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Biomedical subjects

D G Beevers

Publications and source records attributed to D G Beevers.

32 records · Page 2Linked to original sources

Alcohol and hypertension.

Liver-function data were compared in 158 unselected hypertensives and 105 normotensives aged 45-64 years. Serum concentrations of alanine and aspartate aminotransferase (S.G.O.T. and S.G.P.T.) were higher, and more often raised, in the hypertensive patients. Serum bilirubin and alkaline phosphatase concentrations were similar in both groups. In hypertensive patients aminotransferase concentrations tended to be higher in those with increased alcohol intake.

Alanine Transaminase

Angiotensin II in essential hypertension.

Plasma concentrations of angiotensin II (PAC) were measured in a group of 146 hypertensive patients (diastolic pressure greater than 105 mm Hg) who had no apparent underlying cause for their condition and 113 randomly selected normotensive controls (diastolic pressure less than 90 mm Hg). There was no evidence of bimodality in the frequency distribution curves for plasma angiotensin II concentrations among the hypertensive patients. It was concluded that hypertension associated with low angiotensin II concentration and by implication "low-renin" hypertension is not a condition separate from essential hypertension.

Angiotensin II

Blood pressure measurement at screening and in general practice.

As part of an epidemiological study of hypertension, an analysis was made of the general practitioner records of all attenders at a screening survey. A blood pressure recording, made before screening, was found in 37-9 per cent of cases. The pressures obtained correlated well with those obtained by the screening unit, though the practitioners' readings tended to be lower. Further cases of hypertension were found, not diagnosed by the screening unit; the estimate made of the prevalence of hypertension at the survey could be corrected by inclusion of these cases. Chest pain, headaches, lightheadedness, and dizziness were common reasons for blood pressure measurement in general practice, but these symptoms were not associated with a rise in the blood pressure; symptoms were not helpful in the diagnosis of hypertension. Some form of screening programme is necessary to detect cases of hypertension. This could be carried out by general practitioners.

Blood Pressure Determination

Blood-cadmium in hypertensives and normotensives.

70 hypertensive patients and 70 controls matched for age and sex were investigated for a possible relationship between blood-cadmium and hypertension. No significant differences between the two groups were detected, although the blood-cadmium level was significantly higher in smokers as compared to non-smokers. These data do not support the hypothesis that cadmium is involved in the development of hypertension in man.

Antihypertensive Agents

Blood-lead and hypertension.

Blood and tap-water lead levels were examined in 135 hypertensives and 135 age and sex matched normotensives. Among male hypertensives there was a significant excess of cases with high blood-lead levels and a similar but statistically non-significant trend was found amongst female hypertensives. A positive correlation was found between blood-lead and tap-water lead. It is concluded that in the West of Scotland high blood-pressure is associated with high blood-lead levels, which might explain the high prevalence of cardiovascular disease in the area.

Blood Pressure

Effectiveness of screening for hypertension in Scotland.

1. Data from long-term follow-up of subjects screened for hypertension indicate that the elevation of blood pressure represents a major contribution to community-attributable risk of death. 2. Attendance rates at screening, and drop-out rates from follow-up, have been assessed in studies in Glasgow. 3. Screening and follow-up are probably best conducted from general practice, and should be regarded as an extension of good primary care.

Cardiovascular Diseases

A blood pressure clinic in a health centre.

Following a screening survey for hypertension in Renfrew, a blood pressure clinic was established in a health centre. Three hospital doctors, each working an average of two sessions weekly, saw 368 patients. A specially trained nurse played an important part in the running of the clinic. Attendance of patients was high, and defaulting amongst those needing treatment was low. Blood pressures were well controlled in 75% of the patients. The clinic has proved an acceptable method of managing large numbers of hypertensives without reference to hospital.

Community Health Centers

Renal abnormalities and vascular complications in primary hyperaldosteronism. Evidence on tertiary hyperaldosteronism.

The frequency of underlying renal or renal artery disease, and the incidence of vascular complications were reviewed in a series of 136 cases of primary hyperaldosteronism. This was in order to investigate the possible existence of 'tertiary' hyperaldosteronism, and to examine the commonly held view that primary hyperaldosteronism is a relatively benign form of hypertension. Ten cases (7-4 per cent) had evidence of renal artery stenosis and eleven (8-1 per cent) parenchymatous renal disease. In comparison with the reported frequency in large general series of hypertensives, these data show no evidence of an excess of underlying renal disease. It is unlikely, therefore, that autonomous aldosterone secreting adenomata occur commonly as a consequence of prolonged secondary hyperaldosteronism. Four cases (2-9 per cent) had evidence of the malignant-phase of hypertension, and over a mean observation time of 5-9 years, 31 cases (22-8 per cent) developed 39 vascular complications. It appears, therefore, that vascular complications are not rare in primary hyperaldosteronism, and early and effective treatment is thus necessary.

Adenoma

Is low-renin hypertension a stage in the development of essential hypertension or a diagnostic entity?

A study of the frequency distribution of plasma-renin concentration in 81 patients with essential hypertension produced no evidence of a distinct sub-population with low renin levels. An arbitrary dividing line was used, therefore, to define low-renin hypertension (36% of patinets). Patients in this group were older than those with normal renin levels, and there was a significant negative correlation between renin and age among all patients. Low-renin hypertension was not characterized by increased exchangeable sodium, but exchaneable postassium was significantly lower than in patients with normal plasma-renin. This difference became insignificant when five patients in the low-renin group with persistent hypokalaemia were excluded. It is concluded that low-renin hypertension does not represent a separate diagnostic entity but that plasma-renin falls with age in essential hypertension.

Adult

Rectal potential difference in the diagnosis of aldosterone excess.

Rectal potential difference (pd) is directly related to the plasma aldosterone concentration, and rises when aldosterone is stimulated by sodium deprivation. However, when the measurement of rectal pd was tested at a screening test for hyperaldosteronism in 19 hypertensive subjects, four of the eight with primary hyperaldosteronism had a normal pd and four of the eight without aldosterone excess had an abnormally raised potential difference. The technique cannot therefore be recommended as a routine screening test for hyperaldosteronism. No relationship was found between rectal pd and hypertension associated with excess of deoxycorticosterone. Rectal pd rises in response to the mineralocorticoid-like agent carbenoxolone.

Adult

Occupational lead exposure and renin release.

Hypertension may result from chronic lead exposure. Lead poisoning arising from "moonshine whiskey" drinking has been associated with a rise in plasma renin activity. In the present study, plasma renin concentration following intravenous administration of frusemide was measured in eleven subjects with moderate or severe lead poisoning of industrial origin. The results were compared with those obtained for seven normal, control subjects. There was no significant difference in response obtained in the two groups. Industrial lead poisoning does not appear to affect renin release. The combined insult of lead and alcohol may explain the findings in the previous study.

Adolescent