In 13 untreated patients with essential hypertension, the plasma volume (T-1824) and the extracellular fluid volume ( 82 Br - distribution space) were determined three times. During treatment with 50 to 100 mg of hydrochlorothiazide daily, determinations of plasma volume and extracellular fluid volume were repeated after treatment for 1 mo (13 patients), 2 mo (13 patients), 4 mo (eight patients), and 6 mo ( seven patients). In all cases the average plasma and extracellular fluid volumes were reduced compared with the averages of three control values. The plasma volume was significantly reduced at the 5% level after treatment for 1, 2, and 4 mo. Corresponding studies from the literature have been reviewed and, on the basis of these studies and our own results, it is concluded that thiazides have a volume-depleting effect which is continued during long-term treatment of patients with essential hypertension.
ABSTRACT. The occurrence of rupture of the external cardiac wall (CR) in a consecutive series of 2 244 admissions with confirmed acute myocardial infarction (AMI) has been analysed. The series comprises the unselected admissions to a single department, evaluated according to uniform criteria, with postmortem examination in 95% of fatal cases. The incidence of CR was 3.2% af all cases of AMI, and 12.6% of all deaths. CR was significantly more frequent in women than in men, and in both sexes significantly more frequent after the age of 60, though the age distribution did not differ significantly from that of the patients dying from other causes. Moreover, CR was significantly more frequent in anterior wall infarctions, and in patients with no previous AMI. The majority of CR (84%) occurred within the first week, and a considerable part (32%) within the first 24 hours after the onset of infarction. According to findings at autopsy, CR was accompanied particularly often (in 71%) by complete occlusion of a major coronary artery. Autopsy findings gave no evidence that attempts at resuscitation, including external cardiac massage (65 patients), as well as intracardial injections (55 patients) and transthoracic introduction of a pace catheter (3 patients), could have any connection with the development of CR. The usual strict immobilization of the patients was applied during the first part of the series, but in the latter half (1 337 admissions) the patients were allowed to be out of bed from the first day with no imposed immobilization at all. The incidence of CR did not change significantly throughout the period, and the indication for maintaining the traditional immobilization of patients with AMI is questioned.
Serum concentrations of parathyroid hormone (s-PTH) calcium, phosphorus and alkaline phosphatase were measured during treatment with furosemide or bumetanide for congestive heart failure. Significant elevations both of s-PTH and alkaline phosphatase were found, whereas serum calcium concentration was decreased. The changes were not related to the dose of drug or to the duration of treatment. It is concluded that treatment with furosemide or bumetanide may cause hypocalcaemia, resulting in elevation of s-PTH. The increased concentration of alkaline phosphatase may indicate accelerated bone remodelling, as found in primary hyperparathyroidism.
1. Twenty-five patients with mild essential hypertension, identified during a survey of a population born in 1936, were investigated.2. Basal and post-frusemide values for plasma renin concentration and plasma angiotensin I1 concentration did not differ markedly from reference values in 25 40-year-old control subjects.In the untreated, sodium replete state saralasin infusion (5.4 nmol min-I kg-I) produced an increase in mean arterial pressure in the patient group as a whole. 3. Twenty-one patients were treated with hydrochlorothiazide, mean dose 75 mg/day for 3 months.Pre-treatment, frusemide-stimulated plasma renin concentration and plasma angiotensin 11, and values during thiazide treatment were higher in 'non-responders' (n = 10) to hydrochlorothiazide treatment than in 'thiazideresponders' (n = 11). During thiazide therapy, angiotensin I1 blockade induced a clear-cut decrease in mean arterial pressure in all 'thiazide-nonresponders' whereas only four out of 11 'thiazideresponders' showed a borderline decline in mean arterial pressure.4. The functional significance of the reninangiotensin system in mild essential hypertension emerges only after thiazide treatment. Thiazideinduced stimulation of the renin-angiotensin system counter-balanced the hypotensive effect of thiazide in some 40% of the treated patients. Thus the responsiveness of the renin-angiotensin system Correspondence: Dr H. Ibsen, Department of C h i d Physiology, Glostrup Hospital, 2600 Glostrup, Denmark. determined the blood pressure response to thiazide treatment. Plasma renin concentration (PRC), angiotensin II concentration (PA II) and aldosterone concentration rest supine and after frusemide with ambulation, in mild untreated essential hypertension (n = 23) and normotensive control subjects (n = 25) Median values are shown with range in parentheses. n.s. = Not significant. Essential hypertension Normotensive (control) PRC (mi.u./l) Rest supine PA11 (pmol/l) Rest supine PAC (pmol/l) Rest supine Frusemide + ambulation Frusemide + ambulation Frusemide + ambulation 29 (1 1-67) n.s. 31 (11-49) 57 (14-162) n.s. 78 (17-225) 8 (4-22) n.s. 10 (4-20) 26 (6-72) P < 0.05 35 (12-91) 195 (56-417) ns.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.