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J R Viskoper

Publications and source records attributed to J R Viskoper.

10 recordsLinked to original sources
PubMed1992

Does isradipine exert a special early-morning blood pressure-lowering effect?

The blood pressure-lowering effect of isradipine at 1.25-2.5 mg twice daily (taken at 0700 and 1900 h) was assessed in a double-blind study involving 28 men with mild-to-moderate hypertension. After a 4-week placebo period, patients were randomized to receive either isradipine (group I) or placebo (group II) for 8 weeks. At the end of the placebo and active-treatment periods, patients were evaluated by 24-h ambulatory blood pressure monitoring. Data were analyzed according to two time periods: daytime, 1000-2300 h; nighttime and early morning, 2300-1000 h. Intersubject analyses were performed comparing values at the end of placebo with those at the end of active treatment. Intrasubject two-way analysis of variance showed that the time of day or night had no influence on blood pressure changes. Comparison of systolic (SBP) and diastolic (DBP) blood pressures with isradipine indicated that there were significantly greater average decreases in SBP at 0600-0800 h than at 1800-2000 h (p = 0.038), and at 0800-1100 h than at 2000-2300 h (p = 0.045). This was also true for the average decreases in DBP (p = 0.006). In conclusion, isradipine exerts blood pressure control throughout 24 h with a pronounced action during the early morning (0600-0800 h) period.

Adult↗
PubMed1991

Twenty-four-hour blood pressure control with isradipine in mild essential hypertension.

The hypotensive effect of isradipine was assessed in 26 male patients, aged 40 to 64 years, with hypertension. After withdrawal of previous antihypertensive treatment and a four-week placebo period, patients were randomized into a double-blind active-treatment period of eight weeks to receive either placebo or 1.25 to 2.5 mg isradipine twice daily. Twenty-four-hour ambulatory blood pressure was measured by Accutracker (Suntech, Oxford, England) after the placebo period and at the end of the active-treatment period. In the isradipine group n = 13), both systolic and diastolic blood pressure and number of blood pressure spikes decreased significantly (P less than .0001), whereas there was a significant increase of these variables in the placebo control group (n = 13). The results of this study indicate that, in these subjects, blood pressure control was achieved throughout the 24-h period by monotherapy with isradipine.

Adult↗
PubMed1991

Urinary albumin excretion in patients with familial Mediterranean fever: a pilot study.

Amyloidosis of the kidney is the most threatening complication in familial Mediterranean fever (FMF), and colchicine has been shown to reduce its occurrence. In the preclinical stage of kidney amyloidosis, no proteinuria is observed by the standard Albustix method. However, whether these patients have normal or increased urinary albumin excretion is not known. The purpose of this study was to evaluate albumin excretion in FMF patients treated with colchicine and to compare these values to those of a normal control group. Twenty-two subjects with FMF were compared with 16 normal subjects matched with regard to age and body surface area. The two groups did not differ with regard to female/male ratio and arterial pressure. Urine samples were collected overnight while patients were recumbent and in the daytime while they were ambulant. After measuring albumin concentration (Ua) by radio-immunoassay and creatinine concentration through the standard method, the urinary albumin excretion rate (UaV) and urinary albumin creatinine ratio (Ua/c) were calculated. In the FMF group, three patients had microalbuminuria--defined as an albumin excretion rate higher than 20 micrograms/min. Two of them had this condition only in the early morning collection. These three patients were characterized by a longer duration of symptoms (18 vs. 9 years). No patient in the control group had microalbuminuria. The mean UaV in the FMF group did not differ significantly from that of the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Twenty-four hour arterial pressure and heart rate as predictors of left-ventricular hypertrophy.

Hypertrophy of the left ventricle occurs in some but not all hypertensive patients. The present study was designed to examine the office and the 24-hour arterial pressure (AP) and heart rate (HR) recordings, and the AP response to physical stress in two age- and sex-matched hypertensive groups who differed in their left-ventricular mass (LVM). In addition, we tried to determine whether AP and HR measured at rest, under stress, or with 24-hour AP monitoring correlate with LVM. Ten hypertensive subjects with left-ventricular hypertrophy (LVH) made up the study group and 10 hypertensive subjects without LVH made up the control group. Antihypertensive medication was withdrawn at least four weeks prior to evaluation. The mean office AP measured during the washout period was 157 +/- 13/100 +/- 11 mm Hg in the study group and 157 +/- 17/104 +/- 7 mm Hg in the control group. However, 24-hour AP monitoring disclosed that the study group had significantly higher AP than the control group during both day and night. The control group had a significantly faster HR in the clinic and at night. The HR response to bicycle exercise was less in the control group than in the LVH group. The maximal AP and the rise in AP during bicycle exercise did not differ between groups. The LVM index did not correlate with the office AP or with maximal AP during effort, but did correlate negatively with the office HR and with the HR prior to the exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The effect of cilazapril, a new angiotensin converting enzyme inhibitor, on peak and trough blood pressure measurements in hypertensive patients.

Cilazapril (CLZ) is a new, long-acting nonsulfhydril converting enzyme inhibitor (ACE-I). Its effect on peak and trough sitting diastolic blood pressure (SDBP) was studied in a total of 85 patients with uncomplicated, essential hypertension at three centers. After 4 weeks of a single-blind placebo (PLA) run-in period, patients whose SDBP was between 100 and 115 mm Hg, were randomized into active treatment with either PLA (n = 27), CLZ 2.5 mg (n = 29), or CLZ 5 mg (n = 29) once daily in a double-blind fashion for another 8 weeks. At the end of the PLA run-in and after 4 and 8 weeks active therapy, an hourly blood pressure (BP) profile during 1-10 and 21-24 h postdose was performed. The drop in SDBP at the end of the active treatment period at peak and trough was statistically and clinically significant for both CLZ doses in comparison with the PLA group. The peak/trough ratio after subtraction of the PLA effect was 62% for CLZ 2.5 mg and 59% for CLZ 5 mg. These results indicate that the dose regimen of CLZ 2.5-5 mg once daily is adequate and effective for 24 h.

Adult↗
PubMed1991

The antihypertensive action of isradipine in mild essential hypertension.

The antihypertensive effect of isradipine compared with placebo was assessed in 28 male patients (aged 40-64 years) with mild-to-moderate essential hypertension. After withdrawal of all previous antihypertensive treatment, these patients were entered into a 4-week placebo period followed by randomization to receive double-blind, for 8 weeks, either placebo (n = 14) or isradipine at 1.25-2.5 mg twice daily (n = 14). Twenty-four-hour ambulatory blood pressure was measured by Accutracker at the end of the placebo period and at the end of active treatment. In the isradipine group, both systolic and diastolic blood pressures decreased significantly (p less than 0.0001) whereas blood pressure increased in those taking placebo. In addition, isradipine as monotherapy controlled blood pressure throughout the day and night, and especially during the early morning, in these patients.

Adult↗
PubMed1991

Extrapulmonary tuberculosis: five case reports.

Since the 1950s, tuberculosis (TB) morbidity has been decreasing steadily in Israel. However, recent waves of Ethiopian immigrants have brought new cases and have renewed our awareness of the disease. As in other immigrant populations, the incidence of extrapulmonary TB is relatively high, challenging the clinician to make the correct diagnosis at an early stage. Many of the new immigrants settled in the Ashkelon are and were diagnosed and treated in our hospital. We present five cases of TB with extrapulmonary manifestations. Proof of TB infection was found in sites remote from the major clinical manifestation in four of the patients, emphasizing the difficulty in diagnosing the disease. Four of the patients recovered after treatment, but the patient admitted with neurological involvement remained comatose until her death.

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PubMed1990

[The "Ashkelon" hypertension detection and follow-up program].

The program described aims at enhancing awareness of high blood pressure and other risk factors for cardiovascular disease (CVD) and promoting a healthy lifestyle. The study population consisted of 11,000 workers at worksites and visitors to community centers, aged 25-65 years. The program was carried out in cooperation with primary care clinics and non-pharmacological control of high blood pressure was by a community center for prevention of CVD. In 1980, 56.0% of hypertensives were unaware of their condition, while by 1988 this was reduced to 6.1%. Body weight reduction resulted in lowering of blood pressure which enabled cessation of all antihypertensive treatment in 25%. Deep muscle relaxation enabled cessation in 47%. The savings effected in terms of antihypertensive treatment outweight the total cost of the program 3-fold.

Adult↗
PubMed1989

Perirenal and renal subcapsular haematoma as presenting symptoms of polyarteritis nodosa.

Two young men, were hospitalized due to acute massive blood loss with left abdominal flank pain. In both cases renal angiography showed signs of a haemorrhagic event in the left kidney, perirenal in one and subcapsular in the other. Microaneurysms indicated a diagnosis of polyarteritis nodosa, supported by renal biopsy in one case. Renal haemorrhage is an infrequent presentation of polyarteritis nodosa. Furthermore, one patient suffered also from familial Mediterranean fever, and is the fifth reported case with this combination of diseases.

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