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Biomedical subjects

I B Puddey

Publications and source records attributed to I B Puddey.

At least 91 records · Page 5Linked to original sources
PubMed1991

A controlled study of the effects of aerobic exercise on antihypertensive drug requirements of essential hypertensive patients in the general practice setting.

1. To investigate the effect of an exercise training programme on antihypertensive drug requirements, 19 sedentary subjects (14 men and five women) with mild essential hypertension (systolic blood pressure greater than 140 mmHg but less than 180 mmHg), aged 29-55 years, were randomly assigned to 16 weeks of moderate intensity exercise or light intensity exercise (control), and titrated on antihypertensive drug therapy (captopril and hydrochlorothiazide) until resting systolic blood pressure (sitting) of less than 140 mmHg was achieved. 2. The moderate exercise group (n = 11) followed a graded walk-jog programme to greater than 60% age-predicted maximum heart rate (HRmax), attending 45 min sessions, three times each week. The light exercise group (n = 8) followed a programme of flexibility (stretching exercises) and walking to less than 60% age-predicted HRmax, attending 45 min sessions, three times each week. 3. There was no difference between treatment groups for the level of reduction in both resting systolic and diastolic blood pressure over the 16 weeks (15.64 +/- 10.6/12.81 +/- 9.97 mmHg in the moderate intensity group and 15.31 +/- 10.9/7.7 +/- 7.1 mmHg in the light intensity group). The change in 24 h ambulatory blood pressure profile was also similar in both treatment groups. The final antihypertensive drug requirements to achieve these changes in blood pressure was not significantly different between the two treatment groups. This was despite a significant improvement in submaximal exercise performance in the moderate intensity exercise group (P less than 0.001). 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Urinary steroid profiles and alcohol-related blood pressure elevation.

1. From an earlier cross-sectional survey of 343 public servants, 15 pairs of non-smoking teetotallers and heavy drinkers (alcohol intake more than 350 mL/week) were matched for age and adiposity and utilized for a case-control study of the effects of alcohol on 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) activity and blood pressure. 2. Two successive 24 h urine collections were analysed by radio-immunoassay (RIA) for cortisol excretion, and for the cortisol and cortisone metabolites, tetrahydrocortisol (THC), allo-tetrahydrocortisol (allo-THC) and tetrahydrocortisone (THE), by capillary column gas chromatography. 3. Heavy drinkers had higher systolic and diastolic blood pressure (BP) than teetotallers (132.6 +/- 2.5 vs 123.2 +/- 1.3 and 78.7 +/- 1.6 vs 71.7 +/- 1.4, respectively; unpaired t-test, P less than 0.01). Twenty-four-hour urinary sodium and cortisol excretion were similar in the two groups. 4. The THC plus allo-THC:THE ratio was similar in drinkers and teetotallers (1.81 +/- 0.20 vs 2.03 +/- 0.20), consistent with no effect of alcohol on 11 beta-OHSD activity. The ratio of THC to allo-THC was increased in drinkers compared with teetotallers (1.49 +/- 0.18 vs 1.05 +/- 0.13; unpaired t-test, P less than 0.05), consistent with either a decrease in 5 alpha-reductase activity or an increase in 5 beta-reductase activity. 5. This study provides no evidence for alcohol-related inhibition of 11 beta-OHSD, despite substantially higher blood pressures in heavy drinkers compared to teetotallers. Such an effect is, therefore, unlikely to contribute significantly to the mechanism of alcohol-related hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effect of smoking cessation on serum apolipoprotein A-I and A-II concentrations.

This study investigated the effects of 6 weeks' smoking cessation on serum levels of total-cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C) and apolipoproteins A-I and A-II (apo A-I and apo A-II) in 64 subjects of both sexes. Smoking cessation was associated with an increase in levels of apo A-II. Concurrent changes in weight and alcohol consumption during attempted smoking cessation, together with change in thiocyanate level, were entered as predictor variables into a multiple regression analysis. The change in apo A-II was found to be best accounted for by change in plasma thiocyanate level, and, in women, change in HDL-C and apo A-I by change in weight. The changes induced by smoking cessation may be due, at least in part, to associated changes in alcohol consumption and/or dietary intake, but in the case of apo A-II there is evidence of a more direct effect.

Adult↗
PubMed1990

Controlled comparison of effects of exercise and alcohol on blood pressure and serum high density lipoprotein cholesterol in sedentary males.

1. Seventy-two sedentary male drinkers, aged 20-45 years, and with mean blood pressure (BP) at entry of 132 +/- 1.2/73 +/- 0.9 mmHg, completed a 4 week study during which they were assigned randomly to either drink a low alcohol beer (effectively reducing their weekly alcohol intake from 481 +/- 47 mL to 52 +/- 5 mL) or to continue their normal drinking habits. 2. Within these two groups subjects were further assigned to either a moderate exercise programme of three 30 min sessions per week of stationary cycling at 60-70% maximum workload or to a control light exercise programme where they pedalled against zero or minimal resistance. 3. Both alcohol restriction and moderate exercise were associated with mean falls in bodyweight of 0.5 kg. After adjustment for bodyweight a significant main effect of alcohol restriction on systolic BP (-4.1 +/- 1.7 mmHg, P less than 0.05) and diastolic BP (-1.6 +/- 0.8 mmHg, P = 0.05) was demonstrated. There was no significant main effect of moderate exercise on systolic or diastolic blood pressure despite a significant improvement in physical fitness (maximal oxygen uptake increasing from 33.2 +/- 0.8 mL/kg per min to 35.5 +/- 0.1 mL/kg per min). 4. Significant falls in high density lipoprotein cholesterol (HDLC) and triglyceride levels seen with alcohol restriction were unaffected by the increase in fitness, the magnitude of the fall being similar in both the moderate and light exercise groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Two-way factorial study of alcohol and salt restriction in treated hypertensive men.

The aim of this study was to determine whether moderate restriction of dietary salt intake leads to an additional fall in blood pressure in treated hypertensive men who are asked to simultaneously reduce their usual alcohol intake. Sixty-three subjects entered an initial 2-week familiarization period during which they continued their usual alcohol intake and commenced a "low sodium" diet (less than 60 mmol/day) supplemented with 100 mmol sodium chloride per day as enteric-coated tablets. Subjects were then randomly assigned to either drink a low alcohol beer alone for a 4-week period (reducing their self-reported alcohol consumption from 537 to 57 ml/week) or to continue their usual alcohol intake (543 versus 557 ml/week). Within the low and normal alcohol intake groups, subjects were assigned to either a low or normal sodium intake. The low sodium groups continued the sodium-restricted diet but were switched to placebo sodium chloride tablets for the 4 weeks. This resulted in a fall in the 24-hour urinary sodium excretion from 144 to 69 mmol/day. The normal sodium groups continued the low sodium diet but kept taking 100 mmol/day of the sodium chloride tablets, and their urinary sodium excretion remained unchanged (125 versus 142 mmol/day). Regular antihypertensive therapy was continued throughout. Fifty-nine subjects completed the trial. In those who reduced their alcohol intake there was a fall in both systolic blood pressure (-5.4 mm Hg supine, p less than 0.01) and diastolic blood pressure (-3.2 mm Hg supine, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Lifestyle- and occupation-related changes in blood pressure over a six-year period in a cohort of working men.

Determinants of change in blood pressure between two examinations separated by a 6-year period were investigated in 340 working men aged 20-45 at first examination and not on antihypertensive medication at either examination. A London School of Hygiene sphygmomanometer was used for all measurements of blood pressure. Relationships between change in blood pressure (residuals of follow-up blood pressure regressed on baseline blood pressure) and changes in weight, physical activity, cigarette smoking, diet, alcohol intake and a range of psychological characteristics were examined using multiple regression. Systolic and diastolic changes in blood pressure were both positively related to baseline age and weight. Regression equations indicated independent effects of change in weight, with similar increases of 0.5 (s.e. 0.1) mmHg in systolic and diastolic blood pressure for each kg of weight gain. Decreased coffee consumption and increased participation in sports were negatively associated with systolic changes in blood pressure. Men who had stopped smoking cigarettes were observed to have higher than average increases in both systolic and diastolic blood pressure, although these relationships were not independent of other variables. The difference in ambient temperature between baseline and follow-up measurement days was an important determinant of change. Changes in mean systolic and mean diastolic blood pressure in 76 manual workers (+10.1/+6.4 mmHg) compared unfavourably with changes in professional men (-2.8/+2.7 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Alcohol consumption, age and personality characteristics as important determinants of within-subject variability in blood pressure.

Intra-individual variability in blood pressure is well recognized but its determinants have been largely unexplored. In a recent cross-sectional study, 343 subjects from a male working population were assessed. Ten supine blood pressure readings were taken at 2-min intervals for 20 min on each of three consecutive days. Each subject's body mass index (weight/height2) was recorded and a questionnaire completed to record demographic details and information about physical activity, personality characteristics, dietary habits, tea and coffee consumption, smoking habits and alcohol consumption. When systolic and diastolic blood pressure variability was defined as the average coefficient of variation of the 10 readings each day, systolic blood pressure variability was found to be positively correlated with alcohol consumption, verbal aggression score and extroversion score. Diastolic variability was positively correlated with verbal aggression score, type-A personality score and extroversion score, and negatively associated with age. Stepwise regression analysis revealed alcohol consumption to be the strongest determinant of systolic variability while age was the strongest determinant of diastolic variability. We conclude that alcohol consumption, age and personality characteristics may be important determinants of intra-subject variability in blood pressure.

Adult↗
PubMed1988

An appraisal of the effects of usual vs recent alcohol intake on blood pressure.

1. In a population-based study of 343 men from two public utilities, 260 subjects reported drinking alcohol at least once a week. In these subjects a comparison was made of the relative effects on blood pressure of either their usual alcohol intake (assessed from a 7-day retrospective diary) or recent alcohol intake (alcohol consumed at the last drinking session in the 24 h prior to blood pressure measurement). 2. Both usual and recent alcohol intake showed similar correlations with level of blood pressure (BP). After adjustment of BP for the potential confounding influences of body mass index, age and smoking status, systolic and diastolic BP remained highest in those subjects with the highest reported levels of both usual and recent alcohol intake. 3. In regression analyses comprising only those subjects who reported drinking in the 24 h before BP measurement, a 3-4 fold greater effect of usual rather than recent intake on both systolic and diastolic BP was predicted from the b coefficients. Regression analysis also demonstrated that the relationship between usual alcohol intake and BP was independent of recent intake, while the relationship between recent intake and BP was no longer significant when usual alcohol intake was entered into the regression equation. 4. These observations suggest that consistent regular drinking is a more important determinant of the alcohol/BP relationship than intake in the previous 24 h.

Adult↗
PubMed1987

Regular alcohol use raises blood pressure in treated hypertensive subjects. A randomised controlled trial.

44 men with treated essential hypertension who were moderate to heavy drinkers took part in a randomised, controlled, crossover trial of the effects of alcohol intake on blood pressure. Usual antihypertensive treatment was maintained throughout 6 weeks of normal drinking and 6 weeks of drinking only a low-alcohol beer. Self-reported changes in alcohol consumption (mean [SEM] from 452 [30] ml ethanol/week during normal drinking to 64 [8] ml/week while drinking the low-alcohol beer) were confirmed by biochemical measurements. Mean systolic and diastolic blood pressures were significantly lower during the last 2 weeks of the low-alcohol period than during the normal-alcohol period, the mean difference in the supine readings being 5.0 (1.4) and 3.0 (0.9) mm Hg, respectively. Regression analysis suggested that reduction in alcohol intake contributed to the fall in both systolic and diastolic blood pressures independently of changes in weight. Thus, curtailing alcohol intake may lead to improved blood-pressure control and may reduce the need for antihypertensive drugs.

Adult↗
PubMed1986

Effects of alcohol consumption on serum lipoprotein-lipid and apolipoprotein concentrations. Results from an intervention study in healthy subjects.

Serum levels of cholesterol, triglyceride, cholesterol in low density lipoprotein (LDL) and in high density lipoprotein (HDL) and its major subfractions, and of apolipoproteins A-I, A-II and B were measured in 48 healthy men at the end of two 6-week periods in which they consumed normal alcohol (5.0%, v/v) or low alcohol (0.9%, v/v) beer, respectively. Other dietary and behavioural variables were kept constant. Mean levels of triglyceride, HDL cholesterol, HDL2- and HDL3 cholesterol, and apolipoproteins A-I and A-II were higher at the end of the normal compared with the low alcohol periods, and levels of LDL cholesterol were lower. Body weight was greater at the end of the normal alcohol period than at the end of the period of low alcohol but multiple regression analysis suggested that the changes in lipoprotein-lipid and apolipoprotein levels were due primarily to the change in alcohol consumption rather than concomitant changes in body weight. This study confirms an effect of alcohol on both major subfractions of HDL and on its major apolipoproteins.

Adult↗
PubMed1986

Effect of regular alcohol use on blood pressure control in treated hypertensive subjects: a controlled study.

Forty-four males with treated essential hypertension and a moderate-to-heavy alcohol intake participated in a randomized controlled crossover trial of the effects of varying alcohol intake on blood pressure control. Usual antihypertensive therapy was maintained unchanged throughout. Self-reported alcohol consumption fell from 452 ml ethanol/week (s.e.m. = 29) during normal drinking habits to 64 ml/week (s.e.m. = 8) while drinking low alcohol content beer. Mean systolic and diastolic blood pressures were significantly lower during the last 2 weeks of reduced alcohol (supine 5.0 mmHg, s.e.m. = 1.4, and 3.0 mmHg, s.e.m. = 0.9, respectively; erect 5.9 mmHg, s.e.m. = 1.6, and 2.9 mmHg, s.e.m. = 1.0, respectively). Body weight was also lower (0.94 kg, s.e.m. = 0.25) at the conclusion of the low alcohol intake period. Regression analysis suggested that reduction in alcohol intake contributed independently to the fall in both systolic and diastolic blood pressure, while weight change contributed independently to the fall in systolic blood pressure alone. It was concluded that curtailing moderate to heavy alcohol intake leads to improved blood pressure control in treated essential hypertensive males.

Adult↗
PubMed1986

Fluid temperature and volume dependence of the dissociated plasma epinephrine and norepinephrine response to drinking.

The ingestion of cold fluids results in a rise in plasma norepinephrine (NE) and a fall in plasma epinephrine (E). To assess the relative roles of fluid volume and temperature in mediating this dissociated sympathetic response to drinking, NE and E levels were measured on 3 separate occasions in 10 men before and after ingestion of either 750 ml distilled water at 4 C, 750 ml at 25 C, or 150 ml at 4 C. An increase in plasma NE occurred after drinking 750 ml water at both 4 C and 25 C. Levels rose during ingestion of fluid and fell again when drinking was completed, consistent with a sympathetic response to deglutition. There was no change after 150 ml at 4 C. In contrast, plasma E fell after the men drank 750 ml water at 4 C, but it did not change after they drank 750 ml water at 25 C or 150 ml at 4 C. The fall was maximal 10 min after drinking was completed and levels remained depressed for a further 30 min. These findings suggest that the fall in E is temperature dependent and is a response to the presence of cold fluid in the stomach rather than to deglutition. We conclude that the dissociation of the plasma NE and E response after drinking cold fluids is therefore a result of independent and contrasting influences of, respectively, the volume and temperature of the fluid ingested.

Adult↗
PubMed1986

Lack of effect of acute alcohol ingestion on erythrocyte Na+, K+ -ATPase activity or passive sodium uptake in vivo in man.

Erythrocyte ouabain-sensitive 86rubidium uptake (as an index of Na+,K+-ATPase activity) as well as passive sodium uptake were measured in a group of young men in response to drinking either nonalcoholic beer (as a control) or the same drink with alcohol (1 ml/kg) added. Plasma alcohol concentration rose to 16.7 mM within 70 min of commencement of drinking. There was no change in uptake of 86rubidium or sodium after 60 min in either the alcohol or control studies. There was a late increase in plasma sodium levels 90 min after alcohol ingestion, attributed to fluid volume contraction following diuresis. In contrast, plasma potassium levels fell after alcohol ingestion. This was associated with a decrease in urinary potassium excretion, hence ascribed to an intracellular shift of potassium ions, a change inconsistent with NA+,K+-ATPase inhibition. It is concluded that acute moderate doses of alcohol do not influence NA+,K+-ATPase activity or passive sodium uptake in circulating erythrocytes. Unless vascular smooth muscle is more sensitive to the effects of alcohol in vitro, these findings make it less likely that inhibition of NA+,K+-ATPase mediates alcohol-related hypertension in man.

Adult↗
PubMed1986

Serum apolipoprotein A-II as a marker of change in alcohol intake in male drinkers.

The relative usefulness of high-density lipoprotein cholesterol (HDL-C) and the HDL components, apolipoproteins A-I and A-II (Apo A-I and Apo A-II), as prospective markers of change in alcohol intake was compared to gamma-glutamyl transferase (gamma GT) and erythrocyte mean corpuscular volume (MCV) in a controlled crossover trial of 46 moderate male drinkers whose alcohol intake was reduced by approximately 80% for six weeks by the substitution of their normal drinking habits for a low alcohol content beer only. Only serum Apo A-II levels correlated significantly with self-reported alcohol intake at the commencement of the study (r = 0.46; P less than 0.001). All five indices fell significantly with reduction of alcohol intake. The change in these indices between normal and low alcohol intake periods correlated directly with change in alcohol intake, the highest correlation being with delta Apo A-II (r = 0.72; P less than 0.001). Using discriminant analysis this variable was found to achieve an accuracy of 96% in classifying subjects into the correct drinking category (either normal or low alcohol intake). The relative percentages for the other variables were delta Apo A-I 78%, delta HDL-C 82%, delta gamma GT 78% and delta MCV 76%. We conclude that Apo A-II may prove a valuable marker of alcohol intake in cross-sectional epidemiological studies, while delta Apo A-II may be a sensitive marker of change in alcohol intake in the prospective management of the heavy drinker.

Adult↗
PubMed1985

The effect of stopping smoking on blood pressure--a controlled trial.

Epidemiological studies have found evidence of lower blood pressure in smokers and predict an increase in blood pressure after stopping smoking. We have therefore monitored blood pressure change in 33 smokers following entry into a 6-week smoking cessation programme and compared the results to 33 matched controls who continued their normal smoking habits over the same period. Fourteen subjects were successful in quitting smoking for the entire 6 weeks, 13 were unsuccessful and 6 withdrew before completion of the programme. No significant increase in supine or erect systolic or diastolic blood pressure was observed following reduction in or cessation of smoking habit. Complete cessation of smoking was, however, associated with an increase in weight and anxiety levels and a decrease in alcohol consumption. We conclude that although stopping smoking affects several factors which may potentially influence blood pressure, this does not result in any significant change in blood pressure over a 6-week period. Concern that advice to patients to cease smoking may lead to a prompt increase in blood pressure appears unnecessary.

Adult↗
PubMed1985

Differential effects of sulindac and indomethacin on blood pressure in treated essential hypertensive subjects.

Attenuation of the effectiveness of antihypertensive therapy by non-steroidal anti-inflammatory (NSAI) drugs has been attributed to inhibition of systemic or renal vasodilator prostaglandin synthesis, or a combination of both. Indomethacin is a NSAI drug with both renal and extrarenal cyclo-oxygenase inhibition properties. Sulindac is a relatively selective cyclo-oxygenase inhibitor said not to affect urinary prostaglandin excretion. This study examines the relative effect on blood pressure of 4 weeks' treatment, with indomethacin 25 mg three times daily and sulindac 200 mg twice daily, in a randomized placebo controlled trial in 26 hypertensive subjects. In nine patients treated with indomethacin, supine blood pressure rose 11 mmHg systolic and 4 mmHg diastolic by the end of the first week, whereas nine subjects treated with sulindac showed a fall in blood pressure similar to the trend seen in placebo-treated subjects. Indomethacin treatment inhibited renal cyclo-oxygenase with a 78% reduction in urinary prostaglandin E2 excretion and 89% suppression of plasma renin activity. Neither measurement was affected by sulindac. Extrarenal cyclo-oxygenase activity was inhibited by both indomethacin and sulindac with serum thromboxane B2 decreasing by 96% and 69% respectively. The results suggest that the pressor effect of NSAI drugs is predominantly related to renal cyclo-oxygenase inhibition. the lack of effect of sulindac on blood pressure may make it a safer therapeutic option if NSAI drug therapy is necessary in the hypertensive patient.

Adult↗