[Diuretics in hypertension].
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Biomedical subjects
Publications and source records attributed to T Hilden.
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In 123 patients with arterial hypertension the haemoglobin values were determined before and during long-term antihypertensive drug treatment. The haemoglobin values found before treatment did not differ from those found in the normal population. In both sexes the haemoglobin values showed a significant increase after prolonged treatment. In males the average values rose from 15.1 to 16.7 g./100 ml., and in females from 13.96 to 14.82 g./100 ml. The increase in the haemoglobin concentration does not seem to be clearly correlated to the duration of treatment or to the decrease produced in mean blood pressure. On the other hand, the increase in haemoglobin depended to some extent on the nature of treatment. Diuretics alone resulted in a moderate increase only, whereas diuretics in combination with other antihypertensive drugs produced a more pronounced increase in haemoglobin values.
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N"-Cyano-N-4-pyridyl-N'-1,2,2-trimethylpropylguanidine (P 1134) is a new vasodilating antihypertensive compound. In an open study, P 1134 was given in single oral doses of from 10 to 25 mg to 12 previously untreated patients with essential hypertension. All patients responded with decreases in mean arterial pressure (MAP) of at least 10 mm Hg and with almost equal blood pressure decreases in the supine and erect position. The increase of dose was significantly correlated with a progressive reduction of blood pressure. At a dose of 25 mg, the maximal decrease in supine MAP averaged 38 mm Hg, and the maximal increase in heart rate averaged 23 beats/min. Peak effect and serum concentration were seen about 1 h after tablet intake. The serum half-life from the peak concentration averaged 2.5 h. It is concluded that P 1134 is a fast-acting, effective antihypertensive agent.
In a series comprising 482 patients with hypertension requiring treatment 79 percent had to be classified as essential hypertension. Bilateral renal disease was found in 9 percent, unilateral renal disease in 3.3 percent, but only one patient underwent surgery. Renal artery stenosis was found in 24 patients (5 percent), but only 5 (1 percent) were operated on. Two cases of primary hyperaldosteronism and one of phaeochromocytoma were found; in all three surgical intervention was successful. Oral contraceptives had caused the elevated BP in 7 patients (1.5 percent). It is emphasized that the frequency of curable hypertension is still very low and this should be taken into account when routine examination of patients with hypertension requiring treatment is discussed.