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Biomedical subjects

E Reisin

Publications and source records attributed to E Reisin.

At least 55 records · Page 3Linked to original sources
PubMed1983

Cardiovascular changes after weight reduction in obesity hypertension.

Intravascular volumes and systemic and regional hemodynamic variables were measured before and after weight reduction in 12 patients with obesity and essential hypertension. These findings were compared with those in nine patients who did not have any weight loss. Reduction of mean arterial pressure significantly correlated with the fall in total body weight (r = 0.46, p less than 0.05). Total circulating and cardiopulmonary blood volumes were significantly reduced (p less than 0.05 and p less than 0.01, respectively), and these changes permitted a decreased venous return and cardiac output (p less than 0.01). This fall in cardiac output was directly related to a contracted total blood volume (r = 0.49, p less than 0.05) and decreased cardiopulmonary blood volume (r = 0.52, p less than 0.05). Patients who did not lose weight showed no changes in any of these hemodynamic measurements. In addition, weight loss was associated with reduced resting circulating levels of plasma norepinephrine (p less than 0.01), suggesting that diminished adrenergic function may also be related to weight reduction and its associated fall in arterial pressure.

Blood Pressure↗
PubMed1982

Effects of weight reduction on arterial pressure.

Obesity and hypertension are closely correlated. Weight loss obtained with hypocaloric diet and without reduced sodium intake affected a considerable fall in systolic and diastolic pressures in overweight hypertensive patients. This pressure-weight reduction was maintained for at least 12-18 months. The mechanism(s) for the pressure reduction may be explained by a decreased sympathetic activity associated with a reduced participation of the renin-angiotensin-aldosterone system, natriuresis, contracted plasma volume, and a reversal of the high cardiac output state.

Blood Pressure↗
PubMed1982

Hemodynamics, biochemical and reflexive changes produced by atenolol in hypertension.

Hemodynamic (systemic and regional), metabolic and cardiovascular reflexive variables were measured before and after 4 weeks of beta blockade with atenolol in 10 patients with mild essential hypertension. Atenolol reduced mean arterial pressure, heart rate, cardiac index (all p less than 0.005) and renal vascular resistance (p less than 0.01) and increased total peripheral resistance (p less than 0.005). Glomerular filtration rate and renal blood flow were unchanged; plasma renin activity fell 43%. Reflexive cardioacceleration during the Valsalva maneuver and upright passive tilt was blunted. No changes were observed in circulating fluid volumes. In six patients followed for 1 year, blood pressure and heart rate were maintained at levels similar to those during the first 4 weeks. Atenolol was shown to be an effective oral antihypertensive that has no apparent deleterious hemodynamic effects on the renal and splanchnic circulations.

Adrenergic beta-Antagonists↗
PubMed1982

Borderline hypertension and obesity: two prehypertensive states with elevated cardiac output.

Systemic, renal and splanchnic hemodynamics, intravascular volume, circulating catecholamine levels and plasma renin activity were compared in 39 patients with borderline hypertension and 28 normotensive subjects, who were less than 5% (n = 42, lean patients) or more than 40% overweight (n = 25, obese patients). Lean borderline hypertensive patients had greater cardiac output (p less than 0.05), heart rate (p less than 0.01) and renal blood flow (p less than 0.05); cardiopulmonary redistribution of intravascular volume (p less than 0.05); and higher circulating norepinephrine levels (p less than 0.05). Obese normotensive subjects also showed an increased cardiac output (p less than 0.005), stroke volume (p less than 0.01), left ventricular stroke work (p less than 0.05), and renal blood flow (p less than 0.05) (but not respective indexes), but intravascular volume was expanded (p less than 0.05) without redistribution and circulating catecholamine levels were normal. Obese borderline hypertensive patients had hemodynamic characteristics similar to those of obese normotensive subjects except for an increased peripheral resistance (p less than 0.05). The data indicate that although both populations have an increased cardiac output, the lean borderline hypertensive patients have signs of enhanced adrenergic activity as evidenced by higher circulating catecholamine levels and heart rate with blood volume translocation to the cardiopulmonary circulation. In contrast, the obese subjects (whether normotensive or borderline hypertensive), who also have increased cardiac output, seem to have normal adrenergic activity and an expanded intravascular volume without cardiopulmonary redistribution.

Adult↗
PubMed1981

Echocardiographic diastolic ventricular abnormality in hypertensive heart disease: atrial emptying index.

To analyze changes in left ventricular diastolic properties in hypertensive heart disease, the atrial emptying index was used to assess the rapid phase of diastolic filling of the left ventricle. Ten normal subjects (Group 1), 11 hypertensive patients without evidence of cardiac involvement (Group 2) and 10 hypertensive patients with echocardiographic evidence of left ventricular hypertrophy (Group 3) were compared using M mode echocardiography and systemic hemodynamic data. Whereas cardiac index (dye-dilution method) and rate of circumferential fiber shortening (echocardiogram) were normal in all three groups, there was a progressive increase in left atrial index (p less than 0.001, Group 1 versus Group 2 and versus Group 3) and a progressive decrease in the atrial emptying index (p less than 0.001, Group 1 versus Group 2 and versus Group 3). No correlation existed between the atrial emptying index and the left atrial index, mean arterial pressure or total peripheral resistance in any of the three groups. These data suggest that rapid filling of the left ventricle is reduced early in hypertension, even before electrocardiographic or systolic echocardiographic abnormalities are detectable. The atrial emptying index therefore appears to be an early indicator of abnormalities of left ventricular diastolic compliance in uncomplicated hypertension.

Adult↗
PubMed1981

Hypertension in the elderly: haemodynamic, fluid volume and endocrine findings.

1. Systemic and renal haemodynamics, intravascular volume, circulating catecholamines and plasma renin activity were measured in 18 patients with established essential hypertension who were older than 60 years of age. Each patient was matched with respect to mean arterial pressure, body surface area, race and sex with a patient that was younger than 42 years of age. 2. When compared with the younger group, elderly patients had a lower cardiac output, impaired myocardial reserve, lesser aortic elasticity, higher total peripheral resistance, more contracted intravascular volume and higher circulating noradrenaline levels. 3. Similar effects of age, although less pronounced, have been reported in normotensive subjects. We conclude that essential hypertension is a pathophysiological process that seems to accelerate the natural physiological haemodynamic, fluid volume and endocrine processes of aging.

Adult↗
PubMed1981

Borderline hypertension: relationship between age, hemodynamics and circulating catecholamines.

The relationships between age, systemic and renal hemodynamics, circulating catecholamines (norepinephrine, epinephrine and dopamine) and intravascular volumes were studied in 38 normotensive subjects and in 77 patients with borderline essential hypertension. Borderline hypertensive patients had a higher cardiac index (p less than 0.02) and renal blood flow (p less than 0.05) than normotensive subjects if they were younger than 30 years of age, whereas in older patients no difference was observed. In contrast, total peripheral resistance was normal in young borderline hypertensive patients, but significantly increased (p less than 0.02) in patients older than age 40 years. Cardiac output (r = -0.28, p less than 0.01) and renal blood flow (r = -0.47, p less than 0.001) correlated inversely with age in the entire population and in both subgroups. Cardiac output also correlated closely with renal blood flow in all subjects (r = 0.45, p less than 0.001). Circulating norepinephrine levels increased with age (r = 0.25, p less than 0.05), whereas epinephrine concentration tended to decrease. Plasma and total blood volume correlated directly with cardiac output (r = 0.39, p less than 0.001) and inversely with peripheral resistance (r = -0.34, p less than 0.001). These data indicate that the hyperdynamic circulation (high cardiac output and renal blood flow) of borderline hypertension is found predominantly in patients younger than age 30 years. Older patients are characterized by an elevated total peripheral resistance and normal cardiac output. The age-dependent increase in circulating norepinephrine and decrease in epinephrine levels may participate in the shift of the hemodynamic profile from high-cardiac-output hypertension in the young to a high-arteriolar-resistance hypertension in the older patient.

Adolescent↗
PubMed1980

Haemodynamic changes associated with obesity and high blood pressure in rats with ventromedial hypothalamic lesions.

1. The haemodynamic and plasma volume changes associated with obesity and high blood pressure were studied in nine male rats with electrolytic ventromedial hypothalamic lesions and their paired sham-operated controls. Body weight and arterial pressure were greater in the rats with ventromedial hypothalamic lesions (565 +/- 16 vs 462 +/- 14 g, P < 0.001; 128 +/- 3 vs 118 +/- 3 mmHg, P < 0.05, respectively). Cardiac output was slightly elevated, and that portion of cardiac output distributed to the kidneys was reduced (P < 0.001). Plasma volume was contracted in the rats with ventromedial hypothalamic lesions (21.0 +/- 0.1 vs 2.8 +/- 0.1 ml/100 g, P < 0.001). 2. The haemodynamic characteristics of rats in which obesity and mild hypertension have been induced by electrolytic ventromedial hypothalamic lesion are similar to mild obesity essential hypertension in men.

Animals↗
PubMed1980

Exercise tolerance in patients on chronic hemodialysis.

Twenty-two patients on chronic hemodialysis were tested on a bicycle ergometer to determine their near-maximal physical work capacity. The patients were found to have low physical work capacity that averaged 51.6 +/- 3.8 (SE)% predialysis and 50.3 +/- 3.7% postdialysis, when compared with the physical work capacity of healthy control subjects. The exercise was stopped when patients complained of muscular fatigue, and the work load at this point was considered their subjective maximal work capacity. At this stage the patients had high blood lactic acid levels and an increased double product (systolic blood pressure x heart rate), the latter indicating a high stage of cardiac output. The oxygen consumption and oxygen pulse were similar to those obtained from control individuals at the same work load. This study suggests that limited physical work capacity of chronic hemodialysis patients is due to early muscular fatigue. This phenomenon is associated with the rapid onset of anaerobic metabolism and may thus be caused by limited maximal oxygen uptake.

Adult↗
PubMed1978

Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients.

Overweight patients with uncomplicated essential hypertension were followed up biweekly for six months: 24 not receiving antihypertensive-drug therapy (Group I) and 83 on regular but inadequate (despite drug manipulation) antihypertensive-drug therapy (Group II). All patients in Group I and 57 randomly selected patients from group II (IIa) participated in a weight-reduction program. The remaining 26 from Group II (IIb) did not receive a dietary program. Salt intake was in the normal range in all three groups. All patients on the dietary program lost at least 3 kg (mean, 10.5 kg), and all but two showed a meaningful reduction in blood pressure; 75 per cent of Group I and 61 per cent of Group IIa returned to normal blood pressure. The weight and blood-pressure reductions were highly significant (P less than 0.001), were present in both sexes and all ages, and were directly associated. In Group IIb, no significant change in blood pressure or weight occurred (P greater than 0.30).

Adult↗
PubMed1978

Acid-activated renin responses to hydrochlorothiazide, propranol and indomethacin.

1. Six essential hypertensive patients (five with low renin) were treated in successive weeks with placebo; hydrochlorothiazide 100 mg (382 micromol)/day; hydrochlorothiazide and 50 mmol of sodium/day diet; hydrochlorothiazide, 50 mmol of sodium diet and propranolol 160 mg (544 micromol)/day; and hydrochlorothiazide, 50 mmol of sodium and indomethacin 100 mg (287 micromol)/day. 2. Although blood pressure remained unchanged and serum potassium fell on diuretic with or without low salt, there was a marked increase of active renin and a lesser increase of inactive renin, resulting in an increased proportion of active to total renin. 3. Propranolol decreased both active and inactive renin, but not significantly. 4. Indomethacin produced a marked suppression of active renin, a smaller reduction in inactive renin, and a reduction of the ratio of active to total renin almost to placebo values. 5. Blood pressure rose to control values on indomethacin despite the fall in renin whereas it fell with propranolol with little change in renin. 6. Serum aldosterone rose with stimulation but remained elevated despite effective renin suppression with indomethacin and continuing reduced serum potassium concentration.

Adult↗
PubMed1978

Propranolol for the treatment of hypertension in pregnancy.

Twenty-five women were treated with propranolol during 26 pregnancies complicated by hypertension. The fetal wastage, which had been 48 per cent before treatment with propranolol was reduced to 15.4 per cent, with one missed abortion and three stillbirths. Of the 22 liveborn infants 2 were small-for-dates but all 22 had Apgar scores of 9 or 10 at five minutes. There were no congenital anomalies in 25 viable infants and none of the 22 liveborn infants had clinical or laboratory evidence of hypoglycaemia. The blood pressure was controlled in 17 of 19 patients taking propranolol alone (40 to 160 mg/day) and in 6 of 7 taking propranolol with diuretics.

Adult↗
PubMed1978

Reproducibility of plasma renin activity (PRA) profile in essential hypertension patients.

Whether the same patient with essential hypertension (EH) has the same PRA profile at different occasions, is still uncertain. The validity of the classification of these patients into low or normal renin hypertension depends upon the reproducibility of this profile. A nomogram based on PRA and 24 hr urine sodium in normals, was constructed by computing the regression line with its tolerance limits of not less than 95%. In 30 patients with EH, the PRA and 24 hr urine sodium were determined in 2 separate occasions. Classification of patients showed a change of 30% when PRA was taken during at least 2 hours recumbency. However, when PRA following ambulation is considered, the change appeared only in 6/30 (20%). This change was not large. Thus good reproducibility of PRA is obtained on post-ambulation PRA and changes larger than the 95% tolerance limits, are considered.

Humans↗
PubMed1977

Cholestyramine in uraemic pruritus.

In a patient with longstanding severe uraemic pruritus who was undergoing chronic haemodialysis cholestyramine caused the pruritus to disappear completely within a few days. A four-week randomised controlled double-blind study was therefore performed in 10 other patients with uraemic pruritus who were on chronic haemodialysis. The pruritus improved considerably in four of the five treated patients, whereas only one of those treated with placebo experienced relief. The patient who had no relief while on cholestyramine showed a considerable improvement when the dose subsequently doubled. One of the five patients receiving cholestyramine experienced mild and easily reversible constipation, and another suffered nausea. Neither of these complications prevented the patients from continuing treatment. Cholestyramine seems to be useful in treating uraemic pruritus, although it is not known how it acts.

Cholestyramine Resin↗
PubMed1977

Two methods for determination of renin secretion rates in rats.

1. Renin secretion rates in normal rats were determined with two different methods: (a) the product of renal plasma flow as measured by sodium p-aminohippurate and the difference between renal and peripheral vein renin activity; (b) the product of this latter difference and the renal plasma flow as calculated from the clearance and extraction of inulin. 2. The renin secretion rates, as calculated by these two methods, were not significantly different (P greater than 0-1) and were found to be highly correlated (r = 0-943; P less than 0-001).

Animals↗
PubMed1977

Probability of survival in hypertensive and nonhypertensive patients on maintenance hemodialysis.

The actuarial survival rate for 58 unselected patients who entered a program of maintenance hemodialysis and transplantation was found to be 43.0 +/- 8.3 (SE)% for the six-year period of observation. The survival rate was considerably lower in hypertensive patients as well as in patients with familial Mediterranean fever with amyloidosis, all of whom were nonhypertensive. When the patients with familial Mediterranean fever were excluded from the non-hypertensive group, the expected survival rate of this group became greater than that of the hypertensive group, the difference being about 25% in five years and about 50% in six years. This difference in the survival rate approaches that between normotensive subjects and untreated severely hypertensive patients in the general population. It is concluded that hypertension is a serious limiting factor in the survival of patients on chronic hemodialysis, and that the difference in survival between the hypertensive and the non-hypertensive patients is attributable to hypertension.

Adolescent↗