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Biomedical subjects

H Haller

Publications and source records attributed to H Haller.

At least 253 records · Page 14Linked to original sources

Effects of angiotensin II infusion on the early morning surge of ACTH and o-CRH-provoked ACTH secretion in normal man.

UNLABELLED: The question of whether elevated plasma angiotensin II (AII) levels modulate ACTH secretion in man still awaits a definite answer. We performed two sets of experiments pertinent to that problem: Seven healthy young males each received AII (5 ng/kg/min) and sham infusions on different days in a randomized sequence from 03.00 h to 06.00 h in the morning, while plasma ACTH and cortisol were measured every 20 min. Mean blood pressure rose by about 10 mmHg during AII infusion. Mean plasma ACTH levels were slightly higher with AII than with sham infusion in every single individual (P less than 0.05). Differences in a pre- and post-infusion period were significant. Plasma cortisol levels were almost identical with or without AII infusion. Nine healthy young males received AII (5 ng/kg/min) or sham infusions on different days from 16.30 h to 20.00 h in a randomized sequence and a 100 micrograms o-CRH injection at 17.00 h. Plasma ACTH and cortisol were measured every 15 or 30 min between 16.30 h and 20.00 h. Mean blood pressure rose by about 14 mmHg during AII infusion. The rapid increment and further change in plasma ACTH and cortisol was not significantly different between the AII and sham infusion studies. CONCLUSIONS: The dose of AII infused was probably just above the threshold of ACTH stimulation, although AII plasma levels obtained were probably far above the physiological range. On the adrenal level, a vasoconstrictor effect of AII may have prevented stimulation of cortisol. This may be different in states of sodium depletion with reduced vascular effects of AII.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Humoral and blood pressure effects of the angiotensin converting enzyme inhibitor ramipril in essential hypertension.

The humoral and antihypertensive activities of the angiotensin converting enzyme (ACE) inhibitor 2-[N-[(S)-1-ethoxycarbonyl-3-phenylpropyl]-L-alanyl]-(1S, 3S, 5S)-2-azabicyclo[3.3.0] octane-3-carboxylic acid (ramipril, Hoe 498) were investigated in 10 patients with essential hypertension (WHO stage I or II). After a 7-day placebo period, the patients were treated with 5 mg ramipril orally once daily for 14 days. Peak serum concentrations of the active metabolite M1 (dicarboxylic acid) of 5.4-62.0 ng/ml were observed 2-6 h after the first oral dose. The maximum ACE inhibition of 95% was reached 2-4 h after the first oral dose, inhibition exceeded 70% 24 h after dosing. The maximum drop in the systolic and diastolic blood pressure (random zero sphygmomanometer) was measured 4 h after ramipril (p less than 0.02, p less than 0.01), but blood pressure on days 7 and 14 of the treatment period was not different from pretreatment values. Automatically recorded blood pressure results showed a marked reduction of both systolic and diastolic blood pressure during treatment compared to placebo. No side effects occurred. From the present data it is concluded that ramipril is a potent ACE inhibitor in hypertensive patients and that further controlled studies are required for the evaluation of the antihypertensive effect of 5 mg ramipril in essential hypertension.

Adult↗

Effect of angiotensin II on plasma ACTH in patients with Addison's disease.

Short-term angiotensin II (AII) infusions (3 ng/kg/min) were performed in 5 patients with Addison's disease in order to assess the effect of AII on ACTH secretion. Base line ACTH levels were elevated due to a 9-h time lag between hydrocortisone administration and onset of the study. In 2 separate infusion periods of 30-min duration, AII had no unidirectional effect on plasma ACTH. Mean ACTH increased slightly but insignificantly. Mean blood pressure rose by about 10 mmHg. The degree of angiotensinaemia induced is probably similar to the state of moderate to severe sodium deficiency. Short-term changes of AII in this order of magnitude have obviously no major effect on ACTH secretion.

Addison Disease↗

Free intracellular calcium in essential hypertension. Effects of nifedipine and captopril.

The acute effects of nifedipine (20 mg sublingually) and of captopril (12.5 mg orally) on blood pressure and on platelet intracellular free calcium were investigated in 11 and 12 patients, respectively, with essential hypertension. Platelet calcium was measured by the Quin 2 method. Application of both drugs resulted in a significant fall in blood pressure within 60 min. Platelet calcium, however, was lowered by nifedipine only. There was no correlation between blood pressure reduction and changes in platelet calcium. Platelet intracellular free calcium concentration was 99 +/- 3 nmol in 30 normotensive subjects and 109 +/- 5 nmol (+/- s.e.m.) in 26 patients with essential hypertension (P < 0.05). There was a wide overlap between the values of normotensives and hypertensives. Thus there is no positive evidence of an increased platelet intracellular free calcium concentration in a large proportion of patients with essential hypertension.

Adult↗

Intracellular free calcium and ionized plasma calcium during mineralocorticoid-induced blood pressure increase in man.

Intracellular free calcium is considered to play a key role in vascular smooth muscle contraction. Platelet-free intracellular and plasma total and ionized calcium were assessed during mineralocorticoid-induced blood pressure increase in eight normotensive subjects receiving 0.8 mg fludrocortisone per day for 6 weeks. Blood pressure rose within 1 week and showed a further increase up to the 6th week. Plasma noradrenaline and renin activity (PRA) showed a decrease after 1 week and remained suppressed throughout the study. Ionized plasma calcium fell during mineralocorticoid treatment without any significant changes in total plasma calcium. Intracellular free calcium markedly increased after 1 week and decreased towards control levels thereafter. Previous studies have shown that after 1 week of fludrocortisone administration total peripheral resistance is still normal or even subnormal, whereas it is increased after 6 weeks. Therefore, the initial increase in intracellular free calcium, if also present in arteriolar smooth muscle cells, does not appear to be directly related to the final elevation of total peripheral resistance.

Adolescent↗

Sympathetic tone and pressor response to noradrenaline during mineralocorticoid-induced blood pressure rise in man.

To gain insight into the role of the sympathetic nervous system in the development of mineralocorticoid hypertension, we determined noradrenaline and adrenaline in plasma and urine before, during and after administration of the synthetic steroid, fludrocortisone, for a period of 6 weeks in normotensive volunteer subjects. In addition, pressor reactivity to exogenous noradrenaline, platelet alpha 2- and lymphocyte beta 2-receptors, and platelet intracellular free calcium were determined. Fludrocortisone induced a fall in free and sulpho-conjugated plasma noradrenaline and after 6 weeks, a rise in free and sulpho-conjugated noradrenaline excretion. The number of alpha 2- and beta 2-adrenergic binding sites decreased. A marked increase in platelet free intracellular calcium was found after the first week of fludrocortisone administration followed by a decrease in the following weeks. Reactivity to exogenous noradrenaline was found to be enhanced and this could be a factor contributing to the development of hypertension. Whereas the decrease in plasma noradrenaline observed would suggest a diminution in sympathetic tone, the finding of a rise in urinary noradrenaline excretion after 6 weeks of steroid administration in the presence of suppressed plasma levels points to an increased renal sympathetic drive. The decreased number of platelet alpha 2- and lymphocyte beta 2-receptors observed would also be consistent with the assumption of an increased sympathetic tone.

Adult↗

[Results of protein-sparing modified fasting in hyperlipoproteinemias].

We investigated the influence of a PSMF on body weight, body composition, blood lipids, physical working capacity, and nitrogen balance in obese HLP patients. During 4 weeks, 12 patients were treated by PSMF (approximately 340 kcal/d) under health resort conditions. At the same time, they daily exercised on a bicycle with an intensity of 80% of their physical working capacity estimated by an exercise load. The therapeutic regimen induced a significant weight loss (10.1 kg in the mean). Evidently, the patients diminished their body fat only as could be shown by estimations of total body water. Triglycerides, total cholesterol, and LDL-cholesterol also decreased significantly, while HDL-cholesterol remained unchanged. In spite of the weight reduction, the physical working capacity significantly increased from 57.8 to 93.2 kgm. Measurements of total nitrogen excretion with urine gave evidence of the protein saving effect of the therapy. Thus, PSMF--representing an effective therapeutic procedure--can be recommended to be used in obese HLP patients, proceeded that contraindications have been taken into consideration carefully.

Body Weight↗

Reduced incidence of cardiovascular complications and mortality in hyperlipoproteinemia (HLP) with effective lipid correction. The Dresden HLP study.

The influence of the efficacy of triglyceride and cholesterol correction on cardiovascular complications and mortality was analysed in a follow-up study with 260 patients with primary HLP (triglycerides before entry greater than 2.9 mmol/l and/or cholesterol greater than 7.8 mmol/l). The follow-up time was 67.4 +/- 27 months. It was hypothesised that reduction of elevated levels of triglycerides and/or cholesterol influenced favourably the incidence of angina pectoris, MI, stroke and total mortality. For ethical reasons, it was not possible to carry out the investigations with a control group. Therefore, we performed an internal comparison of 3 categories of lipid correction achieved during the trial (effective, moderate, insufficient). A substantial improvement of the lipid disorder was obtained by individualizing the therapy. Triglycerides and cholesterol decreased on average by 50% and 20%, respectively. The incidence of MI was 10 times higher than in the general population. With respect to the type of HLP, hypertriglyceridemia revealed a significantly higher incidence of MI compared with hypercholesterolemia and mixed HLP. The therapy variant was only of importance with respect to gallstone diseases accumulating in the CPIB-treated subgroups. We found a majority of cases with newly manifested angina pectoris and stroke in the group with moderate correction of both triglycerides and cholesterol. Patients with effective triglyceride and cholesterol correction suffered less frequently from MI than those with insufficient correction. This was also the case with secondary prevention in cases with MI prior to entry. There was no significant difference in the distribution of lipid categories at entry between those with and without recurrent infarction. In the group without reinfarction, however, the percentage with insufficient control diminished significantly. Associated risk factors such as hypertension, diabetes, smoking and obesity were of minor or no significance. In subjects with effective triglyceride correction, the total mortality was 0.97/1000 treatment months vs. 3.63 in insufficiently treated patients. The figures for MI mortality were 0.36 and 1.91, respectively.

Adolescent↗

Insulin resistance in diabetics and non-diabetics with impaired triglyceride removal.

Endogenous triglyceride turnover has been measured in patients with normotriglyceridemia or with hypertriglyceridemia using the radioglycerol labelling technique. In parallel, a 50 g oral glucose tolerance test was performed (blood glucose, serum insulin, free fatty acids). Non-diabetics, borderline diabetics, and overt diabetics were included. In the non-diabetics, insulin levels were negatively correlated with fractional catabolic rates for triglycerides, whereas no correlation with triglyceride synthesis rates existed. Patients with low fractional catabolic rates for triglycerides have significantly higher insulin and free fatty acid concentrations, pointing to an association between impairment of triglyceride removal and insulin resistance. There is no typical kinetic pattern of triglyceride metabolism in non-insulin-dependent diabetes mellitus.

Adult↗

[Results of linseed oil and olive oil therapy in hyperlipoproteinemia patients].

Only few informations exist on the effect of different oils and the transformation of these precursor fatty acids to prostaglandins in patients with hyperlipoproteinemia. Therefore we investigated the impact of linseed oil and olive oil intake resp. on serum lipoprotein levels, platelet aggregation and fatty acid pattern of serum phospholipids and triglycerides resp. in patients with primary hypercholesterolemia (HC) (n = 13) and hypertriglyceridemia (HTG) (n = 16). The probands were randomly admitted to a 4 week test period with 30 ml olive or linseed oil intake. After linseed or olive oil intake all lipid fractions did not change significantly. Olive oil significantly reduced the platelet aggregation only in patients with HTG, whereas linseed oil failed to influence aggregation. After linseed oil intake there was a significant increase in linolenic and also in eicosapentaenoic acid content of phospholipids in patients with HTG. In contrast to HTG in HC linseed oil only increased significantly the linolenic acid fraction. Our data suggest, that the response of serum lipoproteins, fatty acids and platelet aggregation on modifications in dietary fats depends on the type of lipoprotein disorder.

Adult↗

[Field bean protein diet in hypercholesteremia].

The lipid-lowering effects of Vicia faba protein are well-known only from animal experiments. According to these studies Vicia faba protein is the most powerful cholesterol-lowering agents among vegetable proteins. Therefore we examined these effects in a group of patients with hypercholesterolemia (HLP type IIa). We observed a cholesterol-reducing efficacy of the Vicia faba protein comparable with those under soy protein diets.

Adult↗

[The relation between lipoprotein fractions, sex and IHD in patients with primary hyperlipoproteinemia].

The evidence of known risk factors in 228 patients with primary hyperlipoproteinaemia was analysed in relation to the ECG-findings. In 34% of the patients symptoms of the ischaemic heart disease were present. In these cases the ischaemic heart disease prevailing rates for the HLP-types IIa and IIb were higher for the male sex, in the HLP-types III-V, on the other hand, higher for the female sex. With the appearance of the hypertriglyceridaemia, independent on the HLP-type, an increasing reversion of the sex ratio became evident. The total cholesterol level scarcely allowed evidence on the coronary risk in HLP-patients. The importance of the HDL-cholesterol as indicator of risk must be regarded in connection with the actual triglyceride values as well as with sex. Thus the general validity of the HDL-cholesterol was relative.

Cholesterol↗

[Alcohol and lipid metabolism].

Alcohol has a direct and/or indirect influence on the fat metabolism, evoking a HLP and this again may lead to secondary defects. Liver defects, pancreatitis, haemolytic conditions may be the sequel of the alcohol as well as of the HLP. When a HLP, particularly of type IV. is present, these statements demand a careful alcohol anamnesis. A control after absolute alcohol abstinence is necessary. If within a few days the HLP shows tendencies to involution, the alcohol can be proved as pathogenetic factor. The exclusion of the noxa is of decisive therapeutic importance and often spares a little effective and loaded with side-effects pharmacotherapy.

Alcohol Oxidoreductases↗

[Long-term effects of weight reduction on body weight and metabolic parameters in adipose non-diabetics and adipose maturity-onset diabetics].

In 28 adipose patients (15 females, 13 males) with normal carbohydrate tolerance and in 35 adipose maturity-onset-diabetics (27 females, 8 males) a significant reduction of the ideal weight index was achieved by a stationary zero diet. The serum fasting values of triglycerides. cholesterol and uric acid decreased. The clearest influence was found in pathologically increased values. This also concerns the improvement of the glucose tolerance in diabetics, which is expressed in the change of the antidiabetic regime. 48.5 +/- 11.7 months after the cure in the after-examined patients with normal carbohydrate tolerance (n = 27) a slight decrease of the weight, in the group of diabetics (n = 31) a slight increase was observed. Despite these slight, non-significant changes of weight the situation in the carbohydrate, fat and purin metabolism on an average deteriorated.

Adult↗