[Renin-angiotensin system in the diagnosis of essential hypertension].
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Biomedical subjects
Publications and source records attributed to H Aberg.
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Propranolol was given to 30 patients with essential hypertension following randomised, double-blind administration of either placebo or a new cardioselective beta-adrenergic receptor antagonist, atenolol (Tenormin, ICI 66 082). Both atenolol and propranolol caused statistically significant reduction of recumbent and erect blood pressure and heart rate. There were no important differences between these variables on comparison of atenolol and propranolol.
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1. Atenolol (ICI 66.082, Tenormin) is a new beta-adrenoreceptor-blocking agent, devoid of intrinsic sympathomimetic and membrane-stabilizing properties. It does not cross the blood-brain barrier. 2. Atenolol given to hypertensive patients in initial open trials reduced arterial blood pressure significantly. 3. A double-blind comparison between atenolol and placebo in forty-five patients with essential hypertension demonstrated that atenolol gave a statistically significant reduction of blood pressure (delta 28/15 mmHg, P less than 0-005). 4. The optimum anti-hypertensive dose of atenolol in patients with mild to moderately severe essential hypertension was 200 mg daily. 5. Atenolol was compared with propranolol in thirty patients with essential hypertension. No statistically significant differences of anti-hypertensive effect were observed between the two drugs. 6. Long-term results (up to 2 years) in 117 hypertensive patients indicate that drug tolerance is good. No serious toxic effects were observed. 7. In four of twelve hypertensive patients with obstructive airways disease atenolol had to be withdrawn owing to deterioration of ventilatory function.
1. In a health examination survey of 2322 men, aged 49-50 years, the prevalence of hypertension was 7-5%. All men with a supine diastolic blood pressure greater than or equal to 105 mmHg were invited to a hypertension clinic. 2. Two years' treatment in eighty-six men achieved a blood pressure reduction of 31/16 mmHg, which was maintained for a 4 years period and considered satisfactory in 80% of the subjects. Propranolol was used in more than 80% of the cases. 3. The study indicates that it is possible to obtain acceptable blood pressure control in the community.
A report is given from an on-going multicenter trial in Sweden, in which 117 hypertensive patients have been treated with a new cardioselective beta-adrenergic blocking agent, atenolol (ICI 66.082, Tenormin) for an average of six months (range 2-21). Statistically significant reductions of BP were observed, recumbent by 29/19 mmHg (p less than 0.0001) and standing by 28/18 mmHg (p less than 0.0001). Few and comparatively mild side-effects were seen.
In a health examination survey of more than 2,000 middle-aged men the prevalence of hypertension, defined as supine DBP greater than or equal to 105 mmHg and including those on treatment, was 7.5%. Half of the hypertensives were untreated. A satisfactory BP control was present in 27.6% of the total hypertensive population. Untreated hypertensives had a higher relative body weight and a greater skinfold thickness, indicating a greater degree of obesity, than a population sample from the same survey. They also had more hyperuricaemia, hypertriglyceridaemia and hyperinsulinaemia, fasting as well as during i.v. glucose tolerance test. However, when the hypertensives were compared to normotensive, weight-matched controls, most of these differences were eliminated. The findings indicate that the metabolic disturbances in hypertensives are associated with overweight and suggest that weight reduction might be beneficial not only for the BP but also for correcting the metabolic pattern.
In a health examination survey of 2322 middle-aged men the prevalence of hypertension, defined as supine DBP greater than or equal to 105 mmHg and including those on treatment, was 7.5%. All untreated and those inadequately treated were invited to a hypertension clinic. One year's treatment in 86 men achieved a BP reduction of 29/17 mmHg in supine and 27/16 mmHg in erect position. This reduction was maintained for a three-year period and considered satisfactory in 80% of subjects. Propranolol, alone or in combination with other agents, was used in more than 80% of the cases. Special considerations in treating asymptomatic individuals are discussed.
The blood pressure (BP) development in 142 middle-aged men with BP within the lower region of the BP distribution (supine BP less than or equal to 120/70 mmHg) has been studied. Over a 3-year period there was a moderate but significant rise in supine systolic BP but not in supine diastolic BP. However, no subject developed hypertension defined as supine BP greater than or equal to 175/105 mmHg. These findings support the assumption that among middle-aged men the hypertensives are recruited from the upper part of the BP distribution. Subjects with low BP may be rescreened at longer intervals, if at all.
One patient with acrodermatitis enteropathica complicated by hypertension is presented. The pathogenesis of the markedly elevated blood pressure is unknown. The acrodermatitis healed completely on zinc therapy and parallel to this improvement the hypertension could easily be controlled with a gradually decreased antihypertensive drug dosage.
The role of the sympathetic nerve system is still unknown in different types of hypertension. The procedure used in the evaluation of suspect renovascular hypertension has been revised in such a way that renal blood flow, renal arterial blood pressure and plasma renin activity in renal vein could be determined prior to and after splanchnic blockade. A new divice-videovolumeter-has been used to investigate the blood flow. Some preliminary data are given.
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Middle-aged men's knowledge of the circumstances of their parents' diseases and death is reliable to such an extent that it can be used when appropriate for therapeutic purposes in familial diseases. This conclusion is based on findings in a health examination survey of 441 middle-aged men in Uppsala, Sweden where the men were asked whether their parents were dead and, if so, the known cause of death and at what age they had died. The information reported was then compared with the official data kept by the authorities. In 87% of cases it was possible to perform such a comparison. The study showed good conformity of the two sources, in general.