Echocardiographic assessment of ejection fraction in left ventricular hypertrophy.

Objective: To investigate the value of Simpson's rule, Teichholz's formula, and recording of mitral ring motion in assessing left ventricular ejection fraction (EF) in patients with left ventricular hypertrophy.

Design: Left ventricular ejection fraction calculated by Simpson's rule and by Techholz's formula and estimated by mitral ring motion was compared with values obtained by radionuclide angiography.

Setting: Secondary referral centre.

A comparison of 100 mg atenolol and 100 mg metoprolol once a day at rest and during exercise in hypertensives.

The effects of once daily dosage of the two cardioselective beta-adrenoceptor blocking agents, atenolol and metoprolol, were studied in 26 patients with primary hypertension. The study was a randomized double-blind cross-over trial with placebo run-in and wash-out. Assessment of effect was performed about 1 and 25 hours after dosing.

Timolol and hydrochlorothiazide-amiloride in primary hypertension.

Fifty-five patients with primary hypertension, World Health Organization (WHO) stages I and II, were randomly allocated to a 9-mo multicenter, controlled, double-blind, crossover study with timolol, a nonselective beta adrenoceptor blocker, and hydrochlorothiazide combined with the potassium-sparing drug amiloride (AHCT). In 54% of the patients the blood pressure responded to timolol, in 87% to AHCT, and in 91% to a combination of the two. The diurectic was more effective than the beta blocker in patients with low-renin hypertension, who all responded to AHCT.

Clinical and biochemical effects of spironolactone administered once daily in primary hypertension. Multicenter Sweden study.

In a prospective, double-blind, intraindividual, cross-over, placebo-controlled multicenter study, clinical and biochemical effects of once daily postprandial dose regimens of 50, 100, and 200 mg spironolactone were investigated in 45 outpatients with primary hypertension, WHO (World Health Organization) Stage I-II. Each of the three active therapy periods, which were randomly allocated to patients, were of 2 months' duration, with intervening placebo periods, Clinical and biochemical parameters, including furosemide-stimulated plasma renin activity (PRA), were recorded at regular intervals. All three spironolactone doses resulted in statistically significant blood pressure (BP) reductions independent of initial pretreatment levels and yielded satisfactory BP control in more than half of the patients.

Once-daily metoprolol in primary hypertension.

The antihypertensive effect of the selective beta-1-adrenoceptor blocker, metoprolol, administered once daily was evaluated in 32 patients with primary hypertension. After a 4-wk placebo period, the patients were treated with either 150 mg or 300 mg of metoprolol, once daily, for 8 wk. Initially and during the treatment periods blood was drawn for analysis of metoprolol in plasma, plasma renin activity (PRA), and electrolytes, and urine was collected for determination of the urinary aldosterone excretion.

Atenolol administered once daily in primary hypertension. Effects on blood pressure in relation to pre-treatment plasma renin activity.

The antihypertensive effect on the selective beta-1-adrenoceptor blocking agent, atenolol, given in doses of 100 and 200 mg once daily, was evaluated in 37 patients with primary hypertension. The drug induced an efficient reduction of BP, and in the whole patient series there was no difference in BP on either dosage. Exercise tests, performed in 10 patients, showed the same degree of partial beta-blockade 24 hours after intake of 100 and 200 mg atenolol.

Angiotensin II in primary hypertension, relationship to plasma renin activity, aldosterone and urinary electrolytes.

Plasma concentrations of angiotensin II (AII) were studied in 36 patients with primary (essential) hypertension and 15 normotensive control subjects during basal (1 h supine rest), upright and frusemide-stimulated (80 mg orally) conditions. Plasma renin activity (PRA) and plasma aldosterone (PA) were determined on the same occasions. AII was then correlated statistically to PRA, PA and 24-hour urinary excretions of aldosterone (Aldo-U), sodium and potassium and to the blood pressure (BP) levels.

Aldosterone in primary hypertension relationship to plasma renin activity and urinary electrolytes and a comparison with normotensive subjects.

Plasma aldosterone (PA) and urinary aldosterone (Aldo-U) concentrations were studied in 123 patients with primary (essential) hypertension during basal (1 h supine rest), upright and frusemide (80 mg orally) stimulated conditions, and were related to urinary sodium and potassium excretions, supine and sitting blood pressure (BP) and the relationship to plasma renin activity (PRA). As controls, 120 normotensive subjects, matched for age and sex, were investigated identically during strictly defined out-patient conditions. No differences regarding the different mean PA levels, urinary electrolyte excretion or the urinary sodium: potassium ratio were observed between the hypertensive and the normotensive populations.

Age, blood pressure, renin and urinary electrolytes in primary hypertension and in the normotensive state.

One hundred and twenty-three patients, sixty-four men and fifty-nine women, with primary hypertension were studied with regard to supine and sitting blood pressure (BP), plasma renin activity (PRA) during basal and stimulated conditions, and urinary sodium and potassium excretions. The patients ranged in age from 20 to 76 (mean 48) years. A control material of 120 normotensive subjects, forty-nine men and seventy-one women, with an age range 22--78 (mean 47) years were studied during the same strictly standardized conditions.

Plasma and urinary aldosterone and their interrelations with blood pressure, plasma renin activity and urinary electrolytes in normotensive subjects.

Plasma aldosterone (PA), urinary aldosterone excretion (Aldo-U), urinary sodium and potassium excretion and supine and sitting blood pressure (BP) were studied in 120 normotensive subjects. PA was determined after 1 h supine rest (basal PA), after ambulation for 3--4 h (upright PA) and after stimulation with 80 mg frusemide orally (stimulated PA). Aldo-U and urinary electrolytes were measured the day before the PA determinations.

Platypnoea after pneumonectomy caused by a combination of intracardiac right-to-left shunt and hypovolaemia. Relief of symptoms on restitution of blood volume.

A patient developed platypnoea about a month after pneumonectomy. The symptoms proved to be due to a combination of an atrial right-to-left shunt and hypovolaemia. Blood volume substitution did not change the direction of the shunt, but the symptoms were relieved.

Relationships between blood pressure, age, plasma renin activity and electrolyte excretion in normotensive subjects.

Plasma renin activity (PRA), supine and sitting blood pressure (BP) and urinary sodium and potassium excretion were studied in 120 normotensive subjects aged 22--78 years, during strictly standardized conditions. PRA was measured after 1 h supine rest (basal PRA) after ambulation for 3--4 h (upright PRA) and after stimulation with 80 mg frusemide orally (stimulated PRA). PRA was determined with a new, simple, accurate and sensitive radioimmunoassay method.

Different antihypertensive effect of beta-blocking drugs in low and normal-high renin hypertension.

The treatment response to beta-adrenoceptor blocking drugs was compared in two groups of patients with primary (essential) hypertension and different renin levels. Each group consisted of 25 patients and was equally distributed regarding age, severity and stage of hypertension. In the first group (group 1), the mean upright plasma renin activity was 0.

Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity.

Twenty-seven patients with hypertension were randomly allocated to a 10 month crossover study. Treatment consisted of spironolactone (200 mg/day for 2 months), propranolol (320 mg/day for 2 months) and combined administration of both drugs at half the dosage. Between treatment periods placebo was given for 2 months.

Renin concentrations and effects of propranolol and spironolactone in patients with hypertension.

In a crossover study 32 patients with hypertension were randomly allocated to treatment with spironolactone 200 mg/day for two months, propranolol 320 mg/day for two months, and a combination of both drugs at half the dose. Between the treatments placebo was given for two months. Both spironolactone and propranolol lowered the blood pressure significantly in both positions.