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Biomedical subjects

E Paran

Publications and source records attributed to E Paran.

At least 37 records · Page 2Linked to original sources
PubMed1991

Effect of isradipine on factors affecting blood viscosity.

The objective of the study was to investigate the effect of isradipine on red blood cell filtrability in 20 men with mild-to-moderate hypertension. In this prospective, double-blind study, parallel groups of hypertensive male patients were randomized to receive either isradipine (n = 11) or placebo (n = 9). An additional group of nine normotensive age-matched volunteers served as controls. Tests were performed before and after patients were treated with either isradipine or placebo. The hypertensive patients differed from the normotensive controls in having a higher level of fibrinogen (P less than .04), a higher hematocrit (P less than .001), a higher filtration rate (P less than .05; impaired red blood cell deformability), and a higher mean corpuscular volume (MCV; P less than .005). Treatment with isradipine lowered blood pressure and improved red blood cell filterability (P less than .05) compared with placebo.

Adult↗
PubMed1991

Higher Na(+)-H+ exchange rate and more alkaline intracellular pH set-point in essential hypertension: effects of protein kinase modulation in platelets.

Na(+)-H+ exchange is known to be elevated in essential hypertension. To examine the mechanism of this elevation, we studied a group of 19 male hypertensive patients (mean age 46 years; systolic/diastolic blood pressure 144/99 mmHg), without medication for at least 2 weeks, and a control group of 19 male normotensives (mean age 49 years; systolic/diastolic blood pressure 118/77 mmHg). Na(+)-H+ exchange and intracellular pH set-point, at which the exchange is approximately nil, were studied spectroflurometrically in blood platelets loaded with 2',7'-bis carboxyethyl-5,6-carboxyfluorescein in an isotonic medium containing 60 mmol/l sodium propionate, pH 7.35. The exchange rate (delta pH per 9 s at intracellular pH 7.0) of hypertensives (0.050 +/- 0.005) is significantly greater (P less than 0.001) than the rate of normotensives (0.027 +/- 0.003), but both groups attain similar high (approximately 0.074) rates when phosphorylation is stimulated by 0.5 mumol/l phorbol 12-myristate 13-acetate (PMA) and similar low rates (approximately 0.01) when inhibited by 0.5 mumol/l staurosporine. Furthermore, although hypertensive set-point is significantly (P less than 0.01) more alkaline (7.33 +/- 0.01) than that of the normotensives (7.27 +/- 0.02), both groups attain a similar set-point in the presence of PMA or staurosporine (approximately 7.62 and approximately 7.08, respectively). It is concluded that more extensive phosphorylation of the exchanger, known to be regulated by phosphorylation, is the reason for the modified properties of Na(+)-H+ exchange in essential hypertension, rather than larger numbers of the exchanger per cell.

Alkaloids↗
PubMed1991

Antihypertensive duration of action of cilazapril in patients with mild to moderate essential hypertension.

The efficacy of cilazapril monotherapy was evaluated in 2 multicentre double-blind dose-response trials. After 4 weeks of a single-blind placebo run-in period, patients with uncomplicated mild to moderate essential hypertension and a sitting diastolic blood pressure of 100 to 115 mm Hg, 24 hours after the last placebo dose (trough), were randomised to take either placebo or cilazapril 2.5 mg or 5 mg for 4 weeks (study 1, 86 patients) or 8 weeks (study 2, 78 patients). Sitting diastolic blood pressure was checked every 2 weeks at trough in both studies and at peak in study 2. The reductions in sitting diastolic blood pressure from baseline at trough, and the difference from placebo, were clinically and statistically significant for both cilazapril groups in the 2 studies. The reduction in blood pressure in both active treatment groups was similar, but the response rate with cilazapril 5 mg was greater than that with 2.5 mg. More than 50% of the peak effect was still present at trough for both cilazapril groups. It is concluded that both dosages of cilazapril are effective and reduce blood pressure compared with placebo over a 24-hour period.

Adult↗
PubMed1990

Increasing public awareness of the risk of cardiovascular disease using 'health activists' in a community health project in Israel: a feasibility study.

An innovative approach to health education in the field of cardiovascular risk factor control was implemented in an urban community in southern Israel. The objective of the project was to determine the efficiency of utilising lay health activists (HAs) to convey the health message to the community. After undergoing a selection process, 22 HAs completed the course of instruction which included: 24 hours of lectures on health topics given by medical experts; 25 hours of training in communication skills, group supervision and assistance in coping with problems encountered during their field work in the community. In the execution of their field work, the HAs paid home visits to members of the community in order that a) two questionnaires could be completed: one dealing with attitude to and knowledge of CVD risk factors and the other, with health habits; b) according to the outcome of the interview, advice concerning desirable changes in life-style could be offered, and c) a follow-up visit could be made in order to reinforce the health message and to evaluate any changes in knowledge, attitudes and behaviour. During the 18 weeks of the project, 612 homes were visited by the HAs. Evaluation of the project is based on an assessment of the changes in knowledge, attitudes and behaviour of the HAs themselves. Results of this study suggest that improving the efficiency of health promotion by utilising the services of lay health activists is a viable proposition. Finally, the applicability of the programme is discussed.

Cardiovascular Diseases↗
PubMed1988

Hypertension Control Program of the Negev: evaluation after two years of intervention.

In 1981 a nationwide effort to control high blood pressure was implemented. One of the first programs was the "Hypertension Control Program of the Negev." The program's major objective was to introduce early detection and improve diagnostic, treatment, and follow-up procedures to 27 primary-care clinics of the area. The evaluation was based on the program's three levels of intervention: (a) basic training program and written protocol, containing guidelines for diagnosis, treatment, and follow-up; (b) additional consultation in the primary-care clinics by internal medicine specialists from the regional medical center, and (c) additional consultation in the primary-care clinics by the hypertension unit's medical team. In 1981 (prior to any intervention) a random sample of 5,717 medical records of the target population (30 years or older) was reviewed. High blood pressure was found in 1,032 patients (18%); however, a written diagnosis of hypertension was recorded in only 57% of these cases, and of these only 37% were being regularly treated for high blood pressure. In 1983, a second, independent random sample of 7,791 records was reviewed. High blood pressure was again found in 18% (1,428) of the cases, but 69% of these had a recorded high blood pressure diagnosis (a relative increase of 21% from 1981), and 85% of these were treated for high blood pressure (a relative increase of 130%). Improved performance in the steps of care provided for high blood pressure was observed in all the clinics. Surprisingly, the percentage of well-controlled patients increased only in those clinics where the staff gave consultation services.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Efficacy of clonidine as transdermal therapeutic system: the international clinical trial experience.

Worldwide clinical trial data concerning the pharmacokinetic and pharmacodynamic characteristics of the clonidine transdermal therapeutic system (TTS) are reviewed with reference to its antihypertensive efficacy. The amount of clonidine delivered to the systemic circulation is a direct function of TTS size. After initial patch application, there is a delay of 2 to 3 days before the onset of action, but after removal of the patch, plasma clonidine levels decline slowly, at an elimination half-life of about 20 hours. Evaluation in approximately 2000 patients with mild to moderate hypertension has shown that the bioavailability of transdermal clonidine is comparable to that of oral clonidine and that equivalent blood pressure reductions are achieved. The rate at which dose increases were found necessary to maintain adequate blood pressure control over extended periods reflects a low incidence of tolerance to this new once-a-week dosage form of clonidine, and there has been little evidence of rebound hypertension after discontinuation of TTS treatment.

Administration, Cutaneous↗
PubMed1986

Treatment of hypertension during pregnancy with hydralazine monotherapy or with combined therapy with hydralazine and pindolol.

Forty-four consecutive patients referred for treatment because of hypertension (greater than 150/90 mmHg) occurring during pregnancy were randomly allocated to one of two treatment groups, hydralazine alone (n = 21) or hydralazine combined with pindolol (n = 23). Satisfactory blood pressure control (diastolic pressure less than 90 mmHg) was achieved in 86% of patients receiving hydralazine alone and 91% of those on combined therapy. Although the treatment did not lower the overall incidence of hypertensive complications it appeared to delay the onset of such complications until successful surgical intervention was possible. Fetal outcome was similar in both groups and there was no perinatal mortality in this high-risk population. Although blood pressure control was similar in both groups of patients, combined therapy with hydralazine and pindolol can be considered to be superior to hydralazine monotherapy, since in patients treated with the combination the incidence and intensity of troublesome side-effects was markedly lower.

Adult↗
PubMed1986

Infectious complications of acute myocardial infarction.

Four cases of purulent complications in the heart following acute myocardial infarction are described. Fever occurred during the first week after coronary occlusion. In one case thrombophlebitis at an infusion site was followed by purulent pericarditis. One patient had an infected mural thrombus with peripheral septic embolic, and two suffered from streptococcal endocarditis. The association between these infections and recent acute myocardial infarction could be related to tissue necrosis and local thrombosis, but the increasing risk of bacteremia following invasive monitoring procedures in these patients is a risk factor that should not be ignored.

Aged↗
PubMed1986

Thermodynamic properties of erythrocyte Li efflux may facilitate detection of essential hypertension in pregnant women.

Thermodynamic properties of red cell lithium efflux were examined in pregnant women in relation to hypertension. Twenty-two normotensive women, 15 women with essential hypertension, and 27 with pregnancy-induced hypertension were studied. The rates of Li efflux at 37 degrees C in the three groups of pregnant women were similar and nondiscriminatory. The temperature dependence of the Li efflux, known to be uniquely modified in essential hypertension, allowed the differentiation of most (73%) of the pregnant women with essential hypertension as well. Among the women with pregnancy-induced hypertension, 63% showed a temperature-dependence pattern typical for normotensives, and they may be classified as patients with toxemia of pregnancy. The others (37%) showed a thermodynamic pattern of essential hypertension, but a follow-up study is required to ascertain whether they will indeed develop essential hypertension in the future.

Adult↗
PubMed1986

Captopril as a replacement therapy in hypertension improving quality of life--a multicentre study.

A multicentre study was undertaken to determine whether side effects induced by hypotensive drugs could be reduced by replacement with low dose captopril. There were 100 patients on combinations of drugs, including diuretics, beta-blocking agents, methyldopa, clonidine and vasodilators. A questionnarie to obtain information on quality of life was completed by the patients. Each patient had major drugs, possibly responsible for side effects, withdrawn. Captopril was added at an initial dose of 12.5 up to 25 mg b.i.d. and titrated to a maximum of 50 mg t.i.d., until the blood pressure was equal to or lower than the level on entry into the study. Blood pressure was measured every two weeks and questionnaries were completed a number of times during the treatment period and scored at random, not in chronological order. A marked drop in blood pressure was obtained: mean systolic blood pressure went down from 173.4 +/- 2 to 154.5 +/- 2 mm Hg and diastolic blood pressure dropped from 104.5 +/- 11 to 9l.5 +/- 12 mm Hg. Neither tachycardia nor orthostasis was observed. Side effects, including inability to concentrate, nightmares, dizziness and sexual dysfunction, were reduced in 36% of the patients. Captopril itself produced no significant additional adverse reactions. It is concluded that captopril is a safe and effective drug, which can replace antihypertensive drugs that have deleterious side effects.

Adult↗