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Biomedical subjects

G Berglund

Publications and source records attributed to G Berglund.

At least 289 records · Page 16Linked to original sources
PubMed1977

Sodium excretion and sympathetic activity in relation to severity of hypertension.

The relationship between the severity of hypertensive disease and sodium excretion and sympathetic activity has been studied in normotensive (n = 19) and hypertensive (n = 19) men of the same derived from screening a total population. Sympathetic activity was determined from noradrenaline excretion and the severity of hypertension was assessed by measuring resting diastolic BP, left ventricular hypertrophy on orthogonal ECG and the glomerular filtration rate. In the hypertensive group the resting BP correlated well both with signs of left ventricular hypertrophy, i.e. with the degree of severity of the hypertensive disease. Up to the level of 90 mm Hg resting diastolic BP, sodium excretion rose in agreement with theory of pressure diuresis. Above 90 mm Hg, however, both sodium and noradrenaline excretion fell with increasing BP. This indicated that in more advanced hypertension the sodium balance overrides the sympathetic activity in the long-term relation of BP. In another series of 49-year-old-men noradrenaline excretion fell with increasing renal vascular resistance indicating that the increase in the latter variable could not be explained by increased sympathetic tone. On the basis of the results a hypothesis on the sequence of events leading to development of hypertension, is presented.

Blood Pressure↗
PubMed1976

Prevalence of primary and secondary hypertension: studies in a random population sample.

The prevalence of primary and secondary hypertension was determined in a random sample of 7455 Swedish men aged 47 to 54 years. Three hundred and sizty-one men were undergoing treatment for hypertension. Seven hundred and ninety-eight men who had blood pressures above 175/115 mm Hg at preliminary screening were recalled for further blood pressure measurements. Those on treatment and all the untreated men whose blood pressures were still over 175/115 mm Hg then underwent extensive investigation for secondary hypertension. Renal parenchymal hypertension was found in 25 (3-6%) patients, renovascular hypertension in four (0-6%), and other forms of secondary hypertension in 11 (1-6%). The investigation led to surgical treatment in only two cases (0-3%). The low prevalence of secondary hypertension, especially surgically curable forms of hypertension, makes routine screening for these cases unnecessary, at least when patients with hypertension have been found at screening. These data must be taken into account in planning community control programmes in hypertension.

Humans↗
PubMed1976

Sodium excretion and sympathetic activity in relation to severity of hypertensive disease.

The relationship between the severity of hypertensive disease and sodium excretion and sympathetic activity has been studied in subjects of the same age and sex derived from screening a total population. 19 untreated subjects with casual blood-pressure (B.P.) above 175/115 mm Hg on two separate occasions made up the hypertensive group. A normotensive group (n =19) was obtained by selecting a 5% random sample from all subjects with casual B.P. below 160/95. Sympathetic activity was determined from noradrenaline excretion and the severity of hypertension assessed by recording resting diastolic B.P., signs of left ventricular hypertrophy on orthogonal E.C.G., and the glomerular filtration-rate. In the hypertensive group the resting B.P. correlated well both with signs of left ventricular hypertrophy and with the glomerular filtration-rate--i.e., the degree of severity of the hypertension. Up to the level of 90 mm Hg resting diastolic B.P., sodium excretion rose in complete agreement with the theory of pressure diuresis. Above 90 mm Hg, however, sodium and noradrenaline excretion fell with increase of B.P. These two findings indicated that with increasing severity of hypertension the sodium balance overrides the sympathetic activity in the long-term regulation of B.P. This may have both prognostic and therapeutic implications.

Adrenal Medulla↗
PubMed1976

Comparative study of metoprolol and alpha-methyldopa in untreated essential hypertension.

The hypotensive actions of metoprolol and alpha-methyldopa have been compared in 37 men with previously untreated essential hypertension; 36 belonged to stage 1 and 1 to stage 2 of the WHO classification. After four weeks of placebo treatment the patients were randomly allocated to treatment with either of the two drugs. Treatment was started with metoprolol 75 mg daily or alpha-methyldopa 375 mg and was doubled after eight weeks. Satisfactory blood pressure control was defined as systolic blood pressure below 160 mm Hg and diastolic below 95 mm Hg. The patients were examined every four weeks and in those with unsatisfactory control the dose was gradually increased up to a maximum daily dose of metoprolol 450 mg or alpha-methyldopa 2250 mg. The trial lasted for 24 weeks after randomization. Five patients dropped out of the study. After six months, satisfactory blood pressure control was recorded in 16 out of 17 patients and 14 out of 15 patients treated with metoprolol and alpha-methyldopa, respectively. The average reduction in blood pressure produced by the two drugs was comparable. One patient in the alpha-methyldopa group developed drug exanthema and two patients a positive Coombs' test. Other side effects were few and did not differ between the two compounds.

Blood Pressure↗
PubMed1976

Renal function in normo- and hypertensive 50-year-old males.

Renal function, measure as glomerular filtration rate (GFR), sodium excretion and osmolality after thirst, has been determined in untreated (n=35) and treated (n=22) hypertensives and in a reference group (n=80), all derived from a random population sample of 50-year-old men. Renal function was related to casual and resting BP and to relative body weight. Hypertension was defined as SBP greater than 175 or DBP greater than 115 mmHg on two separate occasions or current antihypertensive treatment. Mean GFR was 100 +/- 11.7 ml/min in the reference group and significantly lower, 94 +/- 15.7 ml/min, in the hypertension group. In the hypertension group, 20% had a reduced GFR, although the standard diagnostic procedure, serum creatinine, demonstrated only 4%. Hypertensives with reduced GFR were characterized by higher BP, lower urinary sodium excretion, reversed diurnal rhythm of salt and water excretion and a higher relative body weight, which was, however, explained by the correlation of BP to relative body weight. GFR was negatively correlated to DBP at rest and positively correlated to urinary sodium excretion. Untreated hypertensives with persistent high BP after rest and lower GFR, lower urinary sodium excretion and reversed diurnal rhythm of salt and water excretion, indicating high renal resistance. The results suggest that subjects with relatively severe hypertension as judged by BP and renal function have an increased renal vascular resistance.

Blood Pressure↗
PubMed1976

Plasma renin activity and hypertensive organ manifestations in 50-year-old males.

From a screening examination in a randomly selected third of the 50-year-old male population in Göteborg, Sweden, a 10% subsample was selected as a reference group (n=80). All untreated persons with SBP greater than 175 or DBP greater than 115 mmHg on two separate occasions made up the hypertension group (n=35). The reference group and the hypertension group were subjected to the same investigations, including BP measurement before and after rest and determination of plasma renin activity (PRA), urinary sodium and norepinephrine excretion and GFR. Plasma renin activity was approximately normally distributed in both the reference and the hypertension group. Mean values were 0.78 +/- 0.18 and 0.65 +/- 0.17 ng/ml/h respectively, the difference being almost statistically significant (0.10 greater than p greater than 0.05). There was no difference with respect to sodium excretion between the reference group and the hypertension group. In the reference group, heart rate was positively correlated to PRA and to urinary norepinephrine excretion during the day. No linear correlation between PAR and BP was found, either in the reference group, or in the hypertension group. Sodium excretion during the day was positively correlated to GFR in the hypertension group, but not in the reference group. Compared to hypertensives with normal or high sodium excretion during the day, the hypertensives with low sodium excretion during the day were characterized by a higher BP, a lower GFR and a reversed diurnal rhythm of urine excretion. Thus, low sodium excretion seemed to indicate more severe hypertension with increased renal resistance during the day. The hypertension group was also divided with regard to sodium excretion into a low, normal and high renin group. The low renin group had the lowest GFR and with rising renin group (from low via normal to high) there was a significant increase in GFR and a significant decrease in resting BP. The results indicate that low renin hypertension is not a more mild, but indeed rather a more severe form of hypertension.

Blood Pressure↗
PubMed1976

Antihypertensive effect and side-effects of bendroflumethiazide and propranolol.

The antihypertensive effect and side-effects during 12 months' treatment with bendroflumethiazide and propranolol have been compared in two randomly selected, equally large groups (n= 53) of previously untreated male hypertensives. Systolic BP above 170 or diastolic BP above 105 mmHg on two occasions were defined as hypertension. The same BP reduction was achieved in both groups. During the 12 months' treatment one subject on bendroflumethiazide developed diabetes mellitus and one on propranolol developed cardiac decompensation. None developed gout. Contrary to what had been presumed, glucose tolerance improved during 12 months' treatment with both agents, while there were no changes in fasting blood sugar, insulin or triglyceride concentrations. No changes were found in serum potassium or total body potassium during 12 months' bendroflumethiazide treatment, while serum potassium increased during treatment with propranolol. Uric acid increased slightly during treatment with both agents. Prolongation of the follow-up to 24 months did not change any of the findings regarding metabolic changes during treatment. The frequency of subjective side-effects decreased to the same extent during treatment with both drugs. It is concluded that bendroflumethiazide and propranolol are equally useful as antihypertensive agents and that the risk of impariment of glucose metabolism and potassium balance seems to be very slight during treatment with bendroflumethiazide in mild hypertension.

Bendroflumethiazide↗
PubMed1976

Body composition and glucose metabolism in hypertensive middle-aged males.

Body fat, body cell mass, fasting blood sugar, glucose tolerance and fasting insulin have been determined in 106 hypertensive males aged 47-54years and in 41 normotensive 50-year-old males. Both groups were derived from screening examinations in random population samples. The hypertensive subjects were more often obese and had more often an impaired glucose tolerance and a higher fasting insulin compared with the normotensive subjects. The metabolic differences were not explained simply by the higher degree of obesity in the hypertensive subjects, as the differences remained when the hypertensive subjects were matched for body fat with normotensive controls. The impaired glucose metabolism demonstrated quantitatively in an unselected group of hypertensive subjects, might be one of the factors explaining the variable prognosis in hypertensive subjects.

Blood Glucose↗
PubMed1976

Non-invasive assessment of the heart in the hypertensive.

The prevalence of signs of heart involvement was studied non-invasively with orthogonal and conventional ECG, apexcardiogram, carotid pulse tracing and phonocardiogram in a group of untreated hypertensives (n = 35) and a reference group (n = 73). All were derived by screening a random population sample of 50-year-old men.

Animals↗
PubMed1976

Orthogonal electrocardiogram, apex cardiogram, and atrial sound in normotensive and hypertensive 50-year-old men.

The prevalence of signs of heart involvement was studied non-invasively in a group of untreated hypertensives (n=35) and a reference group (n=73), all derived from a random population sample of 50-year-old men. Signs of left ventricular hypertrophy were studied by means of orthogonal electrocardiography and conventional electrocardiography. Signs of decreased distensibility of the left ventricle were studied by apex cardiography and registration of atrial sounds. Left ventricular hypertrophy among hypertensives was significantly more common according to orthogonal electrocardiography (33%) than according to conventional electrocardiography (9%), indicating that the former may be a better method for detection of left ventricular hypertrophy than the latter. In the hypertension group the amplitude of the R wave in lead X on orthogonal electrocardiography was positively correlated to casual diastolic blood pressure (r=0-40) and to diastolic blood pressure after one hour's rest (r=0-65). The degree of pressure load leading to left ventricular hypertrophy seems to be better reflected by resting than by casual blood pressure. There was no hypertensive subject with both signs of left ventricular hypertrophy on orthogonal electrocardiography and either an a/H ratio over 15 per cent or an abnormal atrial sound, indicating two different forms of cardiac involvement as the result of hypertension. Casual blood pressures became normal during rest in hypertensives with a/H ratio over 15 per cent on apex cardiography or abnormal atrial sound, not in hypertensives with signs of left ventricular hypertrophy on orthogonal electrocardiography.

Blood Pressure↗
PubMed1976

Morbidity and mortality in untreated and treated hypertension: results from the Göteborg 50-year-old men study.

Total mortality, and mortality and morbidity from myocardial infarction, have been followed in one-thrid (n = 855) of a totoal male population from the age of 50 to the age of 60. An initial screening examination was performed in 1963 when the participants were 50 years old. Mortality data were gathered from death certificates and autopsies. Fatal and non-fatal myocardial infarction was followed by means of an infarction register. The participants were divided into four groups according to blood pressure in 1963 and the mortality and morbidity data in these 4 groups were compared with those who had been on antihypertensive treatment from 1963 to 1973.

Antihypertensive Agents↗
PubMed1976

Pre-treatment workup for antihypertensive treatment.

The prevalence of primary and secondary hypertension and of heart and kidney involvement was thoroughly studied in 689 hypertensive subjects derived from a blood pressure screening examination of a total population sample of Swedish men (n = 7,452). The prevalence of secondary hypertension was found to be only 5%, the prevalence of surgically curable hypertension being even lower. Left ventricular hypertrophy and slight heart enlargement were each found in about one-third of the hypertensive patients, while severe heart enlargement, left ventricular hypertrophy on ECG, proteinuria, abnormal serum creatinine and urinary sediment were each found in about 5%. On the basis of these findings, a minimum pre-treatment workup in uncomplicated hypertension is proposed.

Antihypertensive Agents↗