Short-term changes in lipoproteins and apoproteins during cyclical oestrogen-progestogen replacement therapy.

Lipoproteins and apoproteins were measured weekly in a group of 18 post-menopausal women treated with a cyclical hormone replacement regimen comprising 28 days on conjugated equine oestrogens (0.625 mg/day) with the addition of norgestrel (0.15 mg/day) for the last 12 days of the cycle.

The effects of age on the pharmacokinetics, antihypertensive efficacy and general tolerability of dilevalol.

1. This study investigated the influence of age on the pharmacokinetics, pharmacodynamics, general tolerability and concentration-effect relationships in 18 patients with essential hypertension (age range 23-73 years) during treatment with dilevalol, a non selective beta-adrenoceptor antagonist with vasodilator properties. 2.

Physiological changes due to age. Implications for cardiovascular drug therapy.

Cardiovascular disease is the single largest cause of death in the elderly. Many of the published studies concerning the physiology and pharmacology of the aging cardiovascular system are seriously flawed. Problems include failure to measure the drug bioavailability and the selection of subjects with overt or subclinical disease.

Studies with abanoquil (UK-52,046) a novel quinoline alpha 1-adrenoceptor antagonist: II. Duration of action, pharmacokinetics and concentration-effect relationships in normotensive subjects.

1. This study further examines the quinoline-derivative abanoquil with particular respect to the duration of its alpha 1-adrenoceptor antagonist activity and its concentration-effect relationship following a single intravenous bolus dose of 0.5 micrograms kg-1 in young, normotensive males.

Studies with abanoquil (UK-52,046) a novel quinoline alpha 1-adrenoceptor antagonist: I. Effects on blood pressure, heart rate and pressor responsiveness in normotensive subjects.

1. Abanoquil (UK 52,046) is a novel, quinoline-derivative, alpha 1-adrenoceptor antagonist which, on the basis of animal studies, possesses antiarrhythmic activity at doses which have little or no effect on blood pressure. 2.

A dose-ranging study of UK-68,798, a novel class III anti-arrhythmic agent, in normal volunteers.

1. UK-68,798, a novel class III anti-arrhythmic agent was administered intravenously to twelve healthy volunteers in a placebo controlled, double-blind, dose-escalating study. 2.

The influence of age on the pharmacokinetics of verapamil.

The influence of age on the pharmacokinetics of verapamil at steady state has been studied in 74 individuals, age range 19-79 years, including healthy normotensive volunteers and patients with essential hypertension. The peak plasma concentrations (Cmax) of verapamil were significantly higher in older subjects (r = 0.24; P = 0.

Plasma oxalate in patients with chronic renal failure receiving continuous ambulatory peritoneal dialysis or hemodialysis.

Plasma oxalate was measured in 20 patients receiving continuous ambulatory peritoneal dialysis (CAPD) and 20 patients receiving hemodialysis (HD). All patients had levels well above the reference range of less than 2.0 to 5.

Combined lipid-lowering and antihypertensive treatment as part of a strategy of multiple risk factor intervention.

Thirty-six patients with treated mild to moderate hypertension and hypercholesterolaemia (greater than 6.5 mmol/l) entered a 12 week study to evaluate the efficacy and patient tolerability of combined lipid-lowering and antihypertensive treatment as part of a strategy of multiple risk factor intervention. The principal effects on the plasma lipid profiles were significant reductions of 30-40% in total and LDL cholesterol.

Hypertension and coronary artery disease. Can the chain be broken?

Hypertension is an established risk factor for all the clinical sequelae of coronary artery disease. Despite this, individual therapeutic trials of antihypertensive therapy have not demonstrated the expected reduction in coronary morbidity and mortality. This apparent failure is perhaps not surprising when one considers the multifactorial nature of coronary artery disease and the different ways in which hypertension may affect the coronary circulation.

The response to the first dose of an angiotensin converting enzyme inhibitor in uncomplicated hypertension--a placebo controlled study utilising ambulatory blood pressure recording.

1. The importance of total dose to the initial hypotensive response with an angiotensin converting enzyme inhibitor (quinapril) was assessed using a suggested 'maintenance' dose (20 mg) or matched placebo in a randomised double-blind study in patients with uncomplicated hypertension. 2.

The interactions between nisoldipine and two beta-adrenoceptor antagonists--atenolol and propranolol.

1. The interactions between the dihydropyridine calcium antagonist nisoldipine and two beta-adrenoceptor blocker drugs (atenolol and propranolol) were investigated in two groups of healthy normotensive subjects. 2.

Imidazole binding sites in rabbit kidney and forebrain membranes.

1. The binding of [3H]-clonidine, [3H]-idazoxan and [3H]-yohimbine to rabbit forebrain and kidney membranes was compared. 2.

Case report: duodenal diverticula and jaundice: ultrasound can be misleading.

Most duodenal diverticula are asymptomatic, but they may create diagnostic difficulties. We report a case of obstructive jaundice in which ultrasound revealed a mass in the region of the head of the pancreas produced by a diverticulum in the second part of the duodenum which was initially misdiagnosed as a carcinoma of the pancreas.

A pilot study of the efficacy and safety of bolus administration of alteplase in acute myocardial infarction.

Objective: To examine the efficacy, safety, and the pharmacokinetic profile of a bolus dose administration regimen of alteplase in the treatment of acute myocardial infarction.

Design: An open pilot study.

Setting: District general hospital.

Transpulmonary pharmacokinetics of an ACE inhibitor (perindoprilat) in man.

1. The transpulmonary pharmacokinetics of the intravenous diacid ACE inhibitor perindoprilat were studied in 10 male patients undergoing diagnostic cardiac catheterisation for the management of ischaemic heart disease. 2.

Inhibitory effect of uraemia on the hepatic clearance and metabolism of nicardipine.

1. The principal aim of this study was to investigate the effect of renal impairment on the pharmacokinetics of nicardipine following intravenous and oral dosing. 2.

Doppler evaluation of a left atrial myxoma.

We present a detailed Doppler evaluation of a left atrial myxoma. Doppler recordings varied considerably with the position of the patient and of the sample volume. Maximum obstruction to flow was observed in the left lateral position; but no gradient was present when sitting upright.

Left ventricular hypertrophy in hypertension.

Major advances in left ventricular hypertrophy (LVH) and hypertension have occurred in recent years. The ability to diagnose LVH has been improved by echocardiography, and with this technique it has been shown that evidence of LVH is an important independent risk factor for cardiovascular disease. The major cause of death in patients with hypertension and LVH is coronary artery disease.

The protective effect of a conductive hearing loss in workers exposed to industrial noise.

There is controversy as to whether a conductive hearing loss protects the inner ear from the effects of loud noise. A retrospective study was carried out on 24 patients with a combination of unilateral conductive hearing loss and noise-induced hearing loss. This allowed subjects to act as their own controls.

The effect of renal impairment on the pharmacokinetics and metabolism of bopindolol.

The pharmacokinetics of the non-selective beta-adrenoceptor antagonist, bopindolol, have been studied in 18 hypertensive patients with varying degrees of renal impairment following single and multiple oral dosing. Bopindolol, which undergoes extensive hepatic metabolism, was found to accumulate in patients with chronic renal failure but the disposition in patients on regular haemodialysis did not differ significantly from patients with normal renal function. The mechanism underlying these changes in pharmacokinetics is not clear but suggests the presence of metabolic inhibitors in uraemic plasma which are removed by regular haemodialysis.