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T S Chu

Publications and source records attributed to T S Chu.

24 records · Page 2Linked to original sources

[Blood pressure and metabolic response to converting enzyme inhibitor in hypertensive patients: comparison between delapril and captopril].

The antihypertensive and metabolic responses to delapril and captopril in hypertensive patients were studied. Forty-six hypertensive patients entered the study and were divided into two groups. The delapril group included 21 essential hypertensive and five renoparenchymal hypertensive patients; while the captopril group included 11 essential hypertensive and nine renoparenchymal hypertensive patients. The patients in the delapril group took delapril 7.5 mg twice a day for 2 weeks. If the antihypertensive effect was inadequate, the dose was increased to 15mg twice a day, and then to 30mg twice a day. The period of delapril treatment was 12 weeks. The patients in the captopril group took captopril 25 mg twice a day or three times a day for 12 weeks. After delapril treatment, there were significant decreases in the systolic (from 163 +/- 17 to 141 +/- 15 mmHg) and diastolic blood pressure (from 105 +/- 13 to 91 +/- 10 mmHg). There were also significant decreases in the systolic (from 161 +/- 18 to 141 +/- 24 mmHg) and diastolic blood pressure (from 100 +/- 10 to 90 +/- 12 mmHg) after captopril treatment (p < 0.001). The pulse rates in both groups showed no significant changes after treatment. The laboratory data in both groups showed few changes after treatment. Plasma renin activity increased after delapril treatment. A cough was the side effect most commonly seen. We conclude that hypertensive patients have the same blood pressure and metabolic responses to delapril as captopril.

Adult↗

Exaggerated natriuresis in primary aldosteronism.

Acute response in blood pressure (BP) and natriuresis to saline infusion was evaluated in 16 patients with primary aldosteronism caused by aldosteronoma (PA) and 12 patients with salt-sensitive essential hypertension (SSEH). Salt-sensitivity was defined by a decrease in mean BP exceeding 5% at the second hour after a 20 mg furosemide injection. Plasma renin activity (PRA), plasma aldosterone concentration (PAC) and urine electrolytes in response to saline infusion were determined. During a 2-liter isotonic saline infusion, a similar degree of natriuresis and change in BP were observed in PA and SSEH patients. A significantly inverse correlation between the increase in mean BP and the degree of natriuresis at the end of the infusion was found in patients with SSEH (r = -0.80, p less than 0.01). No correlation was observed between these parameters in patients with PA (r = 0.28, p greater than 0.05). These results suggest that hypernatriuresis in SSEH may play a protective mechanism against abrupt increases in BP and volume during acute saline loading. This protective mechanism was not evident in patients with PA.

Adrenal Cortex Neoplasms↗

Exaggerated natriuresis in salt-sensitive essential hypertension.

Acute responses of blood pressure and natriuresis to intravenous injection of furosemide and saline infusion were evaluated in 38 patients with essential hypertension. Twelve patients whose mean arterial blood pressure decreased by more than 5% at two hours after intravenous administration of 20 mg furosemide were classified as salt-sensitive (SS); the remainders as salt-resistant (SR). The extent of natriuresis induced by furosemide was not different between the two subgroups. During 2-liter isotonic saline infusion the SS subjects excreted more sodium than the SR subjects did (108.7 +/- 11.9 vs 55.9 +/- 6.6 mmole, p less than 0.001). There was a significant correlation (r = 0.57, p less than 0.001) between the hypotensive effect of furosemide and the 4-hour sodium excretion during saline infusion. A reverse correlation between the sodium excretion during saline infusion and the increase in mean blood pressure at the end of infusion was shown in the SS subgroup (r = -0.72, p less than 0.01), but not in the SR subgroup (r = 0.045). The results suggest that prompt natriuresis on saline infusion in the SS hypertensives may function as a protective mechanism to prevent abrupt increase in blood volume and blood pressure during acute sodium loading.

Adult↗

Evaluation of cardiovascular autonomic function tests in normal subjects.

We studied autonomic function in 76 normal adults (aged 20-80 years, 46 men and 30 women) with noninvasive cardiovascular reflex tests. The autonomic function tests included heart rate (HR) response to standing up, during the Valsalva maneuver, deep breathing, diving, and blood pressure (BP) response to standing up, during immersion of the hand in ice water, and a sustained handgrip. The patients were connected to an EKG monitor. All tests were performed in the resting state. The results show that (1) HR response to standing up, during the Valsalva maneuver, and while deep breathing were less variable and more suitable for follow-up; (2) women had a greater fall in systolic BP after standing up, and less rise in diastolic pressure during sustained handgrip than did men; (3) age correlated negatively with the HR response to standing, to deep breathing, Valsalva ratio, and the cold pressure test. But, age correlated positively with a fall in systolic BP as women stood up, but not in men; (4) there is a significant correlation between the HR response to standing up and the HR response to deep breathing. We concluded that sex and age do have an influence on some autonomic test results. The influence of the former is more related to sympathetic function while that of the latter is related to both the sympathetic and parasympathetic system. In addition, a normal range of autonomic function test results in healthy subjects is proposed.

Adult↗

Association of hypertriglyceridemia and insulin resistance in uremic patients undergoing CAPD.

OBJECTIVE: Hyperlipidemia is frequently encountered in uremic patients and may be worsened by continuous ambulatory peritoneal dialysis (CAPD) treatment. The lipid abnormalities in these patients may be multifactorial. Insulin resistance (or its compensatory hyperinsulinemia) is commonly observed in uremic patients, but its association with hyperlipidemia in these patients has not been studied. PATIENTS AND METHODS: Lipid profiles of 35 nondiabetic nonobese patients undergoing CAPD for more than 1 year (mean 52.3 months) were studied. Current laboratory data and parameters related to peritoneal dialysis (PD) within the previous 3 months were recorded. After overnight fasting and interruption of PD, an oral 75-g glucose tolerance test (OGTT) was examined. RESULTS: After CAPD treatment for more than 12 months, these patients had higher serum triglyceride (TG) (p = 0.001) and total cholesterol (p = 0.0058) levels than their values before commencing CAPD. Twelve of 14 patients with serum TG higher than 200 mg/dL (high-TG) were diagnosed de novo, in contrast with only 1 patient diagnosed of de novo hypercholesterolemia (total cholesterol > 240 mg/dL). There was no difference in age, gender, body mass index (BMI), duration of PD treatment, serum albumin, hematocrit, intact serum parathyroid hormone (iPTH), peritoneal glucose load, solute transport, or weekly Kt/V urea between normal-TG and high-TG patients. After adjusting for age, gender, BMI, weekly Kt/V urea, and iPTH, the high-TG patients had higher levels of area under the curve for glucose (AUC(Glu)), area under the curve for insulin (AUC(Ins)), and AUC(Ins)/AUC(Glu) ratios (F = 10.63, 10.14, and 8.65; p = 0.0029, 0.0035, and 0.0065, respectively), indicating that the high-TG patients were more insulin resistant. There were 24 patients with normal glucose tolerance (NGT), and 11 patients with impaired glucose tolerance (IGT). The IGT group had higher serum TG (F = 10.43, p = 0.003) and total cholesterol (F = 8.05, p = 0.009) than the NGT group, after adjusting for BMI, duration of CAPD treatment, peritoneal glucose load, solute transport, serum albumin, and lipid levels before PD treatment. TheTG levels after CAPD treatment were positively correlated with AUC(Glu), AUC(Ins), and AUC(Ins)/AUC(Glu) ratio (r = 0.48, 0.53, and 0.49; p = 0.0037, 0.001, and 0.0028, respectively). CONCLUSIONS: These results indicate that insulin resistance is an important factor in the development of hypertriglyceridemia in CAPD patients.

Adult↗