[Antihypertensive efficacy of aerobic physical conditioning. A critical analysis of experimental findings].
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Biomedical subjects
Publications and source records attributed to F D Fuchs.
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The relationship between corneal arcus (arcus senilis) and mortality from coronary heart disease (CHD) and cardiovascular disease (CVD) is examined in a prospective study of White men (n = 3,930) and women non-hormone users (n = 2,139), ages 30-69, followed for an average of 8.4 years as part of the Lipid Research Clinics Mortality Follow-up Study. After excluding those with clinically manifest CHD at baseline, corneal arcus was strongly associated with CHD and CVD mortality only in hyperlipidemic men ages 30-49 years, for whom the relative risk for CHD and CVD death was 3.7 and 4.0, respectively, after adjusting for age, total cholesterol, HDL cholesterol, and smoking status using a Cox proportional hazards model. Among 30-49 year old males, corneal arcus appears to be a prognostic factor for CHD, independent of its association with hyperlipidemia in this age-group, of about the same magnitude as other common risk factors, underscoring the usefulness of corneal arcus as a prognostic factor to the practicing clinician.
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1. Seventeen normal volunteers aged 19 to 22 were randomly subjected, in a trial of crossover design, to three distinct regimens of sodium chloride intake: high (16 to 20 g), normal (8 to 12 g) and low (0.5 to 1 g). Each regimen lasted nine days, with determination of blood pressure and heart rate (in the supine position and after sudden rising), body weight, and urinary output of creatinine, sodium and potassium on the third, sixth and ninth days. In addition, plasma levels of creatinine, sodium and potassium were determined on the ninth day so that sodium and potassium clearance and fractional excretion could be calculated. 2. Eleven of the volunteers had a family history of hypertension. Compared to the six without such a history, these subjects showed: 1) higher supine systolic blood pressure on the third day of sodium overload (124.7 +/- 3.0 vs 112.3 +/- 2.9 mmHg, P less than 0.02); 2) higher supine diastolic blood pressure on the third day of sodium overload (76.5 +/- 2.8 vs 64.5 +/- 4.3 mmHg; P less than 0.05); 3) higher supine diastolic blood pressure on the sixth day of sodium overload (73.7 +/- 2.3 vs 63.8 +/- 3.2 mmHg, P less than 0.05); 4) lower supine heart rate on the ninth day of sodium overload (61.0 +/- 3.1 vs 72.7 +/- 4.6, P less than 0.05), and 5) lower plasma potassium on the ninth day of sodium overload (4.10 +/- 0.05 vs 4.28 +/- 0.06 mEq/l, P less than 0.05). 3. These results suggest that normal individuals whose familial history places them at risk for the development of hypertension differ from those not at risk during their adaptation to sodium load by suffering a transient elevation of blood pressure within a few days of the increase in load. The low levels of plasma potassium observed in these volunteers after a period of sodium load may be due to the operation of different renal mechanisms of sodium excretion in this group, leading to increased kaliuresis, and may explain the high vascular reactivity of such individuals.
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UNLABELLED: It has been recommended to take the average of several blood pressure (BP) determinations with a sphygmomanometer to diagnose hypertension, but there is no agreement on the reading numbers. PURPOSE: Describing the behavior of BP readings taken in three different days to establish the classificatory BP in an outpatient hypertension clinic. METHOD: In the outpatient hypertension clinic of the Clinical Pharmacology Division of the Hospital de Clínicas de Porto Alegre, we use the mean of six readings taken in three different days to establish the classificatory blood pressure, except for those with very high or low values in the first day. In this report we describe the behavior of BP in 58 patients submitted to this routine. RESULTS: The mean of systolic (SBP) and diastolic (DBP) blood pressures decreased from the first to the 6th reading (ANOVA for repeated measurements: F = 4.45, P = 0.001 for SBP and F = 5.54, P < 0.001 for DBP). Afterward, the patients were classified into two groups according their first SBP and DBP reading. The decreasing in both SBP and DBP was confined to those with the first measurement in the upper half of the entire group (ANOVA: F = 8.03; P < 0.0001 for SBP and F = 6.33, P < 0.0001 for DBP). Regression to the mean and some reactiveness in the first day are possible explanations for this. CONCLUSION: These data corroborate that the hypertension diagnosis should not be based in an single blood pressure determination and suggest that the recommendation to diagnose severe hypertension based on high values in the first two readings could misclassify some patients.
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Hypertension (HTN) has frequently been cited as a general risk factor for epistaxis. However, studies dealing with this association have yielded equivocal results. In this study, a sample of 121 hypertensives (blood pressure > or = 140/90 mmHg) was selected to evaluate the association between the severity of HTN and a previous history of epistaxis. Patients with an average blood pressure > or = 160/100 mmHg were classified as suffering from a more severe form of HTN and were compared with those with a less severe form of the disease (160/100 mm Hg < or = blood pressure > or = 140/90 mm Hg). The frequency of epistaxis did not differ among patients categorized by the severity of HTN. Users of aspirin were found to be twice as likely to have a history of epistaxis. In addition, there was a statistical tendency for an association between a history of epistaxis and the duration of hypertension. We conclude that the severity of HTN and a history of epistaxis were not associated in a cohort of hypertensive patients. The identification of other risk factors for epistaxis, including the duration of HTN, deserves further study.
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