The effects of angiotensin II receptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed. The ascending aortic distensibility in 26 patients (48 +/- 3 years) with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan (50 mg/day) was evaluated by using two-dimensional echocardiography. M-mode measurements of aortic systolic (Ds) and diastolic diameter (Dd) were taken at a level approximately 3 cm above the aortic valve. Simultaneously, cuff brachial artery systolic (SBP) and diastolic (DBP) pressures were measured. Aortic pressure-strain elastic modulus (Ep) was calculated as Dd x (SBP-DBP)/(Ds-Dd) x 1333 and stiffness index beta (beta) was defined as Dd x Ln (SBP/DBP)/(Ds-Dd). Blood pressure significantly decreased from 148 +/- 13/95 +/- 9 mmHg to 138 +/- 12/88 +/- 8 mmHg (systolic blood pressure, P = 0.001; diastolic blood pressure, P = 0.003). There was no significant difference in pulse pressure before and after treatment with losartan (53 +/- 10 mmHg vs 50 +/- 7 mmHg). The distensibility of ascending aorta increased significantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42 +/- 5.79 x 10(6) dynes/cm2 to 1.99 +/- 1.49 x 10(6) dynes/cm2 (P = 0.02) and stiffness index beta from 27.4 +/- 32.9 to 13.3 +/- 9.9 (P = 0.02). Although there was a weak correlation between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in diastolic blood pressure after losartan treatment (r = 0.40, P = 0.04 and r = 0.55, P = 0.004, respectively), no correlation was found between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in systolic blood pressure (r = 0.04, P = 0.8 and r = 0.24, P = 0.2, respectively). Our study demonstrated that angiotensin II receptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.
Aorta/*physiopathology ; Aorta/ultrasonography ; Echocardiography ; Elasticity ; Hypertension/*drug therapy ; Hypertension/*physiopathology ; Hypertension/ultrasonography ; Losartan/*therapeutic use ; Receptors, Angiotensin/*antagonists & inhibitors

Antihypertensive Agents ; therapeutic use ; Chronic Disease ; Drug Therapy, Combination ; Humans ; Hypertension ; drug therapy ; Proteinuria ; physiopathology

Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; complications ; drug therapy ; physiopathology ; Hypotension, Orthostatic ; complications ; drug therapy ; physiopathology ; Male ; Middle Aged ; Syncope ; complications ; drug therapy ; physiopathology

Tadalafil is an oral phosphodiesterase type-5 inhibitor for male erectile dysfunction (ED). It has been proved to improve erectile function, with safety and effectiveness lasting up to 36 h, allowing patients to choose when to have sexual activities. Tadalafil is also efficacious in the treatment of ED associated with such diseases as hypertension, diabetes mellitus, etc. This article reviews the available evidence for the efficacy of tadalafil on ED and related diseases.
Carbolines ; therapeutic use ; Diabetes Mellitus ; drug therapy ; physiopathology ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Tadalafil ; Treatment Outcome

To briefly introduce the updated principles for treatment of hypertension by reviewing foreign literatures in point of this aspect and its progress. The strategies of hypertension treatment in our country experienced the development from "non-principles (NP)", "partial principles (PP)" to "full principles (FP)", and already realized five conversions, i.e. the conversion from simply depress the blood pressure to multi-drugs, multi-targets and multi-pathways comprehensive therapy, and put stress on both prevention and treatment. The authors emphasized that NP should be rejected completely, and population proportion of PP, especially FP used should be elevated in hypertension treatment in the future.
Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; China ; Drug Therapy, Combination ; Humans ; Hypertension ; drug therapy ; physiopathology ; prevention & control

OBJECTIVETo observe the effect of sodium ferulate on the hemodynamics of hepatic cirrhosis patients.

METHODSEighty-two hepatic cirrhosis patients were randomly assigned to two groups, the 27 patients in the control group were treated by conventional liver protecting therapy, and the 55 patients in the treated group were treated with sodium ferulate besides the conventional therapy. The therapeutic course for both groups was two weeks. The following indexes were measured before treatment and two weeks after treatment respectively: inner diameter of portal vein (PV), inner diameter of splenic vein (SPV), maximum portal vein flow rate (PVX), maximum splenic vein flow rate (SPVX), portal vein blood flow (QPV) and endothelin-1 (ET-1) concentration. The adverse effect was observed meanwhile.

RESULTSIn the treated group after treatment, levels of PV, SPV and ET-1 decreased (P < 0.01), PVX and SPVX increased significantly (P < 0.01), but QPV was unchanged; while no significant change of all the indexes was found in the control group (P > 0.05). Further analysis showed that in the treated group, PV, SPV and ET-1 decreased significantly in patients of Child grade A and B (P <0. 01), but QPV changed insignificantly (P > 0.05, and all indexes were unchanged in patients of Child grade C (P > 0.05).

CONCLUSIONSodium ferulate can effectively lower the pressure of portal vein in hepatic cirrhosis patients without any influence on the blood flow of portal vein, the effect is more significant on patients of Child grade A and B.

Adult ; Aged ; Coumaric Acids ; therapeutic use ; Female ; Hemodynamics ; drug effects ; Humans ; Hypertension, Portal ; drug therapy ; physiopathology ; Liver Cirrhosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Treatment Outcome

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; drug therapy ; pathology ; physiopathology ; Myocardial Infarction ; drug therapy ; pathology ; physiopathology ; Phytotherapy ; Ventricular Remodeling ; drug effects

AIMTo investigate whether pulmonary vascular remodeling in hypoxic pulmonary hypertensive rats could be prevented by treatment with a selective K(ATP)CO, iptkalim (Ipt).

METHODSRats were fed in hypoxic and normobaric environment (10% +/- 0.5% O2, 8 h/day and 6 day/week) and divided into control group, hypoxia group (hypoxic rat treated with ig NS 5.0 ml x kg(-1) x d(-1)), treated group I (hypoxic rat treated with ig Ipt 0.75 mg x kg(-1) x d(-1)), treated group II (hypoxic rat treated with ig Ipt 1.5 mg x kg(-1) x d(-1)). After 4 wk, the mean pulmonary arterial pressure (mPAP), right ventricle/left ventricle and septum [RV/(LV + S)] were measured, and the small pulmonary arterial morphologic changes were observed with morphometric analysis under microscopes in four groups.

RESULTSThe level of mPAP and RV/(LV+ S) was significantly higher in the hypoxic group than those in control group (P < 0.01). Morphometric analysis revealed that the ratio of vascular medial wall thickness to external diameter (MT%) and the ratio of vascular medial cross-sectional area to total arterial cross-sectional area (MA%) were also significantly increased in the hypoxic group than those in control group (P < 0.01) and the ratio of vessel lumen cross-sectional area to total arterial cross-sectional area (VA%) was significantly lower in the hypoxic group than those in control group (P < 0.01). Ipt 0.75 mg x kg(-1) x d(-1) or 1.5 mg x kg(-1) x d(-1) decreased the level of mPAP(mmHg), RV/(LV+ S), and inhibited the small pulmonary arterial remodeling significantly. Ipt 1.5 mg x kg(-1) x d(-1) reversed all pathological indices.

CONCLUSIONK(ATP)CO iptkalim can be a very promising candidate for the treatment of hypoxic pulmonary hypertension.

Animals ; Hypertension, Pulmonary ; drug therapy ; etiology ; physiopathology ; Hypoxia ; physiopathology ; KATP Channels ; agonists ; Male ; Propylamines ; pharmacology ; Rats ; Rats, Sprague-Dawley

Hypertension is one of the common cardiovascular diseases, and the role of endothelial dysfunction in pathogenesis and development of hypertension was paid more and more attention to increasingly. The laboratory and clinical studies on the improvement of vascular endothelial function by Chinese herbal medicine in hypertensive patients were reviewed in this paper.
Animals ; Antihypertensive Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; metabolism ; physiopathology ; Humans ; Hypertension ; drug therapy ; metabolism ; physiopathology

OBJECTIVETo explore the current status of morning blood pressure and medication of hypertensive patients in Beijing.

METHODSThis study included 2187 hypertensive patients who visited the ambulance of our cardiology department in the morning (7:00-10:00) from March 2012 to April 2012. Patients were divided into three groups: no antihypertensive agent group, single antihypertensive drug therapy group (include CCB, ARB, ACEI, β-blocker) and combined drug therapy group at least one month. Blood pressure control rate was compared among the groups.

RESULTSTarget blood pressure was not reached in 1193 patients (54.6%), most patients took CCB and the target blood pressure was not reached in 61.7% (295/478) patients taking CCB. There was no significant difference on target blood pressure uncontrolled rate among the four single drug subgroups (CCB, ARB, ACEI, β-blocker). The blood pressure uncontrolled rate was 46.3% (63/136) for amlodipine, 70.5% (55/78) for nifedipine and 73.8% (31/42) for felodipine. There OR of uncontrolled blood pressure rate was 0.36 (amlodipine vs. nifedipine, 95%CI:0.20-0.65) and 0.31% (amlodipine vs. felodipine, 95%CI:0.14-0.66).

CONCLUSIONThe morning blood pressure uncontrolled rate is high in hypertensive patients visiting Beijing tertiary hospitals. Amlodipine is possible superior to nifedipine and felodipine on morning blood pressure control in this patient cohort.

Adult ; Aged ; Blood Pressure ; drug effects ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Middle Aged ; Time Factors