302 results on '"Rahn KH"'
Search Results
2. Alterations of plasma calcium and intracellular and membrane calcium in erythrocytes of patients with pre-eclampsia
- Author
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Kosch, M, Hausberg, M, Louwen, F, Barenbrock, M, Rahn, KH, and Kisters, K
- Published
- 2000
- Full Text
- View/download PDF
3. Studies on diurnal blood pressure variation in kidney diseases associated with excessive salt and water retention
- Author
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Barenbrock, M, Spieker, C, Hausberg, M, Rahn, KH, Zidek, W, and Kisters, K
- Published
- 1999
- Full Text
- View/download PDF
4. A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients
- Author
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Barenbrock, M, Hausberg, M, Kosch, M, Kisters, K, Hoeks, APG, and Rahn, KH
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- 1998
- Full Text
- View/download PDF
5. Decreased cellular Mg2+ concentrations in a subgroup of hypertensives – cell models for the pathogenesis of primary hypertension
- Author
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Kisters, K, Tepel, M, Spieker, C, Dietl, KH, Barenbrock, M, Rahn, KH, and Zidek, W
- Published
- 1997
- Full Text
- View/download PDF
6. Renal function in treated and untreated hypertension
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Rahn, KH
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- 1998
- Full Text
- View/download PDF
7. Die »Hypertension Optimal Treatment« (HOT)-Studie: Behandlungsergebnisse nach zwölfmonatiger Therapie in Abhängigkeit vom Alter
- Author
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Kolloch Re and Rahn Kh
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Pediatrics ,medicine.medical_specialty ,Aspirin ,business.industry ,Optimal treatment ,Diastole ,General Medicine ,Hydrochlorothiazide ,Blood pressure ,Felodipine ,Medicine ,Platelet aggregation inhibitor ,business ,Prospective cohort study ,medicine.drug - Abstract
BACKGROUND AND OBJECTIVE: The prospective, randomized multicentre HOT study (Hypertension Optimal Treatment) is at present being undertaken in 26 countries. The cardinal questions to be answered were: (1) the relationship between three targeted diastolic pressures ( or = 100 to or = 65 years, n = 6113) were compared to those of younger patients ( 65 years, n = 6113) the corresponding percentage proportions were higher: 86%, 76% and 61%. Side effects were noted only rarely, despite the intensive treatment (> 65 years and or = 1%. The same treatment (with felodipine) was still being given after one year to 88% of all patients. CONCLUSION: These results after one year indicate that most patients well tolerate consistent blood pressure reduction. This raises the hope that the primary questions of the study can be answered.
- Published
- 2008
8. 2003 European Society of Hypertension???European Society of Cardiology guidelines for the management of arterial hypertension*
- Author
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MANCIA, GIUSEPPE, Rosei, EA, Cifkova, R, DeBacker, G, Erdine, S, Fagard, R, Farsang, C, Heagerty, AM, Kawecka Jaszcs, K, Kiowski, W, Kjeldsen, S, Luscher, T, McInnes, G, Mallion, JM, Brien, EO, Poulter, NR, Priori, SG, Rahn, KH, Rodicio, JL, Ruilope, LM, Safar, M, Staessen, JA, van Zwieten, P, Waeber, B, Williams, B, Zanchetti, A, Zannad, F., Mancia, G, Rosei, E, Cifkova, R, Debacker, G, Erdine, S, Fagard, R, Farsang, C, Heagerty, A, Kawecka Jaszcs, K, Kiowski, W, Kjeldsen, S, Luscher, T, Mcinnes, G, Mallion, J, Brien, E, Poulter, N, Priori, S, Rahn, K, Rodicio, J, Ruilope, L, Safar, M, Staessen, J, van Zwieten, P, Waeber, B, Williams, B, Zanchetti, A, and Zannad, F
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Physiology ,optimal treatment hot ,left-ventricular hypertrophy ,end-point reduction ,target-organ damage ,Blood Pressure Determination ,Guideline ,Clinical practice ,isolated systolic hypertension ,Risk Assessment ,Europe ,ambulatory blood-pressure ,randomized controlled trial ,Hypertension ,Internal Medicine ,Humans ,MED/09 - MEDICINA INTERNA ,coronary-heart-disease ,intima-media thickness ,Cardiology and Cardiovascular Medicine ,Risk Reduction Behavior ,converting-enzyme-inhibition ,Antihypertensive Agents - Abstract
ispartof: Journal of hypertension vol:21 issue:6 pages:1011-1053 ispartof: location:Netherlands status: published
- Published
- 2003
9. AMELIORATION OF ARTERIAL PROPERTIES WITH A PERINDOPRIL-INDAPAMIDE
- Author
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ASMAR RG, LONDON GM, O'ROURKE ME, MALLION JM, ROMERO R, RAHN KH, TRIMARCO, BRUNO, FITZGERALD D, HEDNER T, DUPREZ D, DE LEEUW PW, SEVER P, BATTEGAY E, HITZENBERGER G, DE LUCA, NICOLA, POLONIA P, BENETOS A, CHASTANG C, OLIVIER JP, SAFAR M.E., Asmar, Rg, London, Gm, O'Rourke, Me, Mallion, Jm, Romero, R, Rahn, Kh, Trimarco, Bruno, Fitzgerald, D, Hedner, T, Duprez, D, DE LEEUW, Pw, Sever, P, Battegay, E, Hitzenberger, G, DE LUCA, Nicola, Polonia, P, Benetos, A, Chastang, C, Olivier, Jp, and Safar, M. E.
- Published
- 2001
10. Hochschulambulanzen: heutiger Stand und zukünftige Perspektiven
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Bauer, H, Fölsch U, R, Gaebel, W, Korting, HC, Müller, W, Niebling, W, Rahn, KH, Roeder, N, Wagner, W, and Wienke, A
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Eine Stellungnahme der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) Erarbeitet von einer ad-hoc-Kommission der AWMF* und verabschiedet vom Präsidium der AWMF am 29. September 2011 * Mitglieder: Professor Dr. med. H. Bauer, Professor Dr. med. U. R. Fölsch, Professor Dr. med. W. Gaebel, Professor Dr. med. H. C. Korting, W. Müller M.A., Professor Dr. med. W. Niebling, Professor Dr. med. K. H. Rahn, Professor Dr. med. N. Roeder, Professor Dr. med. Dr. med. dent. W. Wagner, Dr. iur. A. Wienke Zusammenfassende Empfehlungen Die Verlagerung von Krankenversorgungsleistungen aus dem stationären in den ambulanten Sektor hat Konsequenzen für Forschung, Lehre und Weiterbildung in den Medizinischen Fakultäten und in den Universitätsklinika. Dadurch gewinnen Hochschulambulanzen zunehmend an Bedeutung. Nach § 117 Sozialgesetzbuch V ist der Zulassungsausschuss verpflichtet, auf Antrag Hochschulambulanzen zur ambulanten ärztlichen Behandlung von Versicherten in dem für Forschung und Lehre erforderlichen Umfang zu ermächtigen. Zu einer besseren Nutzung der Hochschulambulanzen hat die AWMF Empfehlungen erarbeitet. Hochschulambulanzen sind erforderlich, damit die Medizinischen Fakultäten ihre Aufgaben in Forschung, Lehre und Weiterbildung erfüllen können. Medizinische Fakultäten und Universitätsklinika müssen ihren Rechtsanspruch auf Ermächtigung zur ambulanten ärztlichen Behandlung durchsetzen. Die Patienten müssen unabhängig von einer Überweisung durch einen niedergelassenen Facharzt einen direkten Zugang zu den Hochschulambulanzen haben. Für den Zugang sollte es differenziert nach Fächern Fallzahlobergrenzen geben. Diese richten sich nach den Forschungsschwerpunkten der Fakultäten sowie nach den Aktivitäten der Fächer in Forschung, Lehre und Weiterbildung. Die Krankenversorgungskosten der Hochschulambulanzen müssen transparent und leistungsgerecht über Einzelleistungsvergütungen oder über Komplexpauschalen finanziert werden. Zusätzliche Kosten, die sich aus der Beteiligung an Forschung und Lehre ergeben, müssen aus dem Zuführungsbetrag der Medizinischen Fakultäten beglichen werden. Die Einrichtung von Ambulanzportalen wird für jedes Universitätsklinikum empfohlen. Von diesen Ambulanzportalen aus können die Patienten gezielt zu den jeweiligen Spezialambulanzen weitergeleitet werden. Die Ambulanzportale sollten eine eigene ärztliche Leitung haben. Hier bietet sich die Möglichkeit, Hochschullehrer für Allgemeinmedizin stärker in die Aktivitäten der Medizinischen Fakultäten einzubinden. An den Universitätsklinika sollte ein integriertes Informationssystem unter Einbeziehung der Hochschulambulanzen erarbeitet werden. Schnittstellen von den in den Hochschulambulanzen für die Krankenversorgung notwendigen Dokumentationssystemen zu den IT-Systemen der Forschung und des Studienmanagements müssen vorgesehen werden., GMS Mitteilungen aus der AWMF; 8:Doc28; ISSN 1860-4269
- Published
- 2011
11. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force documental
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Mancia, Giuseppe, Laurent, S, AGABITI ROSEI, Enrico, Ambrosioni, E, Burnier, M, Caulfield, Mj, Cifkova, R, Clément, D, Coca, A, Dominiczak, A, Erdine, S, Fagard, R, Farsang, C, Grassi, G, Haller, H, Heagerty, A, Kjeldsen, Se, Kiowski, W, Mallion, Jm, Manolis, A, Narkiewicz, K, Nilsson, P, Olsen, Mh, Rahn, Kh, Redon, J, Rodicio, J, Ruilope, L, Schmieder, Re, Struijker Boudier HA, Van Zwieten PA, Viigimaa, M, and Zanchetti, A.
- Published
- 2009
12. Circadian Blood Pressure Rhythms in Elderly Hypertensive Patients
- Author
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Grotemeyer Kh, Claus Spieker, Rahn Kh, Suss M, Walter Zidek, Michael Barenbrock, Wienecke M, and Zierden E
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hemodynamics ,Blood Pressure ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Rhythm ,Internal medicine ,medicine ,Humans ,Circadian rhythm ,Aged ,Aged, 80 and over ,Heart Failure ,Geriatrics ,Chronobiology ,Circadian blood pressure ,business.industry ,Biochemistry (medical) ,Age Factors ,Cell Biology ,General Medicine ,Middle Aged ,medicine.disease ,Circadian Rhythm ,Endocrinology ,Blood pressure ,Heart failure ,Hypertension ,Cardiology ,Female ,business - Abstract
Blood pressure was recorded for 24 h in 121 essential hypertensive patients aged between 20 and 90 years. To characterize the circadian blood pressure rhythm, the differences between the daytime blood pressures (recorded at 8-min intervals between 8 a.m. and 10 p.m.) and the night-time blood pressures (recorded at 30-min intervals between 10 p.m. and 8 a.m.) were calculated. The difference between daytime and night-time blood pressures was significantly ( P < 0.01) decreased in elderly hypertensive patients aged between 65 and 90 years compared with in those aged 20 – 39 years. In patients with heart insufficiency the circadian blood pressure rhythmicity was significantly ( P < 0.05) further reduced compared with in uncomplicated hypertensives. This may be explained by increased sympathetic tonus in patients with heart insufficiency and reduced vascular compliance may be the cause of the overall reduced circadian blood pressure rhythmicity in elderly hypertensive patients.
- Published
- 1991
13. Ambulatory 24-H Blood Pressure Monitoring in Essential Hypertensives Treated with the Angiotensin-Converting Enzyme Inhibitor Ramipril
- Author
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Claus Spieker, H Vetter, Rahn Kh, and Walter Zidek
- Subjects
Adult ,Male ,Ramipril ,medicine.medical_specialty ,Systole ,medicine.medical_treatment ,Urology ,Hemodynamics ,Angiotensin-Converting Enzyme Inhibitors ,Blood Pressure ,Placebo ,Biochemistry ,Bridged Bicyclo Compounds ,Double-Blind Method ,Diastole ,Heart Rate ,Internal medicine ,medicine ,Humans ,Chemotherapy ,biology ,business.industry ,Biochemistry (medical) ,Angiotensin-converting enzyme ,Cell Biology ,General Medicine ,Middle Aged ,Crossover study ,Blood Pressure Monitors ,Blood pressure ,Endocrinology ,Hypertension ,Ambulatory ,biology.protein ,Female ,business ,medicine.drug - Abstract
A double-blind, crossover study was carried out on the antihypertensive effect of 5 mg ramipril. Continuous 24-h blood pressure monitoring was performed on 15 essential hypertensives [mean (+/- SD) blood pressure 155.2 +/- 6.5/101.3 +/- 4.8 mmHg], 24 h prior to treatment and 48 h after having received either antihypertensive therapy or placebo; the patients taking part in the study had not taken any antihypertensive treatment 4 weeks prior to the beginning of the trial. After receiving 5 mg ramipril the mean 24-h blood pressure was significantly (P less than 0.05) reduced to 148.3 +/- 5.8/91.5 +/- 5.5 mmHg. After 48 h the blood pressure increased to 153.1 +/- 4.8/96.0 +/- 6.4 mmHg. In the placebo group there was only a slight, non-significant reduction in blood pressure on day 1 (154.3 +/- 6.9/97.3 +/- 5.7 mmHg) and during day 2 the blood pressure increased to 155.4 +/- 5.3/99.5 +/- 5.9 mmHg. The results showed that a once-daily administration of 5 mg ramipril produced a reduction in blood pressure, which lasted 24 h. This simple therapeutic regime offers the advantage of being easy for patients to follow and, therefore, promotes compliance with therapy.
- Published
- 1991
14. ESH-ESC guidelines for the management of hypertension
- Author
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Erdine, Serap, Ari, Oben, Zanchetti, A, Cifkova, R, Fagard, Robert, Kjeldsen, S, Mancia, G, Poulter, N, Rahn, KH, Rodicio, JL, Ruilope, LM, Staessen, Jan A, van Zwieten, P, Waeber, B, and Williams, B
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Male ,medicine.medical_specialty ,Ambulatory blood pressure ,Systole ,Cardiology ,Secondary hypertension ,Risk Assessment ,Prehypertension ,Pharmacotherapy ,Sex Factors ,Diastole ,Risk Factors ,Diabetes mellitus ,medicine ,Humans ,Diabetic Nephropathies ,Intensive care medicine ,Exercise ,Life Style ,Antihypertensive Agents ,Societies, Medical ,Aged ,Dyslipidemias ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,business.industry ,Age Factors ,Blood Pressure Determination ,Blood Pressure Monitoring, Ambulatory ,Middle Aged ,medicine.disease ,Prognosis ,Diet ,Europe ,Blood pressure ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,Emergency medicine ,Hypertension ,Aortic pressure ,Drug Therapy, Combination ,Female ,Kidney Diseases ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business - Abstract
The following is a brief statement of the 2003 European Society of Hypertension (ESH)-European Society of Cardiology (ESC) guidelines for the management of arterial hypertension. The continuous relationship between the level of blood pressure and cardiovascular risk makes the definition of hypertension arbitrary. Since risk factors cluster in hypertensive individuals, risk stratification should be made and decision about the management should not be based on blood pressure alone, but also according to the presence or absence of other risk factors, target organ damage, diabetes, and cardiovascular or renal damage, as well as on other aspects of the patient's personal, medical and social situation. Blood pressure values measured in the doctor's office or the clinic should commonly be used as reference. Ambulatory blood pressure monitoring may have clinical value, when considerable variability of office blood pressure is found over the same or different visits, high office blood pressure is measured in subjects otherwise at low global cardiovascular risk, there is marked discrepancy between blood pressure values measured in the office and at home, resistance to drug treatment is suspected, or research is involved. Secondary hypertension should always be investigated. The primary goal of treatment of patient with high blood pressure is to achieve the maximum reduction in long-term total risk of cardiovascular morbidity and mortality. This requires treatment of all the reversible factors identified, including smoking, dislipidemia, or diabetes, and the appropriate management of associated clinical conditions, as well as treatment of the raised blood pressure per se. On the basis of current evidence from trials, it can be recommended that blood pressure, both systolic and diastolic, be intensively lowered at least below 140/90 mmHg and to definitely lower values, if tolerated, in all hypertensive patients, and below 130/80 mmHg in diabetics. Lifestyle measures should be instituted whenever appropriate in all patients, including subjects with high normal blood pressure and patients who require drug treatment. The purpose is to lower blood pressure and to control other risk factors and clinical conditions present. In most, if not all, hypertensive patients, therapy should be started gradually, and target blood pressure achieved progressively through several weeks. To reach target blood pressure, it is likely that a large proportion of patients will require combination therapy with more than one agent. The main benefits of antihypertensive therapy are due to lowering of blood pressure per se. There is also evidence that specific drug classes may differ in some effect or in special groups of patients. The choice of drugs will be influenced by many factors, including previous experience of the patient with antihypertensive agents, cost of drugs, risk profile, presence or absence of target organ damage, clinical cardiovascular or renal disease or diabetes, patient's preference. ispartof: Herz vol:31 issue:4 pages:331-8 ispartof: location:Germany status: published
- Published
- 2006
15. Determination of arterial compliance using blood pressure waveform analysis with the CR-2000 system: Reliability, repeatability, and establishment of normal values for healthy European population--the seven European sites study (SESS)
- Author
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Zimlichman, R, Shargorodsky, M, Boaz, M, Duprez, D, Rahn, Kh, Rizzoni, Damiano, Payeras, Ac, Hamm, C, and Mcveigh, G.
- Published
- 2005
16. Contrasting effects of verapamil and amlodipine on cardiovascular stress responses in hypertension
- Author
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Lefrandt, JD, Heitmann, J, Sevre, K, Castellano, M, Hausberg, M, Fallon, M, Urbigkeit, A, Rostrup, M, Agabiti-Rosei, E, Rahn, KH, Murphy, M, Zannad, F, de Kam, PJ, Smit, AJ, Groningen Kidney Center (GKC), and Vascular Ageing Programme (VAP)
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verapamil ,CALCIUM-ANTAGONISTS ,noradrenaline ,HEART ,BLOCKERS ,rate-pressure product ,BLOOD-PRESSURE ,amlodipine ,stress responses ,ISCHEMIA - Abstract
Aims To compare the effects of two long-acting calcium antagonists of different types on cardiovascular,tress responses in hypertension. Methods One-hundred and forty-five patients with mild to moderate hypertension and a mean (+/- s.e.mean) age of 51 +/- 0.9 years received for 8 weeks the phenylalkylamine verapamil sustained release (240 mg) and the dihydropyridine amlodipine (5 mg) in a double-blind cross-over design, both after 4 weeks of placebo. Blood pressure, heart rate and plasma noradrenaline were monitored during 3 min of sustained isometric handgrip and 2 min of cold pressor. Results Blond pressure was equally reduced by both drugs. After 3 min handgrip, systolic blood pressure. heart rate and rate-pressure product were lower with verapamil compared with amlodipine. Verapamil attenuated the increases in systolic blood pressure (25 +/- 2 vs 30 +/- 2 mmHg, difference 4.6, 95% CI (1.0, 8.1), P
- Published
- 2001
17. Interaktionen von Antihypertensiva mit anderen Arzneimitteln
- Author
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Rahn Kh
- Subjects
General Medicine - Published
- 2008
18. Calciumantagonisten in der Hochdrucktherapie
- Author
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Rahn Kh
- Subjects
chemistry ,business.industry ,Medicine ,chemistry.chemical_element ,General Medicine ,Pharmacology ,Calcium ,business - Published
- 2008
19. Acute hypertension after renal allograft rejection therapy with OKT3 monoclonal antibody
- Author
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Walter Zidek, Claus Spieker, Michael Barenbrock, R. Wieneke, B. Buchholz, and Rahn Kh
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Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Prednisolone ,Diastole ,Hemodynamics ,Blood Pressure ,030204 cardiovascular system & hematology ,Monoclonal antibody ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,Internal medicine ,medicine ,Humans ,Adverse effect ,Monitoring, Physiologic ,Kidney ,business.industry ,Biochemistry (medical) ,Cell Biology ,General Medicine ,Immunotherapy ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Surgery ,medicine.anatomical_structure ,Blood pressure ,030220 oncology & carcinogenesis ,Heart failure ,Acute Disease ,Hypertension ,Injections, Intravenous ,Cardiology ,Female ,business ,Muromonab-CD3 - Abstract
Acute rejection of renal allografts was treated with the monoclonal antibody OKT3 given intravenously. A variety of adverse events were observed on days 1 and 2 following treatment with 5 mg/day OKT3 for 10 days including heart failure, pulmonary oedema and hypertension. Continuous monitoring of 19 patients treated with OKT3 for acute renal allograft rejection detected a transient increase, lasting 2 h, in systolic and diastolic blood pressures on day 1. A larger increase in systolic and diastolic pressures lasting 11 – 13 h was observed on day 2. Treatment with 5 mg OKT3 on day 3 did not significantly increase systolic or diastolic pressure. It is concluded that OKT3 can aggravate hypertension and hypertensive emergencies may be encountered during the initial phase of OKT3 treatment.
- Published
- 1991
20. Increased membraneous calcium concentrations in primary hypertension: a causal link to pathogenesis?
- Author
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Kosch, M, primary, Hausberg, M, additional, Barenbrock, M, additional, Posadzy-Malaczynska, A, additional, Rahn, KH, additional, and Kisters, K, additional
- Published
- 2000
- Full Text
- View/download PDF
21. How to assess glomerular function and damage in humans.
- Author
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Rahn KH, Heidenreich S, Brückner D, Rahn, K H, Heidenreich, S, and Brückner, D
- Published
- 1999
- Full Text
- View/download PDF
22. Risk factors associated with alterations in carotid intima-media thickness in hypertension: baseline data from the European Lacidipine Study on Atherosclerosis.
- Author
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Zanchetti A, Bond MG, Hennig M, Neiss A, Mancia G, Dal Palù C, Hansson L, Magnani B, Rahn KH, Reid J, Rodicio J, Safar M, Eckes L, Ravinetto R, Zanchetti, A, Bond, M G, Hennig, M, Neiss, A, Mancia, G, and Dal Palù, C
- Published
- 1998
- Full Text
- View/download PDF
23. Clinical Pharmacology of Diuretics
- Author
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Rahn Kh
- Subjects
Sodium Chloride Symporter Inhibitors ,Spironolactone ,Pharmacology ,Intestinal absorption ,law.invention ,chemistry.chemical_compound ,Pharmacokinetics ,law ,Canrenone ,Internal Medicine ,medicine ,Humans ,Diuretics ,Thiazide ,Clinical pharmacology ,business.industry ,Kinetics ,PHARMACODYNAMIC DRUG INTERACTIONS ,Ethacrynic Acid ,Hydrochlorothiazide ,Intestinal Absorption ,chemistry ,Pharmacodynamics ,Canrenoic Acid ,business ,Protein Binding ,medicine.drug - Abstract
Diuretics belong to the drugs most frequently used. Thiazide diuretics, loop diuretics and potassium sparing diuretics are the agents with practical significance. Many data concerning the pharmacokinetics of these drugs have been reported. Nevertheless, the metabolism of some diuretics is not yet fully elucidated. There are numerous pharmacodynamic drug interactions with diuretics which in general can be predicted from the spectrum of pharmacodynamic actions of the drugs involved.
- Published
- 1983
24. Hypercalcitoninaemia in patients with pheochromocytoma
- Author
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Raue F, Ch. Herfarth, H. Minne, R. Ziegler, Rahn Kh, and J. M. Bayer
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Adult ,Calcitonin ,endocrine system ,medicine.medical_specialty ,Adolescent ,endocrine system diseases ,Pheochromocytoma ,Angina Pectoris ,Thyroid carcinoma ,Vanilmandelic Acid ,Pregnancy ,Internal medicine ,Drug Discovery ,medicine ,Humans ,Thyroid Neoplasms ,Genetics (clinical) ,Tumor marker ,Goiter ,business.industry ,Thyroid ,Radioimmunoassay ,General Medicine ,Middle Aged ,medicine.disease ,Pentagastrin ,Endocrinology ,medicine.anatomical_structure ,Medullary carcinoma ,Hypertension ,Molecular Medicine ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
As pheochromocytoma sometimes is accompanied by medullary thyroid carcinoma (in the sense of multiple endocrine adonomatosis type II = Sipple-Syndrome), serum calcitonin (CT) was measured by radioimmunoassay in 4 patients with pheochromocytoma. Before extirpation of the adreno-medullary tumor, serum CT was distinctly increased to 3 and 30 ng/ml in 2 of 4 patients, respectively. After removal of the tumor, serum CT was normal in the patients and pentagastrin stimulation produced no exaggerated CT response. In hydrochloric acid extracts from the two corresponding pheochromocytoma tissues, immunoreactive-Calcitonin (IR-CT) was detected, the concentrations amounting 1 and 4 ng/mg wet tissue. These findings suggest that hypercalcitonism in patients with pheochromocytoma cannot always be ascribed to the thyroid, i.e. increased calcitonin levels do not necessarily indicate a medullary carcinoma of this organ.
- Published
- 1978
25. Clinical evaluation of antiarrhythmic drugs
- Author
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Rahn Kh
- Subjects
Pharmacology ,business.industry ,medicine.medical_treatment ,Sodium ,Pharmacology toxicology ,Arrhythmias, Cardiac ,Blood Pressure ,General Medicine ,Plasma levels ,Antiarrhythmic agent ,Electrocardiography ,Therapeutic index ,medicine ,Humans ,Cardiac Output ,business ,Anti-Arrhythmia Agents ,Venous Pressure ,Clinical evaluation - Abstract
Electrocardiogram recordings allow evaluation of antiarrhythmic effects in man. Unwanted effects on cardiovascular function are most easily detected by hemodynamic studies. It seems most important to know the therapeutic range of plasma levels of each antiarrhythmic agent in man and also the dosage to obtain these levels.
- Published
- 1971
26. Beta-adrenergic blocking activity and haemodynamic effects in man of K� 1313, a new beta-adrenergic antagonist
- Author
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Gilfrich Hj, Nicolescu Rf, and Rahn Kh
- Subjects
Adult ,Tachycardia ,medicine.medical_specialty ,Cardiac output ,Adolescent ,Adrenergic receptor ,Cardiac Volume ,Adrenergic beta-Antagonists ,Administration, Oral ,Blood Pressure ,1-Propanol ,Propranolol ,Pharmacology ,Electrocardiography ,Heart Rate ,Oral administration ,Internal medicine ,Nitriles ,Heart rate ,medicine ,Humans ,Pharmacology (medical) ,Cardiac Output ,Beta-adrenergic blocking agent ,Propylamines ,business.industry ,Hemodynamics ,Isoproterenol ,General Medicine ,Middle Aged ,Amino Alcohols ,Dose–response relationship ,Endocrinology ,Injections, Intravenous ,Sympatholytics ,Vascular Resistance ,medicine.symptom ,business ,medicine.drug - Abstract
The beta-adrenergic blocking activity and haemodynamic effects of o-[2-hydroxy-3-(isopropylamino)-propoxy]-benzonitril (Ko 1313) have been studied in 22 patients. Antagonism of isoproterenol-induced tachycardia was used as a measure of the beta-adrenergic blocking activity. Ko 1313 1.0 mg had its maximum beta-adrenoceptor blocking effect 5–30 min after intravenous injection. Ko 1313 10.0 mg produced maximum betablockade 1–4 h after oral administration. 1.0 mg Ko 1313 injected intravenously had approximately the same beta-adrenergic blocking effect as 1.0 mg propranolol also given intravenously. After intravenous administration Ko 1313 was 3–4 times as potent as the same dose given orally. An intravenous dose of 2.0 mg Ko 1313 reduced the heart rate and produced insignificant fall in cardiac output. Total peripheral resistance was increased by Ko 1313.
- Published
- 1971
27. The use of calcium antagonists in patients with renal failure
- Author
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Rahn Kh, Mooy Jm, and Van Bortel Lm
- Subjects
medicine.medical_specialty ,Nifedipine ,Physiology ,chemistry.chemical_element ,Calcium ,urologic and male genital diseases ,Angina ,Diltiazem ,Pharmacokinetics ,Nitrendipine ,Internal medicine ,Internal Medicine ,Medicine ,Humans ,business.industry ,medicine.disease ,Calcium Channel Blockers ,Blood pressure ,chemistry ,Verapamil ,cardiovascular system ,Cardiology ,Kidney Failure, Chronic ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Calcium antagonists are now frequently used for the treatment of high blood pressure, angina pectoris and cardiac arrhythmias. Increasingly, these drugs are also given to patients with renal failure, since several studies have demonstrated that calcium antagonists lower blood pressure in patients with renal hypertension and renal insufficiency. Relevant pharmacokinetic parameters for verapamil, nitrendipine and diltiazem are not altered in renal failure. The situation is more complex in the case of nifedipine. However, studies with repeated administration have demonstrated that the calcium antagonists verapamil, diltiazem, nifedipine and nitrendipine can be given in the same doses to patients with renal failure as to patients with normal renal function.
- Published
- 1987
28. A comparison of catecholamine concentrations and dopamine-beta-hydroxylase activities in plasma from normotensive subjects and from patients with essential hypertension at rest and during exercise
- Author
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G. Planz, A. Hawlina, Rahn Kh, H. W. Gierlichs, W. Stephany, and R. Planz
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physical Exertion ,Physical exercise ,Dopamine beta-Hydroxylase ,Essential hypertension ,Catecholamines ,Internal medicine ,Drug Discovery ,Dopamine β hydroxylase ,medicine ,Humans ,In patient ,Genetics (clinical) ,Rest (music) ,business.industry ,Sympathetic nerve activity ,Dopamine beta-monooxygenase ,General Medicine ,medicine.disease ,Endocrinology ,Hypertension ,Catecholamine ,Molecular Medicine ,business ,medicine.drug - Abstract
In 8 normotensive subjects and in 8 patients with essential hypertension total catecholamine content and dopamine-beta-hydroxylase (DBH) activity in plasma were measured at rest and during physical exercise. Catecholamine levels at rest were significantly higher in the hypertensive than in the normotensive persons whereas the 2 groups of subjects did not differ in DBH activity at rest. At a work load of 150 watts there was a more pronounced increase of the catecholamine concentrations and of the DBH activity in the hypertensive patients than in the normotensives. One may conclude from the data that there is an increased sympathetic nerve activity in patients with essential hypertension.
- Published
- 1976
29. Premenstrual Syndrome
- Author
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Böhm R, Mooy J, vd Vet A, and Rahn Kh
- Subjects
Reduction (complexity) ,business.industry ,Medicine ,Verapamil ,General Medicine ,Pharmacology ,business ,medicine.drug ,Bioavailability - Published
- 1985
30. Vascular smooth muscle and striated heart muscle cell magnesium content in SHR.
- Author
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Kisters, K, Krefting, ER, Barenbrock, M, Hausberg, M, and Rahn, KH
- Published
- 1999
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31. Plasma and membrane Ca ++ and Mg ++ concentrations in normal pregnancy and in preeclampsia.
- Author
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Kisters, K, Louwen, F, Witteler, R, Westermann, G, and Rahn, KH
- Published
- 1999
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32. Agreement within Europe about antihypertensive treatment and education - results from the European Society of Hypertension questionnaire.
- Author
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Olsen MH, Mallion JM, Rahn KH, Erdine S, Viigimaa M, Laurent S, Agabiti-Rosei E, Mancia G, Schmieder RE, Cifkova R, Dominiczak A, Kjeldsen SE, Redon J, Zanchetti A, Nilsson P, Narkiewicz K, and ESH Council
- Published
- 2010
- Full Text
- View/download PDF
33. High blood pressure in pregnancy: effects of Ca2+ and Mg2+.
- Author
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Kisters K, Louwen F, Witteler R, Hausberg M, Barenbrock M, and Rahn KH
- Published
- 1998
34. Sodium transport and exchange in spontaneously hypertensive rats.
- Author
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Kisters K and Rahn KH
- Published
- 1999
35. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group.
- Author
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Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, Menard J, Rahn KH, Wedel H, Westerling S, Hansson, L, Zanchetti, A, Carruthers, S G, Dahlöf, B, Elmfeldt, D, Julius, S, Ménard, J, Rahn, K H, Wedel, H, and Westerling, S
- Abstract
Background: Despite treatment, there is often a higher incidence of cardiovascular complications in patients with hypertension than in normotensive individuals. Inadequate reduction of their blood pressure is a likely cause, but the optimum target blood pressure is not known. The impact of acetylsalicylic acid (aspirin) has never been investigated in patients with hypertension. We aimed to assess the optimum target diastolic blood pressure and the potential benefit of a low dose of acetylsalicylic acid in the treatment of hypertension.Methods: 18790 patients, from 26 countries, aged 50-80 years (mean 61.5 years) with hypertension and diastolic blood pressure between 100 mm Hg and 115 mm Hg (mean 105 mm Hg) were randomly assigned a target diastolic blood pressure. 6264 patients were allocated to the target pressure < or =90 mm Hg, 6264 to < or =85 mm Hg, and 6262 to < or =80 mm Hg. Felodipine was given as baseline therapy with the addition of other agents, according to a five-step regimen. In addition, 9399 patients were randomly assigned 75 mg/day acetylsalicylic acid (Bamycor, Astra) and 9391 patients were assigned placebo.Findings: Diastolic blood pressure was reduced by 20.3 mm Hg, 22.3 mm Hg, and 24.3 mm Hg, in the < or =90 mm Hg, < or =85 mm Hg, and < or =80 mm Hg target groups, respectively. The lowest incidence of major cardiovascular events occurred at a mean achieved diastolic blood pressure of 82.6 mm Hg; the lowest risk of cardiovascular mortality occurred at 86.5 mm Hg. Further reduction below these blood pressures was safe. In patients with diabetes mellitus there was a 51% reduction in major cardiovascular events in target group < or =80 mm Hg compared with target group < or =90 mm Hg (p for trend=0.005). Acetylsalicylic acid reduced major cardiovascular events by 15% (p=0.03) and all myocardial infarction by 36% (p=0.002), with no effect on stroke. There were seven fatal bleeds in the acetylsalicylic acid group and eight in the placebo group, and 129 versus 70 non-fatal major bleeds in the two groups, respectively (p<0.001).Interpretation: Intensive lowering of blood pressure in patients with hypertension was associated with a low rate of cardiovascular events. The HOT Study shows the benefits of lowering the diastolic blood pressure down to 82.6 mm Hg. Acetylsalicylic acid significantly reduced major cardiovascular events with the greatest benefit seen in all myocardial infarction. There was no effect on the incidence of stroke or fatal bleeds, but non-fatal major bleeds were twice as common. [ABSTRACT FROM AUTHOR]- Published
- 1998
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36. [New hypertension guidelines].
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Rahn KH
- Subjects
- Humans, Antihypertensive Agents standards, Antihypertensive Agents therapeutic use, Cardiology standards, Hypertension diagnosis, Hypertension therapy, Sympathectomy standards
- Published
- 2013
- Full Text
- View/download PDF
37. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document.
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Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfield MJ, Cifkova R, Clément D, Coca A, Dominiczak A, Erdine S, Fagard R, Farsang C, Grassi G, Haller H, Heagerty A, Kjeldsen SE, Kiowski W, Mallion JM, Manolis A, Narkiewicz K, Nilsson P, Olsen MH, Rahn KH, Redon J, Rodicio J, Ruilope L, Schmieder RE, Struijker-Boudier HA, van Zwieten PA, Viigimaa M, and Zanchetti A
- Subjects
- Europe, Humans, Hypertension physiopathology, Hypertension drug therapy, Practice Guidelines as Topic
- Published
- 2009
- Full Text
- View/download PDF
38. [Differential hypertensive therapy according to the guidelines].
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Rahn KH
- Subjects
- Germany, Humans, Antihypertensive Agents administration & dosage, Antihypertensive Agents classification, Cardiology standards, Hypertension drug therapy, Practice Guidelines as Topic
- Abstract
The goal of antihypertensive therapy is to lower blood pressure and, by doing so, to decrease cardiovascular risk. Life style changes and drugs are available for the treatment of hypertensive patients. In order to reach the target blood pressure, most patients with hypertension need drug treatment in addition to life style changes. In all hypertensive patients, the target blood pressure is <140/90 mmHg. In patients with diabetes mellitus, with chronic renal failure as well as in patients with complications of hypertension and, thereby a very high cardiovascular risk, the target blood pressure is <130/80 mmHg. Diuretics, beta-blockers, calcium antagonists, ACE-inhibitors and angiotensin receptor blockers are the drugs of first choice in the treatment of hypertension. The selection among these drug classes has to consider probable side effects as well as accompanying diseases and complications of hypertension. One should also take into account that most of the beneficial effects of antihypertensive therapy is due to the decrease of blood pressure per se and that the majority of hypertensive patients require the combination of two or more antihypertensive drugs in order to reach the target blood pressure.
- Published
- 2009
- Full Text
- View/download PDF
39. A randomized, double-blind study of valsartan versus metoprolol on arterial distensibility and endothelial function in essential hypertension.
- Author
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Kosch M, Levers A, Lang D, Bartels V, Rahn KH, Pavenstädt H, and Hausberg M
- Subjects
- Adult, Antihypertensive Agents pharmacology, Blood Flow Velocity physiology, Blood Pressure physiology, Dose-Response Relationship, Drug, Double-Blind Method, Elasticity, Female, Humans, Hypertension physiopathology, Male, Metoprolol pharmacology, Middle Aged, Sympathetic Nervous System physiology, Tetrazoles pharmacology, Tunica Intima diagnostic imaging, Tunica Media diagnostic imaging, Ultrasonography, Valine pharmacology, Valine therapeutic use, Valsartan, Antihypertensive Agents therapeutic use, Brachial Artery physiopathology, Carotid Arteries physiopathology, Endothelium, Vascular physiopathology, Hypertension drug therapy, Metoprolol therapeutic use, Tetrazoles therapeutic use, Valine analogs & derivatives
- Abstract
Background: Antihypertensive drugs may have differential, pressure-independent effects on hypertension-associated alterations of arterial function. We compared the effects of a 12-week therapy with the AT(1)-receptor antagonist valsartan (Val) versus the beta-blocker metoprolol (Met) on arterial stiffness and endothelial function in mildly hypertensive patients at rest and during generalized sympathetic stimulation., Methods: Sixty-eight patients (37 male, 31 female, 46 +/- 6 years) were randomized to Val (80-160 mg/d) or Met (50-100 mg/d). Effects of therapy on endothelial function, brachial and carotid artery distensibility coefficients, pulse wave velocity, carotid intima-media thickness and elastic modulus were assessed at rest and during the cold pressor test., Results: Fifty-two patients were available for per protocol analysis. Blood pressure was comparably reduced in both treatment groups. Effects on endothelial function and large artery elastic wall properties did not differ significantly between the two antihypertensive treatment regimens. Trends did not differ significantly between groups for any parameter including carotid intima-media thickness and elastic modulus., Conclusion: Short-term treatment with Val and Met had similar effects on large artery functional vessel wall properties in a population of mildly hypertensive patients.
- Published
- 2008
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40. ACE inhibition after renal transplantation: the effect on persistent left ventricular hypertrophy.
- Author
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Rahn KH
- Published
- 2008
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41. [Are beta blockers no longer the medicines of choice for the treatment of hypertension?].
- Author
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Rahn KH
- Subjects
- Adrenergic beta-Antagonists therapeutic use, Antihypertensive Agents therapeutic use, Blood Pressure drug effects, Diuretics adverse effects, Diuretics therapeutic use, Drug Therapy, Combination, Heart Failure drug therapy, Humans, Meta-Analysis as Topic, Treatment Outcome, Adrenergic beta-Antagonists adverse effects, Antihypertensive Agents adverse effects, Hypertension drug therapy, Stroke chemically induced
- Abstract
Intervention studies indicate that beta blockers as well as diuretics have unfavourable effects on lipid metabolism and lead to new onsets of diabetes mellitus more frequently than ACE inhibitors, AT1 antagonists and calcium antagonists. Moreover, a meta-analysis showed an elevated risk for strokes in hypertensive patients treated with beta blockers. Until the conclusion of other controlled studies, beta blockers will nevertheless retain their important role in the treatment of hypertensive patients with coronary heart disease or heart failure. They should continue to be one of the preferred antihypertensives.
- Published
- 2007
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- View/download PDF
42. [Treating essential hypertension. Are beta blockers still first choice?].
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Rahn KH
- Subjects
- Amlodipine therapeutic use, Atenolol therapeutic use, Bendroflumethiazide therapeutic use, Coronary Disease mortality, Coronary Disease prevention & control, Drug Therapy, Combination, Humans, Multicenter Studies as Topic, Myocardial Infarction mortality, Myocardial Infarction prevention & control, Outcome Assessment, Health Care, Perindopril therapeutic use, Practice Guidelines as Topic, Randomized Controlled Trials as Topic, Stroke mortality, Stroke prevention & control, Adrenergic beta-Antagonists therapeutic use, Antihypertensive Agents therapeutic use, Hypertension drug therapy
- Published
- 2007
43. ESH-ESC guidelines for the management of hypertension.
- Author
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Erdine S, Ari O, Zanchetti A, Cifkova R, Fagard R, Kjeldsen S, Mancia G, Poulter N, Rahn KH, Rodicio JL, Ruilope LM, Staessen J, van Zwieten P, Waeber B, and Williams B
- Subjects
- Age Factors, Aged, Aged, 80 and over, Antihypertensive Agents administration & dosage, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory, Cardiology, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 1 therapy, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 therapy, Diabetic Nephropathies prevention & control, Diastole, Diet, Drug Therapy, Combination, Dyslipidemias complications, Dyslipidemias therapy, Europe, Exercise, Female, Humans, Hypertension classification, Hypertension complications, Hypertension diagnosis, Hypertension drug therapy, Kidney Diseases complications, Kidney Diseases prevention & control, Kidney Diseases therapy, Life Style, Male, Middle Aged, Prognosis, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Sex Factors, Societies, Medical, Systole, Antihypertensive Agents therapeutic use, Hypertension therapy
- Abstract
The following is a brief statement of the 2003 European Society of Hypertension (ESH)-European Society of Cardiology (ESC) guidelines for the management of arterial hypertension. The continuous relationship between the level of blood pressure and cardiovascular risk makes the definition of hypertension arbitrary. Since risk factors cluster in hypertensive individuals, risk stratification should be made and decision about the management should not be based on blood pressure alone, but also according to the presence or absence of other risk factors, target organ damage, diabetes, and cardiovascular or renal damage, as well as on other aspects of the patient's personal, medical and social situation. Blood pressure values measured in the doctor's office or the clinic should commonly be used as reference. Ambulatory blood pressure monitoring may have clinical value, when considerable variability of office blood pressure is found over the same or different visits, high office blood pressure is measured in subjects otherwise at low global cardiovascular risk, there is marked discrepancy between blood pressure values measured in the office and at home, resistance to drug treatment is suspected, or research is involved. Secondary hypertension should always be investigated. The primary goal of treatment of patient with high blood pressure is to achieve the maximum reduction in long-term total risk of cardiovascular morbidity and mortality. This requires treatment of all the reversible factors identified, including smoking, dislipidemia, or diabetes, and the appropriate management of associated clinical conditions, as well as treatment of the raised blood pressure per se. On the basis of current evidence from trials, it can be recommended that blood pressure, both systolic and diastolic, be intensively lowered at least below 140/90 mmHg and to definitely lower values, if tolerated, in all hypertensive patients, and below 130/80 mmHg in diabetics. Lifestyle measures should be instituted whenever appropriate in all patients, including subjects with high normal blood pressure and patients who require drug treatment. The purpose is to lower blood pressure and to control other risk factors and clinical conditions present. In most, if not all, hypertensive patients, therapy should be started gradually, and target blood pressure achieved progressively through several weeks. To reach target blood pressure, it is likely that a large proportion of patients will require combination therapy with more than one agent. The main benefits of antihypertensive therapy are due to lowering of blood pressure per se. There is also evidence that specific drug classes may differ in some effect or in special groups of patients. The choice of drugs will be influenced by many factors, including previous experience of the patient with antihypertensive agents, cost of drugs, risk profile, presence or absence of target organ damage, clinical cardiovascular or renal disease or diabetes, patient's preference.
- Published
- 2006
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- View/download PDF
44. The role of calcium antagonists in patients with chronic renal failure.
- Author
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Rahn KH
- Subjects
- Adolescent, Angiotensin II Type 1 Receptor Blockers pharmacology, Angiotensin-Converting Enzyme Inhibitors pharmacology, Calcium Channel Blockers pharmacology, Cardiovascular Diseases prevention & control, Child, Disease Progression, Humans, Kidney Failure, Chronic prevention & control, Renin-Angiotensin System drug effects, Angiotensin II Type 1 Receptor Blockers therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Calcium Channel Blockers therapeutic use, Hypertension drug therapy, Kidney Failure, Chronic drug therapy
- Abstract
The objective of antihypertensive treatment in patients with chronic renal failure, many of whom have elevated blood pressure levels, is to reduce cardiovascular events and to slow down the progression of kidney function impairment. Calcium antagonists have been shown to be effective and safe antihypertensive drugs in patients from different age groups, including children. On the basis of numerous studies, one may conclude that the main benefit of antihypertensive therapy is because of the blood pressure lowering effect per se and that calcium antagonists do not differ from other antihypertensive drugs in the ability to prevent cardiovascular complications of hypertension. In particular, calcium antagonists are not inferior to other groups of antihypertensive agents in the prevention of coronary artery disease. There is, however, now evidence from controlled clinical trials that drugs interfering with the renin-angiotensin system are more beneficial than other antihypertensive agents in patients with chronic renal failure. Thus, several studies have demonstrated that ACE-inhibitors and, in patients with type-2 diabetic nephropathy, AT 1-antagonists are superior to other classes of antihypertensive drugs, including calcium antagonists, in delaying the progression of renal insufficiency. Therefore, in hypertensive patients with chronic renal failure antihypertensive treatment should be initiated with a drug that inhibits the renin-angiotensin system.
- Published
- 2005
- Full Text
- View/download PDF
45. Arterial distensibility, intima media thickness and pulse wave velocity after renal transplantation and in dialysis normotensive patients.
- Author
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Posadzy-Malaczyñska A, Kosch M, Hausberg M, Rahn KH, Stanisic G, Malaczynski P, Gluszek J, and Tykarski A
- Subjects
- Blood Flow Velocity, Female, Humans, Kidney Failure, Chronic diagnostic imaging, Kidney Transplantation, Male, Middle Aged, Postoperative Period, Ultrasonography, Doppler, Pulsed, Carotid Artery, Common pathology, Kidney Failure, Chronic pathology, Renal Dialysis, Tunica Intima pathology
- Abstract
Aim: Structural and mechanical properties of the arterial wall are altered in patients with renal failure. The ageing process of the arterial wall appears to be accelerated in patients with end-stage renal failure. The mechanisms responsible for reduced arterial compliance and distensibility in dialysis patients and renal transplant recipients without hypertension remain to be evaluated., Methods: Thirty-five normotensive dialysis patients (D), 35 normotensive renal transplant recipients (T) and 35 healthy volunteers (N) matched for age, sex and blood pressure as controls were enrolled into the study. The arterial blood pressure of all patients was < 140/90 mmHg. The dialysis patients and renal transplant recipients were eligible for the study if the serum creatinine level was < 2 mg/dL. In all subjects, fasting concentrations of serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol and hemoglobin and glucose were determined at enrollment to the study. Blood pressure was measured using an automatic sphygmomanometer. Pulse wave velocity (PWV) was evaluated using non invasive automatic Complior device. The vessel wall properties of the left common carotid artery were studied using multigate pulsed Doppler system. With this method, the end-diastolic diameter (d) and the systolic increase of vessel diameter (distension DELTAd) were measured. From these data the relative systolic increase of vessel diameter (DELTAd/d) and the arterial wall distensibility coefficient (DC) were calculated., Results: Systolic blood pressure (SBP) and central pulse pressure (CPP) were significantly higher in T than in D and N group, respectively 138 +/- 18 mmHg and 59 +/- 16 mmHg vs 128 +/- 13 mmHg and 49 +/- 12 mmHg and 132.12 mmHg and 51 +/- 10 mmHg. The d did not change significantly between all groups. The distension DELTAd was significantly lower in patients group D and T, respectively 466 +/- 38 microm and 511 +/- 37 microm than in controls. Similarly DELTAd/d was in these groups significantly lower than in healthy volunteers, respectively D 6.33 +/- 0.5%, T 6.9 +/- 0.4% vs N 9.15 +/- 0.5%. DC was also significantly lower in D and T than in N groups, respectively D 17.91 +/- 1.5 10-3/kPa and T 18.92 +/- 1.3 10-3/kPa and N 24.28 +/- 0.51-3/kPa. Significant differences were found in the increase of the intima-media thickness (IMT) of carotid artery for dialyzed patients and renal transplant recipients in contrast to the control group, but there were no differences between the patients. PWV in both patient groups was statistically significant higher than in control group correspondingly D 11.1 +/- 1.03 m/s and T 13.3 +/- 1.13 m/s, N 9.4 +/- 0.89 m/s. There was a significant correlation between the change of DC, PWV and CPP in T group (n = 35; r = -0.43; P < 0.01 and n = 35; r = 0.48; P < 0.05). In the T group also an important correlation between PWV and IMT complex (n = 35; r = 0.49, P < 0.001) was found., Conclusions: The elastic and structural properties of arterial wall in dialysis patients and renal recipients are decreased. End-stage renal disease accelerates arterial stiffening despite of arteriosclerosis and hypertension. Renal transplantation does not reverse loss of elastic and morphologic properties of arteries found in patients with end-stage renal insufficiency.
- Published
- 2005
46. Determination of arterial compliance using blood pressure waveform analysis with the CR-2000 system: Reliability, repeatability, and establishment of normal values for healthy European population--the seven European sites study (SESS).
- Author
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Zimlichman R, Shargorodsky M, Boaz M, Duprez D, Rahn KH, Rizzoni D, Payeras AC, Hamm C, and McVeigh G
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Compliance, Female, Follow-Up Studies, Heart Rate physiology, Humans, Male, Middle Aged, Myocardial Contraction physiology, Reference Values, Reproducibility of Results, Sex Factors, Statistics as Topic, Arteries physiology, Blood Pressure physiology
- Abstract
Background: We determined the reliability and repeatability of measurements of arterial compliance (AC) and gender- and age-specific normal ranges for a healthy European population., Methods: Three hundred eight healthy volunteers from seven sites were evaluated. Two measurements were taken during the first visit, repeated on a second visit 1 to 4 weeks later. We used the HDI/PulseWave CR-2000 for measurements of AC., Results: Intravisit measurements, taken 5 min apart, differed by less than 3% (range, 0.36% to 2.97%). All intervisit measures differed by less than 4% (range, 0.24% to 3.67%); none of these differences was statistically significant. All correlation coefficients for pairs of AC parameters measured 5 min apart at the same visit were significant at P < .0001. Paired AC parameters at visit 1 and 2 were highly correlated (P < .0001). Repeated measures GLM (general linear model) failed to detect a significant association between either of the AC parameters and visit (first or second), time (first or second measure at the same visit), and visit-by-time (the interaction of the two preceding factors), suggesting that order of measure had no effect on the final value. Analysis of reliability was used to develop a strictly parallel model estimate of unbiased reliability. Both intravisit and intervisit estimates of reliability indicate good repeatability of measure and were significant (P < .0001). The AC values were found to differ significantly by age group, with an inverse association between each of the AC parameters and age group., Conclusions: Measurement of the arterial waveform with the CR-2000 system is highly reproducible in healthy subjects.
- Published
- 2005
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47. Regression of left ventricular mass in hypertensive patients treated with perindopril/indapamide as a first-line combination: the REASON echocardiography study.
- Author
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de Luca N, Mallion JM, O'Rourke MF, O'Brien E, Rahn KH, Trimarco B, Romero R, De Leeuw PW, Hitzenberger G, Battegay E, Duprez D, Sever P, and Safar ME
- Subjects
- Adult, Aged, Antihypertensive Agents adverse effects, Atenolol administration & dosage, Blood Pressure drug effects, Brachial Artery, Drug Therapy, Combination, Echocardiography, Female, Humans, Hypertension diagnostic imaging, Hypertrophy, Left Ventricular diagnostic imaging, Indapamide adverse effects, Male, Middle Aged, Perindopril adverse effects, Antihypertensive Agents administration & dosage, Hypertension drug therapy, Hypertrophy, Left Ventricular drug therapy, Indapamide administration & dosage, Perindopril administration & dosage
- Abstract
Background: Increase in left ventricular mass (LVM) may be linked to morbidity and mortality in hypertensive patients. Arterial stiffness, systolic blood pressure (BP), and pulse pressure (PP) seem to be the main determinants of LVM. The perindopril/indapamide combination normalizes systolic BP, PP, and arterial function to a greater extent than atenolol. The aim of this study was to compare the effects of perindopril (2 mg)/indapamide (0.625 mg) first-line combination with atenolol (50 mg) on LVM reduction in hypertensive patients., Methods: Two hundred fourteen patients with essential hypertension participating in the PREterax in Regression of Arterial Stiffness in a ContrOlled Double-BliNd (REASON), randomized, double-blind, parallel-group study, underwent M-mode two-dimensional-guided echocardiography., Results: Perindopril/indapamide and atenolol were both effective at brachial BP reduction during the 12-month period. The systolic BP reduction was significantly greater with perindopril/indapamide than with atenolol (-21.2 v -15.3 mm Hg), whereas the reduction in diastolic BP was similar between treatment groups (-12.1 v -11.3 mm Hg). Reduction in LVM was higher with perindopril/indapamide than with atenolol. The between-group difference was significant for LVM (-13.6 v -4.3 g, P = .027), LVM/body surface area (LVMI1, P = .032), and LVM/body height2.7 (LVMI2, P = .013). The 124 patients with LV hypertrophy at baseline showed greatest LVM regression (LVM: -22.5 v -8.9 g, P = .009; LVMI1, P = .031; LVMI2, P = .028). The reduction in LVM adjusted for brachial systolic BP and heart rate was still significantly greater with perindopril/indapamide than with atenolol., Conclusions: Treatment, based on a first-line perindopril/indapamide combination in hypertensive patients, was more effective than atenolol on regression of echocardiographic indices of LVM and LV hypertrophy., (Copyright 2004 American Journal of Hypertension, Ltd.)
- Published
- 2004
- Full Text
- View/download PDF
48. Twenty-four-hour ambulatory blood pressure monitoring efficacy of perindopril/indapamide first-line combination in hypertensive patients: the REASON study.
- Author
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Mallion JM, Chamontin B, Asmar R, De Leeuw PW, O'Brien E, Duprez D, O'Rourke MF, Rahn KH, Romero R, Battegay E, Hitzenberger G, and Safar ME
- Subjects
- Adrenergic beta-Antagonists adverse effects, Adrenergic beta-Antagonists therapeutic use, Adult, Aged, Aged, 80 and over, Angiotensin-Converting Enzyme Inhibitors adverse effects, Antihypertensive Agents adverse effects, Atenolol adverse effects, Atenolol therapeutic use, Diastole drug effects, Double-Blind Method, Drug Therapy, Combination, Europe epidemiology, Female, Heart Rate drug effects, Humans, Incidence, Indapamide adverse effects, Male, Middle Aged, Perindopril adverse effects, Systole drug effects, Treatment Outcome, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antihypertensive Agents therapeutic use, Blood Pressure drug effects, Blood Pressure Monitoring, Ambulatory, Circadian Rhythm drug effects, Hypertension drug therapy, Hypertension physiopathology, Indapamide therapeutic use, Perindopril therapeutic use
- Abstract
Background: Circadian blood pressure (BP) measurements provide more information on hypertensive complications than office BP measurements. The purpose of this study was to analyze the efficacy of the first-line combination of perindopril 2 mg plus indapamide 0.625 mg versus atenolol 50 mg on BP parameters and variability over 24 h in patients with hypertension., Methods: A double-blind, randomized, controlled, 12-month study comparing perindopril/indapamide and atenolol was performed in 201 patients (age 55.0 years) with uncomplicated sustained essential hypertension. Ambulatory BP measurements (ABPM) were done every 15 min over 24 h., Results: After 1 year of treatment, the decrease in systolic BP was significantly greater for perindopril/indapamide than for atenolol during the entire 24-h period (-13.8 v -9.2 mm Hg), the daytime and the nighttime periods (P <.01). Diastolic blood pressure (DBP) variations were comparable for the two groups (-7.2 v -8.3 mm Hg, NS). Pulse pressure (PP) reduction was also significantly greater for perindopril/indapamide than for atenolol (for the whole 24 h, -6.6 v -0.9 mm Hg, P <.001). The through to peak (T/P) BP ratio and the smoothness index were comparable in the two groups for DBP. For systolic blood pressure (SBP), higher values of the T/P ratio (0.80 v 0.59) and the smoothness index (1.45 v 0.98; P <.02) were achieved for the perindopril/indapamide combination than for atenolol., Conclusions: The perindopril/indapamide first-line combination decreased SBP and PP more effectively than atenolol. Moreover, the BP control effect was smooth and consistent throughout the 24-h dosing interval and BP reduction variability was lower than the one induced by atenolol.
- Published
- 2004
- Full Text
- View/download PDF
49. [Large artery wall properties in dialyse and renal transplant patients with normal blood pressure].
- Author
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Posadzy-Małaczyńska A, Kosch M, Hausberg M, Rahn KH, Małaczyński P, Głuszek J, and Tykarski A
- Subjects
- Adult, Blood Pressure physiology, Body Mass Index, Female, Humans, Hypertension diagnosis, Hypertension etiology, Kidney Failure, Chronic complications, Male, Ultrasonography, Doppler, Pulsed, Carotid Arteries diagnostic imaging, Carotid Arteries physiopathology, Hypertension physiopathology, Kidney Failure, Chronic physiopathology, Kidney Failure, Chronic therapy, Kidney Transplantation, Renal Dialysis methods
- Abstract
Structural and mechanical properties of the arterial wall are altered in patients with renal failure. Age and hypertension are known to affect the vessel wall structure. Aging process of arterial wall appears to be accelerated in patients with end-stage renal failure. The mechanisms responsible for reduced arterial compliance and distensibility in dialyse patients and renal transplant recipients without hypertension remain to be evaluated. 20 normotensive dialyse patients (D), 20 normotensive renal transplant recipients (T) and 20 healthy volunteers (N) matched for age, sex and blood pressure as controls were enrolled in to the study. Patients with cardiovascular risk factors and diabetes were excluded. The arterial blood pressure of all patients placed below 140/90 mmHg. The dialyse patients and renal transplant recipients were eligible for the study if the serum creatinine level was below 2 mg/dl. In all subjects, fasting concentrations of serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol, hemoglobin and glucose were determined at enrollment to the study. Long-term immunosuppression consisted of cyclosporine and prednisolone. Blood pressure was measured using an automatic sphygmomanometer (Criticon Dinamap model 1846 SX). Pulse wave velocity (PWV) was evaluated using non-invasive automatic Complior device. The vessel wall properties of the left common carotid artery were studied using multigate pulsed Doppler's system (Pie Medical Equipment BV Maastricht, The Netherlands). The frequency of transducer used was 7.5 MHz. With this non-invasive method, the end-diastolic diameter (d) and the systolic increase of vessel diameter (distension delta d) were measured using ECG trigger. From these data relative systolic increase of vessel diameter (delta d/d) and arterial wall distensibility coefficient (DC) were calculated. Simultaneously with the ultrasound measurements at the left common carotid artery carotid pulse waveforms are recorded using applanation tonometry (Micro Tip Pulse Transducer, SPT 301 and Transducer Control Unit TCB-500, Millar Instruments, Houston, TX, USA). Systolic blood pressure (SBP) and central pulse pressure (CPP) were significantly higher in (T) than in (D) and (N) group respectively 139 +/- 18 mmHg and 58 +/- 16 mmHg vs 127 +/- 13 mmHg and 49 +/- 11 mmHg and 132 mmHg and 50 +/- 11 mmHg. The end-diastolic diameter (d) did not change significantly between all groups. The systolic increase of vessel diameter (distension delta d) was significantly lower in patients group (D) and (T) respectively 461 +/- 33 microm and 501 +/- 34 microm than in controls. Similar relative systolic increase of vessel diameter (delta d/d) was in these groups significantly lower than in healthy volunteers, respectively (D) 6.26 +/- 0.5%, (T) 6.91 +/- 0.4% vs (N) 9.14 +/- 0.4%. The distensibility coefficient were also significantly lower in (D) and (T) than in (N) groups respectively (D) 18.31 +/- 1.4 10(-3)/kPa and (T) 17.97 +/- 1.4 10(-3)/kPa and (N) 24.3 +/- 0.5 10(-3)/kPa. PWV in both groups of patients was statistically significant higher than in control group correspondingly (D) 11.2 +/- 1.02 m/s and (T) 12.8 +/- 1.12 m/s, (N) 9.5 +/- 0.88 m/s. There was significant correlation between the change of arterial DC, PWV and CPP in (T) group (n = 20; r = -0.42; p < 0.01 and n = 20; r = 0.47; p < 0.05). The arterial wall elastic properties in dialyse and renal recipients patients are decreased. End-stage renal disease accelerates arterial stiffening despite arteriosclerosis and hypertension. Renal transplantation do not reverse lost of elastic properties of arteries in end-stage renal insufficiency.
- Published
- 2004
50. [Recent intervention studies with antihypertensive drugs and their influence on guidelines].
- Author
-
Rahn KH
- Subjects
- Adrenergic beta-Antagonists administration & dosage, Adrenergic beta-Antagonists therapeutic use, Aged, Amlodipine administration & dosage, Amlodipine therapeutic use, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors administration & dosage, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Antihypertensive Agents administration & dosage, Benzothiadiazines, Calcium Channel Blockers administration & dosage, Calcium Channel Blockers therapeutic use, Cardiovascular Diseases mortality, Cardiovascular Diseases prevention & control, Chlorthalidone administration & dosage, Chlorthalidone therapeutic use, Clinical Trials as Topic, Death, Sudden, Cardiac prevention & control, Diuretics administration & dosage, Diuretics therapeutic use, Drug Therapy, Combination, Humans, Hypertension complications, Hypertension diagnosis, Lisinopril administration & dosage, Lisinopril therapeutic use, Meta-Analysis as Topic, Middle Aged, Myocardial Infarction prevention & control, Practice Guidelines as Topic, Prognosis, Randomized Controlled Trials as Topic, Risk, Risk Factors, Sodium Chloride Symporter Inhibitors administration & dosage, Sodium Chloride Symporter Inhibitors therapeutic use, Stroke prevention & control, Time Factors, Antihypertensive Agents therapeutic use, Hypertension drug therapy
- Abstract
Antihypertensive therapy improves the prognosis of essential hypertension. Therapy reduces mortality and decreases the incidence of myocardial infarction, sudden cardiac death and stroke. Target blood pressure in patients with essential hypertension are levels < or = 140/90 mmHg. In patients with essential hypertension and concomitant diabetes mellitus type 2, blood pressure should be lowered to < or = 130/80 mmHg. Diuretics, beta-blockers, calcium antagonists, angiotensin-converting enyzme (ACE) inhibitors, and angiotensin I (AT(1)) antagonists may nowadays be regarded as drugs of first choice in the treatment of essential hypertension. The Joint National Committee in the USA recommends to start treatment with a thiazide diuretic. A Guidelines Committee of European Society of Hypertension-European Society of Cardiology considers the Endgroups of drugs mentioned above to be equally suitable for the initiation and maintenance of antihypertensive therapy. Both groups of experts agree that in the majority of patients with essential hypertension, a combination of two or more drugs is required to reach target blood pressure. Both groups of experts emphasize that the main benefits of antihypertensive therapy are due to decreasing blood pressure per se.
- Published
- 2003
- Full Text
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