ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This double-blind, randomized, parallel-group study was designed to compare the efficacy of the angiotensin-converting enzyme inhibitors, trandolapril and enalapril, in 65 patients with mild to moderate primary hypertension. After a 4-week, single-blind, placebo run-in period, patients were randomized to receive either trandolapril 0.5 mg or enalapril 2.5 mg once daily. At 2-week intervals, trandolapril was titrated to 1, 2, or 4 mg and enalapril to 5, 10, or 20 mg in order to achieve a goal supine diastolic blood pressure (BP) of < 90 mm Hg. In addition to casual BP measurement, 24-h ambulatory BP monitoring was performed at the end of the placebo period (baseline) and after 10 weeks of stable therapy at optimal and/or maximal dosage.Both drugs induced significant and comparable decreases in clinic systolic and diastolic BPs. The mean doses used were 3.2 mg for trandolapril and 16.6 mg of enalapril. The maximal effect was obtained at the highest dosage for both drugs in most patients with a mean decrease in supine diastolic BP of 8.6 mm Hg and 7.3 mm Hg for trandolapril 4 mg and enalapril 20 mg, respectively. Moreover, both agents significantly and similarly reduced mean 24-h as well as awake and sleep ambulatory BPs. Heart rates remained unchanged throughout the study.Our results demonstrate that both trandolapril and enalapril given at high dose exhibited significant decreases in clinic as well as in 24-h, awake, and sleep ambulatory BPs with no clear-cut difference between the two treatment regimens. Moreover, our results emphasize the role of ambulatory BP monitoring when assessing the efficacy as well as the duration of action of new antihypertensive agents.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

To elucidate the effect of a long-term antihypertensive therapy on blood pressure (BP) response to isometric handgrip exercise (IHG) in patients with essential hypertension (EHT,n= 16), IHG was carried out at 30% maximal voluntary contraction of right hand for 3 min before therapy and after a long-term antihypertensive therapy. BP responsiveness to IHG was estimated by the difference between values obtained at rest and at 3 min during IHG (change of systolic BP = δSBP, change of diastolic BP = δDBP).Both δSBP and δDBP before therapy were markedly greater in EHT (δ SBP = 64 ± 18 mm Hg, δDBP = 33 ± 9 mm Hg) than in age-matched normotensive controls (NT,n= 8, 29 ± 4 mm Hg, 18 ± 4 mm Hg). By antihypertensive therapy, SBP and DBP in EHT were decreased from 152 ± 22 mm Hg to 136 ± 14 mm Hg and from 90 ± 18 mm Hg to 83 ± 10 mm Hg, respectively, but both SBP and DBP in EHT after antihypertensive therapy were still greater than those in NT. Both δSBP and δDBP in EHT after a long-term antihypertensive therapy were significantly smaller than those in EHT before therapy but were still significantly larger than those in NT. These results demonstrate that a long-term antihypertensive therapy reduces the exaggerated BP response to IHG in EHT.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Our aim was to investigate possible abnormalities in postprandial hemodynamic changes in hypertensives treated with different vasodilating drugs, calcium antagonists, or angiotensin-converting enzyme inhibitors. Eleven healthy subjects and 22 hypertensive patients effectively treated with an angio tensin-converting enzyme inhibitor (ACEI) (n= 9) or calcium antagonists (n= 13) were studied. Cardiac output and blood pressure were monitored every 20 min from 2 h before lunch to 3 h after using a computer-assisted impedance cardiograph coupled with an automatic blood pressure monitor. After meals, a significant decrease in mean arterial pressure (−7.9% ± 2.1) was observed in ACEI-treated hypertensives when compared with the minor changes observed in calcium-antagonist-treated hypertensives (−3.7% ± 1.5) and in normotensives (−2.7% ± 1.5). When compared with normotensives, the patients treated with ACEI showed a larger postprandial fall in total peripheral resistance index (−20.8% ± 3.4 versus −15.3% ± 4.1) with a larger increase in heart rate (11.3% ± 2.3 versus 8.1% ± 1.3). In hypertensives treated with calcium antagonists, the postprandial hemodynamic changes appeared blunted and not significant. Different antihypertensive drugs appear to have different effects on the postprandial hemodynamic changes.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Immersion of one hand into ice water (cold pressor test) in eight hypertensive subjects induces elevation of mean arterial pressure, increase in heart rate, and no significant changes of plasma renin activity and plasma aldosterone concentrations. Domperidone, a DA2dopaminergic antagonist, attenuates heart rate increase induced by the cold pressor test, and the combination of bromocriptine, a known DA2dopaminergic agonist, with domperidone again provoked a heart rate increase during the cold pressor test. Domperidone caused an increase of both plasma renin activity and plasma aldosterone concentrations, which were reversed by bromocriptine. These results suggest that a dopamine-receptor stimulation is taking place during the cold pressor test.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The purpose of the study was to evaluate the efficacy and safety of a new formulation of colestipol provided in tablet form. This was a randomized, double-blind, placebo-controlled, multicenter, dose-ranging study. A total of 196 patients with primary hypercholesterolemia who were following a low-fat, low-cholesterol diet (NCEP Step I diet), and having mean low-density lipoprotein cholesterol (LDL-C) levels ≥ 4.14 mmol L−1(160 mg dl−1) and ≤ 6.46 mmol L−1(250 mg dl−1) were studied. Study medication was taken twice daily, with breakfast and supper, for 8 weeks. The five parallel treatment groups consisted of colestipol tablets 1, 2, 4, and 8 g BID, and matching placebo tablets BID. The main outcome measures were absolute change and percent change from baseline in selected lipid, lipoprotein, and apolipoprotein measurements; LDL-C was considered primary. Statistically significant (p≤ 0.05) dose-dependent reductions in LDL-C from 5.2% to 25.8% and in total cholesterol from 2.8% to 16.8% were observed. Colestipol tablet treatment also resulted in statistically significant dose-dependent increases in LpAI levels reaching 25.8% at 16 g day−1. The treatment was well tolerated, and no serious adverse events were reported.Colestipol administered in tablet form was efficacious in lowering LDL-C and total cholesterol and was well tolerated in patients with primary hypercholesterolemia.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The bioequivalence of recombinant human growth hormone (rhGH) (somatropin) and itsN-methionyl variant (Met-hGH) [Protropin® (somatrem for injection)] was determined in 42 healthy male volunteers (n= 21 per treatment) who were randomized to receive either protein by subcutaneous administration of 0.1 mg kg−1. Serum samples were collected over 24 h after the injection, and the concentrations of human growth hormone (hGH) were determined by an immunoradiometric assay. Bioequivalence of the two proteins was assessed by determining whether the 90% confidence limits for the ratio of geometric means using logarithmically transformed AUC and Cmaxparameters (log0AUCo0–24, log0AUCo0-x, and log10Cmax) were within the 80–125% range. The bioequivalence of the two treatments was also tested by calculating a bioequivalence index (ζ2) that measured the difference between the two mean concentration-time profiles. The 90% confidence intervals for the ratios of the geometric means for AUC were within the prescribed 80–125% range for bioequivalence. The upper limit of the 90% confidence interval for the ratio of the geometric means for Cmaxfell slightly outside the 125% criterion even though the geometric mean itself, 106.6%, was very close to the ideal of 100%. There was a larger standard error associated with Cmaxthan with the AUCs, and this marginally larger confidence limit for Cmaxresulted more from the variance among the subjects than to the difference in the means. In fact, the bioequivalence index, ζ2, was 0.075, indicating that the mean curves after rhGH and Met-hGH are essentially superimposable.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Pentostatin (2′-deoxycoformycin, dCF) is a product of the fermentation ofStreptomyces antibioticus.It is a tight-binding inhibitor of adenosine deaminase (ADA), an enzyme essential in cellular metabolism of purines. Children with congenital absence of ADA suffer from atrophy of lymphoid tissues and severe combined immune deficiency (SCID) syndrome. It was speculated that pentostatin would be lymphocytotoxic, and this proved to be the case, promoting its investigation in lymphoid neoplasms. It was anticipated that pentostatin would be most active in neoplasms with high intracellular concentrations of ADA-e.g., acute lymphocytic leukemia (ALL), particularly its T cell variety. Although pentostatin proved to be active in ALL, large doses were required and toxic effects outweighed therapeutic benefits. By contrast, pentostatin proved to be exceptionally active in hairy cell leukemia (HCL), a B cell neoplasm withlowintracellular concentrations of ADA. Pentostatin has since been shown to possess activity in chronic lymphocytic leukemia, prolymphocyte leukemia, cutaneous T cell lymphomas, adult T cell lymphoma-leukemia, and low-grade non-Hodgkin's lymphomas. It potentiates the activity of vidarabine against viruses and against the cells of acute myeloid leukemia. Pentostatin is inactive in melanoma and renal carcinoma, but has not been adequately evaluated in other solid tumors. The toxic effects of pentostatin include renal failure, central nervous system (CNS) depression, immunosuppression, keratoconjunctivitis, and opportunistic infections. In the absence of pre-existing bone marrow compromise, pentostatin produces only mild myelosuppression. Aside from its use as an antineoplastic agent, pentostatin has potential applications as an immunosuppressive drug, as an antiviral agent, as an antimalarial compound, and in the protection of cells of the CNS from damage induced by ischemia and anoxia.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The placebo effect is a most curious phenomenon, which has been known since ancient times. After World War II, it became an important methodological tool in the conduction of clinical trials. The so-called “placebo-reactors” show special sensitivity to these inert substances. In general, 35.5 ± 2.2% of patients affected by various conditions proved to react positively to placebos. Several aspects of placebos seem to play a relevant potentiating action on such effects. In this context, surgical rather than clinical seems to be a more efficient placebo. Despite a clearcut role of the limbic system, emphasis has been placed on psychological aspects of the possible pathophysiologic mechanisms.

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1075-2765    

出版商:OVID    

年代:1995

数据来源: OVID