Effect of pindolol on serum lipids and lipid metabolizing enzymes

1 The effect on plasma lipids of pindolol given orally over a 6 month period to 20 patients with essential hypertension was studied. 2 During therapy an adipose tissue biopsy was taken from nine patients for the determination of lipoprotein lipase (LPL) activity and serum samples were taken for lecithin cholesterol acyltransferase (LCAT) assays. An additional biopsy and serum samples were taken after a 3 weeks' break in pindolol treatment. 3 Plasma free fatty acid and triglyceride concentrations remained similar during treatment. 4 Plasma total cholesterol was slightly lower (P less than 0.05) at 6 months than at 1 month. 5 HDL cholesterol concentration and the ratio of HDL to total cholesterol increased slightly, and the increase of HDL-cholesterol was significant (P less than 0.05) at 1 month. 6 LCAT activity was significantly higher (P less than 0.01) during pindolol treatment than after the break in it. No significant changes in adipose tissue LPL activities were found before and after the break of treatment.

Effect of alpha/beta blockers on serum lipids

The effect of an oral alpha/beta blocker on serum lipids was studied over a 6-month period of administration to patients with essential hypertension. Serum free fatty acid level was lower after 1 month than initially but not after 3 and 6 months. There were no significant changes in the concentrations of total cholesterol and HDL-cholesterol or in the ratio of HDL-cholesterol to total cholesterol during therapy. Serum triglycerides increased from 1.9 +/- 1.1 mmol/1 to 2.6 +/- 1.5 mmol/1 at 3 months and to 2.5 +/- 1.6 mmol/1 at 6 months, but this increase was significant only at 3 months (p less than 0.05).

Type IIA hyperlipoproteinemic sera decrease the synthesis of hyaluronic acid by cultured human aortic smooth muscle cells

The synthesis of sulphated glucosaminoglycans (S-GAGs) and hyaluronic acid (HA) by cultured human aortic smooth muscle cells (SMC) was measured in the presence of sera from type IIA hyperlipoproteinemic patients (7 males and 6 females) and their age- and sex-matched controls. Experiments with pooled sera showed that type IIA and control sera differed in their effects on the synthesis of GAGs at high serum concentrations with preincubation times of 24 and 48 h. Therefore, individual sera were tested at 15% with 24 h preincubation. Type IIA sera decreased the synthesis of HA by 21% (P less than 0.001) but had no significant effect on sulphated GAGs. The ratio of sulphated GAGs to Ha was higher in the presence of type IIA sera than control sera. The incorporation of thymidine, the number of cells and the amount of DNA did not differ in cultures incubated with type IIA and control sera. Early human and experimental atherosclerotic lesions are known to have an increased sulphated GAGs to HA ratio. Our results suggest that one explantation for the association between type IIA hyperlipoproteinemia and an increased risk for atherosclerosis is the disturbance in the proportions of hyaluronic acid and sulphated GAGs synthesized by arterial SMC.

Achilles tendon thickness in hypercholesterolaemia

The maximum thickness of the achilles tendon was measured by radiographic technique in twenty-six hypercholesterolaemic patients and thirty-four controls. There were thirteen patients with diagnostic criteria of familial hypercholesterolaemia. All achilles tendons except one of the familial hypercholesterolaemic patients were thicker than normal, but in the non familial hypercholesterolaemic group the thickness of achilles tendons was within normal limits. Achilles tendon thickness and age were positively correlated in II A familial type patients, but not in controls or in the non-familial group. A strongly positive correlation between Achilles tendon thickness and the age multiplied by the serum cholesterol level was seen in familial type II A patients. The Achilles tendon thickness and serum HDL-cholesterol concentration were not correlated. The radiographic measurement of Achilles tendon thickness seems to be a useful procedure for detecting familial hypercholesterolaemia.

Psychological and biochemical strain in firemen's work

Mental load and strain in the work of firemen and fire alarm center operators were studied in a group of 260 fireman and 6 female full-time operators from three fire brigades. The firemen proved to be satisfied with their work, and signs of chronic psychological problems were uncommon. Situational work load and related strain may, however, be extreme during active operations. A large proportion (42%) of the firemen suffered from strain after the 24-h long daily work period. Those who had recently worked as paramedics in the ambulance service or in the alarm center were under more strain than ordinary fire fighters. Biochemical stress indicators revealed a high activation of firemen at the alarm center. The difference found between firemen and full-time female operators may be due to a variation in the adaptive functions of the two sexes.

Serum lipids in soccer and ice-hockey players

The concentrations of serum cholesterol, HDL-cholesterol, triglycerides, phospholipids, and free fatty acids of Finnish top-class football and ice-hockey players were determined during different training programs and the results were compared with those of a control group. The serum levels of total cholesterol, HDL-cholesterol, and the ratio of HDL-cholesterol to total cholesterol were increased to those football players having more aerobic exercise in their training program. The concentrations of HDL-cholesterol and the HDL-cholesterol to total cholesterol ratio were lowest in the ice-hockey players, whose training is more anaerobic. There were no significant differences of serum triglyceride levels in different groups. The serum concentrations of fatty acids were highest in control group and lowest in ice-hockey and football teams during the active playing season. The differences of serum lipids seem thus to be in connection with the kinds of sport that differ in their energy metabolism requirements. This may be of importance when judging the benefit of exercise on the prophylaxis of atherosclerosis.

Long-term effect of sotalol on plasma lipids

1. We studied the effect on plasma lipids of sotalol given orally over a 12 month period to patients with essentially hypertension. 2. Plasma free fatty acid concentration was lower than initially at 1, 3, 6 and 12 months. The difference was significant (P less than 0.01) at 1 and 3 months. 3. Plasma cholesterol (VLDL + LDL-cholesterol) increased during treatment. Plasma total cholesterol increased from 5.49 +/- SD 0.94 mmol/l at the beginning to 6.37 +/- 1.10 mmol/l at 12 months (P less than 0.01). 4. HDL-cholesterol concentration and the ratio of HDL-cholesterol to total cholesterol decreased significantly. The ratios were 0.28 and 0.18 at the beginning and at 12 months respectively (P less than 0.001). 5. Plasma triglycerides increased simultaneously from 1.14 +/- 0.31 to 1.89 +/- 0.99 mmol/l (P less than 0.01).

Long-term effect of the combination of calcium clofibrate and calcium carbonate on serum total cholesterol, triglyceride and high density lipoprotein--cholesterol concentrations in hyperlipoproteinaemia. A comparative study with clofibrate

Thirty hyperlipidaemic patients (19 with type IIA, 4 with IIB and 7 with type IV hyperlipoproteinaemia) were subjected to therapy with calcium clofibrate and calcium carbonate (4C, 2 + 2 g/day for 6 months) and the effect was compared with clofibrate (1C, 2 g/day) which was given for 6 months as well, in a single-blind placebo-controlled study. 4C and 1C decreased total serum cholesterol levels especially in subgroups IIA and IIB. 4C was somewhat more effective than 1C in decreasing (VLDL + LDL)-cholesterol in subgroup IIA. The HDL-cholesterol concentrations and the ratio of HDL-cholesterol and total cholesterol increased during treatment with both 1C and 4C. The HDL-cholesterol increase (vs. placebo) was 18%. The concentrations of serum triglycerides decreased by 33% during both treatment periods and there was no significant difference between 1C and 4C.

Effect of sera from hyperlipidemic subjects and high-density lipoproteinemic runners on the synthesis of DNA and glycosaminoglycans by cultured human aortic smooth muscle cells

Effects of hyperlipidemic, normolipidemic and high-density-lipoproteinemic (HD lipoproteinemic) sera from active runners were studied on cultured human aortic smooth muscle cells. The synthesis of DNA, hyaluronic acid and sulphated glycosaminoglycans (GAGs) in the presence of the various sera was measured by the incorporation of [3H]-thymidine and [3H]-glucosamine. The HD lipoproteinemic sera from runners stimulated the synthesis of DNA and sulphated GAGs less than normolipidemic and hyperlipidemic sera. The hyperlipidemic sera stimulated the synthesis of DNA slightly more than the other sera, but only after a 24 h preincubation. Accordingly, the concentration of HDL-cholesterol in serum was negatively correlated with the synthesis of DNA (r = -0.77, P less than 0.01) and sulphated glycosaminoglycans (r = -0.81, P less than 0.01). The sulphated GAGs/hyaluronate ratio was smaller in the presence of HD lipoproteinemic serum as compared with the other sera. The proliferation of aortic smooth muscle cells and the rate at which they synthesize sulphated GAGs have been considered important during the initiation of atherosclerosis in vivo. The present results suggest that sera having differences in the relative amounts of various lipoprotein fractions differ significantly in their influence on both of these arterial smooth muscle cell functions in vitro.

Dihydralazine therapy and acetylator phenotype

The acetylator phenotype was studied in 21 hypertensive patients receiving chronic treatment with dihydralazine and other antihypertensive drugs. Plasma dihydralazine concentrations were measured 6 hours after the morning dose of the drug. There were no significant differences between the slow and fast acetylators 1) in the daily dose of dihydralazine needed, 2) in the concentrations of dihydralazine achieved in plasma, 3) in the dose/concentration-relationship of dihydralazine or 4) in the appearance of side effects. Antinuclear antibodies were found in five patients. Four of them were fast acetylators. The lowest dose/concentration relationship was found in a patient with impaired renal function. According to these results the acetylator phenotype seems to be an unimportant factor in therapy with dihydralazine. More investigation will be needed in order to elucidate the metabolism of dihydralazine.

Antihypertensive effect and plasma levels of labetalol. A comparison with propranolol and dihydrallazine

Seventeen outpatients suffering from essential hypertension were treated in a double-blind cross-over study with labetalol or with a combination of propranolol and dihydrallazine. The doses were increased depending on the response during the six week treatment periods. Both treatments reduced the blood pressure significantly as compared to the placebo, and the combination more than labetalol with the doses used, apparently because of a higher degree of the beta-blockade. Positive linear correlations were found between the dose of labetalol and the concentration in plasma as well as the concentration of labetalol in plasma and the decrease of standing blood pressures.

High density lipoproteinemia due to vigorous physical work inhibits the incorporation of [3H]thymidine and the synthesis of glycosaminoglycans by human aortic smooth muscle cells in culture

The effect of sera from normolipidemic men engaging in normal physical activity and from high density lipoproteinemic lumberjacks engaging in vigorous physical activity on the incorporation of [3H]thymidine and the synthesis of glycosaminoglycans by human aortic smooth muscle cells in culture was measured. At high concentration (15%) high density lipoproteinemic serum inhibited significantly (P less than 0.001) the incorporation of thymidine. The serum inhibited the synthesis of glycosaminoglycans at all concentrations tested (1--15%) with the most marked inhibition at 10 and 15%. At lower concentrations (1--5%) the inhibition was more pronounced for sulphated glycosaminoglycans than for hyaluronic acid. The inhibition was of the same magnitude for the subclasses (chondroitin, dermatan and heparan sulphates) of sulphated glycosaminoglycans studied. High density lipoproteinemia due to vigorous physical work is postulated as a protective factor against the early biochemical reactions of arterial smooth muscle cells in the development of atherosclerosis.

The effect of vigorous physical activity at work on serum lipids with a special reference to serum high-density lipoprotein cholesterol

Serum lipid concentrations of lumberjacks whose occupational physical activity is most vigorous were compared with those of electricians. The lumberjacks had significantly higher serum HDL-cholesterol and significantly lower triglyceride and free fatty acid concentrations but there were no significant differences in total cholesterol levels. The favourable effect of vigorous physical activity at work on lipid metabolism is, however, epidemiologically not seen, obviously due to negative risk factors in lumberjacks' life.

Connective tissue components in normal and atherosclerotic human coronary arteries

Human coronary arteries with various degrees of atherosclerosis were analyzed for the concentration of different types of glycosaminoglycans (GAGs). The changes in GAGs were considered against the background of macroscopic atherosclerosis, and the concentration of glycoprotein-bound hexosamines, collagen, calcium and cholesterol. The concentration of calcium was increased and that of hyaluronic acid decreased even in mildly atherosclerotic coronary arteries. The additional changes in advanced atherosclerosis included the increase of collagen and dermatan sulphate and the decrease of heparan sulphate. Cholesterol was increased in mild, and even further in advanced, atheroslcerosis. The concentrations of chondroitin sulphates and glycoprotein-bound hexosamines were not significantly affected by atherosclerosis.

Yersinia enterocolitica infection complicated by glomerulonephritis

A case of mild glomerulonephritis in a 24-year-old man with clinical and immunohistological findings associated with Yersinia enterocolitica serotype 3 infection is described. The role of IgA in the pathogenesis of glomerulonephritis associated with mucosal infection is briefly discussed. Although attempts to demonstrate Y. enterocolitica 3 antigen in the biopsy specimen were unsuccessful, the glomerular deposits of immunoglobulins and complement suggest immune pathogenesis.

Plasma concentrations of propranolol in patients with essential hypertension

Sixteen patients with essentialy hypertension were treated with propranolol 160 to 640 mg daily for three months. Significant decreases both in recumbent and standing blood pressure were observed after three days treatment and subsequently. Reduction of blood pressure was more pronounced when the dose of propranolol was increased. However, neither the mean dose nor the plasma concentration of propranolol could be correlated with the mean decrease in blood pressure. There was great interindividual variation in the plasma concentrations of propranolol produced by the same daily dose. The initial stimulation of plasma renin activity and the therapeutic response to propranolol could not be correlated.

Predictive value of sympathetic cardiovascular reflexes and urinary catecholamines when selecting patients for antihypertensive treatment with beta-adrenergic blocking drugs

Two different sympathetic cardiovascular reflexes and the urinary catecholamines were studied to try to predict which patients would respond best to antihypertensive treatment with alprenolol, a beta-adrenergic blocking drug. The antihypertensive effect of sustained release tablets of alprenolol (200 mg twice daily) in 19 young patients with labile hypertension was confirmed. The treatment effectively reduced the tachycardia produced by the Valsalva manoeuvre and by nitroglycerin, and reduced the rise in systolic blood pressure after the Valsalva manoeuvre. The excretion of catecholamines was not affected. Neither the sympathetic cardiovascular reflexes produced by the Valsalva manoeuvre and nitroglycerin nor the excretion of catecholamines revealed which patients would respond best to alprenolol.