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Biomedical subjects

K Savino

Publications and source records attributed to K Savino.

13 recordsLinked to original sources
PubMed1991

[Recent findings on the physiopathology of hypertension].

The numerous pathophysiological theories in the field of essential hypertension are often conflicting, and till now a comprehensive model is not available. The aetiology of human hypertension is probably multifactorial, the control mechanisms of hypertension are strictly interdependent, and the alteration of one induces readjustment of the others, so that it is very difficult to discriminate the "primum movens" from its consequences. In this review the recent acquisitions in the aetiology and the pathophysiology of arterial hypertension are analysed, with particular regard to the role of inheritance, of renal mechanisms of sodium retention, ions transport, humoral factors, central nervous system and of enhanced vascular reactivity. The activation of some of these pathophysiological factors induces the rise in peripheral vascular resistance, which is the final common pathway in the development of essential hypertension.

Biological Transport↗
PubMed1990

Verapamil 240 SR versus verapamil 120 SR in arterial hypertension. A randomized double-blind, placebo-controlled study with 24-hour ambulatory blood pressure monitoring.

Fifteen patients (6 males, 9 females), age range 36-70 years, were enrolled in a randomized, double-blind, placebo-controlled study according to a Latin-square design, with the aim of comparing 24-hour blood pressure profiles after three 15-day treatment periods with placebo, verapamil SR 120 mg (V120 SR) given twice daily (bid), and verapamil SR 240 mg (V240 SR) given once daily (od). All of the patients were diagnosed as mild or moderate essential hypertensives on the basis of standard casual recordings. Noninvasive 24-hour ambulatory blood pressure (BP) monitoring was performed with an ICR Spacelab 5200 automatic device. In comparison with placebo, a clinically and statistically significant reduction in both systolic and diastolic BP over 24 hours was obtained with both active treatments. Comparison of the two active treatments shows that V240 SR led to a greater reduction in systolic and diastolic BP than V120 SR. No changes in heart rate were observed. Both treatments were well tolerated. In conclusion, both verapamil regimens proved to be effective and safe in treating essential hypertensives, with V240 SR giving better 24-hour BP control.

Adult↗
PubMed1990

[Simvastatin versus gemfibrozil in the treatment of primary hypercholesterolemia in hypertensive patients treated with hydrochlorothiazide].

Recent pharmacological studies confirmed the role of hypercholesterolemia in the pathogenesis of coronary atherosclerosis. A 10% reduction in cholesterol levels can reduce the risk of coronary heart disease by 15%. However many hypercholesterolemic patients often suffer from arterial hypertension and drugs such as thiazide diuretics cause an imbalance in lipid metabolism. The efficacy and the tolerability of simvastatin (a inhibitor of HGM-CoA reductase) with that of gemfibrozil (a fibric acid derivative, which can reduce the VLDL level) were compared in a placebo-controlled study in 2 groups of patients with primary hypercholesterolemia and mild-to-moderate essential hypertension treated with hydrochlorothiazide. After 10 weeks standard hypolipidemic diet and hydrochlorothiazide (25 mg od) therapy, 30 patients whose cholesterol levels were still greater than or equal to 250 mg/100 ml and whose diastolic blood pressure was less than 95 mmHg were randomized to one of the following treatments: simvastatin, 20 mg od, gemfibrozil, 600 mg bid or placebo, while continuing dietetic and diuretic treatment. After 24 weeks treatment, simvastatin induced a 37% reduction in cholesterol plasma levels, a 9% increase of HDL and a 16% reduction of LDL. APO-A1 showed a 4% increase, while APO-B showed a 3% reduction. Gemfibrozil induced a 20% reduction in plasma triglycerides and a 13% decrease in plasma cholesterol, with a significant 19% increase in HDL and a 11% reduction in LDL. No significant variations in any of the lipid parameters monitored were observed in the placebo group. Treatment with simvastatin or gemfibrozil in hypertensive patients in hydrochlorothiazide monotherapy can reduce total cholesterol and LDL-cholesterol plasma levels, while significantly increasing HDL plasma levels compared to placebo. Simvastatin, however, resulted more efficient than gemfibrozil on total cholesterol or cholesterol fractions.

Adult↗
PubMed1989

Leucocyte rheology in controlled coronary ischaemia.

Since no studies have been carried out on the exact origin of the alterations in white blood cell rheology during the early stages of controlled ischaemia in coronary arterial disease, a model was set up using a cycle ergometer test (with a 25 watts increase every 2 minutes). Blood samples were taken (before and after exercise and again 8 minutes later at recovery) from 18 patients with stable angina pectoris and a group of 22 matched controls. The filterability (through 5 micrometer diameter pore filters) of the polymorphonuclear leucocyte sub-population (separated by density gradient), the monocyte and lymphocyte sub-fractions (separated by adhesion to Petri dishes) as well as leucocyte activation (observed under a light microscope) were monitored. Our results showed that the total leucocyte count in patients and controls rose after exercise and was accompanied by a differential shift from the polymorphonuclear to the lymphocyte cells. The polymorphonuclear filterability rate increased significantly in patients when compared to their basal values at rest, and to the controls after exercise (+ 19.58%; P less than 0.002 vs basal values at rest; + 18.72%; P less than 0.002 vs controls). This increase persisted throughout the recovery period (+ 19.86%; P less than 0.002 vs basal values; and + 23.52% P less than 0.001 vs controls), indicating that a reduced polymorphonuclear leucocyte filterability can be associated with the first signs of ischaemia.

Aged↗
PubMed1989

[Multicenter clinical study of the antihypertensive activity of lisinopril].

One-hundred patients suffering from slight-moderate hypertension (53 m, 47 f, aged between 18 and 78, average 49.08) have been studied in order to assess the effectiveness and tolerance of lisinopril ("Zestril", ICI-Pharma), a new ACE inhibitor in a single daily administration at doses of between 10 and 80 mg in relation to pressure values. Monotherapy with Lisinopril proved effective in 84 patients (88.4%), in 74 of whom (7.9%) pressure values were returned to normal. 11 patients (11.6%) did not respond to treatment. In most cases, the result was obtained with a dose of 20 mg in a single administration (32.6%). The incidence of side-effects was limited and in no case required the withdrawal of the drug.

Adolescent↗
PubMed1989

[Doppler echocardiography in atrial myxoma].

Two-dimensional echocardiography is the technique of choice for the diagnosis of atrial myxoma. In fact the Echo study allows the recognition of the presence of the tumor, and can show its dimensions, shape, implantation site and motility. However, it is not clear the role of Doppler echocardiography in the evaluation of atrial myxoma. This technique could be useful to recognize patients with more severe obstruction to atrioventricular flow due to large tumors. In 4 patients with large atrial myxomas (3 left and 1 right atrial myxoma) Doppler analysis of atrioventricular flow showed an apparent correlation between variation of trans-mitral or trans-tricuspid diastolic flow and symptoms (syncopal attacks). Only patients with an obstruction to atrioventricular flow and severely restricted calculated mitral or tricuspid orifice had syncopal attacks, at variance with patients without flow obstruction. Further studies on larger population will verify this apparent relation between atrioventricular flow obstruction and clinical symptoms in patients with large atrial myxoma.

Adult↗
PubMed1987

High prevalence of septal thickness overestimation in hypertensive subjects and controls.

The aim of our study was to assess the frequency of important problems in the ultrasonic estimate of septal thickness as a consequence of multiple endocardial lines inside the septum in echocardiographic tracings of otherwise good technical quality. We performed an echocardiographic study in a population composed of 311 subjects (131 essential hypertensive subjects and 180 normotensive healthy controls) by using M-mode echocardiography under two-dimensional control, according to the recommendations of the American Society of Echocardiography. We observed the presence of one or more continuous lines inside the septum, each of them simulating an endocardial border and thus producing the appearance of two or more superimposed septal thicknesses differing by 2 mm or more in greater than 50% of the subjects (54% normotensive and 56% hypertensive). Furthermore, within the group of subjects with multiple septal lines, we found the disappearance of at least one of the farthest linear echoes, with resulting septal thinning of almost 2 mm in 58% of the normotensive and 61% of the hypertensive subjects. These findings suggest the need for caution when interpreting echocardiographic measurements of left ventricular septal thickness. We suggest that in the presence of multiple lines inside the septum, the echocardiographic examination should be continued up to the appearance of the thinnest septal image, possibly devoid of multiple lines inside the septum.

Adult↗