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Biomedical subjects

C Mörlin

Publications and source records attributed to C Mörlin.

At least 37 records · Page 2Linked to original sources
PubMed1987

Comparative trial of lisinopril and nifedipine in mild to severe essential hypertension.

A total of 136 patients with mild to severe uncomplicated essential hypertension were evaluated in a multicenter, randomized, double-blind, double-placebo, parallel study to compare the effect of lisinopril, a new angiotensin-converting enzyme inhibitor, with that of nifedipine. Following a 2-week placebo control period the patients were treated with either 20-80 mg/day of lisinopril (n = 89) or with 40-80 mg/day of nifedipine (n = 47). Blood pressure was significantly reduced in both groups after 4, 8, and 12 weeks of treatment. There was no difference in the effect of lisinopril compared to nifedipine. No serious clinical or laboratory adverse experiences were observed during the study. The incidence of clinical side effects was significantly lower in the lisinopril group than in the nifedipine group (21.3 vs. 48.9%, p less than or equal to 0.01). There were no significant changes in laboratory data in either group. The results indicate that lisinopril is as effective as nifedipine in the treatment of uncomplicated essential hypertension and that lisinopril is well tolerated and has an acceptable safety profile.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1987

Fibromuscular dysplasia of the renal artery--management and outcome.

Fifty-seven patients (48 women, 9 men) with fibromuscular dysplasia (FMD) of the renal artery were investigated. Mean age at detection of hypertension was 37 years. The diagnosis was established by angiography. Patients with lateralization of renin secretion to the stenotic side had a significantly higher peripheral renin level than those without. The patients were initially treated with surgery (n = 19), percutaneous transluminal renal angioplasty (PTRA) (n = 9), or pharmacologically (n = 29). During a mean follow-up period of 6.2 years, thirteen pharmacologically treated patients were transferred for surgical treatment or PTRA, because of progression of the FMD or inadequate blood pressure control. The long-term effect of surgery (n = 22) on the blood pressure was satisfactory in 91% and that of PTRA (n = 18) in 55%. The low success rate after PTRA seems to be due to an inappropriate selection of patients. Age, duration of hypertension and renal vein renin ratio seem to be important prognostic factors for the outcome of surgery or PTRA.

Adolescent↗
PubMed1987

Relationships between calcium metabolic indices and blood pressure in patients with essential hypertension as compared with a healthy population.

Relations between indices of mineral metabolism and blood pressure were examined in 182 subjects, comprising 58 patients with essential hypertension (EHT) and 124 healthy subjects attending a general health survey. Multivariate techniques of statistical analysis were employed to test the hypothesis of different relationships between blood pressure and calcium metabolism within the subpopulations and to eliminate confounding effects of age, sex and obesity. Plasma ionized calcium was inversely related and the urinary calcium excretion positively related to blood pressure in the total group. This was not significantly different between the groups. Serum parathyroid hormone (PTH) was, however, related to diastolic blood pressure only in the EHT group. The EHT patients had significantly lower plasma levels of ionized calcium, significantly higher levels of PTH and significantly greater excretion of calcium in the urine than the healthy subjects. The results of this investigation support the hypothesis that among patients with EHT the renal tubular reabsorption of calcium is impaired resulting in a reduction of plasma ionized calcium and thereby stimulation of PTH. The findings of linear relationships suggests the possibility of a direct association between calcium metabolism and the regulation of blood pressure.

Adult↗
PubMed1986

Indices of mineral metabolism in relation to blood pressure in a sample of a healthy population.

Indices of mineral metabolism in blood and urine were analysed in relation to blood pressure in 97 healthy subjects aged 16-82 years. In a multivariate analysis, after allowing for the effects of sex, body mass index (BMI) and age, there was an inverse relationship between plasma level of ionized calcium and mean blood pressure (MBP) (beta = -50.0 mmHg/mmol/l P-ionized calcium, p = 0.0005). In univariate analyses MBP also showed statistically significant inverse relationships with plasma ionized calcium, serum phosphate and renal threshold concentration of phosphate; positive relationships to MBP were found for fasting urinary excretion of calcium and cyclic adenosine monophosphate. However, when examined multivariately, only the relation between MBP and plasma ionized calcium persisted. This study supports previous findings of an inverse relationship between blood pressure and serum ionized calcium and extends the observations to the physiological range. It is further evident from this study that BMI and age should be taken into account in analyses of the relationship between blood pressure and mineral metabolism.

Adolescent↗
PubMed1985

Percutaneous transluminal renal artery dilatation for fibromuscular dysplasia with special reference to the acute effects on the renin-angiotensin-aldosterone system and blood pressure.

Twelve hypertensive patients (mean age 46.6 years, range 37-55 years) with fibromuscular dysplasia of the renal artery were treated with percutaneous transluminal renal angioplasty (PTRA) and the effects on the renin-angiotensin-aldosterone system and blood pressure were studied in the acute phase. The technical result of PTRA measured by angiography and reduction of PRA and aldosterone excretion was satisfactory in 11 patients. In spite of this only three patients were cured of their hypertension and two patients were improved at six months follow-up. During PTRA an immediate rise in plasma renin activity was noted in patients without beta-receptor blockade but not in patients treated with beta-receptor blocking agents suggesting a beta-receptor mediated release. This peak in renin release was not accompanied by any rise in systemic blood pressure. The blood pressure response in the acute phase did not show any regular pattern. We conclude that PTRA can serve as a model for studying effects of 'clamping' and 'declamping' of the renal artery in man.

Adult↗
PubMed1984

Initial clinical experience with ICI 141,292 (Visacor), a new selective beta 1-adrenoceptor blocker with ISA--a multicentre trial in 59 patients.

The objective of this placebo controlled double-blind multicentre (six centres) trial was to investigate the safety and efficacy of ICI 141,292 (Visacor), a new selective beta 1-adrenoceptor antagonist with modest intrinsic sympathomimetic activity (ISA), in hypertensive patients. Fifty-nine patients with mild essential hypertension were randomized to two of five treatment alternatives (placebo, 50 mg, 100 mg 200 mg or 300 mg of ICI 141,292) each given once daily for 2 weeks with a 4 week placebo period before (run in) and in between (wash out) active periods. Thus, each of the five treatments was evaluated in 20-24 patients. After 2 weeks (24 h after last dose) the reduction in recumbent blood pressure for all doses except 50 mg of ICI 141,292 was statistically significant and in the order of 6/4 mm Hg. Standing systolic blood pressure was reduced in a dose-dependent way but only significant for 200 mg of ICI 141,292 (8 mm Hg). Heart rate changes (delta) less than 4 beats/min) were not statistically significant for any dose. It is concluded that ICI 141,292 was well tolerated and had a significant but weak antihypertensive effect which might be explained by too much beta 1-adrenoceptor ISA.

Adrenergic beta-Antagonists↗
PubMed1983

Muscle sympathetic activity and plasma noradrenaline in normotensive and hypertensive man.

Micro-electrode recordings of muscle sympathetic activity were made in the peroneal nerve of 20 normotensive subjects and 18 patients with essential hypertension resting in the recumbent posture. The level of sympathetic activity was quantitated as bursts/100 heart beats or bursts/min. On another occasion blood was sampled from an antecubital vein and analyzed for plasma noradrenaline using radioenzymatic technique. In both groups the level of sympathetic activity increased with age and taking age into account there was no significant difference in sympathetic activity between normotensive and hypertensive subjects. There was no significant difference in plasma levels of noradrenaline between the groups. Both for normotensive and for hypertensive subjects there was a positive correlation between a subject's level of sympathetic activity and his plasma concentration of noradrenaline, and the regression lines did not differ significantly between the groups. It is suggested (a) that outflow of transmitter from sympathetic terminals in muscles contributes significantly to plasma concentrations of noradrenaline at rest both in normotensive and hypertensive subjects: (b) that neither for muscle sympathetic activity nor for plasma noradrenaline do the resting levels differ between normotensive and hypertensive subjects.

Adult↗
PubMed1982

Spontaneous variations in renal vein renin activity in man.

The spontaneous variations in renal vein renin activity (RVRA) and in peripheral vein renin activity (PVRA) were studied in one normotensive and nine hypertensive patients. Eight of the hypertensive patients had renal artery stenosis on one or both sides. Blood samples were drawn simultaneously from the two renal veins and from a peripheral vein every fifth or tenth minute for one hour. Plasma renin activity (PRA) was measured by radioimmunoassay. The precision of the PRA assay, expressed as coefficient of variation, was related to the PRA level. A large intra-individual variations was found in RVRA, the RVRA ratio and PVRA even in patients with unilateral renovascular hypertension. The intra-individual variation could not be explained by specimen collection error or by error of the assay procedure. The variation seems to be reflect a biological fluctuation. The clinical implication of these findings is that repeated, simultaneous collection from the two renal veins, avoidance of factors known to decrease renin secretion. and consideration of the relation between the RVRA ratio and RVRA level are of importance in the preoperative evaluation of patients with renal artery stenosis.

Adult↗
PubMed1981

Comparison of captopril (SQ 14225) with hydrochlorothiazide in the treatment of essential hypertension.

Captopril, a newly developed, orally active inhibitor of the angiotensin-converting enzyme, and hydrochlorothiazide were given alone or in combination to 39 patients with mild or moderate essential hypertension. After a placebo period the patients were randomly allocated in the proportion 3:2 to treatment with captopril (n = 23) or hydrochlorothiazide (n = 16) for dose titration over 4 weeks. The alternative test drug was added thereafter during an 8-week maintenance period if the supine diastolic blood pressure was more than 90 mmHg. The average supine BP reduction in the captopril group was 29/21 mmHg and in the hydrochlorothiazide group 18/15 mmHg. Only one patient who started on captopril had to have hydrochlorothiazide added. Four of those who started on hydrochlorothiazide had to have captopril added. The antihypertensive effects of captopril and hydrochlorothiazide appear to be additive. Among the side effects due to captopril, there were two patients with taste disturbances and another two with rashes.

Adult↗
PubMed1981

The effect of salt restriction and furosemide in patients investigated for renovascular hypertension.

The effect of five days' regimen with a low-sodium diet (approximately 20 mmol Na+ per day) and with 40 mg of furosemide (Lasix) daily on the blood pressure, the renin-aldosterone system and the electrolyte balance was studied in 42 hypertensive patients who received no antihypertensive drugs for four weeks prior to the investigation. Twenty-three of the patients had renal artery stenosis. Both patients with and those without such stenosis showed a significant decrease in systolic and diastolic blood pressure and in the serum concentrations of sodium and potassium and urinary excretion of sodium. A concomitant increase in plasma renin activity in peripheral veins and in urinary excretion of aldosterone was found both in patients without and in those with renal artery stenosis, but in the latter group this response seemed to be less pronounced.

Adolescent↗
PubMed1979

The effect of splanchnic block on renin production and renal haemodynamics in hypertensive patients.

In eighteen patients with hypertension the effect of a splanchnic block was studied with respect to the plasma renin activity (PRA) in the renal vein and to the renal haemodynamics. A significant reduction of the PRA was noted during splanchnic block, both in kidneys with arterial stenosis, and in those without. The decrease in renin activity took place despite a simultaneous decrease in renal vascular resistance, which in itself should increase the secretion of renin. This supports the view that the sympathetic nervous system dominates over the baroreceptors in patients with hypertension at the pressure levels investigated and if the sodium intake is restricted.

Adult↗
PubMed1978

Renal haemodynamics before and after splanchnic block in patients with hypertension.

In eighteen patients with hypertension of presumed renal origin the haemodynamics of the kidney were studied by arterial pressure recording, blood flow measurement and selective arteriography before and after a splanchnic block. The material was divided into kidneys with and kidneys without arterial stenosis. In these patients with hypertension a positive correlation was found between mean arterial pressure and renal vascular resistance both before and after the splanchnic block. In patients with renal arterial stenosis the change in relative renal vascular resistance was negatively correlated to the initial resistance, implying that in kidneys with a high initial vascular resistance the resistance decreased to a relatively greater extent than in kidneys with a low initial resistance. At high blood pressures ischaemic areas in the kidney were found. The volume of these areas is dependent upon sympathetic tone, such that a high sympathetic tone results in ischaemia of a larger volume of the kidney. This applies both to kidneys with and to those without arterial stenosis. The results of this investigation thus support the assumption that in the presence of hypertension a kidney is under the control of a sympathetic tone that may form a part of the pathogenetic process in hypertension.

Adult↗