Showing papers by "Sverre E. Kjeldsen published in 1994"

Exercise blood pressure predicts cardiovascular mortality in middle-aged men.

Abstract: The outcome of 1999 apparently healthy men aged 40 to 59 years investigated from 1972 through 1975 was ascertained after 16 years to determine whether systolic blood pressure measured with subjects in the sitting position during a bicycle ergometer exercise test adds prognostic information on cardiovascular mortality beyond that of casual blood pressure measured after 5 minutes of supine rest. During a total follow-up of 31,984 patient years, 278 patients died, 150 from cardiovascular causes. Casual blood pressure and pulse pressure as well as peak exercise systolic blood pressure during 6 minutes on the starting workload of 600 kpm/min (approximately 100 W, 5880 J/min) were all related to cardiovascular mortality. The relative risk (RR) of dying from cardiovascular causes associated with an increment of 48.5 mmHg (= 2 SD) in systolic blood pressure at 600 kilopondmeter (kpm)/min was significant (RR = 1.5, 95% confidence interval [CI] = 1.1-2.3, P = .040) even when adjusting for a large number of variables measured in the present study, including age, exercise capacity, smoking habits, and casual blood pressures. The influence of blood pressure at 600 kpm/min was so strong that the predictive value of resting casual blood pressures became nonsignificant when these were analyzed as continuous variables also including exercise blood pressure as a covariate. However, the maximal systolic blood pressure during the exercise test was unrelated to cardiovascular mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between hemorrheologic factors and insulin sensitivity in healthy young men.

Abstract: The present study aimed at testing a possible relationship between hemorrheologic factors, such as hematocrit, fibrinogen, and whole-blood viscosity, and insulin sensitivity in healthy humans. Twenty-one 21-year-old men were studied with the hyperinsulinemic euglycemic glucose clamp technique. We found statistically significant negative correlations between the glucose disposal rate (GDR) and calculated whole-blood viscosity at both high (r = -.55, P = .01) and low (r = -.51, P = .01) shear rates. We observed negative associations between GDR and fibrinogen (r = -.66, P = .002), GDR and hematocrit (r = -.63, P = .002), GDR and body mass index (r = -.51, P = .007), and GDR and resting heart rate (r = -.46, P = .04). Using stepwise multiple regression considering whole-blood viscosity, body mass index, mean arterial blood pressure, and heart rate as independent variables, we found that only whole-blood viscosity and body mass index were independent explanatory variables of the GDR. Together they accounted for 63% of the variability in the GDR in our subjects. These results suggest hemorrheologic, and therefore indirectly hemodynamic, factors as correlates to insulin sensitivity.

The effect of angiotensin II receptor blockade on insulin sensitivity and sympathetic nervous system activity in primary hypertension.

Abstract: The objective of this study was to investigate the effect of Losartan (NK-954, DuP-753), a new selective angiotensin II receptor antagonist, on insulin sensitivity and sympathetic nervous system activity in patients with severe primary hypertension. Five patients with a record of diastolic blood pressure (DBP) ± 115 mmHg, currently either untreated or with DBP > 95 mmHg on antihypertensive treatment, were examined in an open study with the euglycemic glucose clamp examination before and after being treated with Losartan for an average of 6 weeks. The glucose disposal rate increased from 6.2 ± 2.6 to 7.9 ± 2.6 mg/kg x min (27%, p < 0.05) during treatment with Losartan. The insulin sensitivity index (glucose disposal rate divided by mean insulin concentration during clamp) increased from 7.7 ± 4.5 to 10.1 ± 4.1 arbitrary units (30%, p < 0.05). Plasma noradrenaline decreased from 1.87 ± 0.53 to 1.11 ± 0.13 nmol/1 (40%, p < 0.05), while plasma adrenaline was unchanged (0.23 ± 0.10 vs. 0.22 ± 0.11 nmol/1, n.s....

Sympathetic nervous system involvement in essential hypertension: increased platelet noradrenaline coincides with decreased beta-adrenoreceptor responsiveness.

Abstract: Platelet catecholamine content may reflect integrated plasma catecholamine concentrations over time. The present study aimed at examining sympathetic nervous system (SNS) involvment in essential hypertension by assessing platelet noradrenaline (NA) and typically β-adrenoreceptor mediated responses to adrenaline (A) infusion as indices of sympathetic tone. Healthy white men were recruited by public advertising and screening (mean ± SD): Hypertensives (n = 13, sitting blood pressure [BP] 153 ± 13/106 ± 7 mmHg, age 34 ± 5 years, weight 83 ± 10 kg) were compared to normotensives (n = 13, sitting BP 114 ± 9/75 ± 9 mmHg, age 30 ± 6 years [n.s.], weight 82 ± 9 kg [n.s.]). Loss of platelet granular contents (including NA) prior to analysis was minimized by studying young subjects (age range 20–40 years, minimal atherosclerosis), using arterial blood sampling, and processing blood immediately. These procedures resulted in plasma β-thromboglobulin and platelet factor 4 levels which were not significantly different ...

Treatment of hypertension in 1994. Comments on the 1993 guidelines of the Norwegian Society of General Practitioners concerning the treatment program for hypertension

Abstract: An absolute reduction of 2.5% per year in cardiovascular risk among persons treated with drugs indicates that elderly persons should also be treated for hypertension in this way. Today, ambulatory assessments of blood pressure and detection of organ damage using both traditional and new methods (echo-cardiography, microalbuminuria) are useful in identifying high-risk patients in need of treatment. Non-pharmacological treatment of hypertension (changes in lifestyle) has not been proved to have any effect on the clinical manifestations of high blood pressure, and is only a supplement to treatment with drugs. The assertion that diastolic pressure should not be brought down to below 85 mm Hg is based on small numbers and retrospective data. It is our impression that the Society of General Practitioners emphasizes economic savings to an extent that tends to conflict with current scientific knowledge.