Uinical Observation on Antihypertensive Effects of Nitrendipine

1) Daily dose was 10-20mg Q.D. for 12 weeks. 2) Mean systolic and diastolic pressure were decreased by 49mmHg(25.9%), and 18mmHg(16.8%) respectively. But there was no significant change in heart rate before and after treatment. 3) Systolic and diastolic blood pressure were stably maintained on the whole day. 4) There were no significant side effects except two cases of aggravated congestive heart failure and hypertension. 5) There were no significant changes on hematologic & biochemical parameters before and after treatment.

A Clinical Study on Hypertensive Encephalopathy

Hypertensive encephalopathy is an acute clinical syndrome that shows central nerve dysfunction with sudden and marked elevation in blood pressure. But its pathophysiologic mechanisms, clinical courses and prognosis are still not clear. In order to study clinical manifestations and response to treatment in patients with hypertensive encephalopathy, we reviewed 45 patients with hypertensive encephalopathy who were admitted in Dept. of Internal Medicine, National Medical Center, from January 1975 to December 1984. The following results were obtained: 1) The ratio of male to female was 1.1:1. The peak age of incidence was in the 6th and 7th decade with mean age of 57.5 years. 2) Among 45 patients, only 29 had known history of hypertension and the average duration of hypertension was 8.1+/-3.6 years. 3) The most common sympotm was severe headache (68.9%). And altered consciousness, nausea and/or vomiting, focal neurologic signs and visual disturbance were also common symptoms in decreasing order of frequency. 4) Funduscopic examination showed hypertensive retinopathy in 20 of 24 (91.7%) patients and lumbar puncture revealed increased CSF pressure in 12 of 20 (60%) patients. 5) In most patients, the mean interval to symptomatic improvement was 2.1 days after administration of anti hypertensive agents, but in 6 patients with initial mean arterial blood pressure above 170mmHg, 4 patients showed delayed response and 2 patients were expired.

Treadmill Exercise Testing in Hypertensives

Fourteen healthy persons and 43 hypertensives were subjected to treadmill exercise testing to see responses of variable influenced by various degrees of hypertension. The hypertensive were subclassified into 3 groups, mild hypertension(diast. BP<104mmHg), moderate hypertension(diast. BP<129mmHg). 1) The attainability of maximal heart rate was inversely related with levels of basal blood pressure;92.8% of normal control group attained the maximal heart rate, 87.5% of mild hypertension, 69.2% of moderate hypertension and 66.7% of moderately severe hypertension. 2) As the exercise was geaded up, the rate of increase of heart rate was lower in higher blood perssure groups than in lower blood pressuer groups. 3) The rate and extent of rise in systolic pressure was inversely related with basal systolic pressure, the systolic pressure response being least in the group with highest pressure, that is, moderately severe hypertension group. The diastolic pressure seemed to decrease somewhat in early phase of exercise only to return back to basal level at the late phase of exercise. 4) Seven of 43 hypertensive showed significant ST depression during exercise, which may be due to imbalance between oxygen demand and supply caused sither by left ventricular hypertrophy or ischemic heart disease. 5) A case was characterized by very sluggish response in increase of heart rate despite progress in exercise grade and he fell into collase 12 minutes after the interruption of exercise. The tardy response in heart rate may be a hitherto unsuspected risk predictor in exercise test.

Differential Diagnosis in Cases Showing Poor R-Wave Progression on EKG by Vectorcardiography

The vectorcardiography was performed on 34 cases with PRWP of precordial leads. We have studied the vectorcardiographic finding for the differential diagnosis of disease entities were obtrained; 1) Poor R-Wave progression of precordial leads has simply considered as suggestion of anterior myocardial infarction, ischemic heart disease, chronic lung disease and normal variant. 2) The sensitivity and specificity of myocardial infarction criteria were 85.8% and 63.0% respectively in left sagittal plane and 85.8% and 66.7% respectively in horizontal plane. 3) The seneitively and specificity of more than 90 QRS-T vector angle in left sagittal plane were 100.0% and 62.5% respectively in ischemic heart disease and myocardial infarction. 4) The sensitively and specificity of chronic lung disease criteria were 85.7% and 51.9% respectively. 5) Vectorcardiographic study was considered as effective differentiating method for patients with PRWP in EKG.