ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01441.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. The effects on blood pressure of dietary fish oil, sodium restriction and a combination of both strategies were examined in a short‐term dietary intervention study of 50 healthy elderly subjects (average age 67 years) with mean initial systolic and diastolic blood pressures of 133 and 77 mmHg, respectively.2. Subjects were allocated to one of four treatment groups: fish oil with normal sodium, fish oil with low sodium, sunflower oil with normal sodium and sunflower oil with low sodium for 4 weeks. They then crossed over to the alternative sodium treatment for a further 4 weeks whilst remaining on the same oil.3. The combination of fish oil supplementation with dietary sodium restriction caused significant reductions of blood pressure in the first 4 weeks: systolic blood pressure (SBP) fell by 8.9 mmHg, mean arterial pressure (MAP) by 7.4 mmHg and diastolic blood pressure (DBP) by 6.0 mmHg.4. Fish oil enhanced the effect of sodium restriction on blood pressure. In the crossover protocol, a change in sodium excretion of 92 mmol/day was accompanied by changes of 6.4, 3.3 and 2.2 mmHg for SBP, MAP and DBP, respectively, in the subjects taking fish oil. However in those taking sunflower oil, blood pressure did not change significantly.5. The results indicate beneficial interactive effect of dietary fish oil and sodium intake on blood pressur

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01442.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. Plasma atrial natriuretic peptide (ANP), renin activity, aldosterone, sodium, potassium and serum total protein and albumin during and after 14 normal pregnancies were compared with age‐matched controls.2. None developed toxaemia and all delivered healthy babies.3. During pregnancy, plasma renin activity and aldosterone were significantly (P<0.01) higher and potassium, total protein and albumin significantly lower (P<0.01) than in controls, while ANP was not different from the control level.4. At 6–13 weeks postpartum, a significant (P<0.01) suppression of renin and aldosterone was accompanied by significant (P<0.01) elevation of atrial natriuretic peptide when compared with controls.5. The hormonal changes are consistent with ‘effective plasma volume’ reduction during pregnancy and persistent volume expansion after pregnancy, perhaps due to a renal glomerular lesion sustained late in pregnancy. In contrast, levels of potassium, total protein and albumin are consistent with haemodilution during pregnancy and its correction postpartum.6. Measurements available in seven women 40–120 weeks postpartum showed normal renin and aldosterone levels in most, but ANP was still elevated.7. Pregnancy may have a protracted effect on volume r

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01443.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. Clonidine resulted in significant suppression of both noradrenaline (NA) and adrenaline (ADR) in essential hypertensives (EHT) without any false positive findings. That is, every patient who failed to suppress had phaeochromocytoma (PH).2. The clonidine suppression test (CST) produced minimal suppression of NA in NA‐secreting PH (NA‐PH) and correctly identified two NA‐PH with normal basal plasma NA.3. In ADR‐secreting PH (ADR‐PH) the CST did not result in significant suppression of ADR levels, whether elevated or normal basally.4. The CST proved to be an accurate discriminator of PH from other forms of hypertension.nor

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01444.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. To investigate the effect of an exercise training programme on antihypertensive drug requirements, 19 sedentary subjects (14 men and five women) with mild essential hypertension (systolic blood pressure greater than 140 mmHg but less than 180 mmHg), aged 29–55 years, were randomly assigned to 16 weeks of moderate intensity exercise or light intensity exercise (control), and titrated on antihypertensive drug therapy (captopril and hydrochlorothiazide) until resting systolic blood pressure (sitting) of less than 140 mmHg was achieved.2. The moderate exercise group (n= 11) followed a graded walk‐jog programme to>60% age‐predicted maximum heart rate (HRmax), attending 45 min sessions, three times each week. The light exercise group (n= 8) followed a programme of flexibility (stretching exercises) and walking to<60% age‐predicted HRmax, attending 45 min sessions, three times each week.3. There was no difference between treatment groups for the level of reduction in both resting systolic and diastolic blood pressure over the 16 weeks (15.64 ± 10.6/12.81 ± 9.97 mmHg in the moderate intensity group and 15.31 ± 10.9/7.7 ± 7.1 mmHg in the light intensity group). The change in 24 h ambulatory blood pressure profile was also similar in both treatment groups. The final antihypertensive drug requirements to achieve these changes in blood pressure was not significantly different between the two treatment groups. This was despite a significant improvement in submaximal exercise performance in the moderate intensity exercise group (P<0.001).4. We conclude that in these mildly hypertensive subjects, a 16 week aerobic exercise programme did not decrease antihypertensive drug requirements. Captopril therapy did not influence submaximal exercise performance or prevent a training effect from regular aerob

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01445.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. Of 93 patients with primary aldosteronism seen during a 20 year period, 52 had an aldosterone‐producing adenoma (APA) removed (five more await surgery), 14 had bilateral adrenal hyperplasia (BAH), three had glucocorticoid‐suppressible hyperaldosteronism (GSH), one had adrenal carcinoma and 18 are yet to be categorized.2. Seventy‐three presented with hypertension and hypokalaemia. Others had markedly suppressed renal venous plasma renin activity (PRA) or elevated plasma aldosterone (PA)/PRA ratio, in new or resistant hypertensives.3. The PA/PRA ratio was the most reliable screening test.4. Diagnosis depended on the failure of suppression of aldosterone by salt loading and fludrocortisone.5. Differentiation of BAH from APA depended on adrenal venous sampling comparing adrenal and peripheral venous PA/cortisol ratios.6. A new familial variety of primary aldosteronism is described, with two affected members in each of three families.7. Primary aldosteronism should be looked for in resistant and low‐renin hypertension as well as in hypertension with hypokalaemia, and other family members should have PA/PRA measured if they are hyper

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01446.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. From an earlier cross‐sectional survey of 343 public servants, 15 pairs of non‐smoking teetotallers and heavy drinkers (alcohol intake more than 350 mL/week) were matched for age and adiposity and utilized for a case‐control study of the effects of alcohol on 11β‐hydroxysteroid dehydrogenase (11β‐OHSD) activity and blood pressure.2. Two successive 24 h urine collections were analysed by radio‐immunoassay (RIA) for cortisol excretion, and for the cortisol and cortisone metabolites, tetrahydrocortisol (THC), allo‐tetrahydrocortisol (allo‐THC) and tetrahydrocortisone (THE), by capillary column gas chromatography.3. Heavy drinkers had higher systolic and diastolic blood pressure (BP) than teetotallers (132.6 ± 2.5vs123.2 ± 1.3 and 78.7 ± 1.6vs71.7 ± 1.4, respectively; unpairedt‐test,P<0.01). Twenty‐four‐hour urinary sodium and cortisol excretion were similar in the two groups.4. The THC plus allo‐THC: THE ratio was similar in drinkers and teetotallers (1.81 ± 0.20vs2.03 ± 0.20), consistent with no effect of alcohol on 11β‐OHSD activity. The ratio of THC to allo‐THC was increased in drinkers compared with teetotallers (1.49 ± 0.18vs1.05 ± 0.13; unpairedt‐test,P<0.05), consistent with either a decrease in 5α‐reductase activity or an increase in 5β‐reductase activity.5. This study provides no evidence for alcohol‐related inhibition of 11β‐OHSD, despite substantially higher blood pressures in heavy drinkers compared to teetotallers. Such an effect is, therefore, unlikely to contribute significantly to the mechanism of alcohol‐related hypertension. The increase in the THC: allo‐THC ratio

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01447.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. Significant increases in arterial noradrenaline (NA) of similar magnitude were seen in normotensive (NT) and hypertensive humans (HT) during adrenaline (ADR) infusion.2. Significant falls in plasma potassium (K+) were observed in both NT and HT during ADR infusion, even at rates equivalent to minor stress. Levels achieved were significantly lower in HT than in NT.3. Plasma glucose increased significantly in HT at all ADR infusion rates but only at higher rates of infusion in NT.4. Basal insulin levels were significantly higher in NT than in HT. After cessation of infusion, insulin increased three‐fold in HT and two‐fold in NT.5. Infusion of ADR to produce levels seen during mild to moderate stress resulted in significant increases in plasma NA, falls in plasma K+ and increases in plasma glucose. The expected large insulin response to rising glucose was not seen until after ADR was ceased, confirming the inhibitory effect of ADR on glucose stimulated insulin rele

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01448.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. Saline infusion produced concurrent mean increases over basal in plasma and urinary atrial natriuretic peptide (ANP) of approximately 100%.2. Subpressor calcium infusion also produced concurrent increases in plasma and urinary ANP of 38 and 60% respectively.3. Urinary ANP appeared to be as responsive to the dynamic stimulation of saline and calcium infusion as plasma levels.4. Urinary ANP may be useful when an integrated estimation of ANP secretion and metabolism is required. Further studies are required to assess clinical utility in a variety of settings, for example during endopeptidase 3.4.24.11 inhibition.

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01449.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SUMMARY1. Video imaging of single, fura2‐loaded vascular smooth muscle cells was used to examine the spatial and temporal alterations in calcium, Ca2+, in response to low levels of vasoconstrictor stimuli.2. Histamine (0.5 μmol/L) produced repetitive oscillations in Ca2+, which appeared to show some variation in amplitude and frequency between cells.3. Individual oscillations consisted of an initial increase in Ca2+in a localized region followed by a wave‐like propagation of this region of elevated Ca2+throughout the rest of the cell cytoplasm.4. It is suggested that the subcellular spatial organization of Ca2+that was observed during a Ca2+oscillation allows a population of cells to operate in unison. Thus, oscillatory fluctuations in Ca2+may contribute to myogenic

ISSN:0305-1870    

DOI:10.1111/j.1440-1681.1991.tb01450.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY