PubMed HealthSearch

Biomedical subjects

H Dunér

Publications and source records attributed to H Dunér.

17 recordsLinked to original sources

Beta-blocking effect and pharmacokinetics of pindolol in young and elderly hypertensive patients.

The pharmacokinetics and beta-blocking effect of pindolol has been compared in 20 patients with essential hypertension (WHO Stage I), 10 below 25 years of age and 10 older than 60 years. Each patient received pindolol 10 mg p.o. once a day for 5 days. The area under the curve (AUC) of pindolol was larger in the old than in the young patients both on the first (p less than 0.05) and the fifth (p less than 0.01) days. The AUC of pindolol was 14% higher on the fifth day compared to the first day in the elderly group, indicating minor accumulation at steady-state. There was no change in AUC in the young patients. Endogenous creatinine clearance was lower in the old (80 +/- 9 ml/min) than in the young patients (150 +/- 45 ml/min). The beta-blocking effect did not differ between the groups at 2 h after administration of pindolol on Days 1 or 5. However, 24 h after the first and fifth doses approximately 60% of the beta-blockade persisted in the old group whereas 17 and 19% of the beta-blockade, respectively, persisted in the young group; the difference between the groups was statistically significant (p less than 0.01). The most probable explanation for the more sustained beta-blocking effect in the elderly is the physiologically decrease in renal function, which results in a more sustained plasma level of pindolol in those patients.

Adrenergic beta-Antagonists

Haemodynamic effects of pindolol in essential hypertension with special reference to resistance vessels in the forearm during maximal vasodilatation.

Eleven patients, mean age 45 years, with previously untreated hypertension (WHO stage I) were treated over 16 months with pindolol in dosages of 5-30 mg/day. The effects on blood pressure and peripheral vascular resistance (PR) were studied before and after 2 and 16 months of treatment. Recordings were performed at rest, and after maximal vasodilatation obtained by ischaemic work to exhaustion with a hand-ergometer. Blood pressure was significantly reduced after both 2 and 16 months of treatment (P < 0.001). During treatment small reductions in heart rate were seen at rest but not after maximal vasodilatation (P < 0.02 and NS, respectively). At rest there was a great variability and no significant changes in PR. Peripheral vascular resistance after maximal vasodilatation was significantly reduced after both 2 and 16 months of treatment (P < 0.005 and P < 0.01, respectively). We conclude that long-term treatment with pindolol may give a regression of structural vascular changes.

Adult

Hemodynamic effect of long--term treatment with pindolol in essential hypertension with special reference to the resistance and capacitance vessels of the forearm.

Ten patients with essential hypertension have been studied at rest, during and after exercise following oral treatment for on an average 16 months with a beta-adrenoreceptor blocking agent, pindolol. The study was a direct continuation of an earlier, performed after 2 months' treatment. The hypotensive effect of pindolol was highly significant after 2 as well as 16 months of treatment. Heart rate was similarly lowered at 2 and 16 months, while carciac output, which was significantly lower during exercise after 2 months, had increased to the pretreatment level after 16 months. Peripheral vascular resistance, which was not affected after 2 months, had decreased significantly during and after exercise in the long-term study. A comparison between the hemodynamic situations after 2 and 16 months thus suggests that while a decrease in cardiac output is an early mechanism in the lowering of BP, changes in systemic vascular resistance seem to be more important after long-term treatment with pindolol.

Administration, Oral

Haemodynamic effects of pindolol in hypertensive patients.

Five men and five women, mean age 48 years, with hypertension in stages I or II of the WHO classification, were given preoral treatment with pindolol. The pindolol treatment lead a significant decrease in the systolic and diastolic blood pressure, at rest and during work both after 2 months and after 16 months treatment. Three mechanisms seem to be involved in the antihypertensive effect of pindolol: 1) a negative chronotropic effect on the heart, 2) a decrease in peripheral vascular resistance and 3) an increase in venous capacitance affecting the venous return. Comparison of the results after 2 and after 16 months of treatment suggests that a decrease in cardiac output is an early mechanism in the lowering of the blood pressure, while a decrease in vascular resistance seems to be more important after long-term treatment with pindolol.

Cardiac Output

Experience with pindolol, a betareceptor blocker, in the treatment of hypertension.

Ten patients, mean age 48 years, with essential hypertension of stage I and II according to the WHO classification, were studied at rest and during work before and after an average of two and 16 months of oral treatment with the beta-adrenergic blocking agent, pindolol. The pindolol treatment caused a significant decrease in the systemic systolic and diastolic blood pressure, both at rest and during work. Three mechanisms seem to be involved in the antihypertensive effect of pindolol: (1) a negative chronotropic effect on the heart, (2) a decrease in peripheral vascular resistance, and (3) an increase in venous capacitance affecting the venous return. However, the significance of these mechanisms seems to differ when the situations after two months of treatment are compared with those after 16 months of treatment. In the beginning, a decrease in cardiac output seems to be the main cause of the lowering of the blood pressure; later, a decrease in systemic vascular resistance might be of greater importance.

Adrenergic beta-Antagonists

Hemodynamic effect of pindolol in essential hypertension with special reference to the resistance and capacitance vessels of the forearm.

Ten patients, mean age 48 years, with essential hypertension of stage I and II according to the WHO classification, have been studied at rest and during work before and after on average 8 weeks oral treatment with a beta-adrenergic blocking agent, pindolol. The pindolol treatment caused a significant decrease in the systemic systolic and diastolic blood pressure, heart rate and cardiac output both at rest and during work. The systemic vascular resistance and the forearm vascular resistance decreased significantly after and during work, respectively. Forearm venous tone was significantly decreased at rest, during and after work. The plasma renin activity decreased. Three mechanisms seem to be involved in the antihypertensive effect of pindolol: 1) a negative chronotropic effect on the heart, 2) a decrease in peripheral vascular resistance, and 3) an increase in vascular capacitance affecting the venous return.

Adult

[Medical insurance estimation of risks].

The purpose of insurance medicine is to make a prognostic estimate of medical risk-factors in persons who apply for life, health, or accident insurance. Established risk-groups with a calculated average mortality and morbidity form the basis for premium rates and insurance terms. In most cases the applicant is accepted for insurance after a self-assessment of his health. Only around one per cent of the applications are refused, but there are cases in which the premium is raised, temporarily or permanently. It is often a matter of rough estimate, since the knowlege of the long-term prognosis for many diseases is incomplete. The insurance companies' rules for estimate of risk are revised at intervals of three or four years. The estimate of risk as regards life insurance has been gradually liberalised, while the medical conditions for health insurance have become stricter owing to an increase in the claims rate.

Coronary Disease