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Biomedical subjects

A Celentano

Publications and source records attributed to A Celentano.

52 records · Page 3Linked to original sources
PubMed1993

Ambulatory blood pressure monitoring in offspring of hypertensive patients. Relation to left ventricular structure and function.

The relation between 24-h ambulatory blood pressure monitoring and echocardiographic left ventricular (LV) anatomy and function was examined in 30 young, normotensive offspring (16 men, 14 women) of hypertensive, parents and in 20 offspring (12 men, 8 women) of normotensive parents, comparable for age, clinical blood pressure, and gender. Offspring of hypertensive subjects exhibited higher body mass index (P < .01), relative wall thickness, and LV mass/height (both P < .001). No significant difference was found in LV chamber dimensions and in either systolic or diastolic function. The 24-h systolic and diastolic blood pressures were higher in offspring of hypertensive subjects than in controls (P < .001 and P < .0001, respectively), as was the coefficient of variation of 24 h systolic blood pressure (P < .01). In pooled groups, LV mass was positively related to daytime systolic blood pressure (r = 0.48), daytime diastolic blood pressure (r = 0.47) (both P < .001), and the coefficient of variation of 24 h diastolic blood pressure (r = 0.37, P < .01). In a multiple regression model, including as variables, body mass index, daytime systolic and diastolic blood pressures, male gender, and family history of hypertension were the major independent predictors of LV mass (both P < .0001), with an additional contribution of the coefficient of variation of 24 h diastolic blood pressure (P < .05). We conclude that male gender and a family history of hypertension are stronger determinants of early changes in cardiac structure than hemodynamic load in a group of young, normotensive adults.

Adolescent↗
PubMed1993

Management of the patient with left ventricular hypertrophy.

The management of left ventricular hypertrophy (LVH) presupposes that the patient is identified by echocardiography and is carefully evaluated for risk stratification, taking into consideration possible associated complications. The role of non-pharmacological treatment is limited, except in obese patients. Drug treatment, especially using calcium antagonists, angiotensin converting enzyme inhibitors and beta-blockers, has proved to be effective in reducing LVH. These drugs are also effective in controlling, if not reversing, the associated pathophysiological changes and complications, such as impaired systolic and diastolic function, and ventricular arrhythmias. There is, however, no evidence of any beneficial effect on myocardial ischaemia. The desirable goal is LVH regression, but it may not be achievable in over 50% of patients, and it is not possible to identify patients in whom regression is likely. Regression, or control of each sequelae, could prevent sudden death, the evolution of hypertensive heart disease leading to heart failure and, probably, myocardial infarction. Patients must be followed carefully during and, particularly, at the beginning of the antihypertensive therapy which has to be gradually introduced. At best, blood pressure must be reduced while avoiding hypotension. The strategy of antihypertensive treatment has to be reconsidered on the basis of the presence of LVH and could lead to decreased cardiovascular morbidity and mortality of patients with LVH.

Antihypertensive Agents↗
PubMed1991

Comparative effects on blood pressure and regional hemodynamics of nicardipine and captopril.

This randomized, double-blind, crossover study was aimed at detecting efficacy differences in blood pressure control and peripheral circulation in cerebral aortic and femoral districts of slow-release nicardipine, 40 mg, and captopril, 50 mg, given twice daily to 20 primary hypertensive patients (9 male, 11 female; age range 33-60 years) for a period of 4 weeks for each treatment. Blood flow velocities in the aorta, common carotid artery, internal carotid artery, middle cerebral artery, and common femoral artery were noninvasively measured using a 2.0- or 5-MHz Doppler probe. Systolic blood pressure fall was similar with nicardipine (from 156 +/- 12 to 139 +/- 8 mm Hg, p less than 0.001) and captopril (from 158 +/- 13 to 146 +/- 13 mm Hg, p less than 0.001) while significant efficacy difference (p less than 0.005) in diastolic pressure control was detected (from 104 +/- 6 to 91 +/- 8 mm Hg, p less than 0.001 with nicardipine and from 102 +/- 6 to 98 +/- 7 mm Hg with captopril). Regarding regional hemodynamics, nicardipine increased (from 119 +/- 24 to 133 +/- 27 cm/s), and captopril did not affect systolic velocity in the aorta (difference between final data, p less than 0.03). In the common carotid artery systolic velocity was increased solely by nicardipine. No significant changes were detected in the other vessels explored.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Slow-release isradipine in mild to moderate hypertension: hemodynamic and antihypertensive effects.

In this study we used casual and 24-h blood pressure (BP) monitoring and Doppler echocardiographic data to investigate the antihypertensive and hemodynamic effects of isradipine 5 mg in the new slow-release oral (SRO) formulation administered once daily for 12 weeks to 10 patients with mild to moderate hypertension. The antihypertensive action of SR isradipine was revealed by the normalized values of casual BP in 60 patients and by the significant reduction of 24-h BP variability as assessed by mean standard variation, coefficient of variation and the percent incidence of abnormal levels of both systolic and diastolic BP during 24 h (p less than .001). The echocardiographic data showed some beneficial hemodynamic effects (improvement of systolic and diastolic indices) without significant variation of left ventricular structure. The drug was well tolerated, with a low incidence of side effects. In conclusion, SR isradipine can be considered a safe and effective first-choice drug for the treatment of mild to moderate hypertension.

Administration, Oral↗
PubMed1990

Hypertension and arrhythmias: effects of slow-release nicardipine vs chlorthalidone: a double-blind crossover study.

The aim of the study was to compare the effect of slow-release (SR) nicardipine, placebo and chlorthalidone on hypertension-related arrhythmias evaluating 24-h ambulatory ECG. After a 2-week placebo run-in, the patients were randomized according to a double-blind design and treated with either SR nicardipine (40 mg b.i.d.) or chlorthalidone (25 mg once daily) for 8 weeks. At the end of this period, the patients were again treated with placebo for an additional 2 weeks and then crossed over and treated with either SR nicardipine or chlorthalidone for another 8 weeks. Three patients were withdrawn from the study at the end of the first period (1 after SR nicardipine and 2 after chlorthalidone) because of severe arrhythmias (Lown's class 4B) requiring antiarrhythmic therapy. The statistical evaluation was performed on data from 36 patients. SR nicardipine and chlorthalidone determined a significant reduction of both systolic and diastolic BP, with greater decrease with SR nicardipine and without modification of HR. Twenty-four-h ambulatory ECG showed a reduction of both supraventricular and ventricular arrhythmias by SR nicardipine not only compared to placebo but also vs chlorthalidone. Similarly, the severity of ventricular arrhythmias, according to Lown's classes, was reduced only after SR nicardipine. These results were confirmed also dividing the patients according to echocardiographic criteria of LVH. The adverse effects were slight and well tolerated with both drugs. Among hematochemical data, only chlorthalidone induced significant reduction of blood potassium (with 3 cases of hypokalemia). In conclusion, SR nicardipine was found to be more efficacious than chlorthalidone in controlling not only BP but also the arrhythmic events related to hypertension.

Adult↗
PubMed1990

Effects on casual and 24-h ambulatory blood pressure of slow-release nicardipine and chlorthalidone in arterial essential hypertension: double-blind, crossover study.

The antihypertensive effect of slow-release (SR) nicardipine (40 mg twice a day) and chlorthalidone (25 mg once a day), was evaluated in 36 patients with mild to moderate hypertension by casual and 24-h BP monitoring. After 2-week placebo wash-out, patients were treated for 8 weeks with one of the two drugs, according to a double-blind design. Successively, after other 2 weeks of placebo, they underwent a crossover treatment for other 8 weeks. Both drugs were efficacious in reducing BP. The greater activity of SR nicardipine was revealed by: the effect on casual BP, with the higher number of normalized patients; a greater reduction of 24-h BP; a greater influence on BP variability, assessed by mean standard variation and variation coefficient; the lower levels of linear regression between HR and both systolic and diastolic BP; the reduced per cent incidence of abnormal levels of both systolic and diastolic BP during 24 h. Both drugs were well tolerated, with a low incidence of side effects and absence of alterations of biochemical parameters, a part of 3 cases of ipokalemia induced by chlorthalidone. In conclusion, SR nicardipine is considered to be a safe and active first-choice drug for the treatment of mild to moderate hypertension.

Adult↗
PubMed1988

Blood pressure and cardiac morphology in young children of hypertensive subjects.

Our aim was to assess echocardiographic parameters and the effort blood pressure of 50 children of hypertensives with respect to 50 children of normotensives. Systolic and diastolic blood pressures at rest were comparable between the two groups. Left ventricular mass index (LVMI), interventricular septum and posterior wall thicknesses were higher in children of hypertensives (P less than 0.01). Systolic blood pressure was higher in children of hypertensives at maximal effort until 5 min of recovery (P less than 0.01). Similarly, diastolic blood pressure was higher at 1 and 2 min of recovery (P less than 0.01). Direct correlations of mean diastolic wall thickness (r = 0.39, P less than 0.01) and LVMI (r = 0.33, P less than 0.05) with percentage effort systolic blood pressure increases were found in children of hypertensives but not in children of normotensives. In conclusion, we confirmed early cardiac alterations and a tendency for effort hypertension in children of hypertensives. The relationship between these data could be explained either by effort systolic overload or by a common response to an increased adrenergic stimulus.

Adult↗
PubMed1988

Arrhythmias, hypertension and the elderly: Holter evaluation.

In order to clarify the role of age and hypertension in determining arrhythmias, we evaluated the average heart rate, and the number of supraventricular and ventricular premature beats and their severity (Lown grade) by 24-h Holter electrocardiography of 336 patients. We excluded 54 patients with prolonged runs of atrial fibrillation or supraventricular tachycardia because these arrhythmias reduce the possibility of determining the number of premature beats. Analysis of variance, carried out after dividing the patients into four different groups according to age and blood pressure (excluding patients aged 60-65 years with diastolic blood pressure of 91-94 mmHg) showed that the hypertensives had a higher average heart rate (P less than 0.01) and more supraventricular (P less than 0.05) and premature ventricular (P less than 0.01) beats than the normotensives; no difference was found among groups of different ages. The severity of premature ventricular beats was higher in hypertensives than in normotensives, and also higher in elderly than in 'young' patients (P less than 0.01). In the evaluation of all 336 patients we found correlations between age and severity of premature ventricular beats in both normotensives (P less than 0.05) and hypertensives (P less than 0.001). Multilinear regression showed that mean blood pressure was independently related to the average heart rate, and supraventricular and premature ventricular beats and their severity, while age was correlated independently only with the severity of premature ventricular beats (P less than 0.001). We conclude that hypertension induces arrhythmias, and that age increases their severity.

Age Factors↗
PubMedDate not supplied

Effects of nicardipine on chronic stable effort angina: a non-invasive assessment.

The effects of 60 mg/day nicardipine hydrochloride were evaluated in a 4-week single-blind study on 12 patients with chronic stable effort angina. All patients completed the treatment with few reports of adverse effects. Nicardipine hydrochloride was effective in reducing the incidence of anginal attacks and consumption of glyceryl trinitrate. Treadmill exercise time, angina onset time and the time to 1 mm ST-segment depression were increased. The extent of ST-segment depression was reduced at maximum comparable exercise, with a reduced rate-pressure product and, at maximum exercise, with an increased rate-pressure product. Myocardial stress 201Tl scintillography was carried out in eight of the patients and showed improved washout in antero-septal, infero-apical and postero-lateral segments. Echocardiographic measures of left ventricular function were enhanced because of reduction of afterload. Systemic vascular resistance and end-systolic stress were also decreased and a significant correlation was found between the increase in ejection fraction and reduction of systolic blood pressure. It is concluded that nicardipine hydrochloride is effective in the control of stable effort angina by reducing myocardial oxygen consumption and enhancing coronary blood flow thereby improving left ventricular function.

Angina Pectoris↗
PubMedDate not supplied

Left ventricular hypertrophy, compliance and ventricular filling.

A total of 20 untreated hypertensive patients were divided into two equal groups matched for sex, age and blood pressure but with [mean diastolic wall thickness (MDWT) greater than 1.2 cm] or without (MDWT greater than 1.2 cm) left ventricular hypertrophy (LVH). All patients underwent pulsed doppler echocardiography and 99Tc radionuclide ventriculography at rest to assess diastolic and systolic abnormalities. In hypertensives with LVH the interventricular wall thickness, posterior wall thickness and relative diastolic wall thickness were significantly (P less than 0.01) higher and peak filling rate was significantly (P less than 0.01) lower than in hypertensives without LVH. The indices of systolic function, however, were not significantly different in the two patient groups. In hypertensives without LVH peak filling rate directly correlated with heart rate, whereas in those with LVH peak filling rate directly correlated with heart rate and the ratio of peak velocity of early left ventricular filling : peak velocity of late left ventricular filling due to atrial contraction. It is concluded that diastolic parameters may be useful tools for assessing myocardial compliance and may be effective markers of diastolic dysfunction.

Adult↗
PubMedDate not supplied

Ketanserin alone and in combination with enalapril in the treatment of essential hypertension: assessment of the haemodynamic effects.

The antihypertensive and haemodynamic efficacies of ketanserin and ketanserin plus enalapril were compared. The monotherapy phase of the study involved the oral administration of 40 mg ketanserin twice daily or 20 mg enalapril once daily for 12 weeks to 25 hypertensive patients. Systolic and diastolic blood pressures were significantly reduced by both drugs. Left ventricular function both at rest and during effort improved significantly with either drug. This was due to a reduction of end-systolic volume; end-diastolic volume decreased only with the use of enalapril. Combination therapy, involving 16 patients and both drugs given at the original dosage schedule for 12 weeks, resulted in further reductions in systolic and diastolic blood pressures, and an improvement in left ventricular function; indices of diastolic function were not modified. In conclusion, ketanserin and enalapril showed comparable antihypertensive and haemodynamic activities. A combination of ketanserin and enalapril increased the favourable characteristics of both drugs.

Aged↗
PubMedDate not supplied

Comparative evaluation of the antihypertensive efficacy of once-daily sustained-release isradipine and lacidipine using 24-hour ambulatory blood-pressure monitoring.

In this single-blind crossover study the antihypertensive efficacies of two dihydropyridine calcium antagonists, sustained-release isradipine and lacidipine, were compared using clinic and ambulatory blood-pressure measurements. After a 2-week placebo wash-out, 34 patients (19 men, 15 women, mean age 49 years) with mild to moderate hypertension (diastolic blood pressure range 95-110 mmHg) were treated with 5 mg sustained-release isradipine for 4 weeks and 4 mg lacidipine for 4 weeks in a random order. Medications were taken once daily at 08.00 h. Clinic and ambulatory blood pressures were recorded at the end of each placebo or treatment period. Two patients stopped isradipine and six lacidipine because of severe adverse effects. Clinic systolic and diastolic blood pressures decreased by an average of 17/14 mmHg with isradipine and 17/13 mmHg with lacidipine, compared with placebo (P < 0.01 in both cases), without a change in heart rate. Mean ambulatory 24-h and daytime systolic and diastolic blood pressure were significantly reduced by sustained-release isradipine and lacidipine (P < 0.05 and P < 0.01, respectively). At night systolic blood pressure fell compared with placebo (P < 0.05 with both drugs) whereas the reduction in diastolic blood pressure was not statistically significant. Mean 24-h heart rate remained unchanged. Blood-pressure variability did not differ significantly between the two drugs or between either drug and the placebo. The antihypertensive effects of sustained-release isradipine and lacidipine were similar, but the tolerability of isradipine appears to be greater since it caused fewer withdrawals.

Antihypertensive Agents↗