Hypertension, arterial

Diuretics promote the urinary excretion of sodium and water by inhibiting the absorption of filtered fluid across the renal tubular epithelium. The ensuing reduction in Na reabsorption reduces the Na content of the body, the critical determinant of extracellular and plasma fluid volumes. Thus, the use of diuretics is primarily indicated in the treatment of edematous diseases and of arterial hypertension. 

AHF acute heart failure, CHF chronic heart failure, CRF chronic renal failure, NEP neutral endopeptidase, ECE endothelin converting enzyme, PAH pulmonary arterial hypertension. 

Liddle s syndrome is an autosomal dominant disorder that is caused by persistent hyperactivity of the epithelial Na channel. Its symptoms mimic aldosterone excess, but plasma aldosterone levels are actually reduced (pseudoaldosteronism). The disease is characterized by early onset arterial hypertension, hypokalemia, and metabolic alkalosis. 

Bromo-a-ergosine 8 has remarkable activity on arterial hypertension, migraine and heart arrhythmias (refs. 21,22). The action of 2-bromo-9, 10-dihydro-a-ergosine 9 on heart arrhythmias is of a very long duration and of great stability (refs. 23, 24). 

KasseU NF, Peerless SJ, Durward QJ, Beck DW, Drake CG, Adams HP. Treatment of ischemic deficits from vasospasm with intravascular volume expansion and induced arterial hypertension. Neurosurgery 1982 11 337-343. 

Marzan AS, Hungerbuhler HJ, Studer A, Baumgartner RW, Georgiadis D. Feasibility and safety of norepinephrine-induced arterial hypertension in acute ischemic stroke. Neurology 2004 62(7) 1193-1195. 

Hengstenberg, C.,Schunkert, H., Mayer, B. etal. (2001). Association between a polymorphism in the G protein beta3 subunit gene (GNB3) with arterial hypertension but not with myocardial infarction. Cardiovasc. Res., 49 820-7. 

An SPE cartridge can be used multiple times, especially after the samples are pretreated with protein precipitation. Bourgogne et al. (2005) quantitated talinolol, a p -adrenoceptor antagonist used to treat arterial hypertension and coronary heart disease, in human plasma. The sample was first precipitated with perchloric acid and the supernatant was injected directly. An Xterra MS analytical column (50 x 4.6 mm, 3.5 [m, Waters) with a C18 recolumn filter (4x2 mm, 3.5 /.mi, Phenomenex) and a C8 EC cartridge were chosen. The cycle time was 4.8 min and linear range was 2.5 to 200 ng/mL. Protein precipitation allowed the SPE cartridge to be used for more than 90 injections. 

A product ion scan can obtain stmctural information of a given precursor ion while a precursor ion scan is more suited to find stmctural homologues in a complex mixture. Bosentan (Mr = 551, Fig. 1.19) has two metabolites corresponding to the tert-butyl hydroxylation product (Mr = 567) and the dealkylation of the me-thoxy group to form the phenol (Mr = 537). Bosentan (Tracker, Actelion Phrama-ceuticals) is an oral duel endothelin receptor antagonist approved for the use in arterial hypertension [56]. Selection of the fragment at m/z 280 can fish out precursor ions corresponding only to bosentan and these two metabolites (Fig. 1.19C). A similar result is obtained with the constant-neutral loss scan mode (Fig. 1.19D) which is based on neutral loss of 44 units. 

Iodine takes part in the thyroid gland s hormone synthesis. Endemic goiter with hypothyreosis occurs under iodine deficiency as well as arterial hypertension. Iodine deficiency in pregnant women can cause... 

Arterial hypertension (high blood pressure) generally does not impair the well-being of the affected individual however, in the long term it leads to vascular damage and secondary complications (A). The aim of antihypertensive therapy is to prevent the latter and, thus, to prolong life expectancy. 

Acebntol is a selective j j-adrenoblocker. It possesses antianginal, antihypotensive, and antiarrhythmic action. It is nsed for arterial hypertension, preventing attacks of angina, and cardiac rhythm distnrbances. Synonyms of this drag are acebutolol, sectral, and others. 

Cardiac insufficiency is a very common disease. It can be defined as an inability of the heart to pump a sufficient amount of blood to supply oxygen and nutrients to organs and tissue, which leads to fatigue, shortness of breath, and edema. Cardiac insufficiency is most often caused by arterial hypertension and ischemic heart disease. It can be manifested in severe form, as a sharp decline in cardiac output with symptoms of disrupted blood flow, and in chronic form, which is manifest as heart pain. 

Digoxin exhibits strong systolic action and slows heart rate. It is removed from the organism faster than digitoxin. It is used from chronic cardiac insufficiency in decompensated valvular disease of the heart, myocardium overload in arterial hypertension, tachycardia, ventricular fibrillation, and other analogous situations. Synonyms of this drug are cedoxin, lanacordin, lanoxin, and others. 

It is used for stable and nonstable angina pectoris (including after myocardial infarctions) as well as in arterial hypertension. Universally accepted synonyms of this dmg are cardizem, dilacor, tiazac, iproventaril, and others. 

Verapamil is used for preventing angina pectoris attacks, arterial hypertension, and treating and preventing supraventricular arrhythmia (paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, extrasystole). Synonyms of this drug are isoptin, calan, fmoptin, falicard, manidone, and many others. 

It is used for arterial hypertension, chronic, stable angina pectoris, preventing angina pectoris, and for ischemic-type abnormalities of brain blood flow. Synonyms of this drug are nerdipina, carden, and others. 

It is prescribed for arterial hypertension and hypertensive crises. Synonyms of this drug are aldomet, dopegit, mopatil, and others. 

It is used for stable and unstable stenocardia (including after myocardial infarctions), and for arterial hypertension. 

Verapamil is used to prevent attacks of stenocardia, arterial hypertension, and to treat and prevent supraventricular arrhythmia. 

Pulmonary arterial hypertension (PAH) For the treatment of PAH in patients with New York Heart Association (NYHA) Class II to IV symptoms to diminish symptoms associated with exercise. 

Special risk Use with care in patients with a bleeding diathesis, uncontrolled arterial hypertension, or a history of recent Gl ulceration or bleeding, diabetic retinopathy, hemorrhage, and severe liver or kidney insufficiency. 

Syncope Because of the risk of syncope, monitor vital signs while initiating iloprost. In patients with low systemic blood pressure, take care to avoid further hypotension. Do not initiate iloprost in patients with systolic blood pressure less than 85 mm Hg. Be alert to the presence of concomitant conditions or drugs that might increase the risk of syncope. Syncope can also occur in association with pulmonary arterial hypertension, particularly in association with physical exertion. 

Messerli FH, Sundgaard-Riise K, Reisin ED, et al. Dimorphic cardiac adaptation to obesity and arterial hypertension. Ann Intern Med. Dec 1983 99(6) 757-761. 

The synthetic analogues of prostacyclin, be-raprost, treprostinil and iloprost, although also platelet aggregation inhibitors, are used to treat pulmonary arterial hypertension. 

OE229 Cherif, S., N. Rahal, M. Haouala, et al. A clinical trial of a titrated Olea extract in the treatment of essential arterial hypertension. J Pharm Belg 1996 51(2) 69-71. 

Another HMG-CoA reductase inhibitor, benfluorex (structurally an amphetamine), and its D enantiomer, dexfenfluramine, have been withdrawn after several serious pulmonary arterial hypertension cases (Figure 8.59). 

Mechanism of Action An antihypertensive that blocks endothelin-l, the neurohormone that constricts pulmonary arteries. Therapeutic Effect Improves exercise ability and slows clinical worsening of pulmonary arterial hypertension (PAH). Pharmacokinetics Highlybound to plasma proteins, mainlyalbumin. Metabolized in the liver. Eliminated by biliary excretion. Half-life Approximately 5 hr. 

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