Acute blood-pressure reduction in malignant hypertension.
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Biomedical subjects
Publications and source records attributed to T Thien.
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1. Haemodynamic effects of adrenaline were studied in 27 hypertensive patients, succesively during treatment with propranol and metoprolol. In 12 patients beta-adrenoreceptor blockade was combined with diuretics and in 15 patients the blockade was combined with vasodilators. 2. During propranolol adrenaline caused a marked pressor effect: there was a considerable rise in systolic as well as in diastolic blood pressure and a marked fall in heart rate. During metoprolol there was only a slight rise in blood pressure and an increase in heart rate. 3. Forearm blood flow was decreased by adrenaline during propranolol and was increased during metoprolol. Calculated vascular resistance showed opposite changes. 4. Results were essentially the same when beta-adrenoreceptor blockade was combined with diuretics or with vasodilators and did not differ from previous results obtained in patients treated by blockade alone. 5. If adrenaline infusion can be considered as a model for acute stress, our results seem to favour a selective beta 1-adrenoreceptor blocking agent over a non-selective one, even when the blocker is combined with a diuretic or a vasodilator.
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Neurofibromas and phaeochromocytomas derive ultimately from ectodermal tissue. It is therefore not surprising that there is an increase in the incidence of phaeochromocytomas in Recklinghausen's neurofibromatosis. When investigating hypertension in patients with neurofibromatosis one must therefore consider the possibility of a phaeochromocytoma as well as vascular involvement by neurofibromatosis. Two patients with neurofibromatosis and phaeochromocytomas are described.
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