ABSTRACT
Angiotensin-converting enzyme (ACE) inhibitors and calcium antagonists have, by reason of their potentially favourable pharmacological profile, become increasingly established in the treatment of hypertension in recent years. In a double-blind randomized study with an initial placebo phase, carried out by practising physicians and thus aimed at the "usual" practice patients with essential hypertension, we assessed (1) the antihypertensive effect and tolerability of an ACE inhibitor (ramipril, 5 mg/d) or a calcium antagonist (nitrendipine, 20 mg/d) given in a single daily dose, and (2) a possible age-dependent blood pressure (BP) effect of these therapies. In the 4 weeks' placebo phase, the two treatment groups were comparable as regards average age (49.6 and 49.4 years), age-range (27-67 and 25-64 years) and BP. Fifty-two patients completed the following 6 weeks' phase with active drug therapy. On ramipril (n = 26), the BP measured 24-25 hours after the last drug administration was reduced in the supine position from an average of 155/102 to 142/91 mmHg (mean reduction -10.1%) and in the upright position from 156/106 to 141/96 mmHg (-9.3%). Nitrendipine (n = 26) reduced the average BP from 155/102 to 147/94 mmHg (-6.8%) and from 155/106 to 146/99 mmHg (-6.6%) respectively. BP-lowering effects of both treatments were largely independent of age. Including the patients who discontinued the study prematurely because of side effects (1 on ramipril, 4 on nitrendipine), the "intention to treat analysis" shows BP normalization rates (diastolic < or = 90 mm Hg) of 55% (ramipril) and 30% (nitrendipine) respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Hypertension/drug therapy , Nitrendipine/therapeutic use , Ramipril/therapeutic use , Adult , Aged , Blood Pressure/drug effects , Double-Blind Method , Female , Heart Rate/drug effects , Humans , Male , Middle Aged , Nitrendipine/adverse effects , Ramipril/adverse effectsABSTRACT
121 patients who had been treated because of atopic dermatitis (AD) in 1967-1970 (at the age of 1-10 years) at the Department of Dermatology, University Hospital of Zurich (in- and outpatient department), were controlled by means of questionnaires, 62 of them were also personally examined. Interesting items were localisation of the AD, influences on its course, as well as micromanifestations. Infantile atopic eczema was most often localized on the face (65.3%) and on the hair-covered head (34%). The elbows and popliteal regions were attacked in 27% each. In 63% of the patients, personal examination revealed typical lesions of AD, mostly occurring on the elbows (59%) and popliteal areas (56.4%). Other common localisations were: wrist (34%), neck (31%), ankles (31%), eyelids (21%), as well as the areas behind the ears (13%). 73% of the patients had dry skin, only 8% showed a fatty one. In 66.7%, we observed the eczematic form of reaction, in 66.7% the lichenoid type, and in 10.3% the pruriginous form. 26% of the patients actually suffering from AD had perlèche or cheilitis exfoliativa, 54% of them showed follicular keratosis. 17% of the examined persons, who actually did not suffer from classic AD, had perlèche, 56% of them follicular keratosis. We discuss the possible interrelation between these findings and ichthyosis vulgaris which often occurs concomitantly. The course of AD is influenced by seasons in 77%. Deterioration of the skin conditions was predominantly found in periods of psychical stress (22%), with nervousness (33%), or with sweating (51%).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Dermatitis, Atopic/physiopathology , Animals , Animals, Domestic , Child , Child, Preschool , Follow-Up Studies , Humans , Infant , Physical Exertion , Seasons , Stress, Psychological , SweatingABSTRACT
121 patients suffering from atopic dermatitis (AD) who had been treated in the years 1967 to 1970, being then up to the age of 10, now have been controlled by means of questionnaires. 62 of them were additionally checked by way of personal interrogation and reexamination. The checking comprised of the course of the disease as well as allergies of the respiratory system (AR). The infantile phase of AD began in 55.4 percent of the patients already during the first trimenon, in 88.3 percent in the course of the first year. The average age of manifestation was at 5.5 months. At the time of the control, 58 percent of all patients and 62 percent of the reexamined patients still suffered from AD. Only 7.4 percent were free of cutaneous atopic manifestations after the infantile period. In 31.4 percent of the cases, the diseases cleared up after the infantile phase but reappeared at the age of 5 +/- 2.5 years. 61.2 percent of the patients developed a continuous transition from the infantile to the childhood phase of AD. 54.5 percent of all patients showed the following variations of AR: 33.1 percent suffered from hay fever, 28.1 percent from bronchial asthma, and 11.6 percent from perennial rhinitis. According to statistics, bronchial asthma revealed a prevalence to alternate with AD and occurred at the average age of 4.4 +/- 3.3 years, whereas rhinitis showed itself significantly later. Treatment with hyposensitization on account of AR seldom influenced the course of AD. The prognosis of AD turned out to be worse, if the disease had begun early (within the first or second trimenon), if it occurred with firstborn or single children, or if the patients also had allergies of the respiratory system.
