QT dispersion in athletic left ventricular hypertrophy.

Objective: To assess whether physiologic left ventricular hypertrophy as a result of physical training is associated with an increased QT length or dispersion.

Methods: Thirty-three subjects were assessed. These consisted of a group of international endurance athletes (including 8 rowers, 2 cyclists, and 1 triathlete), a group of 12 professional soccer players, and a further group of 10 control subjects.

Key features of candesartan cilexetil and a comparison with other angiotensin II receptor antagonists.

Current research on angiotensin II AT1-receptor antagonists (AIIRAs) and selected studies presented at the recent symposium held in Amsterdam, The Netherlands, on 6 June 1998, titled 'Angiotensin II Receptor Antagonists are NOT all the Same' are reviewed. AIIRAs offer a number of potential advantages over alternative antihypertensive agents acting via the renin-angiotensin-aldosterone system. They combine blood pressure-lowering effects at least equivalent to those of angiotensin-converting enzyme (ACE) inhibitors, coupled with placebo-like tolerability.

Vein graft stenosis and the heparin responsiveness of human vascular smooth muscle cells.

Background: Vascular smooth muscle cell (VMSC) proliferation is an essential component of myointimal hyperplasia, which is implicated in the failure of 30% to 50% of vascular interventions, such as coronary angioplasty and peripheral vein grafting. We have shown that cells derived from stenotic lesions in infrainguinal vein grafts were significantly more resistant than controls to growth inhibition by heparin.

Methods And Results: In a prospective study, we correlated antiproliferative responses to heparin in vitro with graft patency after 1 year.

Ethnic differences in the hypertensive heart and 24-hour blood pressure profile.

Black hypertensive persons have been observed to have a greater degree of left ventricular hypertrophy than white hypertensives. However, previous studies have matched groups for blood pressure (BP) measured in the clinic, and it has been demonstrated that black hypertensives have an attenuated nocturnal BP dip. Clinic BPs may thus underestimate mean 24-hour BP in this group.

Clinical profile of the novel angiotensin II type I blocker candesartan cilexetil.

Unlabelled: PROPERTIES OF CANDESARTAN CILEXETIL: Candesartan is a novel, potent, highly selective antagonist of the angiotensin II receptor subtype 1, which is administered orally as candesartan cilexetil, and is rapidly and completely hydrolysed into candesartan, the active moiety, during absorption in the intestinal tract. At a dose of 4-16 mg once a day, candesartan cilexetil significantly lowers systolic and diastolic blood pressure in a clear dose-dependent fashion, with 16 mg showing the greatest effect. This blood pressure fall is sustained throughout the 24-h period, as shown by a trough to peak ratio in excess of 80%, across all doses.

Retinal vascular network architecture in low-birth-weight men.

Background: Low birth weight is associated with hypertension and increased cardiovascular mortality, but the mechanism of this association is not known. Hypertension is accompanied by abnormalities of the microvasculature including rarefaction.

Objective: To test the hypothesis that low birth weight is associated with an alteration in microvascular architecture.

Left ventricular hypertrophy, blood pressure and ACE genotype in untreated hypertension.

It has been suggested that the deletion polymorphism of the angiotensin-converting enzyme (ACE) genotype may be important in the development of left ventricular hypertrophy (LVH). In order to test this hypothesis we investigated the interaction between blood pressure (BP), LVH and ACE genotype in 86 previously untreated hypertensive patients. Each underwent two-dimensional and Doppler echocardiography and ACE genotyping.

Left ventricular geometry in presenting untreated hypertension.

In order to investigate the spectrum of geometry in our patient population, 63 untreated hypertensives underwent two-dimensional echocardiography. Left ventricular (LV) mass index and relative wall thickness, a measure of wall thickness in relation to cavity size, were calculated from the M-mode strip. In addition, to assess the sphericity of the left ventricle the ratio of LV minor to major hemiaxis was calculated.

Candesartan cilexetil: a new, long-acting, effective angiotensin II type 1 receptor blocker.

Candesartan is a potent and selective angiotensin II type 1 receptor blocker which binds tightly to and dissociates slowly from the AT1 receptor. It is administered orally as the prodrug candesartan cilexetil, which is rapidly and completely converted to the active compound, candesartan, during gastrointestinal absorption. In hypertensive patients, candesartan cilexetil dose-dependently lowers diastolic and systolic blood pressure (BP) over the 24-h dose interval and it maintains its antihypertensive effects in the long term.

Long-term efficacy and tolerability of candesartan cilexetil in patients with mild to moderate hypertension.

The long-term efficacy and tolerability of candesartan cilexetil was assessed in two open-label, prospective multicentre studies in patients with mild to moderate essential hypertension. When administered in a flexible dosage regimen of 4-16 mg once-daily, candesartan cilexetil effectively lowered blood pressure (BP) and maintained its antihypertensive effects over the long term (< or =12 months). At the end of treatment, 81.

The effects on cardiac arrhythmias of antihypertensive therapy causing regression of left ventricular hypertrophy.

To examine the effects of antihypertensive therapy causing regression of left ventricular hypertrophy on cardiac arrhythmias, 26 hypertensive subjects were treated with ramipril with felodipine if required, and followed for 6 months after blood pressure control. Compared with baseline, left ventricular mass index (LVMI) was significantly reduced both at blood pressure control and after a further 6 months of treatment (baseline, blood pressure control, 6 months after blood pressure control; LVMI 142 +/- 3.6, 131 +/- 3.

Radioligand-binding analysis of human prostatic alpha-1 adrenoreceptor density following transurethral microwave therapy.

Objective: To determine the effects of single-session transurethral microwave treatment (TUMT) on human prostatic alpha-1 adrenoreceptor density in patients with symptomatic bladder outlet obstruction caused by benign prostatic hyperplasia.

Patients And Methods: Radioligand-binding assays using 3H-prazosin were performed on prostatic tissue obtained from 25 patients, 10 of whom had received a single TUMT whilst the remaining 15 patients had not, and acted as controls. Prostatic tissue was obtained by cold-punch biopsy immediately before transurethral resection of the prostate from 20 patients (10 following microwave treatment and 10 controls) and from a further five patients at the time of retropubic prostatectomy; these five patients again had undergone TUMT.

Left ventricular hypertrophy and QT dispersion in hypertension.

The interlead variation in QT length on a standard electrocardiograph reflects regional repolarization differences in the heart. To investigate the association between this interlead variation (QT dispersion) and left ventricular hypertrophy, we subjected 100 untreated subjects to 12-lead electrocardiography and echocardiography. Additionally, 24 previously untreated subjects underwent a 6-month treatment study with ramipril and felodipine.

The hypertension trials.

ESTABLISHED ANTIHYPERTENSIVE TREATMENT: Previous studies have clearly demonstrated the benefits of antihypertensive therapy, particularly in reducing the incidence of stroke. However, there is still concern that the full potential for reversing coronary heart disease in the hypertensive patient has not been realized by treatment with established agents, the diuretics and the beta-blockers. TRIALS ON NEWER AGENTS: A question that still remains to be answered is whether treatment regimens based on alternative drugs, including calcium channel blocking agents and angiotensin converting enzyme inhibitors, will confer an advantage over older drugs.

Depletion of resistance vessel polyamines attenuates angiotensin II induced blood pressure rise in rats.

Vascular structural changes in hypertension are proposed to contribute to raised peripheral resistance. Endogenous polyamines (putrescine, spermidine and spermine) have an essential role in cellular growth and may be required in vascular restructuring. We have previously shown raised polyamines in resistance vessels in response to angiotensin II (angII) infusion in the rat and here we examined whether polyamine depletion influences the hypertensive process.

Concomitant risk factors in hypertensives: a survey of risk factors for cardiovascular disease amongst hypertensives in English general practices.

Aims: To determine the prevalence of cardiovascular risk factors among hypertensives in a cross-sectional survey of hypertensives from 13 general practices in England.

Findings: Of 1,948 European hypertensives (systolic blood pressure 150 mmHg and/or diastolic blood pressure > 90 mmHg and/or on treatment for hypertension), 40 to 69 years of age, 53.3% on treatment had controlled blood pressures (systolic blood pressure < 160 mmHg and diastolic blood pressure < 95 mmHg).

Calcium channel blockers in the dock: innocent or guilty?

Several studies have recently been published which have raised doubts over the long-term safety of calcium channel blockers (CCB). These have included retrospective case control studies in hypertension and meta-analyses of small scale studies in unstable angina and myocardial infarction (MI). Most of the reports were primarily concerned with the use of the short acting dihydropyridine nifedipine.

Enhanced tissue polyamine content in the spontaneously hypertensive rat.

1. Endogenous polyamines play a key role in mediating cellular growth and differentiation. Hypertension is associated with structural modifications of the circulatory system, a process that may be facilitated by polyamines.

Effect of angiotension II on the expression of the early growth response gene c-fos and DNA synthesis in human vascular smooth muscle cells.

Objectives: The aims of this study were to characterize the angiotensin II receptor subtype present on vascular smooth muscle cells from human saphenous vein and to assess the effect of angiotensin II on the expression of the early growth response gene c-fos and on DNA synthesis.

Methods And Results: Using radioligand binding studies, we have defined the angiotensin II receptors present on these cells as being predominantly of the AT1 subtype. Angiotensin II increased peak intracellular calcium levels by 126 +/- 16 nmol/l (mean +/- SEM) in 17/49 cultures.