[The comparison of clinical effectiveness of perindopril and acebutolol in the primary hypertension treatment]. / Porównanie skutecznosci klinicznej perindoprilu i acebutololu w leczeniu pierwotnego nadcisnienia tetniczego.

Hypertension is one of the most important risk factors for ischaemic heart disease and stroke. The aim of our study was to assess the antihypertensive effect of angiotensine converting enzyme inhibitor (perindopril) versus beta blocker (acebutolol) in hypertensive patients. It was a double blind, placebo controlled study performed in the group of 31 patients (16 males, 15 females; mean age 46.6 +/- 8.7 years) with newly diagnosed (previously not treated) mild to moderate hypertension. Each patient in the wash-out period (two weeks) was given placebo and then was randomized to active treatment: perindopril (4 mg/day) or acebutolol (400 mg/day) for 3 weeks, following these drugs were cross matched (after one week wash out period). Blood pressure (BP) with mercury sphygmomanometer was measured three times: after 2 weeks of placebo treatment, after 3 weeks of perindopril and 3 weeks of acebutolol treatment. Both perindopril and acebutolol proved to be effective in monotherapy of hypertension. After 3 weeks of the treatment we observed BP systolic and diastolic normalization, but more patients had systolic BP normalization after perindopril treatment.

Comparison of the effect of perindopril and acebutolol on cerebral hemodynamics in hypertensive patients.

PURPOSE: The aim of the study was to compare effect of perindopril (4 mg once a day) versus acebutolol (400 mg once a day) on cerebral hemodynamics in hypertensive patients. METHODS: Thirty untreated patients with mild-to-moderate hypertension were studied. Drug influences on Doppler-derived parameters from the cerebral blood flow (CBF) velocity wave form were evaluated in a randomized, double blind, cross-over, placebo controlled study. The mean CBF velocity, pulsatility index (PI), cerebrovascular resistance and index of CBF were calculated from concomitant transcranial Doppler measurements and systemic blood pressure. RESULTS: Acebutolol and perindopril significantly decreased systolic, diastolic and mean blood pressure in relation to placebo. The mean value of CBF velocity increased to a comparable level after both drugs (54.9 +/- 9.1 cm/s on placebo vs 62.8 +/- 14.5 cm/s on perindopril p<0.01 and 61.4 +/- 9.2 cm/s on acebutolol, p<0.01). Also, the cerebrovascular resistance index decreased similarly after both drugs (2.26 +/- 0.35 on placebo vs 1.68 +/- 0.42 on perindopril p<0.01 and 1.7 +/- 0.36 on acebutolol p<0.01). The calculated CBF index increased significantly after each drug (25.23 +/- 7.99 on placebo vs 33.98 +/- 11.23 p<0.01 on perindopril and 30.90 +/- 8.04 on acebutolol p<0.01). However, perindopril augmented the CBF index more effectively than acebutolol (p<0.05). CONCLUSIONS: Among patients with mild-to-moderate hypertension both acebutolol and perindopril beneficially decreased cerebrovascular resistance and increased the CBF index in comparison with placebo. The increase of CBF index was greater after perindopril than acebutolol, which suggests a more significant improvement in cerebral perfusion by perindopril. The non-invasive transcranial Doppler ultrasonography method of CBF velocity measurement may contribute to choosing optimal antihypertensive therapies and to monitor their effect.

[Clinical evaluation of nitrates in exercise-induced angina]. / Ocena skutecznosci klinicznej nitratów w indukowanej wysilkiem dusznicy bolesnej.

Nitroglycerine (NTG) is still the most important angina relief drug. The aim of the study was to evaluate clinical effects and tolerance of sublingually nitroglycerine sub form Nitromint-spray in patients with exercise induced angina pectoris (AP) using treadmill electrocardiography stress test (EST). The study group consisted of 40 adults patients (mean age 57.4 +/- 10.08 years) hospitalised in our clinic with AP confirmed by clinically and electrocardiographically positive EST. Tests were performed using treadmill Marquette-Centra equipment, according to the modified Bruce protocol after 3 days wash-out period. On the fourth day two ESTs were performed: EST-0 and 30 minutes later EST-NTG after sublingual administration 0.8 mg of NTG. Among measured parameters after NTG exercise induced ST segment depression decline from 2.3 +/- 1.0 to 1.5 +/- 0.8 (p < 0.0001). EST after NTG became electrocardiographically negative in 11 patients. NTG increased workload, and time to angina pain oneset (p < 0.0001). Nitromint-spray proved to be clinically effective, well tolerated and easy to use.

[Physiological and pathophysiological role of histamine in the gastrointestinal tract]. / Rola histaminy w przewodzie pokarmowym w stanach fizjologii i patologii.

In this paper, the authors discuss problems concerning the role played by histamine in various physiological and pathological processes in the gastrointestinal tract. The synthesis and metabolism of histamine is described. Apart from participation in many physiological processes, e.g. secretion of gastric juice, histamine takes part in many pathological reactions occurring in celiac disease, food allergy and inflammatory bowel diseases.

[Evaluation of the antihypertensive efficacy and safety of using sustained release verapamil in elderly subjects using ambulatory blood pressure monitoring]. / Ocena skutecznosci hipotensyjnej oraz bezpieczenstwa stosowania werapamilu o przedluzonym dzialaniu u osób w wieku podeszlym przy uzyciu ambulatoryjnego monitorowania cisnienia krwi.

OBJECTIVE: Calcium antagonists are commonly used drugs in the treatment of hypertension in elderly patients. One of the drugs of this group is verapamil. Especially its slow release formula is convenient for use in elderly patients (drug is given once daily). The aim of our study was to evaluate the antihypertensive efficacy of 240 mg slow release verapamil given once daily in elderly hypertensives using ambulatory blood pressure monitoring (ABPM). We also evaluated the safety of this slow release formula using trough to peak ratio. DESIGN AND METHODS: Twenty hypertensives of mean age 67.5 +/- 5.3 were enrolled into the study. Our study was performed using double-blind, placebo-controlled cross-over study design. After a 2-week wash-out period 24-hour ABPM was performed for the first time and then twice: after 2 weeks of placebo or 240 verapamil slow-release and after 2 weeks of verapamil or placebo treatment. The readings prior to and after the treatment were taken using the same procedure. Blood pressure measurements were recorded every 15 minutes between 7.00 and 23.00 and every 30 minutes between 23.00 and 7.00. RESULTS: Verapamil treatment statistically significantly reduced (p < 0.05) mean 24 hour systolic blood pressure from 148.88 +/- 7.56 mmHg to 132.24 +/- 6.13 mmHg and diastolic respectively from 96.68 +/- 6.05 to 83.04 +/- 5.40 mmHg. Heart rate decreased from 77.16 +/- 3.84 BPM to 68.88 +/- 4.41 BPM. Placebo-corrected trough to peak ratio was 70% for systolic blood pressure.

Studies of aqueous humor proteins in rabbits after posterior chamber lens implantation.

In 13 rabbits, 1 month to 1 year after posterior chamber lens implantation/polymethylmetacrylate/, the level of aqueous humor proteins was evaluated and the proteins separation in polyacylamide gel was performed. The studies were also carried out in unoperated eyes of the same animals and control group was composed of the eyes before surgery. It was found that in pseudophakic eyes an increased level of proteins remained during the whole year/the highest one month after surgery, slowly decreasing afterwards/, with the appearance of additional fractions. The moderate increase of the proteins concentration was also observed in unoperated eyes. The increase of aqueous humor proteins in pseudophakic eyes indicates that the presence of polymethyl metacrylate is not completely indifferent to the eyeball in spite of the suggestions derived from the clinical observations.