Lithium prevents saline deoxycorticosterone acetate (DOCA) hypertension in the rat.

Uni-nephrectomized rats drinking 1% saline instead of water, were given Doca intramuscularly, 50 mg/kg BW per week for 2 weeks. The mean blood pressure in the control group was 105 +/- 4 (+/- S.E.) mm Hg, whereas in the Doca-saline group it rose to 152 +/- 5.1 (p less than 0.001). Rats, similarly treated, were placed on daily intraperitoneal lithium injections of either of two doses: 1.5 or 3.0 mEq/kg BW per day. Their blood pressures, at the end of 2 weeks of treatment, were 117 +/- 2 mm Hg and 103 +/- 2.1, respectively (p less than 0.001 vs. lithium-untreated Doca-saline rats). Water-drinking rats, receiving daily intraperitoneal lithium (3 mEq/kg BW) for 2 weeks, had normal blood pressures, not different from the controls (104 +/- 11 mm Hg). The Doca-saline and Doca-saline-lithium (1.5 mEq/kg/day) groups had similar changes in mean daily body weight, plasma sodium, osmolality, and GFR. The renal beta-adrenergic receptor density in the Doca-saline-lithium rats was in the normal range, 51 +/- 4.5 mol/mg of protein. In the Doca-saline hypertensive rats, it was significantly lower, being 27.2 +/- 3 fmol/mg of protein, p less than 0.05. These renal plasma cell membrane beta-adrenergic receptors were characterized by direct tissue binding with (-)[3H]dihydroalprenolol. These results show that lithium prevents the development of hypertension in the Doca-saline rats. The effect of lithium on the sympathetic nervous system is a possible mechanism in the prevention of the Doca-saline hypertension.

Body weight reduction necessary to attain normotension in the overweight hypertensive patient.

All 212 patients with essential hypertension and an overweight of at least 10 per cent in excess of ideal body weight, referred to out clinic in the years 1975-1979, were included in this study. The patients were advised to take a balanced low-calorie (about 1080 kcal/day) diet containing 83 g carbohydrates, 41.5 g fat and 85 g proteins. They were advised to eat salt freely. There were 40 patients who had four clinic visits or less and 49 others who could not follow their diet. Therefore the compliance-failure rate was 89/212, ie 42 per cent. Decrease in body weight resulted in a significant decrease in blood pressure, despite free ingestion of salt and with 24-h urine sodium which was not different from that obtained before dietary therapy was started. Over two-thirds of the compliant patients will achieve normal blood pressure with a loss of only one-half of their weight excess, even if at this point they are still overweight. In the group receiving no diuretic or any other anti-hypertensive therapy, 82.6 percent reached normal systolic blood pressures and 78.3 per cent reached normal diastolic blood pressures, but only 31/38 reached a body weight within 10 per cent of ideal body weight. It is concluded that most of overweight hypertensive patients can attain a normal blood pressure by reducing body weight, long before achieving the ideal weight.

The relation between therapy and herpes zoster in Hodgkin's disease.

The rate of occurrence of herpes zoster (HZ) was analyzed by the life table method in 108 Hodgkin's disease (HD) patients, diagnosed and treated during the years 1969 to 1976. Three groups, divided according to the degree of severity of the disease, were compared. The cumulative rate of occurrence of HZ at the end of the third year after diagnosis was higher in the group with intermediately extensive disease than in that with the most extensive disease (35 vs. 23%), but the difference was not significant. At the end of the fifth year, the rate was almost identical in both groups (35.3 and 35.6%, respectively). The group with the least severe form of HD had a very low HZ rate (2.2%), which was significantly different from the other two groups and close to the rate reported for normal populations. The five-year mortality rate was 0.0, 20.3 and 40.6%, respectively, in the three groups. These findings were interpreted to mean that in more advanced stages of HD, therapy and not the severity of the disease is the main factor determining the incidence of HZ. Extended field irradiation followed by a few courses of combined chemotherapy appear to have an effect similar to that of prolonged chemotherapy.