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I J Voudoukis

Publications and source records attributed to I J Voudoukis.

11 recordsLinked to original sources
PubMed1976

Correlation of cold pressor response with coronary atherosclerosis and left ventricular performance.

A comparison of cold pressor response with coronary arteriography and left ventriculography was made in 26 consecutive patients having chest pain suggesting coronary heart disease. Patients with normal coronary arteriograms and normal left ventriculograms showed normal cold pressor responses. Patients with coronary atherosclerosis and normal left ventricular performance showed an exaggerated cold pressor response, whereas patients with severe coronary atherosclerosis and poor left ventricular performance did not exhibit an exaggerated cold pressor response. In patients with inferior wall myocardial infarction having dyskinesia or akinesia of the inferior wall, the cold pressor response was not impaired. In contrast, patients with anterior wall myocardial infarction and dyskinesia or akinesia of the anterior wall showed a marked impairment of the left ventricular performance and no exaggeration of the cold pressor response.

Cold Temperature↗
PubMed1975

Prognostic and therapeutic considerations in pure hypertension vs hypertension and superimposed arteriosclerosis.

In summary, a prognostic and therapeutic evaluation of 227 patients first seen from 1967 to the end of 1969 with a follow-up of 4-7 years was made. The results are indeed depressing. In spite of close follow-up and systematic treatment with modern antihypertensive agents, the mortality of patients having hypertension with superimposed arteriosclerosis was 27% (15 to 56) for males as contrasted to 3% (2 of 75) for females. Since the last casual blood pressure in both living and deceased patients of the mixed group were similar, the level of blood pressure following treatment could not be incriminated for the deceased patients. An exaggerated systolic and pulse pressure cold pressor response emerged as an important indicator of presence of arteriosclerosis alone. When hypertension and arteriosclerosis coexisted there was also exaggeration in diastolic cold pressor response. A further exaggeration in systolic and diastolic cold pressor response was seen in the decreased as compared to living male patients, a finding which appears to have grave prognostic significance for coronary heart disease and stroke. Thus a marked exaggeration in both systolic and diastolic cold pressor response in males might prove to be the single most important predictor of premature death from atherosclerotic vascular disease. A further analysis of the deceased male patients having hypertension and superimposed arteriosclerosis, indicates that treatment of hypertension may prevent oeath from stroke but not form coronary heart disease. Two-thirds of the deaths occur suddenly and only one-third of the deceased patients reached the hospital befor dying. In view of these distressing findings a plea for early detection and treatment of hypertension, prior to the development of superimposed arteriosclerotic changes, particularly in males, is made.

Arteriosclerosis↗
PubMedDate not supplied

A clinical approach to hypertension.

1. A new approach to hypertension is introduced by taking into consideration not only casual blood pressure but also baseline blood pressure, blood pressure lability and cold pressor response. 2. In addition to blood pressure measurements the vascular damage in terms of atherosclerosis and/or retinal arteriosclerosis was also taken into consideration by grouping the patients into four groups: Normal; Arteriosclerosis; Hypertension; Hypertension & superimposed arteriosclerosis. 3. Prior to initiating treatment, at least six casual blood pressures were taken by the technical assistant and the physician, during three different visits. 4. The step method, by starting with thiazides and adding other antihypertensive agents during the subsequent office visits according to response was followed. 5. The patients were followed for a four to seven year period so that a meaningful prognostic and therapeutic evaluation was possible. 6. All patients with pure hypertension and without arteriosclerosis and those with pure arteriosclerosis and without hypertension survived during the period of observation. 7. Twenty-three per cent (12 of 51) of males having hypertension with super-imposed arteriosclerosis died, as compared to only 4% (2 of 54) of females; thus a male to female mortality ratio of about 6:1 was observed. 8. A comparison of the living and deceased males of the mixed group having hypertension and superimposed arteriosclerosis showed that the most significant difference between the two subgroups was a marked exaggeration of diastolic cold pressor response in the deceased as compared to the still living patients. 9. It remains to be seen whether or not in these patients with a marked exaggeration of the diastolic cold pressor response, by using a more vigorous treatment with drugs such as methyldopa, propranolol or guanethidine in relatively high doses, we might be able to reduce mortality and increase survival.

Adult↗