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Biomedical subjects

A Strano

Publications and source records attributed to A Strano.

At least 73 records · Page 4Linked to original sources

Ketanserin versus propranolol in the treatment of mild and moderate essential hypertension: corroboration with ambulatory blood pressure monitoring.

In order to assess the medium-term efficacy of ketanserin in comparison with that of the beta-blocker, propranolol, a randomized double-blind crossover trial was conducted involving 13 patients suffering from mild or moderate essential hypertension. Six of these patients were also evaluated on an ambulatory basis using noninvasive intermittent blood pressure monitoring to corroborate these values. Results indicated that both ketanserin and propranolol significantly lowered systolic, diastolic, and mean blood pressure levels after 60-day treatment periods. Diastolic blood pressure levels of less than or equal to 90 mm Hg were achieved in seven patients following ketanserin therapy and in six patients after treatment with propranolol. Both ketanserin and propranolol reduced arterial blood pressure without interfering with its circadian rhythm and variability. A tendency for the blood pressure lowering effect of ketanserin to increase with age was also noted. Side effects were minimal. The results of this trial confirm the efficacy and safety of ketanserin for the treatment of mild or moderate hypertension.

Adult↗

Are the vascular complications of diabetes mellitus preceded by an altered thromboxane/prostacyclin plasmatic ratio?

Although many data regarding the biosynthesis of thromboxane A2 and prostacyclin in diabetes mellitus have recently appeared in the literature, it is not clear whether an imbalance between the generation of the two prostaglandins might be connected to the vascular complications of diabetes. In the present review we have tried to emphasize the most significant aspects of these studies and we have focused on alterations of platelet prostacyclin receptors and on the effects of circulating immune complexes on platelets of diabetics. It is likely that studies on the release of platelet derived growth factor as well as more precise definitions of its action on vessel wall cells leading to a massive release of prostacyclin, will permit us to ascertain whether an alteration in prostaglandin ratio is linked to the genesis of the vascular complications in diabetics.

6-Ketoprostaglandin F1 alpha↗

Calf blood flow and vascular resistance in borderline hypertensives in comparison with control subjects.

A significant reduction of maximal vasodilation capacity at the calf in relation to the severity of the hypertensive state has been demonstrated in essential hypertension. The aim of this study was to evaluate the behavior of calf blood flow and vascular resistance in borderline hypertensives (BH) in comparison with normotensive control subjects (CS). We studied 32 BH, with average age of 47.31 +/- 16.78 years and blood pressure 140-160/90-95 mm/Hg, in comparison with 20 CS, with average age of 47.24 +/- 11.75 years and blood pressure values below 140/85 mm Hg. Calf rest flow (RF) and peak flow (PF) were evaluated by strain-gauge plethysmography, and basal vascular resistance (BVR) and minimal vascular resistance (MVR) were calculated by the ratio between mean blood pressure and RF and PF, respectively. Mean blood pressure was significantly higher in BH in comparison with CS. RF and PF did not differ significantly in BH in comparison with CS. BVR did not differ in BHs in comparison with CS. In contrast, MVR were significantly higher in BH in comparison with CS. These results show that in BH, arterial flow at the calf is normal, whereas MVR are higher, indicating an impairment of maximal vasodilation capacity despite the modest blood pressure elevation.

Adult↗

Clinical evaluation of short-term defibrotide treatment of patients with atherosclerosis obliterans of the lower limbs.

Ten patients with atherosclerosis obliterans of the lower limbs (Fontaine stage IV) were studied under basal conditions during and after short-term administration of defibrotide (800 mg/day intravenously from day 1 to 10 and then 400 mg/day intramuscularly from day 11 to 30). The clinical effectiveness of defibrotide was evaluated not only clinically (subjective and objective symptomatology) but also by Doppler velocimetry (Windsor's Index (WI] and primary antiplasmin activity. Seven patients (70%) showed improvement in subjective and objective symptomatology. There were increases in WI at the end of intravenous treatment in 6 patients (60%). In the remaining 40%, WI did not change from basal values. All patients showed normalization of primary antiplasmin activity versus basal values (55.62%, 17.75 SD) at the end of both intravenous and intramuscular treatment (101.37%, 15.71 SD and 102.5%, 13.86 SD, respectively). Therefore, we think that defibrotide may be useful for therapy of atherosclerosis obliterans of the lower limbs.

Antithrombin III↗

Effects of ketanserin on ambulatory blood pressure monitoring in patients with essential hypertension.

Ketanserin is a new potent antiserotonergic drug which, unlike previous ones, is selective for S2-serotoninergic receptors and does not have an agonist action. A trial was carried out on medium-term treatment with ketanserin or propranolol in subjects suffering from mild to moderate hypertension. The trial was designed as a double-blind crossover randomized study comparing either ketanserin or propranolol with placebo. Thirteen patients completed the study, which was divided into two groups (A and B). Systolic (SBP), diastolic (DBP) and mean (MBP) blood pressures were measured by non-invasive, intermittent ambulatory monitoring performed using a Pressurometer II, from Del Mar Avionics. Heart rate was measured using a continuous electrocardiogram monitoring. Systolic blood pressure was significantly reduced both after ketanserin (A:11.1%; B:10.8%) and propranolol (A:11.7%; B:11.8%) but in group A its decrease was more pronounced after propranolol (P less than 0.01). Diastolic blood pressure was significantly reduced both after ketanserin (A:11.5%; B:11.1%) and propranolol (A:11.4%; B:11.9%), as was MBP (A:11.9%; B:11.8% for ketanserin and A:11.9%; B:11.9% for propranolol). The heart rate diminished significantly only after propranolol administration (P less than 0.01). Ambulatory monitoring showed a significant 24-h reduction of SBP after administration of propranolol (P less than 0.0025) and ketanserin (A:P less than 0.0025, B: P less than 0.005). Diastolic blood pressure was also significantly reduced after ketanserin (P less than 0.0005) and propranolol (A: P less than 0.0025, B: P less than 0.0005). The heart rate obtained by continuous electrocardiogram monitoring diminished significantly only after propranolol administration (P less than 0.0005). No significant changes of circadian behaviour of blood pressure were observed.

Adult↗

Effects of ketanserin on blood pressure, peripheral circulation and haemocoagulative parameters in essential hypertensives with or without arteriosclerosis obliterans of the lower limbs.

Ketanserin is a new strong antiserotoninergic drug that, unlike the previous ones, is selective for 5-hydroxytryptamine receptors. This drug has been employed successfully in the treatment of arterial hypertension and of some peripheral vascular diseases. The authors are carrying out a trial on medium term treatment with ketanserin (K) or propranolol (P) in comparison with placebo, to evaluate their effects on blood pressure, haemocoagulative parameters and peripheral circulation. The trial is a double-blind cross-over random trial on subjects with mild or moderate hypertension. Until now 13 patients have ended the study; six of them are suffering from arteriosclerosis obliterans of the lower limbs at 1st or 2nd stage according to Fontaine. Both propranolol and ketanserin significantly reduced the blood pressure, although the decrease in systolic blood pressure was more evident after propranolol. Heart rate diminished significantly only after propranolol administration. The noninvasive, intermittent (every 30 min) monitoring of blood pressure showed a significant 24-hour reduction of blood pressure after administration of propranolol or ketanserin without significant changes of circadian behaviour of the blood pressure. After administration of ketanserin a slight improvement in peripheral circulation was demonstrated, evaluated by using strain-gauge plethysmography. As regards the results obtained for platelet function and other haemocoagulative parameters examined, adenosine diphosphate-induced platelet aggregation, adenosine diphosphate slope, collagen lag period, antithrombin III biological activity, and serum fibrinogen did not show noticeable modifications after treatment, while beta-thromboglobulin levels decreased slightly after ketanserin administration.

Adult↗

Enhanced platelet sensitivity to prostacyclin after isosorbide-5-mononitrate in patients with stable angina pectoris.

Recently the possibility that nitrates inhibit platelet function in man has been explored in vitro and in vivo. We have studied the effect of isosorbide-5-mononitrate (ISMN), a stable and long-acting organic nitrate, on platelet function in vivo. Given orally within the current therapeutic range, the drug has practically no effect on platelet aggregation nor thromboxane generation in platelet-rich plasma in response to ADP, collagen, arachidonate, epinephrine and PAF. Synergistic effects of prostacyclin and ISMN on inhibition of ADP-induced platelet aggregation have been observed. Thus, local inhibition of platelet aggregation might not have been detectable, due to the short half-life in vitro of prostacyclin.

Adult↗