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Biomedical subjects

M Safar

Publications and source records attributed to M Safar.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Pulsed Doppler: an evaluation of diameter, blood velocity and blood flow of the common carotid artery in patients with isolated unilateral stenosis of the internal carotid artery.

Arterial diameter, blood velocity and blood flow of both common carotid arteries were studied in 24 patients with isolated unilateral internal carotid artery stenosis, without any other significant lesion of the carotid system. The methodology used a pulsed Doppler system with two original characteristics: an adjustable range-gated system and a double transducer probe enabling both the arterial diameter and blood velocity to be evaluated. On the involved side, the diameter, the blood velocity and the blood flow were significantly reduced (p less than 0.001) in comparison with the opposite side. The degree of the internal carotid artery stenosis judged on arteriography was negatively correlated with (i) the blood flow of the common carotid artery homolateral to the stenosis (r = -0.78, p less than 0.001); and (ii) the ratio of the common carotid artery blood flow between the involved and the opposite side (r = -0.80, p less than 0.001). The proposed quantitative evaluation can be suitable for the detection and for the follow up of patients with stenosis of the internal carotid artery who do not have any other lesion of the carotid system.

Aged↗
PubMedDate not supplied

[Diuretics in the treatment of arterial hypertension].

BACKGROUND: Diuretic compounds, which comprise the basis of any cardiovascular prevention in subjects with hypertension, have never been studied in terms of clinical pharmacology according to the classical and well-established rules used nowadays with other anti-hypertensive agents. FINDINGS IN THE LITERATURE: Because edema was the first historical indication for diuretic compounds, very high doses were initially given for drug treatment of chronic hypertension. It was only 10-15 years ago that lower doses were first used due to the effectiveness of treatment in old subjects with hypertension and to the development of fixed associations with either converting enzyme inhibitors or beta-blocking agents. However, only a very small number of pathophysiological studies have been conducted in parallel, particularly to determine the effects on vessels and the endothelium. CONCLUSION: Diuretics are the most effective and the least expensive drugs for cardiovascular prevention of hypertension but the basic mechanisms of their action remains to be evaluated.

Antihypertensive Agents↗
PubMedDate not supplied

[Role of extracellular matrix in angiotensin II signalling in aortic smooth muscle cells: relationship with arterial hypertension].

Angiotensin II (Ang II) is involved in hypertension-related arterial wall hypertrophy [1]. Regulation of AT II transduction pathway in vascular smooth muscle cells (VSMC) may involve cytoskeleton and extracellular matrix (ECM) [2]. We assessed the role of components of ECM on Cai2+ increase induced by Ang II in Wistar-Kyoto (WKY) and Spontaneously Hypertensive Rats (SHR) aortic VSMC. The effect of Ang II (1 mumol) on Ca2+ mobilization was studied in cultured VSMC isolated from the aorta of 6-wk old WKY (MAP (m +/- SE) = 98 +/- 4 mmHg) and SHR (136 +/- 5 mmHg; p < 0.05), using fluorescent imaging microscopy (Fura-2 AM). Cai2+ release from internal stores and Ca2+ influx were assessed in the absence and upon reintroduction of external Ca2+ respectively. Cells were cultured on uncoated glass coverslips (control) or coated with either collagen I (10 micrograms/mL), collagen IV (7 micrograms/mL), vitronectin (0.1 microgram/mL), fibronectin (3 micrograms/mL) and extracellular matrix extract (matrigel, 1/10) and studied at confluence. Paxillin was located in cells by indirect immunofluorescence micrography. Results are expressed in % of Control. Statistical significance (p < 0.05) was assessed with Student's t-test for unpaired data. The effects on Ang II-induced Ca2+ mobilization of growing cells on ECM are in Table. Paxillin in Control cells appeared as dots at the cell boundaries. Density increased in cells grown on collagen I with a diffuse distribution in the WKY cells. On matrigel, paxillin was located in a belt-like fashion at the periphery of the cell. These effects were not linked to differences in cell cycle (flux cytometry).

Angiotensin II↗
PubMedDate not supplied

[Syst-Eur study: analysis of the benefits of nitrendipine in hypertensive type 2 diabetics].

OBJECTIVE: To demonstrate that nitrendipine reduces the morbimortality of elderly type 2 diabetic patients with isolated systolic hypertension. METHODOLOGY: New analyses of the 547 type 2 diabetics patients with isolated systolic hypertension (160 < PAS < 219: PAD < 95 mmHg), included in the international Syst-Eur trial, with an average follow-up of 2 years. Type 2 diabetes is defined according to the 1998 WHO guidelines: a fasting glycemia level, > or = 126 mg/dl and a post-prandial glycemia > or = 200 mg/dl. RESULTS: Nitrendipine as a first line treatment provides better protection against fatal and no fatal cardiovascular events compared with placebo. The risk reduction of cardiovascular mortality is 70% (IC 95%: -89/-18; p = 0.01), 61% (IC 95%: -79/-29; p = 0.001) for fatal and non fatal cardiovascular events, 65% (IC 95%: -86/-10; p = 0.02) for fatal and non fatal stroke and 61% (IC 95%: -83/-11; p = 0.02) for fatal and non fatal cardiac events. Therefore, nitrendipine as a first line treatment, reduces significantly cardiovascular events, strokes and cardiac events (p = 0.02; p = 0.007; p = 0.009; p = 0.04, respectively) in the diabetic group versus the no diabetic group, with a big trend (p = 0.07) for total mortality. Nitrendipine was well tolerated by this population. CONCLUSION: These results demonstrate the benefits of nitrendipine as a first line treatment in type 2 diabetic hypertensive patients.

Antihypertensive Agents↗
PubMedDate not supplied

[Body composition and left ventricular geometry].

Left ventricular mass and cardiac output are, particularly in obesity, correlated with fat free body mass. We assessed the relationship between ventricular geometry and fat body mass in treated hypertensives with or without normalization of blood pressure We investigated 175 patients (age: 57 +/- 15 years, M/F: 111/64, Mean blood pressure (MBP): 111 +/- 18 mmHg, BMI: 27.02 +/- 3.70 kg/m2: 20.3-39.6 kg/m2) with measure of body composition (impedancemetry Analycor2) and echographic left ventricular mass (adjusted to height2.7: mass2.7). Multiple correlation with adjustment to age and MBP were performed in men (M) and in women (W). Mass2.7 is correlated with fat mass percentage in men (R partial R: 5.6, p=0.02). LV diastolic diameter is correlated with fat free body mass while interventricular septum is correlated with fat body mass but only in men. In summary, in hypertensives not selected on BMI or BP, fat body mass is weakly correlated to ventricular wall thickness in men, probably mediated by sympathetic tone, while fat free body mass is related to ventricular volume in both gender probably through the water volume particularly in vascular bed. In conclusion, both components of body composition are differently, and weakly, linked to ventricular geometry in hypertensive patients.

Adult↗
PubMedDate not supplied

[Antioxidant supplements and risk of hypertension in the SU.VI.MAX trial: relationship to plasma antioxidants].

The object of this work was to determine the risk of hypertension after 6.5 years'- follow-up of supplementation in vitamins and antioxidant minerals at nutritional doses in the SU.VI.MAX trial. The authors also studied the association with plasma concentrations of antioxidants at inclusion and at long term. This was a randomised nutritional primary prevention study including 5086 adults of the SU.VI.MAX trial. After 6.5 years' follow-up, no effect of supplementation on the risk of developing hypertension could be shown compared with the placebo group: odds ratios (OR IC 95%): 1.04 (0.87-1.23) in men and 1.10 (0.95-1.29) in women. Besides, in the male 2nd and 3rd tertiles of serum beta-carotene levels at inclusion the risk of hypertension was lower [multivariate OR: 0.70 (0.44-1.12) and 0.53 (0.33-0.86) for placebo, and 0.59 (0.37-0.94) and 0.67 (0.42-1.07) for the supplemented groups]. The authors conclude that, despite a reverse relationship in men between the plasma concentrations of beta-carotene and the risk of hypertension, supplementation in antioxidants at nutritional doses had no effect on the risk of developing hypertension after 6.5 years' follow-up.

Antioxidants↗
PubMedDate not supplied

[Antihypertensive efficacy of the combination of captopril 50mg and hydrochlorothiazide 25mg evaluated by ambulatory blood pressure measurement].

The anti-hypertensive effects of the captopril-hydrochlorothiazide combination administered during three months as one single morning dose were evaluated in 51 patients with moderate essential hypertension by means of ambulatory blood pressure recording. At the end of the study, the mean values of arterial blood pressure recorded over 24 hours were significantly lowered: systolic pressure was reduced from 145 +/- 11 to 131 +/- 10 mmHg (P less than 0.001), and diastolic pressure from 88 +/- 5 mmHg to 81 +/- 4 mmHg (P less than 0.001). The same results were recorded during the day (07.00 to 22.00 hours) and during the night (23.00 to 06.00 hours). No change in heart rate was observed.

Adult↗
PubMedDate not supplied

[Value of the timolol-hydrochlorothiazide-amiloride hydrochloride combination in the mass treatment of arterial hypertension. Results of a multinational study].

In a 10-week double-blind study, 283 hypertensive patients were treated with a beta-blocker (timolol) alone, a combination of two diuretics (hydrochlorothiazide + amiloride) or a combination of both types of treatment. The results on blood pressure figures were very much in favor of the combination therapy as compared to monotherapy. In a second step, the trial was unblinded and all patients continued with the beta-blocker/diuretic combination for a total of 24 weeks. The medium-term results confirmed those obtained during the double-blind study with regard to the effectiveness and good tolerance of the combination treatment.

Amiloride↗
PubMedDate not supplied

[Pharmacological basis for a fixed association of hydrochlorothiazide, amiloride hydrochloride, and timolol maleate (author's transl)].

The treatment of hypertension requires in many cases a therapeutic combination. This survey, carried out in 96 cases, shows the interest of a fixed combination including a thiazide diuretic (hydrochlorothiazide), a potassium sparing (chlorhydrate of amiloride) and a beta-blocking agent (timolol maleate) as compared to therapy with a beta-blocking agent or diuretic alone. This combination, logical from a pharmacological view point, has proved significantly more effective (81% of patients were normalized) and as well tolerated (none additional side effect) as each of its components. As it simplifies prescription by reducing the number of tablets, it appears a considerable contribution to hypertension therapy.

Amiloride↗