ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01255.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01256.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.We have studied eight men with moderate hypertension to determine the atrial natriuretic peptide (α‐hANP) response to acute volume expansion. Rapid infusion of 1000 ml 0.9% saline (10–20 min) caused an increase in central venous pressure (4.7±1.6 cmH2O) while blood pressure and pulse pressure (arterial baroreceptor load) did not change. Stroke volume and heart rate were not affected by the volume load but plasma renin activity (PRA) was significantly suppressed (from 0.83±0.14 to 0.68±0.34 μg AI I/ml‐h;p<0.01). A significant hemodilution was also observed. Renal sodium excretion was significantly increased. Arterial α‐hANP increased significantly from 21.1 ±6.1 to 30.5±4.0 pmol/1 (p<0.02) during volume expansion. There was a significant correlation between corrected plasma volume increase (urine volume subtracted from the infused volume) and α‐hANP plasma elevation (r=0.78;p<0.05). There was also a significant negative correlation between changes α‐hANP and PRA (r=‐0.78,p<0.05). We conclude that only moderate voume loading in human hypertensives is a mechanism for increase in plasma α‐hANP levels. The significant negative correlation between changes in α‐hANP and PRA suggests that α‐hANP may be the humoral factor at least partly responsible for suppression of renin in hypertensive man. Since increased fluid volume also affects sympathetic renal efferents as well as vasopressin secretion, our observed relationship between volume load and renin may well be

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01257.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.The purpose of this study was to identify the frequency of cardiac dysrhythmias in two similar groups of hypertensive middle‐aged males (age 45–66). They had previously been randomized either to a diuretic treatment (n=42), or a β‐blocking agent (n=41). A 24‐hour ambulatory Holter monitoring, and serum potassium, was obtained in all patients, serum magnesium was measured in 35 patients. The mean number of ventricular premature beats (VPBs) and the frequency of complex arrhythmias (19 vs. 5) was significantly higher in the diuretic group (p<0.01). The serum potassium was significantly lower (p<0.001) in the diuretic group, and there was a significant (p<0.005) inverse correlation between the number of VPBs and the serum potassium in all treated patients. The patients with complex arrhythmias were older (p<0.01) than the remainder of the patients. No correlation between serum magnesium and VPBs or complex arrhythmias was found. This study demonstrates increased frequency of VPBs in older hypertensive males, treated with diuretics, and that hypokalaemia predisposes to increased cardiac arrhythmias. We conclude that in older mildly hypertensive men hypokalaemia should be

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01258.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.In a prospective study selected fibrinolysis variables were assessed in plasma samples from 29 consecutive patients recovering a first instance of acute myocardial infarction and the results were correlated with reinfarction during the next four years. Nine patients suffered a reinfarction leaving a group of 20 patients without evidence of relapse. The reinfarction group was characterized by lower tissue plasminogen activator activities in plasma euglobu‐lins (p<0.05), significantly higher plasma concentrations of tissue plasminogen activator antigen (p<0.002) and a tendency to a higher plasma level of plasminogen activator inhibition capacity. There were no significant differences between the groups in plasma concentrations of plasminogen, histidine‐rich glycoprotein, plasminogen kringle‐4‐binding‐protein, and α2

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01259.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.Nocturnal urinary melatonin excretion was evaluated in six patients with nightmares and hallucinations during treatment with β‐adrenoceptor blocking agents, and compared to six control patients with similar diagnoses and treatment but without such symptoms from the central nervous system (CNS). Nightly melatonin excretion was lower in all cases with nightly CNS‐symptoms than in the control patients. The results also suggest drug differences and dose dependency. It is concluded that in predisposed patients CNS side‐effects induced by β‐adrenoceptor antagonists are related to depressed nightly melatonin

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01260.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.The hemodynamic effects of loud noise after central α2‐adrenoceptor stimulation were studied in 13 patients with mild (WHO 1) essential hypertension. The patients were randomized (double‐blind) to treatment with either placebo or guanfacine 1–2 mg for four weeks and then crossed over and treated for another four weeks. All patients were exposed to a loud broad‐band noise (105 dBA for 30 min) and all were studied both on placebo and guanfacine. Guanfacine significantly reduced the resting blood pressure from 141/92 to 134/ 88 mmHg (p<0.01) as well as heart rate at rest from 63 to 58 beats/min (p<0.05). Noise stimulation caused a significant increase in blood pressure and resistance in the placebo‐treated group, while cardiac output decreased significantly. Pretreatment for one month with the central α2‐adrenoceptor stimulating agent guanfacine did not block the noise‐induced pressor response nor the increase in peripheral resistance. A significant decrease in stroke volume was observed and cardiac output also tended to decrease in this group. It could be concluded that loud noise is a potent pressor stimulus which causes vasoconstriction and that the blood pressure response during noise could not be blocked by the centrally acting an‐tihypertensive agent guanfacine. Since noise causes vasoconstriction it also induces an increased tone in the small arteries and, if the noise stimulus is sufficiently strong and repeated for a long time, it might cause structural changes in the resistance vessels and permanent arterial hyper

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01261.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.We compared sorbitol given alone and as part of a mixed meal to nine insulin‐dependent diabetics (IDD's) during continuous subcutaneous insulin infusion (CSII). Blood glucose, sorbitol and breath hydrogen+methane were measured following six test meals: Pure glucose, sorbitol and lactulose, a mixed meal alone, and sweetened with sorbitol and sucrose. Blood glucose increase was very small after lactulose and sorbitol, significantly larger after glucose. A considerable increase in breath hydrogen+methane appeared after sorbitol and lactulose, but not after glucose. No differences in blood glucose responses were found after the mixed meal alone or sweetened with sorbitol and sucrose. A sustained low level increase in breath hydrogen+methane occurred after all solid meals. Sorbitol was not detected in serum after any meal.Conclusion:Sorbitol ingested by IDD's during CSII in watery solution is not absorbed in the small intestine and causes osmotic diarrhoea. Ingested in a composite meal it does not affect blood glucose and does not cause osmotic diarrhoe

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01262.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.A questionnaire designed to test the value of questions identifying benign esophageal disease was sent to patients representing four well‐defined entities: angina pectoris (n=30), benign esophageal disease (n=25), gastroduodenal ulcer or former gallstones (n=27) and normal subjects (n=38). By means of logistic regression, three key‐questions were selected. A combination of an affirmative answer to “difficulty in swallowing solid food” and to “pain in the chest” or “heartburn at night” or both did not occur in the group of normal subjects, while occurring in 68% of the patients with esophageal diseases. The combination occurred in only 10% of the patients with angina pectoris and 15% of those suffering from gastroduodenal ulcer or gallstones. The predictive accuracy of the combination of the three questions is estimated for various hypothetic prevalences of esophageal disease. These questions appear to identify approximately two‐thirds of individuals with esophageal disease with acceptable false‐positive rates and can therefore be used in epid

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01263.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

ABSTRACT.The drug consumption has been studied in two 70‐year‐old cohorts within the frames of the longitudinal population study “70‐year‐old people in Göteborg, Sweden”. The first cohort has been followed for 12 years and the second, which was born 5 years later, for 5 years. In the first cohort the proportion of men and women on drug treatment increased from 61 and 77% at age 70 to 90 and 97% at age 82. The average number of drugs among those on treatment increased from 3.1 (men) and 3.4 (women) to 3.9 and 5.4, respectively. The most common drugs at age 70 were anxiolytics (20 and 29%), diuretics (IS and 29%), analgesics (12 and 20%), and digitalis (13 and 14%) and at 82 years of age analgesics (39 and 56%), anxiolytics (27 and 49%), diuretics (26 and 42%), and laxatives (19 and 28%). The second examined cohort used more drugs mainly at age 75 than the first cohort. The longitudinal follow‐up of the first cohort indicated an overmortality mainly among men on drug treatment at ages 70 and 75. The patients' knowledge of the indications for the treatment was often weak and at age 82, 25% of the patients were unaware of the indications for one or mor

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1987.tb01264.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY