Hypertensive black men and women: quality of life and effects of antihypertensive medications

Article Abstract:

There have been many reports of racial differences in response to antihypertensive medications. Many improvements have occurred in the ability to determine the most appropriate antihypertensive medication for an individual patient. The comparative benefits of antihypertensive agents on the quality of life of black patients have not been fully assessed in large clinical trials. There also may be differences in the quality of life between male and female hypertensive patients. A group of 306 black men and women with mild to moderate hypertension was studied to determine the measures of quality of life associated with treatment with three antihypertensives (atenolol, a beta-blocker; captopril, an angiotensin-converting enzyme inhibitor; and verapamil SR, a sustained-release calcium channel blocker) during an eight-week treatment period. There were five quality of life measures studied: sense of well-being and satisfaction with life, physical state, emotional state, intellectual functioning, and ability to perform in social roles. Adverse reactions were not found to have a negative effect on the quality of life areas studied. There was no association between age and change in quality of life measures. Among male and female patients studied, comparisons between drug treatment groups showed no differences in degree of change on the total quality of life scale scores. There was a general lack of difference in quality of life between the three drugs. Physicians have an increasing number of antihypertensive agents to choose from and they can tailor drug therapy better to the needs of their black patients. Changes in quality of life status can be assessed through the psychosocial measures used in this study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Behavior, Demographic aspects, Quality of life, Blacks

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Dilevalol in severe hypertension: a multicenter trial of bolus intravenous dosing

Article Abstract:

Dilevalol is a drug prescribed to lower high blood pressure. Dilevalol is a beta-adrenergic antagonist and works by blocking the release of chemicals in the body which raise blood pressure. It is similar to the drug labetalol but is four times more potent. To measure the effectiveness of dilevalol in lowering blood pressure, 101 patients with a diastolic blood pressures of greater than 120 mm Hg were given a supine intravenous bolus, a single shot of dilevalol administered while the patient is lying down. A reduction of from 30 mm Hg to 100 mg Hg was achieved in 62 of the patients. Dilevelol was not as effective in treating high blood pressure in black males. Older patients showed better results than younger patients. Dilevalol did not lower blood pressure as much in patients who had previously taken beta-adrenergic antagonists. Transfer to oral dilevalol drug therapy in combination with diuretics, which are drugs that effectively lower blood pressure by lowering blood volume, was able to stabilize blood pressure at an average level of 160 over 100 mm Hg. Intravenous bolus or oral dilevalol is a safe and effective blood pressure lowering agent in the treatment of severe hypertension.

Dilevalol, Adrenergic antagonists

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Intravenous nicardipine for the treatment of severe hypertension: a double blind, placebo-controlled multicenter trial

Article Abstract:

Calcium channel blockers lower blood pressure by inhibiting calcium from entering cells of the blood vessel wall, preventing the vessel from becoming constricted. Although the calcium channel blockers verapamil and nifedipine lower blood pressure, there are some limitations upon their use. Verapamil can be given intravenously but can cause heartbeat abnormalities, while nifedipine given orally can cause a rapid uncontrollable decrease in blood pressure. Nicardipine is similar to nifedipine but has properties more conducive for intravenous injection. Intravenous nicardipine was given to 73 of 123 patients enrolled in the study with severe hypertension. Pretreatment blood pressures averaged 213 over 126 mm Hg. Blood pressures were reduced to an average of 160 over 95 in 67 patients. Of the 49 patients who did not respond to placebo treatment, subsequent nicardipine therapy lowered blood pressures similarly. The most common adverse effect was headache, which was experienced by 24 percent of the patients. The drug worked equally well in patients having organ damage from high blood pressure. Intravenous nicardipine drug therapy was safe and effective in reducing severe hypertension.

Nicardipine

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