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Biomedical subjects

H Wedel

Publications and source records attributed to H Wedel.

At least 127 records · Page 7Linked to original sources
PubMed1981

Effect on mortality of metoprolol in acute myocardial infarction. A double-blind randomised trial.

The effect of metoprolol on mortality was compared with that of placebo in a double blind randomised trial in patients with definite or suspected acute myocardial infarction. Treatment with metoprolol or placebo started as soon as possible after the patient's arrival in hospital and was continued for 90 days. Metoprolol was given as a 15 mg intravenous dose followed by oral administration of 100 mg twice daily. 1395 patients (697 on placebo and 698 on metoprolol) were included in the trial. Definite acute myocardial infarction developed in 809 and probable infarction in 162. Patients were allocated to various risk groups and within each group patients were randomly assigned to treatment with metoprolol or placebo. There were 62 deaths in the placebo group (8.9%) and 40 deaths in the metoprolol group (5.7%), a reduction of 36% (p less than 0.03). Mortality rates are given according to the treatment group to which the patients were initially randomly allocated.

Adult↗
PubMed1981

Methodological aspects in the design of secondary prevention trials.

The aim of a secondary preventive trial is to produce results that may serve as a basis for therapeutic recommendations to other patients. The natural history of a disease studied including the mortality and reinfarction rate must be known and taken into consideration. The patients should be recruited without selection. By comparing the placebo mortality with expected levels the representativeness of patients can be assessed. One type of treatment can be expected to give different results in different groups of patients with the same disease, thus, prognostic prospective stratification may increase the value of comparisons and conclusions. The registration of end-points should preferably be done by a separate independent organization. Carefully classified specific mortality may be used as a major end-point in addition to total mortality. Similarly, different modes of deaths, e.g. sudden death, may be used if reliable definitions are used. Confounding factors are often difficult to isolate and identify and may have profound effects on the interpretation of a study. In all studies it is mandatory that the patient characteristics on entry do not differ between the different treatment groups. Concomitant treatment should be administered according to standardized criteria. The drop-out rate should be kept at a minimum. The possibility of generalization decreases with increasing drop-out rate. If the follow-up time becomes too long it is likely that at some time the relative benefit becomes less. Since the proportion of non-cardiovascular deaths increases with follow-up and age it may be critical to decide on the relevant follow-up time.

Adult↗
PubMed1981

Nine years' follow-up of a maximal exercise test in a random population sample of middle-aged men.

A stepwise bicycle exercise test up to maximum was performed in a random population sample of 793 Swedish men, all aged 54 years. High respiratory rate during exercise characterized those who later suffered myocardial infarction (MI) or sudden coronary death (SD). In addition to high cholesterol, high blood pressure (BP), and smoking, low maximal performance, but not ST changes during exercise, increased the risk of MI + SD also in multivariate analysis. Pulse rate, systolic BP at both submaximal and maximal work load were positively correlated with the initial blood pressure level. BP at these work loads was also positively correlated with subsequent BP increase.

Blood Pressure↗
PubMed1980

Obesity in relation to morbidity and mortality from cardiovascular disease.

Representative population samples of middle-aged women (1462 participants, a participation rate of 90.1%) were followed from 1968-1969 for 10 years with respect to morbidity and mortality from myocardial infarction, stroke and all causes of death. The same sample (1302 participants, 80.3%) was studied in 1974-1975. Data on the incidences of angina pectoris, intermittent claudication and hypertension in these women during the 6-year interval were analyzed. Obesity as a premorbid characteristic was estimated by weight index and sum of triceps and subscapsular skinfold thicknesses. The overall trends between weight index and the incidences of myocardial infarction and angina pectoris were weak, while there were excess frequencies in the top quintiles, indicating that only marked obesity constitutes an increased risk. The incidence of hypertension was positively correlated to both indices of obesity. The death rate irrespective of cause was negatively correlated to the sum of skinfolds but was not correlated to the weight index. The death rate from myocardial infarction seemed to be correlated to both obesity indices.

Adult↗
PubMed1979

Influence of a myocardial infarction on blood pressure and serum cholesterol.

Blood pressure (BP) was measured before and after acute myocardial infarction (MI) in 21 men aged 49--60 years from a random population sample. Men on drugs affecting BP before MI or during follow-up were excluded. Pre- and postinfarction cholesterol levels were analyzed in 49 men not on hyperlipidemic treatment recruited from the same population sample. The mean fall in systolic BP (SBP) was 14 mmHg both five weeks and one year after the acute event, but 10 mmHg after two years. The mean fall in diastolic BP (DBP) was 10 mmHg five weeks after the MI and remained at this level for two years. The decreases in SBP and DBP were significant. There was a positive correlation between the maximum rise in SGOT during the acute phase of MI and the decrease in DBP between preinfarction readings and readings five weeks after the MI. Serum cholesterol was unchanged three months, and one and two years after the MI as compared to the preinfarction level.

Aged↗
PubMed1979

Glucose tolerance, plasma insulin and alpha-lipoproteins in young male myocardial infarction survivors compared with controls matched on serum cholesterol concentration.

In order to identify metabolic risk factors other than hypercholesterolaemia, all cases of acute myocardial infarction, diagnosed in males aged under 40 years, were studied over a period of 6 years in Göteborg, Sweden. Twenty out of twenty-four patients who were alive at the time of the study were compared with forty controls matched for serum cholesterol concentration. A previous report has noted lower apolipoprotein A (apoA) and a higher alpha-lipoprotein triglyceride concentration in these young myocardial infarction patients compared with the matched controls. Basal blood glucose, oral glucose tolerance and plasma insulin levels did not differ between the patients and controls, i.e. decreased glucose tolerance and elevated plasma insulin levels were not found to be additional risk factors for myocardial infarction in young males if serum cholesterol concentration was taken into consideration. This finding could be explained by the fact that patients and controls were all high cholesterol individuals and a difference between the patients and the general population is still possible. Low apoA was a risk factor independent of serum cholesterol as well as glucose intolerance and elevated plasma insulin levels.

Adult↗
PubMed1978

Coronary heart-disease after treatment of hypertension.

Within a group of 1026 men aged 47-54, cause-specific death-rates and the incidence of non-fatal myocardial infarction and stroke in treatment group of 635 hypertensive men (casual systolic B.P. greater than 175 or diastolic B.P. greater than 115 mm Hg on two occasions) treated at a hypertension clinic were compared with those in a control group of 391 men (causal systolic B.P. greater than 175 or diastolic greater than 115 mm Hg on only one occasion) who remained mainly untreated during their 4.3 years of follow-up. The predicted risk of coronary heart-disease (C.H.D.) at entry, calculated by a multiple logistic function, was slightly higher in the treatment group. Total death-rate during follow-up was significantly lower in the treatment group (3.3%) than in the control group (6.1%). The difference in death-rate for C.H.D. was of the same relative order (0.8% versus 1.5%), as was the incidence of non-fatal myocardial infarction (2.8% versus 5.4%), although none of the differences reached statistical significance. However, the pooled incidence of fatal and non-fatal C.H.D. was significantly lower in the treatment group (3.6%) than in the control group (6.9%). The results suggest that antihypertensive treatment might be effective in preventing or postponing C.H.D. in middle-aged men.

Cerebrovascular Disorders↗