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Biomedical subjects

B Fagerberg

Publications and source records attributed to B Fagerberg.

At least 109 records · Page 6Linked to original sources
PubMed1988

Effects of sodium restriction and energy reduction on erythrocyte sodium transport in obese hypertensive men.

Twelve moderately obese middle-aged male out-patients with untreated mild hypertension reduced their sodium intake by about 120 mmol/day during 4-6 weeks. The low sodium diet period was followed by a period of energy reduction as well as sodium restriction for 15 weeks. Mean body mass was then reduced by 7.5 +/- 1.0 kg. Intraerythrocyte sodium (IeNa), sodium influx (Na-influx) and sodium efflux rate constant (Na-efflux rate), were measured before intervention, during salt restriction and during salt and energy restriction. Plasma renin activity (PRA) and urinary excretion of aldosterone (U-Aldo) and noradrenaline (U-NA) were also determined during the three observation periods. During sodium restriction there was a significant increase in PRA and U-Aldo, but no change was seen in IeNa, Na-influx or Na-efflux rate constant. During sodium restriction there was a significant positive correlation between PRA and both Na-influx and Na-efflux rate constant. When energy reduction was combined with sodium restriction, PRA and U-NA both diminished significantly. Na-influx and Na-efflux rate also exhibited a significant decrease while IeNa did not change. Sodium restriction caused a significant fall in mean arterial blood pressure and a tendency to a further decrease was seen when energy intake was also reduced. No significant correlation could be found between the fall in blood pressure and changes in cellular sodium transport. These data indicate that the renin-angiotensin-aldosterone system and sympathetic activity influence the regulation of erythrocyte sodium turnover during sodium and energy restriction in obese hypertensive men.

Biological Transport↗
PubMed1986

Central haemodynamics, baroreceptor sensitivity and alpha 1-adrenoceptor-mediated vascular reactivity during weight-stable sodium restriction in obese men with hypertension.

Ten obese men (20-40% overweight) with previously untreated arterial hypertension (WHO stages I and II) were examined before and during sodium-restricted isocaloric diets. The mean (+/- s.d.) daily sodium excretion was reduced from 199 +/- 65 to +/- 25 mmol/24 h. Intra-arterial blood pressure (BP), cardiac output (CO), plasma volume, circulating and urinary noradrenaline (NA), plasma renin activity (PRA) and urinary aldosterone were measured. Vascular reactivity was assessed with intravenous bolus injections of 50, 100 and 200 micrograms phenylephrine, and baroreflex sensitivity was assessed with the R-R interval response to pressure elevations on electrocardiogram. Significant reductions in systolic BP from 163 +/- 18 to 147 +/- 17 mmHg and in diastolic BP from 97 +/- 7 to 88 +/- 9 mmHg occurred during salt restriction. Blood pressure reductions were correlated with changes of urinary sodium excretion (r = 0.71; P less than 0.05). No significant changes in CO, heart rate (HR) or stroke volume (SV) were observed; therefore, BP reduction was secondary to the fall in total peripheral resistance (TPR) from 21.8 +/- 4.1 to 19.0 +/- 4.1 units (P = 0.05). Plasma volume, as well as total blood volume, was not affected by the moderate sodium restriction, but PRA rose from 0.71 +/- 0.1 to 0.87 +/- 0.1 micrograms angiotensin 1/ml per h (P less than 0.05). Urinary aldosterone was increased from 32 +/- 12 to 54 +/- 9 nmol/24 h. No change in venous or arterial concentrations of NA or of urinary NA was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Body composition, intraerythrocyte sodium content, volume regulation and blood pressure during moderate sodium restriction in hypertensive men.

Eleven moderately obese middle-aged male outpatients with untreated mild hypertension reduced their sodium intake by about 120 mmol per day during 4-6 weeks. Diastolic blood pressure was then significantly reduced in comparison with a matched control group. The reduction of urinary sodium excretion was significantly correlated to the change in mean arterial pressure. Mean body mass showed a small significant decrease, although there were no significant changes in total body water or body fat as determined from measurements of 40K and tritiated water. Nor did mean extracellular water or plasma volume (Evan's blue) show any significant change. The decrease in urinary sodium excretion was associated with increases in plasma renin activity and urinary aldosterone excretion, while a sympathetic nervous natriuretic index (urinary dopamine to noradrenaline excretion ratio) decreased. The low sodium diet period was followed by a period of energy reduction as well as sodium restriction for 15 weeks. Mean body mass was then reduced by about 8 kg. The systolic but not the diastolic blood pressure showed a significant decrease. The intraerythrocyte content of water, sodium and potassium did not change significantly during any of the diet periods. We conclude that moderate sodium restriction lowered the blood pressure and affected the renin-aldosterone and sympathetic nervous system to retain sodium which might explain the constancy of the plasma volume.

Blood Pressure↗
PubMed1986

Cellular sodium turnover in obese hypertensive men.

Seventeen moderately obese middle-aged male outpatients with untreated mild hypertension (OH) and 47 normotensive men with normal weight (C) were investigated with respect to intraerythrocyte electrolytes, transmembrane sodium fluxes, PRA and urinary excretion of aldosterone (U-ALDO). There was no difference between the groups in intraerythrocyte sodium but red cell potassium was significantly elevated in OH compared to C. Sodium influx and the rate constant for sodium efflux were also significantly higher in OH. There was a significant positive correlation between sodium influx and U-ALDO (r = 0.56, p less than 0.05).

Adult↗
PubMed1986

Toxic epidermal necrolysis with extensive mucosal erosions of the gastrointestinal and respiratory tracts.

Toxic epidermal necrolysis with epidermal shedding over almost the entire body occurred in a patient with classical rheumatoid arthritis treated with sulindac, penicillamine and a combination analgesic containing paracetamol and chlormezanone. Erosions in the lower respiratory tract and the intestine contributed to a lethal outcome of the disease and showed a microscopical picture similar to that of the skin involved. The histopathological picture of these extracutaneous lesions have been only briefly reported previously.

Acetaminophen↗
PubMed1985

The sodium intake modifies the renin-aldosterone and blood pressure changes associated with moderately low energy diets.

Thirty middle-aged, moderately obese men with untreated mild hypertension were allocated to two groups of 15 men each. Both groups were placed on energy-reduced diets (5.1 MJ/day) for 9-11 weeks which resulted in similar losses of body mass (8.5 kg). In group I the low energy diet was supplemented with sodium chloride leading to no change in urinary sodium excretion. During dieting there were significant reductions of plasma renin activity (PRA) and urinary excretion of noradrenaline and aldosterone. Heart rate but not mean arterial pressure (MAP) decreased significantly. Then followed a period of sodium restriction which resulted in a significant decrease in MAP and an increase in aldosterone excretion. In group II there was a reduction of sodium intake by about 80 mmol as judged from determinations of urinary sodium excretion. In this group the energy restriction was not accompanied by any changes in PRA or urinary excretion of aldosterone, whereas urinary noradrenaline excretion, heart rate and MAP decreased significantly. Urinary adrenaline excretion remained unchanged. It is concluded that the hypotensive response to moderate energy and sodium reduction cannot be explained by changes in the renin-aldosterone. system.

Aldosterone↗
PubMed1985

Fluid homeostasis and haemodynamics during sodium restriction in hypertensive men.

To investigate the antihypertensive effect of moderate sodium restriction, the sodium intake of 11 male outpatients was reduced by 120 mmol/day for 4-6 weeks. These patients and an untreated control group were slightly obese and had mild untreated hypertension (WHO 1-2). All subjects were examined before and at the end of the experiment. Diastolic blood pressure fell significantly in the diet group in comparison with the control group. Invasive haemodynamic examinations in the diet group showed an unchanged mean cardiac output and a reduction of mean total peripheral resistance. Plasma volume (Evan's Blue) did not change, neither did extracellular volume as calculated from determinations of tritiated water, total body potassium and body mass. During sodium restriction, plasma renin activity and urinary aldosterone excretion significantly increased. Noradrenaline and dopamine excretion in urine showed no significant changes during sodium restriction, neither did the plasma concentrations of atrial natriuretic peptides. The reduction in mean arterial blood pressure was correlated significantly with a decrease in 24-h sodium excretion and an increase in urinary aldosterone excretion. In conclusion, moderate dietary sodium restriction seems to lower blood pressure by diminishing the total peripheral resistance while cardiac output, extracellular and intravascular volumes are maintained.

Body Fluids↗
PubMed1984

Blood pressure control during weight reduction in obese hypertensive men: separate effects of sodium and energy restriction.

The separate and combined effects of dietary energy and sodium restriction on regulation of blood pressure were investigated in 30 middle aged obese men with essential hypertension attending the outpatient department. In group 1 (n = 15) a basal period with no dietary restriction was followed by a period taking an energy reduced diet (5.1 MJ; 1230 kcal), the sodium intake being supplemented and hence unchanged (1:ErSn). In group 2 (n = 15) the basal period preceded a control period with no intervention, which was followed by taking a diet restricted in energy (5.1 MJ; 1220 kcal) and sodium (2:ErSr). During period 1:ErSn there were reductions in heart rate and urinary noradrenaline output but not in systolic or diastolic blood pressure. Body weight decreased by 4.9-11.7 kg and urinary sodium excretion did not change. In period 2:ErSr urinary sodium output was reduced by 81.4 (SEM 17.8) mmol(mEq)/24 h and there was a weight loss of 8.2 (SEM 0.7) kg. Systolic and diastolic blood pressures fell significantly, as did the heart rate and urinary noradrenaline excretion. These results show that in hypertensive obese men a moderate weight reducing diet decreases indices of sympathetic nervous system activity. Reduction of blood pressure to the normotensive range was observed only when there was a concomitant restriction of sodium intake.

Blood Pressure↗
PubMed1984

Increased erythrocyte sodium efflux during overfeeding without evidence of mediation by circulating catecholamines or thyroid hormone.

Ten slightly obese middle-aged men were instructed to increase their energy intake 25% during a period of 1 week, which was preceded by a control period of seven days. Body weight increased by 0.67 kg (SD 0.60) indicating good compliance with the regimen. Transmembrane sodium fluxes were determined with the use of 22Na. The pre-diet erythrocyte sodium content was 9.7 mmol/L (SD 0.8) decreasing to 8.9 mmol/L (SD 1.1) (P less than 0.05) during overfeeding. The Na-efflux rate constant increased from 0.40 h-1 to 0.54 h-1 (P less than 0.05). Urinary excretion of catecholamines and concentrations of catecholamines and insulin in plasma and of thyroxine, triiodothyronine, and reverse T3 in serum did not change. Thus, overfeeding seems to enhance the total Na efflux in erythrocytes from slightly obese men. There were no measurable changes in thyroid hormone or catecholamine levels leaving the regulatory mechanisms unexplained.

Adult↗
PubMed1984

Effect of a moderately energy- and salt-reduced diet on body compartments and blood pressure control in obese men with mild hypertension.

Ten middle-aged moderately obese men with untreated mild hypertension were studied during a 6-week weight maintenance period and a 9-week period on a diet containing 5 MJ when body mass decreased by 8.4 kg (SE 1.4). According to urinary sodium excretion there was a mean reduction of 89 mmol/day (SE 16) in sodium intake. Mean arterial pressure fell by 2.5 to 14.1 mmHg (95% confidence interval) which was correlated to the reduction of body mass. The sympathetic nervous activity diminished with decreasing noradrenaline excretion and heart rate. There were no changes in the renin-aldosterone system. Estimation of the body composition with a four-compartment model utilizing determinations of body mass, total body potassium and total body water (TBW) showed reductions of body fat (8.4 kg (SE 1.4] and body cell mass (BCM) (2.4 kg (SE 0.6], but not of TBW. Extracellular water (ECW) increased significantly as judged from ECW/BCM calculations. Plasma volume was determined by Evan's blue and did not change significantly. We suggest that the observed changes in body composition represent one aspect of the adjustment to a weight reducing diet, while blood pressure is lowered by another mechanism in the adaptive response to dieting, i.e. reduction in sympathetic nervous activity.

Adipose Tissue↗
PubMed1984

Weight-reducing diets: role of carbohydrates on sympathetic nervous activity and hypotensive response.

Two groups of obese, normotensive men were put on weight-reducing diets in an outpatient study. The groups were comparable with regard to age, weight, heart rate, blood pressure, energy and salt intake during a four-week control period. In a four-week dieting period, Gp I (n = 12) received an energy-reduced diet (1370 kcal, 5.7 MJ) with 24 energy per cent carbohydrates. Group II (n = 11) had an isocaloric diet (1400 kcal, 5.8 MJ) with 59 energy per cent carbohydrates consisting of mainly mono- and disaccharides. Significant decreases in systolic blood pressure, heart rate, plasma noradrenaline and urinary excretion of noradrenaline were observed in Gp I but not in Gp II. Weight reduction and decrease of urinary sodium output was equal in both groups. No difference in alcohol consumption was recorded. We conclude that in obese normotensive patients a high proportion of mono- and disaccharides counteracts the expected hypotensive response of weight reduction. On the other hand, and judged from the present data, the blood pressure decrease observed in the group on a low carbohydrate diet seems to be secondary to an effect on the sympathetic nervous system.

Adult↗
PubMed1983

Haemodynamic adjustment to weight reduction--separate effects of energy versus salt restriction.

Repeated invasive haemodynamic investigations were performed in two matched groups of patients before and after weight reduction. The patients in Group I had an individually adjusted energy restricted diet and daily dietary sodium supplementation to keep the sodium intake unchanged from baseline. In Group II the patients had the same energy reduced diet but also sodium restriction from 183 +/- 48 to 87 +/- 34 mmol/24 h (P less than 0.001). The energy intake was reduced by about 50% in both groups and the mean reduction in body weight in Group I was 9.2 kg and in Group II 8.8 kg. In Group II the patients had significant reduction of cardiac output, cardiac index, heart rate and blood pressure. No increase in total peripheral resistance was noted. The patients in Group I had a significant reduction of heart rate only. We suggest that the failure of a blood pressure to fall was caused by the relative increase in blood volume observed in patients on a normal sodium intake during weight reduction. The cardiovascular response observed after concomitant sodium and energy restriction is consistent with a reduction of sympathetic nervous system activity and this conclusion is supported by reduced circulating norepinephrine and urinary excretion of norepinephrine.

Adult↗
PubMed1981

Do carbohydrates promote hypertension?

Several earlier studies indicate an association between plasma insulin level and blood pressure independent of weight. A short review summarizes evidences showing: (a) the association between a high carbohydrate content of diet and hyperinsulinemia; (b) effect of insulin on renal reabsorbation of sodium; and (c) effects of carbohydrate intake on sympathetic activity and blood pressure. A pilot study examined the effect of a glycoside-hydrolase inhibitor (BAY g 5421) on blood pressure, fasting blood glucose, fasting plasma insulin and 100 g peroral sucrose test in six obese middle-aged men with borderline hypertension. The protocol included three periods of four weeks each. During the second and third period placebo and BAY g 5421 (100 mg three times per day) were given in a randomized, double-blind fashion. At the end of each period blood pressure was recorded during 30 minutes of rest in a supine position. The subjects also orally received 100 g sucrose as a 50 per cent solution dissolved in water. BAY g 5421 caused a significant decrease of plasma insulin after a 100 g sucrose tolerance test as compared to placebo. Blood pressure after four weeks of treatment with placebo was 135 +/- 5.7 systolic and 92 +/- 6.6 diastolic (mmHg, mean +/-s.d.) and after four weeks of treatment with BAY g 5421 was not significantly different. There was no change in weight. The question whether carbohydrates promote hypertension has to be further investigated.

Acarbose↗
PubMedDate not supplied

Femoral artery wall morphology, hemostatic factors and intermittent claudication: ultrasound study in men at high and low risk for atherosclerotic disease.

The aim of this study was to examine whether there was a relationship between ultrasound-assessed morphology of the femoral artery wall and hemostatic factors, and whether these factors were associated with intermittent claudication. One hundred and thirty men at high cardiovascular risk and 51 men at low risk were examined. The subjects (high- and low-risk) with moderate/large plaque (n = 96) had higher fibrinogen, thrombin/antithrombin complex and von Willebrand factor, compared to subjects with small/no plaque. The maximum intima-media thickness of the femoral artery was significantly associated with fibrinogen. These associations were independent of current smoking habits. Clinical atherosclerosis was associated with fibrinogen, von Willebrand factor, thrombin/antithrombin complex, plasminogen activator inhibitor activity, mean and maximum intima-media thickness and plaque status of the femoral artery. In conclusion, fibrinogen, von Willebrand factor and thrombin/antithrombin complex were related to plaque occurrence in the femoral artery. Clinical atherosclerosis was associated with fibrinogen, von Willebrand factor, thrombin/antithrombin complex and plasminogen activator inhibitor activity.

Aged↗
PubMedDate not supplied

Importance of dietary salt in the hemodynamic adjustment to weight reduction in obese hypertensive men.

Twenty-three moderately obese middle-aged men with previously untreated hypertension (World Health Organization classification 1-2) were evaluated to assess the effects on blood pressure (BP) of a diet restricted in energy (fats and carbohydrates) but unrestricted in sodium (Group 1) compared to a diet restricted in energy and sodium (Group 2). The patients were randomly allocated to either of the two groups and were comparable in age, sex, weight, and BP. The same energy- and sodium- restricted diet was given to both groups, but the intake of Group 1 (n = 13) was supplemented with dietary sodium. The average urinary output for Group 1 was 192 +/- 39 mmol/24 hr at baseline and 200 +/- 56 mmol/24 hr during the diet. For Group 2 (n = 10), which remained on the initial diet, urinary sodium excretion changed from 188 +/- 53 mmol/24 hr at baseline to 97 +/- 32 mmol/24 hr (p less than 0.001). Intraarterial BP, cardiac output (CO), plasma volume, circulating norepinephrine (NE), and urinary NE were measured at baseline and at the end of the dieting periods. Before the dietary sodium supplement while on the initial diet, the patients in Group 2 showed a reduction in body weight from 97.3 +/- 10.5 kg to 88.6 +/- 9.9 kg (p less than 0.001). Heart rate (HR) and urinary NE output were significantly reduced in comparison with baseline, but intraarterial BP was unchanged. No change in cardiopulmonary blood volume, CO, or stroke volume (SV) was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗