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Biomedical subjects

S B Dimmitt

Publications and source records attributed to S B Dimmitt.

31 records · Page 2Linked to original sources

Urine albumin excretion in healthy subjects.

The relationship between cardiovascular risk factors and urine albumin excretion were studied in 474 healthy office workers. Albumin concentration was measured fresh in first morning midstream urines. Lifestyle details, oscillometric BP and lipids were assessed. Subjects with urine albumin concentration above the median (5.30 mg/l) were compared with those with albumin concentration below the median. Subjects with above median urinary albumin concentration had higher systolic blood pressure (mean 115.2 vs. 113.1 mm Hg for above median, respectively, P = 0.06), were more likely to be male (56.8 vs. 45.0%, respectively, P = 0.01) and to have lower levels of high density lipoprotein (HDL)-cholesterol (mean 1.34 vs. 1.41 mmol/l, P = 0.006). Multivariate analysis following adjustment for urine creatinine concentration to allow for urine volume confirmed the relationship with systolic blood pressure (P = 0.01) and sex (P = 0.02), and in addition revealed a relationship with alcohol intake approaching significance (mean intake 70.8 and 76.0 g/week, respectively, P = 0.06). The univariate finding of increased albuminuria with lower HDL-cholesterol appeared to be attributable to the associated relationships with male sex and lower alcohol intake. The relationships between albumin excretion and BP, male sex and alcohol intake may reflect the effects of asymptomatic developing arterial disease. The relationship with BP may also be a consequence of effects on glomerular hydrostatic or interstitial renal pressure on albumin filtration or resorption. Very low level urine albumin excretion in healthy subjects is associated with factors which predict arterial disease. Urine albumin excretion may prove to be a useful early marker of cardiovascular disease in population studies.

Adolescent↗

Low density lipoprotein composition and oxidizability in coronary disease--apparent favourable effect of beta blockers.

The oxidative modification of LDL in vivo may have an important role in atherogenesis. To determine whether LDL fatty acid, anti-oxidant composition and sensitivity to oxidation in vitro is different in subjects with established atherosclerosis we compared 20 men with angiogram proven coronary disease with 25 controls without clinical evidence of arterial disease. LDL-cholesterol, total triglycerides and LDL fatty acid composition did not differ significantly between the groups. LDL oxidation lag time and oxidation rate in coronary patients (132 min, 0.02 absorbance units/min) and controls (140, 0.017) were not significantly different. However coronary disease subjects taking beta-blockers had evidence for reduced LDL oxidizability (lag time 148 +/- 7 min; oxidation rate 0.017 +/- 0.002 abs units/min) compared with those not on beta-blockers (lag time 114 +/- 7 min, rate 0.025 +/- 0.003, P < 0.005). LDL beta-carotene was significantly lower in coronary patients (0.92 mumol/mmol LDL cholesterol; controls 1.58; P = 0.001). LDL alpha-tocopherol appeared lower in coronary patients (2.8 mumol/mmol LDL cholesterol; controls 3.3; P = 0.056) and was significantly lower in smokers (2.56; non-smokers 3.24; P = 0.04). LDL oxidation rate was negatively correlated with LDL alpha-tocopherol (r = -0.51, P = 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗

Non-diabetic microalbuminuria in clinical practice and its relationship to posture, exercise and blood pressure.

1. The effects of posture and exercise on the relationship between low-level urinary albumin excretion (microalbuminuria) and blood pressure was investigated in two groups of non-diabetic patients at increased cardiovascular risk: 21 otherwise healthy patients with untreated essential hypertension (blood pressure greater than 160/90 mmHg), and 14 age-matched patients with blood pressure at presentation within the normotensive range (less than 160/90 mmHg) attending a cardiovascular clinic for assessment of chest pain. 2. A significant linear relationship between logarithmically transformed 'spot' urinary albumin/creatinine ratio and simultaneous clinic blood pressure existed when data from both groups of patients were analysed (r = 0.58, P less than 0.05). The relationship between the scatter plot of blood pressure and the albumin/creatinine ratio appeared most marked when the mean blood pressure exceeded 120 mmHg. 3. In patients with essential hypertension, clinic systolic blood pressure was related to the albumin/creatinine ratio in simultaneous 'spot' urine samples (r = 0.69, P less than 0.05) and also to the albumin/creatinine ratio in early-morning urine samples (r = 0.51, P less than 0.05). However, the relationship between clinic blood pressure and simultaneous 'spot' urinary albumin/creatinine ratio in the patients with chest pain did not achieve significance when analysed independently. 4. Hourly averaged ambulatory intra-arterial blood pressure was recorded in four of the patients with essential hypertension during normal daytime activity, and a significant correlation with the simultaneous hourly daytime urinary albumin/creatinine ratio was found (r = 0.65, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Xamoterol in the treatment of orthostatic hypotension associated with multiple system atrophy (Shy-Drager syndrome).

The effect of xamoterol on the orthostatic hypotension associated with Shy-Drager syndrome was investigated in three patients. Intra-arterial blood pressure was measured during a control period and during treatment with xamoterol, both in a cardiovascular investigation laboratory and for 24 h of unrestricted activity using portable apparatus. Xamoterol lessened the total number of symptomatic episodes of orthostatic hypotension by 67 per cent. Average untreated 24-h intra-arterial blood pressure was 132/78 mmHg; during treatment with xamoterol it rose to 138/90 mmHg. However episodes of severe hypertension (defined as a systolic intra-arterial blood pressure above 200 mmHg) were more frequent with xamoterol. Although xamoterol attenuated orthostatic hypotension, careful monitoring of ambulatory blood pressure may be necessary, particularly at the start of treatment, because of the development of severe supine hypertension. Intravenous test doses of xamoterol did not predict either the attenuation of orthostatic hypotension or the development of supine hypertension in all patients.

Adrenergic beta-Agonists↗

Usefulness of ophthalmoscopy in mild to moderate hypertension.

A panel of two physicians and two ophthalmologists examined 25 patients with untreated essential hypertension by direct ophthalmoscopy and assessment of fundal photographs; daytime ambulatory sphygmomanometric blood pressure monitoring, estimation of left ventricular mass by electrocardiography and two-dimensional echocardiography, and measurement of urinary microalbumin excretion were also carried out. No relation was found between blood pressure determined by clinic or ambulatory sphygmomanometry and retinopathy. The retinal features sought on fundal photographs were the percentages of arteriovenous crossings with venule nipping, venule deviation, or attenuation of venular light reflex. The ratio of arteriolar to venular diameter was measured. Only focal narrowing of arterioles was associated with higher blood pressure. There was no independent relation between retinal features and age, measures of left ventricular mass, or urinary microalbumin excretion. Assessment of arteriovenous crossing abnormalities by direct ophthalmoscopy was subject to wide variability among the panel members. Direct ophthalmoscopy was not clinically useful in the assessment of mild to moderate hypertension, whereas urinary microalbumin excretion correlated strongly with clinic blood pressure.

Adult↗

Verapamil withdrawal as a possible cause of myocardial infarction in a hypertensive woman with a normal coronary angiogram.

Verapamil is an effective and relatively-safe antihypertensive drug. Serious adverse effects are uncommon and mainly have been related to the depression of cardiac contractility and conduction, especially when the drug is combined with beta-blocking agents. We report a case in which myocardial infarction coincided with the introduction of captopril and the withdrawal of verapamil in a previously asymptomatic woman with severe hypertension. Possible mechanisms that involve a verapamil-related increase in platelet and/or vascular alpha 2-adrenoreceptor affinity for catecholamines are discussed.

Adult↗

Chlamydial endocarditis.

Echocardiographic diagnosis of a case of endocarditis, subsequently proven to be due to a chlamydial organism, is described. Early echocardiographic diagnosis guided initial medical management and directed urgent surgical intervention when the patient deteriorated. Reported cases of chlamydial endocarditis are reviewed.

Antigens, Bacterial↗

Progesterone secretion and ovarian blood flow in the pregnant rat.

A venous outflow technique was used to monitor the rates of ovarian blood flow and progesterone secretion simultaneously during periods of 2-3 h in nine rats pregnant for 16 days and anaesthetized with sodium pentobarbitone. The rate of ovarian blood flow was 0 x 460 +/- 0 x 135 (S.D.) ml/min and that of progesterone secretioin was 27 x 2 +/- 7 x 0 microgram/h per ovary. Within rats, progesterone secretion was unrelated to the rate of ovarian blood flow (common correlation coefficient, r = 0 x 136; degrees of freedom = 61; P, not significant) but the latter was inversely related to the arterio-venous difference in the concentratioin of progesterone (r = --0 x 731; P < 0 x 01).

Animals↗

Ovarian venous blood flow in non-pregnant and pregnant rats.

A modified venous outflow technique was used to measure ovarian blood flow in the rat. The rate of flow through the right ovary was 0-198+/-0-009 (S.E.M.), 0-476+/-0-076 and 0-958+/-0-162 ml/min in six Day 0 (dioestrous), five Day 16 and six Day 22 pregnant rats respectively. The intravenous administration of 50 i.u. human chorionic gonadotrophin increased ovarian blood flow by 26+/-4, 57+/-19 and 46+/-9% respectively, from 2 to 8 min after the injection. The present ovarian venous outflow results are substantially higher than those previously reported in the rat but agree with values determined with radioactive microspheres.

Animals↗