ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08960.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08961.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACT.The clinical value of a clonidine suppression test was assessed in three different groups: I. 14 normotensive, healthy people: II. 34 patients with “neurogenic” hypertension: III. 10 patients with pheochromocytoma confirmed at operation. After clonidine (300 mg by mouth) blood pressure (BP) and circulating plasma catecholamines (CA) were reduced in groups I and II. The maximum fall in mean BP was 25/9 mmHg in group I and 43/24 mmHg in group II; the corresponding fall in patients with pheochromocytoma was 19/0 mmHg. The mean concentrations of ciruculating noradrenaline (NA) were significantly reduced in groups I and II, maximum suppression occurring 2–3 h after giving clonidine. In group I the mean reductions in NA were from 1.3 (SEM 0.2) to 0.6 (0.06) nmol/l (p<0.01), and in group II from 2.6 (0.3) to 0.7 (0.05 nmol/l (p<0.2); plasma concentrations of A were very low (<0.01 nmol/l) in both groups, and remained unchanged throughout the test.In contrast, in the 10 patients with pheochromocytoma the mean basal plasma CA concentrations exceeded our upper reference limit NA 7.7 (2.2 and A 4.0 (1.7 nmol/l), and remained high or even rose during the test. Four patients in this group with only marginally elevated basal plasma CA showed the same pattern of response during clonidine administration. After successful removal of the catecholamine‐secreting tumour all patients achieved a normal BP. The plasma CA was suppressed into the normal range when the clonidine test was repeated 1–2 weeks postoperatively. No serious adverse effects were observed. We conclude that the clonidine suppression test is a safe and useful procedure in the diagnosis of pheochromocytoma, especially when basal levels of CA are normal or only marginally elevated.Part of this matter was presented at the First International Congress of Endocrine Surgery, Paris, September

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08962.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACT.Percutaneous transluminal renal angioplasty (PTRA) was attempted in 17 patients with a diastolic blood pressure greater than or equal to 95 mmHg in spite of treatment with two or three antihypertensive drugs in combination and unilateral or bilateral renal artery stenosis with a reduction of vessel diameter to less than 25%. PTRA resulted in a dilatation of the stenosis in 12 patients. After an observation period of at least 6 months 2 patients were cured, 7 improved and 3 unchanged. Renal vein renin ratio (RVRR) was determined in the last 9 of these patients but was unknown when PTRA was done. RVRR was higher than 1.5 in 5 patients of whom one was cured and 4 improved and less than 1.5 in 4 of whom one was improved and 3 unchanged. No persistent complications were observed after PTRA. It can be concluded that PTRA is an effective antihypertensive treatment in several patients with renovascular hypertension, and a RVRR greater than 1.5 suggests a favourable outcome with regard to blood pressure regulation.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08963.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08964.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACT.The antihypertensive and hormonal effects of a new ACE‐inhibitor, lisinopril (MK‐521), was studied in 11 patients with renal arterial stenosis (bilateral in 1). Oral doses exceeding 5 mg a day significantly reduced blood pressure (BP), the maximum fall occurring 6 h after taking the drug. At higher doses (20–80 mg/day) sustained antihypertensive effects persisted for 24 h. Lisinopril was equally effective in lowering supine and standing BP. When the drug was given stepwisely in increasing doses, (5, 10, 20, 40, and in 5 cases 80 mg/day) the BP was successivly normalized in 10 of 11 patients (supine BP<90 mmHg). 3 patients with low renin hypertension (LRH) responded less well to monotherapy on long‐term treatment with lisinopril than the others. A significant increase in heart rate was observed, initially and after 1 month of treatment.After 5 days treatment with increasing doses the plasma concentrations of angiotensin II (All) and aldosterone (Aldo) fell significantly to very low concentrations. However, on long term treatment (3 months) suppression of All and Aldo did not always take place. A concomitant decrease in 24 h urinary aldosterone excretion occurred.No changes in renal function or other biochemical tests except for a slight increase in S‐K were observed. There were no adverse side‐effects. We conclude that lisinopril is an effective and safe medication for renovascular h

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08965.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

ABSTRACT.We describe a new principle for measuring concentrations of pharmacologically active captopril or other angiotensin‐converting enzyme (ACE) inhibitors in blood. Serum is incubated with 125‐I‐labeled ACE inhibitor (substance 351A, a lisinopril analogue, Merck Sharp&Dohme) in a nonequilibrated system, in which label and ACE inhibitor compete for binding to added serum ACE. Free label is separated by adsorption to coated charcoal. Concentration of captopril or other ACE inhibitor is calculated from a standard curve.Results in healthy volunteers showed rapid absorption of captopril with maximal concentration of active drug within 1 h, and fast disappearance within 2.5 h. Stability of captopril was improved by immediate 1:100 dilution of blood samples with assay buffer. In spite of this precaution, analysis should be performed within two days to avoid loss of active drug due to polymerization and protein binding. Samples of other tested ACE inhibitors can be frozen and later analyzed at convenience. The new principle is simple, sensitive, and spe

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08966.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08967.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08968.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1986.tb08969.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY