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J Zarifis

Publications and source records attributed to J Zarifis.

25 records · Page 2Linked to original sources
PubMed1995

Hormone replacement therapy and cardiovascular risk: the cardiovascular physicians' viewpoint.

Sufficient evidence has accumulated showing that hormone replacement therapy (HRT) does protect against cardiovascular disease in women, although data regarding the true magnitude of that protection remains incomplete. There is no evidence that HRT increases the risk of hypertension or thromboembolism, and beneficial effects have been found for plasma lipids, clotting factors and cardiovascular haemodynamics. However, the evidence is not convincing of any beneficial effect of HRT in preventing strokes, and concerns about the risk of cancer with HRT remain. Despite this, considerable uncertainty continues to exist amongst clinicians as to the balance of beneficial and harmful effects from administering HRT. Overall, HRT seems to do no harm and may be protective. A much greater awareness of the long-term consequences of the menopause and the potential benefits of HRT should be encouraged so that women (and their doctors) can make informed decisions about their requirements.

Adult↗
PubMed1995

Poisoning with anti-hypertensive drugs: methyldopa and clonidine.

Methyldopa and clonidine are anti-hypertensive drugs which are used less commonly nowadays. Experience of toxicity and self-poisoning with these drugs remains limited. This review examines the cases reported in the literature of overdosage or poisoning with methyldopa and clonidine, and the presenting symptoms and management in such cases. With supportive therapy, the prognosis following toxicity with methyldopa and clonidine is good. Although an initial presentation with drowsiness or coma is common, careful attention should also be directed to any cardiovascular complications.

Antihypertensive Agents↗
PubMed1995

Soluble adhesion molecule P-selectin and endothelial dysfunction in essential hypertension: implications for atherogenesis? A preliminary report.

OBJECTIVE: Patients with essential hypertension are at high risk of atherosclerotic vascular disease. To investigate this further, we measured levels of the soluble adhesion molecule P-selectin, which is associated with platelet activity/function and atherosclerosis, von Willebrand factor, which is a marker of endothelial dysfunction, and plasma fibrinogen. PATIENTS AND METHODS: We studied 104 consecutive patients (47 males, 57 females; mean +/- SD age 54.8 +/- 14.1 years) with essential hypertension compared with 47 normotensive healthy controls (55.0 +/- 19.2 years). Levels of soluble adhesion molecule P-selectin and von Willebrand factor were measured by enzyme-linked immunosorbent assay, and plasma fibrinogen by a clotting method (CLAUSS). RESULTS: Compared with normotensives, the hypertensives showed significant increases in soluble P-selectin (300 versus 228 ng/ml; median difference 55 ng/ml, Mann-Whitney test P = 0.03), von Willebrand factor (114 versus 96 IU/I; unpaired t-test P < or = 0.001) and fibrinogen (3.3 versus 2.9 g/l; unpaired t-test P < or = 0.001). There were significant correlations between fibrinogen and P-selectin (r = 0.16; P = 0.02) and von Willebrand factor (r = 0.39; P<0.001), but not between P-selectin and von Willebrand factor. There were no differences in these factors between patients with (n = 53) and without (n = 51) antihypertensive therapy or between those with good blood pressure control (systolic/diastolic < or = 160/90 mmHg; n = 17) and those with poor control. A stepwise multiple regression analysis showed that diastolic blood pressure was a significant predictor for soluble P-selectin levels; diastolic blood pressure and von Willebrand factor levels were significant predictors for fibrinogen levels (P<0.05). CONCLUSIONS: This study suggests that hypertensives have high plasma fibrinogen levels, platelet dysfunction (which could contribute to atherogenesis, as indicated by raised soluble P-selectin levels) and endothelial dysfunction (as indicated by high von Willebrand factor levels), which are related to diastolic blood pressure. These factors may act synergistically to increase atherogenesis and may explain the high risk of atherosclerotic vascular disease in hypertensives.

Arteriosclerosis↗