagard.

At least 487 records · Page 27Linked to original sources
PubMed1977

Antihypertensive therapy in elderly patients. Pilot trial of the European Working Party on High Blood Pressure in the Elderly.

A study protocol for a double-blind randomised control trial of hypotensive treatment in elderly hypertensive patients has been tested in a number of pilot centres throughout Europe. It was shown that this study is possible from the logistic point of view. In these elderly patients, hydrochlorothiazide + triamterene treatment with or without methyldopa, maintained a significant hypotensive effect in the absence of major electrolyte disturbances. The initiation of hypotensive therapy did not provoke an excess of cardiovascular complications. The influence of hypotensive therapy on the general well-being and on the morbidity and the mortality of elderly patients with high blood pressure, is thereby being assessed. The study will continue for 5 years and other centres are invited to join.

Aged↗
PubMed1976

Mechanism of hypotensive effect during betaadrenergic blockade in hypertensive patients.

The mechanism of the hypotensive effect during beta-adrenergic blockade in hypertension was studied in 38 patients with renal or essential hypertension using the new cardioselective beta blocker, Tenormin. During 5 weeks hospitalization the patients received first a placebo for 5 to 12 days, then a 75 mg. dose of Tenormin was given daily for 1 week, and thereafter the dose was doubled weekly as necessary up to 600 mg. daily. The blood pressure decreased from 180 +/- 26.2/118. "/- 13.6 mm. Hg on placebo to 151 +/-25.5/96 +/-13.8 mm. Hg during the final hospitalization period on Tenormin (600 mg. daily). Six patients developed fluid retention and as this occurred blood pressure control was lost. A subsequent follow-up on an outpatient basis of 15 of the patients showed that when the active drug was replaced by a placebo blood pressure rose again, confirming that the initial fall in blood pressure was a genuine effect. Multistage bicycle ergometer exercise tests were performed at weekly intervals to test the degree of beta blockade and indicated that this was nearly complete when a dose of 600 mg. per day was used. A significant correlation between the hypotensive effect and the degree of beta blockade, assessed by exercise tachycardia, was observed. A slight but statistically significant decrease (26 per cent) was observed in the plasma renin concentration, measured recumbent in the morning. This decrease was, however, not correlated with the hypotensive effect of the drug. Although the cardiac output decreased significantly (from 5.5 +/-1.7 to 4.3 +/- 1.1 L per minute, p less than 0.001), no correlation was found in individual patients between the cardiac output and the blood pressure decrease. On the other hand, for the total group of catheterized patients (n = 28) the calculated total peripheral resistance did not change significantly. Yet a significant correlation was found between the changes in total resistance and the hypotensive effect. This suggests that the reaction of the peripheral vessels rather than the cardiac output decrease determines whether the drug will produce a major decrease of blood pressure in patients with hypertension.

Adult↗
PubMed1976

Plasma renin concentration and the hypotensive effect of bendrofluazide and of atenolol.

1. The anti-hypertensive effect of atenolol was greater than that of bendrofluazide. 2. The change in systolic blood pressure caused by bendrofluazide showed a significant inverse correlation iwth the plasma renin concentration (r=-0-47; P less than 0-01). 3. The correlation between the change in systolic blood pressure caused by atenolol and the plasma renin concentration was not significant (r =0-28; 0-1 greater than P greater than 0-05). 4. Plasma renin concentration was unaffected by atenolol.

Antihypertensive Agents↗
PubMed1976

Haemodynamic effects of Sar1-Ala8-angiotensin II in patients with renovascular hypertension.

Sar1-Ala8-angiotensin II was infused intravenously (10 mug/kg/min) in 14 patients with renovascular hypertension, including 11 with renal artery stenosis. Brachial artery pressure and heart rate remained unchanged in six patients who were on a daily sodium intake of 130 mEq. In 12 tests performed after sodium depletion, the decrease in mean arterial pressure ranged from 13 to 76 mm Hg and showed a significant correlation with the plasma renin concentration prevailing immediately before the infusion of the drug (r = 0.81; p less than 0.001). The hypotensive response was due to a drop in total peripheral resistance. Heart rate and cardiac output showed slight increases 10 min after the start of saralasin infusion.

Adult↗
PubMed1976

Relative value of beta blockers and thiazides for initiating antihypertensive therapy. Beta blockers or thiazides in hypertension.

Fifty-five patients with mild to moderate, renal or essential hypertension were admitted to a double blind cross-over trial of 18 weeks, involving treatment periods with placebo, the thiazide bendrofluazide (15 mg daily) and the beta blocker atenolol (600 mg daily). Compared to the placebo period (190/117 mm Hg) the hypotensive effect of atenolol (-24/16 mm Hg) was more pronounced than the hypotensive effect of bendrofluazide (-17/6 mm Hg). Arguments in favor of initiating antihypertensive drug therapy with beta blocker were its more powerful hypotensive effect, the quicker onset of its action, less metabolic disturbance, decreased frequency of complaints and patient's preference. On thiazides body weight and the frequency of swollen ankles decreased. Plasma renin concentration was not found to have a strong predicting power for the hypotensive effect of atenolol or bendrofluazide but low renin patients showed a more pronounced blood pressure decrease on bendrofluazide and high renin patients, especially essential hypertensives, on atenolol. While these points can be a guide to therapy today, the preference of one drug over the other must eventually be based on their relative efficacy in decreasing morbidity and mortality from the hypertensive disease.

Adrenergic beta-Antagonists↗
PubMed1976

The relationship between beta-blockade, hyporeninaemic and hypotensive effect of two beta-blocking agents.

In two consecutive series of hypertensive patients the hypotensive effect, the hyporeninaemic effect and the blockade of cardiac beta-receptors was studied using weekly increasing doses of propranolol or atenolol. With both beta-blockers, cardiac blockade and hypotensive effect increased in a parallel fashion when the dosage was increased suggesting that the hypotensive effect is related to cardiac beta-blockade. On the other hand lack of parallelism between the hypotensive effect and the hyporeninaemic effect suggests that the hypotensive effect was not related to a major extent to the hyporeninaemic effect of the drugs in the dosage range studied here.

Adrenergic beta-Antagonists↗
PubMed1975

Predictive value of various parameters for the antihypertensive effect of the beta blocker ICI 66,082 (1).

The antihypertensive effect of the new beta-blocker, ICI 66,082 was studied in 37 patients with renal or essential hypertension. A daily dose of 75 mg produced a significant antihypertensive effect and a further blood pressure decrease was obtained by increasing the daily dose up to 300 mg; at this treatment level, the antihypertensive effect averaged 29.4/24.0 mm Hg. Increasing the dose from 300 to 600 mg daily did not produce a significant additional blood pressure decrease. Six of the 37 patients retained fluid, producing a loss in the antihypertensive effect. No significant correlation was found between the percentage systolic blood pressure fall and the following parameters determined before therapy: systolic blood pressure and its variability, heart rate (at rest and after stimulation by exercise or isoproterenol), cardiac output and total peripheral resistance, renin concentration (at rest and after stimulation) and urinary excretion of catecholamines and derivates.

Adrenergic beta-Antagonists↗