Additional Salt Intake Research Articles

Frequency and risk factors stratification of hypertension among the rural population of Bangladesh

Background and Objectives: Hypertension is one of the major risk factors of premature morbidity and mortality in our daily clinical practice. Various studies carried out in the urban settings, but there is scarcity of epidemiological data regarding hypertension among the rural people in Bangladesh. Therefore, this current study has been designed to find out the frequency and risk factors stratification of hypertension among the rural people in Jashore, Bangladesh. Materials and Methods: A cross-sectional study recruited 1812 participants above 18 years attending on national hypertensive week of 2019 in Bagherpara and Keshabpur upazila (subdistrict) health complex in Jashore, Bangladesh. 2020 International Society of Hypertension Global Hypertension Practice Guidelines had been demonstrated to classify hypertension. Results: Out of the total study population, the frequency of hypertension was 20.6% (Grade 1 and Grade 2 hypertensive patients 15.8% and 4.9%, respectively), and high normal blood pressure was 9.0%. The mean age of the study population, Grade 1 hypertensive and Grade 2 hypertensive cohorts were 42 ± 16, 49 ± 15 and 51 ± 14 years, respectively, with a male and female ratio was 1:2. Progressive rise of mean systolic and diastolic blood pressure were noticed with increasing age. Age (P: <0.001), sex (P: 0.004), occupation (P: <0.001), BMI (P: <0.001), family (P: <0.001) and past history (P: <0.001) of hypertension, sedentary life style (P: 0.004), additional salt intake (P: <0.001) and smoking (P: 0.011) were significantly associated with hypertension following bivariate analysis. Multivariate logistic regression analysis revealed that age after 50 years (AOR = 1.866, 95% CI: 1.210-2.876), positive past history of hypertension (AOR = 3.493, 95% CI: 2.676-4.558), additional salt intake (AOR = 0.591, 95% CI: 0.453-0.770) and obesity (AOR = 3.389, 95% CI: 1.830-6.274) were significantly associated with developing hypertension. Conclusion: High frequency of hypertension was found among the rural population in Bangladesh where presence with a lot of significantly associated risk factors. The data would be helpful for the health policymakers dealing noncommunicable diseases to reach the sustainable goal and mitigate morbidity and mortality of cardiovascular diseases in Bangladesh.

Frequency and Risk Factors Stratifi-cation of Hypertension among the Rural Population of Bangladesh

Background: One of major predictors of premature mortality and morbidity; and scarcity of epidemiological data regarding hypertension among the rural people in Bangladesh, the study has been designed to find out the frequency and risk factors stratification of hypertension among the rural people in Jashore, Bangladesh. Methods: A cross-sectional study recruited 1812 participants above 18 years attending on national hypertensive week of 2019 in Bagherpara and Keshabpur upazila (sub-district) health complex in Jashore, Bangladesh. 2020 International Society of Hypertension Global Hypertension Practice Guidelines had been demonstrated to classify hypertension. Results: Out of the total study population, the frequency of hypertension was 20.6% (Grade 1 and Grade 2 hypertensive patients 15.8% and 4.9% respectively), and high normal blood pressure was 9.0%. The mean age of the study population, Grade 1 hypertensive and Grade 2 hypertensive cohorts were 42 ±16, 49±15 and 51±14 years respectively with a male and female ratio was 1:2. Progressive rise of mean systolic and diastolic blood pressure occurred with increasing age. Age(p:<0.001), sex(p:0.004), occupation (p:<0.001), BMI(p:<0.001), family(p:<0.001) and past history (p:<0.001) of hypertension, sedentary life style(p:0.004), additional salt intake(p:<0.001) and smoking(p:0.011) were significantly associated with hypertension following bivariate analysis. Multivariate logistic regression analysis revealed that age after 50 years (AOR=1.866, 95% CI: 1.210-2.876), positive past history of hypertension (AOR=3.493, 95% CI: 2.676- 4.558), additional salt intake (AOR=0.591, 95% CI: 0.453-0.770) and obesity (AOR=3.389, 95% CI: 1.830-6.274) were significantly associated with developing hypertension. Conclusion: High frequency of hypertension was found among the rural population in Bangladesh where a lot of significantly associated risk factors. The data would be helpful for the health policy makers dealing Non-communicable diseases to reach the sustainable goal and mitigate morbidity and mortality of cardiovascular diseases in Bangladesh. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 205

Effect of Regulated Add-on Sodium Chloride Intake on Stabilization of Serum Lithium Concentration in Bipolar Disorder: A Randomized Controlled Trial

IntroductionThe therapeutic use of lithium in bipolar disorder is often restricted due to its narrow therapeutic window and adverse drug reactions. Lithium-induced early renal dysfunction is clinically important as it may lead to sodium depletion due to natriuresis leading to lithium retention and lithium toxicity. This is most often seen in the initial phases of therapy, and psychiatrists struggle titrating the dose of lithium and stabilizing the serum lithium level.ObjectivesThe present study was conducted to evaluate the effect of add-on sodium chloride on serum lithium levels in bipolar disorder.MethodsThe present randomized controlled trial (NCT04222816) was conducted in 60 patients with type I bipolar disorder who were randomized into the control group who received lithium carbonate with the advice not to take additional salt (at the table) and the test group who received sachets of sodium chloride (1 g/d) as an add-on to lithium carbonate and were advised to restrict their additional salt intake (at the table) to 1 g/d. After baseline assessments, all patients were followed up at 4 weeks, 8 weeks, and 12 weeks when serum lithium, sodium and potassium were estimated. Serum creatinine and aldosterone were repeated at 12 weeks.ResultsIn the test group, the fluctuation rate in serum lithium (26.7%) was significantly (p=0.01) lower than in the control group (63.3%). There was a significant difference in serum lithium in the control group at different time points; however, the changes were not significant in the test group. There was a significant difference in serum lithium between the groups at 8 and 12 weeks of follow-up. There were no significant differences in the change in serum sodium, potassium, creatinine, aldosterone, creatinine clearance, and blood pressure within the group and between the groups. A significant positive correlation was found between serum lithium and aldosterone at baseline.ConclusionsIntake of add-on sodium chloride (1 gm/day) may reduce the fluctuations in serum lithium during the maintenance phase of lithium therapy in type I bipolar disorder.Disclosure of InterestNone Declared

Prevalence of hypertension and its associated factors among tribal population in Southern Rajasthan

Background: The prevalence of hypertension (HTN) and associated factors across social groups including tribal communities as a major non-communicable disease across world is a topic of very high contemporary relevance, especially when it is misconceived as a cause of morbidity only for the richer strata of the society. Aims and Objectives: The present study was conducted to assess the prevalence of HTN and its associated factors among tribal population in South Rajasthan. Materials and Methods: The cross-sectional study is based on a sample of 300 adult members living in 160 randomly selected tribal households in Udaipur district.The information collected included systolic and diastolic blood pressure along with a set of associated sociodemographic, behavioral risk factors, level of physical activities, and body mass index. The descriptive statistical measures such as class frequencies, mean, standard deviation, and Chi-square test of significance for association were used. Results: The estimated overall prevalence of HTN was 23.33% with 29.05% for male and 17.76% for female tribal adult population. The sex, age,family history of HTN, occupation, socioeconomic class, and landholding size were found significantly associated with HTN.The risk factors such as alcohol consumption, smoking, and additional salt intake emerged with odds ratio of 1.83, 2.94, and 1.14, respectively. Conclusion: The health intervention focused to increase physical activity and to reduce alcohol consumption, smoking, and additional salt intake can prove to be effective control measures for emerging problem of HTN in tribal area.

Awareness of Rural People about Prevention of Non-Communicable Diseases

Background & Objective: Non-communicable diseases, particularly diabetes, hypertension and ischemic heart diseases have created an epidemic situation worldwide. Bangladesh is also in the grip of the menace. The only way to get rid of the menace is prevention of these diseases which demands awareness against the diseases. This study was undertaken to assess the level of knowledge of adult people of Puthia Upazila regarding prevention of the seclected non-communicable diseases (NCDs).
 Methods: The study was carried out in the Department of Community Medicine Rajshahi Medical College, Rajshahi over a period of 2 months from April 2018 to May 2018. All adult people (18 years onwards) residing in the rural area of Puthia Upazila were the respondents (study population) in this study. The survey invited the adult individuals to participate in the study. A total of 1001 individuals voluntarily responded to participate in the study. Of them 648(64.7%) were free from the NCDs and were interviewed to assess their level of knowledge on prevention of selected NCDs. A self-administered questionnaire containing the variables of interest for evaluating knowledge was used.
 Result: Two-thirds (68.2%) of the respondents were 30–50 years old with mean age of the respondents being 44.3(range: 25-90) years. Males outnumbered females by 11:9. Over half (54%) informed that they had little knowledge and 10.7% were familiar with the NCDs. Around half held the view that diabetes, hypertension, ischemic heart diseases and stroke were NCDs/chronic diseases. Approximately 70% told that the NCDs were on a rising trend. Regarding causes of chronic diseases, the respondents told excess intake of fat and sedentary life-style (67.9%), intake of excess CHO (54.2%), indulgence in smoking (68.2%), less intake of vegetables and fruits (57.4%), excess or additional salt intake (50.5%) and family history of NCD (44.1%). Regarding prevention of NCDs, around 70% were in favor of adopting healthy dietary behaviour and avoiding too much fatty food, followed by regular exercise (71.2%), avoiding or giving up smoking (70.8%) and avoiding or giving up taking extra salt (57.9%).
 Conclusion: The study concluded that the people of Puthia Upazilla are aware more or less about the selected NCDs (diabetes, hypertension, ischemic heart diseases and stroke). They are also aware that these diseases are increasing. Around two-thirds of the people are aware about the risk factors of these non-communicable diseases and the ways to prevent them.
 Ibrahim Card Med J 2020; 10 (1&2): 27-32

Prevalence and risk factors of uncontrolled hypertension in the urban population of Kerala

Background: Hypertension is leading risk factor for cardiovascular diseases and stroke, and leads to 12.8% of all deaths in the world. Uncontrolled hypertension doubles the risk of cardiovascular disease among the adults with hypertension. Globally 65% of the treated hypertensive have uncontrolled hypertension and in Kerala about three forth of the treated hypertensive have poor blood pressure control. The burden of uncontrolled hypertension is suggestive of preventable deaths and cardiovascular events.Methods: A cross-sectional study was conducted among 1210 residents of Kochi Corporation of Kerala aged 18 years and above during the period of Sept. 2014 to Sept. 2016. Pre-tested, semi-structured questionnaire was used to collect data on socio-demographic factors such as age, sex, occupation, socio-economic status, education and marital status. Behavioural factors such smoking, alcohol intake, physical activity and dietary factors were collected. Data was analysed by using statistical package for social sciences software version 20.0.Results: The prevalence of uncontrolled hypertension was 13.14% among the study population. Majority of the uncontrolled hypertensive were females (67.3%) and belonged to the age group 45 years and above (92.5%). The independent predictive factors of uncontrolled hypertension were additional salt intake (aOR 3.62; 95% CI 1.36-9.66), health education by a doctor (aOR 3.58; 95% CI 1.48-8.64), poor adherence to medication (aOR 4.45; 95% CI 1.23-16.03) and patients having no other co-morbidity (aOR 3.24; 95% CI 1.36-7.72).Conclusions: The burden of uncontrolled hypertension was high in this urban setting. A comprehensive measure involving doctors and healthcare workers have to be adopted to achieve optimum blood pressure among the hypertensive.

Effect of lifestyle on blood pressure in Portuguese population under antihypertensive drugs

Abstract Background Hypertension is one of the main risk factors for disability and death from cardiovascular diseases. Current guidelines include initiatives to control blood pressure values in hypertensive patients that focus on lifestyle changes. The main objective of this study was to estimate the association between lifestyle and blood pressure in patients under antihypertensive drugs. Methods An analysis of the data of Portuguese Health Examination Survey (INSEF) was performed. Individuals who met INSEF inclusion criteria and who referred to be under antihypertensive drugs in the two weeks prior to the questionnaire were studied. Lifestyle variables (alcohol consumption, smoking, additional salt intake, fruit and vegetables consumption, practice of physical activity) were measured by questionnaire, and blood pressure values were obtained by physical examination. Associations between lifestyle factors and blood pressure, stratified by sex and adjusted to sociodemographic variables and to obesity, were estimated through a multiple linear regression model. Results Alcohol consumption (ß=6.31, p = 0.007) and smoking (ß=4.72, p = 0.018) were associated with systolic blood pressure in men. Additional salt intake, fruit and vegetable consumption, and practice of physical activity were not associated with blood pressure in men. In women, no association was observed for any behavioural variable. Conclusions These conclusions reinforce the need, also in the population under antihypertensive drugs, particularly in the male sex, to focus the fight against high systolic blood pressure in these two modifiable and preventable behaviours: smoking and alcoholic consumption. Key messages Alcohol consumption and smoking are the behavioral determinants associated with high systolic blood pressure values in men under antihypertensive drugs. These conclusions reinforce the need to focus the fight against high systolic blood pressure in the preventable and modifiable behavioural determinants.

Awareness of the role of cardiovascular risk factors and their prevention from the perspective of Tricity adolescents

Introduction. Arterial hypertension (HT) affects 10.4 million adult Poles, and the blood pressure (BP) control rate is only 26%. Beyond any doubt, high blood pressure results in cardiovascular (CV) target organ damage, which markedly influences national healthcare programs. Childhood introduced cardiovascular prophylaxis offers opportunities to decrease incident HT and delay or even eliminate its consequences. Therefore we have decided to study the level of knowledge on HT and CV disease (CVD) among random 1st and 2nd grade high school students in Tricity, Poland. Material and methods. Questionnaire-based study was conducted voluntarily in two selected high schools of the Tricity agglomeration, Poland, in 2000 and repeated in 2016. All participants were presented with a 38-item questionnaire on cardiovascular risk factors knowledge as well as students’ health habits. Results. Studied group consisted of 615 students (57.6% females) at the age of 16, mean BMI 20.89 ± 2.95 kg/m2 (78% BMI norm). The evaluation of the several habits in two time-points was as follows: additional salt intake was reported by 38.3% vs. 35.1% adolescents in 2000 and 2016, respectively; p = 0.43, dining in fast food restaurants at least once a week: 13.9% vs. 44.8%; 2000/2016; p < 0.01; hours per week spent on physical activity: 5.6 ± 4.4 vs. 5.5 } 4.5; p = 0.85; students who never drank alcohol: 19.7% vs. 31.1%; p < 0.01; cigarettes ever smoking: 39.6% vs. 21.2%; p < 0.01; regular smokers: 10.2% vs. 4.1%; p < 0.05. The awareness of CV-preventive measures such as body weight reduction was presented by 88.1% vs. 93.9% students in 2000 vs. 2016; p = 0.01; regular physical activity 92.6% vs. 97.1%; P = 0.01, limiting smoking and alcohol consumption 84.2% vs. 91.2%; p = 0.01; salt reduction: 62.6% vs. 82.3%; p < 0.001. Interestingly, in 2016 the majority of students identified myocardial infarction as a consequence of AH 92.4%, which was markedly less evident in case of stroke and kidney disease (46.2%, and 28%, respectively). Conclusion. Although the awareness of negative consequences of HT and other CV-risk factors has grown over the past 15 years, the implementation of this knowledge is insufficient among high-school adolescents.

An epidemiological study of prevalence of hypertension and its risk factors in a rural community of South India

Background: Chronic non-communicable diseases are important among adult population all over the world. Hypertension (HTN) is the most common cardiovascular disorder accounting for 20-50% of all cardiovascular deaths. The prevalence of HTN is increasing in both rural and urban communities. Objective: The objective of this study was to determine the prevalence of HTN and its associated risk factors in a rural population. Materials and Methods: A community-based cross-sectional study was conducted at rural areas of South India. The sociodemographic variables and risk factors were obtained by interviewing the participants in a predesigned semi-structured questionnaire. The sample size was calculated by the prevalence of HTN in previous studies and 650 participants were included. The blood pressure was assessed and classified according to the Joint National Committee VII classification. Statistical analysis was done using descriptive statistics and Chi-square test of significance. Results: Out of the 650 adults surveyed, 92 individuals (14.1%) were found to be suffering from HTN. Among males, 58 (16.2%) had HTN and 92 (25.7%) were prehypertensives, and among females, 34 (11.6%) had HTN and 71 (24.2%) were prehypertensives. The prevalence rate of HTN shows an upward trend as age advances. The prevalence rate was high among males, higher socioeconomic class, and among the highly educated groups. The risk factors such as tobacco usage, alcohol consumption, additional salt intake, family history of HTN, obesity, high waist-hip ratio, and diabetes mellitus were found to have statistically significant association with HTN. Conclusions: There is an increase in the prevalence of HTN in the rural communities of South India. Population-based prevention strategies and evidence-based clinical strategies should focus on early detection and appropriate treatment.

Syndrome of Inappropriate Secretion of Antidiuretic Hormone Found by Preoperative Electrolyte Analysis

To the Editor A 73-year-old woman, scheduled for extraction of 9 teeth under general anesthesia, had a serum sodium concentration of 137 mEq · L−1 at another hospital 3 weeks earlier. Preoperative blood analysis revealed a serum sodium concentration of 124 mEq · L−1, serum osmolality 260 mOsm · L−1, urinary sodium concentration 48 mEq · L−1 with a urinary osmolality of 822 mOsm · L−1, and serum arginine vasopressin concentration of 1.4 pg · mL−1 (normal range, 0.3–3.5 pg · mL−1). Thyroid and adrenal functions were normal. History included dementia, cerebral infarction, cerebellar atrophy, osteoporosis, lumbar and pelvic fractures, and chronic lymphocytic leukemia with anemia, and she had been bedridden in a hospital for several years. The medication history from the previous hospital disclosed that tablets of combined sulfamethoxazole and trimethoprim (Bactramin®) had been added because of the oral infection and a diagnosis of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with these drugs was suspected.1,2 Discontinuing these drugs, additional salt intake, fluid restriction, and infusion of hypertonic saline (3% NaCl) increased serum sodium concentration to 136 mEq · L−1 by the day before surgery.3,4 General anesthesia and surgery were uneventful and 6 days later, the patient was discharged from our hospital. The patient consented to publication of this report. Diagnosing SIADH based on clinical findings is difficult because of the lack of signs of excessive volume of extracellular fluid.2 In this case, SIADH was identified by chance based on preoperative electrolyte analysis. Drug-induced SIADH can occur with administration of vincristine, tricyclic antidepressants, opioids, antipsychotic drugs, carbamazepine, and selective serotonin reuptake inhibitors.2 To our knowledge, however, no reports have described SIADH induced by sulfamethoxazole and trimethoprim. If preoperative examination shows that hyponatremia is present preoperatively, additional measurements of serum osmolality, urinary sodium concentration, urinary osmolality, and serum arginine vasopressin level are warranted to clarify whether this finding is associated with SIADH. Kazuna Sugiyama, DDS, PhD Atsushi Kohjitani, DDS, PhD Yoko Iwase, DDS, PhD Yozo Manabe, DDS, PhD Department of Dental Anesthesiology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima, Japan [email protected]

Period prevalence and sociodemographic factors of hypertension in rural maharashtra: a cross-sectional study.

Background:Hypertension is most common cardiovascular disease and it account for large proportion of all cardiovascular deaths and disability worldwide.Research Questions:What is the level of prevalence of hypertension in rural area? What are the soociodemographic factors associated with hypertension?Objectives:To find out prevalence of hypertension in rural area.Study Design:A community-based cross-sectional study setting: Rural Health Training Centre Paithan, field practice area of govt. medical college Aurangabad, Maharashtra.Participants:1297 persons aged 19 years and above.Study Period:June 2005 to December 2006.Materials and Methods:A house-to-house survey was conducted by the author himself, interviewed the participants by systematic random sampling method, using pretested structured standard questionnaire. Two independent blood pressure (BP) readings were taken in sitting position by visiting each participant at their home. Hypertension was defined as systolic BP more than or equal to 140 mm of Hg or diastolic BP more than or equal to 90 mm of Hg or those individuals currently taking antihypertensive treatment.Statistical Tests:Percentiles, Chi Square test, Chi-Square for linear trend, multiple logistic regression analysis on SPSS software Version 10.Results:Overall prevalence of hypertension in the study subjects was 7.24%. Multiple logistic regression analysis identified various factors significantly associated with hypertension were age, sex, BMI, additional salt intake, smoking, DM, alcohol consumption, and higher socioeconomic status.Conclusions:The overall prevalence of hypertension in study subjects was 7.24%.

Loss of taste-induced hypertension — caveat for taste modulation as a therapeutic option in obesity

Effective treatment of obesity is extremely difficult, and taste modulation has been suggested as a feasible option. We aim at presenting dangers associated with stroke-induced taste impairment. A case report is presented with clinical and laboratory findings. We review literature on the effect of taste modulation on body weight. Eight months after suffering stroke, a 63-year old obese woman with a nine year-old history of type 2 diabetes reported headache and poor general feeling. Physical examination revealed significantly elevated blood pressure of 190/110 mmHg. The patient had never had elevated blood pressure before nor ever been taking any antihypertensive medication. However, stroke resulted in severe persisting dysgeusia. We found out that she had been using up to 110 g of salt daily to make her meals palatable. Standard gustatory tests confirmed severe taste impairment, reflecting the lesion of the glossopharyngeal nerve. Taste loss was not associated with body weight reduction. Limiting daily salt intake to 5 g within 4 weeks resulted in lowering blood pressure to 120/70 mmHg. Stroke-induced dysgeusia may lead to increased salt intake in a type 2 diabetes patient, which caused development of severe hypertension. The taste loss did not yield any weight reduction. We suggest that aiming at reducing body weight by means of taste modulation should be done with caution. Physicians must be aware that patients may try to overcome dysgeusia by additional salt intake, if not adequately informed of the risk thereof.

Resistance of mice lacking the serum- and glucocorticoid-inducible kinase SGK1 against salt-sensitive hypertension induced by a high-fat diet

Mineralocorticoids enhance expression and insulin stimulates activity of the serum- and glucocorticoid-inducible kinase SGK1, which activates the renal epithelial Na+)channel (ENaC). Under a salt-deficient diet, SGK1 knockout mice (sgk1-/-) excrete significantly more NaCl than their wild-type littermates (sgk1+/+) and become hypotensive. The present experiments explored whether SGK1 participates in the hypertensive effects of a high-fat diet and high-salt intake. Renal SGK1 protein abundance of sgk1+/+ mice was significantly elevated after a high-fat diet. Under a control diet, fluid intake, blood pressure, urinary flow rate, and urinary Na+, K+, and Cl- excretion were similar in sgk1-/- and sgk1+/+ mice. Under a standard diet, high salt (1% NaCl in the drinking water for 25 days) increased fluid intake, urinary flow rate, and urinary Na+, K+, and Cl- excretion similarly in sgk1-/- and sgk1+/+ mice without significantly altering blood pressure. A high-fat diet alone (17 wk) did not significantly alter fluid intake, urinary flow rate, urinary Na+, K+, or Cl- excretion, or plasma aldosterone levels but increased plasma insulin, total cholesterol, triglyceride concentrations, and systolic blood pressure to the same extent in both genotypes. Additional salt intake (1% NaCl in the drinking water for 25 days) on top of a high-fat diet did not affect hyperinsulinemia or hyperlipidemia but increased fluid intake, urinary flow rate, and urinary NaCl excretion significantly more in sgk1-/- than in sgk1+/+ mice. Furthermore, in animals receiving a high-fat diet, additional salt intake increased blood pressure only in sgk1+/+ mice (to 132 +/- 3 mmHg) but not in sgk1-/- mice (120 +/- 4 mmHg). Thus lack of SGK1 protects against the hypertensive effects of a combined high-fat/high-salt diet.

Effects of salt loading and various therapies on cardiac hypertrophy and fibrosis in young spontaneously hypertensive rats

We investigated the effects of salt loading on blood pressure, cardiac hypertrophy and fibrosis as well as on the effectiveness of various antihypertensive therapies in young spontaneously hypertensive rats (SHR). Twenty-five male SHR were salt-stimulated by drinking 1% NaCl from 3 to 6 months of age. Eighteen of them were treated for the last 2 weeks of salt loading with either the angiotensin-converting enzyme inhibitor captopril, the β-adrenergic receptor blocker propranolol or the calcium-channel antagonist verapamil. Age-matched male Wistar-Kyoto (WKY) rats and SHR drinking only water served as controls. At the age of 6 months, SHR had significantly elevated blood pressure that was unchanged by salt loading. Relative heart weight was increased in SHR without (3.3) and even more so with salt intake (3.6 vs. 2.4 in WKY). Left ventricular (LV) hypertrophy was accompanied by a 17-fold increase in the expression of mRNA for atrial natriuretic factor (ANF) both in untreated and salt-loaded SHR compared to WKY ( p < 0.001). Collagen I and III mRNA increased 1.7–1.8-fold in SHR without and with additional salt intake ( p < 0.01). None of the therapies significantly reduced blood pressure or hypertrophy. Although captopril had no antihypertensive effect, it reduced ANF, collagen I and III mRNA in LV to control level. Less pronounced effects were achieved with verapamil. These findings emphasize the cardioprotective role of captopril which may not be fully expressed in the presence of elevated salt intake.

An Observational Study On The Spectrum Of Heat-Related Illness, With A Proposal On Classification

During operations in subtropical areas over the summer months of 2001 and 2003 the authors audited 80 patients with heat-related illness, with the intention of defining the nature and distribution...