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Biomedical subjects

J M Thorp

Publications and source records attributed to J M Thorp.

At least 127 records · Page 7Linked to original sources
PubMed1987

The efficacy and tolerability of antihypertensive treatment based on atenolol in the prevention of stroke and the regression of left ventricular hypertrophy.

Nine hundred and thirty nine moderate to severe hypertensive patients were treated with a combination of atenolol, a beta 1 selective receptor blocker, diuretics and where required, additional vasodilator therapy to achieve adequate blood pressure (BP) control. Patients were followed up for a period of 10.2 years (mean 6.1 years). Amassed clinical exposure amounted to 5465 patient years. Mean BP fell from 183.0 +/- 1.0/109.2 +/- 0.5 mmHg to 145.1 +/- 0.6/89.3 +/- 0.3 mmHg and treatment resulted in a significant regression of the electrocardiographic signs of left ventricular hypertrophy (LVH). Side effects of treatment were consistent with those expected from a regime comprising a combination of a beta 1 selective hydrophilic beta-blocker, diuretics and vasodilators. Reported side effects appeared to diminish with time; were more common in the elderly than in the young and increased in frequency as the dose of atenolol increased. Biochemical disturbance was minimal. Total mortality (n = 91) and mortality from myocardial infarction (n = 40) were positively related to treated systolic blood pressure (SBP). A J-shaped curvilinear relationship between treated diastolic blood pressure (DBP) and death rate from myocardial infarction has been shown. Although the number of deaths from stroke was small (n = 21), there appeared to be a positive relationship with treated DBP: by contrast the data suggest that in the elderly, lowering SBP to below about 140 mmHg might be associated with an increased incidence of death from stroke.

Adolescent↗
PubMed1987

Selected use of midline episiotomy: effect on perineal trauma.

A prospective, nonrandomized controlled study was performed to determine the effect of using midline episiotomy only for mothers who experienced fetal distress and/or operative vaginal delivery. Such a policy resulted in a significant decline in third- and fourth-degree lacerations in nulliparous women. This reduction was most pronounced in nulliparous women delivering infants larger than 3400 g. No third- or fourth-degree laceration occurred without antecedent episiotomy in any woman. A policy of using episiotomy selectively appears to lower the incidence of perineal trauma.

Episiotomy↗
PubMed1987

Low mortality from all causes, including myocardial infarction, in well-controlled hypertensives treated with a beta-blocker plus other antihypertensives.

The aim of the present study was to monitor the efficacy of treatment, morbidity and mortality over a 10-year period in 939 moderate to severe hypertensive patients. All patients were treated in the same hypertension clinic with the beta 1-selective agent atenolol, administered either alone or more usually with a diuretic with or without a vasodilator or other agents. Survival rates were compared with predicted survival rates, had the hypertension not been treated, and also with those of a local reference population matched for age and sex. After a mean follow-up time of 6.1 years, mean blood pressure (BP) was significantly lowered from 183/109 to 145/87 mmHg. Biochemical disturbance was minimal. There were 79 withdrawals from treatment, of whom 37 were lost to follow-up. There were 91 deaths on intention to treat. Systolic blood pressure (SBP) on treatment, and not initial BP, was a powerful predictor of mortality. Patients of all age groups with well-controlled SBP were less likely to die, particularly from myocardial infarction, than those with less well controlled SBP (P less than 0.001). However, due to possible J-curve relationships between treated BP and outcome, lowering SBP below 140-150 mmHg in the elderly, and the diastolic blood pressure (DBP) below about 85 mmHg, may not be beneficial. Total mortality and mortality due to myocardial infarction was about 60% [corrected], of predicted level, had a high BP not been treated, being similar to that in a local reference control population (age- and sex-matched). The death rate from stroke was reduced to about 50% of that predicted. Patients who died showed a mean fall in mean serum triglyceride concentration in contrast to the mean increase that occurred in survivors. It is concluded that patients with moderate to severe hypertension who obtain a high level of general health care and optimal control of BP for up to 10 years, experience a significant decrease in total mortality rate and death from myocardial infarction and stroke.

Adolescent↗
PubMed1985

Plasma fibrinogen--a major coronary risk factor.

The role of plasma fibrinogen as a potential indicator of susceptibility to heart attacks was studied in a sample of 297 men aged 40-69 years at entry who were initially free from overt coronary heart disease. During a mean observation period of 7.3 years (range 0.1-16.1) new heart attacks occurred in 40 men. There was a significant positive correlation between initial plasma fibrinogen levels and the subsequent incidence of heart attacks. In men with high cholesterol or high systolic blood pressure levels the incidence of heart attacks was respectively six times and 12 times greater in those with high plasma fibrinogen levels than in those with low fibrinogen levels. In multivariate models plasma fibrinogen was a highly significant and independent explanatory variable, at least as important as serum cholesterol, blood pressure or cigarette smoking. These results suggest that high plasma fibrinogen levels are an important coronary risk factor and should be included in profiles used to identify those at high risk of heart attacks.

Adult↗
PubMed1976

Effects of oxprenolol on the airways of normal and bronchitic subjects.

In a double blind trial in 11 control subjects and 12 bronchitic patients against an inert control oxprenolol produced significant worsening in airways obstruction in 6 control and in 7 patients. There was marked individual variation in response and no way was found to predict the susceptible subjects. Objective measurement of indices of airways obstruction and the effects of oxprenolol on them is essential where there is significant respiratory impairment. Great care must continue to be exercised since a significant proportion of bronchitic patients will be adversely affected by this drug.

Adult↗