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Biomedical subjects

B Halawa

Publications and source records attributed to B Halawa.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Combination therapy in primary hypertension].

Hypertension is an important risk factor for vascular disease. Primary goal of hypertension treatment is to prevent or delay the onset of blood pressure-related morbidity and mortality. It has been well demonstrated that the responses rate to any single class of antihypertensive agent, give as monotherapy is approximately 45% to 55%, and in half of hypertensive population a second will be required. The data from clinical trials clearly demonstrate that two-drug combination, usually with low-dose diuretics with any one of the other first-line agents increases the response rate to about 80% to 85% and reduces the likelihood of adverse events and alteration in lipid, carbohydrate and electrolyte metabolism. Of the various combinations being given that of an diuretic and ACE inhibitor, and ACE inhibitor and non-dihydropyridine calcium channel blockers seems particularly attractive. Some combinations are inappropriate, such as diuretic and calcium channel blockers, and beta-blocker with verapamil and diltiazem. Combination of ACE inhibitor and a non-dihydropyridine calcium channel blockers may provide benefit in regression left ventricular hypertrophy diabetic nephropathy, and post myocardial infarction.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1998

[Levels of adrenomedullin in plasma of patients with chronic congestive heart failure].

Adrenomedullin is a potent vasodilator and natriuretic peptide that may an important role in cardiovascular disease. To investigate the role of adrenomedullin in the pathophysiology of congestive heart disease, plasma levels of adrenomedullin were measured in patients with congestive heart failure. Venous blood samples at rest were obtained before and after treatment from patients with congestive heart failure in New York Heart Association functional class II (n-23), III (n-26) and IV (n-14) and from normal subjects (n-30). Plasma adrenomedullin, endothelin-1,2, and atrial natriuretic peptide were determined by radioimmunoassay, plasma noradrenaline by radioenzymatic assay. Left ventricular ejection fraction was measured by echocardiography. The mean plasma level of adrenomedullin in normal subjects was 8.2 pmol/l, tended to be increased in patients with congestive heart failure those in class II (12.9 pmol/l) and were significantly increased in classes III and IV (21.3 and 29.9 respectively). Plasma adrenomedullin was correlated strongly with endothelin-1,2, atrial natriuretic peptide, and noradrenaline, and relatively weakly with left ventricular ejection fraction. Plasma adrenomedullin levels significantly decreased after treatment. These findings indicate that plasma levels of adrenomedullin are elevated in congestive heart failure and may be involved in the defense mechanism against further peripheral vascular resistance elevation in congestive heart failure.

Adrenomedullin↗
PubMed1998

[Pharmacological treatment of restenosis after coronary angioplasty and bypass grafting].

Angioplasty and bypass surgery have become standard methods of treating patients with symptomatic coronary atherosclerosis but restenosis remains the major limitation of percutaneous coronary revascularization. In pharmacological management of restenosis after coronary intervention multiple agents have been tried, with mostly discouraging results. Aspirin, dipyridamole, ticlopidine, heparin. Hirudin, and warfarin has failed to show beneficial effects on restenosis. Of all antithrombotics, only an inhibitor of the platelet IIb/IIIa integrin, which may lead to early vessel changes, leading to decrease restenosis. Antiproliferative agent (trapidil and angiopeptin) and probucol have also resulted in improved restenosis rate. In patients after bypass surgery with some degree of hyperlipidemia intensive lipid-lowering therapy is beneficial in slowing the late progressions of atherosclerosis as well as graft occlusion.

Angioplasty↗
PubMed1997

[Does captopril decrease endothelial production of endothelin?].

Serum levels endothelin-1,2 aldosterone, renin activity were performed in 52 patients with chronic congestive heart failure during captopril therapy. The investigations were done before therapy, after 10-15 days therapy and after disappearance symptoms of heart failure. The levels endotelin-1,2,aldosterone and renin activity were determined using radioimmunologic methods. Fraction ejection and peripheral vascular resistance were determined by echocardiography technics. It was found that serum endothelin levels in patients with chronic congestive heart failure were increased proportionally to functional class of heart failure and decreased after disappearance symptoms of heart failure. An increase in plasma endothelin concentration has not correlated with ejection fraction, aldosterone concentration and renin activity. These studies have demonstrated that in patients with congestive heart failure on captopril therapy endothelin serum levels positively correlates with peripheral vascular resistance. No correlation was found between ejection fraction and activity renin-angiotensin-aldosterone system. These findings indicated that captopril therapy decreases endothelin production.

Aged↗
PubMed1997

[Pharmacologic treatment for ventricular arrhythmias].

Pharmacologic management of patients with ventricular arrhythmias remains in a state of considerable flux. New findings from controlled clinical trials, suggest that use of the principles of risk stratification permits identification of patients at very high risk for developing sustained ventricular tachyarrhythmias or ventricular fibrillation. Available data suggest that patients with sustained ventricular tachyarrhythmias require treatment. Patients with frequent ventricular ectopy or nonsustained ventricular tachycardia in the absence structural heart disease do not require treatment except when relief of symptoms is warranted. The indication for treatment of patients with underlying structural heart disease, particularly coronary artery disease and a previous myocardial infarction, who manifest frequent ventricular ectopy or more particular nonsustained ventricular tachycardia remain uncertain. From meta-analytic studies, it has become clear that beta-blockers reduce sudden death and total cardiac mortality. Data also suggest that amiodarone appears to be the safest antiarrhythmic drug for treatment sustained and nonsustained arrhythmias, and improved survival in patients with advanced heart failure.

Amiodarone↗
PubMed1997

[Nonpharmacologic treatment of hypertension].

High blood pressure is associated with increased risk of developing coronary heart disease, stroke, peripheral vascular disease and congestive heart failure. The risk of cardiovascular disease mortality increases progressively with incremental increases in blood pressure from the optimal level od less than 120/80 mm Hg to highest levels. Many observations nad clinical trials have demonstrated that a reduction of just a few mm Hg for everyone could produce cardiovascular benefit. Several non-pharmacological interventions are recommended in primary prevention of hypertension. Reduction of weight in overweight patients, reduction of sodium chloride intake to no more than 5 g a day, reduction of alcohol consumption to no more than 30 g ethanol a day and regular mild exercise in sedentary subjects are effective in lowering blood pressure and can also reduce other risk factors for premature coronary heart disease.

Cardiovascular Diseases↗
PubMed1997

[Circadian urinary excretion of catecholamine, plasma atrial natriuretic peptide, endothelin and neuropeptide Y in obese patients with hypertension].

UNLABELLED: Obesity increases the risk of developing hypertension by two-to fourfold, with more that one third of all cases of hypertension attributable to obesity. The present study tested the role of atrial natriuretic peptide (ANP), endothelin-1,2 (ET-1,2) and neuropeptide Y (NPY) in pathogenesis of obesity hypertension. The plasma concentrations of ANP, ET-1,2 and NPY were determined in the peripheral venous blood by radioimmunoassay in 27 obese hypertensive patients (group I), in 24 obese normotensive patients (group II), and in 35 normal subjects (group III). RESULTS: Mean plasma ANP was significantly higher in obese than in normal subjects. ANP levels were higher in patients group I than in those group II and I. In patients of group I plasma ANP concentrations correlated with III BMI and mean blood pressure. Plasma levels of ET-1,2 and NPY were similar in patients group I, II and III.

Adolescent↗
PubMed1996

[Pharmacologic treatment of chronic congestive heart failure].

Congestive heart failure (CHF) continues to be a lethal end stage of cardiovascular diseases caused by hypertension, coronary heart disease, valve deformity, diabetes and cardiomyopathy. Current therapy for CHF can maintain function, improve quality of life, and prolong survival. Diuretics, angiotensin-converting enzyme inhibitors (ACE), and digoxin remain in standards of therapy. Diuretics remains an important component of the symptomatic management of patients with CHF, but severely II patients may require additional agents. One option frequently used in patients who exhibit resistance to loop diuretics is infusion of low-dose dopamine. Combination diuretics may effectively increase urine output, with the addition of thiazide or spironolactone. Documentation of the clinical benefit of ACE inhibitors represents the most important advance in therapeutics for CHF in the last decade. ACE inhibitors improves left ventricular function, and survival and unless contraindicated, patients with left ventricular systolic dysfunction should receive high dose ACE inhibitor with diuretic if there is peripheral oedema. For patients who cannot take an ACE inhibitor the combination of hydralazine and nitrates may offer some prognostic benefit. Digoxin has been the traditional first drug of choice for CHF, but with protracted controversy about its efficacy and safety. It is hope that new agents as vesnarione, and ibopamine may improve contractility without having adverse consequences. Acceptance of beta-blockade as a potentially beneficial therapeutic intervention increase in the past year. This year, improved diastolic function and afterload reduction were reported with beta-blockade. Amiodarone unlike other antiarrhythmic drugs does not seem depress left ventricular function, and may be the best drug in patients with CHF and symptomatic arrhythmias. The correct role of anticoagulation in patients with CHF remains controversial. Although the benefits of anticoagulation for the treatment of most patients with atrial fibrillation are increasingly accepted, it has not been shown to improve outcome in patients with CHF in normal sinus rhythm.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

[Concentration of neuropeptide Y in serum of patients with primary hypertension].

Neuropeptide Y (NPY) has been recently characterized as a circulating vasoconstrictor peptide which is co-stored with noradrenaline in sympathetic neurons. To investigate the role of NPY concentration in hypertension we measured the circulating NPY, endothelin-1,2 (ET-1,2), atrial natriuretic peptide (ANP), aldosterone, plasma renin activity (PRA) and noradrenaline (NA) in patients with stable mild to moderate primary hypertension. Circulating levels of NPY, ET-1,2, ANP, aldosterone and PRA were measured with radioimmunoassay, NA by double-isotope radioenzymatic assay. There were significant increase in concentrations NPY, ET-1,2, ANP and NA in patients with moderate primary hypertension, and significant positive correlations between the plasma levels of NPY, ET-1,2 and NA.

Adult↗
PubMed1996

[Level of neuropeptide Y in serum of patients with chronic congestive heart failure].

The purpose of the study was to measure plasma concentrations of neuropeptide Y (NPY), endothelin-1,2 (ET-1,2), alpha atrial natriuretic polypeptide (ANP) and noradrenaline (NA) in relation to cardiac index (CI) and left ventricular ejection fraction (LVEF) in patients with congestive heart failure (CHF). There were significant increases in venous blood concentrations of NPY, Na, ET-1,2, ANP in the patients with CHF. Plasma concentrations of NPY correlated with plasma NA concentrations but plasma noradrenaline concentrations alone correlated with CI and LVEF. In patients with CHF plasma NA concentrations seems to be more sensitive index of cardiac dysfunction then the concentrations of neuropeptide Y.

Atrial Natriuretic Factor↗
PubMed1996

[Level of endothelin-1,2,6-keto-pgf1-alpha and atrial natriuretic peptide in serum of pregnant women with late hypertension].

UNLABELLED: The etiology of late hypertension (LH) in pregnant women is still unknown. The purpose of this study was to measure the circulatory levels of endothelin-1,2 (ET-1,2), 6-keto-PGF1-alfa as a major metabolite of prostacyclin, and atrial natriuretic peptide (ANP) in the serum of pregnant women with LH, and in the serum of control healty pregnant women, and control healthy nonpregnant women. RESULTS: The mean level of ET-1,2 among pregnant women with LH did not show any significant difference compared to control group. Serum 6-keto-PGF1-alfa levels was significantly higher (p < 0.001) in healthy pregnant women than in those of the pregnant women with LH and of healthy nonpregnant women. Serum ANP was significantly higher (p < 0.01) in the pregnant women with LH compared to healthy pregnant women and healthy nonpregnant women (p < 0.001). Among the women with LH there was no correlation between ET-1,2, 6-keto-PGF1-alfa and ANP.

6-Ketoprostaglandin F1 alpha↗
PubMed1996

[Treatment of patients after myocardial infarction].

During the first year after myocardial infarction 15-20% of patients die and about 50% because of sudden death. Appropriate therapy is essential to prevent arrhythmias and heart failure. Some pharmacological methods are discussed in main clinical aspects.

Arrhythmias, Cardiac↗
PubMed1994

[Levels of endothelins in plasma of patients with variant angina].

One of the causes of artery spasm in patients with the variant angina could be disordered interaction between the vasodilating action of endothelial derived relaxing factor and vasospastic action of endothelin. The aim of this study is to see whether endothelin participates in etiopathogenesis of the coronary artery spasms in patients with variant angina. The survey was made in 39 patients with variant angina with or without history of myocardial infarction. The control group consisted of 26 patients with chronic stable angina pectoris and 20 healthy persons of the same age and sex as patients with variant angina. One hour before examination a venous catheter had been inserted. Then Tris (pH = 10.5) was given by 5 minutes intravenous infusion followed by hyperventilation, during which the person under test was breathing for 5 minutes with a frequency of 40/min. Endothelin 1 and 2 plasma level was determined immediately before the hyperventilation test, immediately after the termination of the test and 6 minutes later. The appearing of coronary artery spasm was detected on continuous electrocardiographic monitoring. Endothelin 1 and 2 level in plasma was determined with radioimmunologic method ("Endothelin 1.2 high sensitivity (125I) assay system" manufactured in Amersham). The study showed clinical and electrocardiographic symptoms of coronary artery spasm after hyperventilation and Tris buffer infusion in all 39 patients with variant angina--but neither in those with chronic stable angina pectoris nor in healthy persons. Patients with variant angina had higher plasma endothelin 1 and 2 levels after hyperventilation and Tris infusion than those with chronic stable angina pectoris.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗