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H Rüddel

Publications and source records attributed to H Rüddel.

70 records · Page 4Linked to original sources
PubMed1983

Traffic noise and hypertension: an epidemiological study on the role of subjective reactions.

Traffic noise is discussed as a possible risk factor for hypertension. However, no data are available concerning the moderating effect of the subjective reactions and the noise attitudes. In the present epidemiological study the relationship between these subjective factors and blood pressure was investigated separately for the inhabitants of two residential areas. One area had high traffic volumes, resulting in a high sound level (Leq greater than 73 db (A), noisy area); the other was socially comparable but with an essentially low sound level (Leq less than 51 db (A), control area). The relationship between the subjective reactions and blood pressure was checked by analyzing the incidence of treatment for hypertension (n = 919) and by analyzing the change of casual blood pressure after living 2.25 years in the respective residential area in a subgroup of those who had been normotensive (n = 36). The results obtained by either of these approaches indicate that the subjective factors do not modify the risk of hypertension in noisy areas, whereas they seem to be relevant for medium size stimuli. It is concluded that one can physiologically cope with low stimuli, but this is impossible for extreme stimuli. The results suggest also that the subjective reaction to extreme stimuli is strongly biased by attitudes which cannot be related to blood pressure. The family history of hypertension was found to be independent of the subjective reactions to noise.

Adaptation, Physiological↗
PubMed1983

[The effect of beta receptor blockers and diuretics on blood pressure reactivity].

Previous studies showed the importance of the response of blood pressure to emotional stress in essential hypertension. However, it is unclear to what extent the response of blood pressure to emotional stress is influenced by antihypertensive treatment, and especially by beta-blockers. In the present study the influence of antihypertensive treatment with either beta-blockers (beta) or diuretics (D) was compared in two series of experiments on male hypertensives, carried out after 2 weeks (beta, n = 11; D, n = 11) and 1 year of treatment (beta, n = 11; D, n = 9). One of the two drugs was randomly allocated to each patient. In the first series of experiments an ergometric exercise test was also performed (workload depending on age and body surface area, 60-100 W). The two medications caused a similar decrease in basal blood pressure. The response of blood pressure to emotional stress was also the same in both groups, and equal to that in untreated hypertensives. However, the reaction of systolic blood pressure to dynamic exercise was lower in the patients treated with beta-blockers (30.2 +/- 9.5 mm Hg) than in those treated with diuretics (42.9 +/- 12.1 mm Hg; p = 0.013). The effect of antihypertensive treatment on the reactivity of blood pressure therefore cannot comprehensively be tested by means of a single stress test. In terms of controlling the response of blood pressure to stress, beta-blockers are not generally more effective than diuretics, but only in certain situations.

Adult↗
PubMed1982

Effects of beta-blockers on type-A coronary-prone behaviour.

The influence of coronary-prone behaviour on coronary heart disease is well established, but the link between behavioural and pathophysiological processes is still unknown. A beta-adrenergic hyper-reactivity of type-A subjects is assumed. In this investigation the influence of beta-blockers on the type-A behavior pattern was tested in an inter-individual comparison. Sixteen male hypertensive subjects (stage I or II) were divided at random into two therapeutic groups (beta-blockers vs diuretics). Each patient was given a type-A interview before therapy and at a minimum of 4 weeks after the onset of therapy. Subjects in both groups were similar in age and before therapy they had similar blood pressure at rest as well as similar cardiovascular reactivity and type-A behaviour pattern. After therapy, subjects in the group treated with beta-blockers exhibited less type-A behaviour than those in the group treated with diuretics. The possible influence of the attenuation of the type-A behaviour on the risk of coronary heart disease should be investigated in a prospective study.

Amiloride↗
PubMed1982

Coronary prone behavior and cardiovascular reactions during the German version of the type A interview and during a quiz.

Type A behavior (TABP) was assessed in 212 German policemen using the structured interview (Si), whereby 10% were classified as A1 (= extreme type A), 48% as A2 (= moderate), 13% as X (= indefinite), and 29% as B (= non type A) by two independent raters. Moreover, traditional risk factors were assessed: serum cholesterol (CHOL) including high density (HDL) and low density cholesterols (LDL), cigarette smoking habits; at rest, during the Si and during a quiz systolic (SBP), and diastolic blood pressure (DBP), as well as heart rate (HR) were measured, and pressure-rate-index (PRi) was calculated. As in this group of policemen TABP and many of the investigated parameters were dependent on age, in a preliminary data analysis 18 type A1 subjects (group A) were compared to 18 age matched type B or X subjects (group B). Between group A and B no differences were found in CHOL as well as HDL and LDL, cigarette smoking, SBP, DBP, HR, and PRi at rest. During the Si group A exhibited a higher rise in SBP, HR, and PRi as well as higher maximal reactions in SBP and PRi. No differences were found during the quiz. This investigation gives some further evidence that the TABP has to be regarded as an independent risk factor; moreover, in specific situations like the Si it is associated with higher cardiovascular reactions independent of language and culture. This cardiovascular hyperreactivity might be regarded as one of the mediators between TABP and CHD.

Adult↗
PubMed1982

Cardiovascular reactivity during mental stress testing, the type A interview, and exercise testing in healthy male subjects.

We compared the blood pressure (BP) of 61 healthy male Ss during mental arithmetic plus noise, physical exercise testing and the Type A interview. A consistent association between personality characteristics and cardiovascular reactivity was not found. There was a consistent correlation between systolic BP reactivity during mental arithmetic and the Type A interview. Mental arithmetic and exercise testing correlated significantly for middle aged men. No correlation of BP was found between the Type A interview and exercise testing.

Adult↗
PubMed1981

[Traffic noise and hypertension risk. Hypothalamus theory of essential hypertension. Second communication (author's transl)].

In connection with the Bonn Study on Traffic Noise, 56 males with healthy cardiovascular systems were selected at random from two areas with different traffic noise conditions. The blood pressure was measured under the influence of a 5 minute standardized stressor and a 30 minute exposure to traffic noise. The 17 subjects with hereditary tendency to hypertension reacted significantly under the influence of both stressors with more marked rises in systolic and diastolic blood pressures than the 35 subjects who denied a hereditary tendency. On the other hand, the different residential areas did not affect the blood pressures obtained experimentally. The results support the hypothalamus theory of essential hypertension through the decisive etiological factors. At the same time they form the basis of a working hypothesis for a prospective study. According to this it is expected that males with a hereditary tendency to hypertension who have been exposed to traffic noise for several years will be more likely to develop hypertension.

Adult↗
PubMed1981

Relationship between blood pressure reactions on an ergometric and an emotional stress test.

The relationship between blood pressure reactions on an ergometric and an emotional stress test was studied in a population of 62 normotensive subjects. Significant correlations for systolic (r = 0.34, p = 0.004) and diastolic ( r = 0.03, p = 0.01) blood pressure were found. It is concluded that 1) there is a individual-specific blood pressure reactivity, 2) Hypertension is closely related to the individual-specific systolic blood pressure reactivity for it is known that hypertensives exhibit stronger systolic blood pressure reactions on both stressors.

Adult↗
PubMed1980

[On the reaction of finger pulse amplitude to noise (author's transl)].

1. Forty-three (30 male and 13 female) subjects were exposed to traffic noise of ca. 72dB. Their reactions concerning blood pressure, pulse pressure, finger pulse amplitude and radialis pulse amplitude, heart rate, breathing rate, and integrated EMG were analyzed. 2. Each of the circulatory parameters exhibited significant reactions in either direction in more than 40% of the subjects. The vasoconstrictive reaction in finger pulse amplitude was most outstanding. Moreover, pulse pressure, radioalis pulse amplitude and, heart rate also tended to decrease whereas diastolic blood pressure tended to increase. Breathing rate and EMG remained mainly unchanged. 3. Owing to the different direction of reactions the mean values of a sample can yield possible misleading information. Furthermore, it is suggested that the reaction of finger pulse amplitude should be related to the standard deviation of the prestimulus resting period instead of to the mean value of this period. 4. Male subjects react with a stronger decrease of heart rate than female subjects. Male subjects with higher diastolic casual blood pressure and heart rate values exhibit stronger decreases in finger pulse amplitude and heart rate. Older male subjects tend to react with an increase of heart rate. 5. Within the male subjects, the reaction of finger pulse amplitude correlated positively with the reactions of pulse pressure and heart rate, but not with the reaction of radialis pulse amplitude. The attempt to distinguish between vasoactive and pressure-dependent components in finger pulse amplitude means of radialis pulse amplitude failed, which is probably a consequence of artifacts in radialis pulse amplitude.

Adult↗
PubMedDate not supplied

[What are the physical complaints without pathological clinical signs in patients with diabetes mellitus?].

UNLABELLED: In previous research it was found that patients with diabetes mellitus suffer from multiple physical symptoms even early in their disease course. Such complaints may relate to blood glucose levels or can be understood as a sign of distress in respect to the diagnosis of a chronic disease. PURPOSE: This study was performed to evaluate in a cross-sectional analysis all the symptoms that patients may complain of and to relate these symptoms to a possible dysfunction of the autonomic nervous system. METHOD: We assessed the complaints of 66 patients with diabetes mellitus and compared these variables with those of patients with psychological disturbances (n = 794) or somatic disease (n = 162). The symptoms were recorded by means of several questionnaires such as the "Giessener Beschwerdebogen" (GBB), "the Freiburger Persönlichkeitsinventar" (FPI), the German version of the State Trait Anxiety Inventory (STAI) and the German version of the State Trait Anger Expression Inventory (STAXI). The autonomic nervous system was assessed using resting and mental stress conditions in a subset of patients with diabetes mellitus (n = 29) and psychological disturbances (n = 44). RESULTS: Patients suffering from diabetes mellitus and psychological disturbances showed a tendency to higher scores in GBB, STAI and STAXI. As far as psychological disturbances are concerned, the complaints experienced by patients with diabetes mellitus were found to be similar to those with somatic diseases. Both groups, however, rate clearly below those with psychological disturbances. The results of autonomic testing showed a significant disturbance in patients with diabetes mellitus with reduced sensitivity of the baroreceptor indicating autonomic neuropathy. CONCLUSION: Some of the physical complaints of patients with diabetes mellitus can be understood in connection with autonomic dysfunction. Moreover, an explicitly psychological view of these complaints may not be correct.

Adult↗
PubMedDate not supplied

[Rehabilitation outcomes of a psychosomatic clinic integrating fully inpatient and partial hospitalization rehabilitation approaches: a comparison].

As publications from the domain of psychosomatic rehabilitation pertaining to the conceptual approaches and effects of partial-hospitalization rehabilitation have so far relied on very small case numbers, the effectiveness of partial-hospitalization rehabilitation was analysed in 318 patients in comparison to a large sample of rehabilitants who had participated in fully inpatient rehabilitation. No relevant differences were found among the groups studied in sociodemographic respects or range of diagnoses. The same was true concerning the level of complaints present at the onset of rehabilitation. Good rehabilitation outcomes were achieved in both groups, however, the effect sizes found for changes in depressiveness and indulgence to complaining ("Klagsamkeit") (GSI from the SCL-90) were lower in the partial-hospitalization group than in the patients in fully inpatient rehabilitation. Also, the relatively high share of partial-hospitalization patients discharged unable to return to work might be clinically significant. While our findings confirm the good results reported from other disciplines, they nevertheless are a reminder of the need for very careful selection of patients for partial-hospitalization rehabilitation, in order not to withhold "better" rehabilitation than could be provided on a partial-hospitalization basis from patients with special sociomedical problems. The best rehabilitation outcomes seem to be achieved by those patients who, towards the end of fully inpatient rehabilitation, were granted transition to the partial-hospitalization programme.

Adult↗
PubMedDate not supplied

Discontinuation of antihypertensive therapy: prevalence of relapses and predictors of successful withdrawal in a hypertensive community.

Antihypertensive therapy has been thought to be a life-long treatment. Nevertheless, antihypertensive medication may be discontinued in a substantial proportion of hypertensive patients at least for some time. The current study focused on predictors for the development of elevated blood pressure levels after discontinuation of antihypertensive drug therapy. In an open, prospective study, 88 white male patients with newly discovered essential hypertension (age 42 +/- 7 years) were tested at baseline. Blood pressure was measured in various situations (at work, at rest, before and during treatment, and at follow-up), and the hemodynamic profile at rest and cardiovascular response patterns during stress tests were evaluated. Left ventricular mass and other cardiovascular risk factors were also carefully determined. After 6 months of strict blood pressure control (< 140/90 mm Hg), they were treated by their primary care physician (mean duration of antihypertensive therapy 1.3 +/- 1.7 years). After 6 years, 37 patients were still on antihypertensive therapy, but 19 of the 37 had blood pressure values > or = 160/95 mm Hg. In 51 patients, therapy was discontinued: 29 were hypertensive, 15 were borderline hypertensive and 7 were normotensive. Relapse of hypertensive blood pressure in these 51 patients off therapy was predicted by resting blood pressure values before therapy (138 +/- 11/91 +/- 5 vs. 131 +/- 11/85 +/- 7 mm Hg, p < 0.05/0.01), cardiac output at rest (7.5 +/- 1.9 vs. 6.2 +/- 2.1 l/min, p < 0.05), total peripheral resistance (20 +/- 9 vs. 14 +/- 4 U, p < 0.05), increased heart rate during ergometry (50 +/- 8 vs. 44 +/- 6 b.p.m., p < 0.05) and left ventricular mass determined by echocardiography (212 +/- 60 vs. 189 +/- 44 g, p < 0.01). There was no difference in age, blood pressure levels before and during treatment, the number of consultations with the primary care physician or cardiovascular risk factor profiles. In conclusion, intermittent rather than life-long antihypertensive treatment may be possible in hypertensive patients with low resting blood pressure, high cardiac output, low total peripheral resistance and low left ventricular mass.

Adult↗
PubMedDate not supplied

[1-Year follow-up of inpatient treatment in a psychosomatic rehabilitation clinic with either a psychoanalytic or behavior therapy oriented treatment].

In a naturalistic setting, we studied the long-term effects of an inpatient treatment program at a psychosomatic rehabilitation clinic, where patients were assigned to a department with either a psychoanalytic or behavior therapeutic orientated treatment after one week of comprehensive diagnosis. The study is based on a self-developed questionnaire which gathers retrospective information in a broad spectrum of problem areas at the point of admittance and release (t0 and t1) as well as current assessments one year following treatment (t2). Additionally, a symptom checklist (Giessener Beschwerdebogen) and a questionnaire assessing depression (Allgemeine Depressionsskala) were prospectively employed at t0 and t2. We asked a consecutive sample of 376 patients to participate, of which 56% answered at t2. Despite limitations of the internal and external validity of the study, we were able to show that substantial improvements are maintained following treatment for both therapies at one-year follow-up, whereas only small difference are found between the outcomes of the two different schools implemented in the clinic.

Adult↗