Experience in using minipress in essential hypertension

Investigation of the hypotensive action of minipress, a drug belonging to the group of selective blockers of alpha 1-adrenoreceptors, shows its efficacy in 56.3 percent of patients with stage II essential hypertension. The side-effects were recorded in 16.6 percent of the patients. It is noted that application of minipress at a mean daily dose of 3.4 ml for a long time reduces the total peripheral vascular resistance without inducing any substantial changes in the stroke volume of the heart or in the pulse rate. At the same time minipress produces a beneficial effect on the microcirculatory blood flow.     

Changes in calcium metabolic indices during long-term treatment of patients with essential hypertension

1. Disturbances of calcium metabolism, mimicking mild, compensated secondary hyperparathyroidism, accompany essential hypertension, but it is not known whether these alterations are primary or only secondary to the elevated blood pressure. 2. Indices of systemic calcium metabolism were followed prospectively during 6 months' treatment with either propranolol, bendroflumethiazide or verapamil in 35 patients with essential hypertension. Multivariate statistical methods were employed to study the effects of blood pressure reduction upon the metabolic indices with adjustment for the effects of the different antihypertensive agents. 3. Propranolol treatment increased the plasma ionized calcium and serum phosphate concentrations, and reduced the serum levels of parathyroid hormone, free fatty acids and glycerol. Neither the total nor the total albumin-modified serum calcium concentration was significantly affected. Thus, presumably the decrease in free fatty acids reduced the calcium complex and the calcium binding to albumin, and consequently increased the plasma ionized calcium, thereby suppressing the secretion of parathyroid hormone. 4. Bendroflumethiazide caused a reduction of the fasting renal calcium excretion to half the pretreatment level, but produced no other significant changes in the various indices of calcium metabolism. 5. During verapamil treatment, the fasting renal excretion of calcium and magnesium increased, whereas the free fatty acids and glycerol concentrations in serum were reduced. These two changes presumably balanced each other, as the plasma ionized calcium and serum parathyroid hormone concentrations were not significantly altered. 6. There were no consistent relationships between the decrease in blood pressure and the changes in the metabolic indices, either in the total sample or within any subgroup.(ABSTRACT TRUNCATED AT 250 WORDS)     

老年原发性高血压患者的认知功能变化

目的:观察老年原发性高血压患者认知功能损害表现,探讨其发生机制,寻求进行干预的可能性。方法:106例老年原发性高血压患者(≥60岁)接受了中国韦氏智力测试量表评估,并与相同年龄和性别的健康老人1:1配对比较。结果:老年原发性高血压患者智测成绩中填图10.7±3.4和图形排列15.8±6.2两项分测验得分明显低于对照组(14.5±4.0和22.6±10.3)(t=2.176和2.059,P均<0.05)。在按原发性高血压水平分级比较中,中重度原发性高血压患者(2～3级,48例)的算术、数字广度、填图和图形排列等项分测验得分明显低于轻度原发性高血压患者(1级,58例)(t=2.039～2.249,P均<0.05)。按有无危险因素分组比较,有危险因素(60例)的老年原发性高血压患者领悟、算术、数字广度、数字符号、填图、木块图和图形排列等项分测验明显低于无危险因素组(46例)(t=2.134～2.235,P均<0.05)。按危险性量化分层后,高和极高危患者(25例)的领悟、算术、数字广度、数字符号、填图、木块图、图形排列和图形拼凑等项分测验评分均明显低于低中危患者(t=1.957～2.329,P均<0.05)。结论:老年原发性高血压患者认知功能损害不明显,但血压水平高、合并危险因素多及危险性量化分层后,高和极高危险性老年原发性高血压患者的认知功能有较明显的障碍,对这部分患者应     

Changes in left ventricular function in elderly hypertension patients]

As many as 81 patients suffering from stage-II essential hypertension (EH) and 20 practically healthy persons of the same age were examined. EH patients manifested derangement of systolic function of the left ventricle, attested to by a decrease of contractility in the first third of the systole. The lowering of the velocity of active relaxation, change in the structure of the filling of the left ventricle coupled with a decrease of the role of the rapid filling phase and a rise of the contribution of the phases of slow filling and the atrial systole were noted. A decrease of the blood flow velocity at the phase of the atrial systole was also noted, which points to a decrease of the compensatory role of the left atrium in elderly patients. As compared to younger patients, compensatory hypertrophy of the left ventricle was pronounced relatively less in elderly patients. In these patients, compensatory potentialities of the hypertrophied left ventricle are preserved until the index of the left ventricular mass exceeds 170 g/m2. The further growth of that indicator is associated with a decline of the cardiac output.     

Serum aldosterone level in patients with hypertension during treatment by acupuncture

A study was made of the effect of acupuncture procedures on the aldosterone content in the peripheral blood serum of 65 patients with hypertension, Stages I and II. Acupuncture resulted in a hypoaldosteronemic effect which showed statistically significant correlation with a decrease in the arterial blood pressure. The results obtained made it possible to regard the effect of acupuncture as one of the most significant mechanisms of its therapeutic action in hypertension.     

Hemodynamics and myocardial contractile function in patients with chronic obstructive bronchitis complicated by pulmonary hypertension

Eighty patients with chronic obstructive bronchitis complicated by stable pulmonary hypertension were examined for the general, central, intracardial hemodynamics and myocardial contractile function. In addition to the general clinical examination, use was made of tetrapolar rheography, rheography of the pulmonary artery, radiocardiography, radionuclide ventriculography. The majority of the examined manifested hemodynamic disorders both in the pulmonary and greater circulation together with abnormalities of myocardial contractile function of the right and left ventricles. The methods employed were shown to be of high information content.     

左心室心肌做功参数评估原发性高血压患者左心室功能

目的 观察左心室心肌做功(LVMW)参数评估原发性高血压(EHT)患者左心室功能的价值.方法 选取102例EHT患者,按高血压分级分为EHT 1级组(n=39)、EHT 2级组(n=30)及EHT 3级组(n=33);以36名健康成年志愿者作为对照组.对比各组常规超声心动图参数、纵向峰值应变离散度(PSD)、整体纵向应...     

Improvement of renal function during long-term treatment of severe hypertension with minoxidil

Sixty-nine patients with refractory hypertension were treated with minoxidil and in 66 good control of blood pressure was achieved. Renal function was stabilized in 31 patients in whom the serum creatinine was normal at presentation. Twenty-eight patients with impaired renal function had a substantial fall in serum creatinine (25 per cent) during the first three to six months of treatment and this improvement was maintained. In contrast, renal function in six out of seven patients with primary renal disease continued to deteriorate despite adequate control of blood pressure. Effective control of blood pressure prevents or reverses impairment of renal function in patients with refractory hypertension not associated with primary renal disease.     

早期急性心肌梗死患者排便过程中心率、血压及心肌耗氧量的变化研究

急性心肌梗死(acute myocardial infarction,AMI)早期患者并发症的发生率很高,排便困难是AMI早期发生严重并发症的常见诱因.有报道[1],AMI后2～3d有5.3%的患者在排便过程中出现心绞痛、二次AMI、心力衰竭、猝死等并发症.即使无便秘的AMI患者,在排便时或排便后也有发生意外的可能.可见,排便活动是威胁AMI早期患者生命安全的一大难题.     

三维面积应变评价高血压患者左心室心肌收缩功能早期变化

目的 应用三维斑点追踪成像（3D-STE）技术评价原发性高血压患者早期左心室心肌收缩功能改变情况。方法 对40例未经药物治疗的原发性高血压患者（高血压组）及40名健康志愿者（对照组）行常规二维超声心动图和3D-STE,测量并比较两组常规超声心动图指标包括舒张末期室间隔厚度（IVSTd）、舒张末期左心室后壁厚度（LVPWTd）、左心室舒张末期内径（LVEDd）、相对室壁厚度（RWT）、二维左心室心肌质量指数（2D-LVMi）、二维左心室射血分数（2D-LVEF）、舒张末期左心室容积（EDV）、收缩末期左心室容积（ESV）,以及3D-STE指标包括左心室三维射血分数（3D-LVEF）、左心室球形指数（SPI）、三维左心室心肌质量指数（3D-LVMi）及左心室整体面积应变（GAS）差异;采用Pearson相关分析检验GAS与各指标间相关性。结果 两组患者IVSTd、LVPWTd、LVEDd、RWT、2D-LVMi、2D-LVEF、EDV、ESV、3D-LVEF和SPI差异均无统计学差异（P均>0.05）;高血压组3D-LVMi高于对照组[(104.20±7.94) vs (92.85±6.92),P<0.05),GAS低于对照组[(-25.53±3.79) vs (-31.43±3.13),P<0.05]。GAS与3D-EF呈负相关（r=-0.78,P<0.05）,与3D-LVMi、收缩压及舒张压呈正相关（r=0.81、0.60、0.50,P<0.05）。结论 原发性高血压患者早期左心室构型未发生明显变化时,左心室心肌收缩功能已经减低,可通过3D-STE中GAS进行评价。     

Changes in blood rheological properties in patients with hypertension

AIM: To study hemorheology in patients with essential hypertension (EH), to improve EH treatment in terms of blood rheology. MATERIAL AND METHODS: Blood rheology, microcirculation, lipid plasm spectrum, central hemodynamics were studied in 90 patients with mild and 83 patients with moderate or severe EH as well as 30 healthy controls before and after treatment (hypotensive drugs, essential phospholipids, intravenous laser blood radiation, plasmapheresis). RESULTS: Hemorrheological disorders (subnormal deformability of the red cells and elastoviscosity of their membranes, disk-spherical transformation and hyperaggregation of blood cells, high dynamic viscosity) correlated with the disease severity, arterial pressure and total peripheral vascular resistance. Long-term (1-1.5 years) hypotensive therapy, especially with combination of beta-blockers with diuretics, has a negative effect on blood rheology. Optimisation of EH treatment in terms of blood rheology consists in using essential phospholipids in stable hypertension, intravenous laser radiation in complicated hypertension, plasmapheresis in drug-resistant hypertension. Such an approach not only significantly improves hemorheology but also provides good clinical and hypotensive effects in 75-80% patients. CONCLUSION: Blood viscodynamics should be taken into consideration in individual treatment of hypertensive patients.     

急性心肌梗死患者血清肌红蛋白水平在早期冠脉再灌流中的意义

目的　探讨急性心肌梗死患者尿激酶溶栓治疗过程中血清肌红蛋白 (Mb)的变化 ,判断其是否可以作为早期、非侵入性判断冠脉再灌流的指标。方法　对 2 2例尿激酶溶栓治疗和2 2例保守治疗的AMI患者治疗前后的 1h、2h、4h、8h、12h、14h、15h、18h和 2 4h的血清Mb进行测定 ,同时测定血清磷酸肌酸激酶同工酶 (CK MB) ,比较再灌流组和未再灌流组血清Mb的峰浓度和达峰时间 ,并同CK MB进行比较。结果　再灌流组血清Mb和CK MB的峰浓度分别为 6 19 5 9±198 5 5ng/ml和 15 7 10± 36 19u/L ,均显著高于未再灌流组 (487 31± 6 0 87ng/ml和 141 80± 2 2 18u/L) ;再灌流组较未再灌流组血清Mb达峰时间明显提前 (192min对 480min ,P <0 0 1) ,再灌流组血清Mb达峰时间显著早于血清CK MB达峰时间 (192min对 72 0min ,P <0 0 1) ,而且Mb的 2h出现率 (Mb2 /Mb0 )较未再灌流组也显著增高 (4 2 4对 2 12 ,P <0 0 1)。结论　血清Mb值早期上升、快速达峰是一种可靠、简便的非侵入性判断AMI再灌流治疗成功与否的指标。