ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15876.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15877.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Plasma atrial natriuretic peptide (ANP) was measured during dynamic exercise in 10 patients with coronary heart disease before and after single dose atenolol 50 mg and acebutolol 200 mg, respectively. Systolic blood pressure, heart rate and the rate‐pressure product increased during exercise before and after β‐blockade, but levels were lower after β‐blockade. Plasma ANP levels at rest were unchanged after atenolol, but rose after acebutolol (p<0.01). During exercise plasma ANP increased significantly both before and after β‐blockade, but plasma ANP levels were higher after acebutolol at all workloads (p<0.05), whereas plasma ANP levels after atenolol were higher at 125 W exclusively (p<0.05). The augmented ANP levels during exercise after β‐blockade probably reflect catecholamine‐stimulated ANP release, whereas the elevated plasma ANP levels after acebutolol at rest might be a β‐adrenoceptor‐mediated ANP release due to the intrinsic sympathomimetic

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15878.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Enalapril 40 mg or tolerated dose was given once daily to 21 patients with congestive heart failure (CHF), NYHA class III, in addition to treatment with digoxin and/or diuretics. After an 8‐week open period, 19 patients were randomized to continue enalapril or to receive a placebo in a double‐blind manner. After the first enalapril dose of 10 mg, maximal reduction of blood pressure (BP) occurred after 4 hours (mean 34/17 mmHg;p<0.001). No further reduction was found after higher doses. After the open period significant improvement was shown as judged by NYHA class (p<0.01), stroke volume (p<0.05), maximal working capacity (p<0.05), heart volume (p<0.01) and maximum rate pressure product (RPPmax) (p<0.001). Urinary aldosterone markedly decreased (p<0.01), whereas serum potassium and serum creatinine slightly increased (p<0.05). At the end of the blind period enalapril was superior to placebo concerning NYHA class (p<0.01), heart volume (p<0.05) and RPPmax (p<0.05). Other parameters, including aldosterone in urine, did not differ between the groups. Carry‐over effects may have diminished the differences between enalapril and placebo. Diarrhoea (n=5) and hypotension (n=5) were the most common side‐effects. Overall, enalapril was well tolerated and seems to be useful in single daily doses in the treatment

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15879.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.In a 24‐week randomized, single‐blind study Timolol (n=63) and Enalapril (n=57) proved to be potent and safe antihypertensive drugs. However, the effect on lipid metabolism was fundamentally different, despite the fact that the effect on total serum cholesterol did not significantly differ between the two groups. Enalapril had no adverse effect on any lipid fractions, while Timolol increased very low (VLDL) + low (LDL) density lipoprotein cholesterol by 7.6% (p<0.001) and total triglycerides by 34.5% (p<.001), and decreased the favorable high density lipoprotein (HDL) cholesterol by 11.3% (p<0.001). Thus, the ratio HDL/VLDL + LDL cholesterol was reduced by 17.1 % (p<0.001). Enalapril reduced uric acid by 3.4% (NS), while Timolol increased uric acid by 4.0% (p<0.05). The difference between the groups was statistically significant (p<0.01). The first steps in any attempt to solve the hypertension‐coronary dilemma should be to take into consideration all pharmacologic effects of antihypertensive

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15880.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.In 1985, a follow‐up investigation was performed of all patients with acromegaly (n= 166, 89 women and 77 men) seen over a 30‐year period (1955–1984) at our Endocrine Unit, referral centre for the western region of Sweden (population 1.5 million). At the end of 1984, the prevalence of the disease was 6.9 per 105inhabitants, the average incidence per year was 3.3 per million people. Mean age at diagnosis was 46.3 years and at death (n=62) 64.1 years. About one‐third of the patients (50/153), in whom it had been possible to estimate the total duration of the disease, had survived for more than 25 years. Mortality was, however, increased compared to the normal population. The observed number of deaths from vascular and malignant disorders was 32 and 15, respectively, compared to the expected numbers 9.0 (p<0.001) and 5.6 (

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15881.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Cardiac function was studied by echocardiography in 12 patients with active acromegaly and in 12 age‐ and sex‐matched healthy control subjects. None of the patients had cardiovascular diseases or other endocrine diseases than acromegaly. The patients had a mean age of 39±5 years and were short‐term acromegalic with a mean duration of disease of 6±3 years. Mean left ventricular mass was 163±43 g/m2in the acromegalic group versus 120±24 g/m2in the control group. Preload (the diastolic diameter of the left ventricle) was within normal limits, while afterload (end‐systolic meridional wall stress) was significantly decreased in the acromegalic group. Myocardial contractility assessed as fractional shortening of the left ventricle was 39.9±3.6% in the acromegalic group versus 32.9±5.1% in the control group, and cardiac output was increased by 52% in the acromegalic group because of increased heart rate and stroke volume. We suggest that augmented peripheral blood flow is responsible for the condition of cardiac hyperkinesia in short‐term acromegaly and involved in the development of hypertension, which is a frequent complication of long

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15882.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.During the years 1956–1982, 64 pheochromocytoma patients were operated upon without mortality. Twenty‐eight patients had sustained hypertension and 29 paroxysmal hypertension only. In two patients high blood pressure was not related to pheochromocytoma and five subjects were normotensive. In two women the pheochromocytoma demonstrated malignancy by widespread metastases. Sixteen patients also had neuroectodermal manifestations other than pheochromocytoma. Preoperatively, heart disease was found in most of the hypertensive patients aged 50 years or more at operation, but was uncommon in the others. In these subjects, heart disease persisted after surgery. Young subjects with sustained hypertension were not less affected by preoperative cerebrovascular accidents than older subjects. After surgery, hypertension persisted in 12 patients, and was easily controlled by drug therapy in eight. Nine patients died 7 months‐18 years after surgery. In no case was the death directly associated with the pheochromocytoma disease. Three died from other neuroectodermal abnormalities. The 55 surviving patients have been followed up for a mean of 12 years after surgery. During the observation time the survival of the pheochromocytoma patients was similar to that of the normal population. At the end of the study, 44 out of the 55 surviving patients were free from sym

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15883.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Sixty‐two moderately obese (body mass index=34.8), but normotensive females were treated with a balanced hypocaloric diet providing 1600 kcal/day and either a 6.5 g dietary fibre supplement or placebo in a randomized, double‐blind, parallel group design. During a 12‐week treatment programme, weight loss was similar in both groups (4.1 and 4.4 kg, respectively). Initially the blood pressure was 123/76 mmHg in the fibre group compared with 124/74 mmHg in the placebo group (p>0.05). In the fibre‐treated group a significant fall in diastolic blood pressure by 4 mmHg was found (p<0.05). No significant change was seen in the placebo group. It is suggested that dietary fibre may affect blood pressure independently of weight

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15884.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.HbA1cevaluates glycemic control 3–6 weeks retrospectively. To achieve improvements in glycemic control we have tested a patient‐administered HbA1ccontrol program in 12 (11 type I) diabetic patients. In the program, HbA1cwas estimated once a month for 12 months and the results were mailed to the patient who recorded them in a specially designed HbA1cchart. The results in the probands were compared with 24 matched (22 type I) diabetic patients. The results showed that HbA1cfell significantly (p<0.01) during the year in the probands, from 8.84±1.12% to 7.48±0.95%, and was unchanged in the controls (8.41 ±1.78% and 8.17±1.74%, respectively). Accordingly, HbA1cself‐recording improves glycemic control in diabetic

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15885.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY