Relationship between plasma aldosterone concentration and plasma potassium in patients with essential hypertension during alprenolol treatment

Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), plasma potassium, plasma sodium and blood pressure (BP) have been measured in 22 patients with essential hypertension before and after treatment for one month with alprenolol. PAC, PRC and BP decreased and plasma potassium increased significantly during treatment. Plasma sodium, however, was unchanged. Changes in PAC were inversely correlated to changes in plasma potassium. No relationship could be demonstrated between PAC and plasma sodium. Mean BP was inversely correlated to PAC during alprenolol treatment, but bot before treatment. No relationship was found between changes in BP and changes in PRC. The results suggest that plasma potassium is an important regulatory factor for aldosterone secretion during alprenolol treatment. Other factors, however, must have a modulating influence and since the renin- angiotensin system is not suppressed to very low values, this system is possibly the most important of these factors. It is suggested that aldosterone secretion is not of primary importance in BP regulation during alprenolol treatment.     

Digitalis, diuretic and vasodilator treatment of cardiac failure

Angiotensin-converting-enzyme inhibitors increase life expectancy in congestive heart failure, and they have thus changed the therapeutic strategy. The well tolerated highest daily dosage has to be used. Diuretics are often associated with vasodilators; however, they have to be administered at a minimal chronic daily dosage, in order to avoid deleterious neurohormonal effects. Digoxin keeps a great interest, as the unique positive inotropic agent without surmortality. Nitrates associated or not with hydralazine may show an additional interesting benefit. The role of other vasodilators, namely amlodipine and losartan, in the treatment of chronic heart failure remains to be defined. New vasodilators are in development and might further increase our therapeutic possibilities against congestive heart failure.     

Influence of gender on renal thiazide diuretic receptor density and response

The influence of gender and gonadectomy on (1) the density of the renal thiazide-sensitive ion transporter, as quantitated by the ability of renal membranes to bind (3H)metolazone, and (2) the changes in the urinary excretion of electrolytes caused by maximal bendroflumethiazide (BFTZ) in Sprague-Dawley rats was determined. The density of the thiazide receptor was twofold higher (P < 0.001) in females than in males. Orchiectomy increased thiazide receptor significantly in one of two studies (P < 0.01). Ovariectomy decreased thiazide receptor by more than 20% (P < 0.01) in both studies. The rates of the urinary excretion of sodium and chloride after BFTZ and the increases in the urinary excretion of sodium, chloride, and ammonium caused by BFTZ were greater in intact females than in intact males; BFTZ decreased the urinary excretion of calcium 50% in intact females, but not in intact males. Regression analysis of the thiazide receptor (in intact and gonadectomized animals) versus the urinary excretion of electrolytes before and after BFTZ yielded a model in which one-third of the variation in thiazide receptor could be related to the change in the excretion of calcium and ammonium produced by BFTZ, raising the possibility that the density of the thiazide receptor might be related to calcium or acid-base homeostasis. It was concluded that the renal excretion of sodium, chloride, calcium, and ammonium are, in part, controlled by gender and sex hormones via their regulation of the renal density of the thiazide diuretic receptor.     

Clinical effectiveness of cardio-selective blockers associated with small diuretic doses as monotherapy for hypertension

A polymorphic dinucleotide (CA) sequence was isolated from a genomic clone containing the human interleukin 6 receptor (IL6R) gene. High heterozygosity (0.81) makes this polymorphism a useful marker in the genetic study of disorders affecting the inflammation process and bone resorption.     

Hippocampal response patterns during discriminative eyeblink/jaw movement conditioning in the rabbit.

Rabbits were given concurrent training in eyeblink (EB) and jaw movement (JM) conditioning in which 1 tone predicted an airpuff and another tone predicted water. After 10 days of discrimination training, the animals were given 10 days of reversal training. In the discrimination phase, acquisition of the 2 conditioned responses was not significantly different; however JM discrimination errors were much more frequent than were EB errors. In the reversal phase, correct performance on EB trials increased gradually, as was expected, whereas there was immediate behavioral reversal on JM trials. Differences in size and topography of dorsal CA1 multiple-unit responses reflected the ability of the hippocampus to discriminate between stimuli in trained animals, corresponding to the performance of the behavioral discrimination. During JM trials, the rhythmicity of the neural response was further modulated by the type of the prior trial, suggesting the coding of sequential events by the hippocampus. Thus, hippocampal conditioned activity can rapidly change its magnitude and pattern depending on the specific trial type during a concurrent EB/JM discrimination task and its reversal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unusual resetting patterns in response to single atrial extrastimuli during AV junctional reentrant tachycardia

INTRODUCTION: Two unusual resetting patterns were observed in two patients with slow-fast AV junctional reentrant tachycardia (AVJRT) submitted to an electrophysiologic study. METHODS AND RESULTS: After AVJRT induction, resetting was evaluated by introducing single extrastimuli at progressively shorter coupling intervals from the high right atrium (HRA) and the proximal coronary sinus (CS). An alteration in the return cycle length duration allowed demonstration of resetting. In the first patient, during and AVJRT with a large excitable gap, properly timed extrastimuli delivered both from the HRA and CS simultaneously reset the tachycardia and advanced the H electrogram of the preceding tachycardia beat. In the second patient, both HRA and CS stimulation apparently failed to reset AVJRT (return cycle length unchanged), but, at critical coupling intervals, the cycle length duration of the tachycardia beat following the return cycle was consistently shortened. CONCLUSION: During slow-fast AVJRT, single atrial stimulation from sites remote to the reentrant circuit may result in unusual resetting patterns. Further studies are required to evidence the full spectrum of resetting in AVJRT.     

Changes in the intracardiac hemodynamics of patients with essential hypertension during korinfar treatment

A study is presented of the structure and function of the heart in the diastole in 39 patients during corinfar treatment of essential hypertension. It was established that effective corinfar monotherapy of patients with moderate essential hypertension was associated with arteriolo- and venodilating effect of the drug with prevalence of the preloading effect. Changes of the intracardiac hemodynamics resulted in changes of the left ventricular systole phase structure, namely, its transformation in the direction of myocardial hypodynamia.     

Effect of omeprazole and cimetidine on plasma aldosterone response to angiotensin II

The genomic organization of the human gene encoding the receptor for glucagon-like peptide-1 (GLP-1 (7-37)/(7-36) amide) was analyzed to reveal the relationship to other G-protein-coupled receptors. The coding sequence of the GLP-1 receptor is interrupted by 12 introns. These introns are uniformly distributed within the open reading frame. The length of the introns varies between 6.6 kb and 100 bp, in contrast to the relative constant length of 100 bp of the exons. All of the exon/intron splice junctions characterized followed the consensus GT-AG rule. A comparison of the genomic structure with other related receptor genes indicates that the exon/intron organization is well-conserved among the VIP/ glucagon/secretin receptor family.     

Communication patterns and response to treatment among depressed and nondepressed maritally distressed couples.

Compared 35 maritally distressed couples assigned to 1 of 3 cognitive behavioral marital therapy (BMT) groups. Groups represented (1) couples in which 1 spouse was depressed at pretest, (2) couples in which 1 spouse showed psychopathology other than depression, and (3) couples who showed no symptoms of individual psychopathology. Ss were administered, pre- and posttreatment, the Dyadic Adjustment Scale and the Minnesota Multiphasic Personality Inventory (MMPI). Pretreatment couples in Group 1 were the oldest and the least maritally satisfied, and expressed the most negative communication. 12 wks of BMT was an effective treatment modality for all groups when compared with a group of 12 couples on a wait list. BMT significantly increased marital adjustment for all 3 treatment groups and decreased the rates of negative communication. BMT significantly decreased the level of depression in Group 1 and the level of psychopathology in Group 2. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rebound hypertension during anaesthesia

A case of rebound hypertension under anaesthesia, following withdrawal of clonidine, is described and methods of treatment outlined.     

Irbesartan treatment in hypertension

Angiotensin II receptor antagonists lower blood pressure by blocking the final step in the renin pathway, whereas ACE inhibitors reduce angiotensin II production. ACE inhibitors also block kinin degradation, which may alter both efficacy and side-effects. Irbesartan, one of the newer receptor antagonists, has confirmed their tolerability and shown similar dose-related efficacy to other major classes.     

Surgical treatment of renovascular hypertension

Two hundred sixty-four patients exhibiting renal artery occlusive disease underwent operation for renovascular hypertension between 1961 and 1977. Included were 27 pediatric patients. Fibrodysplastic disease affected 132 adults. Atherosclerotic lesions affected 51 patients with and 54 patients without clinically overt extrarenal arteriosclerotic cardiovascular disease. Ischemic kidney renin hypersecretion (renal: systemic index greater than 0.48), associated with suppressed contralateral kidney renin secretion (renal: systemic index approaching 0.0) predicted curability most reliably. Three hundred forty-eight operations were performed, of which 297 were primary and 51 were secondary procedures. Nephrectomy was initial therapy in 15 cases. Three operative deaths occurred among 51 patients manifesting overt extrarenal arteriosclerotic disease. No operative mortality was encountered among the other 213 patients. Surgical benefits were afforded 96% of pediatric patients and adults with fibrodysplastic disease, 91% of patients with focal renal arteriosclerosis, and 73% of those exhibiting overt extrarenal arteriosclerosis.     

Long-term evaluation of combined antihypertensive therapy with lisinopril and a thiazide diuretic in patients with essential hypertension

For the treatment of hypertension, the combination of an angiotensin-converting enzyme (ACE) inhibitor and a thiazide diuretic is supported by multiple lines of evidence, because these drugs have synergistic action and are expected to cancel out each other's adverse side effects. However, the long-term outcome of this combination antihypertensive therapy is not entirely clear. In the present multicenter open trial, we investigated the long-term efficacy and safety of combined antihypertensive therapy with an ACE inhibitor, lisinopril, and a thiazide diuretic, trichlormethiazide. A total of 466 patients with essential hypertension were treated with lisinopril alone (monotherapy group, n = 360) or with a combination of lisinopril with trichlormethiazide (combination therapy group, n = 106) for 1 year. The average blood pressure was effectively lowered to below 150/90 mmHg in both the monotherapy and the combination therapy groups throughout the study period. The average maintenance dose of lisinopril was lower when combined with thiazide than when given alone (9.8 vs. 11.5 mg/day, p < 0.001). Dry cough was the major side effect of lisinopril; no severe adverse effects were observed. The incidence of cough was not significantly different between the monotherapy group (13.1%) and the combination therapy group (11.3%). The increase in serum potassium observed in the monotherapy group was reversed by the concurrent use of the thiazide diuretic in the combination therapy group. Fasting blood glucose was significantly reduced in the monotherapy group; the reduction observed in the combination therapy group was not significant. Thus, the present results provide useful information as to the effectiveness and safety of combined antihypertensive therapy with lisinopril and a thiazide in comparison with monotherapy with lisinopril.     

A comparison of the expression patterns of several senescence-associated genes in response to stress and hormone treatment

The expression of several Arabidopsis thaliana senescence-associated genes (SAGs) in attached and/or detached leaves was compared in response to age, dehydration, darkness, abscisic acid, cytokinin, and ethylene treatments. Most of the SAGs responded to most of the treatments in a similar fashion. Detachment in darkness and ethylene were the strongest inducers of both SAGs and visible yellowing. Detachment in light was also a strong inducer of SAGs, but not of visible yellowing. The other treatments varied more in their effects on individual SAGs. Responses were examined in both older and younger leaves, and generally were much stronger in the older ones. Individual SAGs differed from the norms in different ways, however, suggesting that their gene products play a role in overlapping but not identical circumstances. Some SAGs responded quickly to treatments, which may indicate a direct response. Others responded more slowly, which may indicate an indirect response via treatment-induced senescence. Four new SAGs were isolated as part of this work, one of which shows strong similarity to late embryogenesis-abundant (Lea) genes.