Felodipine or Hydrochlorothiazide/Triamterene for Treatment of Hypertension in the Elderly: Effects on Blood Pressure, Hypertensive Heart Disease, Metabolic and Hormonal Parameters

Trenkwalder P, Plaschke M, Aulehner R, Lydtin H. Felodipine or Hydrochlorothiazide/Triamterene for Treatment of' Hypertension in the Elderly: Effects on Blood Pressure, Hypertensive Heart Disease, Metabolic and Hormonal Parameters.

The aim of the study was to compare the antihypertensive efficacy of either felodipine or the diuretic combination hydrochlorothiazide/triamterene in a group (n = 65) of elderly (≥70 years) hypertensives (office blood pressure ≥ 60/95 mmHg) with special regard to ambulatory blood pressure monitoring, hypertensive heart disease and metabolic parameters. This was a randomized, double-blind study with a treatment period of 6 months. Reduction of office and 24-hr ambulatory blood pressure was comparable with both treatment regimens; after 6 months, 18 of 29 patients in the felodipine group (62%) and 20 of 27 patients in the diuretic group (74%; p = 0.4) were controlled. While episodes of ischemic type ST-segment depression were significantly reduced in the felodipine group (from 49 to 9 episodes), there was no significant change in the diuretic group (from 24 to 21 episodes). Both regimens decreased left ventricular wall thickness, but the decline in left ventricular muscle mass index was significant only for felodipine. Felodipine did not induce any change in metabolic or hormonal parameters; the diuretic combination significantly increased serum creatinine, uric acid, plasma renin activity, and plasma prorenin. Thus, the antihypertensive efficacy of felodipine and the diuretic combination was comparable in elderly hypertensives; only felodipine, however, improved parameters of hypertensive heart diesease and showed a neutral metabolic and hormonal profile.     

噻吗洛尔与普萘洛尔治疗高血压病与心绞痛的疗效比较

劳累性心绞痛38例采用噻吗洛尔2.5-5mg, tid,共4wk;另12例采用普萘洛尔10-20mg, tid,共4wk。结果:前者显效率为79％,显著高于后者42％(P<0.05)。高血压病(Ⅰ,Ⅱ期)37例采用噻吗洛尔治疗,方法同上;另13例采用普萘洛尔20-40mg, tid,疗程亦4wk。结果:2组均有显著降压疗效(P<0.01),噻吗洛尔治疗后1h即获显效,普萘洛尔须24h才获显效。噻吗洛尔7％(5/75)、普萘洛尔4％(1/25)治疗后发生窦性心动过缓,前者被迫停药,后者未停药。     

蛇毒治疗不能解释肺动脉高压的研究

本通过对不能解释的肺动脉高压患，进行右心导管测定肺动脉平均压（ＰＡＭＰ）作为主要对照指标，观察蛇毒制品（精制溶栓酶）的急性药物试验和近期药物试验。发现该药物在近期有理想的降低ＰＡＭＰ作用，症状及胸片、超声心动图异常也明显取得改善，提示其可能为治疗该病的理想药物。     

The Inhibitory Effect of Radix Salviae Miltiorrhizae on Hypoxic Structural Remodeling of Intra－acinarPulmonary Arteries

(席思川)(车东媛)(张婉蓉)ＴｈｅＩｎｈｉｂｉｔｏｒｙＥｆｆｅｃｔｏｆＲａｄｉｘＳａｌｖｉａｅＭｉｌｔｉｏｒｒｈｉｚａｅｏｎＨｙｐｏｘｉｃＳｔｒｕｃｔｕｒａｌＲｅｍｏｄｅｌｉｎｇｏｆＩｎｔｒａ－ａｃｉｎａｒＰｕｌｍｏｎａｒｙＡｒｔｅｒｉｅｓ￥ＸＩＳｉ－ｃ...     

Pattern electroretinogram as a function of spatial frequency in ocular hypertension and early glaucoma

Pattern electroretinograms (PERGs) in response to 8.3 Hz alternating gratings (16.6 rev/sec) of different spatial frequencies were recorded in normal subjects as well as in patients affected by early glaucoma and ocular hypertension. In normal subjects the PERG response is spatially tuned, with a maximum at about 1.5 cycles/deg and attenuation at higher and lower spatial frequencies. In all cases of early glaucoma and in the great majority of cases of ocular hypertension the PERG was reduced, as compared with that of normal subjects, mainly in the medium range of spatial frequencies (at which the PERG has its maximal amplitude).     

等容血液稀释治疗高血压病75例疗效观察

本文报告等容血液稀释（简称ＤＨ）治疗高血压病７５例，总有效率为９０．２％，４８例随访２年血压下降稳定持久，血液流变学改善，总有效率为８７．５％。结果表明：ＨＤ治疗高血压病可以改善血流高粘滞状态，降低血液粘度，增强血液流动性，减少血流阻力，改善微循环灌流，从而达到降低血压和改善器官血流，达到持久降压及减少器官合并症。一次ＨＤ与降压药适量配伍，疗效更显著而持久，可维持数月至２年以上。     

淋巴因子水平改变与妊高征的关系

近年来的研究结果发现由Th1/Th2细胞分泌的淋巴因子与妊娠高血压综合征联系密切 ,可能参与了其病因及病理生理过程 ,对它的深入研究有利于妊娠高血压综合征诊断、治疗水平的提高     

美托洛尔治疗高血压病的疗效及其耐受性

原发性高血压患者425例(男252,女173;年龄60±s12a)采用美托洛尔100mg,po,每晨1次,4wk为一个疗程。总有效率82.4％,治疗2wk后血压继续下降,心率并不继续减慢。不良反应主要为心率减慢后的症状及神经系症状,停药率6.4％。60a以上的患者总有效率及停药率与中、青年患者无明显区别。故美托洛尔同样适用于老年人。     

AUGMENTED ENDOGENOUS NITRIC OXIDE PRODUCTION IN PARTIAL PORTAL VEIN-LIGATED RATS

1. Endothelium-derived nitric oxide (NO) is a potent vasodilator. Because the body oxidizes it to nitrate ions, NO₃-, measurement of the serum concentration and the urinary excretion of NO₃- may be an index for endogenous NO. We investigated the role of NO on hyperdynamic circulation in cirrhotic and partial portal vein-ligated rats by measuring NO₃. 2. Liver cirrhosis was induced by administration of thioacetamide. Systemic and splanchnic haemodynamics and splenic-systemic shunting were determined by tracer microspheres. The concentration of NO₃- was measured by using high-performance liquid chromatography with an anion-column. 3. We found that systemic and splanchnic hyperdynamic circulation existed to almost the same extent in cirrhotic and in portal vein-ligated rats as compared to the controls and sham-operated rats, respectively. Splenic-systemic shunting was markedly greater in portal vein-ligated rats than in cirrhotic rats. 4. Serum NO₃- levels and urinary excretion of NO₃- in cirrhotic rats tended to increase as compared to the controls. On the other hand, the levels in portal vein-ligated rats were significantly increased as compared to those of the sham-operated rats, and were significantly and negatively correlated to the splanchnic arterial resistance and total vascular resistance. The amount of urinary excretion of NO₃- significantly correlated to splenic-systemic shunting (r = 0.61, P<0.05) only in portal vein-ligated rats. 5. We suggest that these high levels of NO₃- in portal vein-ligated rats relate to the extensive formation of porto-collateral vasculature or acute changes in systemic and splanchnic haemodynamics due to portal vein-ligation.