ABSTRACT
Thirty patients (18 male), mean age 49.5 +/- 6.3 years, were treated with lisinopril 10-40 mg once daily for 16 weeks. The effect of treatment on left ventricular mass and improvement in left ventricular diastolic function (measured by echo-Doppler) was assessed. Blood pressure changes were measured conventionally in the clinic and by ambulatory blood pressure monitoring. Clinic blood pressure decreased from 168.3 +/- 13.8/105.5 +/- 5.4 mm Hg to 137.5 +/- 4.1/88.8 +/- 4.1 mm Hg (p < 0.005 for both systolic and diastolic blood pressures), and the heart rate from 75.2 +/- 3.7 to 74.4 +/- 7.6 beats per minute (NS). The frequency of ambulatory systolic blood pressure values > 140 mm Hg decreased in percentage from 63.3 +/- 12.8 to 29.9 +/- 9.1% (p < 0.005) and the frequency of ambulatory diastolic blood pressure values > 90 mm Hg decreased in percentage from 61.1 +/- 12.8 to 28.6 +/- 7.5% (p < 0.005). Septal and left ventricular posterior wall thickness decreased from 11.2 +/- 0.9 to 10.3 +/- 0.6 mm and from 10.9 +/- 0.9 to 10.1 +/- 0.6 mm, respectively (both p < 0.005). Left ventricular diastolic diameter and the shortening fraction did not change significantly. Left ventricular mass, calculated from left ventricular wall thickness and diastolic diameter, decreased from 132.6 +/- 11.5 to 119.9 +/- 6.3 g/m2 (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Cardiac Volume/drug effects , Diastole/drug effects , Hypertension/drug therapy , Hypertrophy, Left Ventricular/drug therapy , Lisinopril/therapeutic use , Ventricular Function, Left/drug effects , Adult , Blood Pressure Monitors , Cardiac Volume/physiology , Diastole/physiology , Dose-Response Relationship, Drug , Echocardiography, Doppler/drug effects , Female , Hemodynamics/drug effects , Hemodynamics/physiology , Humans , Hypertension/diagnostic imaging , Hypertension/physiopathology , Hypertrophy, Left Ventricular/diagnostic imaging , Hypertrophy, Left Ventricular/physiopathology , Male , Middle Aged , Ventricular Function, Left/physiologyABSTRACT
This study assessed the effectiveness of atenolol in the treatment of moderate and severe hypertension during pregnancy. Seventy patients (mean age, 30.3 +/- 6.0 years), 35.7% primiparous, were included. Three groups were formed according to Davey and MacGillivray's classification: 1) chronic hypertension without proteinuria (12 patients), 2) gestational hypertension without proteinuria (52 patients), and 3) preeclampsia (six patients). Treatment with atenolol was started when blood pressure was 150/100 mm Hg or higher after 48 hours' rest. The treatment lasted at least 1 week; follow-up was every 2 weeks up to week 36, and from then on, weekly up to delivery. If blood pressure exceeded 160/110 mm Hg and the fetus was not yet mature, a second drug was added. A significant decrease in blood pressure was observed in the three groups (group 1: 155.8 +/- 15.0/100.8 +/- 7.6 versus 135.0 +/- 12.9/85.0 +/- 6.7 mm Hg; group 2: 154.2 +/- 13.6/104.9 +/- 9.3 versus 129.6 +/- 10.2/83.7 +/- 9.1 mm Hg; group 3: 158.3 +/- 27.1/104.1 +/- 8.0 versus 129.1 +/- 6.6/87.5 +/- 6.1 mm Hg). The doses of atenolol were 62.5 +/- 23.0 mg/day in group 1, 70.0 +/- 30.0 mg/day in group 2, and 100.0 +/- 41.0 mg/day in group 3. There was no fetal mortality. No significant difference occurred in newborn body weights. Four babies from group 2 mothers had an Apgar score of less than 7 at 1 minute, but only one remained abnormal after 5 minutes. In the same group, three cases of respiratory distress were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Atenolol/therapeutic use , Hypertension/drug therapy , Pregnancy Complications, Cardiovascular/drug therapy , Adult , Female , Humans , Parity , PregnancyABSTRACT
Exercise might reduce blood pressure in mild essential hypertensive individuals, but it could raise left ventricular mass, counteracting the beneficial effects induced by a decrease in blood pressure. Seventeen (group 1) of 25 mild hypertensive patients, nonresponders to a 3-month low sodium diet (2 g/day), were admitted into a physical training program consisting of three weekly sessions of aerobics (20 minutes), bicycling at prefixed loads (20 minutes), and induced muscular relaxation (10 minutes). They were compared with 15 mild hypertensive patients (group 2), nonresponders to the low sodium diet who remained untrained. The follow-up lasted 15.7 +/- 5.8 months. There were significant blood pressure decreases in group 1 at rest (155 +/- 9.8/101 +/- 3.3 vs. 136 +/- 8.1/86 +/- 6.6 mm Hg, p less than 0.001) and at maximal effort (219 +/- 27.4/119 +/- 14.4 vs. 196 +/- 21.8/101 +/- 10.5 mm Hg, p less than 0.001). Maximal work capacity increased from 758.8 +/- 256.7 to 944.1 +/- 203.8 kpm (p less than 0.001). Echocardiographic left ventricular mass index tended to decrease (137.8 +/- 36.3 vs. 125.4 +/- 29.9 g/m2, p = NS), without any significant modification of either left ventricular volume index or left ventricular shortening fraction. No significant changes occurred in group 2. There was no correlation between blood pressure and left ventricular mass changes and left ventricular shortening fraction and left ventricular mass index changes. According to these results, it seems prudent to prescribe physical training to mild hypertensive patients because it does not induce left ventricular mass increases.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Hypertension/pathology , Myocardium/pathology , Physical Education and Training , Blood Pressure , Blood Volume , Diastole , Exercise Test , Female , Heart/physiopathology , Heart Rate , Heart Ventricles , Humans , Hypertension/physiopathology , Male , Middle AgedABSTRACT
Changes in left ventricular mass (LVM) were measured by echocardiography in 104 mild and moderate essential hypertensives treated with only one drug for at least 12 months. They were classified into 4 groups. G1: 40 patients (p) treated with atenolol (73.6 +/- 31.8 mg daily), G2: 32 p treated with enalapril maleate (17.7 +/- 8.7 mg daily), G3: 22 p treated with nifedipine (44.0 +/- 10.8 mg daily), G4: control group, 10 mild hypertensives without medication. At the end of the treatment blood pressure (BP) fell significantly in the first 3 groups (G1: 155 +/- 19/.98 +/- 11 vs. 136 +/- 11/86 +/- 15 mm Hg, G2: 163 +/- 19/104 +/- 10 vs. 139 +/- 12/90 +/- 8 mm Hg, G3: 166 +/- 17/103 +/- 7 vs. 142 +/- 7/85 +/- 7 mm Hg, p less than 0.001), but remained unchanged in G4. Heart rate was reduced significantly only in G1. Body weight did not change (71 +/- 7 vs. 67 +/- 7, p greater than .05). Patients were subclassified according to wether they had normal (N, LVM less than 120 g/m2 in females, LVm less than 135 g/m2 in males) or increased (H) LVM. There was a significant reduction in LVM in all H subgroups (G1 163 +/- 37 vs. 131 +/- 27 g/m2, G2: 155 +/- 19 vs. 126 +/- 21 g/m2, G3: 158 +/- 2 vs. 138 +/- 38 g/m2, p less than .005). The LVM/left ventricular end-diastolic volume ratio (M/V) fell in all H subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Atenolol/therapeutic use , Cardiomegaly/drug therapy , Enalapril/therapeutic use , Hypertension/drug therapy , Adult , Blood Pressure/drug effects , Cardiomegaly/etiology , Drug Administration Schedule , Female , Humans , Hypertension/complications , Male , Middle Aged , Research DesignABSTRACT
Changes in left ventricular mass (LVM) were measured by echocardiography in 104 mild and moderate essential hypertensives treated with only one drug for at least 12 months. They were classified into 4 groups. G1: 40 patients (p) treated with atenolol (73.6 +/- 31.8 mg daily), G2: 32 p treated with enalapril maleate (17.7 +/- 8.7 mg daily), G3: 22 p treated with nifedipine (44.0 +/- 10.8 mg daily), G4: control group, 10 mild hypertensives without medication. At the end of the treatment blood pressure (BP) fell significantly in the first 3 groups (G1: 155 +/- 19/.98 +/- 11 vs. 136 +/- 11/86 +/- 15 mm Hg, G2: 163 +/- 19/104 +/- 10 vs. 139 +/- 12/90 +/- 8 mm Hg, G3: 166 +/- 17/103 +/- 7 vs. 142 +/- 7/85 +/- 7 mm Hg, p less than 0.001), but remained unchanged in G4. Heart rate was reduced significantly only in G1. Body weight did not change (71 +/- 7 vs. 67 +/- 7, p greater than .05). Patients were subclassified according to wether they had normal (N, LVM less than 120 g/m2 in females, LVm less than 135 g/m2 in males) or increased (H) LVM. There was a significant reduction in LVM in all H subgroups (G1 163 +/- 37 vs. 131 +/- 27 g/m2, G2: 155 +/- 19 vs. 126 +/- 21 g/m2, G3: 158 +/- 2 vs. 138 +/- 38 g/m2, p less than .005). The LVM/left ventricular end-diastolic volume ratio (M/V) fell in all H subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)
ABSTRACT
En 104 hipertensos esenciales leves y moderados se midieron mediante ecocardiografía los cambios inducidos en la masa ventricular izquierda (MV) por el tratamiento con monodrogas durante por lo menos 12 meses. Los pacientes (p) fueron clasificados en 4 grupos (G). G1: 40p tratados con atenolol, G2: 32p tratados con maleato de enalapril, G3: 22p tratados cocn nifedipina, G4: grupo control, 10 en los primeros 3 grupos, pero no se modificó en el G4. La frecuencia cardíaca se redujo significativamente solo en el G1. El peso corporal no varió. Los pacientes fueron subclasificados de acuerdo a que su MV fuese normal (N, MV, < 120 g/m2 en hombres) o aumentada (H). Hubo una reducción significativa de la MV en todos los grupos H. La relación MV/volumen de fin de diastole del ventrículo izquierdo (M/V) cayó en todos los grupos H. Hubo una correlación pequeña, aunque significativa entre la PA vbasal y la MV. La regresión de la MV fue mayor en los ventrículos hipertróficos, sin que se produjesen cambios significativos en a fracción de acortamiento. En base a estos resultados parecería razonable elegir para el tratamiento las drogas antihipertensivas que reduzcan la MV (AU)
Subject(s)
Humans , Male , Female , Hypertension/drug therapy , Atenolol/therapeutic use , Enalapril/therapeutic use , Blood Pressure/drug effects , Cardiomegaly/drug therapy , Control Groups , Drug Administration Schedule , Hypertension/complications , Cardiomegaly/etiologyABSTRACT
En 104 hipertensos esenciales leves y moderados se midieron mediante ecocardiografía los cambios inducidos en la masa ventricular izquierda (MV) por el tratamiento con monodrogas durante por lo menos 12 meses. Los pacientes (p) fueron clasificados en 4 grupos (G). G1: 40p tratados con atenolol, G2: 32p tratados con maleato de enalapril, G3: 22p tratados cocn nifedipina, G4: grupo control, 10 en los primeros 3 grupos, pero no se modificó en el G4. La frecuencia cardíaca se redujo significativamente solo en el G1. El peso corporal no varió. Los pacientes fueron subclasificados de acuerdo a que su MV fuese normal (N, MV, < 120 g/m2 en hombres) o aumentada (H). Hubo una reducción significativa de la MV en todos los grupos H. La relación MV/volumen de fin de diastole del ventrículo izquierdo (M/V) cayó en todos los grupos H. Hubo una correlación pequeña, aunque significativa entre la PA vbasal y la MV. La regresión de la MV fue mayor en los ventrículos hipertróficos, sin que se produjesen cambios significativos en a fracción de acortamiento. En base a estos resultados parecería razonable elegir para el tratamiento las drogas antihipertensivas que reduzcan la MV
