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Biomedical subjects

P Greminger

Publications and source records attributed to P Greminger.

At least 145 records · Page 8Linked to original sources
PubMed1982

[Renovascular hypertension: comparison between transluminal dilatation and surgical procedures].

Percutaneous transluminal dilatation (PTD; n = 45) was compared with surgical procedures (n = 51) in 96 patients with renovascular hypertension. Since cases with atherosclerotic stenosis (ASS) are known to show a different response to surgery than those with fibromuscular dysplasia (FMD), group-specific analysis was performed. In their two subgroups (ASS and FMD) both surgical and dilated patients showed comparable mean age and sex distribution and serum creatinine. However, differences were observed in mean duration of hypertension and in pretreatment blood pressure values: surgical patients with ASS and FMD showed a lower mean duration of hypertension (operation: ASS 3.2, FMD 1.9 years; PTD: ASS 5.1, FMD 3.4 years) and higher mean blood pressure values (surgery: ASS 207/121, FMD 209/126 mm Hg; PTD: ASS 199/115, FMD 175/108 mm Hg). After a mean observation period of 2.6 years mean blood pressure fell in the surgery group to 147/90 mm Hg in the 26 cases with ASS, and to 139/87 mm Hg in the 25 patients with FMD. In dilated cases respective blood pressure values were 145/90 mm Hg (ASS, n = 17) and 132/84 mm Hg (FMD, n = 11). These results show a comparable blood pressure lowering effect for surgery and dilatation in renovascular hypertension. In cases with lengthy stenosis or involvement of primary branches of the renal artery and in those with aortic or poststenotic renal aneurysm a surgical technique should be performed, whereas in the remaining cases PTD represents a favourable procedure.

Adult↗
PubMed1982

[Factors determining compliance in hypertensive patients].

The influence of various demographic, disease-related and therapeutic factors on compliance has been investigated in 110 patients with hypertension, heart failure or edema. While demographic factors such as age, sex, socioeconomic status, marital status and smoking habits, scarcely influenced drug adherence, duration of therapy showed the greatest compliance-lowering effect. In the 27 hospitalized patients compliance decreased in 3.2 weeks from 92.6% to 75% and in 83 outpatients from 83% to 56% in 17.8 weeks. Totally mean compliance of hospitalized patients was higher (86.9%) than in outpatients (79.7%). The percentage of fully compliant patients was also greater (74%) in hospitalized patients than in outpatients (54.2%). Patients with symptomatic diagnoses complied better than asymptomatic patients: Mean compliance rate was 87% (n = 17) in outpatients with heart failure or edema and 77.3% (n = 66) in hypertensive outpatients. Hypertensives with symptoms due to other diseases also showed a higher compliance (80%) than those with asymptomatic diagnoses (71.1%). New symptoms during therapy and side effects of the antihypertensive treatment decreased the percentage of compliers to 64% and 59% respectively. On the other hand, the severity of hypertension had no effect on drug adherence. Patients with systolic blood pressure values between 140 and less than 180 mm Hg showed an identical compliance (79.8%; n = 47) to those with systolic values greater than 180 mm Hg (79.9% n = 60).

Age Factors↗
PubMed1982

[Weight reduction and blood pressure].

112 patients (78 hypertensives and 34 normotensives) received guidance from a specially trained dietitian on a low-calorie diet. During a mean control period of 10.8 months with a comparable number of visits in each group, the following results were observed: 51% (n = 40) of hypertensive patients achieved a significant weight reduction. In 28% (n = 22) antihypertensive medication was constant and in 23% (n = 18) this medication was reduced or withdrawn. 37% (n = 29) showed no significant changes in body weight or blood pressure and 12% (n = 9) dropped out. In 22 patients a weight reduction of 8.5 kg with a significant fall in blood pressure from 156/99 to 137/90 mm Hg was observed. In 18 hypertensives a weight reduction of 8.5 kg allowed reduction or withdrawal of antihypertensive medication with blood pressure remaining unchanged (139/91 vs. 135/90 mm Hg). Similar results were achieved in 34 normotensive obese patients: 59% (n = 20) had significant weight reduction, 32% (n = 11) no significant reduction in weight or blood pressure, and 9% (n = 3) dropped out. 20 patients with a reduction of 9 kg showed a significant fall in blood pressure from 132/84 to 123/80 mm Hg. The results demonstrate the favourable effect of weight reduction on blood pressure. The time-consuming nature of the frequent and intensive checks should, however, be borne in mind.

Adult↗
PubMed1982

Prizidilol (SK & F 92657), a new vasodilator with beta-blocking properties in the treatment of essential hypertension.

The antihypertensive effect of a new vasodilator with betablocking properties (SK & F 92657) was investigated in 10 patients with mild to moderate essential hypertension. After a mean treatment period of 26,5 weeks (6,5-49 weeks) blood pressure was significantly reduced, from 168 +/- 22/106 +/- 6 mmHg to 144 +/- 19/94 +/- 12 mmHg (p less than 0.05 and 0.025). The mean dose was 410 mg (100-700 mg). Heart rate decreased slightly from 77 +/- 12 to 70 +/- 8 beats/min. Plasma renin activity and plasma aldosterone showed only minor changes. Nausea, heavy dreams, facial and hand flushing and mild depression were reported as side effects. In most patients the symptoms disappeared without reduction in the dose. In one patient anaemia developed after 7 weeks and treatment with prizidilol was stopped. A slight but statistically significant decrease in haemoglobin concentration of 1.1 +/- 0.6 g/dl was observed in 5 of the 10 patients (p less than 0.02). Thus, a mean dose of prizidilol of 410 +/- 242 mg/day had a mean blood pressure lowering effect of 24/12 mmHg. In 7 of the 10 patients (70%) diastolic blood pressure could be reduced to 95 mmHg or less. However, the observed haematological side-effects should be carefully monitored in further studies and may limit the clinical use of prizidilol.

Adrenergic beta-Antagonists↗
PubMed1982

[Blood pressure, renin angiotensin aldosterone system and other cardiovascular risk factors in children of essential hypertensives (author's transl)].

In the present study, blood pressure, the renin angiotensin aldosterone system, and other cardiovascular risk factors, such as glucose, cholesterine, and triglycerides, were investigated in 294 offspring of essential hypertensives (5-34 years) and in 122 children of normotensive parents (5-34 years). Offspring of essential hypertensives showed statistically significant higher systolic and diastolic blood pressure values than those of normotensive parents (p less than 0.003, less than 0.005, respectively). Furthermore, in children of hypertensive parents a statistically significant higher body weight and body mass index than in controls could be observed (p less than 0.006, less than 0.001, respectively). With the exception of statistically significant, lower mean supine plasma aldosterone values (p less than 0.02) in children of hypertensive parents, no major differences between the two groups were seen in stimulated aldosterone, supine and stimulated plasma renin activity, and plasma cortisol. Furthermore, in the present study, 41 hypertensive parents, 65 (normotensive) spouses of hypertensives, and 47 (normotensive) parents of control children were investigated. As expected, hypertensive parents showed statistically significant higher blood pressure values than parents of control children and their spouses (p less than 0.001). Interestingly, hypertensive parents had not only a higher body mass index than control parents but also than their spouses (p less than 0.01 and less than 0.02, respectively). These findings support a genetic disposition as being the underlying cause of higher body weight in hypertensives and make it less probable that a higher food intake in hypertensive families is responsible for this phenomenon. The results of the present study indicate that early body weight control in children of hypertensive parents may be an important contribution to the prevention of hypertension.

Adolescent↗
PubMed1982

Long-term experience with captopril in severe hypertension.

1 The long-term effect of the converting-enzyme inhibitor captopril was investigated in 76 patients with various forms of severe hypertension, most cases being resistant to a standardised triple therapy (100 mg hydrochlorothiazide or 80-500 mg frusemide; 320 mg propranolol; and 200 mg hydralazine). 2 In each of the three groups examined (essential, renovascular, and renal parenchymatous hypertension) captopril led to a prompt and sustained reduction in systolic and diastolic blood pressure. Up to an observation time of 2 1/2 years patients with renovascular hypertension showed a more pronounced fall in mean diastolic blood pressures than those with essential hypertension. About 90% of all patients required a diuretic and a substantial percentage of patients needed propranolol as a third drug. 3 The most frequent side effects were skin manifestations, taste disturbances, dizziness, and non-productive cough. Serious adverse effects were rare and included one case of leucopenia and one of the nephrotic syndrome, both of them reversed after withdrawal of captopril. Further analysis showed that side effects occurred mainly in patients with impaired kidney function receiving relatively high dosages of captopril (greater than 200 mg/day). 4 Our results show that captopril is a very potent blood-pressure-lowering agent in severe hypertension, especially in cases with renovascular hypertension.

Adult↗
PubMed1981

[Computerized tomography in adrenal diseases with excessive production of hormones].

In 41 patients with adrenal diseases and hormonal excess (pheochromocytoma n = 9, Cushing's syndrome n = 6, primary aldosteronism n = 26) computer tomography was performed for localization and classification of the adrenal lesion(s). In all patients diagnosis was confirmed by surgery. In all patients with pheochromocytoma a tumor was detected. 8 patients had unilateral adrenal pheochromocytoma, whereas in one female patient the pheochromocytoma was multilocular. 4 of the 6 patients with hypothalamic-pituitary Cushing's syndrome had enlargement of the adrenals. In the 26 patients with primary aldosteronism, computed tomography showed normal adrenal glands in 2 of the 17 patients with unilateral adenoma (with a diameter of 8 mm in both of the 2 patients) and in 6 of the 9 patients with bilateral hyperplasia. In the remaining patients adenoma or hyperplasia was detected. The results document that in patients with pheochromocytoma, with Cushing's syndrome, and in those with primary aldosteronism, computed tomography is a simple and valid method for localization and classification of the adrenal lesion(s). In primary aldosteronism with a normal adrenal computed tomography, however, differentiation between a small unilateral adrenal adenoma and bilateral adrenal hyperplasia remains problematic.

Adrenal Gland Neoplasms↗
PubMed1981

Renal venous renin activity in various forms of curable renal hypertension.

The diagnostic and predictive value of renal venous renin determinations was investigated in 73 patients who had various forms of hypertension associated with unilateral renal disease and who were operated upon. Patients with fibromuscular hyperplasia showed a markedly higher cure rate than cases with arteriosclerotic renal artery stenosis (64% vs. 25%) and were less frequently not improved (4% vs. 12%). Patients with unilateral (non-vascular) small kidney and patients with unilateral hydronephrosis showed comparable high cure rates (53% and 50%, respectively), whereas in no patient with a unilateral renal cyst did postoperative blood pressure return to normal. In the present study no statistically significant correlation was found between postoperative pressure reduction and PRA-ratios in either the whole group of patients or in the various subgroups. A negative PRA-ratio (less than or equal to 1.4) was found in 36% of all cured patients. In particular, cured patients with fibromuscular hyperplasia showed a high percentage (38%) of falsely negative tests. As expected, characteristic differences were observed in simple clinical data between cured and improved patients. Patients with normal postoperative blood pressure were significantly young (34.7 +/- 13.6 years) than improved cases (47.3 +/- 10.8 years; P less than 0.001) and cured patients showed lower preoperative blood pressure values (192 +/- 29/119 +/- 15) than improved ones (214 +/- 31/126 +/-117 mm Hg). Thus our results document a limited prognostic value of renal venous renin determination in patients with hypertension due to unilateral renal disease.

Adolescent↗
PubMed1978

[Percutaneous transluminal recanalization in a patient with arterial occlusive disease and multiple injuries (author's transl)].

A case of a 66 year old patient with multiple injuries is reported. A combination of conventional trauma treatment and percutaneous transluminal angioplasty (PTR) of a segmented superficial femoral artery occlusion prevented leg amputation. When the patient died 8 weeks later from trauma sequelae the successful recanalization was demonstrated in histopathology investigation. It is concluded that PTR is an ideal accessory to the present therapeutic spectrum in vascular surgery.

Accidents, Traffic↗
PubMed1977

[Primary and secondary hypertension in polyclinical patients].

Hypertension was found in 854 (10.4%) of 8228 patients (3657 females, 4571 males) seen in our outpatient clinic during 1975. Essential (primary) hypertension was found in 92.9% (n = 793) of all hypertensives. Among secondary forms of hypertension (7.1%) renal hypertension, with a rate of 5.8%, was the commonest form (hypertension of renal-parenchymatous origin 4.9%, renovascular hypertension 0.8%, hypertension associated with unilateral hydronephrosis 0.1%. In 2 patients (0.2%) the underlying disease was primary aldosteronism and in 5 (0.6%) coarctation of the aorta. In 4 female patients (0.5%) the hypertension was caused by oral contraceptives. Patients with essential hypertension had higher body weight than those with normal blood pressure. These differences were statistically significant in young and middle-aged patients. Our results show a very high percentage of essential hypertension. In only 18 (2.1%) of 854 hypertensives was a curable form of high blood pressure found (hypertension caused by renal artery stenosis, hydronephrosis, aldosterone producing adenoma of the adrenal gland and oral contraceptives). The very low percentage of curable forms of hypertension should be kept in mind when deciding on expensive procedures in a search for secondary forms of high blood pressure.

Adenoma↗