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Biomedical subjects

G Berglund

Publications and source records attributed to G Berglund.

At least 199 records · Page 11Linked to original sources
PubMed1987

Incidence and prevalence of juvenile chronic arthritis: a population survey.

In a population based epidemiological survey of juvenile chronic arthritis (JCA), performed in Western Sweden in 1983, an incidence of 12/100,000 was found. The estimated prevalence was 56/100,000. Subgroup distribution showed a preponderance of mono- and pauciarticular forms. The peak age of onset was between 0 and 4 years of age. Girls predominated over boys in a ratio of 3:2. Overall, 30% were antinuclear antibody (ANA) positive, 9% rheumatoid factor (RF) positive, and eye involvement occurred in 10% of the children. The results suggest differences in population based studies of JCA compared with previously reported hospital based series.

Adolescent↗
PubMed1987

The relationship between obesity-related metabolic factors and vascular changes in early hypertension.

The relationships of obesity, glucose metabolism and hormonal variables to mean arterial pressure (MAP) regional vascular resistance and signs of structural vascular changes, were determined in 70 men aged 49 years with normal to mildly elevated MAP randomly selected from a population sample. Regional vascular resistances and signs of structural vascular changes were measured in the calf by plethysmography at rest and during maximal dilatation, and in the kidneys by renal blood flow determination during graded subpressor doses of angiotensin II. MAP was positively correlated to body fat, waist circumference, fat cell size, and to blood glucose 60 minutes after an oral load. This supports an association between central obesity, impairment of glucose tolerance and hypertension. MAP was, however, unrelated to sodium intake, blood volume and indices of sympathetic nervous activity and the renin-angiotensin system. Resting vascular resistance in the calf was unrelated to MAP, while renal vascular resistance rose significantly with increasing MAP. Signs of structural change were significantly correlated to MAP in both these vascular areas. These signs were also associated with central obesity of the hypertrophic type and with impairment of glucose tolerance, even when the association to MAP was accounted for. These factors may be involved in the pathogenesis of the structural adaptation of resistance vessels as hypertension develops.

Blood Glucose↗
PubMed1987

Angina pectoris, intermittent claudication and congestive heart failure in middle-aged male hypertensives. Development and predictive factors during long-term antihypertensive care. The Primary Preventive Trial, Göteborg, Sweden.

A group of middle-aged male hypertensives, derived from a random sample of a Swedish urban population, has been treated and followed for 10 years. The development of angina pectoris, intermittent claudication and congestive heart failure have been analysed. The initial prevalence and the average yearly incidence of angina pectoris was 3.9% and 1.3% p.a., of intermittent claudication 1.7% and 0.6% p.a. and of heart failure 1.0% and 0.8% p.a. ECG signs indicating subclinical heart disease (major Q wave, ST depression, T wave inversion) were risk factors for development of angina pectoris and congestive heart failure. Heart enlargement on chest X-ray was also a risk factor for development of congestive heart failure, as were a high serum creatinine, body mass index, serum uric acid and proteinuria. Smoking was found to be a strong and independent risk factor for any one of these cardiovascular disorders. After 10 years about one fourth of all patients, still attending the clinic, had at least one cardiovascular complication. Hence, the risk of developing cardiovascular disorders is substantial and seems to be potentiated by the same risk factors known to operate in the general population.

Actuarial Analysis↗
PubMed1986

Antihypertensive treatment with metoprolol or hydrochlorothiazide in patients aged 60 to 75 years. Report from a double-blind international multicenter study.

In a randomized double-blind study (N = 562), a traditional treatment schedule, starting antihypertensive treatment in elderly hypertensive patients (60 to 75 years old) with 25 mg of hydrochlorothiazide once daily and doubling the dose if a satisfactory response was not achieved, was compared with antihypertensive treatment of 100 mg of metoprolol once daily, adding 12.5 mg of hydrochlorothiazide for patients whose response was not satisfactorialy achieved with metoprolol alone. Systolic and diastolic blood pressure was significantly reduced with both regimens. The frequency rates of responders (diastolic blood pressure, less than or equal to 95 mm Hg) in the metoprolol group and the hydrochlorothiazide group were 50% and 47% after four weeks and 65% and 61% after eight weeks, respectively. There were no significant differences in total symptom score or single symptoms between the regimens, but significantly more patients had hypokalemia and hyperuricemia with the hydrochlorothiazide regimen. Thus, we conclude that beginning antihypertensive treatment with 100 mg of metoprolol once daily and adding a small dose of hydrochlorothiazide (12.5 mg) in patients whose response is not satisfactory with metoprolol alone appears to be effective and safe in elderly hypertensive patients.

Aged↗
PubMed1986

QRS-amplitudes during antihypertensive treatment: a comparison between beta-blocker and thiazide diuretic regimens.

QRS-amplitudes and other ECG variables have been studied in 168 middle-aged men with uncomplicated, mild-to-moderate untreated primary hypertension. They were randomized to treatment with either the beta-adrenoceptor blocker metoprolol (n = 88) or the thiazide diuretic hydrochlorothiazide (n = 80). Significant reductions in combined precordial voltages (S1 + R5-6, S2 + R4, Smax + Rmax) were achieved on both regimens, probably reflecting a regression of hypertensive cardiac involvement. In the group treated with beta-blockers the reduction in all three combined voltage measurements was significant after one year's treatment. A longer period of treatment seemed to be necessary to achieve equal reductions with hydrochlorothiazide although a non-significant reduction was observed after the first year of follow-up in this group. A small increase in 1st degree AV-block was observed on both regimens, but no 2nd degree or total AV-block was recorded.

Adult↗
PubMed1986

The multifactor primary prevention trial in Göteborg, Sweden.

The effect of a multifactorial intervention programme on coronary heart disease (CHD), stroke incidence and total mortality was determined in a random sample of men, 47-55 years old at entry. The intervention group comprised 10 004 men, and the two control groups were of similar size. The intervention consisted of antihypertensive treatment in subjects with screening blood pressure above 175 mmHg systolic or 115 mmHg diastolic, dietary advice to men with serum cholesterol levels above 260 mg per 100 ml (= 6.8 mMol l-1), advice to stop smoking to subjects who smoked more than 15 cigarettes per day. The intervention was applied for 10 years during which time CHD and stroke incidence and mortality were followed by means of special registers. Participation rate at first screening examination was 75%. The risk factor levels, i.e. blood pressure, serum cholesterol and smoking decreased markedly during 10 years in the intervention group, but also among the control groups. Total mortality, stroke and CHD incidence did not differ significantly between the intervention group and any of the two control groups. We conclude that a decrease has taken place in all three major risk factors for CHD in the general male population in Göteborg, Sweden. Strategies other than intervention on high-risk individuals must be chosen if a major impact on disease incidence is to be achieved in the general population.

Aged↗
PubMed1986

Central haemodynamics, baroreceptor sensitivity and alpha 1-adrenoceptor-mediated vascular reactivity during weight-stable sodium restriction in obese men with hypertension.

Ten obese men (20-40% overweight) with previously untreated arterial hypertension (WHO stages I and II) were examined before and during sodium-restricted isocaloric diets. The mean (+/- s.d.) daily sodium excretion was reduced from 199 +/- 65 to +/- 25 mmol/24 h. Intra-arterial blood pressure (BP), cardiac output (CO), plasma volume, circulating and urinary noradrenaline (NA), plasma renin activity (PRA) and urinary aldosterone were measured. Vascular reactivity was assessed with intravenous bolus injections of 50, 100 and 200 micrograms phenylephrine, and baroreflex sensitivity was assessed with the R-R interval response to pressure elevations on electrocardiogram. Significant reductions in systolic BP from 163 +/- 18 to 147 +/- 17 mmHg and in diastolic BP from 97 +/- 7 to 88 +/- 9 mmHg occurred during salt restriction. Blood pressure reductions were correlated with changes of urinary sodium excretion (r = 0.71; P less than 0.05). No significant changes in CO, heart rate (HR) or stroke volume (SV) were observed; therefore, BP reduction was secondary to the fall in total peripheral resistance (TPR) from 21.8 +/- 4.1 to 19.0 +/- 4.1 units (P = 0.05). Plasma volume, as well as total blood volume, was not affected by the moderate sodium restriction, but PRA rose from 0.71 +/- 0.1 to 0.87 +/- 0.1 micrograms angiotensin 1/ml per h (P less than 0.05). Urinary aldosterone was increased from 32 +/- 12 to 54 +/- 9 nmol/24 h. No change in venous or arterial concentrations of NA or of urinary NA was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Double-blind comparison of the cardioselective beta-blockers bisoprolol and atenolol in hypertension: the Bisoprolol International Multicenter Study (BIMS).

The antihypertensive efficacy and tolerability of bisoprolol and atenolol were compared in the Bisoprolol International Multicenter Study (BIMS). In 104 patients with essential hypertension (21 to 70 years of age and diastolic blood pressures (DBP) of 100-120 mm Hg in the sitting position), after a four-week placebo period, the active drug was given in a random double-blind crossover design (10 to 20 mg bisoprolol, 50 to 100 mg atenolol) for eight weeks each, with a 2 to 6 week placebo wash-out phase between active therapy. All blood pressures were recorded 24 h after drug intake. Of the 104 patients, 10 were withdrawn during the study because of unwanted effects, unsatisfactory blood pressure response, or intercurrent disease, leaving 94 for intraindividual comparisons. After 8 weeks active treatment with individually titrated dose, there were slightly, but significantly greater falls in blood pressure with bisoprolol (p less than or equal to 0.05). Diastolic target pressures of less than or equal to 95 mm Hg were reached in 68% with bisoprolol and 56% with atenolol (p less than or equal to 0.05; Mc Nemar). There was no between treatment group difference in the patients' self-assessed well-being. For both drugs, response rates were greater in patients below the age of 60 years than in those above 60 years. Better antihypertensive responses were observed with bisoprolol in patients regularly smoking cigarettes.

Adrenergic beta-Antagonists↗
PubMed1986

Low-dose antihypertensive treatment with a thiazide diuretic is not diabetogenic. A 10-year controlled trial with bendroflumethiazide.

Blood pressure (BP) and metabolic variables were determined initially and after 1, 2, 4, 6 and 10 years' treatment in two groups of hypertensive men (n = 53 each) randomized to bendroflumethiazide 2.5-5 mg/day or propranolol 160-320 mg daily. There was no significant differences in BP or metabolic variables between the two groups at entry. BP was reduced to the same degree by both treatments. Five men in the propranolol group and one man in the thiazide group developed clinically overt diabetes during follow-up. Fasting blood sugar increased slightly but significantly though equally in both groups. Oral glucose tolerance was initially impaired to the same degree in both groups but improved significantly during treatment with both drugs. Fasting insulin increased slightly but to the same degree. While serum potassium decreased significantly in the thiazide group, the total body potassium was unchanged in this group. In the propranolol group, serum potassium rose, while total body potassium decreased significantly. Serum urate increased in both groups, though slightly more during thiazide treatment. One case of gout was found in each group. There was no difference in serum lipids between the two groups. The finding in this long-term trial indicate that in middle-aged men with mild to moderate hypertension a low-dose thiazide diuretic like bendroflumethiazide is as effective and safe an antihypertensive agent as the beta-blocker propranolol is and that it does not induce diabetes. The total clinical picture favors the retention of thiazide diuretics as a first choice drug in hypertension.

Bendroflumethiazide↗
PubMed1986

The Skaraborg hypertension project. I. The prevalence of hypertension.

The prevalence of hypertension in the age group 40-69 in the County of Skaraborg, Sweden (265000 inhabitants) was estimated using diagnostic criteria commonly accepted in Sweden in recent years. The prevalence was higher than expected (16%) and most of the patients (80%) were previously identified and undergoing treatment. The quantitative aspect of hypertension was even more impressive in the ages above 69 years. Eighteen per cent of the men and 33% of the women aged 75 years were on antihypertensive medication. An unexpectedly large proportion of the population had a borderline pressure requiring further follow-up (16%). It is concluded that quantitative aspects must be taken into consideration when planning hypertension care and deciding diagnostic criteria.

Adult↗
PubMed1986

Cellular sodium turnover in obese hypertensive men.

Seventeen moderately obese middle-aged male outpatients with untreated mild hypertension (OH) and 47 normotensive men with normal weight (C) were investigated with respect to intraerythrocyte electrolytes, transmembrane sodium fluxes, PRA and urinary excretion of aldosterone (U-ALDO). There was no difference between the groups in intraerythrocyte sodium but red cell potassium was significantly elevated in OH compared to C. Sodium influx and the rate constant for sodium efflux were also significantly higher in OH. There was a significant positive correlation between sodium influx and U-ALDO (r = 0.56, p less than 0.05).

Adult↗
PubMed1986

The Multifactor Primary Prevention Trial in Göteborg, Sweden. Comparison with a previously untreated population sample.

All male inhabitants of the city of Göteborg, who were born between 1915-1922 and 1924-1925 were included in the trial, and were 47 to 55 years of age on entry to the study in 1970 to 1973. One-third of these men were randomly allocated to an intervention group, whilst the other two-thirds acted as controls. Men of all social classes, employed as well as unemployed, health conscious as well as careless, were invited, with 75% of these responding to the invitation. The intervention group contained 10,000 men and the control group 20,000 men. The intervention group were given advice on diet, both individually and in groups, the type of advice depending upon serum cholesterol level. Smokers were advised to stop smoking, and men with elevated blood pressure were treated with antihypertensive drugs. Due to the large size of the groups and because they formed a random population sample, it was assumed that they had similar characteristics at the start of the trial. Risk factors were only measured in the intervention group at this time, followed by intervention. This design feature solved several ethical problems with regard to no treatment in the control group. These men were, however, subjected to health examinations and treatment as well as general health advice. Risk factor levels were measured in the intervention group, and also in random subsamples (11%) of the control group after 4 and 10 years. Serum cholesterol, blood pressure and smoking decreased among men in both groups, and only slightly more in the intervention group.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebrovascular Disorders↗
PubMed1986

Regional haemodynamics and antihypertensive effects during long-term ketanserin treatment.

The serotonin (S2) antagonist, ketanserin was given to 16 patients with essential hypertension on a single-blind basis. Ten patients were treated for 3 years with ketanserin 40-80 mg daily on a once or twice daily regimen. In this group supine blood pressure fell from 164 +/- 4/101 +/- 2 mmHg on placebo to 152 +/- 5/91 +/- 3 mmHg (NS/P less than 0.01) after 3 years of therapy. During treatment, total serum cholesterol remained essentially unchanged while serum triglycerides were significantly reduced. No side-effects were seen except for dry mouth or slight nasal congestion reported by two patients. In six patients regional haemodynamics were assessed by forearm plethysmography. After 3 months of ketanserin, resting vascular resistance was significantly reduced from 58.3 +/- 12 units on single-blind placebo to 47.0 +/- 12 units (P less than 0.005) on single-blind ketanserin, 40 mg twice daily. We conclude that ketanserin is an effective antihypertensive agent during long-term therapy with some beneficial effects on serum lipids. The antihypertensive effect seems to be mediated chiefly by a decrease in vascular resistance.

Female↗
PubMed1986

The Skaraborg hypertension project. III. Influence on blood pressure of a medical care program for hypertension.

Aiming at a better control of hypertension, a medical care program including nurse-run outpatient hypertension clinics was implemented in one half of the County of Skaraborg (265000 inhabitants), the other half forming a control area. The program was evaluated during a 5-year trial. Among patients registered and followed up for a minimum of one year (n = 2806), systolic and diastolic blood pressure decreased significantly, regardless of the patients' status of treatment prior to admission to the clinics. A baseline and a terminal population study revealed an increasing effectiveness in the treatment of hypertension in the study area. A consistent difference (mean 8/5 mmHg) was found in average blood pressure between patients treated at the hypertension clinics and patients treated in regular care. It is concluded that the medical care program increased the effectiveness of care and that this was due to the program organization.

Adult↗
PubMed1986

The Skaraborg hypertension project. II. Feasibility of a medical care program for hypertension.

The feasibility of a nurse-based care program for hypertension has been evaluated. The program was established in one half of the County of Skaraborg, the other half being selected as control area. Record forms from the diagnostic work-up and annual check-ups of all 3240 patients registered during five years were reviewed. Compliance with diagnostic procedures and treatment was excellent. At the end of the five-year trial period, 7% of the population studied (40-69 years old) were registered at special outpatient hypertension clinics. Random samples were drawn of patients treated at these clinics and patients taken care of in the control area. These patients were interviewed concerning their general opinion about the care, their opinion about nurses as the main deliverers of care, the continuity of care and needs for information. The comparisons favoured care at the hypertension clinics. It is concluded that the program was feasible and preferred to conventional care by the consumers.

Adult↗