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Verhalten der Plasmareninaktivität unter Langzeitbehandlung des Hochdrucks mit Propranolol (1977)

Witzgall, H. ; Klaus, D. ; Braun, B. ; [et al.]

Springer

Journal of molecular medicine 55 (1977), S. 351-353

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ISSN: 1432-1440

Keywords: Plasma renin activity ; Long-term treatment ; Propranolol ; Essential hypertension ; Propranolol ; Essentielle Hypertonie ; Plasmareninaktivität ; Langzeitbehandlung

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Description / Table of Contents: Zusammenfassung 17 Patienten im Alter von 40±9 Jahren mit essentieller Hypertonie wurden mit Propranolol als Monotherapie oral in Dosen von 120, 160 oder 240 mg pro die behandelt. Nach 4wöchiger Behandlung konnten der Blutdruck und die Herzfrequenz statistisch signifikant gesenkt werden und blieben auch bei Fortsetzung der Therapie nach insgesamt 6 Monaten unverändert. Die Plasmareninaktivität betrug vor Behandlungsbeginn 5,7±6,3 ng/ml/h und sank nach 4wöchiger Behandlung auf 1,8±1,3 ng/ml/h ab. 5 Monate später stieg das Plasmarenin im Durchschnitt wieder auf 5,0±0,9 ng/ml/h an. Der erneute Anstieg war ebenfalls statistisch signifikant zu sichern. Von den 17 Patienten hatten nach 6 monatiger Therapie noch 7 (41%) eine niedrigere Plasmareninaktivität als vor Behandlungsbeginn. Davon lagen aber nur 3 (18%) unter dem Wert, der nach 4wöchiger Behandlungsdauer bestimmt wurde. Aus den genannten Befunden wird geschlossen, daß der Wiederanstieg der Plasmareninaktivität möglicherweise ein reaktiver Mechanismus auf die langzeitige Blutdrucksenkung ist. Die Erniedrigung der Plasmareninaktivität nach Kurzzeitbehandlung mit Propranolol kann nicht als ein Mechanismus für den antihypertensiven Effekt dieses Medikaments bei der Langzeitbehandlung angesehen werden.

Notes: Summary 17 patients (40±9 years) with essential hypertension were included in the study. A monotherapy of 120, 160 or 240 mg propranolol per day was administered orally according to the antihypertensive effect. Four weeks after treatment, blood pressure and heart rate showed a statistically significant decrease and remained unchanged over a period of six months. Plasma renin activity decreased significantly from 5.7±6.3 ng/ml/h at the beginning of the study to 1.8±1.3 ng/ml/h after 4 weeks. 5 months later however plasma renin activity increased again to 5.0±0.9 ng/ml/h. The difference was statistically significant. From 17 patients 7 (41%) had lower levels of plasma renin activity after 6 months treatment when compared with pretreatment values. In only 3 patients (18%) was plasma renin activity lower after 6 months than after four weeks. We conclude that the increase in plasma renin activity is a reactive mechanism to the reduced blood pressure under long-term conditions. The decrease of plasma renin activity in short-term treatment of essential hypertension is not a mechanism responsible for the antihypertensive effect of propranolol during long-term treatment.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01488116

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Significance of the inner-surface structure of small-caliber prosthetic blood vessels in relation to the development, presence, and fate of a neo-intima. A morphological evaluation (1984)

Hess, F. ; Jerusalem, C. ; Grande, P. ; [et al.]

Hoboken, NJ : Wiley-Blackwell

Journal of Biomedical Materials Research 18 (1984), S. 745-755

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ISSN: 0021-9304

Keywords: Chemistry ; Polymer and Materials Science

Source: Wiley InterScience Backfile Collection 1832-2000

Topics: Medicine , Technology

Notes: Microvascular prostheses with three different inner surface structures were examined morphologically 1-18 months after implantation to evaluate the presence and structure of the neo-intima. Fibrous polyurethane tubes (length: 5-10 mm, inner diameter: 1.5 mm) were implanted in the rat abdominal aorta in group A with a fibrillar inner structure (pore sizes 20-50 m̈m), and in group B the inner fibrillar structure was coated with an impermeable continuous silicon sheet. Expanded polytetrafluorethylene vascular prostheses (length: 40 mm, inner diameter: 4 mm) were implanted in the dog carotid artery (group C). The specimens were examined by light microscopy and scanning electron microscopy. A continuous and permanent neointima was only found in the prostheses with the porous fibrillar inner structure (group A). The thin new lining sheet was well attached to the prosthetic wall by cellular protrusions. In the silicon-coated prostheses (group B) also a continuous neo-intima had developed which, however, was irregular, thicker, and not anchored to the prosthetic wall. The expanded polytetrafluorethylene prostheses (group C) showed also after 1 year only incomplete lining with a neo-intima. Fresh blood cell deposits could be observed in the unlined prosthetic wall. It is concluded that a continuous lining of vascular grafts with a thin neo-intima is only achieved if the cells invading the prostheses from the anastomotic areas can anchore their cytoplasmic protrusions onto an appropriately structured inner surface. If these anchoring facilities are not provided, the unattached neo-intima will thicken, interfering with the patency of these microvascular prostheses, or fragments of the neo-intima or alternatively mural thrombi may constantly strip off and embolize.

Additional Material: 7 Ill.