Treatment of hypertension in diabetic patients
Article Abstract:
Hypertension is common among both insulin-dependant and non-insulin-dependent diabetics, although the precise nature of the relationship between hypertension and diabetes is unclear. Not only does this hypertension pose its usual risks, but it poses a threat of worsening the retinal and kidney complications to which diabetics are already prone. Moreover, the use of antihypertensive drugs on diabetic patients requires that the medication not affect their utilization of glucose. Since it is important to treat even mild hypertension in diabetic patients, the new oxazoline derivative rilmenidine was evaluated in this population. A total of 29 diabetics were taken off other antihypertensive treatments for 2 weeks to 'wash out' potentially confounding traces of other drugs. They were then placed on a 1 mg per day dose of rilmenidine for two weeks, after which those patients with a resting diastolic blood pressure of greater than 90 mm/Hg (the pressure during the relaxation phase of the heart contraction, measured in millimeters of mercury) were asked to take two 1 mg tablets each day. These doses were continued for 12 weeks, at which time patients whose diastolic blood pressure was still over 90 mm/Hg were given a diuretic as well. The entire drug trial ran 16 weeks. The effect of rilmenidine was rapid and persistent; patients had significantly lowered blood pressure at the end of the first two weeks, and this continued throughout the study. At the end of the study, 26 of the 29 diabetic patients had normalized blood pressure readings. The 1 mg per day dose of rilmenidine was effective in 11 patients, and the 2 mg per day dose was effective in 8 more; 7 patients achieved normalized blood pressure with the combination of rilmenidine and diuretics. During the study period, the glucose utilization of these patients was unaffected. Rilmenidine appears to be safe and effective for the treatment of mild-to-moderate hypertension in diabetic patients. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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Hypertension in the elderly
Article Abstract:
Heart disease and stroke are the major causes of death in developed countries, and both of these conditions may be related to hypertension. Numerous studies have shown that treatment of hypertension, or abnormally elevated blood pressure, reduces mortality in elderly populations; unfortunately, the choice of treatments is sometimes difficult. Thiazide diuretics may uncover or aggravate diabetes. Bronchitis or previous heart disease may prevent the use of beta-blockers, and calcium antagonists may cause headaches. Drugs which lower blood pressure by acting on the central nervous system often have fewer side effects; nonetheless, drugs like clonidine may produce unwelcome drowsiness and dry mouth. Because some studies indicated that rilmenidine causes fewer side effects, the drug was tried in the treatment of 269 hypertensive patients of whom 87 were 65 years or older. After one year, there was no difference among the patients which could be attributed to age; the rate of side effects was low and comparable to placebo. The older patients achieved a greater reduction in blood pressure; this is probably attributable to the fact that their blood pressure higher at the beginning of therapy than the younger patients. A 1 mg per day regimen of rilmenidine appears to be effective and suitable for use in elderly hypertensive patients. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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