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Biomedical subjects

A Gillies

Publications and source records attributed to A Gillies.

42 records · Page 3Linked to original sources

Treatment of mild hypertension.

1. A total of 206 patients, elderly males with hypertension (diastolic blood pressure 95--110 mmHg) were followed for periods varying from 1 to 5 years, 107 patients with diastolic blood pressure less than 95 mmHg were followed over the same period, and 101 patients with diastolic blood pressure greater than or equal to 110 mmHg were also followed. 2. The mortality of each group and the effect of therapy for hypertension on mortality has been compared. 3. The incidence of myocardial infarct in the group treated with thiazide diuretics is greater than in the other groups. 4. It would appear unlikely that therapy will improve the prognosis in elderly people with mild hypertension.

Benzothiadiazines↗

A simplified approach to the treatment of hypertension.

A new beta-adrenoreceptor blocking drug (timolol) was used in two clinical studies. In the first double blind study administration of hydrochlorothiazide and timolol reduced the mean (formula: see text) blood pressure by 23 mm Hg, compared with a fall of nine mm Hg with administration of hydrochlorothiazide and a placebo. Plasma potassium (K+) levels fell with the administration of hydrochlorothiazide alone, but rose back to control values when patients were given timolol. In the second study (patient blind), Moduretic (hydrochlorothiazide, 50 mg and amiloride, 5 mg) and timolol were given once daily. The mean blood pressure fell by 20 +/- 2 mm Hg allowing hypertension to be controlled by this once-daily regimen; the control persisted throughout the day. Plasma potassium (K+) levels fell slightly after treatment with Moduretic, but the fall was not as great as with hydrochlorothiazide. Of the 65 patients who entered these studies, 35 had not been previously treated and had diastolic blood pressure between 105 mm Hg and 130 mm Hg. In 18 patients the diastolic blood pressure was reduced below 95 mm Hg after treatment with a diuretic alone, in 15 patients treatment with a diuretic and timolol (5 mg to 20 mg) reduced the diastolic blood pressure below 95 mm Hg. In two patients, the diastolic blood pressure was between 95 mm Hg and 100 mm Hg. The response achieved with a relatively simple therapeutic regimen that can be administered once daily suggests that the therapy of most hypertensive patients could be supervised by paramedical personnel.

Adult↗

Factors controlling the release of renin. A micropuncture study in the cat.

Blood was collected by micropuncture from the efferent arteriole and superficial venules of the cat's kidney. Blood samples were also collected from the femoral artery and the renal vein. The blood renin concentrations (ng A1 m1-1 2h-1) in a basal state were 37.2 +/- 3.5 (S.E.M.) (n equal to 60) (artery), 32.5 +/- 5.2 [7] (efferent arteriole), 53.5 +/- 4(116) (superficial venule), 54.2+/- 5.4 (43) (renal vein). The corresponding values after haemorrhase were 389 +/- 98 (21), 345 +/- 115 (6), 963 +/- 208 (37), 907 +/- 290 (17), ng A1 m1-1 2h-1. The efferent arteriolar renin did not differ from that in the artery but the concentrations in superficial venular blood and renal vein were higher than arterial concentration. Thus renin entered the circulation between the efferent arteriole and the superficial venule. The blood renin concentration of different superficial venules at a steady arterial renin concentration varied markedly. Into certain venules there appeared to be little or no renin secretion, into others a marked renin secretion, suggesting a heterogeneity of renin secretion by the different nephrons. When the flow of tubular fluid to the macula densa of a group of nephrons was blocked, the renin concentration fell and was significantly less than the renin concentration in venules draining non blocked nephrons and less than in the renal vein. These results suggest that the juxtaglomerular apparatus of the nephrons do not release renin in a synchronous fashion. The release appears to be episodic and is inhibited when flow to the macula densa is ceased. This implies that a high sodium concentration at the macula densa stimulates renin release.

Animals↗

A role of frusemide in resistant hypertension.

Five patients who were resistant to their antihypertensive drug therapy were admitted to hospital. Four had marked falls in blood pressure and an associated loss of weight. This fall in blood pressure was able to be repeated outside hospital by adding frusemide to their other drug therapy. Certain hypertensive patients become resistant to their antihypertensive therapy, owing to the accumulation of sodium. Thiazides may not have sufficient natriuretic properties to correct this accumulation. In these circumstances, frusemide may allow the hypertension to be controlled.

Adult↗

The intrarenal release of renin in the rat.

1. A technique was developed to measure renin concentration in nanolitre volumes of blood. 2. The renin concentration in renal venous blood was higher that in renal arterial blood. 3. The renin concentration in blood from the efferent arteriole was less than in blood from the renal artery and renal vein. 4. Renin enters the circulation distal to the efferent arteriole. 5. The release of renin into the interstitium would allow local formation of angiotensin and the system could act as an intrarenal control mechanism.

Animals↗