Showing papers by "Thomas F. Lüscher published in 1985"

Compliance in hypertension: facts and concepts.

Abstract: The management of hypertension is still far from optimal, although safe and effective drugs are available and the effectiveness of antihypertensive therapy in reducing cardiovascular morbidity is well established. Today, low patient compliance is one of the most important therapy-limiting factors in hypertension. Although patient care seems to have improved, possibly due to increased knowledge about patient compliance in recent years, 10-15% of hypertensives are still lost from follow-up in the first year of therapy, and 20-40% of patients comply insufficiently with prescribed antihypertensive therapy. In this article the magnitude of the problem of drop-outs and non-compliance with medication, the determinants of compliance in hypertension, and the models used to understand patients' health behaviour are reviewed.

The spectrum of renovascular hypertension.

Abstract: This review briefly summarizes pathological findings that may cause renovascular hypertension. Though atherosclerosis is the most common cause of renovascular hypertension, one third of all renovascular disorders has to be contributed to one of the arterial dysplasias. In contrast to atherosclerotic lesions which occur predominantly in older, male patients, fibrodysplastic alterations occur rather in younger, female patients. In very few cases malformations of the renal arteries or generalized diseases may cause renovascular hypertension.

Unilateral Parenchymatous Kidney Disease and Hypertension: Results of Nephrectomy and Medical Treatment

Abstract: In the present study 43 patients with unilateral parenchymatous kidney disease and hypertension were investigated. 20 patients were nephrectomized, 23 treated with antihypertensive drugs. Both therape

Clinical evaluation of semiautomatic blood pressure devices for self-recording.

Abstract: Sixteen semiautomatic blood pressure devices for self-recording were compared with a Hawksley random zero sphygmomanometer using three criteria for determination of accuracy: correlation analysis; mean differences; standard deviation of mean differences. Only one of the tested instruments showed excellent results, but three other devices had satisfactory accuracy of blood pressure recording. These devices could be recommended for self-recording by patients. Only minor differences were found between the devices as regards reliability and convenience in use.

Curable Renal Parenchymatous Hypertension: Current Diagnosis and Management

Abstract: Unilateral parenchymatous kidney disease associated with high blood pressure represents a potentially curable form of hypertension. Surgery may normalize blood pressure in a substantial number of thes

A simple and effective method to teach patients about high blood pressure and obesity.

Abstract: It is an open question whether information about hypertension and obesity increases compliance with therapy. Nevertheless, patients increasingly demand precise but simple and comprehensive information. A simple slide programme is described which can be demonstrated in any waiting room. The learning effect was assessed in 1083 subjects, of whom 485 had seen the programme completely; 256 subjects served as controls. The percentage of subjects with good or excellent knowledge about hypertension and obesity rose from 22.8% in the controls to 64.2% in the experimental group. Age was the only factor influencing learning, but this was of no great importance in subjects under 70. In particular, social status did not have any significant effect on learning. This programme may be an ideal tool to inform patients about hypertension and obesity and to study the influence of information on compliance with therapy.

[Renovascular hypertension: surgery, dilatation or drugs?].

Abstract: The effect of various therapeutic procedures (surgery, percutaneous transluminal dilatation and antihypertensive drugs) was analyzed in 161 patients with renovascular hypertension. The results show that each of the three methods effectively lowers blood pressure. However, marked differences in pretreatment clinical and laboratory data among the three groups were observed, which were most probably caused by different selection criteria before submitting the patient to a given therapeutic regime. The findings also demonstrate that, on the basis of the present analysis, a direct comparison between surgery, dilatation and medical therapy is not possible.

[Fibromuscular renovascular hypertension: comparison of surgery, transluminal dilatation and drug therapy].

Abstract: 82 patients with fibromuscular renovascular hypertension have been studied. 33 patients were treated surgically (group I), 28 underwent transluminal dilation (group II) and 21 received drug treatment (group III). After a follow-up period of 2.5 (0.1-7) years, blood pressure in group I had decreased from 207 +/- 27/128 +/- 17 mm Hg to 135 +/- 15/85 +/- 9 mm Hg after surgery (p less than 0.001). 1.3 (0.1-4) years after dilation, group II showed a decrease of blood pressure from 174 +/- 25/107 +/- 13 mm Hg to 143 +/- 26/88 +/- 12 mm Hg (p less than 0.001). Blood pressure in group III decreased under drug therapy from 203 +/- 41/122 +/- 16 mm Hg to 146 +/- 19/92 +/- 8 mm Hg (p less than 0.001). 52% of the surgical patients and 50% of the dilated patients were cured, whereas 45% and 39% respectively were improved and 3% and 11% respectively did not improve. In group III, under antihypertensive drug therapy, blood pressure normalized in 62% of the patients, 33% showed better values and 5% did not improve. The complication rate was 11% in group I and 3.3% in group II. In two patients dilation was technically impossible. In group III one patient (4.8%) showed a massive but reversible increase of serum creatinine under captopril. In 70% of all patients the renal vein renin ratio was greater than or equal to 1.5. However, this ratio was unreliable as a parameter to predict the blood pressure decrease with curative methods. It is concluded from the above that all three methods offered good to very good results.(ABSTRACT TRUNCATED AT 250 WORDS)