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Biomedical subjects

A Libretti

Publications and source records attributed to A Libretti.

At least 91 records · Page 5Linked to original sources
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Indenolol pharmacokinetics and pharmacodynamics after single and repeated daily doses.

The relationship between indenolol (an investigational agent) plasma levels and the drug's effect on blood pressure and heart rate was investigated after single and repeated once daily administration at two dosage levels (60 mg and 120 mg) in two different groups of patients with first or second stage hypertension, according to the World Health Organization classification. The pharmacokinetic data were indicative of a first order absorption-elimination curve; time of maximum plasma levels was 1.5 to two hours, and elimination half-life was four hours. The drug did not accumulate in the central compartment after repeated administrations. A long-lasting decrease of both resting and isometric exercise systolic pressure values was recorded after acute indenolol administration. Diastolic pressure was affected only by repeated administrations. The lower dose (60 mg daily) of indenolol did not affect heart rate, whereas the higher dose (120 mg daily) decreased this parameter. A steady state of pressure values and heart rate was reached after 14 days of once daily treatment.

Adult↗
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Isolated office hypertension: are there any markers of future blood pressure status?

BACKGROUND: The introduction of ambulatory blood pressure monitoring into clinical practice has defined a clinical condition called 'isolated office hypertension'. OBJECTIVE: The aim of this study was to evaluate the long-term systolic and diastolic blood pressure changes in patients with isolated office hypertension and to identify the presence of markers capable of identifying which patients will develop sustained hypertension. METHODS: All the 407 patients enrolled had a random office systolic or/and diastolic blood pressure of over 140/90mmHg and a mean daytime ambulatory blood pressure of 130/84mmHg or less. At enrollment, each patient underwent a 'baseline examination' made up of a physical evaluation, a 24h ambulatory blood pressure monitoring, and a mental arithmetic test performed at the end of the 24h ambulatory monitoring. RESULTS: Of the 173 patients finally studied, 102 (58.9%) developed sustained hypertension with an increase in both ambulatory systolic and diastolic blood pressure. At the time of the baseline examination, the patients were divided into two groups. Group A included patients with mean ambulatory systolic and diastolic blood pressures in the first hour of 130/84mmHg or less; group B included patients with mean ambulatory systolic and diastolic pressures in the first hour of greater than 130/84mmHg. During the mental arithmetic test, the systolic and heart rate values increased significantly only in group B patients. Of the 102 patients who had become hypertensive by the time of the follow-up examination, 84 (82%) belonged to group B. CONCLUSION: These data suggest that isolated office hypertension may indeed be a transitional state towards the development of sustained hypertension. Moreover, the mean ambulatory blood pressure value during the first hour can be considered to be a marker of a higher risk of developing sustained hypertension.

Adult↗
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[Blood pressure changes induced by physical exercise and tyramine infusion in hypertensive and normotensive subjects].

The aim of our investigation was to assess blood pressure (BP) and heart rate (HR) variations in 20 essential hypertensive male inpatients (WHO class I and II) and in 20 normotensive healthy volunteers submitted to three provocation tests: isometric handgrip (IHG), bicycle ergometric exercise (BEE) and tyramine infusion (TI) given as i.v. boluses with saline in a single-blind manner. According to our data, IHG induced a comparable rise of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate in both hypertensive and normotensive subjects. BEE, compared with IHG, caused a more significant (p less than 0.01) rise in SBP and heart rate in both groups. By contrast, DBP during BEE increased significantly in hypertensive (p less than 0.01), but decreased slightly in normotensive subjects (p = n.s.). TI caused a dose dependent SBP rise in both groups studied, while DBP and HR were unaffected. BP elevation was, however, more marked in hypertensive subjects. Confirming this finding, significantly lower tyramine doses were required to produce the same SBP increase in hypertensive patients than in the normotensive volunteers. In short, an SBP rise during TI, and a DBP rise during BEE may be the markers of enhanced cardiovascular reactivity on the part of hypertensive subjects. Our study suggests that BP reactivity to stress may be different according to the laboratory stress employed and also that BEE and TI are more useful than IHG for the assessment of enhanced cardiovascular response to stress in hypertensive subjects.

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