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Biomedical subjects

H R Brunner

Publications and source records attributed to H R Brunner.

At least 469 records · Page 26Linked to original sources
PubMed1981

[Epidemiology of blood pressure in 4 Swiss cities].

Within the framework of the Swiss National Research Program for the Prevention of Cardiovascular Disease, blood pressure levels of 8140 adults were recorded in four Swiss cities. Repeated measurements yield lower results. The values increase with age and are higher in men than in women. Swiss citizens have higher mean values than foreigners, and values in the French-speaking cities are significantly higher than those of the German-speaking cities. The prevalence of hypertension also depends on sex and age. The prevalence of elevated values (less than or equal to 160/95 mm Hg) identified by measurement, standardized for sex, age and nationality, is 11.6%; if the known, treated hypertensives are included the prevalence is 14.2%. 55% of the hypertensives knew of their condition, 39% were under medical treatment and only 20% were well controlled (greater than 160/95 mm Hg). There were considerable differences between the two region; fewer of the hypertensives were known and fewer were under control in the French-speaking towns.

Adolescent↗
PubMed1980

Sodium-induced elevation of blood pressure in the anephric state.

Normotensive anephric rats infused with 2 milliliters of a hyperosmolar solution of either sodium chloride or mannitol showed an increase in arterial pressure that was very pronounced with the sodium chloride and that could be partly abolished by administration of an antagonist to the vasopressor action of antidiuretic hormone (ADH). Rats with congenital ADH deficiency subjected to the same treatment showed smaller increments in arterial pressure that remained unchanged after administration of the ADH antagonist. Expansion of intravascular fluid volume was similar in all four groups and bore no correlation to the change in arterial pressure. It is concluded that about half of the increase in blood pressure induced by saline was attributable to the vasopressor effect of stimulated ADH and the remainder to an additional sodium-related factor, since it was more pronounced in the saline-infused than in the mannitol-infused groups. Expansion of the intravascular volume per se could only account for a minimal part of the increment in pressure.

Animals↗
PubMed1980

[Cirrhotic ascites and the renin-angiotensin system].

Plasma renin activity and plasma aldosterone have been measured in 31 patients in different clinical stages of alcoholic cirrhosis. Plasma renin activity and plasma aldosterone were within the normal range in patients with compensated cirrhosis and in patients with untreated cirrhosis and ascites. These results are not in keeping with the traditional concepts of reduced "effective' blood volume with stimulation of the renin-angiotensin system. In ascites treated with diuretics, and in the hepato-renal syndrome, the renin-angiotensin system was, however, stimulated. Peritoneo-venous shunt was followed by suppression of this stimulation.

Aldosterone↗
PubMed1980

Is the renin system necessary?

Numerous studies have been carried out to assess the role of the renin system in sustaining abnormally high blood pressure and in contributing to various other cardiovascular disorders such as congestive heart failure, ascites, and shock. The clinical use of potent and specific inhibitors of the renin-angiotensin system has produced important application in the treatment of high blood pressure, severe congestive cardiac failure and experimental hemorrhagic shock. Only in the state of considerable sodium depletion does blockade of the renin system produce any untoward effect, i.e. hypotension. These results are very similar to those obtained previously in patients with bilateral nephrectomy. They raise the question whether under conditions of our present salt-eating habits the renin system is really necessary.

Angiotensin II↗
PubMed1980

Converting enzyme inhibition during chronic angiotensin II infusion in rats: evidence against a non-angiotensin mechanism.

1. To investigate the non-angiotensin effects of converting enzyme inhibition, angiotensin II was infused intravenously at 30 ng/min for 9 days in conscious rats to produce moderate blood pressure elevation. One group was given captopril (SQ 14 225) by gavage (100 mg/kg twice daily) and the other glucose. 2. After 7 days of captopril administration, enzyme blockade was confirmed by a tenfold greater depressor sensitivity to exogenous bradykinin and a markedly decreased plasma angiotensin converting enzyme activity. 3. Mean arterial pressure, heart rate and plasma renin activity were not different between captopril and glucose-treated groups in the presence of angiotensin II. Metabolic studies also revealed no long-term differences in water and food intake, weight change or sodium and potassium metabolism. 4. These findings suggest that, in the presence of angiotensin II, there is no detectable haemodynamic or metabolic effect of converting enzyme inhibition in rats and, therefore, that bradykinin plays little or no role in its long-term antihypertensive action.

Angiotensin II↗
PubMed1980

Effects of tyrosine infusion in normotensive and hypertensive rats.

To clarify further the action of acute administration of L-tyrosine in lowering blood pressure, L-tyrosine ethylester was infused intravenously into awake [deoxycorticosterone acetate (DOCA)-salt] hypertensive rats, two-kidney Goldblatt hypertensive rats, and normotensive rats. The effects of tyrosine were measured on arterial pressure, heart rate, plasma catecholamine levels, and plasma renin activity. Blood pressure and heart rate were lowered in all groups despite significant elevation of plasma dopamine in all groups and epinephrine in the hypertensive groups, norepinephrine did not rise significantly, and plasma renin activity was always found to be within the ranges expected for each model. It was concluded that tyrosine produced the progressive decline in blood pressure and heart rate by bringing about a sustained state of parasympathetic dominance, as effective sympathetic compensation did not occcur. This could be attributed to increased alpha-adrenergic activity in certain sites in brain secondary to increased catecholaminergic activity in these areas.

Animals↗
PubMed1980

Enhancement by diuretics of the antihypertensive action of long-term angiotensin converting enzyme blockade.

Thirty-nine patients with various types of hypertension were treated by chronic blockage of the angiotensin converting enzyme, i.e. by twice daily administration of captopril, 50 to 200 mg p.o. The blood pressure reduction observed 1 hour following administration of the inhibitor was directly related to the baseline plasma renin activity (r=- 0.67, p < 0.001). Whenever blockade of the renin system alone did not lower blood pressure to normal levels additional sodium subtraction brought it under control. With the renin system neutralized, blood pressure becomes exquisitely sensitive to changes in sodium balance. Diuretics seem to preserve optimal natriuretic efficacy despite blood pressure reduction, probably because aldosterone levels are reduced and renal blood flow increases. Blockade of the renin system together with individually tailored salt subtraction provides an attractive new approach to long-term treatment of clinical hypertension.

Adolescent↗
PubMed1980

Angiotensin inhibitors for hypertension.

Inhibition of the angiotensin-converting enzyme emerges as a new promising approach to the treatment of hypertension. The intravenously administered teprotide appears to be suitable as a diagnostic test and for initial treatment of certain hypertensive emergencies. The oral inhibitor captopril is effective for chronic maintenance of blood pressure control in various types of hypertension but has been associated with a number of adverse reactions.

Administration, Oral↗
PubMed1980

[Initial experiences with peritoneo-venous shunting by means of the Le Veen pressure-sensitive valve in the treatment of refractory ascites].

Of all different surgical treatments of ascites, the peritoneo-venous shunt actually seems to be the less risky method. Our short experience confirms the success of this method, but also its contradictions and reveals a little known complication: the thrombosis of the superior vena cava. Its superiority over the lympho-venous anastomosis has been proven in one of our patients.

Adult↗
PubMed1979

[Discontinuation of chronic hemodialysis due to improved kidney function caused by the control of arterial hypertension].

Following effective long-term antihypertensive therapy, hemodialysis could be discontinued in 4 patients with malignant hypertension in view of improved renal function. Diagnoses included nephroangiosclerosis (2 cases), scleroderma and chronic glomerulonephritis. All patients had symptoms of hypertension or renal disease for at least one year prior to initiation of hemodialysis treatment. At the outset, blood pressure averaged 249 +/- 43/150 +/- 22 mm Hg (mean +/- SD) and all patients had grade IV hypertensive retinopathy. After 1 to 20 months strict blood pressure control, renal function had improved to such a degree that hemodialysis could be discontinued. One year later, blood pressure averaged 138 +/- 20/89 +/- 6 mm Hg and serum creatinine 3,2 +/- 1,2 mg/100 ml. These data suggest that in hypertensive patients with chronic renal failure, strict control of blood pressure is of the utmost importance whatever the severity and nature of the underlying renal disease.

Adult↗
PubMed1979

Improvement of chronic congestive heart-failure by oral captopril.

Catopril, an inhibitor of angiotensin converting enzyme, was given orally during cardiac catheterisation to 6 normotensive patients with refractory congestive heart-failure. 60--180 minutes after administration of 25 mg captopril, arterial pressure fell by 25%, cardiac index rose by 38%, and left-ventricular pressure and right-atrial pressure fell by 25% and 40% respectively. Plasma-renin activity rose while plasma noradrenaline and aldosterone fell. These data suggest that, in the short term, captopril can reduce both preload and afterload, and improve cardiac function, in refractory congestive heart-failure.

Administration, Oral↗
PubMed1979

Effect of captopril on renal vascular tone in patients with essential hypertension.

1. The effect of acute inhibition of angiotensin-converting enzyme by captopril (50 mg) on renal haemodynamics and function was assessed in nine patients with essential hypertension on unrestricted sodium intake (n = 8) or low sodium diet (n = 1). 2. Captopril induced a rapid and significant decrease in arterial pressure, which was maximal within 60 min. 3. Effective renal plasma flow (ERPF) increased, glomerular filtration rate (GFR) did not change and filtration fraction (FF) decreased after captopril. No change in sodium excretion and a decrease in urinary potassium occurred. 4. In the patient on low sodium diet, captopril induced striking increases in GFR and ERPF (64 and 106% respectively). 5. The logarithm of baseline plasma renin activity was positvely correlated with the change in ERPF and negatively correlated with changes in FF and renal resistance. 6. The results indicate that in patients with essential hypertension angiotensin participates actively in the maintenance of renal vascular tone at the efferent arteriolar level. A possible influence of kinins remains to be defined.

Adolescent↗
PubMed1979

Orally active angiotensin-converting enzyme inhibitor (SO 14,225) as a treatment for essential hypertension.

1 Captopril (SQ14,225), an orally active inhibitor of angiotensin-converting enzyme, was administered to nine patients with essential hypertension. Plasma renin activity (PRA) was low in four, 'normal' in three and high in two patients. 2 In the hospital, captopril alone induced a significant drop in BP from 165 +/- 6/106 +/- 2 to 140 +/- 5/90 +/- 1 mmHb (P less than 0.001). PRA increased concomitantly (P less than 0.05), whereas plasma-converting enzyme activity (P less than 0.005) and plasma aldosterone (P less than 0.05) were reduced. 3 Six patients underwent chronic ambulatory therapy with captopril for a mean of 16 +/- 3 weeks. After discharge from the hospital, BP remained normalized but in five out of six patients this required additional diuretic therapy. 4 The results suggest that captopril alone or combined with diuretic therapy provides a new, efficient and well tolerated tool to treat patients with essential hypertension independently of their PRA level. It may turn out to be more effective in lowering BP than beta-adrenoceptor-blocking agents.

Adult↗