Trandolapril in Cushing's disease: short-term trandolapril treatment in patients with Cushing's disease and essential hypertension.

A study was performed on seven patients with Cushing's disease and seven age and sex matched patients with essential hypertension. The patients maintained their usual diet and sodium intake and received the ACE inhibitor trandolapril at a dose of 2 mg daily for 8 days. Trandolapril treatment resulted in an increase in the active renin and decrease in the urinary kallikrein activity in both study groups. Blood pressure decreased significantly in patients with Cushing's disease and essential hypertension after 8 days of trandolapril treatment. The opposite responses of renin and kallikrein to ACE inhibition support a possible feed-back mechanism of regulation between the renin-angiotensin system and the kallikrein-kinin system.

Losartan in Cushing's syndrome.

Eleven patients with Cushing's syndrome were included in the study. They maintained their usual sodium intake and received a single oral dose of 50 mg of the angiotensin II antagonist receptor losartan for 3 days. Losartan treatment resulted in stimulation of active renin and decrease of plasma and urinary kallikrein activity. Both systolic and diastolic blood pressure decreased independently of baseline level of active renin. The relationship between kallikrein and renin-angiotensin system are discussed.

Effects of perindopril treatment on plasma and urine of kallikrein activity and the stable metabolite of prostaglandin E2 in patients with essential hypertension.

Eleven male patients with essential hypertension were included in the study. They followed an unrestricted diet and received a single oral daily dose of 4 mg perindopril (ACE inhibitor) for 6 weeks. Plasma renin activity increased significantly and plasma aldosterone decreased significantly after perindopril treatment, suggesting that an effective blockade of angiotensin II formation was accomplished. Both systolic and diastolic blood pressure decreased. Urinary bicycloprostaglandin E2 (an inactive metabolite of prostaglandin E2) increased significantly, while plasma and urinary kallikrein activity decreased significantly after perindopril treatment. The results obtained demonstrated significant changes in prostaglandin E2 and kallikrein activity during ACE inhibition. The contributive role of these humoral factors in the hypotensive effect of perindopril are discussed.

Content of prostaglandins E and F in the blood plasma and kidneys in arterial hypertension (clinical-experimental study).

A dynamic study is made of the content of PGE and PGF2 alpha in the kidneys of rats with experimental coarctation hypertension, as well as the PGF2 alpha-metabolite in the blood plasma of the same experimental model in rats and in patients with arterial hypertension. The level of the PGF2 alpha-metabolite tends to decrease both in the animals with experimental hypertension and in hypertonic patients. In rats with 30-day hypertension low values are established in 55 per cent, while in 45 per cent there are high values of the PGE level in the kidney homogenate compared with the control group. The concentration of PGF2 alpha in the left ("endocrine") kidney (whose artery originates distally from the place of aortic coarctation) is higher than the concentration of the same PG in the right kidney. Our findings give grounds for the following assumptions: 1. The PGF2 alpha-metabolite as hormone and partly PGE in the kidneys seem to be involved in the pathogenesis of arterial hypertension as compensatory factors. 2. PGF2 alpha in the kidneys probably participates directly as one of the elements of the complex pathogenesis of arterial hypertension.

Determination of aortic distensibility and its variations in arterial hypertension.

Aortic distensibility has been determined by non-invasive techniques: radioisotope measurement, quantitative radiocardiography and indirect arterial pressure measurement with calculation of the aortic rigidity index by the formula D = PP pulse (mm or mercury) / stroke volume (ml). The index value, equalling in normotensive subjects D = 0.55 was quite close to the value obtained in haemodynamic laboratories by invasive techniques (intracardiac stroke volume and arterial pressure measurements). Using the hereby determined aortic is rigidity index by non-invasive techniques, it was established that aortic distensibility is reduced since the early phases of arterial hypertension and in early age. Lowering of aortic distensibility correlates very well with diastolic pressure rise and with advancing age of patients with arterial hypertension. The aortic rigidity index, determined by non-invasive techniques, in suggested as an additional diagnostic and prognostic criterion in arterial hypertension.

[Radioisotopic functional diagnosis in uncomplicated hypertension]. / Funktsionalna radioizotopna diagnostika pri neuslozhnenata khipertonichna bolest.

General hemodynamics of 70 patients with hypertonic disease was determined as well as the regional hemodynamics in 22 of them via radio-isotope methods, quantitative radiocardiography (QRCG) and determination of the total coronary output (TCO). Statistically significant decrease of circulating blood volume was radiocardiographically determined as well as increase of stroke volume and ventricular volumes and the indices of post-loading--general peripheral vascular resistance, index of aortic rigidity. The total coronary output is increased in patients with and without manifestations of left ventricular hypertrophy resulting from increased diastolic perfusion pressure.

[Electrocardiographic changes and hemodynamic comparisons in arterial hypertension]. / Elektrokardiografski promeni i supostavki s khemodinamikata pri arterialna khipertoniia.

The electrocardiographic criteria for left-ventricular loading were studied in patients with non-complicated arterial hypertension and were juxtaposed to the basic hemodynamic indices, determined via radio-isotope method--quantitative radiocardiography. Regular changes in the hemodynamics and electrocardiographic criteria were found, in the initial phases within the limits of the norm, and in the later ones--exceeding it. The method of correlation analysis was applied between the separate hemodynamic indisec and electrocardiographic criteria for left ventricular loading both in the separate subgroups and for the whole group. Correlation dependence with various values and sign were found. Finally, it was concluded that the classic electrocardiographic criteria for left ventricular loading in case of arterial hypertension obtained a new meaning and should be assessed with consideration given to the subjects' age and in a comparison with hemodynamic characteristic.

[Several lipid indices in hypertension]. / Niakoi lipidni pokazateli pri khipertonichno bolni

Forty four patients with arterial hypertension were examined. Thorough clinical examinations were carried out. Total lipids, total cholesterin and triglycerides in serum were determined at the laboratory. The lipid-acid composition of erythrocytes was studied by gas chromatography of the same patients. A control group of 10 healthy subjects were also examined. Hyperlipemia incidence among the patients amounts to 75 per cent. The ratio saturated (monoene and monoene) diene fatty acids was found to be increased in erythrocyte lipids of hypertonics. The deficiency of polyene fatty acids in erythrocytes was discussed to correlate to their deficiency in plasma. A relationship was established between the deficiency of polyene fatty acids in erythrocytes and the hyperlipemia present.

[Several "risk factors" in patients with ischemic heart disease and hypertension]. / Nabliudenie na niakoi "faktori na riska" pri bolni s iskhemichna bolest na surtseto i arterialna khipertoniia

The observation covers 123 patients (30 males and 43 females). Serum cholesterin and triglycerides of the patients were investigates. All the patients have been put stereotype questions about the preferred kind of main food, body weight changes and nutritional rhythm especially at an early age. The smokers and alcohol consumers were registered. The patients were subdivided into four groups according to their answers: I-without manifested preference to a special type of main food; II - with preference to protein food; III - to carbohydrate and IV - to fats. The formed groups were also characterized by the indices: changes in body weight, nutritional rhythm, body weight above the norm, smoking and alcohol consumption. The results obtained, confirmed the fact that the patients without preference to certain food, are in the habit of rational feeding, comparatively lower lipid indices in serum and the incidence of coronary symptomatics is the lowest in the same group. The scheme according to which the observation was carried out is proposed as a model of epidemiological investigations.

[Experience with the electrophoretic separation of lipoproteins on Celogel]. / Opit za elektroforetichno razdeliane na lipoproteidi vurkhu tselogel

Hydroxycellulose gel foils (cellogel) were used for the serum lipoproteid separation in conditions of routine practice, Ninety four serum tests of patients with hypertension were investigated as well as with coronary disease, essential hyperlipoproteidemia, diabetes and infarction-acute stage. Total cholesterol and triglycerides in serum were determined to the same patients. The ratio between the numerical values of the latter is confronted to the ratio between the percentage part of beta-lipoproteids and the sum of the same parts of chylomicrons and pre-beta-lipoproteids. The results are presented graphically. The phenotypes were attempted to be determined to a separate group of patients with manifested hyperlipoproteidemia.

[Comparative electro- and vectorcardiographic study of patients with systolic overloading in the left ventricle]. / Sravnitelno elektro- i vektorkardiografsko prouchvane na bolni sus sistolno obremeniavnae na liavata kamera

The potentialities of the two methods for hemodynamic disturbance degree assessment are studied in 80 patients with arterial hypertension (16-first stage, 59-second and 5-third). Five electrocardiographic and five vectorcardiographic indices are confronted to the systolic pressure in brachial artery. The electrocardiographic indices sensitivity is in the range of 25 to 62% and the sensitivity of vectorcardiographic-from 14 to 50%. The correlation dependence level of the same indices (in 30 patients) is from 0, 37 to 0, 52 for ECG and from 0, 11 to 0, 60 for VCG. Statistically significant differences of the "diagnostic" potentialities of both methods were not established as well.