Central nervous system considerations in the use of β-blockers, angiotensin-converting enzyme inhibitors, and thiazide diuretics in managing essential hypertension

Gengo, Fran M.; Gabos, C.

doi:10.1016/0002-8703(88)90105-6

Cited by 18 publications

(3 citation statements)

References 49 publications

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“…A large number of reported side effects during antihypertensive medication have centered on mood and behavioral performance changes such as confusion, lethargy, fatigue, depression, sedation, memory loss, and impairment of motor skills (Gengo & Gabos, 1988; Turkkan, 1988). Impairments in mood and behavioral functioning have been particularly reported by patients medicated with beta-blockers, central alpha-agonists, and calcium channel blockers (Gengo & Gabos, 1988), although it should be noted that such symptoms have been reported for all classes of antihypertensive agents, including placebos. Although some reviewers have concluded that antihypertensive side effects are clinically insignificant (Muldoon, Manuck, Shapiro, & Waldstein, 1991), the relatively few rigorous and systematic studies in this area suggest that such conclusions are premature.…”

mentioning

confidence: 99%

Antihypertensive pharmacotherapy side effects: Behavioral measurement and quality-of-life issues in clinical trials.

Turkkan¹

1993

Experimental and Clinical Psychopharmacology

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Large numbers of hypertensive patients drop out of antihypertensive pharmacotherapy annually, thereby increasing their health risks from elevated blood pressure. Many studies show that adverse side effects (a large number related to behavioral functioning) are pivotal in discouraging patients from continuing with medication regimens. Multidimensional quality-of-life assessment batteries in clinical trials have begun to incorporate objective measures of behavioral functioning in addition to the more typical self-report assessments of symptoms and mood states. This article addresses several experimental design and methodology issues resulting from the use of behavioral assessment procedures in the context of antihypertensive quality-of-life trials, including (a) objective vs. subjective assessments of side effects, (b) time course of side effects after medication onset, (c) practice and placebo effects, and (d) laboratory vs. field assessments. This research aims to aid physicians in selecting optimal treatments among equieffective antihypertensive agents and in assessing the necessary trade-offs between treatment of disease and the creation of new symptoms. Patients in turn can be educated about the extent and duration of likely impairments once they begin treatment.

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confidence: 99%

Antihypertensive pharmacotherapy side effects: Behavioral measurement and quality-of-life issues in clinical trials.

Turkkan¹

1993

Experimental and Clinical Psychopharmacology

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“…HT is associated with subtle cognitive deficits, which were identified mainly in abstract reasoning, attention and memory, less dominantly in perception, constructional skills, mental flexibility and psychomotor speed [85]. Evidence exists that AH therapy can improve [86, 87, 88], sometimes worsen [89, 90, 91]the neuropsychologic deficits.…”

Section: Hemodynamical and Morphological Changesin Htmentioning

confidence: 99%

Comparison of Different Methods Evaluating the Functional and Structural Abnormalities in Hypertension

Ficzere¹,

Csiba²

2002

Eur Neurol

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Functional and morphological abnormalities due to hypertension could be detected in neurologically symptom-free patients by CT, MRI, transcranial Doppler ultrasound, PET and SPECT. Neuropsychological tests also provide useful information. Single or combined application of these techniques reveals different aspects of parenchymal or vascular impairment in hypertension. The advantages and disadvantages of the different imaging techniques are reviewed and compared. The relatively simple, non-invasive transcranial Doppler (alone or combined with neuropsychological observations) could be recommended for screening and follow-up of hypertensive patients and seems to be a promising ancillary tool for evaluation of efficacy of antihypertensive therapy, but cannot replace the prospective controlled trials with hard endpoints.

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“…There are few case reports in the literature demonstrating the toxic CNS effect of angiotensin‐converting enzyme inhibitors. It has been suggested that the action of ACE inhibitors on brain carboxypeptidase enzymes may produce these adverse effects or act to uncover subclinical neurological disease; the activation of central opioids secondary to enzyme inhibition may be causative ,. Two cases of visual hallucinations following initiation of captopril and enalapril have been published: (1) A 73‐year‐old man who developed visual hallucinations with enalapril, then later with captopril and (2) a 64‐year‐old man who developed visual hallucinations and nightmares on rousing from sleep while taking captopril for CHF .…”

mentioning

confidence: 99%

Quinapril‐associated Acute Psychosis in an Older Woman

Tarlow

Sakaris

Wolf‐Klein

2000

J American Geriatrics Society

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Central nervous system considerations in the use of β-blockers, angiotensin-converting enzyme inhibitors, and thiazide diuretics in managing essential hypertension

Cited by 18 publications

References 49 publications

Antihypertensive pharmacotherapy side effects: Behavioral measurement and quality-of-life issues in clinical trials.

Antihypertensive pharmacotherapy side effects: Behavioral measurement and quality-of-life issues in clinical trials.

Comparison of Different Methods Evaluating the Functional and Structural Abnormalities in Hypertension

Quinapril‐associated Acute Psychosis in an Older Woman

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