Hendrika J. Waal-Manning

Metabolic Effects ofβ-Adrenoreceptor Blockers

SummaryThe effects of β-blockade on glucose metabolism are complex. Some patients with impaired glucose tolerance while taking a non-selectiveβ-blocker, showed some improvement in glucose tolerance when therapy was changed to a β1 -blocker (metoprolol). Serum K+ values tend to rise slightly on β-blocking therapy; small increases in serum urea and creatinine also occur. A rise in plasma triglycerides was noted in patients startingβ-blocking therapy; this effect seemed to be more marked on metoprolol than on non-selectiveβ-blockers.: The effects of beta-blockade on glucose metabolism are complex. Some patients with impaired glucose tolerance while taking a non-selective beta-blocker, showed some improvement in glucose tolerance when therapy was changed to a beta1-blocker (metoprolol). Serum K+ values tend to rise slightly on beta-blocking therapy; small increases in serum urea and creatinine also occur. A rise in plasma triglycerides was noted in patients starting beta-blocking therapy; this effect seemed to be more marked on metoprolol than on non-selective beta-blockers.

The prevalence of headache in a small New Zealand town.

SYNOPSIS

The relationship between blood pressure and personality in a large unselected adult sample

As part of a general health survey of a small New Zealand town, the Crow-Crisp Experiential Index, the State-Trait Anxiety Inventory, a shortened version of the Hostility and Direction of Hostility Questionnaire, and the Zung Self-rating Depression Scale were administered to 1173 subjects over the age of 15. Blood pressure was moderately correlated with age and Quetelets Index, a measure of obesity. Low but significant correlations were found between Somatic Anxiety, Hysteria, and the Urge to Act-out Hostility scale. However, when effects of age were controlled for, in a series of multiple regression analyses, the correlations with psychometric test scores were no longer significant. This study confirms several previous reports that neuroticism, anxiety, depression, and hostility are of little significant in predicting levels of blood pressure in the general population.

Ticrynafen: kinetics, protein binding, and effects on serum and urinary uric acid.

The kinetics and acute effects of ticrynafen, a new diuretic and uricosuric, have been studied in 4 normal subjects. In 3 of the 4 subjects given a 250‐mg tablet, peak plasma ticrynafen concentrations of 15 to 35 µg/ml were achieved at 1 to 2 hr; in the fourth subject a peak concentration of 10 µg/ml was attained at 6 hr. Elimination half‐life was 2.0 to 3.3 hr. Bioavailability covered a 2.5‐fold range (61.7–154.6 µg · hr · ml−1). Administration of the same dose as quarter doses at 2 hr intervals produced a progressive rise in plasma ticrynafen concentration to 5.5 to 12.9 µg/ml at 8 hr and thereafter a decline at a similar rate to that seen with the single dose. The hypouricemic effect was similar for the single‐ and divided‐dose treatments: uric acid concentration began to fall within 1 hr, reached a minimum of 53% to 77% of the pre‐drug value at 7 to 10 hr, and had returned to approximately pre‐drug values at 24 hr. Urinary uric acid excretion was significantly increased for up to 12 hr with both treatments. The diuretic effect of the single dose lasted 4 to 8 hr, while that of the divided dose lasted 8 to 12 hr.

Experience with β-Adrenoreceptor Blockers in Hypertension

SummaryAt the Dunedin Hypertension Clinic β-blockers are the drugs of choice for most hypertensive patients, usually in combination with diuretics (especially in older subjects) and often with other drugs in the more severe cases. All β-blockers have an antihypertensive effect, regardless of other characteristics (e.g. cardio-selectivity, instrinsic sympathomimetic effect, or membrane activity). d-Propranolol has no significant effect on blood pressure. β-Blockers do not prevent stress-induced (mental arithmetic) rises in blood pressure in hypertensive subjects though the level of blood pressure reached during stress tends to be lower because the base line is lower. Twice-daily dosage of β-blockers is usually satisfactory.

Effect of propranolol on the duration of the Achilles tendon reflex.

The duration of the Achilles tendon reflex is used in the diagnosis and management of thyroid disease. Extrathyroidal factors which may increase the duration of the Achilles tendon reflex are listed. The influence of propranolol on the duration of the Achilles tendon reflex in 20 patients is reported; a considerable prolongation of the reflex occurred in 80 per cent of patients. These observations may prevent errors in diagnosis and management of thyroid disease based on timing of the Achilles tendon reflex.

The Relationship Between State Anxiety and Depressed Mood: A Validity Study

The validity of the A-State Scale of the State-Trait Anxiety Inventory and the Zung Self-Rating Depression Scale was assessed using data from a general health survey. Depression and anxiety states were found to coexist, however, evidence from a factor analysis, showing items from the two tests loaded on separate factors, demonstrated that these states can be measured independently. Both the A-State and the Zung Scales were found to comprise two factors, and for each scale, one factor consisted of positively phrased items, and the other of negative items. The implications of these findings for the construct validity of the two scales are discussed.

Effect of equivalent antihypertensive doses of mefruside and cyclopenthiazide on serum electrolytes, uric acid and glucose tolerance in hypertensive patients

1. A comparative cross‐over trial of mefruside and cyclopenthiazide, each drug being given for 6 weeks, was conducted on thirty hypertensive patients with diabetes mellitus or impaired glucose tolerance. Other antihypertensive therapy, any antidiabetic therapy and potassium supplementation were kept constant throughout the trial. Dosages of mefruside and cyclopenthiazide were adjusted to give approximately equal blood pressure levels in the two drug periods.