ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00696.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00697.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. The aim of this study was to investigate the growth factor activity in plasma (GFAP) in hypertension, and the correlation of GFAP to blood pressure levels, cardiac structural changes and platelet activation at rest and during exercise.Subjects. Fifteen untreated hypertensive subjects and 15 normotensive controls were recruited from a blood pressure screening programme.Interventions. GFAP before and after 30 min of strenuous exercise was analysed as the ability of patient or control plasma to stimulate incorporation of3H‐thymidine in cultured human smooth muscle cells. M‐mode echocardiography was performed and platelet activity was measured by the excretion of the urinary metabolite of thromboxane A2.Results. There were no significant differences in GFAP or platelet activation at rest or after exercise between the groups. The fractions of labelled cells were 52.6% vs. 56.6% (HT vs. NT) at rest. Septum and posterior wall end‐diastolic thicknesses (PWT[D]) were significantly increased in the HT group (10.4 ± 0.3 vs. 9.2 ± 0.3 mm and 11.4 ± 0.5 vs. 10.0 ± 0.4 mm, respectively,P<0.05). PWT(D) was significantly correlated to GFAP (r= 0.40,P= 0.04) and to blood pressure (r= 0.53,P<0.005) but there was no correlation between blood pressure and GFAP.Conclusion. The data suggest that GFAP could play a role in the early development of cardiac hypertrophy in hypertension, but that this effect does not seem to be directly linked to blood pressure lev

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00698.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To study the prognostic value of several risk factors on incidence and mortality of myocardial infarction (MI) and total mortality in men.Design. Prospective cohort study of 12 years' follow‐up.Setting. All men in Oslo aged 40–49 and a 7% sample of men aged 20–39 were invited for screening.Subjects. Of all 30025 invited men, of whom 25015 were aged 40–49, a total of 16209 men aged 40–49 attended the screening and risk factors were recorded for these men.Main outcome measures. Incidence of first MI (nonfatal and fatal), mortality of MI, total mortality.Results. When examining the rate ratio of the fifth to the first quintile of risk factors we found that systolic and diastolic blood pressures were stronger predictors for mortality than incidence of MI. The rate ratios (95% confidence interval) of systolic blood pressure were 3.73 (2.56, 5.44) and 2.56 (2.01, 3.25) respectively. For diastolic blood pressure the corresponding rate ratios were 4.14 (2.84, 6.04) and 2.78 (2.18, 3.54). Small differences in the rate ratios for these end‐points were found for total serum cholesterol and triglycerides. Daily cigarette smoking versus non‐cigarette smoking was a stronger predictor for MI mortality than incidence, with rate ratios of 3.16 (2.45, 4.24) and 2.34 (2.00, 2.79) respectively. The Cox proportional hazards regression analysis confirmed the above results.Conclusions. Total serum cholesterol and triglycerides predicted incidence and mortality of MI equally well. Whereas blood pressure and daily cigarette smoking predicted mortality of MI

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00699.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To define the effect of asymptomatic hyperuricaemia on various facets of glucose, insulin, and lipoprotein metabolism.Design. Case control study in health volunteers.Setting. The volunteers for this study were selected on the basis of their laboratory results from a larger population participating in a general survey in one large factory.Subjects. The study population consisted of 40 healthy males: 20 with asymptomatic hyperuricaemia (serum uric acid concentration equal to or greater than 420 mmol l−1) and 20 with normal serum uric acid concentrations (180–320 mmol l−1). The two groups were similar in terms of age, general obesity (estimated by body mass index), smoking and alcohol intake, and estimate of work and leisure time activity.Interventions. All subjects received a 75 g oral glucose challenge, with blood taken before and at frequent intervals thereafter.Main outcome measures. Fasting plasma glucose, insulin, and lipid concentrations and plasma glucose and insulin responses to the oral glucose challenge.Results. By selection, mean (±sem) serum uric acid concentration was higher in the hyperuricaemic individuals (454 ± 7 vs. 274 ± 12 mmol l−1). In addition, the plasma insulin response to oral glucose was increased in individuals with asymptomatic hyperuricaemia (P<0.005) as were both systolic (136 ± 3 vs. 126 ± 3 mmHg,P<0.05) and diastolic (91 ± 1 vs. 82 ± 1,P<0.01) blood pressure. Furthermore, subjects with asymptomatic hyperuricaemia were dyslipidaemic (higher plasma TG and cholesterol and lower HDL‐cholesterol concentrations) as compared to the normouricaemic control group (P<0.07–0.005).Conclusions. These results provide a possible explanation for the well‐known association of hyperuricaemia with coronary heart disease, as well as suggesting that hyperuricaemia be added to the cluster of metabolic and haemodynamic abnormalities associated with insulin resistance and/or hyperinsulinaemia and desi

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00700.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To analyse simultaneously sleep habits and sleep disturbances in an elderly population and numerous factors possibly affecting sleep at the same time.Design. A cross‐sectional epidemiological survey by means of questionnaires.Setting. The capital city of Iceland, Reykjavik and surrounding suburbs.Participants. A randomly selected, but stratified sample with 100 men and 100 women in each 5‐year age group of the ages 65–84 years—800 individuals altogether.Main outcome measure. Sleep habits and sleep disturbances.Results. The mean duration of sleep was 7.25 h (sd74 min). Mean sleep onset time was 00.13 hours and was not related to age and gender but was delayed at weekends. Daytime napping was reported by 50% of the men and 31% of the women (P<0.001). Difficulty maintaining sleep (DMS) was the most commonly reported insomnia complaint (men 37% and women 30%). Sleep charts revealed that men woke up an average of 1.2 times per night but women 0.8 times per night (P<0.01). Difficulty initiating sleep was reported by 9.6% and early morning awakening (EMA) by 16.7%. Pain was a strong factor contributing to EMA. There was also an increase in EMA complaints among the elderly with obstructive pulmonary diseases and systemic hypertension. The prevelance of insomnia was only partly related to age and gender. Multiple regression analyses, however, showed different interrelationships between insomnia and other symptoms and findings for men versus women.Conclusion. DMS is the most commonly reported insomnia complaint among the elderly (men 37% and women 30,%). The prevalence of insomnia did not increase with age in our stud

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00701.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To examine the acute effects of captopril administration on insulin sensitivity in normotensive type 1 diabetic patients.Design. An euglycaemic insulin clamp (150 min) was performed in a randomized order twice in each subject: once with the oral administration of captopril (25 mg), once with placebo, both given in the beginning of the insulin infusion.Setting. The study was performed at the clinical research laboratory of Helsinki University Hospital, Second and Third Departments of Medicine.Subjects. We studied seven male, normotensive type 1 diabetic patients with normal body weight, duration of diabetes 15 ± 2 years, HbA, 9.8 ± 0.7% and daily insulin dose 47 ± 4 units. In addition, nine matched healthy control subjects were examined.Results. During placebo administration glucose disposal rate in the diabetic patients was not significantly different from that in the control subjects. Captopril administration reduced blood pressure in both groups, whereas glucose disposal rate did not change significantly in diabetic or control subjects. When diabetic and control subjects were analysed together, captopril decreased glucose disposal by 9% (P<0.05).Conclusions. Acute captopril administration does not improve insulin sensitivity in normotensive type 1 diabetic patients or control subjec

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00702.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. To assess the effect on the fibrinogen concentration of sleep disturbance and mental stress, taking into account the effect of 21 other variables related to the risk of cardiovascular disease.Design. A cross‐sectional study on men threatened by redundancy, and controls.Setting. A health screening programme in Malmö, Sweden.Subjects. Four hundred and eighty five workers in a shipbuilding yard, scheduled for closure, and 190 age‐matched men. The subjects were randomly selected from a larger group of shipyard workers and controls invited to a health screening programme. Mean age was 51.6 years (range 38–62 years).Main outcome measures. Plasma fibrinogen concentration, serum Cortisol concentration, body composition, blood pressure, heart rate, blood lipids, platelet number and size, white blood cell count, haemoglobin concentration, vital capacity, liver enzymes, blood glucose concentration fasting and after an oral glucose tolerance test. Questionnaire designed to evaluate muscle tension, sleep disturbance, anxiety, depression, job stress, alcohol and smoking habits and perceived health.Results. In stepwise regression analysis fibrinogen concentration was found to be correlated to white blood cell count, muscle tension, heart rate, body mass index, age and serum cholesterol concentration in non‐smokers, which together explained 14.9% of the variation in fibrinogen concentration. In smokers, platelet count, heart rate, serum triglyceride concentration, age and fasting glucose explained 22.5% of the variation in fibrinogen concentration. The fibrinogen concentration was inversely correlated to the psychological variables, but unrelated to the serum Cortisol concentration or to factors connected with the job situation, and it was decreased in moderate alcohol consumers.Conclusions. Our interpretation of the findings is that an increase in the plasma fibrinogen concentration reflects the presence of a low‐grade inflammatory process, and poor physic

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00703.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. Peroxidation of lipoproteins may be of critical importance in the development of atherosclerosis. Tocopherol is considered to be the most effective lipid‐soluble antioxidant. The main aim of this study was to measure the serum tocopherol concentrations in a Swedish reference population and to relate them to family history, lifestyle and serum lipoprotein composition.Design. A health survey of risk factors for coronary heart disease was carried out among the employees of a Swedish company.Subjects. Ninety per cent (906) of the employees participated.Results. Mean alpha, beta and gamma tocopherol levels corrected for lipids were 1.57 (SD 0.24), 0.04 (SD 0.01) and 0.20 (SD 0.07) μg ml−1, respectively. Alpha tocopherol levels were slightly higher in women than in men, but there was no difference between different ages. Smokers had a lower alpha tocopherol level than non‐smokers (1.54 and 1.59 μg ml−1;P= 0.03) and persons with low physical activity had a lower level than those with high activity (1.53 and 1.62 μg ml−1, respectively;P= 0.002). Alpha tocopherol concentration was inversely correlated to abdominal sagittal diameter (r= –0.24,P= 0.0001).Conclusions. The average tocopherol concentrations in this Swedish population were higher than in countries with a high incidence of coronary heart disease but similar to those in countries with a similar, intermediate incidence. The inverse correlation to abdominal adiposity may partly explain why this adiposity is a risk factor for coronary

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00704.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Abstract.Objectives. The aims of this study were to determine the possible role of hyperinsulinaemia in the increase in blood pressure in acromegalic patients.Design. After an overnight fast, blood samples were obtained at 0, 30, 60, 120 and 180 min after 75 g glucose ingestion, and plasma growth hormone (GH) and plasma insulin (IRI) were measured by radioimmunoassay. The blood pressure was measured at 10.00 hours for 3 days in a supine position.Subjects. Nineteen (nine women and 10 men) untreated acromegalic patients, aged 25–69 years.Results. There were no significant correlations between mean blood pressure (MBP; diastolic + one‐third pulse pressure) and basal GH, sum of plasma GH at 0, 30, 60, 120 and 180 min or basal IRI. However, significant correlation was observed between MBP and IRI at 120 min (r= 0.57,P<0.02) or sum of plasma IRI at 0, 30, 60, 120 and 180 min) (r= 0.58,P<0.02).Conclusions. We conclude that hyperinsulinaemia may be involved in an increase in blood pressure in active acromegal

ISSN:0954-6820    

DOI:10.1111/j.1365-2796.1993.tb00705.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY