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Biomedical subjects

A Tugayé

Publications and source records attributed to A Tugayé.

8 recordsLinked to original sources
PubMed1993

Hypocaloric diet and antihypertensive drug treatment. A randomized controlled clinical trial.

OBJECTIVE: To compare the amount of drug quantified by a score needed to control blood pressure in two groups of overweight hypertensive patients, receiving or not receiving a hypocaloric diet. DESIGN: Randomized controlled clinical trial. SETTING: Two hospital outpatient hypertension clinics. PATIENTS: Fifty-four subjects with a DBP between 95 and 110 mmHg and a weight > or = 110% of the ideal weight. INTERVENTION: Allocation to either drug treatment (DT) or hypocaloric diet (HD). In the HD group, after 2 months, an antihypertensive drug was administered to the subjects with a DBP > or = 90 mmHg, following the same scheme protocol as in the DT group. Subjects were followed during 10 months by a clinician only in the DT group and by a clinician and a dietician in the HD group. MAIN OUTCOME MEASURES: Score of treatment: hydrochlorothiazide 25 mg [score = 1] with, as needed to obtain a DBP < 90 mmHg, the addiction of enalapril 10 mg [score = 2], 20 mg [score = 3], and nifedipine 40 mg [score = 4]. RESULTS: At the end of the trial, 5 subjects were lost to follow-up in the HD group and 1 in the DT group (p > 0.05). Mean weight loss was 5.9 kg (sd = 1.2) in the HD and 2.3 kg (sd = 0.7) in the DT group (p = 0.02). Mean decrease in DBP was 18 mmHg (sd = 7) and 15 mmHg (sd = 8) in HD and DT groups respectively (p = 0.36). Mean DBP was 84 mmHg (sd = 7.8) in the HD group and 85 mmHg (sd = 7.2) in the DT group. In the HD group, 8 (38.1%) subjects had a DBP < 90 mmHg without any drug treatment. The mean drug treatment score was 0.86 (sd = 0.91) in the HD and 1.52 (0.70) in the DT group (p = 0.01). CONCLUSION: This study shows that in overweight hypertensives, the quantity of drug needed to achieve an acceptable level of BP is nearly reduced by 50% when an efficient hypocaloric diet is prescribed simultaneously.

Adult↗
PubMed1993

Self blood pressure measurement at home.

Forty-six untreated patients measured their blood pressure at home for three weeks using an A and D, UA 751 automatic device, and were examined three times at the outpatient clinic. Home blood pressure was significantly lower than clinic blood pressure, even at the third visit when the correlations between clinic and home values were the most significant. The differences between clinic and home values had a gaussian distribution. The variance analysis of home blood pressure values showed that 67% of the variance was attributable to the between-subject component, 2% to the day effect, 15% to the time of the day effect and 16% to the residual (the measurement error). The standard deviation of the difference between two five-day periods of self blood pressure monitoring at home (5.4 and 4.1 mm Hg) was much lower than what has been reported for clinic measurements or 24-hour ambulatory monitoring.

Adult↗
PubMed1991

[A new contribution of Doppler echography of renal arteries: follow-up studies of angioplasties. A retrospective study of 50 cases].

OBJECTIVE: analysis of Doppler Duplex (DD) contribution to renal artery percutaneous angioplasty (ATL) follow-up. METHOD: between 1983 and 1989, SO ATL were performed in 47 subjects with renovascular hypertension. Their average age was 50 +/- 12 years. The lesions were fibromuscular dysplasia (n = 20) and atherosclerosis (n = 27). The DD was performed simultaneously with arteriography (A degrees) (considered the gold standard), when the stenosis was discovered (n = 32), before (n = 32) and after (n = 39) ATL, and during the follow-up between the 6th and 12th month (n = 38). RESULTS: during the initial exploration, the concordance between DD and A degrees is 78% and the sensitivity of DD for the diagnosis of stenosis is 90%. ATL was performed once on the basis of DD alone, that showed a tight and significant stenosis with dysplasia, when A degrees failed to detect it. ATL confirmed the lesion and was successful, and hypertension cured. The concordance DD-A degrees before and after ATL is respectively 88% and 77%. At the late control, the concordance is 92%, the sensitivity 73% and the specificity 85% for all stenosis. While maintaining a good specificity, DD recognized the 3 tight found by the A degrees control. The complications encountered during ATL were diagnosed by DD most of the time: all the local complications at the site of entry (n = 5), all the dissections with obliteration (n = 2) and 5 of the 8 dissections without obliteration of the renal artery. CONCLUSION: the detection and the lesional assessment of post-ATL complications are facilitated by DD. The good sensitivity of DD combined with satisfactory specificity will allow the reduction of angiographic surveillance by taking advantage of a non-invasive method.

Adult↗
PubMed1990

[Creatinine levels in polycystic kidney disease complicated by arterial hypertension. Role of blood pressure control].

As hypertension often precedes renal failure in polycystic kidney disease, it has been suggested that efficient blood pressure control could slow down the progress of the disease. To test this hypothesis, we made a retrospective study of 32 hypertensive patients with familial polycystic kidney disease who had been followed up for an average period of 75 months (range: 20 to 168 months). We examined the relations between creatinine levels or the slope for their increase with time on the one hand, and the mean blood pressure measurements recorded during the surveillance period on the other hand. For the group of 32 patients as a whole, there was no significant correlation between creatinine levels or their variations and blood pressure or its variations. The 13 patients whose creatinine levels rose by more than 50 p. 100 did not differ from the 19 others as regards age, known duration of hypertension, initial or final blood pressure or the number or nature of the antihypertensive drugs they received. This preliminary investigation does not rule out the existence of a link between blood pressure control and the maintenance of renal function during polycystic kidney disease complicated by hypertension, but it does suggest that any such link is tenuous.

Adult↗
PubMed1981

[Screening for phaeochromocytoma : in which hypertensive patients? A semiological study of 2585 patients, including 11 with phaeochromocytoma (author's transl)].

In an attempt to find out whether phaeochromocytoma could be screened by questioning, the authors have recorded in a population of 2585 hypertensive patients the symptoms known to be most frequently associated with the tumour, i.e. headaches, palpitations and sweating attacks. Since 72.4% of the entire population reported one or another of these complaints, no single symptom could be taken as suggestive of phaeochromocytoma. However, only 6.5% of the patients reported all three symptoms and could therefore be considered as forming a subgroup likely to have the tumour. Patients in this subgroup differed from the others in the predominance of females (p less than 0.01), the higher frequency of anxiety (p less than 0.01) and above all, the higher incidence of phaeochromocytoma (5.9% as against 0.04%; p less than 0.01). The symptomatic triad (headaches, palpitations, sweating attacks) has a specificity of 93.8%, a sensitivity of 90.9% and an exclusion value of 99.9% for the diagnosis of phaeochromocytoma. Its presence in hypertensive patients justifies systematic assays of blood or urinary catecholamines. In its absence, the probability of phaeochromocytoma is inferior to 1 in 1 000.

Adrenal Gland Neoplasms↗