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Biomedical subjects

P Balansard

Publications and source records attributed to P Balansard.

9 recordsLinked to original sources

Effect of atenolol, a new cardioselective beta-blocker, on plasma renin activity in treatment of hypertension.

Atenolol, a cardioselective beta-blocking drug, was prescribed in doses of 100 mg b.i.d. in 23 patients with essential hypertension. At the end of the first month of treatment with Atenolol we found a significant fall in blood pressure, heart rate and plasma renin activity (P.R.A.). Besides, there existed a relationship between changes in diastolic blood pressure, in mean arterial pressure and initial plasma renin activity, and a relationship between changes in blood pressure and changes in P.R.A. It results from this finding that pretreatment P.R.A. is of predictive value of short-term efficacy of the beta-blocker. This correlation was borderline in 21 patients after a mean of 7 month treatment and could no be found for 12 cases after a mean of 10 month-treatment while the fall in P.R.A. was still significant. It therefore appears that--with reserve of the representativeness of the sample--quantitative relations between the antihypertensive effect of Atenonol and P.R.A. are no longer significant on long-term treatment.

Adult

[Abnormalities of insulin secretion in coronary patients. Apropos of 67 cases].

The curve of blood insulin levels recorded during the oral provoked hypoglycaemia test (OPHG) was studied in 67 proven coronary patients. None of the curves obtained was normal. The abnormalities found in this way are of two types: either a hypoinsulinaemic response, with a high non-retarded peak (type 1) or a high retarded peak (type 2), or else a hypoinsulinaemic response, with a flat curve (type 3) or a very small late peak (type 4). The possible role of these abnormalities of insulin secretion in the pathogenesis of atheroma is discussed. The correlations between age, sex, obesity, hypertriglyceridaemia, and the OPHG curve are investigated. The preliminary results of a test in which insulin levels are monitored after intravenous provoked hypoglycaemia, followed by tolbutamide, are reported.

Adult

[Treatment of rhythm disorders by fenoxedil hydrochloride].

Fenoxedil chlorhydrate (FC), which is used as a treatment for cerebral circulatory failure and peripheral vascular disease, has been given to 100 patients with a cardiac arrhythmia: atrial fibrillation (78 cases), atrial flutter (4 cases), atrial tachysystole (2 cases), ventricular extrasystoles (12 cases), and supraventricular extrasystoles (4 cases). FC has been prescribed alone, or as a complement to current anticoagulant or digitalis treatment; combination with prenylamine, amiodarone, dysopyramide or a drug of the quinidine group must always be avoided, and the potassium level checked and corrected if necessary before treatment. In 78 cases of atrial fibrillation, the authors found that sinus rhythm was restored in 58 (74.4%); four cases of flutter were restored, and one case out of two of atrial tachycardia. In case of supraventricular and ventricular extrasystoles the results are less clear, and merit a further study with a larger number of cases. The electrocardiographic disorders encountered in this series have been evaluated: lenghthening of the QT interval, disorders of atrioventricular conduction, sinus inhibition. They were either produced by or aggravated by the FC. No cases of axis deviation were encountered. The authors make mention of the complications observed by other authors, but draw a distinction between the prescription of FC in cases of cerebral vascular insufficiency, without previous knowledge of the exact cardiac status of the patient (otherwise there is a risk of severe accidents), and the use of FC in cases of arrhythmia which have undergone full assessment before the drug is used. According to this study, FC appears to be a very effective anti-arrhythmic agent, but its use demands very rigorous clinical and electrocardiographic supervision.

Anti-Arrhythmia Agents

[Propranolol and arterial hypertension: study with frequent daily checking of blood pressure and serum levels after 1 week of treatment].

In order to establish correlations between serum levels of Propranolol, blood pressure in hypertensive patients and cardiac rate, these parameters have been recorded at three different times in a day and after a week. This study points out that therapeutic response is variable. However the patients may be classified into 4 groups. This classification and the value of serum levels of propranolol are discussed.

Blood Pressure

[Sinus arrest: severe complication of intravenous lidocaine].

Sinus arrest occured after intravenous administration of Lidocaine in therapeutic disage in a patient with coronary artery disease and sinus node disease. This complication of Lidocaine, though rare (this case is the fourth of the literature), induces to use this drug carefully in patients with sinus node disease. Temporary pacing is recommended if Lidocaine must be used in this group of patients.

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