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Biomedical subjects

C L Curry

Publications and source records attributed to C L Curry.

At least 37 records · Page 2Linked to original sources
PubMed1987

Coronary artery bypass grafting in a predominately black group of patients.

The preoperative profiles of a predominately non-white group of patients undergoing coronary artery bypass grafting were reviewed. Data were obtained from a retrospective analysis of medical records of 163 patients operated on at Howard University Hospital between July 1983 and July 1986. The analysis was carried out primarily to determine whether patients requiring myocardial revascularization were somehow different from their non-black counterparts. Ninety-one percent of the patients were black, 5 percent white, 0.5 percent Hispanic, and 3.5 percent others (Iranian, Filipino, etc).The study was not designed to review the prevalence of coronary disease in blacks, or to determine the natural history following coronary artery bypass grafting, but to determine whether those with established coronary disease of such a severity as to warrant revascularization had the usual clustering of risk factors. Patient records were reviewed to determine the prevalence of hypertension, diabetes, obesity, cigarette smoking, previous myocardial injury, and total serum cholesterol. Because of the well-recognized increased incidence of hypertension in black patients, and its role as a major risk factor in coronary heart disease, the sequelae of hypertension were considered in relation to results of surgical therapy.The study population included 93 men (57 percent) and 70 women (43 percent); mean age was 59 years (fourth to ninth decade). Seventy-four percent of the patients were hypertensive, 35 percent were diabetic, and 77 percent had a smoking history. Obesity was prevalent among the female patients in general, with 36 percent of the diabetics and 21 percent of the nondiabetics being greater than 50 percent over ideal body weight. Ninety percent of the female patients and 80 percent of the male patients presented with New York Heart Association class III or IV angina. Left ventricular function was, on the average, well preserved. The immediate surgical mortality (following exclusion of patients in extremis) was 4 percent. The surgical mortalities were related to easily identifiable factors. Peri-operative infarctions were profoundly influenced by the presence of diabetes.Although this group was distinguished from most reported groups of patients undergoing aortocoronary bypass grafting by the presence of advanced age, the large percentage of women and diabetics and the marked prevalence of hypertension, and the usual risk factors for coronary artery disease reported in the majority population, the study reconfirms previous epidemiologic findings. It appears that racial "clumping" of a heterogeneous non-white population has minimal usefulness, except as it may be related to socioeconomic status and access to quality health care.

Adult↗
PubMed1986

Noninvasive determination of small vessel distensibility in man.

The present study describes and illustrates a noninvasive method for computing extensibility of the 'resistance vessels', from an experimentally obtained resistance vs transmural pressure plot, in a maximally dilated vascular bed of man. Limb blood flow was measured plethysmographically following 10 min of arterial occlusion, and blood pressure was measured by the arm cuff method. A ratio of two resistance values taken 30 mm Hg apart was used to compute percent change in radius and the extensibility, E. The computed values of E were 0.71 mm Hg-1 for normal hand and 0.13, 0.22 and 0.69 for the hypertensive forearm, hand and finger respectively. These results indicate that the method may prove useful in the understanding and management of diseases such as hypertension or other small vessel diseases.

Capillaries↗
PubMed1986

Clinical studies of a new, low-dose formulation of metolazone for the treatment of hypertension.

Two multicenter, double-blind, randomized studies were performed to determine the antihypertensive efficacy and effects on laboratory values of a new, shorter-acting formulation of metolazone in patients with mild to moderate hypertension. After baseline placebo-control periods, 105 patients were randomly assigned to receive single daily doses of either placebo or 0.5, 1.0, or 2.0 mg of the new formulation of metolazone for six weeks in one study, and 164 patients were randomized to receive 0.5, 1.0, or 2.0 mg of the new formulation of metolazone or 2.5 mg of the older, long-acting metolazone in the other. Mean blood pressure reductions in all three metolazone groups were statistically and clinically significant. Blood pressures of 51% to 58% of patients in the 0.5-mg metolazone group were controlled (diastolic blood pressure less than 90 or a fall of greater than or equal to 10 mmHg from baseline). Reductions in mean serum potassium levels were dose-related. We conclude that 0.5 mg of metolazone is safe and effective therapy for hypertension; it will significantly reduce systolic and diastolic blood pressure and minimizes changes in laboratory test values.

Adult↗
PubMed1984

Coronary artery disease in blacks: risk factors.

The current literature indicates that of the major risk factors for coronary artery disease (CAD), United States blacks and whites have similar rates for cigarette smoking and cholesterol levels. The prevalence of diabetes mellitus is higher in black females than white females. Both black males and females have higher prevalence rates for hypertension. These differences in risk factors between blacks and whites in spite of similar degrees of CAD suggest that the relative importance of specific risk factors might differ between the two racial groups. Research is needed to determine if there are protective factors in blacks (e.g., high-density lipoprotein cholesterol) and/or previously unrecognized risk factors (e.g., diuretic-induced lipid abnormalities) that may be playing a major role in the epidemiology of CAD in the black population.

Adult↗
PubMed1984

Blood pressure and urinary sodium in black American adolescents.

For 56 black American adolescents ranging in age from 13 to 19 years, 24-hour urinary sodium excretion was compared with blood pressure. The volunteers came from families of middle to low economic levels. Their body weight varied from 70 to 129 percent of ideal body weight. The average systolic pressure of all the subjects was 112.1 mmHg with a standard deviation of 9.5 mmHg; mean diastolic pressure was 69.6 mmHg with a SD of 8 mmHg. The average 24-hour urinary sodium excretion of the total population was 131.5 mEq/24 h with a SD of 59 mEq. For the 29 male subjects, the mean value was 137 mEq/24 h (range, 30 to 309 mEq) and for 27 female subjects, 126.3 mEq/24 h (range, 40 to 197 mEq). The average urinary excretion among these groups was not significantly different (P > .05) and the urinary Na/K ratio of the total group was 4.3 with a SD of 2.0. This ratio among various age and sex subgroups was not significantly different (P > .05). Urinary sodium excretion values were taken as a reflection of dietary salt intake among these volunteers. The data suggest that the black adolescents studied do not consume excess sodium and contradict the belief that blacks eat excess sodium. Further, these baseline data must be considered among the factors responsible for the development of hypertension.

Adolescent↗
PubMed1981

Blood levels of ethynylestradiol, caffeine, aldosterone and desoxycorticosterone in hypertensive oral contraceptive users.

Twenty normotensive and ten hypertensive black women taking oral contraceptive (OC) were studied. Age, body weight, family medical history of hypertension, length of OC use, and type of OC were comparable. At midcycle approximately 10-12 hours following OC intake, blood was drawn and the plasma was used to determine ethynylestradiol (EE2), caffeine, aldosterone (Aldo) and desoxycorticosterone (DOC) levels. The results showed that in hypertensive OC users, EE2 and caffeine levels were significantly higher (P less than .01) compared to normotensive OC users. While no significant differences were found in Aldo and DOC levels between hypertensive and normotensive OC users, OC users had higher levels of Aldo (P less than .01) compared to non-OC users.

Adolescent↗
PubMed1977

Echocardiographic observations in opiate addicts with active infective endocarditis. Frequency of involvement of the various values and comparison of echocardiographic features of right- and left-sided cardiac valve endocarditis.

Echocardiographic observations are described in 25 opiate addicts with active infective endocarditis involving apparently previously normal valves. Infective endocarditis was isolated to the tricuspid valve in 11 patients, involved both right- (tricuspid valve) and left-sided valves in 7 and was isolated to the left-sided valves in 7 (mitral valve in 6). Twenty patients (80%) had tricuspid valve regurgitation, 12 had mitral regurgitation, 3 had aortic regurgitation and none had pulmonary valve regurgitation. Considering the 75 cardiac valves (excluding the pulmonary) in the 25 patients, echocardiographic abnormalities consistent with active infective endocarditis were detected in 26 (74%) of the 35 clinically incompetent valves but in none of the 40 competent valves. Comparison of the 20 incompetent tricuspid valves with the 12 incompetent mitral valves indicated that (1) the echocardiogram was less sensitive in detecting tricuspid valve lesions, (2) rupture of tricuspid valve chordae tendineae was absent or not detectable, and (3) tricuspid valve vegetations tended to be larger.

Adult↗
PubMed1977

Cardiovascular effects of dobutamine in severe congestive heart failure.

The effects of continuous infusion of dobutamine 5 to 15 microgram/Kg./min. were studied in 17 patients using right heart catheterizations, echocardiography, and/or the Systolic Time Intervals. HR increase was dose-related, but insignificant (p less than 0.05) rate increase was obtained at infusion rates below 15 microgram/Kg.)min. C.O. increased from 2.9 +/- 0.7 to 5.0 +/- 1.2 liters/min. (p less than 0.001), and the stroke volume from 30 +/- 6 to 49 +/- 14 ml./min. (p less than 0.005). The mean BP did not change, P.A.W.P. decreased from 30 +/- 7 to 20 +/- 8 mm. Hg (p less than 0.001) and R.A.P. from 20.0 to 12.0 mm. Hg (p less than 0.005). The P.E.P.I. decreased from 160.93 +/- 54.91 to 133.4 +/- 28.7 msec. (p less than 0.050). Echo-determined mean VCf increased from 0.387 +/- 0.14 to 0.537 +/- 0.13 cm. (p less than 0.010), diastolic diameter did not change significantly, but the end systolic diameter decreased from 6.020 +/- 0.69 to 5.750 +/- 0.70 cm. (p less than 0.025). During a mean infusion period of 75 hours, the only side effects noted were transient nausea and/or vomiting at 15 microgram/Kg./min. dose range in two patients, and multifocal P.V.C.'s following 68 hours of infusion in another patient. It is concluded that in the dose range of 5 to 15 microgram/Kg./min., dobutamine is well tolerated and is a very potent inotropic agent with only minor effects on the heart rate and blood pressure.

Adult↗
PubMed1977

Evidence of higher ethynylestradiol blood levels in human hypertensive oral contraceptive users.

These studies were designed to investigate the differences in blood plasma levels of ethynylestradiol (EE2) in women who developed hypertension while taking combined estrogen and progesterone oral contraceptives (OCs) and in normotensive OC users. Blood samples were collected in heparinized tubes 10 hours after OC ingestion, the plasma was separated, and EE2 was measured by radioimmunoassay. The results showed significantly higher plasma levels of EE2 in the hypertensive OC users as compared with the levels in normotensive OC users (P less than 0.01). In another study, blood samples from hypertensive and normotensive OC users were obtained for 3 consecutive days at fixed intervals following OC ingestion, and plasma levels of EE2 were measured. The results showed consistently higher EE2 blood levels during this 3-day period in the hypertensive subjects (P less than 0.01). It is postulated that the higher blood levels of EE2 in hypertensive OC users result from either decreased metabolism or excretion of synthetic estrogens.

Adult↗