Biomedical subjects
Publications and source records attributed to A M Radin.
There is no doubt that hypertension is of importance to the health of the elderly, in terms of both mortality and disability. There is mounting evidence that antihypertensive therapy is effective in reducing target organ disease. More data are needed to arrive at optimal treatment regimens and to examine the efficacy of therapy in pure systolic hypertension. A stepped care, cautious approach to therapy should prove to be safe and beneficial.
Both pure systolic, and systolic plus diastolic hypertension are risk factors for cerebrovascular and cardiovascular disease in patients over 65 years old, but the efficacy of antihypertensive therapy in preventing the complications of hypertension in the elderly has been questioned. The risks associated with such therapy seem to have been overemphasized. Although the evidence is incomplete, elderly patients should be treated when the systolic blood pressure exceeds 160 mm Hg or the diastolic pressure exceeds 95 mm Hg, or both. A revised stepped-care approach, with use of vasodilating agents as the Step-2 drugs, is proposed.
The incidence of side effects due to two dosage regimens of minocycline was examined over a 5-day period. A total of 60 normal women volunteers were randomly assigned in a double-blind manner to either a group who took 100 mg of minocycline twice a day or a group who took 75 mg of minocycline twice a day for 5 days. Both groups were comparable from the standpoints of age, size, race, and the use of oral contraception, nicotine, and ethanol. They were seen on a daily basis, and symptoms were evaluated by both volunteers (from diaries) and physicians. Minocycline serum concentrations were determined on blood samples taken 2 h after the a.m. dose. Volunteers taking 150 mg of minocycline per day had significantly lower serum antibiotic concentrations than those taking 200 mg per day. However, both low- and high-dose groups exhibited similar incidence and prevalence of recorded symptoms, with the single exception of nausea, where the low-dose group had fewer symptoms than the high-dose group (P = 0.035). Symptomatic volunteers did not have higher serum concentrations of minocycline than their asymptomatic counterparts. When either weight or surface area was examined with antibiotic serum concentration there was a significant inverse correlation between the two on day 2 for both groups and also on day 4 for the low-dose group. It is concluded that, in women, a dose of 150 mg of minocycline per day is associated with the same degree of side effects as a dose of 200 mg per day.