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Biomedical subjects

I Os

Publications and source records attributed to I Os.

At least 73 records · Page 4Linked to original sources
PubMed1993

Effect of cold pressor test and awareness of hypertension on platelet function in normotensive and hypertensive women.

Plasma beta-thromboglobulin (beta-TG) concentration, reflecting platelet function in vivo, was compared in fertile women with untreated essential hypertension and age-matched normotensives, in two separate studies. In the first study, hypertensives and normotensives were aware of their blood pressure status. Blood was sampled through arterial and venous indwelling catheters, and no difference in beta-TG was found between the groups. Arterial beta-TG was significantly lower than venous concentration (p < or = 0.05). Cold pressor test increased arterial beta-TG significantly in both groups (p < 0.05). In the second study, both women and investigator were unaware of blood pressure status, and beta-TG concentration, platelet count, and mean platelet volume obtained by venipunctures were similar in the hypertensive and normotensive group. Thus, platelet function in vivo seems to be normal in fertile hypertensive women, in contrast to the platelet dysfunction previously reported in hypertensive men. In women, as in men, platelet release occurred during venous catheter blood sampling and during cold pressor test. However, at variance from men, platelet function was not influenced by awareness of blood pressure status in the hypertensive females.

Adult↗
PubMed1992

[Cough during treatment with angiotensin-converting enzyme inhibitors is gender related].

In a Norwegian, double-blind, double-dummy multicenter study, 828 patients with mild to moderate hypertension were randomized to treatment by either lisinopril or nifedipine. One of the aims of the study was to specifically investigate the frequency of side effects. Spontaneously reported coughing reached 8.5% for lisinopril, as against 3.1% for nifedipine. In two patients coughing led to withdrawal from the study, and in another three it contributed partially to discontinuation of the treatment. A significant sex difference was found for spontaneously reported coughing among patients on lisinopril; 12.6% of the women and 4.4% of the men. A similar difference between the sexes was found for specific questioning about coughing. Use of a visual analogue scale by both patient and spouse revealed similar frequency of coughing as when reported spontaneously. The reason for sex being an important determinant for lisinopril-induced coughing remains obscure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1992

[Treatment with lisinopril or nifedipine in essential hypertension. A Norwegian multicenter study of the effect, tolerance and quality of life of 828 patients].

In a randomized, parallel, double-blind study, lisinopril (n = 412) reduced systolic and diastolic blood pressure more than nifedipine did (n = 416) after ten weeks treatment in patients (40-70 years) with mild to moderate essential hypertension. Lisinopril was tolerated better than nifedipine, with fewer withdrawals. Adverse experiences reported after a general question on discomfort were significantly lower for lisinopril than for nifedipine. Questions referring specifically to symptoms revealed higher frequency of coughing with lisinopril, while flushing, edema, palpitations, dizziness, tiredness and rash were reported more frequently with nifedipine. Quality of life was similarly assessed by both patients and spouses. No significant differences in well-being during treatment were found for either drug, except in the case of the highest dose level of nifedipine, which caused a deterioration of well-being.

Adult↗
PubMed1992

[Rhabdomyolysis in self-induced poisoning. A prospective study].

In a prospective study of 103 patients hospitalized for self-poisoning the incidence of rhabdomyolysis (creatine kinase > 1000 U/l) was nearly 7%. A further 9.7% had elevated creatine kinase activity, but lower than 1000 U/l. Two patients showed clinical symptoms of rhabdomyolysis at time of admission; one after heroin and the other after salicylate intoxication. Both developed renal failure, and one of them underwent peritoneal dialysis. The high incidence of rhabdomyolysis found in the study suggests that creatine kinase activity should be considered in all cases of intoxication admitted to hospital. Rhabdomyolysis may often present no symptoms even in conscious patients, and serious complications can be limited by preventive measures if rhabdomyolysis is recognized early.

Acute Kidney Injury↗
PubMed1992

[Treatment of hypertension in the elderly].

The effect of treating hypertension in the elderly (aged 60-65 years and above), and isolated systolic hypertension in particular, has not been adequately documented. In three recent studies, however, a good effect in respect of cardiovascular end points has been observed in this group of patients. We have previously suggested pharmacological treatment of a diastolic blood pressure above 100mm Hg after three to six months' observation and non-pharmacological intervention. In a patient with essential hypertension, and with no concomitant disease, systolic blood pressure should also be taken into account, and when this exceeds (100 + age) mm Hg after the same period of observation the patient should be treated pharmacologically. If a patient shows additional indications for treatment of high blood pressure, the level for initiating treatment may be lower. As of today, diuretics and beta-blockers have proven effective in reducing cardiovascular morbidity and mortality, while data on the other antihypertensive agents are still lacking.

Age Factors↗
PubMed1992

Mild essential hypertension in nonobese premenopausal women is characterized by low renin.

The pathophysiological mechanisms in hypertension may differ in men and women. Plasma renin activity was measured in 27 premenopausal, never-treated hypertensive women (blood pressure 141 +/- 2/93 +/- 1 mm Hg) and in 18 age-matched normotensive women (blood pressure 113 +/- 2/71 +/- 2 mm Hg). All subjects were unaware of their blood pressure status. The hypertensive women had on average lower plasma renin activity (0.21 +/- 0.03 nmol/L/h) than their normotensive controls (0.42 +/- 0.07 nmol/L/h, P less than .01). Serum estradiol was also lower in the hypertensive women (0.57 +/- 0.06 v 0.81 +/- 0.09 nmol/L, P less than .05). No difference in epinephrine, norepinephrine, atrial natriuretic peptide, or vasopressin was found between the groups. Plasma renin activity was positively correlated to plasma norepinephrine in the hypertensive women only (r = 0.41, P less than .05). Since low renin hypertension is associated with less cardiovascular complications, this may offer an explanation for the better prognosis of hypertension in women.

Adult↗
PubMed1992

Haemodynamic and neurohumoral effects of cold pressor test in severe heart failure.

The effect of a cold pressor test (CPT) on haemodynamics in relation to general and regional sympathetic activity and arginin vasopressin (AVP), was studied in eleven patients with severe congestive heart failure (CHF). Compared to an age-matched control group (C), resting arterial plasma noradrenaline (NA) (419 +/- 77 vs. 182 +/- 15 pg ml-1), and adrenaline (A) (142 +/- 28 vs 54 +/- 10 pg ml-1) were higher (P less than 0.05) in CHF. AVP showed no significant difference (14 +/- 4 vs. 9 +/- 4 pg ml-1). During CPT systolic and diastolic blood pressure and systemic vascular resistance increased (P less than 0.01), as did NA (delta 114 +/- 39 pg ml-1, P less than 0.01), A (delta 33 +/- 10 pg ml-1, P less than 0.01) and heart rate (delta 10 beats min-1, P less than 0.01). The myocardial v-a difference of NA decreased (P less than 0.05), but was unchanged across the renal vascular bed during CPT. The a-v difference of NA in the hepatic vascular bed, and fractional extraction of A in the coronary sinus, renal and hepatic vascular beds remained unchanged during CPT. AVP did not change significantly and no change in cardiac index or left ventricular filling pressure was observed during CPT. These data suggest that despite an increased activation of the sympathetic nervous system at rest, a further increase in blood pressure and catecholamines took place during CPT. Thus, the effect of a CPT which activates the central sympathetic system seems not to be altered in patients with severe CHF.

Aged↗
PubMed1992

Evidence of decreased fibrinolytic activity in hypertensive premenopausal women.

In 29 lean, premenopausal, never-treated hypertensive women (142 +/- 2/93 +/- 1 mmHg, mean +/- SEM) plasminogen activator inhibitor (PAI-1) was elevated (11.0 +/- 1.5 U/ml vs 6.3 +/- 1.0 U/ml, p less than 0.05) compared to healthy, normotensive women (113 +/- 2/71 +/- 2 mmHg). Euglobulin clot lysis time tended to be longer in the hypertensive than in the normotensive women (p = 0.06). PAI-1 was positively correlated to triglycerides (r = 0.60, p less than 0.001), haematocrit (r = 0.45, p less than 0.05), insulin (r = 0.38, p less than 0.05) and body mass index (r = 0.38, p less than 0.05), and inversely correlated to HDL cholesterol (r = -0.43, p less than 0.05) in the hypertensive women. Fibrinogen was not significantly different in the hypertensive and normotensive women, while the hypertensive smokers had higher fibrinogen than the hypertensive non-smokers (3.01 +/- 0.17 g/l vs 2.54 +/- 0.10 g/l, p less than 0.05). All participants were investigated in the same phase of the menstrual cycle. Despite that, oestradiol was significantly lower in the hypertensive than in the normotensive women (0.57 +/- 0.06 vs 0.81 +/- 0.09 nmol l-1, p less than 0.05), while progesterone was similar in the two groups. These results suggest that premenopausal, never-treated hypertensive women are characterized by low oestradiol levels as well as decreased fibrinolytic activity. PAI-1 seems to be associated with other risk factors for cardiovascular disease in hypertensive women.

Adult↗
PubMed1992

Hypertension and the metabolic cardiovascular syndrome: special reference to premenopausal women.

It has been proposed that hyperinsulinemia may not constitute a cardiovascular risk in women, and that the metabolic risk profile is less apparent in women than in men. In two different studies, we have assessed the interrelationship between classical coronary risk factors in women with untreated essential hypertension and looked for possible hypertensive-normotensive differences. Hypertensive women (HT1, 156 +/- 2/98 +/- 1 mm Hg, n = 18) in study I turned out to be overweight and had nearly three times higher fasting serum insulin levels than the normotensive control subjects (NT1, 118 +/- 3/77 +/- 2 mm Hg, n = 9). HT1 women with a body mass index (BMI) above 25 kg/m2 had significant higher insulin levels than HT1 women with a BMI less than 25 kg/m2, and when adjusting for BMI the hypertensive-normotensive difference in insulin levels was lost. In HT1 women, the serum insulin level correlated positively to the BMI and triglycerides. In study II, insulin was positively associated with the systolic blood pressure in HTII women (150 +/- 3/99 +/- 1 mm Hg, n = 29), and a negative correlation appeared between the glucose/insulin ratio and the systolic as well as diastolic blood pressure. No difference was observed in BMI and insulin between HTII and NTII women (121 +/- 3/79 +/- 1 mm Hg, n = 18). In HTII women, plasminogen activator inhibitor (PAI-1) levels were higher and the euglobulin clot lysis time prolonged compared to NTII women. PAI-1 was positively correlated to insulin and triglycerides and negatively to high-density lipoprotein (HDL) cholesterol in HTII women. Strong associations between potential cardiovascular risk factors seem to be present even in untreated women with mild hypertension, with insulin being correlated to hypertension, BMI, fibrinolytic activity, triglycerides, and HDL cholesterol.

Adult↗
PubMed1992

Physical activity and the metabolic cardiovascular syndrome.

Hyperinsulinemia, lipid abnormalities, and impaired fibrinolytic capacity may accompany hypertension, and comprise the metabolic cardiovascular syndrome. They are all independent risk factors for coronary artery disease. Lifestyle modifications can reduce the coronary artery risk. Physical activity has been shown to improve insulin sensitivity, reduce hypertriglyceridemia, improve fibrinolytic capacity, and reduce the blood pressure. A sedentary lifestyle is associated with increased mortality compared to a physically active lifestyle. Hypertensive patients, who often have other atherothrombogenic risk factors, should be encouraged to undertake physical activity as an adjuvant to other nonpharmacological interventions as well as to pharmacological treatment.

Blood Pressure↗
PubMed1991

[Hypertension as a part of metabolic cardiovascular syndrome].

Hypertension is only one of several cardiovascular risk factors that tend to cluster. Hypertension is associated with glucose intolerance, hyperinsulinemia, decreased HDL-cholesterol, high triglycerides and decreased fibrinolytic activity. One possible link is insulin resistance, which also links hypertension to obesity and diabetes mellitus type II. The authors review the literature and discuss clinical and therapeutic implications in the treatment of hypertension. Since the hypertensive patient may have an unfavourable cardiovascular risk profile, a non-pharmacological approach is essential in the treatment. Furthermore, if antihypertensive agents have to be used, metabolic side effects should be monitored closely, since they may reduce the beneficial effects of the blood pressure reduction on the cardiovascular risk profile.

Antihypertensive Agents↗
PubMed1991

[Ambulatory non-invasive 24-hour blood pressure measurement--do we need it?].

The introduction of non-invasive, portable, automatic blood pressure measurement devices enables characterization of the blood pressure profile throughout the day in an ambulatory setting. The article advises against uncritical use. 24-hour ambulatory blood pressure measurements have become a valuable tool in scientific research, however, especially in studies dealing with antihypertensive efficacy. In hypertensive patients with "white coat hypertension", important data cannot be obtained without the use of 24-hour ambulatory blood pressure monitoring or blood pressure measurement at home.

Ambulatory Care↗
PubMed1991

Lisinopril or nifedipine in essential hypertension? A Norwegian multicenter study on efficacy, tolerability and quality of life in 828 patients.

In a randomized, parallel, double-blind study, lisinopril (n = 412; average dose 18.8 mg) reduced systolic and diastolic blood pressure (change = 20.2/13.8 mmHg; P less than 0.01/P less than 0.01) more than nifedipine (n = 416; average dose 37.4 mg; change = 13.3/11.2 mmHg) after 10-week treatment in patients, aged 40-70 years, with mild-to-moderate essential hypertension. Lisinopril was better tolerated than nifedipine. The withdrawals from treatment were fewer in the lisinopril-treated group (11 versus 46; P less than 0.01). The frequency of adverse experiences reported after a general question of discomfort was significantly lower for lisinopril than for nifedipine (P less than 0.01). When questioned on specific symptoms, frequency of coughing was higher with lisinopril (P less than 0.01), while flushing, edema, palpitations, dizziness, tiredness and rash were reported more frequently (P less than 0.01, for all) in the nifedipine-treated group. Quality of life was assessed by both patients and spouses. No significant changes in wellbeing were observed for either drug, except for the highest dose level of nifedipine which caused a deterioration.

Antihypertensive Agents↗
PubMed1990

[Hyponatremia. A retrospective study of occurrence, etiology and mortality].

In patients admitted to a general medical ward, the incidence of hyponatremia on admission was 3.6%. Mortality was more than three times higher among patients with hyponatremia than among the patients as a whole. The triad hyponatremia, hypoalbuminemia and hypervolemia indicated a poor prognosis. A diversity of medical illnesses was associated with hyponatremia, and the use of diuretics was a major contributor to the electrolyte disturbance. Treatment of asymptomatic hyponatremia is discussed, with special emphasis on restriction of fluids.

Adolescent↗
PubMed1990

Increased arterial adrenaline is related to pain in uncomplicated myocardial infarction.

Plasma levels of catecholamines, beta-thromboglobulin (BTG) and arginine vasopressin (AVP), and degree of pain were examined in 22 patients with suspected uncomplicated myocardial infarction within 24 h following onset of chest pain. Sixteen patients developed infarction with peak creatine phosphokinase at 1280 Ul-1 (range 293-3770 Ul-1). Fifteen healthy men served as controls (C). Arterial adrenaline levels were significantly higher in patients with pain (1.15 +/- 0.23 nmol l-1, n = 8, mean value +/- SEM) than in those without pain (0.60 +/- 0.10 nmol l-1, n = 14, P less than 0.05). Plasma catecholamines were moderately but significantly elevated in myocardial infarction; the concentration of arterial adrenaline was 0.83 +/- 0.14 nmol l-1 and that of arterial noradrenaline was 2.70 +/- 0.28 nmol l-1 compared with 0.44 +/- 0.04 nmol l-1 (P less than 0.025) and 1.47 +/- 0.05 nmol l-1 (P less than 0.0005), respectively, in C. One week later, plasma catecholamines had returned to baseline levels. Plasma BTG showed borderline elevation (1.0 +/- 0.1 pmol l-1) compared with C (0.6 +/- 0.1 pmol l-1, P = 0.04), and remained unchanged 1 week later. Plasma AVP was at baseline level. Uncomplicated myocardial infarction, regardless of size, was associated with only moderately increased sympathetic tone. Plasma adrenaline was related more to the degree of pain than to the presence of acute myocardial infarction. Arterial adrenaline may be a sensitive marker of sympatho-adrenal activity related to pain.

Arginine Vasopressin↗