Drugs during pregnancy: an issue of risk classification and information to prescribers.

The Swedish system for the classification of fetal risk of drugs was the first of its kind and was implemented in 1978. Drugs for use in pregnant women are classified in 4 general categories--A to D. The US Food and Drug Administration (FDA) introduced a system in 1979 also using the letters A to D, together with an X category.

Visceral fat accumulation in men is positively associated with insulin, glucose, and C-peptide levels, but negatively with testosterone levels.

Twenty-three healthy men (age 25 to 50 years), covering a wide range of fatness and body fat distribution, were studied. An oral glucose tolerance test was performed and adipose tissue areas were calculated from computed tomography (CT) scans made at the level of L4/L5. Visceral fat area was associated with elevated concentrations of insulin and C-peptide and with glucose intolerance before and after the oral glucose load.

Does hyperkinetic circulation constitute a pre-hypertensive stage? A 5-year follow-up of haemodynamics in young men with mild blood pressure elevation.

In a previous haemodynamic examination, 44 young men (18-22 years) with blood pressure elevation above the 98th percentile, mean arterial blood pressure (MAP) greater than or equal to 95 +/- 6 mm Hg, showed an increased cardiac index (dye-dilution) and an enhanced resistance at maximal vasodilation of the hand (venous occlusion plethysmography during hyperaemia). This latter finding suggested arteriolar wall hypertrophy. However, the subgroup with the highest cardiac index (greater than or equal to 3.

Regional distribution of muscle and fat mass in men--new insight into the risk of abdominal obesity using computed tomography.

We studied 24 healthy men (25-50 years old) covering a wide range of fatness (body mass index range: 21-34 kg/m2) and fat distribution (waist/hip range: 0.75-1.06).

Blood pressure response in relation to blood lactate during exercise in patients with essential hypertension.

Thirty-four untreated patients with essential hypertension WHO I-II, 17 patients under treatment with beta-blockade, and 32 healthy controls with a wide range of exercise capacity were studied at loadless pedaling (W0) and at the work load eliciting a blood lactate concentration corresponding to 4 mmol X l-1 (onset of blood lactate accumulation or OBLA). At W0 the treated patients had approximately the same systolic blood pressure (SBP) as the healthy controls, while the untreated patients had a higher SBP than the controls. At WOBLA the SBP was higher in the untreated patients than in both the treated patients and the healthy controls.

Drug use during pregnancy and breast-feeding. A classification system for drug information.

Since 1978 the Swedish catalogue of registered pharmaceutical specialties (FASS) has carried a special section entitled "Pregnancy and breast-feeding" in each product presentation, intended to form an aid for the prescription of drugs to women during childbearing and lactation. After a brief review of transplacental transport and milk secretion, reproduction-toxicology studies in animals, and methods for clinical evaluation of drugs for use during pregnancy, the classification system is presented. On the basis of available data with regard to effects on early and late stages of pregnancy and labour, all the pharmaceutical specialties concerned are assigned to one of the following pregnancy categories: A, B 1, B 2, B 3, C or D.

Essential hypertension--implications for pathogenesis from repeated haemodynamic investigations in young men with elevated blood pressure.

Repeated invasive haemodynamic studies were performed in young men (18-21 years) with elevated blood pressures and age and sex-matched normotensive controls before military service and five years later as a follow-up study. Patients with high blood pressure initially showed increased cardiac output and increased vascular resistance during maximal vasodilatation. The latter observation suggests arteriolar wall hypertrophy but was restricted to the subgroup of patients with low/normal cardiac output (normokinetic subgroup).

Blood pressure and heart rate recordings at home and at the clinic. Evidence for increased cardiovascular reactivity in young men with mild blood pressure elevation.

In 41 apparently healthy men, aged 22-25 years, with mild blood pressure elevation (MBPE) and 19 age- and sex-matched normotensive controls (MC), blood pressure (BP) and heart rate (HR) readings at the clinic were compared to self-determined morning and afternoon values at home. The criteria for inclusion in the MBPE group were auscultatory BP less than 150 mmHg systolic and/or less than 90 mmHg diastolic at the military enlistment center from which the subjects were recruited, and systolic BP less than 140 mmHg on two subsequent occasions at the clinic. The BPs of the controls, who were mainly recruited from the same center, did not exceed 130/80 mmHg either at the enlistment center or at the clinic.

Medication during pregnancy and breast-feeding--a new Swedish system for classifying drugs.

As an aid for the prescription of drugs for women during pregnancy and lactation, a special section entitled "Pregnancy and breast-feeding" has been added to the description of most of the products in the Swedish catalogue of registered pharmaceutical specialties (FASS) since 1978. This article describes the system and also presents examples of the general texts proposed for certain groups of drugs.

Effect of treatment of hypertension in the primary preventive trial, Göteborg, Sweden.

1 A treatment group comprising 635 hypertensive men (casual SBP greater than 175 or DBP greater than 115 twice) was compared with a reference group (n = 391 men; casual SBP greater than 175 or DBP greater than 115 only at screening). All men belonged to the same population sample of 7,455 men aged 47-54 yr. 2 The two groups did not differ with respect to age, smoking habits or cholesterol values, but screening BPs were higher in the treatment group.

Haemodynamic effects of static and dynamic exercise in males with arterial hypertension of varying severity.

Sustained handgrip at 30% of the maximal strength and submaximal supine bicycle exercise elicited mean blood pressure increases of similar magnitude in healthy males and in men with essential hypertension WHO Stage 1 and 2, but with different contributions of systolic and diastolic blood pressure changes. While systolic blood pressure exceeded 22.7 kPa (170 mmHg) during static exercise in every hypertensive man, this did not occur in any of the control subjects.

Coronary heart-disease after treatment of hypertension.

Within a group of 1026 men aged 47-54, cause-specific death-rates and the incidence of non-fatal myocardial infarction and stroke in treatment group of 635 hypertensive men (casual systolic B.P. greater than 175 or diastolic B.

Metoprolol--a new cardioselective beta-adrenoceptor blocking agent for treatment of tachyarrhythmias.

The antiarrhythmic effect of the cardioselective beta-adrenoceptor blocking agent metoprolol, given intravenously, was studied in 44 patients with various tachyarrhythmias, including patients with congestive heart failure and signs of digitalis intoxication. All patients with atrial tachycardia (12 cases) reverted to normal sinus rhythm. In 3 out of 18 patients with atrial fibrillation, sinus rhythm was restored, and in the others there was a significant reduction in ventricular rate.

Acute haemodynamic effects of metoprolol in hypertensive patients.

1. The acute haemodynamic effects of metoprolol (0.15 mg/kg body weight) intravenously were studied at rest and during exercise, in a recumbent position in five patients with arterial hypertension of WHO Stage 1 or 2.

Evidence for peripheral vascular involvement in mild elevation of blood pressure in man.

1. Cardiac output at rest, intra-arterial blood pressure and hand blood flow at maximal vasodilatation were studied in two groups of 18-25 year-old men: forty-four with mild blood pressure elevation were referred from a military enlistment centre, and twenty-nine normotensive volunteers were mainly recruited from the same enlistment centre. 2.

Haemodynamics studies in young men with mild blood pressure elevation.

The cardiac output at rest, and the intra-arterial blood pressure and hand blood flow at maximal vasodilation were determined in two groups of men aged 18-22 years. 44 patients were referred from a military enlistment centre because of mild blood pressure elevation, and 29 normotensive volunteers were mainly recruited from the same enlistment centre. In addition, in a majority of subjects in both groups the auscultatory blood pressure of both parents was determined.