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Biomedical subjects

G Berglund

Publications and source records attributed to G Berglund.

At least 235 records · Page 13Linked to original sources
PubMed1984

Acute and subacute haemodynamic effects of enalapril. Non-invasive studies of a new converting enzyme inhibitor for antihypertensive treatment.

After a run-in period on placebo, 15 patients with primary hypertension got antihypertensive treatment with enalapril in single therapy during six weeks. Before and four hours after drug administration simultaneous non-invasive recordings of ECG, phonocardiogram and carotid pulse tracing or apexcardiogram or impedance cardiogram were made. After six weeks' therapy the recordings were repeated 12 hours and four hours after dose intake. The results showed enalapril to be a potent antihypertensive agent with considerable effect already four hours after the first dose intake. The blood pressure reduction was explained by a decrease in total peripheral resistance, semiquantitatively measured with impedance cardiography. Cardiac output was significantly higher during long-term treatment than before therapy started, due to a significant increase in stroke volume. Lef ventricular (LV) diastolic function was not altered but a considerable improvement in LV systolic function was achieved as judged from the systolic time intervals. Open questioning regarding side effects indicated good tolerance.

Aged↗
PubMed1984

Heart and kidney involvement during antihypertensive treatment. Results from the primary preventive trial in Göteborg, Sweden.

The prevalence of signs of heart (Minnesota-coded ECG, chest X-ray) and kidney involvement (proteinuria, abnormal serum creatinine) was studied before and after 5 years' antihypertensive treatment in 686 middle-aged, hypertensive men derived from a screening examination of a random population sample. The prevalences of heart enlargement (X-ray) and abnormally high serum creatinine increased. A pronounced regression of S-T and T wave changes in the ECG was achieved. In a subgroup of 375 patients without digitalis therapy and not having had myocardial infarction, ECG signs of left ventricular hypertrophy decreased.

Antihypertensive Agents↗
PubMed1983

Cardiovascular response to exercise and regional haemodynamics during treatment with prizidilol hydrochloride (SK & F 92 657) in moderately severe essential hypertension.

Fourteen men with moderately severe essential hypertension were treated with prizidilol hydrochloride 400-700 mg once daily (mean +/- S.D. 612 +/- 56 mg/day). The study was open and ambulatory, with an initial placebo period followed by dose titration of prizidilol. Prior to treatment and during optimal control of blood pressure cardiovascular adaptation was examined in a submaximal exercise test. Plethysomographic assessment of vascular flow, resistance and tone in the calf musculature during supine rest and during maximal vasodilatation was also performed. A highly significant reduction in systolic (from 164 +/- 4.5 to 141 +/- 2.7 mmHg; p less than 0.001) and diastolic blood pressure (from 105 +/- 1.6 to 87 +/- 1.3 mmHg; p less than 0.001) at supine rest was noted during therapy with prizidilol. There was no significant change in heart rate. Systolic pressure in the standing position was reduced (from 159 +/- 4.2 to 139 +/- 2.9 mmHg; p less than 0.001) and so was the diastolic pressure (from 111 +/- 2.5 to 95 +/- 1.9 mmHg; p less than 0.001). The heart rate in the standing position was significantly increased compared to supine rest in the placebo period and during optimal treatment with prizidilol. The beta-adrenoceptor blocking properties of prizidilol were apparent as a reduction in the exercise-induced heart rate response at even the lowest work load. During prizidilol therapy an increase in resting calf muscle blood flow was found from 3.1 +/- 1.5 ml/min X 100 ml to 4.3 +/- 2.1 ml/min X 100 ml (p less than 0.025). Vascular resistance and vascular tone were significantly reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Ketanserin in essential hypertension: effects during rest and exercise.

Ketanserin is a new, specific serotonin receptor blocking agent, which causes vasodilatation, presumably by an action on the vascular wall. The antihypertensive response to ketanserin 40 mg twice daily as monotherapy was assessed in 8 patients with essential hypertension. The investigation was an 8 week, double-blind, cross over study, which also included measurements during isometric (handgrip) and dynamic exercise (bicycle ergometry), as well as determination of plasma catecholamines and ketanserin. Ketanserin caused a reduction of supine and standing systolic and diastolic blood pressure (BP) during rest and a slight bradycardia. Although there was attenuation of the pressor response to handgrip, treatment with ketanserin did not really affect the changes in BP or heart rate during exercise, i.e. the base-line differences remained the same. There was no significant correlation between the effect on BP and the plasma level of ketanserin. The changes in BP produced by ketanserin showed little correlation with the initial levels of plasma catecholamines or with alterations in those levels. Although the results did not indicate direct interference by ketanserin with sympathetic tone, the lack of reflexogenic tachycardia, as well as the lack of increase in plasma noradrenaline during hand grip, indicates at least some modulation of autonomic function. It is concluded that ketanserin lowers BP in essential hypertension without interference with cardiovascular reflexes during standing or exercise, and that the compound may offer an alternative approach in the treatment of hypertension.

Antihypertensive Agents↗
PubMed1983

Incidence and importance of metabolic side-effects during antihypertensive therapy.

Three long-term, randomised trials examining antihypertensive treatment with either diuretics or beta-blockers are in progress. On the basis of these, the following conclusions may be drawn regarding metabolic side-effects. Diuretics decrease whereas beta-blockers increase serum potassium. Neither drug has any obvious influence on total body potassium. Serum urate increases on both drugs but more so in those taking diuretics. Serum triglycerides increase while total serum cholesterol is unchanged in both treatments. It is still a matter of controversy whether there is a decrease in glucose tolerance and an increase in the incidence of diabetes in patients on diuretics. The possible negative influence of metabolic side-effects on morbidity and mortality may limit the beneficial effects of blood pressure reduction, especially in patients with low pressures before treatment. Thus, it seems crucial to minimise theses side-effects. Since they are dose-related for both diuretics and beta-blockers, the use of low doses and, if needed, combination treatment is preferable.

Adrenergic beta-Antagonists↗
PubMed1983

The relation between cardiac hypertrophy and hypertension.

Left ventricular mass determined echocardiographically was related to blood pressure in a stratified random sample (n = 120) of 49-year-old men selected from a blood pressure screening and covering a wide range of blood pressures. Only subjects not on antihypertensive treatment were studied. Left ventricular mass was also related to sympathetic activity, the renin-angiotensin-aldosterone system and glucose metabolism. A poor correlation between left ventricular mass and blood pressure was found in the entire study group. In the upper blood pressure range only blood pressure during isometric exercise was significantly correlated with left ventricular mass. In this range there were significant correlations between left ventricular mass and 24 hour urinary noradrenaline excretion and plasma aldosterone. In the intermediate blood pressure range there was an association between left ventricular mass and blood glucose and plasma insulin. It is concluded that in mild to moderate hypertension other factors probably modify the hypertrophic response to rising arterial pressure.

Aldosterone↗
PubMed1983

The role of salt in hypertension.

Epidemiological data indicate a weak but significant positive correlation between the level of salt intake and blood pressure. It is unclear how this relationship is mediated but some studies indicate that heredity for hypertension is associated with an increased sensitivity to salt. Decrease of the salt intake decreases blood pressure in established hypertension and should be used as a therapeutic adjuvant in mild uncomplicated hypertension much more often than is now the case. Increased salt intake in young subjects with or without heredity for hypertension does not seem to increase the blood pressure during a 4-12 week load. Increased salt intake in middle-aged men, on the other hand, seem to induce a blood pressure increase irrespective of the presence or absence of a positive family history. The sensitivity to a high salt intake might thus be associated with aging. Increase of the salt intake from the normal level seems to induce an increase in sympathetic nervous activity. The interplay between the level of salt intake and sympathetic nervous activity should be studied in more detail.

Aging↗
PubMed1983

Changes in intraerythrocyte content and transmembrane fluxes of sodium during salt loading in subjects with and without family history of hypertension.

We studied 17 young normotensive men with family history of hypertension (H) in two generations (father and grandfather) and 17 age matched control subjects (C) with respect to intraerythrocyte sodium (IeNa), sodium influx, and rate of sodium efflux. The investigation was done during ordinary salt intake and after four week's salt load. H had a significantly higher IeNa (9.5 +/- 0.4 mmol/l) compared to C (8.2 +/- 0.3 mmol/l), p less than 0.01. After salt loading H decreased significantly to 8.1 +/- 0.3 mmol/l while C did not change significantly (7.6 +/- 0.3 mmol/l). There was no significant difference between H and C in Na influx either on normal or on high salt intake. The rate constant for Na efflux was significantly lower on normal salt intake in H (0.0038 +/- 0.0003 vs 0.0050 +/- 0.0004 min-1, p less than 0.05). High salt intake increased the efflux rate constant significantly in H (0.0048 +/- 0.0003 min-1, p less than 0.05), while control subjects showed no difference (0.0053 +/- 0.0004 min-1) compared to pre-salt conditions. Our results suggest that young men with heredity for hypertension have a higher intraerythrocyte Na-content secondary to a lower rate of Na efflux. The Na influx did not differ between the two groups probably indicating an unchanged permeability for sodium in subjects with a family history of hypertension.

Cell Membrane Permeability↗
PubMed1983

Ketanserin, a novel 5-hydroxytryptamine antagonist: monotherapy in essential hypertension.

Blood pressure and heart rate, supine and standing, were studied in patients with essential hypertension during 8 weeks of oral therapy with two dosage schedules of ketanserin, 40 mg once and twice daily. Ketanserin caused significant reductions in both supine and standing blood pressure but no significant alterations in heart rate in both groups of patients. Measurements of blood pressure and heart rate over a 24 h period during steady state conditions revealed that maximal blood pressure reduction was correlated with time to peak plasma concentrations. Steady state plasma concentrations of ketanserin were significantly higher in the patients receiving 40 mg twice daily compared to 40 mg once daily. In the group with once daily treatment, tmax was 1.2 +/- 0.17 h, Css 13 +/- 4.3 ng/ml, Cmax 137 +/- 19.6 ng/ml and t1/2, z h. 9.6 +/- 1.27 h.

Adult↗
PubMed1983

Renal denervation and sodium balance in young spontaneously hypertensive rats.

In 7-week-old male, spontaneously hypertensive rats (SHR) and matched normotensive control rats, Wistar Kyoto Rats (WKY), a bilateral renal denervation was performed. In two additional groups of rats a sham denervation was done (SHRS, WKYS). The animals were then kept in metabolic cages during a 10-day period during which sodium intake, urine volume, urinary sodium excretion, fecal sodium excretion, urinary aldosterone excretion and plasma renin activity were determined. Fractional urinary excretion of sodium was higher in the denervated SHR (p less than 0.1) and WKY (p less than 0.05) during the first 3 days after denervation, but during the following 3-day periods no difference between denervated and sham-operated groups was noted. The difference in fractional urinary excretion of sodium initially was due to a diminished urinary sodium excretion in the sham-operated groups since both SHRS and WKYS exhibited a significant increase between the first and the last 3-day period. Urine volume increased significantly in both SHR and WKY after denervation. Urinary aldosterone excretion on the 7th day after denervation was significantly lower in SHR compared to WKY, but there was no significant difference between the denervated and sham-operated groups. PRA was also significantly lower in SHR but no significant decrease was seen after denervation.

Aldosterone↗
PubMed1983

Left ventricular mass in middle-aged men. Relationship to blood pressure, sympathetic nervous activity, hormonal and metabolic factors.

Left ventricular (LV) mass was studied echocardiographically in 120 middle-aged men representing a wide range of blood pressures (BP) and its relation to the following factors was analysed: BP measured in different resting situations and during isometric exercise, 24 hour urinary noradrenaline excretion and plasma noradrenaline, plasma renin activity, plasma angiotensin II, plasma aldosterone, blood glucose and plasma insulin. Each BP measurement showed weak but significant correlation with LV mass in the entire study group. In the upper BP range only BP measured during isometric exercise was correlated with LV mass. In the upper BP range there were also significant correlations between both the 24 hour urinary noradrenaline excretion and plasma aldosterone and LV mass, while blood glucose and plasma insulin were significantly correlated with LV mass in the intermediate BP range. Thus there was a surprisingly low correlation between LV mass and arterial BP. The findings regarding sympathetic nervous activity, hormonal and metabolic factors might indicate that these factors are involved in the pathogenesis of an increased LV mass in some individuals with essential hypertension.

Angiotensin II↗
PubMed1983

Influence of age on the response to increased salt intake: effects on blood pressure and sodium in erythrocytes.

Blood pressure (BP), sodium in erythrocytes (IeNa) and transmembrane sodium fluxes were determined in normotensive 30 and 50-year-old men with a family history of hypertension (group H; n = 17 and 11 respectively) and without such history (group C; n = 15 and 26 respectively) during normal salt intake and after four weeks on ordinary diet plus 12 g NaCl daily. The 50-year-old men showed a significant increase in BP and weight during high salt intake while the younger men did not. On normal salt, group H had a significantly higher IeNa than group C in both age groups. In the younger group this was accompanied by a decreased Na efflux rate constant. IeNa decreased significantly in group H in both age groups. The decrease in IeNa and increase in pump activity in group H during high salt intake does not support the existence of a sodium transport inhibitor. The increase in BP in the older group during high salt indicates that age is an important factor in BP response.

Adult↗
PubMed1983

Effects of anti-hypertensive therapy on serum lipoproteins. Treatment with metoprolol, propranolol and hydrochlorothiazide.

The effects of metoprolol, propranolol and hydrochlorothiazide on lipoprotein metabolism were studied in three different but comparable groups of middle-aged men with previously untreated hypertension (n=10, n=10, and n=11, respectively). All three treatments were associated with an increase in serum triglyceride and VLDL-cholesterol levels. Propranolol treatment was associated with consistent and significant decreases in HDL-cholesterol, apoA-I and A-II levels, whereas these changes during the other treatments were neither significant nor consistent. An increase in adipose tissue LPL-activity and a decrease in serum free fatty acids were seen in the propranolol treatment group. Significant changes were not observed in glucose tolerance or catecholamine excretion. The blood pressure reduction was similar in the three groups. The design of the present study was in some important respects different from that of others. This may help to explain why we found a difference between the two beta-blockers in our study.

Adipose Tissue↗
PubMed1982

Effects of labetalol and propranolol on the peripheral circulation in hypertensive patients.

Eleven patients with essential hypertension participated in a double-blind cross-over comparison of labetalol (L) and propranolol (P). Each drug was given for 5--8 weeks. The dose reducing the supine diastolic blood pressure when given b.d. to or below 90 mm Hg was titrated out. At the end of each period, isometric exercise (sustained handgrip) and calf plethysmography were performed. L (mean daily dose 636 mg) was slightly more effective in lowering supine and standing blood pressure than P (mean dose 276 mg). There was no significant difference between the drugs in their effect on the blood-pressure response to handgrip. However, compared with no treatment, L attenuated the blood-pressure rise at near-maximal handgrip; this has not been reported with other beta-blockers. Resting vascular resistance and basal vascular tone were significantly lower (20%, p less than 0.05) during treatment with labetalol than when the patients were taking propranolol. - The differences may be explained by the alpha-receptorblocking action of labetalol.

Adult↗