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Biomedical subjects

C Lemne

Publications and source records attributed to C Lemne.

25 records · Page 2Linked to original sources

Dyslipoproteinemic changes in borderline hypertension.

The present study examined plasma lipoprotein, lipoprotein lipase, hepatic lipase, and insulin levels in men with borderline hypertension (diastolic blood pressure 85 to 94 mm Hg) compared with age-matched normotensive control subjects (diastolic blood pressure less than or equal to 80 mm Hg, n = 75 + 75). High-density lipoprotein (HDL) subclasses were determined in a subset (n = 45 + 45). While total and low-density lipoprotein cholesterol levels were similar, levels of very-low-density lipoprotein (VLDL) cholesterol and triglycerides (0.46 versus 0.41 mmol/L, P = .027, and 1.0 versus 0.85 mmol/L, P = .031) and total triglycerides (1.53 versus 1.33 mmol/L, P = .009) were elevated and HDL cholesterol was reduced in the borderline group compared with the normotensive group (1.17 versus 1.26 mmol/L, P = .043). The HDL subclass HDL2b concentration was lower (0.16 versus 0.24 mmol/L, P = .006), while HDL3b and HDL3c concentrations were higher in the borderline group (0.38 versus 0.32 mmol/L, P = .016, and 0.19 versus 0.16 mmol/L, P = .042). Significantly higher activities of hepatic lipase in the borderline group (282 versus 232 mU/mL, P = .024) and significant correlations between lipoprotein lipase activity and VLDL and HDL concentrations suggest an involvement of these enzymes in the development of these differences. When adjusted for body mass index or insulin level, all differences disappeared, except for HDL3b and HDL3c concentrations, which remained significantly elevated. These results indicate that dyslipoproteinemic changes are present in early hypertension. Although most of these changes are related to obesity, alterations in HDL profile were not explained by influences of body mass index and insulin.

Adult↗

Impaired glucose and insulin metabolism in borderline hypertension.

This study investigated glucose and insulin metabolism in borderline hypertension (BHT) defined as repeated diastolic blood pressures (DBP) of 85-94 mmHg. Seventy-five BHT and 75 age-matched normotensive (NT, DBP < or = 80 mmHg) men were recruited from a population screening programme. Plasma lipoproteins were determined and an oral glucose tolerance test was performed (WHO criteria). Fasting insulin was significantly higher in the BHT group (17.2 vs 14.2 mU/ml, p < 0.001), whereas fasting blood glucose levels were similar in the two groups, indicating a reduced insulin sensitivity. The BHT group had significantly lower levels of HDL cholesterol and higher levels of plasma triglycerides, VLDL cholesterol and VLDL triglycerides. When adjusted for BMI these differences disappeared, whereas the basal insulin levels remained significantly elevated (F = 10.7, p < 0.001). These results indicate that an altered glucose and insulin metabolism is present already in the early stages of hypertension. They also suggest that these disturbances are only partly dependent on BMI. This supports the hypothesis that reduced insulin sensitivity could be of importance in the early phases of essential hypertension.

Adult↗

Mental stress induces different reactions in nutritional and thermoregulatory human skin microcirculation: a study in borderline hypertensives and normotensives.

It has recently been shown that the reactivity of total (= thermoregulatory) and nutritional (= capillary) skin microcirculation differs in hypertension and normotension (NT) with a reduced stress response in hypertension. The present study investigated skin microcirculation in 40 patients with borderline hypertension (BHT) and 38 NT controls. Capillary blood flow (CBV, dynamic capillaroscopy) and subpapillary thermoregulatory flow (Laser Doppler fluxmetry, LDF) was measured at rest, after arterial occlusion and during and after a mental stress test. Resting CBV (0.48 vs. 0.50 mm/s) and LDF (3.19 vs. 3.06 AU) were equal in the two groups and no difference was found in postocclusive hyperaemia response. Reactivity to mental stress was similar in both groups with a significant increase in LDF (45% and 39%) and a significant decrease in CBV (35% and 30%). In nonsmokers the BHT group tended to increase less in LDF (50% vs. 72%) and decrease slightly more in CBV (35% vs. 28%) than the NT group. No such difference was seen in smokers. Mental stress induces opposite reactions in total and nutritional skin microcirculation both in borderline hypertensives and normotensives. There were no significant differences in reactivity between the two groups, possibly due to the alleviated responses seen in smokers in both groups.

Adult↗

Plasma growth factor activity and cardiac wall thickness.

OBJECTIVES: The aim of this study was to investigate the growth factor activity in plasma (GFAP) in hypertension, and the correlation of GFAP to blood pressure levels, cardiac structural changes and platelet activation at rest and during exercise. SUBJECTS: Fifteen untreated hypertensive subjects and 15 normotensive controls were recruited from a blood pressure screening programme. INTERVENTIONS: GFAP before and after 30 min of strenuous exercise was analysed as the ability of patient or control plasma to stimulate incorporation of 3H-thymidine in cultured human smooth muscle cells. M-mode echocardiography was performed and platelet activity was measured by the excretion of the urinary metabolite of thromboxane A2. RESULTS: There were no significant differences in GFAP or platelet activation at rest or after exercise between the groups. The fractions of labelled cells were 52.6% vs. 56.6% (HT vs. NT) at rest. Septum and posterior wall end-diastolic thicknesses (PWT[D]) were significantly increased in the HT group (10.4 +/- 0.3 vs. 9.2 +/- 0.3 mm and 11.4 +/- 0.5 vs. 10.0 +/- 0.4 mm, respectively, P < 0.05). PWT(D) was significantly correlated to GFAP (r = 0.40, P = 0.04) and to blood pressure (r = 0.53, P < 0.005) but there was no correlation between blood pressure and GFAP. CONCLUSION: The data suggest that GFAP could play a role in the early development of cardiac hypertrophy in hypertension, but that this effect does not seem to be directly linked to blood pressure levels alone.

Adult↗

Platelet activation and prostacyclin release in essential hypertension.

To evaluate platelet activation thromboxane A2 (TxA2) and beta-thromboglobulin (beta TG) were used as markers and in addition we studied the biosynthesis of prostacyclin. Synthesis of TxA2 and prostacyclin was assessed by measurement of urinary metabolites. Fifteen untreated hypertensive patients (HT) and 15 age-matched normotensive controls (NT) were investigated at rest, during and after exercise. HT patients were re-examined after 3 months on enalapril. During basal conditions there was no difference in the excretion of Tx-M, PGI-M or beta TG between the groups. During strenuous exercise HT exhibit a significantly higher increase in prostacyclin synthesis (162%) compared to NT (76%). The levels of beta TG increased with 82% in the HT and 24% in the NT group, Tx-M increased with 27% and 23% respectively. Treatment with the ACE-inhibitor enalapril did not significantly alter these findings. These results indicate that there is no evidence of basal platelet activation in early essential hypertension. Strenuous exercise leads to some increase in Tx-M in both groups, with no pronounced differences between the groups. Hypertensive patients exhibit a significantly increased prostacyclin response to exercise which could be due to differences in vessel-wall reactivity. Enalapril seems to exert no effect on platelet activation or on prostacyclin biosynthesis.

Adult↗

Non-invasive assessment of vessel-wall changes in hypertensives and normotensive controls.

The aim of this study was to evaluate the feasibility of non-invasive assessment of vessel wall changes in early, untreated hypertension. Measurement of intimal+medial (I-M) thickness in the common carotid artery (CCA) using B-mode ultrasound imaging showed no differences between 12 patients with untreated, newly diagnosed hypertension and 9 age-matched controls (0.63 mm vs 0.63 mm just proximal to the carotid bulb). Echocardiography showed that the hypertensive group had thicker left ventricular walls (LVW) than the normotensive group. Correlation analyses disclosed that I-M thickness was significantly associated with age (r = 0.63; P less than 0.05) for the whole material but not with blood pressure levels, serum lipids, or LVW thickness. These results imply that the arterial I-M layers of the CCA are less responsive to pressure overload than the left ventricle. The feasibility of using I-M thickness as an early marker of structural vessel wall changes in hypertensive patients must await results from large scale prospective studies. In view of the present results, age homogenous materials should be selected for such studies.

Adult↗

Effects of dilevalol, a beta-adrenoceptor antagonist with intrinsic sympathetic activity in asthmatic patients.

The effects on baseline ventilation as well as beta 2-receptor stimulant-induced bronchodilation and tremor of atenolol and dilevalol, a beta-blocking agent with non-selective beta-antagonistic properties and intrinsic activity on the beta 2-receptor were evaluated in 8 patients with stable asthma. Both atenolol and dilevalol were found to significantly decrease both forced expiratory volume during 1 s (FEV1) and forced vital capacity (FVC). This decrease was significantly more pronounced after atenolol. Both agents decreased systolic and diastolic blood pressure as well as heart rate to a similar degree. Increased activation of beta 2-adrenoceptors by terbutaline infusion resulted in increased FEV1 and FVC as well as beta 2-adrenoceptor mediated reflex tachycardia and skeletal muscle tremor. The dose response curves for all these parameters were significantly shifted to the right and a decrease of the maximum relative response was seen after atenolol pretreatment. This effect was more pronounced after treatment with dilevalol with a further shift to the right of the response curve and a decrease of the maximum relative response. The haemodynamic and ventilatory effects of dilevalol are consistent with a non-selective beta-adrenoceptor blockade combined with intrinsic activity on the beta 2-receptors.

Adrenergic beta-Antagonists↗