Microalbuminuria in non insulin dependent diabetes and essential hypertension: a marker of severe disease.

Sixty five (65) hypertensive, 91 non-insulin dependent diabetes and 50 matched, healthy controls were examined for the presence of microalbuminuria, using the Micral strip test. Microalbuminuria was observed in 25 per cent of diabetics and 21.54 per cent of hypertensive subjects. None of the controls demonstrated microalbuminuria. Diabetics with microalbuminuria were poorly controlled and demonstrated significantly higher systolic pressure. In hypertensive subjects, microalbuminuria was seen more in patients with severe disease. In both diabetics and hypertensives, presence of microalbuminuria was significantly influenced by the disease duration.

A study of hyperinsulinaemia in Indian hypertensive subjects.

Fasting and 2 hours post-prandial serum insulin levels were estimated in 100 hypertensive subjects and 25 matched, healthy controls, by radio-immuno assay (RIA). Seventy four of the 100 hypertensives exhibited fasting hyperinsulinaemia. Post-prandial hyperinsulinaemia was present in 85 hypertensives. None of the healthy individuals demonstrated hyperinsulinaemia. Although, most hyperinsulinaemic patients exhibited an abnormal lipo-protein profile, there was no statistical correlation between absolute values of lipo-protein and insulin.

Enalapril monotherapy in essential hypertension.

Thirty adults with essential hypertension (systolic BP greater than 150 mmHg or diastolic BP greater than 100 mmHg) were treated with 5-20 mg of enalapril to study its anti-hypertensive efficacy and safety. Ten patients had mild hypertension (diastolic BP greater than 90 mmHg and less than 105 mmHg), 10 had moderate hypertension (diastolic BP greater than 105 mmHg and less than 115 mmHg) and 6 had severe hypertension (diastolic BP greater than 115 mmHg). Of the 20 patients who completed the trial, 9 (45%) showed optimum reduction of BP to less than 130/90 mmHg) and a further 7 (35%) showed significant reduction. The mean fall in systolic BP was 32.5 mmHg (0-80 mmHg) and in diastolic BP was 18.5 mmHg (0-50 mmHg). The peak fall in BP was achieved in 3.5 weeks (1-6 weeks) with a mean dose of 7.2 mg of enalapril daily (5-15 mg/day). Mild side effects not needing drug withdrawal were seen in 8/20 patients (40%). Monotherapy with enalapril appears to be effective and safe as step one therapy for patients with essential hypertension.

Plasma renin activity in diabetics with and without microangiopathy.

Plasma renin activity was measured in ten diabetics with nephropathy, 10 uncomplicated diabetics and 10 normal healthy controls. All the groups were comparable for age, sex, and duration of diabetes. Plasma renin activity was found to be significantly lower in patients with nephropathy in comparison to uncomplicated diabetics and normal healthy controls. There was no correlation between plasma renin activity and mean blood pressure or degrees of renal failure. These findings raise the possibility that microangiopathic changes occurring in the glomeruli and juxta-glomerular apparatus may alter the renin-angiotensin system. Also the finding of low renin in diabetics with nephropathy may modify management policies.

Blood histaminase in phlyctenulosis.

Blood Histaminase estimations were done in 42 cases of phlyctenulosis and 25 normal subjects. Significantly higher level of blood Histaminase was found in patients of phlyctenulosis, which may be a consequence of its induction secondary to increased release of histamine in the early phase of disease.