PubMed · 4740880
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T Wada. 1973. Post exercise P wave changes; correlation with ST-T.. https://doi.org/10.1253/jcj.37.361
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Hypertension or high blood pressure is a risk factor that increases risk of myocardial infarction, renal failure or cerebral stroke. The pathogenesis of hypertension is due to a variety of causes, including inherited predisposition, dietary habits, especially salt intake, smoking, and also 'general lifestyle'. But for the scientist interested in the complex interplay of physiological and molecular factors, the actual causes of high blood pressure remain uninvestigated. The following article is concerned with new reports that ouabain, a plant derivative, occurs in human beings, in whom it appears to have a hormonal function; ouabain may even play a key role in the pathogenesis of hypertension. We are thus brought a step closer to the background of cardiovascular disease; we may also be afforded a lead to a new therapeutic principle.
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Therapeutic and toxic actions of cardiac glycosides are attributed to an inhibition of Na, K-ATPase. The therapeutically relevant range is between 25% and 50% inhibition. There is a good correlation between the average steady state serum concentration of glycosides and their therapeutic action. However, therapeutic and toxic effects set in with a latency and therefore do not follow the daily variations in glycoside concentration. Although the effect follows the average serum concentrations, only the minimal concentration is measured. In principle this is only adequate if the ratio of average/minimal concentration is constant. A model calculation showed that with a constant average steady state concentration an increase in the distribution volume or a decrease in total body clearance with corresponding reduction of the daily dose lead to an increase of the minimal concentrations of 5-7%. This means a corresponding underestimation of the average concentration from the minimum concentration. However, the deviations are too small to be of clinical relevance.