Biomedical subjects
Publications and source records attributed to V I Kharchenko.
The therapeutic efficacy of combined and separate application of a diuretic (brinaldix) and beta-adrenoblocker (visken) was compared in the treatment of 69 patients with essential hypertension running a stable course; the patients were kept on a low-sodium diet (4-6 g NaCl daily) and given a potassium substitute for NaCl.
The drug albetol (labetalol) was used in 97 patients with stage I-III essential hypertension (according to the WHO classification) and 13 patients with stable arterial hypertension of renal genesis. Albetol exerted a marked hypotensive effect beginning from the 2-3d day of the treatment and peaking on the 6-8th day of the treatment. To normalize the blood pressure, the patients with labile hypertension were given the drug in a dose of 200-400 mg/day whilst in the patients with a stable course the dose used was 600-2200 mg/day (858 mg/day on the average). In patients with the hyperkinetic type of the hemodynamics the blood pressure decreased following albetol administration at the expense of a reduction in the cardiac index and the heart rate whereas in patients with the hypokinetic type it was achieved mostly at the expense of a decreased vascular resistance to the blood flow. The drug was effective in 69% of the patients, it was well tolerated and induced no side effects.
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Thirty-seven subjects including 29 patients with essential hypertension (8 with labile and 21 with stable disease patterns) and 8 controls received salt and water loads. Sodium chloride was administered per os at a rate of 0.12-0.22 g bw, water at a rate of 20 ml bw. Before loads the measurements were taken of the total water content in the body and of the total metabolic sodium. Radiocardiography was employed to study the central hemodynamics. After sodium chloride load BP measurements were taken over 2 h, within the first 45 min every other 5 to 10 min. Sodium excretion with urine was measured hourly, whereas the changes in the central hemodynamics were evaluated every other 5 to 10 min. After water load BP measurements were taken for 1.5 h. Urine excretions were evaluated too. It was demonstrated that patients with labile and stable hypertension responded differently to salt and water loads. In the first case the increment of BP was similar to that seen in the controls, being measured by increases in the cardiac and stroke indices. In the second case BP rises were more prolonged and more significant than in the controls and occurred primarily at the expense of the high total peripheral resistance of the blood flow. There were two types of the response to salt load: the first one involved a rapid BP elevation (after 1 to 5 min) accompanied by the violent vegetative symptomatology and BP returning to normal after 20 to 30 min.(ABSTRACT TRUNCATED AT 250 WORDS)
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Forty-two hypertensive patients and seven controls were subjected to the lasix test (20 mg intravenously) followed by the assessment of the time-course of water and electrolytes excretion as well as by arterial pressure measurements. Prior to the test the authors, using isotopic and non-isotopic dilutions, determined the indices of central hemodynamics and sodium, potassium and water distribution in the body. In more than 60% of the patients, the diuretic, sodium- and potassiumuretic response to the administration of lasix was higher than in control. In the patients with essential hypertension, the nature of this response did not depend on the initial level of the arterial pressure, cardiac index, rate of glomerular filtration, content of the total metabolic sodium and potassium, or on the amount and distribution of water in the extracellular and intracellular spaces of the body. The patients with an excessive response to lasix had a significantly lower baseline urine excretion of stable sodium, a higher sodium concentration in the red blood cells and, in cases of stable hypertension, a higher activity of plasma renin as well. Modifications in hypotensive therapy are proposed in relation to the response to lasix administration.
Sodium transport was investigated, using the isotope exchange method, in the erythrocyte membranes of normal subjects and patients with essential and symptomatic (renal) hypertension. In hypertensive patients, the constant of balanced Na/Na exchange rate was increased by more than 60%, and the balance concentration of erythrocytic sodium by 30%, as compared to the controls, in the presence of ouabain. These differences become far less pronounced if furosemide is added to the incubation medium. In patients with secondary (renal) hypertension, the Na/Na exchange rate and erythrocytic balance concentration of sodium are not affected by ouabain as compared to the controls. It is suggested that Na/Na-countertransport plays the principal role in the disruption of erythrocyte membrane permeability by sodium in essential hypertension.
The parameters of water-electrolyte metabolism and central hemodynamics were studied in 44 patients with essential hypertension (stage II-III) after 3-week treatment with sympatholytics and diuretics. Patients with hyperkinetic type of hemocirculation had a sodium lack at the stage of stable hypertension, therefore the diuretic treatment is not indicated for such patients. The treatment with the diuretic oxodolin was accompanied by the decrease in the peripheral resistance of blood vessels, in sodium metabolism and its extracellular fraction, and by the increase of the deposit sodium fraction. The elevation of the renin-angiotensin system activity due to the diuretic therapy did not influence the blood pressure level and the central hemodynamics parameters.
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Potassium metabolism was studied with the use of 42K nuclide in 68 patients with hypertensive disease, stage I-III (WHO classification) without signs of cardiac and renal insufficiency and in 13 persons of the control group, total body volume with tritium oxide dilution and central haemodynamics with radiocardiography were also recorded. Patients with the stable course of arterial hypertension show decreased potassium metabolism in the body, apparently with deterioration of the tissue metabolism. Decrease of the total metabolised potassium was seen in patients with hypertensive disease only in the sclerotic stage of illness, it is more marked in men than in women. Decrease of potassium content in the body did not depend on the duration and severity of arterial hypertension and on the changes in central haemodynamics. It is concluded that more information on total potassium content in the body is gained with calculated percentage to the predicted normal values in milliequivalents per liter of total water in the body.
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Water-sodium metabolism and central hemodynamics were studied in 44 males with hypertensive disease whose ages ranged from 17 to 72 and in 10 persons of the control group. It was established that disorders of water-sodium metabolism already occur in the early stages of hypertensive disease. In patients with border-line hypertension a decrease in content of total metabolic sodium and of total body water with elevation of arterial pressure was encountered. The values of total metabolic sodium and total water in the body are restored in stage I of the disease. The increase in the content of total metabolic sodium is most marked in stage III hypertensive disease (without renal and cardiac insufficiency). Accumulation of sodium in the organism of patients wih hypertensive disease closely correlates with a decrease in creatinine clearance. The decrease in the circulating blood volume with the advancement of the disease depends to a great measure on the growing vascular resistance to the blood flow.