RESUMO
The prevalence of peripheral vascular disease in patients with coronary artery disease has been investigated in many different ways and depends on the diagnostic methods and the definition of the atherosclerotic manifestations in the different vascular beds. In this study we used the non-invasive methods digital volume pulse plethysmography and ankle and toe blood pressure measurements to identify arterial abnormalities in the lower limbs in 58 patients (49 males and 9 females; age 37-72 years) examined with coronary angiography. The prevalence of peripheral artery disease was 22%, in agreement with the results of most previous investigations. There was a tendency towards increasing prevalence of peripheral artery disease with more advanced coronary artery disease: 14% of the patients with no or minimal coronary atheromotous lesions, 18% of the patients with moderate coronary atheromotous lesions and 32% of the patients with marked coronary atheromotous disease. For this reason a non-invasive investigation of the peripheral arterial circulation should be included early in the clinical consideration of patients with chest pain or similar symptoms suggesting coronary heart disease. Toe pressure measurement appears to be the most appropriate technique being rather simple in management and also in evaluation of results.
Assuntos
Arteriosclerose/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Doenças Vasculares Periféricas/epidemiologia , Arteriosclerose/diagnóstico , Determinação da Pressão Arterial , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/diagnóstico , Pletismografia , Prevalência , Dedos do Pé/irrigação sanguíneaAssuntos
Hidroclorotiazida/uso terapêutico , Hipertensão/tratamento farmacológico , Metoprolol/uso terapêutico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Preparações de Ação Retardada , Método Duplo-Cego , Quimioterapia Combinada , Exercício Físico , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hidroclorotiazida/administração & dosagem , Hidroclorotiazida/efeitos adversos , Hipertensão/fisiopatologia , Masculino , Metoprolol/administração & dosagem , Metoprolol/efeitos adversos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , ComprimidosRESUMO
The effect of carvedilol on cardiovascular and physical performance parameters at rest and during exercise was evaluated in an open, uncontrolled study. Assessments were made at rest, at one-half anaerobic threshold (1/2AT), at AT, and at maximal work load (WLmax) before and after 3 weeks of treatment with 12.5 mg carvedilol once daily for 1 week, followed by 25 mg carvedilol once daily for 2 weeks. Ten well-conditioned healthy male volunteers maintained their regular training program during the study, and all completed the study. End-of-study measures of physical performance (time to WLmax, WLmax, and VO2/kg) and behavioral measures (Borg scale) of perceived exertion were unchanged from prestudy values. End-of-study diastolic BP (DBP) at rest and at WLmax was unchanged compared with prestudy values (mean +/- SD; 81.0 +/- 7.38 and 84.4 +/- 4.95 mm Hg, respectively, compared with 82.0 +/- 8.88 and 85.0 +/- 7.07 mm Hg, respectively). Mean +/- SD change from prestudy to end-of-study baseline resting systolic BP (SBP) was a reduction of 11.5 +/- 8.83 mm Hg, and mean +/- SD change from prestudy to end-of-study SBP at WLmax was a reduction of 20.0 +/- 12.25 mm Hg. Mean +/- SD change from prestudy to end-of-study resting heart rate (HR) a reduction of 7.8 +/- 18.45 beats/min, and mean +/- SD change from prestudy to end-of-study HR at WLmax was a reduction of 19.7 +/- 9.24 beats/min. The effect of carvedilol thus represents a combination of reduction in resting systolic BP and HR and attenuation of the exercise-induced changes in these parameters.(ABSTRACT TRUNCATED AT 250 WORDS)