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Biomedical subjects

C Wilhelmsson

Publications and source records attributed to C Wilhelmsson.

At least 91 records · Page 5Linked to original sources

The effect of beta-blockade on glucose tolerance and insulin release in adult diabetes.

Blood glucose and plasma insulin levels were studied in ten adult diabetics treated in a cross-over fashion for at least three weeks with alprenolol, a non-selective beta-blocker, or with metoprolol, a cardioselective beta 1-blocker. Dietary intake was controlled three days prior to the study which comprised both i.v. and oral glucose tolerance tests. Mean fasting blood glucose levels were significantly higher on alprenolol than on metoprolol. The increase in fasting blood glucose was particularly pronounced in two patients. In these subjects the glucose tolerance following both an i.v. and an oral glucose load was reduced when treatment was switched from metoprolol to alprenolol. Lower plasma insulin levels in response to glucose were also found in these patients on alprenolol than on metoprolol. The mean insulin levels for all ten patients did not differ significantly between the two treatment periods. These data show that treatment with a non-selective beta-blocker can in some patients cause a considerable deterioration of the glucose tolerance, presumably due to inhibition of insulin release.

Administration, Oral↗

Intrinsic sympathomimetic activity of penbutolol.

Six healthy volunteers took part in a randomized, single-blind, crossover study to quantitate the intrinsic sympathomimetic activity (ISA) of penbutolol in comparison with one drug possessing ISA (alprenolol) and with the standard non-ISA drug (propranolol). Single intravenous and one week oral administrations were studied. Complete parasympathetic and sympathetic isolation of the heart was obtained by administration of atropine 0.04 mg/kg body weight i.v. and propranolol 0.4 mg/kg i.v., or corresponding equipotent doses of alprenolol 0.4 mg/kg i.v. and penbutolol i.v. 0.08 mg/kg. In the chronic, oral study propranolol 160 mg b.i.d. was given, or corresponding equipotent doses of alprenolol (400 mg b.i.d.) or penbutolol (40 mg b.i.d.). The test procedure included measurement of heart rate and blood pressure in the supine, sitting and standing positions, and during isometric and dynamic exercise. ISA was calculated by comparison of the change in of heart rate with that produced by propranolol. The ISA of alprenolol was 22--26% and of penbutolol 12--18% of maximal sympathetic activity. Isometric and dynamic exercise gave comparable ISA values.

Adrenergic beta-Antagonists↗

Effects of labetalol and propranolol on blood pressure at rest and during isometric and dynamic exercise.

The influence of intravenous labetalol and propranolol on the blood pressure response to isometric and dynamic exercise was examined in a double blind study in eight, young, normotensive volunteers. Effects were recorded after propranolol 7.5, 15 and 30 mg i. v., and after labetalol 30, 60 and 120 mg i. v. In control experiments saline was administered. Mean blood pressure rose with successive handgrip tests following saline and propranolol, but not after labetalol, and the difference was significant. The total dose of each drug produced the same reduction in heart rate during sub-maximal bicycle exercise. The exercise-induced systolic blood pressure response did not differ between the drugs.

Adult↗

Influence of a myocardial infarction on blood pressure and serum cholesterol.

Blood pressure (BP) was measured before and after acute myocardial infarction (MI) in 21 men aged 49--60 years from a random population sample. Men on drugs affecting BP before MI or during follow-up were excluded. Pre- and postinfarction cholesterol levels were analyzed in 49 men not on hyperlipidemic treatment recruited from the same population sample. The mean fall in systolic BP (SBP) was 14 mmHg both five weeks and one year after the acute event, but 10 mmHg after two years. The mean fall in diastolic BP (DBP) was 10 mmHg five weeks after the MI and remained at this level for two years. The decreases in SBP and DBP were significant. There was a positive correlation between the maximum rise in SGOT during the acute phase of MI and the decrease in DBP between preinfarction readings and readings five weeks after the MI. Serum cholesterol was unchanged three months, and one and two years after the MI as compared to the preinfarction level.

Aged↗

QT time in patients treated with alprenolol or placebo after myocardial infarction.

Studies were made on the effects of long-term beta-blockade on the QT interval in patients discharged alive from hospital after myocardial infarction. The patients (n = 230) in this study constituted all those who participated in the alprenolol study on postmyocardial patients in Göteborg, Sweden. The study was double-blind (alprenolol 200 mg b.i.d. or placebo) and randomised. The patients were divided into 4 risk groups (1-4) with different predicted mortality. The electrocardiograms before and after 8 weeks of treatment were analysed with respect to heart rate and QT time. There was a decrease in heart rate of about 10% in the alprenolol treated patients. The QT time was not significantly influenced by alprenolol. The rate corrected QT time (QTc) decreased in the subgroup of the most severely diseased patients (subgroup 4) treated with alprenolol.

Aged↗

Hypertension and myocardial infarction.

In a representative series of male patients (n = 504) surviving the hospital stay of a first myocardial infarction the prevalence of hypertension and the influence of hypertension on the prognosis during 2 yr follow-up were studied. According to the definitions used hypertension had been detected before or was detected after myocardial infarction in 36% of the patients. Two thirds had a history of hypertension known before infarction. The systolic and diastolic blood pressures measured at 3 months and 1 yr after infarction increased with age. There was no difference between patients with and without hypertension with respect to a number of different variables recorded during the hospital period, nor in multiple risk according to a logistic function. There was no difference in death rate between the two groups. However, the rate of non-fatal reinfarction was significantly higher among the hypertensive patients. Hypertension remained as a risk factor for after myocardial infarction when the possible confounding influences of serum lipid levels and tobacco smoking were analysed.

Adult↗

Myocardial infarction among men below age 40.

Studies were made in Göteborg over a period of 6 years of all cases of acute myocardial infarction diagnosed among men below the age of 40. Thirty-six cases were registered and 8 of these died outside hospital. Three patients died early during the hospital stay. The remaining 25 patients were compared with a random sample from the general population in Göteborg with respect to conventional risk factors. Smoking, and high plasma cholesterol values were dominating findings among the patients, whereas there was no significant differences in blood pressure levels. Coronary angiography was performed in 18 patients of whom 2 showed normal coronary arteries and left ventricular angiograms. These 2 patients were the only ones free from risk factors. Of the remaining 16 patients, 10 had only one vessel affected.

Adult↗

Prediction of cardiovascular deaths and non-fatal reinfarctions after myocardial infarction.

The present study concerns the development and validation of a logistic multivariate prognostic function in patients followed for two years after myocardial infarction. The patients studied constituted at least 90% of all cases in a total community--the City of Göteborg, Sweden. Using a multivariate logistic function with 7 variables, based on 30 cardiovascular deaths during two years after discharge from hospital among 292 men with first infarction, breathlessness at onset of symptoms of infarction, SGOT quartile, left heart failure, relative heart size, atrial fibrillation, a history of hypertension, and AV block recorded during the hospital phase were the most important variables. The first five of these variables made significant contributions (p less than 0.01) to the predictive power. The predictive capacity was confirmed in an independent series of 195 men with first infarction, among whom 17 cardiovascular deaths occurred. Around 60% of the total cardiovascular mortality was concentrated in the highest risk quintile. Deaths from non-cardiovascular causes were predicted less efficiently. Non-fatal recurrences could not be predicted by the present model. Thus, the function can predict the excess risk of mortality but not the excess risk of reinfarction during two years among men after an initial myocardial infarction.

Aspartate Aminotransferases↗

Angina pectoris and myocardial infarction.

Angina pectoris was studied in a representative series of male patients (n = 504) with a first myocardial infarction (MI) surviving the hospital stay. The prevalence of questionnaire angina before MI was 28% and of effort-induced chest pain alone 40%. Of the patients with effort-induced chest pain, 72% retained symptoms also after MI. No correlation with age was found. Three months after and one year after infarction the prevalence of effort-induced chest pain was 55% and 45%, respectively. The patients with effort-induced chest pain before MI had a somewhat more severe clinical course and a significantly higher death rate (15% versus 6%) than those without chest pain.

Adult↗

Effects of a new beta1-selective beta-blocker H 87/07 in angina pectoris.

The efficacy and toleration of a new beta1-selective beta-blocker, H 87/07, was compared with placebo in 33 patients with angina pectoris. The efficacy was evaluated using subjective assessments of attack rate and nitroglycerin consumption as well as objective assessments of exercise tolerance on a bicycle ergometer. H 87/07 significantly reduced the attack rate and the nitroglycerin consumption compared with placebo. The mean reduction amounted to 13 and 36% respectively. No significant differences were found between H 87/07 and placebo with regard to exercise tolerance. Due to high intrinsic stimulating activity (I.S.A.) H 87/07 altered the heart rate and blood pressure only slightly at rest but during exercise significant reductions were seen. Except for one patient who had cardiac decompensation on H 87/07 no side-effects of clinical importance were seen. No significant changes were seen with regard to the laboratory tests performed.

Adrenergic beta-Antagonists↗