Biomedical subjects

R Ketelhut

Publications and source records attributed to R Ketelhut.

23 records · Page 2Linked to original sources

PubMed1988

Regression of left ventricular hypertrophy during combined atenolol and nifedipine treatment.

36 patients with previously untreated essential hypertension and left ventricular hypertrophy were treated with a fixed dose combination of atenolol 50 mg and sustained release nifedipine 20 mg once daily for a mean period of 12.1 months. Echocardiography showed a significant decrease after a mean period of 7.9 months in interventricular septal thickness (13.6%, p less than 0.01), posterior wall thickness (12.6%, p less than 0.001) and left ventricular mass index (18.3%). After 12.1 months the reductions were 20.7% (p less than 0.001), 22.5% (p less than 0.001) and 30.8% (p less than 0.001), respectively. Posterior wall thickness was significantly reduced, but left ventricular end-systolic and end-diastolic dimensions and fractional shortening remained unchanged. Treatment significantly reduced resting blood pressure from 153/105 mm Hg to 122/79 mm Hg (p less than 0.001), and exercise blood pressure at 100W from 189/109 to 157/93 mm Hg (p less than 0.001). Thus, nifedipine in combination with atenolol produces significant blood pressure reduction accompanied by regression of left ventricular hypertrophy without noticeable changes in left ventricular function.

Adult↗

PubMed1987

Regression of left ventricular hypertrophy from systemic hypertension by gallopamil.

In 26 previously untreated patients with essential hypertension (mean age 49.7 +/- 11 years), the effect of long-term treatment with the calcium antagonist gallopamil (n = 13, 100 mg; n = 13, 150 mg daily) on blood pressure and left ventricular hypertrophy (LVH) was studied. After the treatment of 22.3 +/- 2.5 months, the blood pressure of 157 +/- 19/103 +/- 84 mm Hg at rest prior to therapy was significantly (p less than 0.001) reduced to 130 +/- 12/82 +/- 7.3 mm Hg. Blood pressure reduction was accompanied by a significant (p less than 0.001) decrease in left ventricular mass index from 170 +/- 49.8/m2 to 150 +/- 44 (11.9%) and 116 +/- 26 (31.9%) after 8.2 and 22.3 months, respectively. Interventricular septum (14.2 to 13.2 and 11.8 mm; 16.9%) and posterior wall thickness (11.5 to 10.4 and 9.4 mm; 18.3%) were also significantly (p less than 0.001) reduced, whereas left ventricular dimensions and fractional shortening were unchanged. We conclude that LVH from hypertension can be lessened by calcium antagonists without deterioration of left ventricular function.

Adult↗

PubMed1987

Resting and exercise blood pressure with atenolol, enalapril and a low-dose combination.

This study was designed to assess the efficacy of 100 mg atenolol daily, 20 mg enalapril daily and a low-dose combination of 50 mg atenolol and 10 mg enalapril, in reducing blood pressure at rest and during ergometry (50-100 W). Twenty-three men and three women (aged 25-56 years, mean 44.5 +/- 7.4 years) were admitted to this randomized, single (observer)-blind crossover study, which had a 2-week placebo period and 4-week treatment periods. Both atenolol and enalapril provided significant (P less than 0.001) and almost identical reductions in blood pressure at rest. However, during exercise, systolic blood pressure decreased with atenolol and with the combination of atenolol and enalapril by 15.8% and 18.4%, respectively, compared with 6.2% with enalapril monotherapy. The differential effect of atenolol and enalapril was also demonstrated for the rate-pressure product. Twenty-four hours after the last dose, systolic and diastolic blood pressures were significantly lower (P less than 0.01) with atenolol (139.5/92.8 +/- 17/12 mmHg) than with enalapril (146.8/97.7 +/- 17/9 mmHg). It is concluded that atenolol is significantly more effective in reducing systolic blood pressure during exercise than enalapril, and that the addition of atenolol to enalapril therapy produces a significant supplementary antihypertensive effect.

Adult↗

PubMed1987

Long-term effect of antihypertensive therapy on left ventricular hypertrophy.

We studied a total of 88 previously untreated hypertensives in order to determine the long-term effect of antihypertensive therapy on echocardiographically confirmed left ventricular hypertrophy. The drugs tested were the beta-blocker metoprolol (200 mg/day; 26 patients; mean age 43.9 years; follow-up 32 months), the calcium antagonist gallopamil (100-150 mg/day; 26 patients; mean age 49.7 years; follow-up 23 months) and a combination of 50 mg atenolol and 20 mg nifedipine (36 patients; mean age 44.2 years; follow-up 18 months). Despite similar reductions in resting blood pressure, each of the three therapeutical regimens had a different effect on the left ventricular mass index after 1 year of treatment: gallopamil reduced the index by 13.2% (170 +/- 49 to 148 +/- 41 g/m2, P less than 0.001), metoprolol by 21.9% (150 +/- 27 to 117 +/- 27 g/m2, P less than 0.001) and atenolol + nifedipine by 30.8% (148 +/- 33 to 103 +/- 21 g/m2, P less than 0.001). Similar results were obtained for interventricular septal (9.9, 15.4 and 20.7%, respectively) and posterior wall thicknesses (10.4, 16.7 and 24.1%, respectively). During the follow-up there was a further significant reduction in ventricular hypertrophy under all three treatments, but no significant changes in ventricular end-diastolic and end-systolic dimensions or in fractional shortening.

Adult↗

PubMed1986

[Regression of myocardial hypertrophy in hypertensives on chronic beta-receptor block].

25 patients (24 males, 1 female; mean age 43.7 years), with previously untreated essential hypertension and echocardiographically proven left-ventricular hypertrophy, received metoprolol 200 mg daily over a period of 12.7 months, five of them additionally hydrochlorothiazide 25 mg. After four weeks, resting recumbent blood pressure had decreased from 157 +/- 18 systolic and 106 +/- 9 diastolic to 128 +/- 11 and 85 +/- 9, respectively; after 12.7 months to 123 +/- 12 and 83 +/- 8 mm Hg (P less than 0.001). On 100 W exercise the blood pressure fell from initially 206 +/- 13 and 117 +/- 9 168 +/- 12 and 97 +/- 9, after 12.7 months to 170 +/- 14 and 98 +/- 9 mm Hg. Left-ventricular mass fell from 147.0 +/- 26 g/m2 by 14% after 6.1 months, by 22.5% after 12.7 months (P less than 0.001). While the left-ventricular diameter in enddiastole and endsystole remained unchanged, septal thickness decreased from 15.5 +/- 2.1 to 14.2 +/- 2.2 mm after 6.1 months and 13.1 +/- 1.9 mm after 12.7 months (reduction of 15.5%). The corresponding values for the left-ventricular posterior wall were 11.9 +/- 1.6 before and 10.8 +/- 1.8 after 6.1 months and 10.1 +/- 1.4 mm after 12.7 months (reduction of 16%). Thus long-term administration of metoprolol resulted in a significant reduction in myocardial hypertrophy without impairment of ventricular function.

Adrenergic beta-Antagonists↗