Biomedical subjects
Publications and source records attributed to U K Lindner.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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In the present study, 20 patients with both hypertension and stabile angina pectoris were treated twice daily for 6 months with 50 mg atenolol and 20 mg retard-formulation nifedipine. The effect of this treatment on blood pressure and heart rate was investigated at rest and under standardized ergometric conditions, and by means of a 24 h Holter ECG. The frequency of angina pectoris episodes in 6-week periods was reduced by 34% over 6 months. The initial decrease in systolic and diastolic blood pressure (by 25%) was maintained over the long term at rest and under exercise. Patient exercise tolerance with reduced oxygen utilization, as represented by the product of pressure x rate, showed a lasting improvement. After 6 months, monotopic ventricular premature beats in particular were reduced significantly (46%) as compared with the initial situation.
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The effects of a beta-blocker/diuretic combination and a reserpine-containing combination on exercise hypertension were compared in 20 patients suffering from mild hypertension with a diastolic pressure between 90 and 105 mmHg and a positive exercise test. This double-blind, randomized, within-patient, cross-over study involved two four-week phases, each preceded by a two-week wash-out period. The effect on the double product (tension-time index) and the physical working capacity at a heart rate of 170 bpm (PWC170) was also measured. The advantage of the preparation containing the beta-receptor blocker was apparent in both phases as physical work load increased. The PWC170 was twofold greater in the beta-receptor blocker group than in the reserpine group. The tension-time index was lowered in the normal range in both phases by the beta-blocker combination. The reserpine-containing preparation in the second phase did not further enhance the improvement produced by the beta-blocker in the first phase. These results suggest that it is worth questioning the traditional antihypertensive treatment in elderly patients, in whom mild hypertension is common, in order to better protect them from cardiovascular complications.
The efficacy and safety of doxazosin, a selective alpha 1-inhibitor, were assessed in hypertensive patients who failed to respond to nifedipine. Fifty patients were entered into a study that involved three phases: (1) a 2-week baseline period, (2) a 10-week period in which patients received doxazosin, 1 to 8 mg, once daily, and (3) a 4-week maintenance period. After 14 weeks, all 43 efficacy evaluable patients were considered therapy successes (sitting diastolic blood pressure either less than or equal to 90 mm Hg or greater than or equal to 10 mm Hg reduction) at a mean daily dose of 3.1 mg. Ninety-three percent achieved blood pressure control (sitting diastolic blood pressure less than or equal to 90 mm Hg) at a mean dose of 3.1 mg once daily. By the final treatment visit, sitting systolic and diastolic blood pressures of efficacy evaluable patients were reduced (p less than 0.05) by 16/18 mm Hg from a mean baseline of 157/103 mm Hg to a final value of 141/85 mm Hg. The most prevalent side effect was vertigo (six patients). Most side effects were mild or moderate and disappeared or were tolerated with continued therapy. No clinically significant laboratory changes were apparent, and no trends were observed with regard to organ systems or correlations with dose or duration of treatment. The investigators' global assessment was excellent or good for 98% of patients for both efficacy and toleration. From baseline to final visit there was a highly significant reduction of 17% (p less than 0.001) in the calculated coronary heart disease risk score, which was based on the Framingham equation.
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