ABSTRACT
Oliver Cromwell, Lord Protector of the British Isles, probably died of the complications of recurrent urinary tract infection and obstruction, not of a 'bastard tertian ague' as claimed soon after his death. Blaise Pascal, a pioneer in hydraulics and a contemporary of Cromwell, shortly thereafter accurately reported course and historical consequence of his death, an event which seems at least partly attributable to the effects of Pascal's law on the Protector's kidneys.
Subject(s)
Famous Persons , Urinary Calculi/history , England , France , History, 17th Century , HumansABSTRACT
A 31-year-old obese man with essential hypertension developed progressive optic disc edema despite mild-to-moderate elevations of his blood pressure. Neurologic evaluation, including cranial axial tomography, nuclear magnetic resonance scan, and lumbar puncture, was unremarkable. Further evaluation revealed that the patient had sleep apnea syndrome. In contrast to the few patients reported with this syndrome, he had normal cerebrospinal fluid pressures and hypertension. The possible interplay of sleep apnea and hypertension in the development of optic disc edema is considered.
Subject(s)
Hypertension/complications , Obesity Hypoventilation Syndrome/complications , Papilledema/etiology , Sleep Apnea Syndromes/complications , Adult , Diagnosis, Differential , Humans , Male , Sleep Apnea Syndromes/diagnosisABSTRACT
Recent investigations suggest that calcium supplementation may cause a lower arterial pressure in hypertensive individuals. We studied 32 patients with mildly elevated arterial pressure (diastolic pressure 88-95 mmHg) and inadequate dietary calcium intake (less than 750 mm/day), who were randomly assigned to placebo or 1500 mg/day elemental calcium for 4 weeks. Baseline and post-treatment urinary calcium concentrations and 3 biweekly supine blood pressures were recorded. Supine systolic blood pressure in the calcium group rose during the first 2 weeks of treatment (delta systolic blood pressure +5.9 mmHg; P less than 0.025) compared with no change in supine blood pressure for the placebo group. Within the calcium group, seven out of 15 patients had decreased or unchanged supine blood pressure during treatment. A lower urinary calcium concentration and a lower dietary sodium intake were found in this subgroup compared with those whose supine blood pressure increased with calcium administration.
