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Biomedical subjects

E O'Brien

Publications and source records attributed to E O'Brien.

At least 271 records · Page 15Linked to original sources
PubMed1983

Antihypertensive and renal haemodynamic effects of atenolol and nadolol in elderly hypertensive patients.

As little is known of the antihypertensive efficacy or renal haemodynamic effects of beta-adrenoceptor blocking drugs in the elderly we studied two such drugs, atenolol and nadolol, in elderly hypertensive patients. Ten patients took part in a placebo-controlled double-blind study of atenolol and 10 received nadolol in a single-blind placebo-controlled study. Treatment phases lasted 12 weeks for atenolol or 10 weeks for nadolol. Blood pressure, effective renal blood flow and glomerular filtration rate data obtained at the end of each treatment phase were analysed. Atenolol lowered mean arterial pressure (mean +/- s.e. mean) from 129.9 +/- 1.5 to 108.2 +/- 2.3 mm Hg (P less than 0.01) while it increased mean effective renal blood flow 512.5 +/- 86.6 to 646.0 +/- 116.1 ml min-1 1.73 m-2 (P less than 0.05). Nadolol reduced mean arterial pressure from 133.2 +/- 2.0 to 113.5 +/- 3 mm Hg (P less than 0.001) but reduced mean effective renal blood flow from 558.8 +/- 32.2 to 446.0 +/- 26.9 ml min-1 1.73 m-2 (P less than 0.05). Glomerular filtration did not alter significantly with either drug. We conclude that beta-adrenoceptor blocking drugs are effective antihypertensive agents in the elderly but have disparate effects on effective renal blood flow perhaps because of differences in cardioselectivity. These data suggest that comparative studies with thiazide diuretics and beta-adrenoceptor blocking drugs are warranted in elderly hypertensives.

Adrenergic beta-Antagonists↗
PubMed1982

Clinical and haemodynamic responses to captopril and hydralazine in chronic congestive heart failure: the importance of preload reduction.

1 Although many vasodilators are effective in the treatment of severe congestive heart failure, there have been few comparative studies of these drugs. We compared the acute haemodynamic effects of captopril and hydralazine in 11 patients with congestive cardiac failure unresponsive to diuretics and digoxin. Both drugs increased resting cardiac index, although this effect appeared more pronounced for hydralazine (33% v 23%). Captopril reduced pulmonary capillary wedge pressure (-8 mm Hg, p less than 0.01) which decreased only slightly on hydralazine. 2 Long-term treatment was then started on the dose found effective during acute administration. Each drug was given for eight weeks. Exercise tolerance improved with both drugs, the increase during the hydralazine phase correlating with the increase in cardiac index at rest (r = 0.75; p less than 0.05). Clinical improvement appeared more definite on captopril than on hydralazine, however. This improvement was maintained during the captopril phase only in those patients who had a greater than 25% reduction in pulmonary capillary wedge pressure in the acute study.

Adult↗
PubMed1982

Antihypertensive therapy in patients above age 60 with systolic hypertension. A progress report of the European Working Party on High Blood Pressure in the Elderly (EWPHE).

1. Although systolic blood pressure elevation is responsible for increased incidence of cardiovascular accidents in old people, the preventive benefit of lowering systolic hypertension in elderly has not been confirmed. 2. A double blind study comparing the effects of a placebo and of an active regimen (hydrochlorothiazide-triamterene with or without methyldopa) in people over 60 years with isolated systolic hypertension has been undertaken by the European Working Party on High blood pressure in the Elderly (EWPHE). 3. The actively treated group shows a lowered sitting blood pressure (-15/6 mm Hg), a mild increase of serum creatine, serum uric acid and blood glucose and a mild decrease of serum potassium after two years of treatment when compared to the spontaneous changes observed in the placebo treated group. 4. The study is continuing to evaluate if the blood pressure reduction prevents or reduces the incidence of cardiovascular accidents, although some biochemical changes were provoked by the treatment.

Aged↗