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Biomedical subjects

A R Lorimer

Publications and source records attributed to A R Lorimer.

At least 91 records · Page 5Linked to original sources
PubMed1981

Non-invasive cardiovascular assessment of indapamide in patients with essential hypertension.

The antihypertensive effect and a non-invasive cardiovascular assessment of indapamide in patients with idiopathic hypertension have been investigated in an uncontrolled study. Indapamide was found to be an effective antihypertensive agent in a dose of 2.5 mg per day with a mean fall in blood pressure of 25/18 mmHg. Apart from the development of impotence in one patient, no side effects were encountered. Its effect on heart rate and cardiac output suggest that vasodilatation may contribute to its mode of action. Exercise performance is well maintained and cardiac performance appears to improve when blood pressure is lowered with this drug.

Adult↗
PubMed1980

Relation between extent of coronary artery disease and blood viscosity.

Blood viscosity (shear rate 100/s) and its major determinants (packed cell volume, plasma fibrinogen concentration, and plasma viscosity) were measured before coronary angiography in 50 men aged 30-55 and related to the extent of coronary artery disease. Twenty-six men had extensive disease (stenosis of two or three major coronary vessels), and 24 had either stenosis of one vessel or no stenosis. The 26 men with extensive disease had significantly higher mean blood viscosity than those with mild or no disease and 25 healthy controls (p less than 0.001). The increased viscosity was due partly to a higher packed cell volume and partly to a higher fibrinogen concentration; plasma viscosity was not significantly increased. These differences could not be explained by smoking history. These results suggest an association between increased blood viscosity and extensive coronary artery disease in men, which merits further investigation.

Adult↗
PubMed1980

Long-term comparison of metoprolol and methyldopa in the treatment of hypertension.

The effect of the cardioselective beta-adrenoreceptor blocking compound, metoprolol, was compared with methyldopa in the long-term management of hypertension. Thirty patients given metoprolol and twenty-six given methyldopa were treated for 2 years. The maximum dose of metoprolol was 200 mg twice daily (average 308 mg) and of methyldopa 1,000 mg twice daily (average 1,120 mg). Blood pressure was similar at entry to the study (metoprolol 177/110 mmHg and methyldopa 181/111 mmHg). After 2 years of treatment the blood pressure levels were again similar (metoprolol 149/91 mmHg and methyldopa 148/91 mmHg). Erect pressures were lower in the methyldopa group, but there was no difference between supine and erect blood pressure levels in those on metoprolol. At an exercise load of 300 and 600 kpm the increase in systolic pressure was significantly less in the metoprolol group. The proportional increase in systolic and diastolic pressure in response to a standardized stress situation was reduced by treatment with metroprolol but not by methyldopa. Tolerance to therapy did not develop in either group. The main difference between metoprolol and methyldopa was in the incidence and severity of side effects. Four patients were withdrawn from the metoprolol group. Seventeen were withdrawn from the methyldopa mainly because of side effects including drowsiness, depression, skin rash, and impotence. Six patients on metoprolol and seventeen on methyldopa continued on therapy although side effects were present. It is concluded that metoprolol and methyldopa lower blood pressure to the same extent, but metoprolol is advantageous because of a lower incidence of side effects.

Adult↗
PubMed1980

Effect of blood pressure control on left ventricular hypertrophy in patients with essential hypertension.

1. Changes in left ventricular structure and function were assessed by echocardiography in 22 patients before and after 9 months blood pressure control. 2. Nine patients had normal baseline echocardiograms (group 1) and 13 had echocardiographic evidence of left ventricular hypertrophy (group 2). 3. Group 2 patients demonstrated significant reductions in posterior wall thickness (P < 0.01), septal wall thickness (P < 0.025) and left ventricular mass (P < 0.005). Only six of the 13 patients showed a reduction of greater than or equal to 3 mm in posterior wall thickness. The remainder showed no alteration or only a slight non-significant reduction. 4. The regression of voltage in some patients but not in others did not appear to be related to initial blood pressure, the extent of the fall in blood pressure or duration of follow-up. It was not possible to say whether any specific therapy was beneficial to regression since most of the patients were on multiple therapy.

Adult↗
PubMed1980

Control of hypertension in out-patients. Experience of the Glasgow Blood Pressure Clinic.

Five hundred and sixty-two patients who had attended the Glasgow Blood Pressure Clinic regularly for 3 years between 1969 and 1978 were studied. The mean BPs for the group were 187/115 mmHg initially, 157/100 mmHg after 6 months, and 153/98 mmHg after 3 years. Twenty-eight per cent had 'normal' systolic pressure and 22% 'normal' diastolic pressure at 3 years. Thirty-seven per cent with mild, 83% with moderate, and 89% with severe systolic pressure elevation had moved into less severe categories by 3 years, as had 30% with mild, 60% with moderate and 84% with severe diastolic evaluation. Those patients with severe hypertension, who did not attain a less grade, had a statistically significant drop in pressure. Four per cent of all patients, however, had moved into a more severe severe grade of systolic pressure evaluation and 6% into a more more severe diastolic pressure grade at 3 years. These results suggest that the hospital Hypertension Clinic can play a useful part in the lowering of BP in out-patients. It is clear, however, that 'normal' BP levels are not achieved in a significant proportion of patients.

Adolescent↗
PubMed1980

Combined drug therapy for familial hypercholesterolemia.

Six familial hypercholesterolemic subjects were treated with a combination of cholestyramine (16 g/day) and nicotinic acid (3 g/day). This therapy consistently lowered plasma cholesterol and triglyceride by, on average, 41% and 37% respectively. Very low density and low density lipoprotein cholesterol fell, while high density lipoprotein cholesterol rose significantly. Plasma apolipoprotein levels were also affected by treatment. Apolipoprotein A-I rose 26% and apolipoprotein B fell 31%. In addition, there was a fourfold increase in plasma high density lipoprotein subfraction2 (HDL2), although HDL3 remained unaltered. These favorable changes in a number of atherosclerotic risk indices commend the use of this drug combination in the treatment of heterozygous familial hypercholesterolemia.

Adult↗
PubMed1979

The significance of the abnormal rest thallium-201 myocardial image in coronary artery disease.

Rest Thallium-201 myocardial images were abnormal in 20 out of 40 patients with arteriographically proven coronary artery disease. The myocardial image appearances did not accurately reflect the extent of coronary artery disease present. However, in 35 of the 40 patients (88%) the presence or absence of abnormalities on the rest myocardial image correleted respectively with the presence or absence of abnormal wall motion at left ventriculography. Most rest image abnormalities could be attributed to previous myocardial infarction, but in six patients myocardial ischaemia was possibly the cause. These results suggest that though myocardial fibrosis is usually the cause of rest myocardial image abnormalities in coronary artery disease, this is not invariably so. The possible therapeutic implications are discussed.

Adult↗
PubMed1979

Effect of exercise in hypertension controlled with metoprolol or methyldopa.

1. The adequacy of the control of essential hypertension during exercise was studied in patients whose resting blood pressure had been controlled for 1 year with either metoprolol or methyldopa. 2. Systolic blood pressure increased with exercise in both groups, the increase being significantly less in the metoprolol group than in the methyldopa group.

Adult↗
PubMed1979

Objective measurement of performance during acute stress in patients with essential hypertension: assessment of the effects of propranolol and metoprolol.

1. A standardized method of objectively measuring performance during simulated car driving is described. 2. The effect of a single dose of propranolol and metoprolol were compared with placebo in two groups of patients with untreated essential hypertension. 3. Performance was similar after beta-adrenoreceptor-blocking agents or placebo. 4. Blood pressure response to stress persisted after administration of the blocking agents.

Adult↗
PubMed1979

Receptor-mediated low density lipoprotein catabolism in man.

Binding of human low density lipoproteins (LDL) to their specific receptor on cultured cells can be inhibited by treatment with 1,2-cyclohexanedione which blocks a number of functionally significant arginyl residues on the apolipoprotein. We have used this observation to examine the role of the receptor pathway in LDL catabolism in man. The plasma clearance rates of 125I-LDL and 131I-cyclohexanedione-treated LDL were measured in four normal and four heterozygous familial hypercholesterolemic subjects. Chemical modification of the lipoprotein significantly reduced its fractional clearance rate and permitted calculation of receptor-mediated and receptor independent catabolism in both groups. The normal subjects cleared 11% of their plasma LDL pool (corresponding to 3.0 mg/kg per day) by a receptor-independent path. In tared daily by these pathways, respectively. Because the mean apoLDL pool size in the group was increased 3-fold over normal, this gave absolute clearance rates for the apoprotein of 2.5 mg/kg per day via the receptors and 12.8 mg/kg per day by the nonreceptor pathway. We conclude that the specific LDL receptor mechanism operates in vivo and probably accounts for 33% and 16% of overall LDL catabolism in normal and heterozygous familial hypercholesterolemic subjects, respectively.

Adult↗
PubMed1979

Can the extent of coronary artery disease be predicted from thallium-201 myocardial images?

The accuracy with which the extent of coronary artery disease can be predicted from stress thallium-201 myocardial images has been assessed in 81 patients with chest pain. Whereas the appearance of the myocardial images was both a sensitive means of detecting coronary artery disease (images abnormal in 43 of 47 patients with abnormal coronary arteriograms) and specific in excluding it (images normal in 31 of 34 patients with normal arteriograms), there was poor correlation between the extent of disease predicted from the Tl-201 images and the findings at arteriography. It is concluded that although stress Tl-201 myocardial imaging is a useful method for the noninvasive diagnosis of coronary artery disease, it cannot be relied upon to predict the number of abnormal vessels.

Adult↗
PubMed1978

Benzothiadazine diuretics and death from myocardial infarction in hypertension.

1. Case records were examined of 66 patients who died while being treated for high blood pressure. 2. The possibility that benzothiadazine diuretics may have some deleterious as well as beneficial effects was investigated. 3. It is possible that the thiazides may have some adverse clinical effects, at least in females, with regard to the incidence of myocardial infarction in hypertensive patients.

Adult↗
PubMed1978

Standardized stress and hypertension: comparison of effect of propranolol and methyldopa.

1 Using a standardized form of mental stress, 21 patients with idiopathic hypertension were investigated before and after treatment with placebo (n=8), propranolol (n=7) or methyldopa (n=6). 2 Blood pressure was satisfactorily controlled in the propranolol and methyldopa groups but only the propranolol group showed modification of the pressor response to stress testing. 3 These results suggest that propranolol may provide more uniform control of blood pressure than methyldopa in patients with essential hypertension.

Adult↗
PubMed1977

Lipoprotein concentrations in untreated adult onset diabetes mellitus and the relationship of the fasting plasma triglyceride concentration to insulin secretion.

Plasma lipoprotein concentrations in 64 untreated adult onset diabetics were compared to the lipoprotein levels found in non diabetics. No significant difference was found. The relationship of the fasting plasma triglyceride concentration to the plasma immunoreaction insulin response to 50 g glucose orally was investigated. Using correlation analysis a significant and insulin response in the non diabetics but not in the diabetics.

Cholesterol↗
PubMed1976

Beta-adrenoreceptor blockade in hypertension.

There is good evidence from many sources that beta-adrenoreceptor blockade is an effective form of therapy in mild, moderate and severe hypertension either alone or in combination with other antihypertensive agents. Although a number os such beta blocking compounds are now available, they appear to have a hypotensive effect of approximately equal magnitude. This hypotensive effect is obtained in both the supine and standing positions thus avoiding postural hypotension. The maximum hypotensive effect may take some time to become apparent. Despite considerable work the mode of action remains uncertain, reduction in cardiac output, resetting of baroreceptors, reduction in plasma renin and a central nervous system effect have been suggested but remain unproved. There is evidence to suggest that these compounds can control, to some degree, the surges in blood pressure resulting from either mental or physical stress. A low incidence of serious side effects has been reported by many workers. Only the long-term use of these compounds in comparison with other antihypertensive agents will determine their place in the management of hypertension.

Adrenergic beta-Antagonists↗