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Biomedical subjects

M Carrageta

Publications and source records attributed to M Carrageta.

30 records · Page 2Linked to original sources
PubMed1996

[Antihypertensive effect of fosinopril in mild hypertension].

The aim of this double-blind randomized placebo-controlled study was to evaluate the antihypertensive and safety of fosinopril in mild essential hypertension. After a 2-week placebo period, patients received either placebo or fosinopril 20 mg, once daily. Thirty-four patients finished the study (18 patients in the placebo group and 16 patients in the fosinopril group). Systolic blood pressure decreased from 160.1 +/- 22.1 mmHg to 156.0 +/- 24.2 in the placebo group (NS) and from 151.8 +/- 14.0 mmHg to 141.5 +/- 14.5 in the fosinopril group (p < 0.005); diastolic blood pressure decreased from 100.1 +/- 2.4 mmHg to 94.3 +/- 7.4 mmHg in the placebo group (p < 0.005) and from 100.8 +/- 4.8 mmHg to 88.1 +/- 9.0 mmHg in the fosinopril group (p < 0.001). Mean decrease in diastolic blood pressure was 5.7 mmHg in the placebo group and 12.6 mmHg in the fosinopril group (p < 0.05). A statistically significant difference was seen between the percentage of controlled patients in the two groups: 16.6% in the placebo group vs 56.2% in the fosinopril group (p < 0.05). No statistically significant difference in biochemical parameters was seen between the two groups. Tolerance was good and no patients were withdrawn from the study for adverse events.

Adolescent↗
PubMed1992

[Angina pectoris--particular aspects in the elderly].

The incidence of the coronary heart disease increases dramatically with age, representing in Portugal the second largest cause of death in patients older than 65 years. The cause of this high prevalence of the disease is not completely understood, but the pathogenic role of the cardiovascular risk factors has a singificative importance. It seems to be essential, even in elderly, to control these risk factors in order to limit the progression of the atherosclerotic disease. Regarding symptomatology, effort dyspneia appears to be one of the most frequent disease manifestations, differing from the typical chest pain presentation observed in the younger patients. Exercise stress testing can be used safely in the elderly and it is not just an important diagnostic tool, but it is also essential to the stratification of the patients to be more agressively treated. Concerning treatment, the search and correction of the precipitating factors are a key to success in the elderly patients. Pharmacologic therapy must be prescribed in agreement with the clinical pharmacologic principles, carefully adjusted to the elderly, in order to avoid adverse drug effects. In spite, coronary bypass surgery has some higher risk in the elderly. The results obtained are satisfactory, and the patients subset with ventricular disfunction, benefit the most. Percutaneous transluminal coronary angioplasty constitutes a very atractive therapeutic modality in the elderly. Cardiac reabilitation programe are very useful in the elderly, contributing to the desired psycosocial reintegration of these patients.

Aged↗
PubMed1990

[X syndrome: review of concepts].

Patients with syndrome X or microvascular angina present complains of effort angina associated with normal--appearing coronary arteries. Ischemia seems to be caused by myocardial perfusion abnormalities, related to microcirculatory disfunction, characterized by excessive vasoconstriction and/or inadequate vasodilation response. The intimal cause of this microcirculatory disfunction, located in the small pre-arteriolares arteries with 100-200 microns caliber, is still unknown. It seems that these patients present a generalized abnormality of the systemic smooth muscle, affecting territories other than the vascular. The diagnosis should be suspected whenever a patient presents effort angina, angiographically normal arteries and evidence of ischemia to exercise. As this syndrome is better understood some subsets of patients with different clinical characteristics and prognosis, are being identified. The calcium channel blockers seem to be the drug more effective in the control of ischemia and symptoms. The prognosis is, in general, better than in patients with coronary angiographic lesions.

Angina Pectoris↗
PubMed1990

[Arterial hypertension associated with hyperlipoproteinemia].

Hypertension and serum cholesterol levels are strongly interrelated as cardiovascular risk factors. The Framingham study showed that the risk of both ischaemic heart disease and brain infarction doubles in presence of mild hypertensive status and triplicates in presence of a definitive hypertension. The systolic pressure showed to be the best predictor of both ischaemic heart disease and cerebral infarction particularly in persons aged more than 65 years. In terms of physiopathology we point out several mechanisms by which hypertension could interact with hypercholesterolemia on the arterial wall causing endothelial lesion, enhancing the penetration of arterial wall by lipoproteins, calcium accumulation on smooth subendothelial muscle and suppression of the relaxation factor produced by endothelial cells. In relation to the dietetic treatment, we must restrict more rigorously the ingestion of salt, saturated fatty acids, and total calories. In terms of anti-hypertensive drugs, we should: Avoid thiazide diuretics in case of cholesterol levels of moderate to high risk. Avoid beta blockers in patients with high levels of triglycerides, low HDL and low ratio total cholesterol/HDL. Consider to choose a calcium antagonist, a converting enzyme or an alpha blocker.

Humans↗
PubMed1990

[Atherosclerosis and cardiovascular risk factors in the elderly].

Atherosclerosis is an age-related process that reflects the interaction between aging and the factors that influence the rate of atherogenesis. The great difficulty in the study of the cardiovascular consequences of aging is due to the fact that it is not easy to distinguish between the effects aging per se (primary aging) and the effects of changes in behaviour and life style that usually accompany old age and may influence the rate of atherogenesis. Most risk factors known to contribute to cardiovascular disease are highly prevalent in the aged and all of them are modifiable. Ideally, preventive measures should be initiated early in the life, when such measures however instituted in the aged, also have beneficial effects. Because incidence rates of atherosclerotic disease are high in the elderly, preventive measures could have a great impact on older persons. Thus interventions aimed to decrease cardiovascular morbidity and mortality will reduce the health costs and improve the quality of the last years of life.

Aged↗
PubMed1990

[Value of the ergometric test after myocardial infarction].

Exercise stress testing (EST) after myocardial infarction helps to define the clinical subsets of patients at high and low risk. It should be performed before hospital discharge, unless a contraindication exists. In order to exclude false positives, EST must be repeated 4-6 weeks later. EST helps to recognize the presence of residual ischaemia. Significant ST segment depression during exercise, associated or not with angina, is the most important indicator of ischemia. These patients with ischaemia at distance i.e., those with ST segment changes in ECG leads without W waves, are at high risk. Some continuous exercise variables (degree of ST deviation, time of recovery and exercise duration) are related to cardiac mortality. Exercise induced complex ventricular arrhythmias seem to be related to left main or three vessels disease, and a greater likelihood of sudden death, particularly when coexist a low ejection fraction, important segmentar disturbances of contractility and ST segment depression. EST after myocardial infarction has great value to assess the results of medical therapy and/or coronary angioplasty or bypass grafting. EST also constitutes a valuable clinical tool to support a comprehensive rehabilitation programme.

Clinical Protocols↗
PubMed1990

[Rhythm profile in patients with psoriatic arthritis].

OBJECTIVE: To analyze the rhythmic profile in patients with psoriatic arthritis (PA). DESIGN: In order to evaluate the rhythmic profile of patients with PA, we have carried out ambulatory 24 hour ECG recordings in 22 patients presented consecutively to the Holter ECG laboratory. SETTING: Patients followed in a specialised rheumatology consultation, in Santa Maria Hospital. PATIENTS: We have studied 22 patients (pts), 10 male and 12 female, aged 49.8 +/- 8.4 years, presenting PA diagnosed in average 12.9 years before. A group of 36 individuals, 25 male and 11 female, aged 37 +/- 8 years and without disease, were used as control. RESULTS: All patients were in sinus rhythm with a mean heart rate of 71 +/- 6 (min - 51.5 +/- 7.0 and max - 130.3 +/- 15.0). In 8 (36.6%) there were sinus bradycardia less than 50/min and sinus tachycardia (greater than 120/min) in 15 patients (68.1%). Two patients (9%) presented supraventricular tachycardia and one had AV block. There were premature atrial systoles in 14 pts (63.6%), and ventricular arrhythmias in 9 (40.9%). In control group, there were sinus bradycardia in 16.6%, sinus tachycardia in 33.3%, premature atrial systoles in 33.3% and ventricular arrhythmias in 25% of them; in 11% there were conduction disturbances. CONCLUSIONS: a) Premature atrial systoles were the rhythm disturbance more prevalent. b) Patients with PA presented a significant higher incidence of sinus bradycardia and sinus tachycardia. c) Cardiac conduction disturbances were not frequent. d) Our results may suggest the presence of a subtle autonomic dysfunction in patients with psoriatic arthritis.

Adult↗
PubMed1989

[Silent ischemia in patients with previous myocardial infarct. Correlation of Holter and coronarography].

OBJECTIVE: Our objective was to determine the presence of silent myocardial ischemia and the degree of coronary obstructions. DESIGN: Successively patients with myocardial infarction. SETTING: Patients admitted to the coronary intensive care, later followed in a specialised out-patients consultation. PATIENTS: 62 patients with previous myocardial infarction. INTERVENTIONS: All the patients were submitted to Holter-monitoring and coronary angiography. RESULTS: Silent ischemia was present in 14 (22,6%) of the patients. Seven of these (50%) had 3 vessels disease, 2 (14,3%) had 2 vessels disease, and 5 (35,7%) had 1 vessel disease. Twelve of the patients (86%) had occlusive lesions (greater than 90%), localised in 11 (79%) in the third proximal segment of the artery. CONCLUSIONS: Our results showed that the presence of silent myocardial ischemia was predominantly associated with 3 vessels disease, and with lesions of more than 90% of occlusion, localised in the 1/3 proximal of the vessel. Patients with previous myocardial infarction and silent ischemia may belong to a subgroup with surgical indication. And so, Holter studies in these patients should be followed by angiographic studies for localization of the obstructive lesions.

Adult↗