Microalbuminuria in type 2 diabetic patient with hypertension.

The prevalence of microalbuminuria (MAU) was determined in type 2 diabetic patients with hypertension attending at the Outpatient Department from October 2002 to November 2003. Nephurฎ tests were performed in all cases to detect macroalbuminuria. Patients without any documented urinalysis or those with normoalbuminuria tested previously were enrolled. Demographic and clinical data were collected through questionnaires. Micralฎ tests were subsequently carried out in those who did not have macroalbuminuria. A hundred males (aged of 59.3 + 11.0 years) and 200 females (aged of 60.3 + 10.1 years) were enrolled with the mean BMI of 27.3+ 4.3 kg/m2 (26.9 + 4.1 kg/m2 in males and 27.6 + 4.4 kg/m2 in females). It was found that he prevalence of macroalbuminuria was 7.3% (22/300), 10% in males and 6% in females (p = 0.78), while the prevalence of MAU was 40.7% (113/278), 48.9% in males and 36.7% in females (p = 0.0001). There was no significant differences between patients with normoalbuminuria and those with MAU in age, sex, ethnic, BMI, levels of BP, fasting plasma glucose, glycosylated hemoglobin, creatinine, LDL-C, HDL-C, including the rate of BP normalization recommended by ADA 2003 guidelines and the use of ACE inhibitors or angiotensin receptor blockers. The prevalence of MAU rose in relation with the duration of diabetes of 1 to 5 years (35.5%), >5 to 10 years (50.0%), and > 10 years (63.2%) as well as with an increase in duration of hypertension, i.e. 1 to 5 years (36.0%), > 5 to 10 years (42.0%), and > 10 years (51.0%). Average number of antihypertensive drugs taken was 2.5 + 1.1 to keep the mean BP of 137.5 + 12.3/80.6 + 7.8 mm Hg.

Prevalence of erectile dysfunction among treated hypertensive males.

OBJECTIVE: Study the prevalence rate of erectile dysfunction (ED) in treated hypertensive males. MATERIAL AND METHOD: Four hundred and twenty nine patients attending the outpatient clinic at Siriraj Hospital between April 2001 and October 2002 were interviewed. The International Index of Erectile Function, a 5-item version (IIEF-5) questionnaire was used. All questions were carried out by a well-trained interviewer. RESULT: Of the 429 patients (mean age of 57.5 +/- 12.0 years) interviewed, 241 cases (56.2%) reported ED. The prevalence was found to increase with age: from 0% in men aged < 40 years, 47.4% in men aged 40-59 years, and 75.3% in men aged > 60 years. Risk of ED was significantly (p < 0. 01) associated with the elderly (OR = 4.7, 95%CI= 3.1-7.1), patients who suffered from hypertension longer than 5 years (OR = 4.0, 95%CI = 2.6-6.1), those with a history of back/pelvic surgery (OR = 2.8, 95%CI = 1.4-4.8), smoking (OR = 1.5, 95%CI = 1.0-2.2), alcohol ingestion (OR = 2.0, 95%CI = 1.3-3.0), diabetes mellitus (OR = 6.3, 95%CI = 3.5-11.2), diuretics (OR = 1.9, 95%CI = 1.3-2.8), and alpha-2 agonist (OR = 7.9, 95%CI = 2.3-26.1) usage. On multivariate regression analyses, the elderly (OR = 4.0, 95%CI = 2.5-6.4), diabetes mellitus (OR = 6.4, 95%CI = 3.5-11.8), the usage of diuretic (OR = 2.1, 95%CI = 1.3-3.4), and alpha-2 agonist (OR = 6.0, 95%CI = 1.7-21.3) predicted ED (p < 0.005 in all categories). Neither history of back/pelvic operation, smoking, alcohol ingestion, overweight (BMI > or = 30 kg/m2), or any other antihypertensive medications independently predicted ED. CONCLUSION: Our results indicated that ED in male hypertensive patients is common and the cause should be sought and avoided. Diabetic patients or those who have been using diuretic or alpha-2 agonists should receive much attention and be routinely evaluated for ED.

Hypertension study among attendants at the Board of Investment Fair 2000.

To study the prevalence of hypertension, blood pressure (BP) controlled and cardiovascular risk factors in people who attended the Board of Investment 2002 Fair (BOI Fair). Altogether 1,774 participants aged more than 15 years old voluntarily participated in BP check-ups during the 3rd-17th February 2000 at the BOI Fair. Three hundred and fifty participants (19.7%) were known cases of hypertension (HT) and 340 participants (19.2%) were newly diagnosed hypertension cases (NHT). Of the HT group, 216 cases were under current treatment (61.7%) and only 69 cases (31.9%) had adequate BP control. Of the NHT group, cardiovascular risk factors were found more frequently than in normotensive participants. This study indicates the necessity of building up awareness in the population, improving in clinical detection, effectively controlling of the risk factors and the normalization of BP. This might prevent hypertension and reduce the cardiovascular disease.

The efficacy and tolerability of an angiotensin II receptor blocker, telmisartan, in Thai patients with mild to moderate essential hypertension.

This open-labeled single-blinded study was performed to evaluate the efficacy and tolerability of telmisartan in the treatment of mild to moderate essential hypertension. Each patient was assigned to take a placebo for 4 weeks followed by once daily-titrated telmisartan (40-80 mg) for 8 weeks. "Office BP" and "24-hour ambulatory BP" measurements (24-h ABPM) were recorded as scheduled. Thirty-one patients (10 males: 21 females) with a mean age of 48.1 years were enrolled. The final SBP/DBP reductions of 14.6 +/- 14.2/9.9 +/- 6.2 mm Hg were obtained. Full response defined as office DBP reduction of > or = 10 mm Hg from baseline and/or DBP < 90 mm Hg was achieved in 73.3 per cent of cases. Excluding 5 cases of white coat HT diagnosed by 24-h ABPM, full response rate (DBP reduction of > or = 10 mm Hg from baseline and/or < 85 mm Hg) was 76 per cent. Trough to peak ratio and smoothness index for SBP/DBP were highly acceptable (0.75/0.76 and 0.97/1.01, respectively). There were 4 cases of adverse events (2 cases of dizziness, 1 case of headache, and 1 case of acute myocardial infarction).

Malaria and ciprofloxacin.

Ten case of uncomplicated P. failciparum were treated with ciprofloxacin 500 mg orally twice a day for 3 days. Mean parasitemia declined from 117.2 per 200 wbc before treatment to 60, 39.4, 17.3, and 2.6 per 200 wbc at 24, 48, 72, and 92 hours after the first dose of ciprofloxcin. Two cases were malaria free after 1 month follow up. No malaria complications developed during the trail. The drug was safe and well-tolerated.