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2.
Clinics ; 62(6): 749-756, 2007. graf, tab
Article in English | LILACS | ID: lil-471795

ABSTRACT

INTRODUCTION: Administration of the NO inhibitor Nwð-nitro-L-arginine methyl ester (NAME) and a high-salt diet (HS) promotes severe albuminuria and renal injury, which regresses upon discontinuation of treatments. OBJECTIVE: We investigated whether these changes reappear after reinstitution of HS, and whether they are prevented by treatment with the antilymphocyte agent mycophenolate mofetil (MMF) or the AT-1 receptor blocker losartan (L). Adult male Munich-Wistar rats received NAME and HS. A control Group (C) received only HS. After 20 days, rats receiving HS and NAME exhibited severe hypertension and albuminuria. After a 30-day recovery period, hypertension was attenuated and albuminuria had virtually disappeared. MATERIAL AND METHODS: Rats were then distributed among the following groups: HS, receiving HS; NS, receiving a normal salt (NS) diet; HS-MMF, receiving HS and MMF; HS-LOS, receiving HS and L; HS-HDZ, receiving HS and hydralazine (HDZ). Sixty days later, NS rats showed only slight albuminuria and renal damage or inflammation. In contrast, HS rats developed severe hypertension, marked glomerulosclerosis with interstitial expansion and renal infiltration by macrophages and angiotensin II-positive cells. The group treated with losartan had lowered blood pressure and a lack of albuminuria or renal injury. MMF provided similar protection without altering blood pressure, suggesting a nonhemodynamic effect, a hypothesis reinforced by the finding that HDZ lowered blood pressure without preventing renal injury. RESULTS: These results indicate that treatment with HS and NAME predisposes to the development of hypertension and renal injury upon salt overload, characterizing a new model of chronic nephropathy. CONCLUSION: The response to MMF or L, but not HDZ, suggests a key role for inflammatory rather than hemodynamic factors.


INTRODUÇÃO: A administração de Nômega-nitro-L-arginina metiléster (NAME), um inibidor da produção de NO, com dieta rica em sal (HS) promove albuminúria e dano renal graves, reversíveis ao interromperem-se os tratamentos. OBJETIVO: Investigamos se tais alterações recrudescem ao reinstituir-se a HS e se são prevenidas pelo micofenolato mofetil (MMF), um agente antilinfócito, ou losartan, um bloqueador do receptor AT-1. MATERIAL E MÉTODOS: Ratos Münich-Wistar machos adultos receberam NAME e HS. Um grupo controle (C) recebeu apenas HS. Após 20 dias, os ratos que receberam HS e NAME exibiam hipertensão e albuminúria graves. Após recuperação de 30 dias, a hipertensão atenuou-se e a albuminúria praticamente desapareceu. Formaram-se então os grupos: HS, recebendo HS; NS, recebendo dieta normal em sal (NS); HS-MMF, recebendo HS e MMF; HS-LOS, recebendo HS e losartan; HS-HDZ, recebendo HS e hidralazina. Após sessenta dias os ratos NS tinham albuminúria e dano/inflamação renal apenas discretos. Já os ratos HS desenvolveram hipertensão e glomerulosclerose acentuadas, expansão intersticial e infiltração renal por macrófagos e células positivas para angiotensina II. Losartan baixou a pressão arterial e preveniu albuminúria e lesão renal. MMF proporcionou proteção semelhante sem alteração pressórica, sugerindo a ação de mecanismos não hemodinâmicos, hipótese reforçada pelo achado de que a HDZ baixou a pressão arterial sem prevenir a nefropatia. RESULTADOS: Esses resultados indicam que o tratamento com HS e NAME predispõe ao desenvolvimento de hipertensão e lesão renal induzidos por excesso de sal, caracterizando um novo modelo de nefropatia crônica. CONCLUSÃO: A resposta ao MMF ou losartan, mas não à hidralazina, sugere o predomínio de fatores inflamatórios.


Subject(s)
Animals , Male , Rats , Hypertension/chemically induced , Kidney Failure, Chronic/chemically induced , Nitric Oxide/antagonists & inhibitors , Sodium Chloride, Dietary/toxicity , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Antihypertensive Agents/therapeutic use , Disease Models, Animal , Drug Evaluation, Preclinical , Hydralazine/therapeutic use , Hypertension/prevention & control , Immunohistochemistry , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/pathology , Kidney Failure, Chronic/prevention & control , Kidney/drug effects , Kidney/pathology , Losartan/therapeutic use , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Rats, Wistar
3.
Rev. Assoc. Med. Bras. (1992) ; 52(6): 390-394, nov.-dez. 2006. tab
Article in Portuguese | LILACS | ID: lil-440203

ABSTRACT

OBJETIVO: Comparar as intercorrências clínicas materno-fetais e a efetividade do tratamento entre grupos das síndromes hipertensivas na gestação (SHG). MÉTODOS: Foram revisados 200 prontuários de gestantes com SHG, sendo avaliados as intercorrências fetais, a classificação da síndrome hipertensiva e o uso de anti-hipertensivos. RESULTADOS: Entre as intercorrências maternas, 85 (42,5 por cento) das pacientes foram classificadas no grupo controle; 32 (16 por cento) apresentaram hipertensão gestacional (HG); 67 (33,5 por cento) PE; 6 (3 por cento) hipertensão crônica; e 10 (5 por cento) pré-eclâmpsia sobreposta a hipertensão crônica (PSHC). Os menores valores para a idade gestacional, peso dos recém-nascidos e para o índice de Apgar foram observados nos grupos de pacientes com PE e PSHC. A utilização do tratamento não alterou os parâmetros perinatais em relação aos grupos com HG. O grupo de pacientes com PE apresentou a menor idade gestacional e o menor índice de Apgar quando comparado ao grupo controle. CONCLUSÃO: A introdução da terapia anti-hipertensiva durante a gestação foi de fundamental importância para o atendimento à gestante com SHG, embora tenha proporcionado poucos avanços em relação à prevenção das intercorrências perinatais, pois não houve alteração dos parâmetros gestacionais nos casos em que se comparou a utilização do tratamento. A medicação utilizada pouco interfere no fluxo sangüíneo materno-fetal, e conseqüentemente, nas condições de nascimento da criança.


OBJECTIVE: To compare the maternal-fetal clinical intercurrences and the effectiveness of treatment in the different clinical forms of hypertensive syndromes during pregnancy (HSP). METHODS: Medical records of 200 pregnant women with HSP were reviewed to appraise fetal intercurrences, classification of the hypertensive syndrome and use of antihypertensives. RESULTS: Of the 200 patients analyzed, 85 (42.5 percent) were controls; 32 (16 percent) presented gestational hypertension (GH), 67 (33.5 percent) had Pre-eclampsia (PE), 6 (3 percent) had chronic hypertension and 10 (5 percent) cases had PE superimposed chronic hypertension (PSCH). The lowest values for gestational age, weights of the newborn and for the Apgar index were observed in the patients with PE and PSCH. Treatment did not alter the Apgar index in relation to control and non-treated GH patients. Patients with PE presented the lowest gestational age and the smallest Apgar index when compared to controls. CONCLUSION: Introduction of an antihypertensive therapy during gestation was of fundamental importance for health improvement and pressure control of the pregnant woman with HSP. Nevertheless, it has been of little help for prevention of perinatal intercurrences. This was substantiated by the absence of improvement in the gestational conditions between the treated group when compared to the non-treated. Medication did not significantly improve the maternal-fetal blood flow and consequently in the birth condition of the child.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Antihypertensive Agents/therapeutic use , Hypertension, Pregnancy-Induced/drug therapy , Pregnancy Outcome , Birth Weight , Chronic Disease , Gestational Age , Hydralazine/therapeutic use , Hypertension, Pregnancy-Induced/diagnosis , Hypertension/complications , Hypertension/drug therapy , Methyldopa/therapeutic use , Pre-Eclampsia/diagnosis , Risk Factors , Statistics, Nonparametric , Syndrome
5.
In. Timerman, Ari; Machado César, Luiz Antonio; Ferreira, Joäo Fernando Monteiro; Bertolami, Marcelo Chiara. Manual de Cardiologia: SOCESP. Säo Paulo, Atheneu, 2000. p.36-40, tab.
Monography in Portuguese | LILACS | ID: lil-265380
6.
J. bras. ginecol ; 107(11/12): 433-5, nov.-dez. 1997. ilus, tab
Article in Portuguese | LILACS | ID: lil-225454

ABSTRACT

É apresentado a conduçäo de 41 pacientes com DHEG (forma grave) com o uso de hipotensor exclusivamente, desde a internaçäo até o parto. Näo se utilizou nenhum tipo de anticonvulsivante. Os resultados mostram ausência de convulsöes embora tenha ocorrido, em alguns casos, agravamento clínico da doença. Näo ocorreram óbitos maternos e a mortalidade perinatal foi de 17 por cento


Subject(s)
Humans , Female , Pregnancy , Hypertension/drug therapy , Hydralazine/administration & dosage , Hydralazine/therapeutic use , Nifedipine/administration & dosage , Nifedipine/therapeutic use , Pre-Eclampsia/drug therapy , Pregnancy , Pregnancy Complications
7.
Rev. bras. clín. ter ; 23(5): 173-84, set. 1997. tab, graf
Article in Portuguese | LILACS | ID: lil-208236

ABSTRACT

A emergência hipertensiva é uma condiçäo de risco iminente de vida caracterizada por elevaçäo súbita da pressäo arterial e comprometimento de órgäo-alvo. O cérebro, coraçäo, rins, retina e aorta säo alvos frequentes. Säo importantes a presteza diagnóstica e o tratamento precoce. Dá-se escolha aos anti-hipertensivos parenterais de açäo rápida e de curta duraçäo, evitando-se, porém, quedas pressóricas que comprometam a perfusäo de órgäos ou sistemas. O objetivo desta revisäo é mostrar como se diagnostica e se trata precocemente a emergência hipertensiva.


Subject(s)
Humans , Antihypertensive Agents/therapeutic use , Emergencies , Hypertension , Calcium Channel Blockers/therapeutic use , Diazoxide/therapeutic use , Hypertension/classification , Hypertension/physiopathology , Hypertension/drug therapy , Hydralazine/therapeutic use , Labetalol/therapeutic use , Nitroglycerin/therapeutic use , Nitroprusside/therapeutic use , Phentolamine/therapeutic use , Trimethaphan/therapeutic use
8.
Article in English | IMSEAR | ID: sea-20206

ABSTRACT

The in vivo response of a transplantable mouse tumour, Sarcoma 180 to AK-2123 (AK), local irradiation (RT) and local hyperthermia, as influenced by a vasoactive drug, hydralazine (HDZ), was assessed on the basis of tumour cure (complete response CR), volume doubling time (VDT), regrowth delay (RD) and animal survival up to 120 days. A single ip injection of 200 mg/kg b.wt. AK produced more than 15 per cent CR. Combination of any two agents resulted in a better response than the single agent treatments. AK in combination with 43 degrees C, 30 min (HT) was more effective than HT combination with 10 Gy. The presence of 5 mg/kg HDZ, injected immediately after 5 Gy, in combination with AK increased the therapeutic effect over that produced by AK+10Gy. Combination of all the three agents (AK+10Gy+HT) produced 100 per cent CR and prolonged disease free animal survival. A similar response could be obtained by the presence of HDZ with a lower radiation dose of 5 Gy in combination with AK and HT (AK+5Gy+HDZ+HT). This multimodality treatment offers the possibility of further reduction in the doses of individual agents, and in the possible side effects on normal tissues without compromising the tumour cure effect.


Subject(s)
Animals , Combined Modality Therapy , Female , Hydralazine/therapeutic use , Hyperthermia, Induced , Mice , Mice, Inbred BALB C , Neoplasm Transplantation , Peritoneal Neoplasms/drug therapy , Radiation-Sensitizing Agents/therapeutic use , Sarcoma, Experimental/drug therapy , Triazoles/therapeutic use , Vasodilator Agents/therapeutic use
10.
Rev. méd. IMSS ; 34(2): 149-52, mar.-abr. 1996. ilus
Article in Spanish | LILACS | ID: lil-202991

ABSTRACT

El infarto renal puede definirse como la muerte de tejido renal debido a interferencia con su circulación sanguínea. Se presenta el caso de un paciente masculino, de nueve años de edad, con cefalea universal, vómitos de contenido gástrico y una tensión arterial (TA) de 140/100 mmHg. Su renina plasmática periférica fue de 7.4 ng/mL/h (normal hasta 2.5 ng/mL/h). La arteriografía renal indicó infarto parenquimatoso en polo superior de riñón derecho. Actualmente, está controlado con una tensión arterial de 110/70 mmHg, para lo cual recibe 1 mg/kg/día de captopril complementado con dieta hiposódica.


Subject(s)
Child , Humans , Male , Vascular Diseases/physiopathology , Captopril/therapeutic use , Renal Insufficiency/blood , Hydralazine/therapeutic use , Kidney Cortex Necrosis/physiopathology , Kidney Diseases/therapy , Diet, Sodium-Restricted/methods , Hypertension, Renal/therapy , Kidney/pathology
12.
Rev. bras. ginecol. obstet ; 17(2): 103-11, mar. 1995. ilus, graf
Article in Portuguese | LILACS | ID: lil-165215

ABSTRACT

Cinqüenta gestantes compressao arterial diastólica maior ou igual a 110 mmHg foram submetidas a estudo prospectivo, randomizado e duplo-cego com o objetivo de comparar os efeitos de dois hipotensores, a hidralazina e a nifedipina, no tratamento das emergências hipertensivas na gestaçao. Vinte e cinco pacientes receberam 5mg endovenoso de hidralazina e um placebo correspondente a nifedipina por via oral e, as demais, o inverso. A reduçao dos níveis pressóricos e a vitalidade fetal através da cardiotocografia anteparto foram avaliadas durante os períodos pré e pós-droga, além da ocorrência de efeitos colaterais. Ambas as drogas promoveram reduçao lenta e progressiva da pressao arterial. Os efeitos colaterais mais observados com a nifedipina foram rubor facial e tonturas e, com a hidralazina, palpitaçoes. Os registros cardiotocográficos mostraram-se intalterados após a ministraçao dos anti-hipertensivos, na maioria dos casos. Os autores concluem que as duas drogas foram eficazes, sendo a nifedipina uma alternativa útil e segura, por via oral, no tratamento da hipertensao severa, na gravidez.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Cardiovascular/drug therapy , Emergencies , Hypertension/drug therapy , Hydralazine/therapeutic use , Nifedipine/therapeutic use , Diastole/physiology , Double-Blind Method , Arterial Pressure/physiology , Prospective Studies , Systole/physiology
13.
Rev. cuba. med. gen. integr ; 10(4): 340-3, oct.-dic. 1994. tab
Article in Spanish | LILACS | ID: lil-168861

ABSTRACT

Se realiza un estudio en pacientes con hipertension cronica desde antes de su embarazo, las cuales requerian tratamientos con drogas hipotensoras y dieta hiposodica y cuyas cifras tensionales al iniciar la gestion se mantenian por debajo de 109 mmHg de presion diastolica. Se constituyeron 2 grupos de estudio tomados al azar, a uno se le administraron hipotensores y al otro no. Las pacientes fueron observadas durante todo su embarazo hasta el parto. Se encuentra en este trabajo que el bajo peso al nacer y la prematuridad, tienen una incidencia mayor estadisticamente significativa en las pacientes que tuvieron tratamientos con drogas antihipertensivas; el uso de estas drogas no disminuyo la incidencia de preeclampsia sobreanadida


Subject(s)
Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Hydralazine/therapeutic use , Infant, Low Birth Weight , Infant, Premature , Methyldopa/therapeutic use , Pre-Eclampsia/epidemiology , Pregnancy Complications, Cardiovascular/drug therapy
14.
J. bras. med ; 67(2): 158-63, ago. 1994. tab
Article in Portuguese | LILACS | ID: lil-163354

ABSTRACT

O autor, após breve resumo das alteraçoes fisiopatológicas encontradas na toxemia gravídica, aconselha o uso de hidralazina, inibidores dos canais lentos de cálcio ou metildopa e condena o uso dos betabloqueadores, diuréticos e inibidores da ECA.


Subject(s)
Humans , Female , Pregnancy , Adrenergic beta-Antagonists/adverse effects , Calcium Channel Blockers/therapeutic use , Diuretics/adverse effects , Hydralazine/therapeutic use , Methyldopa/therapeutic use , Pre-Eclampsia/drug therapy , Pre-Eclampsia/physiopathology
15.
Acta méd. (Porto Alegre) ; 15: 523-31, 1994.
Article in Portuguese | LILACS | ID: lil-161379

ABSTRACT

Os autores ao fazerem esta revisäo bibliográfica, pretendem abordar aspectos de atualizaçäo e controvérsias no uso do digital em pacientes com insuficiência cardíaca congestiva


Subject(s)
Humans , Digitalis , Heart Failure/drug therapy , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Calcium Channel Blockers/therapeutic use , Hydralazine/therapeutic use , Nitrates/therapeutic use
16.
Article in English | IMSEAR | ID: sea-89251

ABSTRACT

We compared the effects of Hydralazine and Isosorbide dinitrate (ISDN) with those of an angiotensin-converting-enzyme inhibitor, captopril on mortality in patients with chronic congestive heart failure (NYHA class III and IV). Patients receiving conventional treatment with digoxin and diuretics were randomly assigned to receive either placebo (n = 51), hydralazine-ISDN. (n = 50) or captopril (n = 52) in a double blind trial. At the end of 6 months there were 14 deaths in the placebo group (27.4%) as compared with 11 deaths in the hydralazine-ISDN group (22%)--a mortality reduction of 20% (P > 0.05) and 10 deaths in the captopril group (19.2%)--a mortality reduction of 30% (p > 0.05). At the end of one year, mortality was 50%, 42% and 30% in the placebo, hydralazine-ISDN and captopril groups respectively with a mortality reduction of 16% in the hydralazine-ISDN group (p > 0.05) and 40% in the captopril group (p < 0.05) compared to the placebo group. The mortality reduction was mainly due to reduction in deaths attributed to progressive heart failure. The data suggests that the addition of captopril to conventional treatment significantly reduces mortality in patients with severe congestive heart failure. Hydralazine-isorobide dinitrate also reduced mortality but statistically this was not significant.


Subject(s)
Adult , Aged , Captopril/therapeutic use , Chi-Square Distribution , Chronic Disease , Double-Blind Method , Drug Therapy, Combination , Female , Heart Failure/drug therapy , Humans , Hydralazine/therapeutic use , Isosorbide Dinitrate/therapeutic use , Male , Middle Aged , Vasodilation/drug effects , Vasodilator Agents/therapeutic use
17.
Ginecol. obstet. Méx ; 61(3): 76-9, mar. 1993. tab
Article in Spanish | LILACS | ID: lil-121148

ABSTRACT

Se compararon los efectos maternos y fetales entre la hidralazina parenteral y la infedipina sublingual, usados como antihipertensivos en el manejo de la preeclampsia severa. El diseño fue prospectivo, comparativo, longitudinal, de asignación clínica aleatoria. Se realizó en el Centro Médico Nacional IMSS Torreón, Coah., división de Gineco-Obstetricia. las pacientes fueron mujeres embarazadas con diagnóstico de preeclampsia severa, asignadas al azar para recibir hidralazin parenteral o nifedipina sublingual como manejo antihipertensivo. La única diferencia observada fue que los recién nacidos cuyas madres recibieron hidralazina, tuvieron calificación de Apgar significativamente menor que los que recibieron nifedipina. Ambos medicamentos son una buena alternativa como tratamiento antihipertensivo en casos de preeclampsia severa. Los hijos de madre tratada con nifedipina tuvieron calificación de Apgar más alta.


Subject(s)
Humans , Female , Pregnancy , Eclampsia/drug therapy , Hydralazine/adverse effects , Nifedipine/adverse effects , Pregnancy Complications , Hydralazine/therapeutic use , Nifedipine/therapeutic use
18.
Acta méd. domin ; 14(6): 222-4, nov.-dic. 1992.
Article in Spanish | LILACS | ID: lil-132231

ABSTRACT

Estudiamos 30 pacientes con pre-eclampsia severa, manejados 15 de ellos con metildopa y los otros 15 con Hidralazina, en el Hospital Materno Infantil San Lorenzo en Los Mina D. N. Nuestro trabajo ofrece evidencia de superioridad de la Hidrazalina sobre la metildopa, pues la respuesta hipotensora es algo más rápida y el medicamento produce menos efectos colaterales indeseables. Ambos medicamentos son efectivos en reducir la presión arterial


Subject(s)
Humans , Female , Pregnancy , Hypertension/drug therapy , Hydralazine/therapeutic use , Methyldopa/therapeutic use , Pre-Eclampsia/drug therapy
20.
Arq. bras. cardiol ; 56(5): 381-383, maio 1991. tab
Article in Portuguese | LILACS | ID: lil-107856

ABSTRACT

Purpose­To evaluate the efficacy and safety of intravenous hidralazine in arterial hypertension. Patients and Methods­12 patients, meanage 45,33 15,82,8 men and 4 women all of them with systolic (S) arterialpressure (AP) 180 and or diastolic (D) 126 mmHg with symptoms like headache, incaracteristic toraxic pain and others but without an hypertensive emergency neither acute manifestation of hypertensive encephalopathy through fundi examination were studied. The AP was taked 10 minutes after rest (inicial) and 5, 15, 30 and 60 min (final) after intravenous administration of hidralazine-HCL (5mg) which was repeated when at least 20% AP reduction was not achieved. Results­ The inicial and final SAP, DAPand heart rate (HR) wre 208 ± 19,4 and 176 ± 17,2 (p < 0.0001), 133 ± 11,3 and 112 ± 11,5 (p< 0.001) and 72 ± 12,9 and 80 ± 15,5 (NS), respectively. Side effects related to the drug were observed in 3 (25%) patients. One had symptomatic ortostatic hypotension, the second had precordial pain with ST-T changes compatible with myocardial ischemia and the third presented a torax and abdominal cutaneous erithema, but all of them reversible. Conclusion­ Intravenous hydralazineHC1 is an alternative when rapid arterial pressurereduction is needed


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Emergencies , Hydralazine/therapeutic use , Hypertension/drug therapy , Hydralazine/administration & dosage , Hydralazine/pharmacology , Injections, Intravenous , Drug Evaluation , Heart Rate , Arterial Pressure
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