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Biomedical subjects

D Clement

Publications and source records attributed to D Clement.

At least 127 records · Page 7Linked to original sources

Antihypertensive therapy in patients above age 60. Third interim report of the European Working Party on High blood pressure in Elderly (EWPHE).

Three hundred forty nine hypertensive patients above the age of 60 have entered the double-blind multicentre trial of the European Working Party on High blood pressure in the Elderly (EWPHE). After stratification and randomisation half were treated with one or two capsules containing 25 mg hydrochlorothiazide and 50 mg triamterene and if blood pressure control was insufficient methyldopa was added up to 2 g daily; the other half received matching placebo. No significant differences between the groups were present prior to randomisation. A significant blood pressure difference of 25/10 mm Hg was obtained between the groups and maintained during two years of follow-up. No major disturbances in serum potassium or serum sodium were noted with the present drug combination. However, during the initial phase an increase in serum creatinine and serum uric acid was noted in the actively treated group, which was maintained for two years. Also glucose tolerance was impaired after 2 years in the actively treated group. A favourable influence on prognosis by active treatment can be expected on the basis of the blood pressure reduction and in the absence of major electrolytes disturbances. But this benefit must be proven by observed statistical differences in terminating events between the groups. Therefore the patients are being followed for a longer period of time and more patients are admitted into the trial.

Aged↗

Antihypertensive therapy in elderly patients. Pilot trial of the European Working Party on High Blood Pressure in the Elderly.

A study protocol for a double-blind randomised control trial of hypotensive treatment in elderly hypertensive patients has been tested in a number of pilot centres throughout Europe. It was shown that this study is possible from the logistic point of view. In these elderly patients, hydrochlorothiazide + triamterene treatment with or without methyldopa, maintained a significant hypotensive effect in the absence of major electrolyte disturbances. The initiation of hypotensive therapy did not provoke an excess of cardiovascular complications. The influence of hypotensive therapy on the general well-being and on the morbidity and the mortality of elderly patients with high blood pressure, is thereby being assessed. The study will continue for 5 years and other centres are invited to join.

Aged↗

Left ventricular systolic time intervals during acute myocardial infarction.

Left ventricular systolic time intervals (LVSTI) were measured several times daily during 10 days in 47 patients with acute myocardial infarction without major complications. Left ventricular ejection time (LVET) and the interval between the beginning of depolarization and the aortic component of the second heart sound (Q-A2) decreased progressively during the first 72 hr. Shortening of Q--A2 and LVET was most marked in patients with heart failure and persisted till the end of the observation period. Q-upstroke (Q-U) prolonged progressively during the first 3 days, mainly in patients with heart failure. After 10 days, Q-U tended to return to normal except in decompensated patients. Definite diurnal variation in LVSTI were observed; LVET and Q--A2 were longest in the morning hours. Multiple regression analysis of LVSTI with a series of clinical variables revealed that R-R interval, age, sex, digitalis administration, day after infarction, hour of the day, peak of SGOT, and survival are significantly and independently correlated with the changes in LVSTI.

Acute Disease↗