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Biomedical subjects

D G Beevers

Publications and source records attributed to D G Beevers.

At least 217 records · Page 12Linked to original sources
PubMed1990

The interaction of alcohol and beta-blockers in arterial hypertension.

The acute effects of consuming alcohol after a single oral dose of 200 mg of metoprolol or placebo were examined in eight healthy men in a randomized, controlled study. Alcohol, in a dose of 0.75 g/kg body weight, did not abolish the antihypertensive effect of metoprolol upon supine systolic blood pressure. The interaction of alcohol with antihypertensive drugs requires further investigation as hypertensive patients who consume alcohol regularly are known to have less adequate blood pressure control.

Adult↗
PubMed1990

Biochemical investigation of hypertension.

Underlying causes of hypertension are found in less than 5% of cases but they are frequently surgically remediable. Elementary biochemical tests are usually sufficient to exclude most renal and endocrine causes of hypertension. However, young patients with very high blood pressures merit more detailed investigation in specialized centres. As coexistent hyperlipidaemia or glucose intolerance substantially worsen the prognosis for a given level of blood pressure, these two risk factors are worth assessing in all hypertensive patients. Their presence may also alter the choice of antihypertensive drug therapy. About 25% of the population have raised blood pressure at first screening and about 10% are in need of drug therapy, so this represents an appreciable load on biochemical laboratories. Most patients, however, need only a single biochemical profile on one occasion, and should be exclusively managed in general practice.

Blood Chemical Analysis↗
PubMed1990

A meta-analysis of mortality and coronary prevention in hypertensive patients treated with beta-receptor blockers.

As beta-adrenoreceptor blockers have been shown to reduce mortality following myocardial infarction by around 20%, a similar pattern of 'cardioprotection' was looked for in hypertensive patients. Several non-randomised retrospective studies have suggested that beta-blockers may reduce either the mortality or morbidity from vascular complications. In the three randomised studies published to date, the effect of beta-blockers was compared with other managements using the technique of meta-analysis or overview. The overall mortality rate ratio in hypertensive patients treated with beta-blockers compared with those receiving placebo or diuretic treatment was 0.93 (95% confidence interval, 0.8 to 1.1). The pooled rate ratio for coronary heart disease (CHD) events was 0.95 and for cerebrovascular accidents 0.92. When beta-blockers were compared with diuretics, the overall pooled mortality rate ratio was 0.93 (95% confidence interval, 0.8 to 1.1). The pooled rate ratios for CHD events and cerebrovascular disease events were 0.98 and 1.22, respectively. These results raise the possibility that, in hypertensive patients, treatment with beta-blockers is associated with a small reduction in overall mortality when compared with other treatments.

Adrenergic beta-Antagonists↗
PubMed1990

Sodium, potassium, body mass, alcohol and blood pressure in three United Kingdom centres (the INTERSALT study).

Standardised data on blood pressure, 24 h urinary electrolyte excretion, body mass index (BMI) and alcohol intake were collected as part of the INTERSALT study in 598 men and women aged 20-59 years, selected randomly from three population groups in the United Kingdom. For the three centres combined, mean systolic blood pressure was 121.4 mm Hg and diastolic pressure 72.1 mm Hg, urinary sodium excretion 152.1 mmol/24 h, urinary potassium excretion 61.0 mmol/24 h, urinary sodium/potassium ratio 2.64 and BMI 25.2 kg/m2. Prevalence of heavy alcohol drinking in men (greater than or equal to 300 ml/week) was 27.5 per cent. Applying overall INTERSALT regression coefficients to the United Kingdom data suggested that modest changes in average sodium and potassium intakes, together with reductions in the prevalence of obesity and (in men) of heavy alcohol drinking could lead to important reductions in average population blood pressures and the prevalence of hypertension. The potential of this multifactorial approach to blood pressure control was illustrated by stratifying individuals within each of the United Kingdom centres by sodium and potassium excretion, BMI and alcohol intake. The 20 (out of 299) men considered at 'lower risk' for high blood pressure with respect to the above variables had systolic pressure lower by 11 mm Hg (P less than 0.01); for the 27 (out of 299) 'lower risk' women, systolic pressure was lower by 5 mm Hg (P = 0.06). These non-pharmacological approaches towards more favourable blood pressure levels could be accompanied by reductions in mortality from stroke and coronary heart disease.

Adult↗
PubMed1990

The survival of malignant hypertension in blacks, whites and Asians in Britain.

Life table analysis was used to compare survival rates in 168 whites, 39 blacks and 26 Asians with malignant phase hypertension. Amongst men, survival until death or the requirement of chronic renal dialysis was significantly worse in blacks, who initially presented with higher blood pressures and more renal impairment. There were no differences in survival in women in the three ethnic groups. Malignant hypertension remains common in Britain and still carries a poor prognosis.

Asian People↗
PubMed1989

Overprescribing.

Explore the source record for details and available documents.

Adolescent↗
PubMed1989

Cigarette smoking. A risk factor for hemorrhagic and nonhemorrhagic stroke.

Cigarette smoking habit was studied in 621 patients with stroke and in 573 control subjects using case control methods. There was an excess of smokers among the stroke group when compared with control subjects. Relative risks of cigarette smokers compared with nonsmokers, after adjustment for the possible confounding variables for subarachnoid hemorrhage, intracerebral hemorrhage, and cerebral infarction, were 4.5, 1.8, and 3.2 for men and 2.5, 1.3, and 2.3 for women, respectively. For all subtypes of stroke combined, the increased relative risk was related to the daily intake of cigarettes, the heaviest smokers having a higher relative risk than that for light smokers. The estimated increase in relative risk among smokers was 1.5 for each 10 cigarettes smoked daily in both men and women. We conclude that cigarette smoke may be an important preventable factor for both hemorrhagic and nonhemorrhagic stroke.

Cerebral Hemorrhage↗
PubMed1989

ACE inhibitors compared with thiazide diuretics as first-step antihypertensive therapy.

While ACE inhibitors are considerably more expensive than thiazide diuretics, they are slightly more effective antihypertensive agents in white patients and have fewer side effects. They can be regarded as suitable first-line therapy in diabetic hypertensives. It is probable that as new drugs in this class are marketed, the price differential will lessen and they will be regarded as acceptable and useful first-line drugs in an increasingly large number of patients.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

Urinary albumin excretion and blood pressure in the general population.

1. Twenty-four hour urinary albumin excretion rate was measured by a sensitive radioimmunoassay in 99 male and 100 female randomly selected factory workers, aged between 20 and 60 years. 2. The median (range) albumin excretion rates for men and women of 4.67 (1.0-25.8) and 5.25 (0.2-33.0) mg/24 h, respectively, were not significantly different. 3. No correlation was established between diastolic, systolic or mean arterial blood pressure and albumin excretion rate for the whole group. 4. Twenty-eight subjects with systolic and/or diastolic blood pressures greater than or equal to 140/90 mmHg (18.7/12.0 kPa) showed a positive correlation between mean arterial blood pressure and albumin excretion rate (r = 0.412, P less than 0.01). 5. There was no significant relationship between number of cigarettes smoked, age or alcohol intake and albumin excretion rate. 6. The data suggest that in the general population albumin excretion rate is variable and not dependent on blood pressure, but at blood pressures greater than 140/90 mmHg (18.7/12.0 kPa) albumin excretion rate may become pressure dependent, although high albumin excretion rates were sometimes found in subjects with blood pressures less than 140/90 mmHg (18.7/12.0 kPa).

Adult↗
PubMed1989

Clinical correlates in parathyroid hypertension.

There is a known association between hypertension and hyperparathyroidism but the mechanism remains unclear. A total of 115 patients with hyperparathyrodism were examined in a retrospective study, and 54.8% were hypertensive. Serum urea and creatinine levels were higher in the hypertensive patients compared with the normotensive patients. Parathyroidectomy had little effect on blood pressure, suggesting that hypertension alone is not an indication for surgery in these patients.

Female↗
PubMed1989

The effects of anti-hypertensive drugs on sexual function in men and women: a report from the DHSS Hypertension Care Computing Project (DHCCP).

One thousand, two hundred and eighty-five men and 1,080 women being followed in the DHSS Hypertension Care Computing Project answered the questions on sexual activity included in a self-administered questionnaire. In men, both impotence and sexual inactivity were increased in patients receiving hydralazine. No gross excess of these complaints could be determined in patients receiving either beta-adrenoceptor blocking drugs or methyldopa, nor was failure of ejaculation increased with these drugs. The survey could not exclude any deterioration in sexual function occurring uniformly across all treatment groups. However, the rates of complaint were similar in men taking a diuretic alone, a beta-adrenoceptor blocking drug alone and those taking the combination of these two drug groups. In women with hypertension, frequency of sexual intercourse and the achievement of orgasm was not associated with the giving of hydralazine, beta-adrenoceptor blocking drugs or methyldopa.

Adult↗
PubMed1989

The catecholamine content of a cystic phaeochromocytoma.

We report a case of phaeochromocytoma in which the tumour was a single 10 cm adrenal cyst. The cyst fluid contained noradrenaline and adrenaline in concentrations 100 to 200 fold higher than are seen in the serum of phaeochromocytoma patients. Possibly cystic tumours containing large amounts of catecholamine may if inadvertently compressed at operation, present a greater surgical hazard than solid tumours.

Adrenal Gland Neoplasms↗