[Comparative study of potassium-sparing effects of triamterene and amiloride in the treatment with hydrochlorothiazide]. / Sravnitel'noe izuchenie kaliisberegaiushchego éffekta triamterena i amilorida pri lechenii gidrokhlortiazidom.

Hydrochlorothiazide (HCT), 25 or 50 mg a day, alone and in combination with triamterene (T), 50 and 100 mg, respectively, or amiloride (A), 2.5 and 5 mg, respectively, was examined for effects on daily urinary potassium and sodium excretion. Daily sodium excretion was increased 1.5-2-fold with a double dose of the combined drugs as compared with their single dose. T and A produced additive effects on the natriuretic action of HCT. Lower doses of HCT and T failed to prevent urinary potassium loss, but their potassium-sparing effect was shown with their double dose. This effect was largely displayed by A given in a single or double dose. Lower serum potassium levels were seen with all the drugs, but this was less marked with HCT combined with T or A than with HCT monotherapy. Their double dose reduced serum potassium levels to an insignificantly greater extent. In some cases, the elderly patients developed hyperkalemia during the combined therapy. Thus, with the routine dose ratios, A showed a slightly higher potassium-sparing effect than did T. Some patients taking HCT in combination with T showed reddish-brown crystals and casts in the urinary sediment, which may indicate its tubular interstitial damaging action. Consequently, use of the combined drugs is more preferable than HCT monotherapy, and HCT in combination with A is likely to be more preferable than that with T.

[Effect of nifedipine on renal activity]. / Vliianie nifedipina na deiatel'nost' pochek.

Sublingual administration of nifedipine (N) at a dose of 20 mg to 8 persons without cardiovascular and renal pathology and to 19 patients with congestive heart failure (CHF) increased renal excretion of sodium (by an average of 51.1-132.8%), water (by an average of 31.7-101.9%), potassium (by an average of 43.2-63.2%) and calcium (by an average of 118%). The natriuretic effect of N appeared in 20 min reaching its maximum in 45-60 min, being more noticeable in CHF. An increment of natriuresis resulted from a decrease in sodium tubular reabsorption (correlation factor--0.92) rather than from an increase in glomerular filtration (correlation factor +0.50). N suppressed sodium reabsorption in the proximal tubule (by an average of 34.1%) as well as in the segment, more distal of Henle's loop (by an average of 6.8%). N might suppress directly calcium-dependent mechanisms of sodium transtubular transport but it could also produce a mediated effect as a result of shifts of renal hemodynamics.

[Renal effects of captopril in chronic heart failure]. / Renal'nye éffekty kaptoprila pri khronicheskoi serdechnoi nedostatochnosti.

The effect of captopril on renal function, central hemodynamics and the hormonal status was studied in 14 patients with chronic congestive heart failure in single administration of the drug at a dose of 25 mg and during short-term course therapy at a daily dose of 75 mg for 7 days. Captopril single administration was shown to cause an increase in natriuresis by 121% and diuresis by 120%. Correlation analysis showed that the natriuretic effect of captopril resulted from a decrease in tubular sodium reabsorption which, in its turn, was determined by a decrease in the production of angiotensin II and changes of pritubular circulation. Seven-day course therapy was accompanied by the patients' improved general status, improved indices of hemodynamics, and better tolerance to physical exercise. At the same time diuresis and renal excretion of sodium were above the basal level by 113 and 86%, respectively. It can be assumed that this natriuretic effect was determined by the suppression of angiotensin II, aldosterone and probably norepinephrine and vasopressin production. The analysis has shown that a favorable captopril renal effect is not mediated through improved central hemodynamics but results from changes of the hormonal and neurohumoral status.

[Should antihypertensive pharmacotherapy have occupational limitations?]. / Nuzhdaetsia antigipertenzivnaia farmakoterapiia v professional'nykh ogranicheniiakh?

Neurophysiologic effects of a course of treatment with reserpin (0.5-0.75 mg/day), dopegyt (750-1500 mg/day), clophelin (0.3-0.6 mg/day), anaprilin (80-160 mg/day), hydrochlorothiazide (25-100 mg/day) were examined in 294 patients with first- and second-stage essential hypertension (EH), using the correction test and the numbers-finding test, determination of the highest data processing rate by the Diagnoz-2 device, and the time of response to sound and light stimulation under monotonous conditions. There were no significant differences in test results between EH patients treated with the above-mentioned drugs and the placebo-treated ones. Neither single doses, nor courses taken in hospital (1 to 3 weeks) or outpatient clinic (6 to 36 months) produced any regular suppressive effect on the neurophysiologic status of EH patients.

[Secondary prevention of arterial hypertension in an organized population: methods of implementation, efficacy, prospects]. / Vtorichnaia profilaktika arterial'noi gipertonii v organizovannoi populiatsii: puti realizatsii, éffektivnost', perspektivy.

Five-year follow-up of an organized population of males between 35 and 54 years of age and medication of patients with arterial hypertension (AH) demonstrated possibilities of considerably reducing the incidence of cerebral insult (by 42.9%) and myocardial infarction (by 15.5%) and the respective mortality rates (by 56.1% and 23.8%), invalidism associated with cardiovascular diseases (by 36%), temporary disability because of AH (by 38.2%). The efficiency of treatment for AH increases considerably where medication is given on a regular basis. Possible approaches to improving the efficiency of secondary AH prevention within an organized population are discussed, as are possibilities of introducing preventive measures in routine work of the factory therapeutic service.