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U Laaser

Publications and source records attributed to U Laaser.

At least 37 records · Page 2Linked to original sources
PubMed1990

Antihypertensive treatment in Germany, subjected to a cost-effectiveness analysis.

German physicians are increasingly adopting national and international recommendations on the promotion of non-pharmacological treatment of elevated blood pressure. This reflects a greater sensibility to the advantages and disadvantages of antihypertensive drugs versus dietary means. Furthermore, the rapid growth of health expenditure is a central issue in many policy decisions. Increasingly, the use of cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) is being advocated as a possible means of making the medical care system more efficient. We report an analysis of the value of treating hypertension in Germany-West.

Aged↗
PubMed1990

Treatment of mild hypertension in primary health care: results of a physicians' inquiry, Stuttgart, 1986.

One of the most widely discussed problems in the field of hypertension is the treatment of mild hypertension: 90-104 mmHg diastolic BP. Organizations like the WHO recommend caution with respect to drug therapy. To investigate the actual treatment of hypertension by primary health care services, a standardised questionnaire, based on the study protocol of the WHO-coordinated HYRAP project, was sent to all private practitioners, internists and gynaecologists in private practice in Stuttgart in 1986 (n = 480). The response rate among the general practitioners and internists was 68%. The data indicate that a major part of the physicians favour treatment by health counselling. In contrast, the vast majority (89%) of the physicians report treating mild hypertension exclusively by drug therapy. This wide use of drug therapy may be due to the influence of certain reference groups and the health care system itself. The results support recommendations that special attention be given to the training of physicians in health counselling.

Counseling↗
PubMed1989

[Management of increased cholesterol values in general practice--results of a survey of established primary care physicians].

In connection with a large population screening (N = 24317) in Bielefeld/Federal Republic of Germany a physicians inquiry has been carried out with a return of 55 out of 105 general practitioners or internists (52.4%), about 60% practicing already more than 10 years in Bielefeld. Only 42% of the answering physicians determine cholesterol in every new patient. Only 13% used own laboratory equipment, only 4% dry chemistry (almost indispensable for screening purposes). About 35% consider cholesterol lowering drug therapy to be necessary only beyond values of 300 mg/dl total cholesterol, the mean borderline value for the prescription of cholesterol lowering drugs was 265 mg/dl. Especially positions of shorter practice experience seemed to be sceptical taughts pharmacological means. The most utilized pharmacological preparations in Bielefeld correspond well with the "Arzneiverordnungs-Report '88". Side effects seem to be frequent as only three positions indicated that none of the patients under drug therapy had reported unwanted effects. Most physicians considered dietary therapy to be less effective than drug therapy. Almost all of them took means to increase the compliance of their patients, mainly (82%) through at least three monthly consultations. The prevalence of patients under cholesterol lowering dietary or pharmacologic therapy varied from 5 to 65% with the median of 17.5% which indicates a considerable underdetection of cases. However, physicians seem to be conscious about that as almost 80% hold more public information on cholesterol for desirable or (60%) very desirable.

Attitude of Health Personnel↗
PubMed1989

[Public health sciences graduate study at the Bielefeld University in the framework of comparative endeavours].

Beginning with the summer term 1989 the University of Bielefeld offers-for the first time in the FRG-an interdisciplinary graduate program on health sciences which follows the American School of Public Health model. The association of the university with regional medical institutions guarantees teaching, research and practice in the core disciplines of public health.

Curriculum↗
PubMed1989

[The Intersalt study: results and perspectives].

The recently published Intersalt Study comprising 10,079 participants from 52 study centers in 32 countries demonstrated that the simple linear relationship so far postulated for the association between electrolytes and hypertension is history. In addition overweight and alcohol consumption make an independent contribution to the level of individual blood pressures. The study results have to be interpreted carefully in the framework of a differentiated epidemiologic analysis.

Adult↗
PubMed1988

[Strategies for the prevention of cardiovascular diseases in the German Federal Republic].

The increased relevance of cardiovascular prevention for improved population health is mainly a result of recent epidemiologic research. The identification of essential risk factors of the arterio-sclerotic process as well as their interventive modification are generally accepted. The prolongation of the life-expectancy has been achieved more and more by preventive successes in higher age. Participation of the individual and cooperation of institutions are essential prerequisites of the necessary life style change. The German health offices have to be prepared for essential functions in health management.

Cardiovascular Diseases↗
PubMed1988

[Cholesterol screening within the scope of preventive strategies].

The "Consensus-Conference" of the European Atherosclerosis Association held in June 1986, came to an agreement, that all adults with cholesterol levels above 200 mg/dl should receive medical attention. First representative investigations in the Federal Republic of Germany showed that levels below 200 mg/dl are found in less than 30% of persons aged 30 to 59 years. 76% of all patients who where examined didn't know their own cholesterol level. These data verify the urgency of intensive preventive actions. Cholesterol screening without simultaneous supply of information for behaviour modification (especially nutrition education), would be of little use. Therefore in the proposed screening-concept communicative procedures are of great significance. In addition, cooperation between physicians, psychologists, teachers and suitable organisations is necessary.

Adult↗
PubMed1986

Blood viscosity: a pathogenetic factor in the development of essential hypertension?

Inhibition of the ouabain-sensitive Na-K-ATPase by digoxin significantly decreases erythrocyte deformability (5). Since first a decrease in this transport system has been discussed as a pathogenetic factor in the development of essential hypertension and second an increase in blood viscosity, due to an increased hematocrit has been observed in elderly hypertensives, hemorheology and sodium transport systems were examined in adolescent hypertensives and compared with age-matched normotensive controls. 73 normotensives (N; mean blood pressure 127/80 mmHg) and 53 hypertensives (H; mean blood pressure 147/94 mmHg) aged 23-27 yrs were randomly selected from an epidemiological survey, covering 1342 adolescents. While apparent whole blood viscosity at different shear rates, hematocrit, plasma fibrinogen were not significantly different, erythrocyte deformability, measured with a positive pressure filter system (pore phi 5 mu) and expressed as Q = delta P/ery.susp.Hct 10%/delta P/plasma was significantly attenuated with Q = 1.77 +/- 0.05 in H, compared to 1.64 +/- 0.04 in N (p less than 0.05) The decrease in erythrocyte deformability was not accompanied by an inhibition of the Na-K-pump nor of total K+-uptake in erythrocytes, both measured with the 86Rb uptake. There was only a slight increase in Na+-excretion in urine of 184.4 + 12.2 mval in H, compared to 162.0 +/- 10.4 mval in N (n.s.). K-/+-excretion and serum electrolytes did not show any difference. Whether the decrease in erythrocyte deformability may contribute to an increase in peripheral vascular resistance in essential hypertension has to be further clarified.

Adult↗
PubMed1986

Vasopressor and vasodepressor hormone-systems in adolescent hypertension.

We investigated the activity of the renin-angiotensin-aldosterone-system, the secretion of catecholamines and the kallikrein-kinin-system in 126 adolescents randomly selected from a large study of 1342 young people examined in an epidemiological survey conducted in Cologne in 1975, 1976 and 1980. 73 of them with arterial blood pressures below 145/90 mm Hg were called "normotensives" (systolic blood pressure 127.2 +/- 1.0 mm Hg, diastolic bp 79.7 +/- 0.8 mm Hg). They were compared with 53 "hypertensives" (systolic blood pressure 147.2 +/- 1.6 mm Hg, diastolic bp 93.7 +/- 1.1 mm Hg). Urinary catecholamines were significantly higher in the hypertensives (155.0 +/- 13.3 micrograms/d) compared to the normotensives (100.7 +/- 5.3 micrograms/d) (p less than 0.001) whereas plasma levels of adrenaline and noradrenaline were similar. Serum aldosterone levels and plasma-renin-concentrations were not different between the two groups. Angiotensin-converting-enzyme-activity was slightly higher in the hypertensive group (107.1 +/- 3.5 U/l versus 98.0 +/- 2.6 U/l, p less than 0.001). Urinary kallikrein excretion was found to be modestly lower in hypertensives compared to normotensives (0.40 +/- 0.05 versus 0.55 +/- 0.06 mU/mg creatinine). Urinary excretion of sodium and potassium, blood levels of glucose, uric acid, cholesterol and triglycerides were similar in both groups. The results of the present study suggest an increased sympathetic activity in the early stage of hypertension in adolescents.

Adolescent↗
PubMed1985

Haemorheology in adolescent hypertensives.

Fifty-three untreated borderline hypertensives and 73 normotensives were randomly selected from 1342 adolescents (age range 23-27 years) who were examined in 1975, 1976 and 1980 in an epidemiological study. Blood pressure was 127.2 +/- 1.0/79.0 +/- 0.8 mmHg in normotensives and 147.2 +/- 1.6/93.7 +/- 1.1 mmHg in hypertensives (P < 0.001). Erythrocyte deformability was measured with a positive pressure filter system (pore diameter 5 microns) at 37 degrees C. Erythrocyte deformability was significantly increased in hypertensives with a value of 1.77 +/- 0.05, compared with 1.64 +/- 0.04 in normotensives (P < 0.05). No difference in apparent whole blood viscosity, haematocrit and plasma fibrinogen was measurable between the groups. Although plasma noradrenaline and adrenaline concentration at rest and after 3 min standing were not different, excretion of urinary catecholamines was significantly elevated in hypertensives with 155.0 +/- 3.3 micrograms/24 h (normotensives: 100.7 +/- 5.3 micrograms/24 h; P < 0.001).

Adolescent↗
PubMed1982

Antihypertensive therapy in patients above age 60 with systolic hypertension. A progress report of the European Working Party on High Blood Pressure in the Elderly (EWPHE).

1. Although systolic blood pressure elevation is responsible for increased incidence of cardiovascular accidents in old people, the preventive benefit of lowering systolic hypertension in elderly has not been confirmed. 2. A double blind study comparing the effects of a placebo and of an active regimen (hydrochlorothiazide-triamterene with or without methyldopa) in people over 60 years with isolated systolic hypertension has been undertaken by the European Working Party on High blood pressure in the Elderly (EWPHE). 3. The actively treated group shows a lowered sitting blood pressure (-15/6 mm Hg), a mild increase of serum creatine, serum uric acid and blood glucose and a mild decrease of serum potassium after two years of treatment when compared to the spontaneous changes observed in the placebo treated group. 4. The study is continuing to evaluate if the blood pressure reduction prevents or reduces the incidence of cardiovascular accidents, although some biochemical changes were provoked by the treatment.

Aged↗