Search PubMed⌕ Search

Biomedical subjects

G Berglund

Publications and source records attributed to G Berglund.

At least 163 records · Page 9Linked to original sources
PubMed1991

Blunted renal sodium excretion during acute saline loading in normotensive men with positive family histories of hypertension.

The natriuretic and intra-arterial blood pressure response to an acute saline load (1000 mL 0.9% NaCl), was studied in normotensive young men with positive (n = 11) and negative (n = 21) family histories of hypertension. The age-matched (36 +/- 5 years) control group with negative family histories of hypertension was subdivided into two groups, one matched for body mass index (BMI) to the subjects with positive family histories of hypertension (n = 10), and another lean control group (n = 11). Baseline blood pressure was significantly higher in subjects with positive family histories of hypertension and in controls matched for BMI as compared with lean controls. Sodium excretion increased in all three groups during the saline infusion, while subjects with positive family histories of hypertension disclosed a diminished natriuretic response as compared with the two control groups. Systolic blood pressure increased significantly during the saline load in subjects with positive family histories of hypertension, while in subjects with negative family histories of hypertension, no significant change in blood pressure was observed. Plasma renin activity, angiotensin II, serum aldosterone, plasma noradrenaline, blood volume, and ouabain-sensitive erythrocyte sodium efflux rate constant did not differ between the three groups at baseline. A significant negative correlation was found between baseline sodium excretion and sodium efflux rate constant in subjects with positive family histories of hypertension. We conclude that the subjects with positive family histories of hypertension exhibit a blunted natriuretic and an exaggerated blood pressure response to an acute saline load as compared with the two control groups with negative family histories of hypertension. This could be of neuronal and/or hormonal origin.

Adult↗
PubMed1991

Resting and volume-stimulated circulating atrial natriuretic peptide in young normotensive men with positive family histories of hypertension.

Normotensive young men (36 +/- 5 years old) with positive family histories of hypertension (n = 11) and age-matched controls (n = 21) with negative family histories of hypertension were examined. The control group was divided into one group matched for body mass index with those subjects with positive family histories (n = 10) and one group with normal body mass index (n = 11). Blood pressure, central venous pressure (CVP), plasma atrial natriuretic peptide (ANP) and serum aldosterone were examined at a baseline and during an acute volume load with 1000 ml saline solution. Subjects with positive family histories and controls matched for body mass index had a higher blood pressure at baseline than controls with normal body mass index. CVP and serum aldosterone did not differ between the three groups, while sodium intake and plasma concentrations of ANP were significantly higher in subjects with positive family histories. During volume loading, CVP increased significantly more in subjects with positive family histories as compared with the two control groups. A blunted response to ANP was observed during volume loading in subjects with positive family histories, while subjects in the two control groups demonstrated comparable and significant increases in circulating ANP. Serum aldosterone, however, decreased during volume loading in all three groups, with no difference between the groups. We conclude that normotensive subjects with positive family histories are characterized by increased basal concentrations of ANP and exhibit a blunted response to an acute volume load.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Cardiovascular effects of weight reduction versus antihypertensive drug treatment: a comparative, randomized, 1-year study of obese men with mild hypertension.

The aim of the study was to compare cardiovascular effects of weight reduction and sodium restriction with antihypertensive drug treatment in obese middle-aged men with mild hypertension in an open randomized trial lasting for 1 year, preceded by a 6-week run-in period. In the diet group (n = 31), weight decreased by 7.8 kg and salt intake by 2 g/day. In the other group (n = 30), treatment was structured with atenolol as the first line drug. The differences in antihypertensive response were highly significant when measured as casual blood pressure, with drug treatment being favoured. Echocardiographic estimations of left ventricular morphology and function showed no difference in effects between the two treatment modalities. Further analyses showed that the presence of previous antihypertensive treatment was modulating the effect of intervention on left ventricular mass. The response to treatment in plethysmographic estimations of resistance at maximal dilatation in the forearm did not differ between the groups. We conclude that drug treatment was superior to the diet regimen in controlling hypertension, that no differences were observed in effects on cardiovascular structure and that previous antihypertensive treatments seems to be a potent confounding factor that should be taken into consideration in future studies.

Adult↗
PubMed1991

Normotensive young men with family histories of hypertension gain weight and decrease their intraerythrocyte sodium content during a 5-year follow-up.

Young normotensive men matched for age and body mass index with (n = 16) and without (n = 13) family histories of hypertension were investigated at baseline and after 5 years of follow-up with respect to blood pressure, body weight and intracellular sodium content. Subjects with positive family histories of hypertension increased significantly in body weight (from 81.9 +/- 11.5 kg to 89.5 +/- 11.4 kg, P less than 0.001) compared to subjects with negative family histories of hypertension (from 79.9 +/- 10.8 kg to 80.7 +/- 12.2 kg, NS). Their blood pressure did not differ initially (137 +/- 12/75 +/- 11 mmHg vs. 135 +/- 8/72 +/- 9 mmHg), but was reduced in subjects without family histories of hypertension (to 125 +/- 3/68 +/- 13 mmHg) in the follow-up examination. At follow-up, body mass index showed a positive correlation with blood pressure among subjects with positive family histories of hypertension (r = 0.77, P less than 0.001). At baseline, subjects with hypertensive fathers had significantly higher intraerythrocyte sodium levels than subjects with normotensive parents. At re-examination 5 years later, this difference was no longer present. We conclude that normotensive subjects with positive family histories of hypertension are predisposed to gain weight rather than to show an increase in blood pressure at this age. Normalization of intracellular sodium content, as found in the present study, could be a consequence of this weight gain and the ensuing metabolic adaption.

Adult↗
PubMed1991

Ultrasound measurement of wall thickness in the carotid artery: fundamental principles and description of a computerized analysing system.

A B-mode [two-dimensional (2D)] image from the carotid artery may be described as containing seven echo zones. The aim of the present work is to discuss how lumen diameter and wall thickness can be measured from these zones, and to review some of the basic principles of ultrasound physics and imaging. Simple experiments were performed to identify the echoes defining intima-lumen interfaces. The results showed that: (1) The intima-media thickness of the near wall cannot be measured in a valid way. (2) The lumen diameter of a blood vessel is defined by the distance from the leading edge of the intima-lumen interface of the near wall (echo zone 3) to the leading edge of the lumen-intima interface of the fall wall (echo zone 5). (3) Previously published studies have validated the intima-media complex of the far wall as the distance from the leading edge of the lumen-intima interface of the far wall to the leading edge of the media-adventitia interface of the far wall (echo zone 7). We suggest that if measurements on the near wall are performed, measurements from the far wall should also be presented separately, and if lumen diameter is measured, that this measurement is carried out according to the leading edge principle. We describe a computerized analysing system for the measurement of wall thickness and plaque area on the carotid and femoral arteries. The system is based on a low-cost PC and a frame grabber board and calculates minimum, maximum and mean values of lumen diameter and wall thickness from a section of the artery.

Carotid Arteries↗
PubMed1991

Body weight is more important than family history of hypertension for left ventricular function.

Left ventricular function was studied in young men with a positive family history of hypertension for two generations (n = 15). The findings were compared with three control groups: one age-, sex-, and weight-matched group with a negative family history of hypertension (n = 14); one normotensive control group unselected as regards family history of hypertension (n = 27); and one group also unselected regarding family history of hypertension but selected with blood pressure criteria to have mild blood pressure elevation (n = 59). The group with a positive family history of hypertension, in comparison with the normotensive control group, was heavier, had higher blood pressure, increased left ventricular wall thickness, increased left ventricular mass, and signs of changes in diastolic and systolic left ventricular function. There were no differences in these variables between the group with a positive family history and the other two control groups. Data clearly indicated that subjects with a positive family history of hypertension, as well as subjects with mild blood pressure elevation, were heavier than the normotensive control group. It is not possible to judge, with available data, if the changes in left ventricular morphology and function in the two groups with a different family history of hypertension and in the group with mild blood pressure elevation occurred as a physiological response to the increase in afterload or if the neurohormonal and metabolic disturbances leading to the condition of slight overweight also affected left ventricular function.

Body Mass Index↗
PubMed1991

Beta-blockade in the primary prevention of coronary heart disease in hypertensive patients. Review of present evidence.

The aim of this review is to present an overview of the results of randomized primary preventive trials with beta-blockers in patients with hypertension. For statistical and biological reasons, any preventive effect on coronary events is hard to demonstrate in women in these primary preventive trials because of the low incidence of coronary events in middle-aged, white women. Therefore, special attention will be focused on the effect in men. Four beta-blockers have been studied: propranolol, oxprenolol, atenolol, and metoprolol. Results from the Metoprolol Atherosclerosis Prevention in Hypertensives (MAPHY) trial showed that the risk for coronary events was 24% lower in patients receiving beta-blockade compared with patients receiving diuretics (p less than 0.001). In men, three beta-blockers (propranolol, oxprenolol, and metoprolol) have shown significantly lower risk for coronary events (fatal and nonfatal) in the nonsmoking subgroup. Results from the MAPHY study also indicated a reduction in total and coronary mortality with the beta-blocker as compared with thiazide diuretics. The observed reduced risk for coronary events with beta-blockers as compared with diuretics is probably independent of the reduction in blood pressure. Mechanisms currently under study include antiatherosclerotic effects, antithrombotic effects, anti-ischemic effects, and antifibrillatory effects. It is not possible to judge, with present evidence, if all beta-blockers are equally effective in preventing sudden death and other coronary events.

Adrenergic beta-Antagonists↗
PubMed1990

Reduced stroke incidence with structured hypertension care: the Skaraborg Hypertension Project.

The Skaraborg Hypertension Project is a 5-year trial testing the impact of structured hypertension care implemented in half of the country, the other half serving as control. Population investigations revealed improved blood pressure control in all treated hypertensives in the study area, blood pressure reduction averaging 2-5 mmHg. The primary trial hypothesis of a possible impact on stroke incidence in the community was tested in this study. Cases of fatal and non-fatal stroke were identified from local and national mortality and morbidity registers, and diagnoses were validated against medical records. Of an initial 1169 reported cases, 1097 proved to be true stroke after validation. A statistically significant difference in stroke incidence trends (fatal and non-fatal) between the study and control populations was identified (P = 0.0251). Improved hypertension control in the study area seems the most plausible explanation for the relative decline in stroke incidence in the study area.

Adult↗
PubMed1990

Coronary artery disease can be prevented by antihypertensive therapy: experiences from the MAPHY Study.

The present randomized primary prevention study in hypertensive men aged 40-64 years (n = 3,234) was aimed at investigating whether metoprolol given as initial treatment would prevent coronary artery disease (CAD) better than thiazide diuretics. Two hundred fifty-five patients had a definite CAD event during the 15,730 patient-years of follow-up; 25% of these events were fatal, and 38% were definite acute myocardial infarctions. The incidence of CAD was significantly lower during follow-up in patients randomized to metoprolol than in patients randomized to diuretics: 111 vs. 144 cases (p = 0.001). Stroke mortality was significantly lower in the metoprolol group than in the diuretic group, but the overall stroke incidence was similar in the two treatment groups. A majority of events occurred among smokers in both treatment groups although only one-third of patients were smokers at baseline. Blood pressure (BP) control was similar in the two treatment groups; therefore, the difference between the groups in CAD events is mediated via mechanisms other than the BP-reducing effect of metoprolol.

Adult↗
PubMed1990

Symptoms and well-being during antihypertensive treatment with thiazide diuretics.

Diuretic drugs seem to be well tolerated during long-term antihypertensive treatment. Although they induce severe side effects necessitating withdrawal more often than placebo, the frequency of such withdrawals seem to be equal to that induced by beta-blocker treatment. The subjective tolerability as judged by questionnaires for symptoms and well being scores seems to indicate an over-all small improvement in patient well being. The effects in this respect seem to be similar to those exerted by a selective beta-blocker.

Aged↗
PubMed1989

Antihypertensive effect of diet compared with drug treatment in obese men with mild hypertension.

OBJECTIVE: To determine whether dietary treatment has a similar antihypertensive effect to conventional drug treatment while being superior to drugs in improving serum lipid concentrations in obese men with mild hypertension. DESIGN: Six week run in period followed by randomisation to either diet or drug treatment groups for one year. SETTING: Outpatient clinic in city hospital. PATIENTS: 61 Men aged 40-69 years, body mass index greater than or equal to 26, diastolic blood pressure 90-104 mm Hg when untreated. Exclusion criteria were signs of organ damage secondary to hypertension and diseases that might have interfered with compliance or with interpretation of results. INTERVENTIONS: Dietary treatment was based on weight reduction, restriction of sodium, and decrease of excess alcohol intake (defined as greater than or equal to 250 g alcohol per week). Drug treatment used a stepped care approach with atenolol as drug of first choice. MAIN OUTCOME MEASURES: Diastolic blood pressure less than 90 mm Hg; absolute reductions in blood pressure and serum lipid concentrations. RESULTS: Mean body weight decreased 7.6 kg in the diet group and increased 0.9 kg in the drug treatment group (p less than 0.0001), and mean sodium excretion decreased 42 and 10 mmol/24 h respectively (p = 0.019). There was no difference in reported alcohol intake. Mean systolic blood pressure decreased 4 mm Hg in the diet group and 16 mm Hg in the drug group (p = 0.003) and diastolic blood pressure 3 and 11 mm Hg respectively (p = 0.002). Diastolic blood pressure of 90 mm Hg was attained by 29% of the diet group (nine men) and 73% (22) of those receiving drug treatment (mean difference 44%, 95% confidence interval 21 to 67%, p = 0.001). Dietary treatment produced decreases in mean serum concentrations of total and low density lipoprotein cholesterol as well as triglycerides and an increase in high density lipoprotein cholesterol concentration. In the drug treatment group the changes were in the opposite direction, and the groups differed significantly in all but total cholesterol. CONCLUSIONS: Dietary treatment was inferior to conventional drug treatment in controlling mild hypertension but superior in lowering serum concentrations of lipids.

Adult↗
PubMed1989

Radio-iodobenzylguanidine scintigraphy of neuroblastoma: conflicting results, when compared with standard investigations.

Seventy-one patients with neuroblastoma (NB) and 25 patients with other neoplastic or nonneoplastic diseases were studied with MIBG scintigraphy. Sensitivity and specificity at diagnosis were 94% and 88%, respectively. Of 52 patients with NB studied during follow-up, 14 had on one or several occasions conflicting results, when the findings at MIBG scintigraphy were compared to standard investigations (SI: CT scan, bone scan, x-ray, and ultrasound). The correlation of MIBG scintigraphy and SI to clinical outcome were in these 14 patients not significantly different. Adding VMA-excretion measurements did not significantly improve the predictive value of MIBG scintigraphy or SI. Patients with tumor-suspected lesions only at MIBG scintigraphy should be followed closely and the nature of the lesions should be explored through biopsy.

3-Iodobenzylguanidine↗