卡托普利联合硝苯地平缓释片治疗72例原发性高血压患者的临床研究

目的探讨原发性高血压(EH)采用卡托普利联合硝苯地平缓释片治疗的疗效。方法选取2015年11月～2017年11月我院收治的144例EH患者,随机分组进行对照研究,对照组(72例)予以卡托普利治疗,观察组(72例)在对照组基础上加用硝苯地平缓释片治疗,对比两组总有效率、舒张压(DBP)、收缩压(SBP)、不良反应发生率。结果观察组总有效率为94.44%,高于对照组81.94%(P0.05);两组治疗后DBP、SBP水平均低于治疗前,且观察组DBP、SBP降低幅度大于对照组(P0.05);观察组不良反应发生率11.11%与对照组6.94%相比无显著差异(P0.05)。结论 EH采用卡托普利联合硝苯地平缓释片治疗,可降低患者血压水平,安全可靠,疗效显著。     

脑卒中急性期血压的变化规律及肢体运动前后血压变化

目的：监测脑卒中急性期患者血压变化规律, 观察急性脑梗死患者肢体运动前后血压变化的幅度。方法：随机选择脑卒中急性期患者148例, 分为两组,其中，脑梗死组102例，脑出血组46例。观察急性期两组患者的血压变化，测量102例急性脑梗死患者右侧肱动脉血压，床边肢体松动运动前测量1次,运动后即5、10、15min各测量1次。结果：脑卒中急性期血压增高者占86.5%，以后在无特殊降压措施并且不用对血压有影响的药物条件下，血压随时间逐渐下降。第7天与第1天比较,收缩压(SBP)及舒张压(DBP)均有明显下降[SBP(145.6±16.3)vs(157.1±22.5) mmHg (P<0.01);DBP(84.7±15.2)vs(89.8±21.2)mmHg(P<0.01) ];脑出血组动态血压均高于脑梗死组。[SBP(159.7±19.8)vs(154.7±23.4)mmHg；DBP(96.2±13.1)vs(91.3±17.5)mmHg (P<0.01)]。 86%的脑卒中患者血压的昼夜节律消失。脑梗死组床边肢体松动运动前后血压比较，差异无显著性(P>0.05)。结论：脑梗死急性期患者血压增高, 血压有自发下降的趋势；脑出血患者血压水平比脑梗死者高；绝大多数脑卒中患者血压的昼夜节律消失；脑梗死患者床边肢体松动运动前后的血压比较差异无显著性。     

伊贝沙坦治疗轻、中度原发性高血压的临床研究

目的观察伊贝沙坦对轻、中度原发性高血压患者的降压疗效。方法5 0例轻、中度高血压患者服用伊贝沙坦 ,每天 1次 ,每次 15 0mg ,连服 6周。采用偶测血压和 2 4h动态血压监测。结果临床总有效率为 84 % ,显效为 72 % ,有效为 16 % ,未达标者 8例 ,收缩压 (SBP)从治疗前的 (15 2 .4± 11.5 )mmHg降至治疗后 (130 .2± 8.2mm)Hg(P <0 .0 1) ,舒张压 (DBP)从治疗前 (96 .4± 4 .8)mmHg降至治疗后 (82 .1± 4 .6 )mmHg。动态血压监测SBP下降幅度为 (18.9± 0 .9)mmHg ,DBP下降幅度为(12 .8± 3.1)mmHg。降压谷 /峰比率 :SBP为 6 8% ,DBP为 6 3% ,血压负荷均有不同程度的降低。结论口服安博维对轻、中度原发性高血压降压疗效确切 ,不良反应少而轻。     

静脉滴注尼卡地平治疗老年人高血压危象的临床观察

目的　观察静脉滴注尼卡地平对老年人高血压危象的疗效及安全性。方法　选择老年人 (≥ 6 0岁 )高血压危象患者 92例 ,治疗前平均收缩压 (SBP) (2 36± 16 )mmHg和 (或 )舒张压 (DBP) (12 5± 11)mmHg ,以恒速输液泵持续静脉滴注尼卡地平 (佩尔地平 ) ,剂量为 0 5～ 6 μg·kg-1·min-1,根据血压每 5min调整剂量 1次 ,每次增加 5 μg/min ,直至达到目标血压 15 0～ 16 0 /10 0～ 110mmHg,然后维持此血压水平 1～ 3d。结果　用药后 5min、10min、30min、1h、2h的平均血压降至 2 31/12 5、2 2 6 /12 3、2 17/12 1,2 0 7/118、2 0 3/10 7mmHg ,2 4h后达最大效应 ,血压平均为 (16 8± 11) /(10 0± 9)mmHg ,并稳定至用药结束。未发现严重不良反应。结论　静脉滴注尼卡地平治疗老年人高血压危象起效快、降压作用平稳、安全性高。     

氟西汀及心理治疗对原发性高血压伴抑郁症患者的作用

目的:观察氟西汀及心理治疗对原发性高血压伴抑郁症患者血压和生活质量的影响。方法:将127例原发性高血压伴抑郁的患者采用随机数字表法分为治疗组和对照组,治疗组62例在口服硝苯地平控释片30mg/d基础上给予心理治疗及氟西汀20mg/d口服,共12周;对照组65例仅给以硝苯地平控释片30mg/d口服。观察两组患者血压控制及生活质量改善情况。结果:①12周后治疗组降压总有效率79%(49/62),而对照组总有效率57%(37/65),两组之间有差异(χ2=14.2,P<0.005)。②治疗组55例平均收缩压(SBP)及舒张压(DBP)分别下降(19.2±2.1)mmHg及(10.6±1.2)mmHg而对照组58例分别下降(10.2±1.6)mmHg及(5.2±0.7)mmHg,治疗组下降幅度优于对照组(t=26.0,P<0.01;t=29.8,P<0.01)。③生活质量定量观察:治疗前后体力健康、精神健康、总体功能评分及生活质量总分的改变,治疗组高于对照组(分别为3.5±4.1比2.1±4.1,t=1.98,P<0.05;4.0±5.0比1.6±4.7,t=3.77,P<0.01;2.3±3.4比0.9±3.4,t=2.29,P<0.05;9.6±8.7比5.5±9.1,t=2.66,P<0.01)。④生活质量定性观察:治疗组在体力健康、精神健康、总体功能方面改善的百分比高于对照组(分别为53.4%比23.7%,χ2=24.5,P<0.005;60.3%比27.8%,χ2=26.4,P<0.005;44.7%比25.2%,χ2=10.2,P<0.005)。结论:氟西     

平板运动试验观察原发性高血压降压药使用者运动血压特征

目的 观察原发性高血压降压药使用者平板运动试验时运动血压特征。方法 回顾分析590例平板运动试验者临床资料,记录各组运动中3 min,运动峰值,运动后1 min、3 min及5 min仰卧位血压与静息直立位血压变化值。观察各组运动曲线的差异及特征,了解降压药控制静息血压情况与运动血压变化特征。结果 整体运动SBP趋势组间比较:各组与正常组差异均有统计学意义(P<0.01);各阶段点成对比较:运动峰值及恢复各阶段原发性高血压组与观察2组变化趋势相近,且总体收缩压(SBP)增量低于观察1组、正常组SBP平均值约10 mmHg(P<0.05及P<0.01)。整体运动舒张压(DBP)趋势组间比较:各组与正常组比较差异均有统计学意义(P<0.01);各阶段点成对比较:运动峰值时高血压组DBP变化幅度小(P<0.05),运动后1 min、3 min、5 min,观察2组和原发性高血压组DBP降低明显(P<0.01),低于静息DBP值6～8 mmHg。结论 药物控制不佳的高血压患者,运动峰值SBP增量低于正常组10 mmHg左右。峰值DBP轻度增高,恢复期平均DB...     

厄贝沙坦治疗前后原发性高血压患者血浆内皮素-1的变化

目的　观察厄贝沙坦治疗前后原发性高血压 (EH)患者血浆内皮素 - 1(ET - 1)水平的变化 ,探讨ET - 1在EH发展中所起的作用。方法　 88例高血压患者作为EH组 ,服用厄贝沙坦治疗 4周 (剂量 15 0～ 30 0mgd-1) ,4 8例健康人作为对照组。测量两组血压和血浆ET - 1水平 ,检测厄贝沙坦治疗后EH组血压和血浆ET - 1的变化。结果　3例患者因不良反应退出研究。EH组与对照组血浆ET - 1水平分别为 90 .2 4± 2 9.2 3ng/L、5 8.31± 11.4 2ng/L ,前者较后者显著增高 (P <0 .0 5 ) ,且高血压III级ET - 1水平显著高于高血压II级 (P <0 .0 5 ) ,高血压II级ET - 1水平显著高于高血压I级 (P <0 .0 5 )。厄贝沙坦组治疗后ET - 1水平为 6 8.98± 8.2 0ng/L ,较治疗前显著降低 (P <0 .0 1)。厄贝沙坦组治疗前SBP和DBP分别为 16 8.34± 12 .92、112 .33± 8.0 4mmHg ,治疗后分别为 12 8.32± 18.4 3、82 .76± 4 .2 2mmHg ,均较治疗前明显降低 (P <0 .0 5 )。结论　EH患者血压与ET - 1水平正相关 ,厄贝沙坦在有效降压的同时 ,血浆ET - 1水平亦降低。     

西尼地平、阿罗洛尔和咪达普利对原发性高血压患者生活质量的影响及疗效比较

目的:比较钙离子拮抗剂西尼地平与阿罗洛尔、咪达普利对原发性高血压患者生活质量的影响和降压疗效。方法:符合入选标准的62例高血压患者在2周清洗期后,采用随机数字表随机分为尼莫地平组(n=22),阿罗洛尔组(n=20),咪达普利组(n=20),分别服用国产西尼地平5mg/d、阿罗洛尔20mg/d、咪达普利5mg/d治疗。4周后若患者舒张压未降至90mmHg以下,药物剂量相应增加治疗2周结束。血压控制满意者继续原剂量治疗2周。监测治疗前后血压、心率、血常规、尿常规、血糖、血脂、肝肾功能、电解质等指标的变化。试验前后采用Croog的高血压生活质量量表进行评分。结果:西尼地平和阿罗洛尔、咪达普利都可以明显降低血压,3组血压在研究前后分别为犤(149±11)/(101±3)mmHg和(127±15)/(83±9)mmHg,(152±19)/(135±11)mmHg和(102±5)/(86±10)mmHg,(153±16)/(136±15)mmHg和(102±3)/(87±16)mmHg,P<0.01犦,降压疗效、总有效率在各组之间无显著差异。阿罗洛尔有明显减慢心率的作用犤(76±8)次/min和(65±10)次/min,P=0.004犦。治疗前后,3组患者的健康愉快感评分分别为11.8±4.1和14.6±3.9,12.1±4.5和14.9±3.9,12.4±4.2和15.7±5.3,躯体症状评分分别为11.3±2.8和13.5±3.5,10.4±3.6和13.8±4.8,10.9±3.8和14.1±4.8,生活     

非洛地平治疗原发性高血压病的疗效观察

目的 观察非洛地平对原发性高血压病的疗效。方法 原发性高血压病102例,其中非洛地平组56例,硝苯地平组46例。排除继发性高血压、急进型高血压、脑血管意外等病人。用随机方法进行自身对照试验,测量非洛地平组服药后第1、2、4周时的血压,进行自身服药前、后值对比。设硝苯地平对照组与非洛地平组对比服药后第1、2周的血压值。结果 ①自身对照试验病人在服药第1、2、4周的降压疗效结果:第1周平均显效率76.88％,第2周平均显效率88.5％,第3、4周显效率达100％。②非洛地平组与硝苯地平组对比,1周后非洛地平组DBP 90.71±7.28 mmHg,硝苯地平组DBP 96.43±10.01 mmHg,2周后非洛地平组DBP 89.83±6.02 mmHg,硝苯地平组DBP 95.0±8.60 mmHg。结论 非洛地平是治疗轻、中度原发性高血压的有效药物,其疗效好,副作用少,优于硝苯地平。     

综合护理干预在妊娠期高血压护理的效果

目的 分析对妊娠期高血压的孕妇实施综合护理干预的临床效果;方法 将84例妊娠期高血压孕妇随机分为常规干预组与综合护理干预组,前者在治疗过程中配合常规护理措施,后者则是在前者护理的基础上实施综合护理干预,比较两组干预后的血压水平,随访至分娩统计胎儿不良妊娠结局发生率;结果 干预之前,两组孕妇DBP(98.41±15.31)mmHgVS(98.43±15.28)mmHg、SBP水平(158.21±11.57)mmHg VS(158.24±11.54)mmHg无统计学差异(P>0.05),不同干预方案2个月后,而综合护理干预组DBP(82.24±3.15)mmHg、SBP(124.54±8.25)mmHg低于常规干预组(87.14±3.25)mmHg、(139.54±8.56)mmHg,且P<0.05,综合护理组的胎儿不良结局总发生率4.76%低于常规干预组16.67%,且P<0.05;结论 针对妊娠期高血压孕妇,实施综合护理干预,有助于降低其血压水平,降低胎儿不良妊娠结局发生率。     

Effects of combination therapy with captopril and nifedipine in severe or resistant hypertension

To assess the effect of potent vasodilator therapy in patients with severe or resistant hypertension, 10 patients underwent therapy with captopril and nifedipine alone and in combination. Blood pressure (BP), heart rate, and blood chemistry values were monitored for 4 weeks during captopril monotherapy and after 8 weeks during combination therapy with captopril and nifedipine. Compared with baseline, the BP decreased during captopril monotherapy (180 +/- 11/98 +/- 7 vs. 209 +/- 16/118 +/- 12 mm Hg; P less than 0.005). After the addition of nifedipine, the BP was further reduced (148 +/- 23/85 +/- 16 mm Hg), but there was no change in heart rate. In three patients not achieving the diastolic BP goal during combination therapy with dosing every 8 hours, automatic 24-hour ambulatory BP monitoring demonstrated lack of antihypertensive control for only the last 2 to 3 hours of the dosing interval. These data demonstrate that combination therapy with captopril and nifedipine is effective in patients with severe hypertension, but frequent dosing intervals are necessary for adequate antihypertensive control.     

Effects of cardiac rehabilitation program on exercise capacity and chronotropic variables in patients with orthotopic heart transplant

AIM: To evaluate the effects of home- and hospital-exercise programs on exercise capacity and chronotropic variables in patients with heart transplantation. METHODS: Forty patients were randomized into two groups either hospital- or home-based exercise program. The patients were compared, before and after the rehabilitation program, with respect to maximal oxygen uptake (pVO(2)), chronotropic variables [heart rate reserve (HRR(e)), heart rate recovery (HRR(1)), and chronotropic response index (CRI)] and Duke Treadmill Score (DTS). RESULTS: Hospital-based exercise group has shown a significant recovery in post-exercise pVO(2) (pre-exercise 16.73 +/- 3.9 ml/kg/min, post-exercise 19.53 +/- 3.89 ml/kg/min, P = 0.002) and DTS (pre-exercise 4.74 +/- 1.17, post-exercise 5.61 +/- 1.11, P = 0.002). A significant recovery in favor of the hospital-based exercise group was found in HRR(e) (pre-exercise 26.9 +/- 14.6, post-exercise 34.6 +/- 14.6, P = 0.01). No significant change was observed in HRR(1) (pre-exercise -1.38 +/- 1.04, post-exercise -1.21 +/- 1.89, P = 0.49) and CRI (pre-exercise 0.44 +/- 0.23, post-exercise 0.48 +/- 0.20, P = 0.15) in hospital-based exercise group. No significant change was observed in any parameters of home-based group (P > 0.05). CONCLUSION: A significant recovery was observed both in the functional capacity and the chronotropic response in hospital-based exercise program. Exercise programs that are planned to be performed under supervision in rehabilitation units are useful for the patients with heart transplant in terms of the exercise capacity and chronotropic variables.     

卡托普利联合氨氯地平对冠心病并高血压患者的疗效及安全性观察

目的:探析卡托普利联合氨氯地平对冠心病并高血压患者的疗效及安全性。方法 :选取2014年1月~2015年10月来我院就诊的冠心病并高血压患者80例,随机分为观察组与对照组,每组40例,对照组给予尼群地平、硝酸异山梨酯联合双氢克尿噻进行治疗;观察组给予卡托普利联合氨氯地平进行治疗,分析两组的临床疗效。结果:治疗后,观察组患者的舒张压与收缩压分别是(73.64±1.35)mm Hg、(129.90±3.10)mm Hg,对照组患者的分别是(89.35±3.88)mm Hg、(140.98±4.83)mm Hg,差异有统计学意义,P0.05;观察组的冠心病治疗总有效率是92.5%,对照组的是75.0%,差异有统计学意义,P0.05;观察组患者的心电图改善率是87.5%,对照组的是62.5%,差异有统计学意义,P0.01。结论:卡托普利联合氨氯地平对冠心病并高血压患者的疗效较为理想,且安全性良好,能够有效缓解患者的临床症状。     

Comparative effect of captopril and nifedipine in normotensive patients with incipient diabetic nephropathy

In these studies, the effect of a 6-wk treatment by placebo, the calcium-channel blocker nifedipine, or the converting-enzyme inhibitor captopril was assessed in normotensive patients with insulin-dependent diabetes and incipient nephropathy. In response to captopril and nifedipine, arterial pressure decreased slightly and to a similar extent. These drugs resulted in opposite effects on urinary excretion of albumin [i.e., increase in urinary albumin excretion (UAE) by 40% during nifedipine treatment and decrease by 40% during captopril treatment]. No change in UAE was observed in the placebo group. This observation of opposite changes in UAE in the presence of a similar fall in arterial pressure suggests that the effects of captopril and nifedipine on UAE result from some difference in their intrarenal action. The data do not present recommendations for the use or disuse of captopril or nifedipine in such a group of patients and do not allow extrapolation to hypertensive diabetic subjects well controlled by other conventional antihypertensive agents.     

Evaluating the treatment of hypertension in diabetes mellitus: a need for better control?

Objectives To determine how well and to what extent blood pressure (BP) is controlled in diabetic hypertensive patients treated by primary care doctors, and to evaluate drug therapy in the backdrop of risk factors and laboratory findings. Methods A therapeutic audit of the medical records of diabetic hypertensives from nine primary care health centres in Bahrain. Results In 266 diabetic hypertensives (82 males and 184 females), the recommended target BP < 130/< 85 mmHg (WHO/ISH guidelines, 1999) was achieved in 20 (9.8%) with a BP of 119 ± 4/76 ± 5 mmHg. Among those who did not achieve target BP, 70 (34.5%) lacked systolic BP control (BP = 153 ± 17/79 ± 3 mmHg), four (2%) lacked diastolic BP control (BP = 123 ± 3/86 ± 3 mmHg) and 109 (53.7%) lacked both systolic and diastolic BP control (BP = 158 ± 20/94 ± 7 mmHg). The mean age of the group achieving target BP was significantly lower than the group which lacked systolic BP control (51.6 ± 9 vs. 63.5 ± 9 years; P < 0.0001). While there were no significant differences in fasting blood glucose, glycosylated haemoglobin, triglycerides, urea, creatinine, uric acid and serum electrolytes between the group achieving target BP vs. groups without target BP, a significant difference in total cholesterol was seen. Patients with ischaemic heart disease and/or isolated systolic hypertension did not achieve the target BP. Antihypertensive monotherapy was prescribed in 145 (54.5%) patients, whereas two‐ and three‐drug combinations were prescribed in 32.3 and 8.2% of patients, respectively. As monotherapy, angiotensin‐converting enzyme (ACE) inhibitors were the most frequently prescribed drugs followed by β‐blockers, calcium channel blockers (CCBs) and diuretics. As two‐drug combinations, an ACE inhibitor with a β‐blocker/diuretic and a β‐blocker with a CCB/diuretic were usually prescribed. Conclusions According to the WHO/ISH 1999 guidelines, approximately one out of 10 diabetic hypertensives achieved target BP control. In many instances, the drug therapy prescribed was inappropriate considering the comorbidity in patients and their laboratory findings. Improved BP control is needed in treating high‐risk groups such as patients with diabetes mellitus, and efforts should be made to improve the treatment of hypertension in the primary care setting.     

Long-term effects of captopril treatment on the course of stable effort angina pectoris and structural-functional characteristics of platelets in patients with hypertension and ischemic heart disease

AIM: To assess clinical efficacy and effect on platelet alterations of 12-month captopril monotherapy in essential hypertension (EH) patients with coronary heart disease (CHD). MATERIAL AND METHODS: A randomized placebo-controlled parallel study was performed. Arterial blood pressure (BP), frequency of angina pain attacks, standard submaximal bicycle exercise test (BET), echocardiography, ADP-induced platelet aggregation (PA), levels of cholesterol (CH), lipid peroxidation products, intracellular Ca, Ca(++)-ATPase activity were studied before and 2 weeks, 2, 6 and 12 months after captopril therapy in 68 males aged 35-58 years with moderate EH in combination with CHD, stable angina of effort and normal left ventricular ejection fraction (57.5 +/- 1.2%). RESULTS: In spite of a stable antihypertensive effect of C within all the treatment period, frequency of anginal pain attacks and number of positive BET markedly reduced only during 6 months of C therapy. Left ventricular hypertrophy regression was not registered. Of all the platelet parameters only Ca(++)-ATPase, Ca and malonic dialdehyde (MDA) beneficial changes persisted for 12 month treatment period: Ca(++)-ATPase activity increased, Ca and MDA content reduced. The other platelet parameters were less persistent. BP lowering correlated with Ca(++)-ATPase, CH, MDA and PA changes whereas the number of anginal pain attack correlated with CH and PA reduction. CONCLUSION: A beneficial effect of captopril on BP persisted for 12 months, on angina symptoms--for 6 months. One of the mechanisms of antihypertensive and antianginal effect of captopril is attributed to platelet alterations correction.     

Effects of cold pressor test on circulating atrial natriuretic peptide 99–126 (ANP) in patients with Raynaud's phenomenon and influence of treatment with magnesium sulphate and nifedipine

Summary. The effect of a standardized cold pressure test (CPT) on the venous concentration of immunoreactive atrial natriuretic peptide (ir ANP) was studied in 12 females with primary Raynaud's phenomenon (PRP) and 12 female age-matched controls. The test was performed at the end of three stages. During the first stage no medication was given. During the second stage a magnesium infusion was given. After fourteen days of medication with a calcium antagonist (Nifedipine) the third stage of the study was performed. The venous irANP increased significantly (P < 0.05) 10 min after the start of the CPT both in the PRP group and in the control group (136±39 to 159±54 and 153±45 to 179±40 pg ml^-1, given as mean and SD). Baseline irANP did not change in the PRP group after treatment with magnesium or nifedipine. In the control group nifedipine treatment significantly (P < 0 01) lowered venous irANP compared to the no treatment or magnesium sulphate infusion stages (128±31 vs. 153±45 and 160±41 pg ml^-1). After the CPT in both PRP group and control group the venous irANP did not increase either during magnesium sulphate infusion or nifedipine treatment. In conclusion the study has demonstrated that a standardized CPT results in a delayed increase in irANP in venous plasma and that magnesium sulphate infusion and nifedipine treatment prevent this increase. Furthermore, our data do not suggest a role for irANP in the symptomatology of primary Raynaud's phenomenon.     

Advantages of blood pressure optimization

Lowering blood pressure (BP) reduces cardiovascular events, but aggressive BP management may not be advantageous. Optimal BP control (target: < 120/ 80 mm Hg) and conventional BP control (target: < 140/90 mm Hg) were compared in patients with hypertension in terms of target-organ damage and tolerability. A total of 23 patients with hypertension were randomly assigned to optimal versus conventional therapy for 6 months. Therapy was initiated with lercanidipine 10 mg/day. For BP control, the dose could be doubled or other drugs added. Three indices of target-organ damage were studied: left ventricular mass (LVM) index, flow-mediated dilatation (FMD) of the brachial artery, and 24-hour urinary albumin excretion. The BP decreased markedly by 21.3±3.4/13.2±1.7 mm Hg in the conventional therapy group and by 26.6±3.6/17.9±1.5 mm Hg in the optimal therapy group. Diastolic BP was significantly lower, by 4.7±2.3 mm Hg, in the optimal therapy group (P < .05). Ambulatory BP was also decreased in both groups. There was no significant change in LVM or FMD in either group. Baseline LVM index and FMD values were correlated with systolic BP (r=0.51, P=.02; r=0.54, P=.009). In the optimal therapy group, urinary albumin excretion increased significantly (P=.04). Plasma levels of B-type natriuretic peptide (BNP) decreased with antihypertensive therapy (P=.03). Treatment was well tolerated, and none of the patients withdrew from the study. There was no significant difference in adverse events between the 2 groups. Optimization of BP is feasible, safe, and well tolerated; however, a larger study of longer duration may be needed to demonstrate improvements in LVM and endothelial function with conventional versus optimal therapy.     

Profile of blood pressure and glycemic responses after interval exercise in older women attending (in) a public health physical activity program

Backgroundand purpose: Interval exercise causes a positive impact on health status. Our aim was to evaluate the effects of a feasible and low-cost interval exercise on blood pressure and glycemic responses in people with controlled systemic arterial hypertension.MethodsThirteen women with hypertension (HG; age: 60.2 ± 2.8 years) and 11 without hypertension (CG; age: 54.4 ± 3.8 years) were recruited. Groups performed one session of interval exercise with elastic resistance (10 series of 1:1 min/effort:rest).ResultsThere were slight reductions of absolute systolic blood pressure values for HG at 10, 30, and 60 min (4, 9, and 8 mmHg, respectively) at post-compared to pre-exercise. Glycemia was reduced (respectively, 17.6%, 17.6%, 19.4%, and 23.1%; p < 0.05) at pre-exercise vs. 0 min and 10, 30, and 60 min post-exercise for the HG.ConclusionA single session of a feasible and low-cost interval exercise modifies and promotes significant clinical effects in blood pressure and glycemic levels in female older adults with and without hypertension.     

Abnormal glomerular and tubular function during angiotensin converting enzyme inhibition in renovascular hypertension evaluated by the lithium clearance method

Glomerular filtration rate (GFR) and tubular function were measured by means of the lithium clearance technique in 14 patients with renovascular hypertension (RVH) and eight patients with essential hypertension (EH) before and after oral administration of captopril 25 mg. In RVH captopril reduced 51-Cr-EDTA clearance (67.3 (median) to 47.5 ml min-1, P less than 0.01), proximal absolute reabsorption of fluid (53.9 to 41.5 ml min-1, P less than 0.01) and distal absolute reabsorption of sodium (2195 to 1402 mumol min-1, P less than 0.01), whereas proximal fractional reabsorption increased slightly (77.5 to 80.2%, P less than 0.02). In EH, however, these parameters were practically unaffected by captopril. In both RVH and EH plasma concentrations of angiotensin II and aldosterone were reduced after captopril, but atrial natriuretic peptide in plasma and urinary excretion rate of prostaglandin E2 were unchanged. Blood pressure decreased after captopril in both groups, but the maximum fall in systolic BP was more pronounced in RVH (22%) than EH (13%). It is concluded that angiotensin converting enzyme inhibition markedly reduced absolute reabsorption in both the proximal and distal tubules in RVH, in contrast to EH, predominantly due to fall in the GFR, and that the slight increase in proximal fractional reabsorption may be attributed to a reduction in the hydrostatic pressure in the peritubular vessels.