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The anti-hypertensive activity and influence on some forms of stress of slow-release Nicardipoine and Captopril were compared using a randomized 2:1 protocol. Thirty-six patients, mean age 55.9 years, suffering from slight or moderate arterial hypertension were treated with either 40 mg of Nicardipine retard twice a day (b.i.d.), or Captopril in a dose of 25 mg (b.i.d.) for 8 weeks. A significant reduction was observed in arterial pressure, both in orthostatism and clinostatism, following both treatments in comparison to the placebo period, but the group treated with slow-release Nicardipine showed a greater and statistically significant reduction in arterial pressure. No significant change in heart rate was reported using either drug. Non-invasive out-patient monitoring of arterial pressure, performed using Spacelabs 5300, showed a significant reduction in arterial pressure using both drugs and the conservation of the normal circadian rhythm of arterial pressure. The pressure response to the cold pressor test (CPT), mental arithmetic test (MAS), and to dynamic and isometric effort was positive with both drugs, thus revealing a degree of protection offered by treatment using these two substances. In overall terms, the two drugs were well tolerated.

Thirty-six patients (17 males and 19 females), aged between 40 and 70 years old (mean age 55.9), suffering from slight or moderate arterial hypertension, were monitored for four weeks after 14 days of placebo treatment. In a double-blind and random study 24 patients were treated with Nicardipine Retard (40 mg twice a day) whereas a further 12 received placebo twice a day. Sphigomanometric controls carried out after two and four weeks showed a significant reduction in arterial pressure only in those patients receiving active treatment. 24-hour out-patient monitoring of arterial pressure, carried out using Spacelabs 5300, showed a reduction in both systolic and diastolic arterial pressure throughout the day in subjects treated with calcium-antagonists compared to the placebo group. The normal physiological 24-hour trend of arterial pressure was always taken into account. The pressure response to a cold pressor test, mental arithmetic test, isometric and dynamic effort tests, measuring using a cycloergometer, was not modified by anti-hypertensive treatment, thus confirming the preservation of normal physiological behaviour during daily activities. There was no significant change in heart rate and the drug was well tolerated.

The aim of the study was to compare efficacy and safety of quinapril and lisinopril once-daily administered in patients with mild to moderate hypertension. After a two-week placebo period, 23 patients with sitting diastolic blood pressure between 95 and 110 mmHg were randomly assigned to the therapy with quinapril 20 mg/die or lisinopril 10 mg/die for 4 weeks in a single-blind design. After 4 weeks patients with diastolic blood pressure greater than 90 mmHg were treated with a higher dose (lisinopril 20 mg/die; quinapril 40 mg/die). Therapy with lisinopril normalized 83% of patients, and quinapril 45% of patients. Lisinopril was significantly better than quinapril in reducing blood pressure after 4 and 8 weeks of active treatment. The 24 hours ambulatory blood pressure monitoring showed that quinapril failed to control blood pressure after 12 hours from the administration of the drug.

We have measured the blood pressure to 1500 children aged between 6 and 14 years by sphingomanometric method, using various cuffs according to the recommendations of the A.H.A. Systolic and diastolic pressure was taken and the average value and standard deviations were calculated for each age. On the ground of the values equal or higher than 97 degrees percentil was the presence of 99 subjects afflicted with not secondary hypertension. We noticed that blood pressure increases with the age, is independent of sex, but bears relationship to the presence of obesity (out of 72 obese subjects, 25 were afflicted with hypertension), of menarca (17 hypertensive menstruated out of 27) and of family hypertension (31 hypertensive parents out of 41 examined). Neither relation was found between children's hypertension and socio-economical level nor between hypertension and presence of pathological proteinuria.

In spite of the widespread use of intravenous urography and its extensive employment in the study of hypertension, there is still no unanimity of views as to its application in such pathology. 147 urographies belonging to 330 hypertense patients admitted to the Bari Medical Pathology Department between 1-1-1975 and 30-9-1977 have therefore been examined so as to assess its diagnostic value. Thereafter, the percentage of abnormalities found with urography were evaluated and compared with those in the population at large. Results stress on the one hand the higher incidence of renal ptosis and poly-cystic kidneys in the hypertense, and also highlight the possibility of revealing clinically silent diseases with this technique; on the other hand, many urographies (more than 50%) were useless and it is not always possible to diagnose certainly the presence of stenosis of the renal artery owing to the presence of false positives and negatives.

Thirty hypertensive diabetic patients were randomly, double blindly, treated with Captopril (CPT) 50 mg + hydrochlorothiazide (HCTZ) 15 mg (No 19) or HCTZ 25 mg alone (No 11) for 3 months, to assess blood pressure control and some metabolic modifications. The results indicate that CPT + a low dose of HCTZ maintains the synergistic effect of the two drugs, minimizing the metabolic problems related to HCTZ in hypertensive diabetic patients.

It is well recognized that the co-administration of some drugs to persons receiving digoxin results in an increase of serum digoxin levels: it occasionally precipitates digoxin toxicity. There are some possible mechanisms by which different drugs may increase serum glycoside levels: 1) by displacing digoxin from tissue binding sites, 2) by decreasing digoxin renal excretion, 3) by enhancing digoxin absorption, 4) by increasing the inhibition of the ATP-dependent pump. Combined administration of calcium antagonists and B-methyldigoxin is common in patients with heart diseases. Other Authors have found that the co-administration of these drugs with digoxin increases glycoside serum levels, without signs of intoxication. We have examined the effects of this combination on digitalis activity, by Rubidium 86 uptake in erythrocytes. Thirty patients aged 52 to 66 with congestive heart failure were studied. All of these had normal serum creatinine, blood urea and serum protein levels. These subjects received 0,20 mg of B-methyldigoxin daily for nine days; afterwards, ten of them were given in addition 320 mg of verapamil for seven days; the other ten received in addition 60 mg of nifedipine, for seven days; the remaining ten patients received in addition 320 mg of verapamil and 60 mg of nifedipine together, for seven days. Digoxin activity was measured on the eighth, ninth and sixteenth day of treatment by Rubidium 86 uptake in erythrocytes. The technique was that of Bertler. Means were compared with the t test, with the assumption of the equal variances in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

ECG traces from 60 children aged 10-14 yr with hypertension were examined to see whether this condition itself was enough to alter the parameters in a statistical comparison with the traces for 19 normotensive children of the same age. Some statistically significant differences were noted in: the deviation of the P wave axis, increased left ventricle activation time, frequency and QTc segment, presence of anticlockwise rotation on the longitudinal plane and junctional rhythms. These support the view that changes in these parameters is not dependent on the concomitance of other diseases, but due to hypertension itself.