Search PubMed⌕ Search

Biomedical subjects

L Corea

Publications and source records attributed to L Corea.

At least 19 recordsLinked to original sources
PubMed1996

Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: a comparative study of the efficacy and safety against amlodipine.

OBJECTIVE: To compare the antihypertensive efficacy of a new angiotensin II antagonist, valsartan, with a reference therapy, amlodipine. METHODS: One hundred sixty-eight adult outpatients with mild to moderate hypertension were randomly allocated in double-blind fashion and equal number to receive 80 mg valsartan or 5 mg amlodipine for 12 weeks. After 8 weeks of therapy, in patients whose blood pressure remained uncontrolled, 5 mg amlodipine was added to the initial therapy. Patients were assessed at 4, 8, and 12 weeks. The primary efficacy variable was change from baseline in mean sitting diastolic blood pressure at 8 weeks. Secondary variables included change in sitting systolic blood pressure and responder rates. RESULTS: Both valsartan and amlodipine were effective at lowering blood pressure at 4, 8, and 12 weeks. Similar decreases were observed in both groups, with no statistically significant differences between the groups for any variable analyzed. For the primary variable the difference was 0.5 mm Hg in favor of valsartan (p = 0.68; 95% confidence interval, -2.7 to 1.7). Responder rates at 8 weeks were 66.7% for valsartan and 60.2% for amlodipine (p = 0.39). Both treatments were well tolerated. The incidence of drug-related dependent edema was somewhat higher in the amlodipine group, particularly at a dose of 10 mg per day (2.4% for 80 mg valsartan; 3.6% for 5 mg amlodipine; 0% for valsartan plus 5 mg amlodipine; 14.3% for 10 mg amlodipine). CONCLUSIONS: The data show that valsartan is at least as effective as amlodipine in the treatment of mild to moderate hypertension. The results also show valsartan to be well tolerated and suggest that it is not associated with side effects characteristic of this comparator class, dihydropyridine calcium antagonists.

Adult↗
PubMed1996

Twenty-four-hour antihypertensive efficacy of felodipine 10 mg extended-release: the Italian inter-university study.

We assessed the 24-h antihypertensive efficacy of an extended-release (ER) 10-mg formulation of the dihydropyridine felodipine in mild-to-moderate essential hypertension [World Health Organization (WHO) stage I-II]. Thirty patients, 23 men and 7 women, aged 37-70 years (mean 53 +/- 9 years) participated in a double-blind, randomized, cross-over study of felodipine 10 mg ER versus placebo. An ambulatory daytime diastolic blood pressure (DBP) >90 mm Hg at the end of a 4-week run-in period was necessary to enter the 10-week treatment phase. Twenty-nine patients completed the treatment phase. Twenty-two underwent a 2-day single-blind placebo follow-up to assess residual drug effects. All patients underwent ambulatory BP monitoring (ABPM) by Spacelabs 90207 recorders. Recorders were programmed to make automatic BP and heart rate (HR) measurements every 15 min throughout the 24 h. Felodipine 10 mg ER significantly (p < 0.01) reduced ambulatory systolic BP (SBP) and DBP values throughout the 24-h, day (7 a.m. to 11 p.m.) and night (11 p.m. to 7 a.m.) periods, but not influencing average ambulatory HR values. Trough-to-peak (T/P) ratios, calculated on the average ambulatory BP values measured in the 7-9 a.m. 2-h interval of the second day of ABPM (before the new drug administration: trough) and in the 10 a.m. to 12 noon 2-h interval of the first day of ABPM (peak BP-lowering effect), were 0.71 and 0.58 for SBP and DBP, respectively. Individual T/P calculations, after post hoc selection of nonresponders, gave superimposable results, the consistency of which was judged on mean, median, and confidence intervals (CI). However, the wide variability of the individual T/P ratios suggests that this method cannot be the only means to evaluate the duration of action of an antihypertensive drug by ABPM. The long-acting BP-lowering drug effect was clearly shown by the ABPM performed in the follow-up when SBP and DBP average values of the 24-h, day, and night periods were still reduced. Felodipine 10 mg ER effectively reduced BP in patients with mild-to-moderate hypertension, showing prolonged duration of its antihypertensive action beyond the time of the next dose.

Adult↗
PubMed1992

Leucocytes and free radicals in stable angina pectoris.

Bicycle ergometer exercise was used to induce ischemia in 20 patients with stable angina pectoris (SAP). Superoxide dismutase (SOD) blood concentrations, free radical generation (by the SOD-inhibitable reaction of ferricytochrome C), malondialdehyde (MDA) plasma concentrations, the unfractionated leucocyte filterability rate and the filterability rates of the granulocyte and mononuclear sub-fractions (using a positive pressure filtration system and 5 mu diameter Nuclepore filters), were monitored before and after exercise in the patients and in 18 matched controls. At the onset of ischemia a significant increase in the level of MDA plasma concentrations and significant decreases in both SOD blood concentrations and the SOD-inhibitable reduction of ferricytochrome C indicated oxygen free radicals had been released in the SAP patients. These changes were associated with significant impairments of granulocyte and unfractionated leucocyte filterabilities and with morphological evidence of granulocyte activation.

Aged↗
PubMed1992

[The Study Group of Quinapril in Arterial Hypertension. The Steering Committee].

The efficacy and safety of the treatment of arterial hypertension with the ACE-inhibitor quinapril, were evaluated in a multicentre study conducted in Italy. The study, lasting 14 weeks, after a preliminary wash-out period, allowed response-based titration of quinapril dose from 10 mg to 40 mg once a day, with provision to combine additional hydrochlorothiazide (12.5 to 25 mg), in case of persistently high diastolic pressure levels. The efficacy sample included 1267 patients: at therapy week 14, 78.6% of patients were treated with quinapril alone. Global response rate (intent-to-treat) was 83.3%, with a mean reduction of diastolic pressure of 15.8 mmHg (95% confidence interval from 15.5 to 16.2 mmHg). 91 patients reported 126 associated adverse events (7.0%); the most frequently reported event was cough (2.7%). First-dose hypotension was rarely reported (1.3%), even in elderly and diabetic patients.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1991

[Recent findings on the physiopathology of hypertension].

The numerous pathophysiological theories in the field of essential hypertension are often conflicting, and till now a comprehensive model is not available. The aetiology of human hypertension is probably multifactorial, the control mechanisms of hypertension are strictly interdependent, and the alteration of one induces readjustment of the others, so that it is very difficult to discriminate the "primum movens" from its consequences. In this review the recent acquisitions in the aetiology and the pathophysiology of arterial hypertension are analysed, with particular regard to the role of inheritance, of renal mechanisms of sodium retention, ions transport, humoral factors, central nervous system and of enhanced vascular reactivity. The activation of some of these pathophysiological factors induces the rise in peripheral vascular resistance, which is the final common pathway in the development of essential hypertension.

Biological Transport↗
PubMed1990

Verapamil 240 SR versus verapamil 120 SR in arterial hypertension. A randomized double-blind, placebo-controlled study with 24-hour ambulatory blood pressure monitoring.

Fifteen patients (6 males, 9 females), age range 36-70 years, were enrolled in a randomized, double-blind, placebo-controlled study according to a Latin-square design, with the aim of comparing 24-hour blood pressure profiles after three 15-day treatment periods with placebo, verapamil SR 120 mg (V120 SR) given twice daily (bid), and verapamil SR 240 mg (V240 SR) given once daily (od). All of the patients were diagnosed as mild or moderate essential hypertensives on the basis of standard casual recordings. Noninvasive 24-hour ambulatory blood pressure (BP) monitoring was performed with an ICR Spacelab 5200 automatic device. In comparison with placebo, a clinically and statistically significant reduction in both systolic and diastolic BP over 24 hours was obtained with both active treatments. Comparison of the two active treatments shows that V240 SR led to a greater reduction in systolic and diastolic BP than V120 SR. No changes in heart rate were observed. Both treatments were well tolerated. In conclusion, both verapamil regimens proved to be effective and safe in treating essential hypertensives, with V240 SR giving better 24-hour BP control.

Adult↗
PubMed1990

Stable angina pectoris and controlled ischemia: what causes the abnormalities in whole blood filterability?

The determinants of the altered whole blood filterability observed during coronary ischemia are still under discussion. Since no studies have been carried out to date on what exactly causes these alterations during the early stages of controlled ischemia in coronary heart disease, a model was set up using a bicycle ergometer test (with a 25 W increase every 2 minutes). Blood samples were taken from 48 stable angina pectoris patients and from a group of 28 matched controls before and immediately after exercise and 8 minutes later. Plasma viscosity, the filterability (through 5 microns diameter pore filters) of whole blood, erythrocytes, and polymorphonuclear and mononuclear leukocytes (separated by density gradient) were monitored. Alterations in whole blood filterability could be linked only to an impairment in polymorphonuclear cell filterability in those stable angina pectoris patients who reported chest pain and/or whose ST segment depression was greater than or equal to 2 mm.

Angina Pectoris↗
PubMed1990

[Simvastatin versus gemfibrozil in the treatment of primary hypercholesterolemia in hypertensive patients treated with hydrochlorothiazide].

Recent pharmacological studies confirmed the role of hypercholesterolemia in the pathogenesis of coronary atherosclerosis. A 10% reduction in cholesterol levels can reduce the risk of coronary heart disease by 15%. However many hypercholesterolemic patients often suffer from arterial hypertension and drugs such as thiazide diuretics cause an imbalance in lipid metabolism. The efficacy and the tolerability of simvastatin (a inhibitor of HGM-CoA reductase) with that of gemfibrozil (a fibric acid derivative, which can reduce the VLDL level) were compared in a placebo-controlled study in 2 groups of patients with primary hypercholesterolemia and mild-to-moderate essential hypertension treated with hydrochlorothiazide. After 10 weeks standard hypolipidemic diet and hydrochlorothiazide (25 mg od) therapy, 30 patients whose cholesterol levels were still greater than or equal to 250 mg/100 ml and whose diastolic blood pressure was less than 95 mmHg were randomized to one of the following treatments: simvastatin, 20 mg od, gemfibrozil, 600 mg bid or placebo, while continuing dietetic and diuretic treatment. After 24 weeks treatment, simvastatin induced a 37% reduction in cholesterol plasma levels, a 9% increase of HDL and a 16% reduction of LDL. APO-A1 showed a 4% increase, while APO-B showed a 3% reduction. Gemfibrozil induced a 20% reduction in plasma triglycerides and a 13% decrease in plasma cholesterol, with a significant 19% increase in HDL and a 11% reduction in LDL. No significant variations in any of the lipid parameters monitored were observed in the placebo group. Treatment with simvastatin or gemfibrozil in hypertensive patients in hydrochlorothiazide monotherapy can reduce total cholesterol and LDL-cholesterol plasma levels, while significantly increasing HDL plasma levels compared to placebo. Simvastatin, however, resulted more efficient than gemfibrozil on total cholesterol or cholesterol fractions.

Adult↗
PubMed1989

Leucocyte rheology in controlled coronary ischaemia.

Since no studies have been carried out on the exact origin of the alterations in white blood cell rheology during the early stages of controlled ischaemia in coronary arterial disease, a model was set up using a cycle ergometer test (with a 25 watts increase every 2 minutes). Blood samples were taken (before and after exercise and again 8 minutes later at recovery) from 18 patients with stable angina pectoris and a group of 22 matched controls. The filterability (through 5 micrometer diameter pore filters) of the polymorphonuclear leucocyte sub-population (separated by density gradient), the monocyte and lymphocyte sub-fractions (separated by adhesion to Petri dishes) as well as leucocyte activation (observed under a light microscope) were monitored. Our results showed that the total leucocyte count in patients and controls rose after exercise and was accompanied by a differential shift from the polymorphonuclear to the lymphocyte cells. The polymorphonuclear filterability rate increased significantly in patients when compared to their basal values at rest, and to the controls after exercise (+ 19.58%; P less than 0.002 vs basal values at rest; + 18.72%; P less than 0.002 vs controls). This increase persisted throughout the recovery period (+ 19.86%; P less than 0.002 vs basal values; and + 23.52% P less than 0.001 vs controls), indicating that a reduced polymorphonuclear leucocyte filterability can be associated with the first signs of ischaemia.

Aged↗
PubMed1989

[Multicenter clinical study of the antihypertensive activity of lisinopril].

One-hundred patients suffering from slight-moderate hypertension (53 m, 47 f, aged between 18 and 78, average 49.08) have been studied in order to assess the effectiveness and tolerance of lisinopril ("Zestril", ICI-Pharma), a new ACE inhibitor in a single daily administration at doses of between 10 and 80 mg in relation to pressure values. Monotherapy with Lisinopril proved effective in 84 patients (88.4%), in 74 of whom (7.9%) pressure values were returned to normal. 11 patients (11.6%) did not respond to treatment. In most cases, the result was obtained with a dose of 20 mg in a single administration (32.6%). The incidence of side-effects was limited and in no case required the withdrawal of the drug.

Adolescent↗
PubMed1989

[Doppler echocardiography in atrial myxoma].

Two-dimensional echocardiography is the technique of choice for the diagnosis of atrial myxoma. In fact the Echo study allows the recognition of the presence of the tumor, and can show its dimensions, shape, implantation site and motility. However, it is not clear the role of Doppler echocardiography in the evaluation of atrial myxoma. This technique could be useful to recognize patients with more severe obstruction to atrioventricular flow due to large tumors. In 4 patients with large atrial myxomas (3 left and 1 right atrial myxoma) Doppler analysis of atrioventricular flow showed an apparent correlation between variation of trans-mitral or trans-tricuspid diastolic flow and symptoms (syncopal attacks). Only patients with an obstruction to atrioventricular flow and severely restricted calculated mitral or tricuspid orifice had syncopal attacks, at variance with patients without flow obstruction. Further studies on larger population will verify this apparent relation between atrioventricular flow obstruction and clinical symptoms in patients with large atrial myxoma.

Adult↗
PubMed1987

A multicenter trial of low dose captopril administered twice daily in patients with essential hypertension unresponsive to beta blocker-diuretic treatment.

Two hundred and one patients with essential hypertension, whose supine diastolic blood pressure (SDBP) was greater than or equal to 95 mmHg following 2 weeks of treatment with the optimal dose of a beta blocker-diuretic combination (Phase 1), were randomly assigned to the addition of either 25 or 50 mg captopril BID for 6 weeks (Phase 2). At the end of Phase 2, the dose of captopril was doubled in the patients not normalized (SDBP greater than or equal to 95 mmHg) and maintained in the others (SDBP less than 95) for an additional 4 weeks (Phase 3). At the end of Phase 3, the beta blocker was withdrawn in the normalized (SDBP less than 95 mmHg) patients, and captopril plus diuretic was given for 4 weeks (Phase 4). The addition of captopril at either dose level led to a significant fall (p less than 0.01) in standing and supine diastolic and systolic blood pressure after the first 2 weeks of treatment. There was no significant difference in response between the two dose levels of captopril. At the end of Phase 2, 59.4% and 55.8% of patients, respectively, assigned to 25 and 50 mg captopril BID, were normalized. Doubling the dose of captopril (Phase 3) led to approximately an additional 30% of patients being normalized. At the end of Phase 4 (captopril plus diuretic) the SDBP was still less than 95 mmHg in 63% of patients, whereas it was increased in the others. Side effects were noted in 10 patients (5%). The incidence was similar in each treatment group, and a total of four patients (2%) were withdrawn due to side effects.

Adrenergic beta-Antagonists↗