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Biomedical subjects

E Grossman

Publications and source records attributed to E Grossman.

At least 163 records · Page 9Linked to original sources
PubMed1990

Treatment of hypertension by enalapril and hydrochlorothiazide separately and together: a multicenter study.

The efficacy and safety of enalapril and hydrochlorothiazide was investigated in a multicenter study of 81 patients with mild to moderate essential hypertension. The subjects were randomly assigned to one of three groups and, following a placebo period, given enalapril maleate (20 mg), hydrochlorothiazide (12.5 mg), or a combination of the two drugs (32.5 mg). A significant decrease in blood pressure was observed after only 2 weeks in the enalapril and enalapril-hydrochlorothiazide groups. A double dose was required to achieve a satisfactory response in one-third of the patients in both the enalapril (9 of 27) and the enalapril-hydrochlorothiazide groups (8 of 27). Adverse reactions included cough in one patient and mild hyperkalemia in another, both of whom received enalapril. Two patients on the drug combination developed side effects--symptomatic orthostatic hypotension in one and impotence in the second. Enalapril alone and in combination with hydrochlorothiazide appears to be effective and well tolerated.

Adult↗
PubMed1990

Fate of tritiated 6-fluorodopamine in rats: a false neurotransmitter for positron emission tomographic imaging of sympathetic innervation and function.

In evaluating positron-emitting analogs of dopamine (DA) as imaging agents for visualizing tissue sympathetic innervation and function, we assessed the metabolic fate of systemically injected [3H]-6-fluorodopamine [( 3H]-6F-DA) in plasma, in sympathetically innervated tissues (left ventricle, spleen and salivary glands) and in excretory organs (liver and kidney) of rats. By 5 min after intravenous bolus injection of a physiologically inactive amount (450 ng, 10 microCi) of [3H]-6F-DA, 3H was concentrated in all the organs compared with that in blood or plasma. In the sympathetically innervated organs, most of the radioactivity was in [3H]-6F-DA and [3H]-6-fluoronorepinephrine [( 3H]-6F-NE), whereas in the blood, plasma and excretory organs most of the radioactivity was in noncatechol compounds such as O-methylated and conjugated metabolites. In sympathetically innervated organs, tissue/blood ratios exceeded 1.0 at all time points between 5 and 120 min after injection of [3H]-6F-DA and increased progressively (from 8 to 60 in myocardium), whereas the tissue/blood ratios in the kidney and liver increased by less than 2-fold during this interval. In all the studied tissues, the proportion of total tissue 3H that was due to [3H]F-NE increased progressively while that due to [3H]F-DA declined, consistent with conversion of [3H]F-DA to [3H]F-NE in vesicles in sympathetic nerve endings.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Levels and correlates of blood pressure in recent and earlier Ethiopian immigrants to Israel.

Blood pressure (BP) and anthropometric data were collected on 483 recent immigrants from Ethiopia to Israel, and on 171 adults and 100 adolescent boarding school students who had immigrated two to three years earlier. Comparison of samples within the Ethiopian groups, and between new and early Ethiopian immigrants with Israel and resident Israelis revealed the following: Systolic and diastolic BP were considerably lower in recent immigrants of both sexes than among counterparts residing in Israel for two to three years. The latter group significantly approached, but did not reach, the BP levels of veteran Israelis. A similar comparison of 100 immigrant Ethiopian boarding school children with an Israeli high school population revealed apparently larger differences among the boys than the girls, whose BP was 'adapted' to a greater degree. Differences in relative weight paralleled those identified for BP, with the Quetelet index (QI) progressively higher when comparing new immigrants with earlier ones, and with persons who have lived in Israel for a longer period. Whether the weight differences provide a complete explanation for BP changes cannot be definitely stated, pending prospective data on weight and BP changes. Correlations of BP with anthropometric parameters and pulse rate indicated that weight rather than QI was the stronger correlate of BP in adults, whereas weight and height, but not QI, correlated with BP in adolescent boys. QI correlated with BP in adolescent, apparently sexually mature girls, but not in boys.

Adolescent↗
PubMed1989

Disparate hemodynamic and sympathoadrenergic responses to isometric and mental stress in essential hypertension.

The hemodynamic and sympathoadrenergic responses during isometric handgrip and mental arithmetic tests were compared in 18 patients with mild essential hypertension. Mean blood pressure increased significantly after both maneuvers (27% during isometric stress and 10.7% during mental stress), but the increase was significantly higher during isometric stress (p less than 0.001). Both stressors increased the heart rate (p less than 0.001) and cardiac output (p less than 0.001). However, the total peripheral resistance behaved differently, for it increased during isometric stress (p less than 0.05) and remained unchanged during mental stress. Both stressors increased the epinephrine levels (p less than 0.005), but only isometric stress increased the norepinephrine levels (p less than 0.001). It is concluded that both stressors increase cardiac output by way of an increase in heart rate, but isometric stress also increases total peripheral resistance and thus causes a greater increase in arterial pressure. Isometric stress activates both the adrenergic and noradrenergic systems, thereby accounting for the exaggerated response in arterial pressure, whereas mental stress stimulates the adrenergic system only.

Adolescent↗
PubMed1989

Hemodynamic and humoral effects of intravenous dilevalol in patients with moderate hypertension.

The acute hemodynamic and humoral responses to intravenous dilevalol (10 to 390 mg) were evaluated in 10 patients with moderate hypertension. Dilevalol, in doses of 30 mg or more, decreased arterial pressure (p less than 0.0001) through a decrease in total peripheral resistance (p less than 0.0001) associated with an increase in stroke volume and cardiac output (p less than 0.0001). Heart rate increased moderately at doses above 190 mg. Plasma norepinephrine levels increased (p less than 0.05), but epinephrine levels remained unchanged. Plasma renin activity and level of atrial natriuretic peptide decreased (p less than 0.01 and p less than 0.01, respectively). The hypotensive and humoral changes persisted 3 hours after the last dose. Dilevalol modified the pattern of hemodynamic response to isometric stress, slightly enhancing the increases in peripheral resistance and blunting increases in cardiac output and heart rate. The response in arterial pressure during administration of dilevalol remained similar to that seen in the pretreatment phase. The results show that dilevalol, when given intravenously in a dose of 30 to 90 mg, reduces arterial pressure by reducing total peripheral resistance without acceleration in heart rate. On the basis of these hemodynamic effects, dilevalol should be further evaluated for treatment of hypertensive emergencies.

Adult↗
PubMed1989

Endothelin induces an initial increase in cardiac output associated with selective vasodilation in rats.

The systemic and regional hemodynamic effects of endothelin (ET), a novel endothelial derived vasoconstrictor peptide were studied in Wistar Kyoto rats. A bolus of 1 nmol/Kg ET intravenously induced a transient 43% decrease in blood pressure associated with a 57% decrease in systemic resistance and a 30% increase in cardiac output (p less than 0.01 for all parameters). This was followed by an increase of 20% in arterial pressure and of 71% in systemic resistance and a decrease of 30% in cardiac output at 10 minutes. The initial fall in blood pressure was not abolished by pretreatment with verapamil, captopril, indomethacin, ketanserin, atropine, methylene blue or ethanol. Verapamil abolished the hypertensive phase by markedly decreasing cardiac output. ET had selective effects on the arterial tree; during the hypotensive phase it caused a transient increase in blood flow in the carotid and femoral arteries (+41% and +83% respectively, p less than 0.01) but a decrease in flow in the renal and mesenteric arteries (-53% and -44% respectively, p less than 0.05). Accordingly, there was a decrease in resistance in the carotid and femoral beds (-55% and -67% respectively, p less than 0.01) and an increase in resistance in the renal and mesenteric beds (+102%; p less than 0.01 and +23%; p = N.S. respectively). Subsequently there was an increase in resistance in all vascular beds to variable degrees. The maximal increase in resistance was in the renal bed (+156%). Thus, ET causes initially a potent systemic vasorelaxation and an increase in cardiac output later progressing to systemic vasoconstriction and a decrease in cardiac output. The initial vasodilation is selective, appearing in musculocutaneous beds but not in visceral beds.

Animals↗
PubMed1989

Polychlorinated biphenyl congeners in adipose tissue lipid and serum of past and present transformer repair workers and a comparison group.

The concentrations of individual PCB's were determined in both serum and adipose tissue lipid from 35 transformer repair workers currently exposed to PCBs, mainly Aroclor 1260, 17 previous transformer repair workers, and 56 comparison workers never occupationally exposed to PCBs. The analysis used fused-silica capillary gas chromatography with electron capture detector (FSCGC/ECD) and FSCGC with negative ion chemical ionization mass spectrometry to verify PCB congener levels. Eighty-nine PCB peaks were identified and confirmed. More congeners were detected in adipose tissue. In serum approximately 50% of peaks were below the level of detection. Statistical techniques to account for left and interval censoring allowed comparison of concentration distributions even where data were incomplete. We found that unquantifiable levels were unlikely to contribute substantially to the true values for total [PCBs] over and beyond the contribution of the measured values. However, the total serum [PCBs] determined by FSCGC/ECD greatly exceeded that from standard packed cell gas chromatography (PCGC/ECD). The underestimation was less marked for adipose samples. In serum the total [PCBs] was highest in currently exposed workers and lowest in unexposed workers, with past-exposed workers clearly intermediate. In adipose tissue [PCBs] in the currently exposed group was much higher than in the other two groups, in whom the distribution of results was broadly similar. In all worker groups hexachlorinated and heptachlorinated species predominated followed by octachlorinated and pentachlorinated. The relative distribution of individual PCB congeners in the three groups was similar although the amounts varied. The seven major peaks in serum and adipose tissue were 2,3,5,6,3',4',5'/2,3,4,5,2',4',5' hepta-CB; 2,3,4,2',3',5' hexa-CB; 2,4,6,3',4',5'/2,4,5,2',4',5'/2,3,4,5,2',5' hexa-CB; 2,3,4,5,2',3',4' hepta-CB; 2,3,4,5,2',3',5',6'/2,3,4,5,6,2',3',5', octa-CB; 2,4,5,3',4',/3,4,5,2',3' penta-CB; and 2,3,4,2',3',4'/2,3,5,6,2',4',5'/2,3,4,5,2',4',6' multi-CB. The distribution of PCB peaks in our populations differs from that in capacitor workers (exposed to less highly chlorinated PCBs) and from Yu-Cheng patients suggesting differing toxic potentials from PCBs in these three circumstances.

Adipose Tissue↗
PubMed1989

Urinary output of urodiolenone in essential hypertension.

Increased amounts of urodiolenone, an isomer of a phytoalexin, were found in the urine of 34% of patients with essential hypertension. Urodiolenone was also excreted in 70% of patients with neurocirculatory asthenia (hyperkinetic syndrome) and labile hypertension; very small quantities were found in normal subjects. When grapefruit juice, which is rich in urodiolenone, was offered to hypertensive subjects, urodiolenone excretion was much higher than the amount ingested, indicating that output was not due to precursors present in the diet.

Adolescent↗
PubMed1989

Blood pressure in Ethiopian immigrants in Israel: comparison with resident Israelis.

Blood pressure was examined in 483 Ethiopian immigrants a few weeks after their arrival in Israel. The results were compared with those from a group of 171 Ethiopian immigrants who came to Israel 2-3 years earlier. Mean blood pressure was significantly higher in the veteran immigrants, whose weight was also greater. Both groups had lower blood pressure than the resident Israeli population.

Adolescent↗
PubMed1989

A clinical comparison of antibacterial mouthrinses: effects of chlorhexidine, phenolics, and sanguinarine on dental plaque and gingivitis.

This study compared the clinical efficacy of three mouthrinses containing either 0.12% chlorhexidine, phenolic compounds, or sanguinarine, which were used unsupervised, in a placebo-controlled, double-blind study of 6 months' duration. The study was conducted according to ADA clinical guidelines for evaluation of antigingivitis agents and was completed by 481 adults. Following baseline exams and a prophylaxis, subjects were randomly divided into treatment groups matched for age, gender, and gingivitis severity, and were instructed to use the rinses in accordance with manufacturer's directions. Followup examinations evaluated supragingival plaque, gingivitis, and gingival bleeding. Compared to placebo at 6 months, the group rinsing with 0.12% chlorhexidine had significantly less gingivitis (31% reduction), gingival bleeding (39% reduction), and plaque (49% reduction) and was significantly better than any of the other treatment groups (P less than 0.05). Both the phenolic and sanguinarine groups showed moderate, yet significant, reductions in plaque compared to placebo (24% and 12% respectively) yet were significantly less effective than the 0.12% chlorhexidine rinse (P less than 0.05). However, neither the phenolic nor sanguinarine rinses were significantly different than placebo in their effects on gingivitis or gingival bleeding. These results support previous published results on the superiority of 0.12% chlorhexidine when used in conjunction with professional care and as an adjunct to routine oral hygiene practices.

Adult↗
PubMed1989

Toothbrush bristle density: relationship to plaque removal.

A double-blind, parallel, controlled study was conducted to determine the effect of toothbrush bristle density (total number of bristles divided by the brush head area) in removing plaque from tooth surfaces. Ninety subjects (29 males, 61 females), aged 18-65, were randomly assigned to one of three groups using the Sensodyne Search 4-Rowa toothbrush modified to have the following bristle densities: A (4.5 bristles per mm2); B (8.3 bristles per mm2); or C (11.8 bristles per mm2). The average trim height of the bristles was 10.77 mm. Subjects brushed without any dentifrice once a day for 7 days in order for adherent deposits (salivary pellicle and plaque remnants) to accumulate on their teeth. On the eight day, examinations for stained deposits were performed according to the Global Scoring Index before and after one minute of brushing with a commercially available toothpaste. Percent reductions in deposits were highly significant for the eighty-seven subjects who completed the study. A paired t-test between the pre- and post-treatment scores (p = 0.005) demonstrated the following: Toothbrushes A, B and C had reductions in plaque of 45.5%, 51.9% and 56.8%, respectively. On an overall basis, the intergroup percent reductions were significantly different using ANOVA (p = 0.001), and demonstrated a relationship in terms of data clustering for percent plaque removal of toothbrushes with varied bristle densities.

Adolescent↗
PubMed1988

Myocardial contractility and left ventricular function in obese patients with essential hypertension.

Although the risk of developing congestive heart failure increases in parallel with the degree of obesity, load-dependent indexes of left ventricular function are found to be reduced in patients with morbid obesity only. We used the ratio of end-systolic wall stress to end-systolic volume index, which is load-independent, to assess myocardial contractility in 23 nonobese, 28 mildly obese and 26 moderately obese patients with mild to moderate essential hypertension. Although load-dependent indexes (i.e., ejection fraction, fractional fiber shortening and velocity of circumferential fiber shortening) were similar in the 3 groups, end-systolic wall stress to end-systolic volume index was lower in the moderately obese group (2.63 +/- 0.4, p less than 0.002) and even in the mildly obese group (2.88 +/- 0.8, p less than 0.05) than in the nonobese group (3.27 +/- 0.7). Further, there was a significant inverse relation between end-systolic wall stress to end-systolic volume index and body mass index (r = -0.34, p less than 0.005), diastolic diameter (r = -0.56, p less than 0.001) and left ventricular mass index (r = -0.55, p less than 0.001). Some obese patients have depressed myocardial contractility when compared with lean patients despite well-preserved pump function.

Adult↗
PubMed1988

Nisoldipine: a replacement therapy for nifedipine in the treatment of severe hypertension.

The use of nisoldipine (10-20 mg b.i.d.) was evaluated as a replacement therapy for long-acting nifedipine (40-120 mg/day) in 21 patients with severe hypertension, who were resistant to or intolerant of nifedipine. Except for one patient with specific contraindications, all participants received an individually determined constant dose of beta blocker throughout the 8-month study. Results indicated a significant decrease in blood pressure after four weeks of treatment with nisoldipine (173 +/- 5/98 +/- 4 to 156 +/- 3/91 +/- 2 mmHg, p less than 0.05) without an associated change in pulse rate in 19 patients; only 5 of the 21 patients showed no further benefit from nisoldipine. No significant biochemical changes were noted in any of the patients during the study. In three patients, leg edema that had developed as a consequence of previous nifedipine therapy resolved completely following nisoldipine administration. Two patients withdrew from the study before term because of headaches and palpitations. An additional two patients suffered headaches, but tolerated the drug and continued the study. One patient suffered from polyuria. Nisoldipine appears to be an effective substitute treatment for nifedipine in severely hypertensive patients sensitive or resistant to nifedipine.

Adult↗
PubMed1988

The absence of long-term therapeutic effect of calcium channel blockade in the primary aldosteronism of adrenal adenomas.

The absence of long-term effect of calcium channel blockers in primary aldosteronism due to adrenal adenoma is described in two patients. Calcium entry channel blockers, which were claimed to be a new medical therapy for primary aldosteronism, neither prevented the increase of plasma aldosterone nor decreased potassium levels over time in these patients. The drugs did not even lower blood pressure in one patient. Whereas calcium channel blockers may be effective in adrenal hyperplasia, they are apparently not effective enough in the long term treatment of patients with primary aldosteronism due to adrenal adenoma.

Adenoma↗
PubMed1988

Systemic and regional hemodynamic and humoral effects of nitrendipine in essential hypertension.

The hemodynamic effects of 3 months of nitrendipine therapy were evaluated in 14 patients with mild to moderate essential hypertension. Nitrendipine reduced systolic and diastolic pressures from 145 +/- 4/95 +/- 3 to 119 +/- 3/78 +/- 2 mm Hg, respectively, (p less than 0.001) through a fall in total peripheral resistance index (46 +/- 4 to 34 +/- 3 units/m2, p less than 0.001) without associated reflex cardiac stimulation. This antihypertensive effect was related directly to the height of pretreatment arterial pressure (r = -0.67, p = 0.006) but not to age or pretreatment plasma renin activity. Renal and forearm blood flow increased, vascular resistance decreased, and glomerular filtration rate remained stable. In addition, nitrendipine reduced left ventricular mass index (133 +/- 7 to 116 +/- 5 g/m2, p = 0.003) and wall thickness, changes that were accompanied by improvement in diastolic as well as systolic (ejection fraction and fractional fiber shortening rate) left ventricular functions. Intravascular volume did not expand with reduction in pressure. This study provides new information concerning the long-term hemodynamic effects and associated echocardiographic changes with nitrendipine. It also provides the first regional hemodynamic data in essential hypertensive patients detailing forearm and splanchnic changes and renal blood flow increase during prolonged treatment.

Aged↗
PubMed1988

Left ventricular hypertrophy and antihypertensive therapy.

Cardiac adaptation to long-standing arterial hypertension consists of left ventricular hypertrophy (LVH), usually of the concentric type, i.e. an increase in wall thickness at the expense of chamber volume. LVH can no longer be considered only as a simple adaptive myocardial process; it drastically increases the risk of sudden death and cardiovascular morbidity and mortality, irrespective of the levels of arterial pressure. Patients with LVH have more premature ventricular contractions than patients without LVH or normotensive subjects, which indicates that LVH per se increases ventricular ectopic activity. Antihypertensive therapy should not only lower blood pressure, but also prevent or improve end-organ damage and therefore allow left ventricular mass to regress. Although they lower blood pressure, certain antihypertensive agents such as the thiazide diuretics and arteriolar dilators (hydralazine, minoxidil) have little or even a detrimental effect on LVH. In contrast, other agents such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, antiadrenergic drugs, and certain calcium antagonists decrease left ventricular mass in parallel with arterial pressure. Recent evidence has shown that a decrease in left ventricular mass induced by certain antihypertensive drugs suppresses ventricular ectopic activity by 85%. In contrast, left ventricular mass and ventricular ectopic activity remain unchanged or may even increase in patients treated with diuretics. It is not known whether the risk of sudden death can be decreased and the ominous prognosis of LVH altered by such specific antihypertensive therapy.

Antihypertensive Agents↗