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Biomedical subjects

A R Krogsgaard

Publications and source records attributed to A R Krogsgaard.

At least 19 recordsLinked to original sources
PubMed1986

Severe hypertension with cerebral symptoms treated with furosemide, fractionated diazoxide or dihydralazine. Danish Multicenter Study.

Emergency treatment of acute, severe hypertension defined as diastolic blood pressure (DBP) greater than or equal to 135 mmHg combined with cerebral symptoms was prospectively monitored in a randomized multicenter study including 64 patients. Treatment was divided into two periods. In the first hour the patients were observed in the supine position after being given 40 mg furosemide intravenously. If DBP remained greater than 125 mmHg (n = 52), the patients were put on fractionated diazoxide administered intravenously (n = 28) or dihydralazine administered intramuscularly (n = 24). Blood pressure (BP) decreased with diazoxide from an average of 241/149 mmHg to 180/111 mmHg after 5 hours and with dihydralazine from 237/149 to 161/101 mmHg. The inter-individual BP response varied considerably. A clear and identical regression in neurological symptoms was observed on both drug regimens. No new neurological symptoms were seen to develop. It is concluded that a gradual fall in BP can be obtained after fractionated dosage of diazoxide (i.v.) as well as after dihydralazine (i.m.). The indication of acute parenteral therapy compared to less aggressive oral treatment is discussed.

Adult↗
PubMed1986

Reversibility of cerebral symptoms in severe hypertension in relation to acute antihypertensive therapy. Danish Multicenter Study.

Cerebral symptoms were registered in a multicenter study including 64 patients with severe hypertension, diastolic blood pressure (DBP) greater than or equal to 135 mmHg, and more or less pronounced hypertensive encephalopathy. The symptoms were: headache (70%), dizziness (35%), consciousness disturbances (28%), nausea (27%), paresis (23%), blurred vision (22%), paraesthesia (21%) and vomiting (14%). None had convulsions or coma. Initial treatment was furosemide i.v., and if DBP was greater than or equal to 125 mmHg after one hour, patients were randomized to treatment with either i.v. diazoxide (bolus injections of 75-150 mg) or i.m. dihydralazine (bolus injections of 6-12.5 mg). A gradual fall in blood pressure (BP) was obtained in all three groups. Along with BP reduction a substantial regression of neurological symptoms was registered. After 5 hours only minor cerebral symptoms were present without significant difference between diazoxide and dihydralazine. None developed cerebral complications. The study failed to show a significant correlation between BP reduction and regression of neurological symptoms graded semiquantitatively. Reduction of BP by titration using small repeated bolus injections is recommended, but oral treatment should be considered in the patients who are able to ingest peroral medication in spite of neurological symptoms.

Aged↗
PubMed1986

Changes in blood pressure, heart rate and thyroid hormones after sudden withdrawal of pindolol and atenolol in hypertensive patients.

In a double-blind study 19 patients with mild and uncomplicated arterial hypertension were randomized to treatment with either pindolol 10 mg or atenolol 100 mg once daily for 4 weeks. After abrupt withdrawal a minor overshoot of free-T3 was seen in both groups. This was, however, statistically significant in the pindolol group only. The only overall haemodynamic changes which was observed after the withdrawal was an overshoot in heart rate in the standing position in the atenolol group. Great inter-individual differences in the haemodynamic parameters were found, however, and changes suggestive for withdrawal syndrome were found in 14 patients (pindolol = 7). The time for this overshoot varied considerably from 48-132 h post-drug in both groups. No correlation between the alterations in free-T3 and the cardiovascular parameters was found.

Adult↗
PubMed1981

Association between the C3F-gene and essential hypertension.

1. The complement 3 (C3) phenotype distribution in 112 patients with essential hypertension was compared with the distribution of 316 normotensive control subjects. 2. A significant increased frequency of the C3F-gene was found among the patients (0.2637 vs 0.1721, P = 0.0031), indicating an association between the C3F-gene and essential hypertension. 3. The relative risk of essential hypertension was calculated to be 1.90 for C3F-positive individuals. 4. The association between the C3F-gene and essential hypertension was stronger among the untreated patients, where a relative risk of 3.89 was found for C3F-positive subjects. 5. A significant negative correlation was found between the C3F-positivity and the severity of the hypertensive disease estimated by eye group changes. This might be in accordance with a negative natural selection of C3F-positive hypertensive patients. 6. The study supports the hypothesis that immunogenetic factors may be of pathogenetic importance in essential hypertension.

Adolescent↗
PubMed1980

Immediate effects of labetalol on central, splanchnic-hepatic, and forearm haemodynamics during pleasant emotional stress in hypertensive patients.

The effects of intravenous administration of labetalol in a dose of 0.75 mg/kg body weight on central, splanchnic-hepatic and forearm haemodynamics were studied in 8 hypertensive patients resting in the supine position and during pleasant psychic stress induced by practice of a television-game of tennis. In the resting state labetalol caused immediate reduction of arterial blood pressures and of total vascular resistance, whereas heart rate, cardiac output and splanchnic-hepatic and forearm blood flow remained unchanged. After labetalol, the stress-induced increase in heart rate, cardiac output, estimated myocardial oxygen demand and forearm blood flow was significantly reduced, whereas total vascular resistance and splanchnic-hepatic vascular resistance remained unchanged. This is taken to indicate that the alpha-adrenoceptor blocking properties of labetalol may offer haemodynamic advantages as compared to the widely used non-selective beta-adrenoceptor blocking agents in the management of hypertension.

Ethanolamines↗
PubMed1980

Hydralazine in arterial hypertension. Randomized double-blind comparison of conventional/Slow-Release formulation and of b.i.d./q.i.d. dosage regimens.

Blood pressure (BP) control and tolerability of three two-week dosage regimens of hydralazine--conventional hydralazine q.i.d., conventional hydralazine b.i.d. and slow-release hydralazine b.i.d--were compared in a double-blind, randomized, cross-over trial in 20 out-patients with arterial hypertension controlled with hydralazine in combination with other antihypertensive drugs. The efficacy of the treatments was assessed during the last two days of each treatment period by determination of BP and pulse rate every hour between 8 a.m. and 6 p.m. No statistically significant differences in BP and pulse rate were found between the three treatment regimens, either in the variation during the day or in the mean value for the day. There was a tendency to lowest BPs on conventional hydralizine q.i.d. and to highest on conventional hydralazine b.i.d. Mean differences in supine BP between conventional hydralazine b.i.d. and slow-release hydralazine b.i.d. were 3.2 systolic and 0.5 mmHg diastolic. In this short-term study, mean values with 95% confidence limits indicate that conventional hydralazine in a q.i.d. dosage can be replaced by the same preparation or slow-release formulation in a b.i.d. dosage. Acetylator phenotype was determined and had no significant influence on the results, although there was a tendency to more widespread variability in systolic pressure and to a lower pulse rate in fast acetylators. Unwanted effects were few and did not differ obviously between the treatments. Whether the frequency of late toxicity of hydralazine is lower with slow-release formulation remains to be evaluated in long-term studies.

Adult↗