Biomedical subjects
A Uusitalo
Publications and source records attributed to A Uusitalo.
Blood pressure and heart rate variability and reactivity as related to daily activities in normotensive men measured with 24-h intra-arterial recording.
The effect of blood pressure and heart rate reactivity on respective variability in everyday life conditions was studied in a group of middle-aged, normotensive men (n = 22, mean age 39.3 years, range 35-45 years). Continuous intra-arterial tape recording was used to measure 24-h blood pressure and heart rate and the subjects completed a 24-h behavioural diary. The variability of blood pressure and heart rate was analysed using 30-s averages and cumulative distribution curves. The overall blood pressure and heart rate variability was calculated as the difference between the 90 and 10% levels of the cumulative distribution curves. Reactivity caused by different daily activities was calculated as the change from baseline level, defined as the 10% level determined from the cumulative distribution curve of waking hours. All regular activities were monitored. Large interindividual differences were found in variability and reactivity. The mean reactivity to different activities varied from 3.3 to 44.7 mmHg for systolic blood pressure, from 1.8 to 16.3 mmHg for diastolic blood pressure and from 2.0 to 46.0 beats/min for heart rate. The mean contribution of reactivity to variability varied between 21 and 74% for systolic blood pressure, from 19 to 58% for diastolic blood pressure and from 20 to 82% for heart rate. As expected, blood pressure and heart rate levels were significantly higher at work than at home. We conclude that the reactivity caused by daily activities has a pronounced influence on blood pressure level and variability during waking hours.
Sialic acid secretion of patients with gastric and duodenal ulcers in the dose-response pentastrin test.
The secretion of HCl and sialic acid into the gastric juice was investigated in 13 patients with gastric, 52 with duodenal ulcers and 27 control patients, during the dose-response pentagastrin test. The basal output of sialic acid was clearly highest in patients with gastric ulcers, and the differences between these and other groups of patients were significant. During pentagastrin stimulation a significant initial decrease was found in patients with gastric ulcers with small doses, and the minimum was reached with a dose of 0.1 micrograms/kg/h. After increasing the dose, an increase in sialic acid output occurred in all groups, reaching its maximum with a pentagastrin infusion rate of 1.0 micrograms/kg/h. The basal concentration of sialic acid was also highest in patients with gastric ulcers. In all groups the concentration decreased during the stimulation, which obviously depended on the sialic output not increasing in the same relationship as the volume of gastric secretion.
A comparative study of three beta 1-adrenoreceptor blocking drugs with different degree of intrinsic stimulating activity (metoprolol, practolol and H 87/07) in patients with angina pectoris.
Three beta1-selective beta-blocker (metoprolol, practolol and H 87/07) were compared in 29 patients with stable angina pectoris. The main pharmacological difference between the three beta-blockers was their intrinsic stimulating activity (I.S.A.), metoprolol being devoid of I.S.A., practolol having moderate I.S.A. and H 87/07 having high I.S.A. Each drug was given in randomized order and the length of each cross-over period was 2 weeks. Daily activity was measured by an automatic step-counter, and subjective symptoms and nitroglycerin consumption were registered on a diary-card. Objective data, such as ECG changes and exercise capacity, were obtained by bicycle ergometer tests performed at the end of each period. At rest, the heart rate was significantly lower on metoprolol than on practolol or H 87/07. During exercise, the heart rate was significantly higher on H 87/07 than on practolol or metoprolol. No other haemodynamic differences were found between the three beta-blockers. No differences were found between the three test periods with regard to daily activity, expressed as the number of steps walked, while on the beta-blocker with high I.S.A., H 87/07, the attack rate and nitroglycerin consumption were significantly higher than when the patients were on metoprolol and practolol. No difference was found between the three beta-blockers with regard to total work or exercise time until 1 mm of S-T segment depression. Except for one patient who experienced a severe exanthema on practolol, the three beta-blockers were equally well tolerated.
[Timolol in long-term treatment of patients with angina pectoris].
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Effects of metoprolol in angina pectoris. A subacute study with exercise tests and a long-term tolerability study.
Eighteen patients with angina pectoris, who had previously participated in a cross-over study with 20 mg metoprolol t.i.d. and placebo, have been included in this study. During an introductory six-month open tolerability study, all patients were treated with 50 mg metoprolol t.i.d. and during a subsequent cross-over study, the efficacy of this dose was compared with that of placebo under double-blind conditions. An exercise was performed at the end of each cross-over period. Metoprolol, in a dose of 50 mg t.i.d., gave a significant improvement compared with placebo in respect of the number of anginal attacks, nitroglycerin consumption and daily subjective assessment of the patients' anginal symptoms. Metoprolol also gave a significant increase in exercise capacity, both until the appearance of 1 mm ST segment depression and until the end of exercise. Heart rate and blood pressure were reduced both at rest and during exercise. No severe unwanted effects were observed during this study ranging over eight months, and none of the patients had any signs or symptoms of cardiac failure or pulmonary dysfunction on any occasion. Unwanted effects reported were mild to moderate, and the frequency was the same as during placebo treatment. No abnormal laboratory findings were observed and the relative heart volume was not significantly changed. Administration of 50 mg metoprolol t.i.d. seems to be of greater benefit than 20 mg metoprolol t.i.d., previously investigated in these patients.