Validity of Out-Patient Screening in Arteriosclerosis to Identify Multiple Lesions

A total of 594 patients admitted for cerebrovascular disease (CVD) and for peripheral vascular disease (PVD), were examined in a study aimed at clarify ing by a simple, inexpensive out-patient method, a) the relationship existing between the different locations of the vascular disease: brain, lower limbs, coro naries; b) the prevalence in the patients studied of risk factors such as hyperten sion, hyperlipidaemia and diabetes, and of migraine. The results were as follows: a) of the patients admitted for CVD, 44% also presented arteriosclerosis in other locations; this figure was 32% for PVD cases; b) hypertension was found in 38.5% of CVD and 27% of PVD cases; diabetes in 11.5% of CVD and in 18% of PVD cases; hyperlipidaemia in 31 % of CVD and 24% of PVD cases; migraine in 11% of CVD and 1% of PVD cases

A multicenter study of doxazosin in the treatment of patients with mild or moderate essential hypertension and concomitant intermittent claudication

This study assessed the efficacy and safety of once-daily doxazosin in the treatment of patients (n = 19) with mild or moderate essential hypertension (sitting diastolic blood pressure [DBP] 95 to 114 mm Hg) and concomitant intermittent claudication (Doppler ankle/arm ratio of less than 0.80 and walking tolerance of less than 700 m on the treadmill). After 14 weeks of treatment with doxazosin, a significant (p less than 0.05) reduction in systolic blood pressure and DBP was observed. Mean blood pressures were reduced from 170/100 mm Hg at baseline to 161/93 mm Hg at the end of treatment. Minor changes in heart rate occurred, which with continued treatment were not statistically significant from baseline. In 12 of 16 (75.0%) efficacy-evaluable patients blood pressure was normalized (DBP to less than or equal to 90 mm Hg with an greater than or equal to 5 mm Hg reduction from baseline) with a mean daily dose of 7.6 mg/day. Doxazosin improved the hypertension severity category in 13 of 16 (81.3%) patients. The blood pressure ratios between both the thighs and arms and ankles and arms showed no statistically significant changes after treatment with doxazosin. Thigh blood flow at rest and the reactive hyperemia after 3 minutes of arterial occlusion did not change statistically. There was a tendency for pain-free distance to improve. Laboratory data were not significantly changed after treatment with doxazosin. Of the 19 patients studied, 5 reported mild or moderate side effects that were either tolerated or disappeared with continued treatment. No patient had therapy withdrawn and no patient required a dose reduction

Lipid profile during antihypertensive treatment. The SLIP Study Group. Study on Lipids with Isoptin Press

Some antihypertensive drugs adversely affect the plasma lipid profile, and this has to be taken into account when choosing treatment for hypertension because it may offset the beneficial blood pressure-lowering effect of these agents. In this study, the long term effects of verapamil sustained release (SR) 240mg daily and enalapril 20mg daily on plasma lipid levels were investigated in 931 patients with mild to moderate hypertension. Patients whose blood pressure was not effectively lowered after at least 1 month of monotherapy had either enalapril 20mg once daily added to their verapamil treatment or hydrochlorothiazide 12.5mg once daily added to their enalapril treatment. Blood pressure and lipid profile were assessed before and after 6 months of treatment. Of 864 evaluable patients, 563 patients (65.1%) were successfully treated with monotherapy and 220 patients (25.5%) required combination therapy. A total of 81 patients withdrew from the trial. Systolic and diastolic blood pressure were significantly reduced by treatment with either verapamil or enalapril, and heart rate was reduced slightly, but significantly, by both treatments. Total cholesterol, triglycerides and low density lipoprotein were significantly reduced by both treatments. High density lipoprotein levels were significantly increased in verapamil recipients, but not in enalapril recipients. Adverse effects occurred in 37 (3.9%) patients receiving verapamil SR and 25 (2.7%) patients receiving enalapril. In conclusion, long term treatment with the antihypertensive agents verapamil and enalapril, alone or in combination regimens, significantly improved the plasma lipid profile. Verapamil SR had the most beneficial effect on plasma lipid levels

Captopril in the treatment of hypertension associated with claudication

The effect of captopril was studied in 40 hypertensive patients (WHO stages I and II) with peripheral vascular disease of the lower limbs (Fontaine stages IIa and IIb). We assessed systolic and diastolic arterial pressure, heart rate in supine and upright position, relative and absolute pain free intervals, and ankle/arm pressure index at rest and after treadmill exercise test. In the first part of the study 20 patients were divided into two groups, one of which was treated with chlorthalidone (25 mg/day) and the other with captopril (50 mg two times a day) for 8 weeks. Statistically significant improvements were only obtained in the captopril-treated group. They concerned the ankle/arm pressure index at rest (P<0.05) and after exercise (P<0.05) and the absolute pain free interval (P<0.05) as well as systolic arterial pressure. Furthermore, 20 more patients were treated with captopril (50 mg two times a day) for 8 weeks, and improvements were found in ankle/arm pressure index at rest (P<0.01) and after execise (P<0.001) and in relative and absolute pain free intervals (P<0.001) as well as in as in systolic and diastolic arterial pressure. These results indicate an increase in flow to the limbs of patients with vascular disease treated with captopril, and suggest that captopril is an effective drug without contraindications for the treatment of hypertension associated with claudication

Treatment of claudication with dipyridamole and aspirin

The effects of dipyridamole in association with acetylsalicylic acid were compared with the effects of acetylsalicylic acid alone in patients with peripheral vascular disease. The following parameters were studied in each patient: symptoms-free interval on the treadmill, ankle-arm arterial pressure gradient, oscillographic index, venous occlusion plethysmography and any untoward reactions. Changes were observed in the pain-free interval (p less than 0.005), and in the venous occlusion plethysmography (p less than 0.001) in the patients treated with the two drugs in association

Captopril for the Treatment of Patients with Hypertension and Peripheral Vascular Disease

Many epidemiological studies have shown up the frequent association of ar terial hypertension (HT) with atherosclerosis of different localizations. How ever, many of the drugs used to treat HT are contraindicated in patients with peripheral vascular disease (PVD), because they cause unfavorable metabolic changes or vasoconstriction. The aim of the present study was to assess the effect of a proven hypotensive drug, captopril, on the peripheral circulation. The drug appeared to be effec tive in improving blood flow to lower limbs, prolonging the pain. Free interval and increasing the angle/arm arteral pressure index