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Biomedical subjects

L Hansson

Publications and source records attributed to L Hansson.

At least 415 records · Page 23Linked to original sources
PubMed1985

Long-term effects of captopril and atenolol in essential hypertension.

Fifty patients with mild or moderate essential hypertension were randomized (double-blindly) to treatment with either captopril (n = 26) or atenolol (n = 24). Their mean supine diastolic blood pressure after placebo was 100-125 mmHg. The study included an initial dose finding phase (12 weeks) during which the dosages of captopril and atenolol were increased stepwise every second week in order to obtain normotension (supine diastolic blood pressure less than 95 mmHg). Hydrochlorothiazide was added when necessary. During the second phase of the study the patients were followed on active treatment for 2 years. After the initial 12 weeks of active treatment, recumbent and standing blood pressures had fallen significantly both in the captopril group (by 31/20 and 33/19 mmHg, p less than 0.001) and in the atenolol group (by 24/18 and 30/20 mmHg, p less than 0.01 (systolic), p less than 0.001 (diastolic)). The antihypertensive effect was maintained in both groups during long-term treatment. The antihypertensive effect of both agents was potentiated to the same extent by addition of hydrochlorothiazide. Side-effects were few and mild. It can be concluded that both captopril and atenolol are safe and effective antihypertensive drugs.

Adult↗
PubMed1985

Blood pressure and response to "stress" in 11-16 year old children.

Blood pressure at rest and cardiovascular response to "stress" were studied in 27 girls and 33 boys 11-16 years old. One group (HT, n = 23) had hypertensive mothers with a previous hypertensive pregnancy, another group (NT, n = 20) had normotensive mothers with a previous hypertensive pregnancy and the control group (C, n = 17) had normotensive mothers with normotensive pregnancies. Resting blood pressure was 124/71 mmHg (HT), 117/67 mmHg (NT) and 112/65 mmHg in the 3 groups. Systolic pressure was significantly different in all 3 groups (p less than 0.05 - p less than 0.001). Responses to noise stimulation (100 dBA) were identical in all groups with increases in diastolic and mean arterial blood pressure and cardiac output. During a video game session increases in blood pressure and heart rate were equal in the groups but during physical exercise a slight decrease in diastolic blood pressure was seen in the NT and C groups only. Differences in blood pressure in children with varying maternal history of hypertension do not seem to reflect alterations in the cardiovascular response pattern to "stress".

Adolescent↗
PubMed1985

Hemodynamic effects of combined beta-adrenoceptor blockade and precapillary vasodilatation in hypertension.

Carvedilol (BM14190) is a new compound with combined properties of nonselective beta-adrenoceptor blockade, devoid of ISA, and precapillary vasodilatation. Its acute hemodynamic effects were studied with invasive technique (dye-dilution using Cardio-Green) in 10 patients taking 25 mg orally and noninvasive (fore-arm plethysmography) in 10 patients taking 25 mg and in 10 patients taking 50 mg orally, all with essential hypertension. Significant reductions of systolic and diastolic blood pressures (p less than 0.05 - 0.001) were observed in all groups. TPR did not change acutely whereas resistance in the fore-arm was reduced by 16% (p less than 0.05). When a comparison with propranolol (80 mgx2) was made in a randomized, double-blind placebo controlled trial comprising 30 patients with essential hypertension, carvedilol acutely reduced blood pressure significantly 13/6 mm Hg (25 mg) and 17/10 mm Hg (50 mg) in contrast to propranolol. Resistance in the fore-arm (plethysmography) fell significantly with carvedilol 50 mg whereas propranolol caused a significant rise. After 4 weeks both compounds had reduced blood pressure significantly and to the same extent. Blood flow was still reduced with propranolol in contrast to the findings with carvedilol. We conclude that carvedilol given orally has a useful antihypertensive effect both acutely and during prolonged treatment. It has an attractive hemodynamic profile.

Adrenergic beta-Antagonists↗
PubMed1985

Patient attitudes in short-term psychiatric care. Relations to social and psychiatric background, clinical symptoms, and treatment model.

The attitudes of patients were measured after 4 days and at discharge during two 4-month periods. The attitudes were related to ratings of symptoms, patient background, and type of treatment contract used (cooperation or staff-directed). The patients were generally satisfied with their treatment. A mere 7% disapproved of the general ward structure. The attitude data were subjected to a factor analysis and a 7-factor solution explaining 70% of the variance was found to be suitable. The factors were labelled Ward Structure, Key Worker, Nursing Care, Group Treatment, Psychopharmacological Treatment, Social Network, and Other Patients. A high level of satisfaction in the Ward Structure, Nursing Care, Psychopharmacological Treatment, and Other Patients factors was found to be related to a lower incidence of symptoms at discharge. The staff-contract group showed more favourable attitudes in the Nursing Care factor (both initially and at discharge) and the Psychopharmacological Treatment factor (only initially), while the cooperation-contract group did so in the Social Network factor. It is suggested that the two contract procedures resulted in the development of different kinds of interpersonal relationships during treatment, the cooperation group relying more on the social network, whereas the staff-contract group was more apt to rely on psychopharmacological treatment and on the nursing staff.

Consumer Behavior↗
PubMed1985

Standardized intraabdominal abscess formation with generalized sepsis: pathophysiology in the rat.

Gelatine capsules containing Escherichia coli and Bacteroides fragilis in a standardized mixture with rat colonic content and barium sulfate were implanted intraabdominally into rats. Capsules of 0.75 g gave approximately 50% mortality whereas 0.35 and 1.10 g caused no or 100% mortality, respectively. In subsequent experiments, using the 0.75 g capsule, all animals became ill with signs of tachypnea, piloerection, low physical activity and hypersecretion of saliva 6-8 h after the implantation. The animals reduced their water and food intake substantially and the body weight decreased. A significant reduction in blood pressure, glucose and leukocyte and platelet counts was found 12 h after challenge. Blood cultures obtained at 12, 24, 48 and 60 h all grew E. coli but none B. fragilis. Succumbed animals revealed diffuse peritonitis with growth of E. coli and B. fragilis at autopsy, whereas surviving animals showed abscess formation at investigation on day 8 after challenge. It was concluded that the model closely resembled intraabdominal abscess formation with sepsis in man.

Abdomen↗
PubMed1985

Potentiation of the antihypertensive effect of enalapril by randomized addition of different doses of hydrochlorothiazide.

The purpose of this study was to evaluate the potentiating effect of hydrochlorothiazide (HCTZ) 12.5 or 25 mg once daily when added in a placebo-controlled double-blind randomized study of patients with essential hypertension, whose diastolic blood pressure (DBP) was not adequately controlled (DBP > 90 mmHg) following 6 weeks of single-blind treatment with the angiotensin converting enzyme (ACE) inhibitor enalapril, 20 mg once daily. Forty-eight patients started the first period with enalapril after 4 weeks on placebo. In 13 patients DBP fell to < or = 90 mmHg after enalapril for 6 weeks. In this group supine mean arterial pressure (MAP) was reduced by 13% (P < 0.01). In the patients whose DBP was > 90 mmHg after 6 weeks on enalapril (n = 32) the average supine MAP fell by 9% (P < 0.001). After 3 weeks there was no further drop in blood pressure (BP). Addition of HCTZ to the 32 patients with DBP > 90 mmHg caused a significant further drop in supine BP by 13/7 mmHg with 12.5 mg and by 15/7 mmHg with 25 mg. Seven patients discontinued the study, none due to side effects on enalapril alone. Well-being, assessed with a special questionnaire, was significantly better with enalapril as monotherapy compared with previous treatment, but not different from well-being during the placebo periods. It is concluded that 20 mg enalapril once daily lowered BP effectively and was well tolerated. The maximum BP lowering effect was seen within 3 weeks. Addition of HCTZ caused a significant, and clinically relevant, further drop in BP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Vasodilators in hypertension--a review with special emphasis on the combined use of vasodilators and beta-adrenoceptor blockers.

This paper presents a review of studies dealing with combined beta-adrenoceptor blockade and vasodilatation in the treatment of hypertension. This therapy can be achieved either through the combined use of conventional beta-adrenoceptor blocking compounds given together with vasodilator drugs or with agents which show multiple action of this kind. From a hemodynamic point of view this therapeutic approach is quite logical since most forms of established hypertension are characterized by increased vascular resistance. It can therefore be concluded that combined beta-adrenoceptor blockade and vasodilation offers a rational and useful treatment of hypertension.

Adrenergic alpha-Antagonists↗
PubMed1985

Assessment of the patient's response.

Assessment of a patient's response to antihypertensive therapy consists of the evaluation of the therapeutic effect in relationship to adverse effects and possible improvement in well-being. The therapeutic effect can be assessed at various levels of aim, such as: (1) a reduction in cardiovascular morbidity and mortality, (2) a normalization of hypertension-induced cardiovascular hypertrophy or renal damage or (3) simply a fall in blood pressure. Adverse effects must also be assessed with various degrees of ambition and, although studies during the initial phases of drug evaluation are of primary importance, there is also the need for chronic surveillance during routine clinical therapy. Finally, the possibility of increased well-being has been raised, in particular in conjunction with angiotensin converting enzyme inhibition therapy. The final assessment of a patient's response to therapy therefore requires that all of these aspects be considered together.

Antihypertensive Agents↗
PubMed1985

Hypertension in pregnancy. Analysis of 261 consecutive cases.

In the years 1969 - 1973, 0.3% of 17000 unselected non-diabetic pregnancies were complicated by severe pre-eclampsia, 0.6% by mild pre-eclampsia and 0.6% by hypertension in pregnancy. Records from affiliated maternity centers and the hospital were studied for these 261 women and for 260 women with matched normotensive pregnancies. The women with pre-eclampsia/hypertension in pregnancy had higher blood pressure than the control group very early in pregnancy. The hypertensive women were more often primiparous and they had a slightly higher body weight. The patients with severe pre-eclampsia were older than the other women (30.4 vs 25.4 years for controls, p less than 0.001). Immigrants were not more commonly found in the hypertensive groups, but unmarried mothers were more often seen in the mild pre-eclampsia and pregnancy hypertension groups, 19.1% and 20.6% respectively compared to 7.7% in the control group (p less than 0.01). A family history of hypertension was frequently reported in all groups. The most striking characteristic of women with pre-eclampsia/hypertension in pregnancy was their elevated blood pressure before or very early in pregnancy.

Adult↗
PubMed1984

Hypertension and coronary heart disease: cause and consequence or associated diseases?

Numerous epidemiologic and experimental studies have shown that increased arterial pressure accelerates atherosclerotic disease including coronary heart disease. Left ventricular hypertrophy also develops along with the development of hypertension. In uncomplicated stages of hypertension, left ventricular hypertrophy may enable the heart to maintain its performance against an increased afterload. Development of coronary heart disease in hypertensive heart disease could be one of the factors that impairs cardiac function in later stages of the disease so that the function of the heart can no longer match the increased afterload. It can also be argued that atherosclerotic disease commonly contributes to an increase in systolic blood pressure. Short-term increases in arterial pressure due to angina pectoris or other stressful events may trigger permanent hypertension; this is an interesting alternative that is yet to be investigated. Thus, it is possible that a cause/consequence relationship is involved between hypertension and coronary heart disease as opposed to a simple association. Furthermore, this cause/consequence relationship could sometimes be bidirectional.

Animals↗
PubMed1984

Haemodynamic effects of loud noise in hypertensive patients treated with combined beta-adrenoceptor blockade and precapillary vasodilatation.

The effects of acute exposure to noise on central and regional (calf and forearm) haemodynamics were studied during placebo therapy and during combined nonselective beta-adrenoceptor blockade and precapillary vasodilatation in 9 patients with essential hypertension. On placebo therapy a loud noise (105 dBA for 10 min) caused a significant increase in diastolic and mean arterial pressure due to vasoconstriction. There was also a significant increase of vascular resistance in the calf. After combined precapillary vasodilatation and non-selective beta-adrenoceptor blockade, the increase in blood pressure during stimulation with noise was not prevented. Thus, systolic as well as diastolic and mean arterial pressures increased significantly. This indicates a temporary resetting of the baroreceptors, allowing a higher level of blood pressure during stimulation with noise. Such a resetting would involve the central nervous system pathways of the baroreflex and this would explain why the peripherally active therapeutic principle--precapillary vasodilatation and beta-adrenoceptor blockade--was unable to inhibit the blood pressure response induced by noise.

Adult↗
PubMed1984

Haemodynamic effects of carvedilol, a new beta-adrenoceptor blocker and precapillary vasodilator in essential hypertension.

Carvedilol (BM 14190) is a new antihypertensive compound which combines beta-adrenoceptor blocking and precapillary vasodilating properties but is devoid of intrinsic sympathomimetic activity. The acute and long-term effects on blood pressure and regional haemodynamics (forearm plethysmography) were studied with carvedilol 25 mg b.i.d. or 50 mg b.i.d. Comparisons were made with propranolol 80 mg b.i.d. in a randomized double-blind placebo controlled trial comprised of 30 patients with essential hypertension. After a four-week placebo period active therapy was given for four weeks. Carvedilol administered acutely reduced blood pressure at both doses, delta 13/6 mmHg (P less than 0.001/P less than 0.01) and 17/10 mmHg (P less than 0.001/P less than 0.01). Resistance in the forearm fell significantly with the higher dose. This was in contrast to propranolol which only reduced heart rate acutely, and as expected caused a rise in forearm resistance. After four weeks both compounds had reduced blood pressure significantly and to the same extent. Blood flow was still significantly reduced with propranolol in contrast to the findings with carvedilol. We conclude that carvedilol given orally has a useful antihypertensive effect both acutely and during prolonged treatment. It is well tolerated and its haemodynamic profile is attractive.

Adrenergic beta-Antagonists↗
PubMed1984

Initial clinical experience with ICI 141,292 (Visacor), a new selective beta 1-adrenoceptor blocker with ISA--a multicentre trial in 59 patients.

The objective of this placebo controlled double-blind multicentre (six centres) trial was to investigate the safety and efficacy of ICI 141,292 (Visacor), a new selective beta 1-adrenoceptor antagonist with modest intrinsic sympathomimetic activity (ISA), in hypertensive patients. Fifty-nine patients with mild essential hypertension were randomized to two of five treatment alternatives (placebo, 50 mg, 100 mg 200 mg or 300 mg of ICI 141,292) each given once daily for 2 weeks with a 4 week placebo period before (run in) and in between (wash out) active periods. Thus, each of the five treatments was evaluated in 20-24 patients. After 2 weeks (24 h after last dose) the reduction in recumbent blood pressure for all doses except 50 mg of ICI 141,292 was statistically significant and in the order of 6/4 mm Hg. Standing systolic blood pressure was reduced in a dose-dependent way but only significant for 200 mg of ICI 141,292 (8 mm Hg). Heart rate changes (delta) less than 4 beats/min) were not statistically significant for any dose. It is concluded that ICI 141,292 was well tolerated and had a significant but weak antihypertensive effect which might be explained by too much beta 1-adrenoceptor ISA.

Adrenergic beta-Antagonists↗
PubMed1984

The use of treatment contracts in short-term psychiatric care.

Two different treatment contracts, one with and one without active patient cooperation were compared during two 4-month periods on a short-term psychiatric ward. Attitudes and symptoms were measured at admission after 5 days and at discharge by an independent rater and by self-ratings. The length of stay was similar during the two periods. Patients with cooperation contracts showed a significantly larger reduction of anxiety compared with the others. Patients benefitting most from a cooperation contract were those with socio-psychological treatment contract objectives and those treated in a basic activation group. It is concluded that treatment contracts with an active patient cooperation on a short-term psychiatric ward are useful especially for patients not primarily suitable for specific psychotherapy or specific psychopharmacological treatment.

Adult↗
PubMed1984

Characteristics of hypertension in pregnancy. A retrospective study of 261 consecutive cases.

During the period 1969-73, 0.3% of 17 000 unselected non-diabetic pregnancies in our hospital were complicated by severe pre-eclampsia, 0.6% by mild pre-eclampsia and 0.6% by hypertension in pregnancy. Records from affiliated maternity centres and the hospital regarding these 261 women were studied and pertinent data assembled for comparison with 260 matched normotensive pregnancies. Instrumental deliveries were more common in all types of hypertensive pregnancy, with a 35% frequency of caesarean section in severe pre-eclampsia compared with fewer than 5% for controls. Significantly longer hospitalization and increased perinatal mortality were observed in hypertensive pregnancies, most pronounced in severe pre-eclampsia. The combination of high blood pressure and proteinuria was associated with the greatest risk for premature birth, low infant weight and perinatal mortality. The overall incidence of hypertensive disorders in pregnancy was relatively low, 1.5%, but these women counted for a significant proportion of obstetric complications requiring hospitalization and instrumental delivery.

Apgar Score↗
PubMed1984

Acute haemodynamic effects of carvedilol (BM 14190), a new combined beta-adrenoceptor blocker and precapillary vasodilating agent, in hypertensive patients.

Carvedilol (BM 14190) is a new compound with combined nonselective beta-adrenoceptor blocking activity, devoid of ISA, and a precapillary vasodilating effect. Its acute haemodynamic effects were studied by invasive techniques in 10 patients given 25 mg carvedilol and noninvasively in 10 patients given 25 mg and in 10 given 50 mg orally. All had essential hypertension. In the invasive study intraarterial blood pressure was measured and cardiac output was determined by the dye-dilution method using Cardio-Green as the indicator. Peripheral haemodynamics in all 30 patients were studied in the forearm using strain gauge plethysmography. Measurements were made at rest before and repeatedly for 90 minutes after oral administration of one capsule of 25 mg or 50 mg carvedilol. Significant reductions in the systolic and diastolic blood pressures (p less than 0.05-0.001) were observed in all groups. Cardiac output showed a small, non-significant decrease from 5.81/min to 5.1 l/min. Total peripheral resistance did not change, whereas resistance in the forearm fell by 16% (p less than 0.05). These findings are different from what would have been expected acutely after administration of a pure beta-adrenoceptor blocking agent. They indicate that carvedilol possesses vasodilating activity in addition to its beta-adrenoceptor blocking effect.

Adrenergic beta-Antagonists↗
PubMed1984

Low erythrocyte Na+/K+ ratio in children with mild blood pressure elevation and a positive family history of hypertension.

Thirty-seven children aged 6-16 years were studied. Their mothers had a history of previous pre-eclampsia or hypertension in pregnancy on average 10.4 years earlier and had later developed sustained hypertension. Blood pressure in these children was significantly higher than in an age-matched control group (125/71 versus 113/64 mmHg, P less than 0.001). Intracellular Na+ in erythrocytes were not elevated, on the contrary the Na+/K+ ratio was significantly lower than in an age- and sex-matched control group (0.095 versus 0.103, P less than 0.05). Thus women with hypertension in pregnancy who later developed sustained essential hypertension have children with elevated blood pressures at an early age. The observation that the erythrocyte Na+/K+ ratio is reduced in such children suggests that the rise in intracellular Na+ commonly described in essential hypertension is not a primary event.

Adolescent↗