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Biomedical subjects

D T Nash

Publications and source records attributed to D T Nash.

At least 37 records · Page 2Linked to original sources
PubMed1989

Risk factor knowledge, status, and change in a community screening project.

This report describes a community-based cardiovascular risk-reduction program which targeted high-risk individuals. A total of 1,471 individuals participated and were screened for blood pressure, fasting serum cholesterol, blood glucose level, and appearance of the serum. These individuals also completed a questionnaire regarding their knowledge of heart disease. Overall, 522 (35.5%) individuals had a cholesterol level of 240+ mg/dl; 261 (17.7%) had hypertension; 118 (8%) had a glucose level of 120+ mg/100 ml blood; 266 (18.1%) smoked; and the serum was evaluated as "turbid" or "lipemic" in 105 (7.1%). Therefore, of the 1,471 individuals examined, 733 (49.8%) could be considered "at risk" due to the presence of one or more risk factors. Interestingly, 73% of respondents knew their blood pressure, whereas only 15% and 12%, respectively, knew their cholesterol and glucose levels. Eighty percent of the sample knew that smoking, hypertension, and cholesterol were risk factors, but only 50% of the sample identified diabetes as an independent risk factor. Contrary to expectation, knowledge of heart disease and diabetes was not related to either initial level or change in cholesterol at 18-month retest. Overall, these results indicate that a community screening program can identify high risk individuals at a relatively low cost, and that knowledge of risk factors and disease is not related to initial risk status or self-initiated change in risk status.

Adolescent↗
PubMed1988

Long-term efficacy and safety of nitrendipine in severe essential hypertension.

This multicenter study evaluated nitrendipine, a dihydropyridine calcium antagonist, alone or in combination with hydrochlorothiazide and/or propranolol in severe essential hypertension (baseline supine diastolic BP greater than or equal to 115 mm Hg). After an initial 3- to 7-day drug-free run-in, a 2- to 5-week titration phase, and a 4- to 6-week maintenance period, patients with supine diastolic less than or equal to 90 mm Hg entered long-term maintenance. Four centers enrolled 57 patients initially; 43 qualified for the extended therapy trial, and 30 had completed greater than 2 years of therapy (mean duration of 756 days) at the time of analysis. Supine BP fell from 186/122 +/- 5/2 mm Hg at baseline (group mean +/- SEM) to 139/89 +/- 3/2 mm Hg after 2 years (p less than 0.001/0.001). Standing BP fell from 185/126 +/- 5/2 to 138/90 +/- 3/2 mm Hg (p less than 0.001/0.001). Supine pulse rate changed from 82 beats/min at baseline to 74 beats/min (p less than 0.01) and standing pulse rate from 88 to 78 beats/min (p less than 0.01). Seventeen patients received nitrendipine alone, 4 received nitredipine plus HCTZ, 2 received nitrendipine plus propranolol, and 7 patients received all three drugs. Response was similar in patients less than 50 years old and in those greater than or equal to 50 years, and also in black and nonblack patients. Three patients were lost to follow-up, six were terminated for inadequate BP control, and four terminated for side effects. Twenty-four patients completed greater than 2.5 years treatment (mean duration of 933 days).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

A double-blind parallel trial to assess the efficacy of doxazosin, atenolol and placebo in patients with mild to moderate systemic hypertension.

The antihypertensive and lipid effects of doxazosin and atenolol were compared in a 10-week, double-blind, parallel, placebo-controlled study. The 129 adults enrolled had mild to moderate hypertension (average supine diastolic blood pressures for doxazosin, atenolol and placebo were 100.6, 101.0 and 99.7 mm Hg, respectively). Patients were randomly assigned to treatment with doxazosin, 1 to 16 mg daily, atenolol, 50 to 100 mg daily or placebo. Among 114 patients included in the efficacy analysis, standing blood pressure (systolic/diastolic) changed by -13/-11 mm Hg with doxazosin (n = 37), -12/-12 mm Hg with atenolol (n = 39) and +1/-1 mm Hg with placebo (n = 38). Mean reductions in blood pressure for doxazosin and atenolol were significantly greater than those for placebo (p less than 0.01), although no statistically significant differences between the active agents were noted. Serum lipid measurements were evaluable for 116 patients, and the 38 doxazosin-treated patients in this group experienced reductions in total cholesterol, total triglyceride and very low density lipoprotein cholesterol levels. Both doxazosin and atenolol demonstrated comparable acceptance profiles. Doxazosin is an effective hypotensive agent with beneficial effects on serum lipid levels.

Adrenergic alpha-Antagonists↗
PubMed1987

Controlled multicenter study of the antihypertensive effects of lisinopril, hydrochlorothiazide, and lisinopril plus hydrochlorothiazide in the treatment of 394 patients with mild to moderate essential hypertension.

Lisinopril (LIS) is a lysine analog of enalaprilat, the active metabolite of enalapril, an angiotensin-converting enzyme inhibitor (ACEI). Unlike enalapril, the precursor of enalaprilat, LIS is not a prodrug but has equal ACEI efficacy and potency and a slightly longer duration of action after oral administration. Short-term (12 weeks) and long-term (24 weeks) blood pressure control has been studied with LIS, hydrochlorothiazide (HCTZ), and LIS + HCTZ when given once a day. Drug treatment had three phases: (i) 2-4 weeks of single-blind placebo washout; (ii) 12 weeks of double-blind comparison therapy with LIS 20, 40, and 80 mg vs. HCTZ 12.5, 25, and 50 mg, vs. LIS + HCTZ 20 + 12.5, 40 + 25, and 80 + 50 mg; (iii) 13-24 weeks single-blind LIS vs. LIS + HCTZ. Starting double-blind therapy at the lowest dose, all three groups doubled the dose at weeks 4 and 8 if BP was not controlled with sitting diastolic BP (SDBP) less than 90 mm Hg. At the end of 12 weeks of double-blind therapy, uncontrolled HCTZ-only and LIS-only treatment groups were advanced to combination LIS + HCTZ therapy but uncontrolled LIS + HCTZ patients were dropped. Mean BP reductions (systolic/diastolic, mm Hg) for all three groups after 12 weeks of double-blind comparison therapy were: (i) LIS (n = 162), -16.6/-12.5; (ii) HCTZ (n = 155), -10.4/-6.8; (iii) LIS + HCTZ (n = 74), -23.9/-18.2 with p less than 0.01 for all groups compared to baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Hypercholesterolemia during hospitalization. The case for closer surveillance.

The medical records of patients hospitalized in a teaching hospital between August 1981 and January 1983 were examined retrospectively, and 38 patients with elevated (greater than 350 mg/dl) serum cholesterol levels were identified. Follow-up information was obtained from the office records of attending physicians. Hyperlipidemia had been diagnosed during hospitalization in only 13 patients, and lipid levels had been determined during follow-up in only eight patients. Elevated serum cholesterol has been identified as a major risk factor in the development of coronary artery atherosclerosis. However, results of this study indicate that significant hyperlipidemia discovered during hospitalization is infrequently treated and seldom monitored during follow-up. Practicing physicians can readily improve this situation by closer surveillance of patients with elevated cholesterol levels.

Adolescent↗
PubMed1986

Lisinopril cough.

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Angiotensin-Converting Enzyme Inhibitors↗
PubMed1986

Lisinopril cough.

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Journal Article↗