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AIM: The objective of this study was to determine the subacute blood pressure behavior of pharmacologically-treated elderly hypertensive patients after a session of resistance exercise. This was a controlled clinical trial carried out on 30 elderly hypertensive women. The study procedures took place over three days with an interval of 48 hours, and included a test session, an experimental protocol (EP) and a control protocol (CP). METHODS: A 10RM test was carried out to define the EP load for the following exercises: leg press, knee extension, pull-up, biceps curl and machine bench press. In the EP, three sets of exercises with 8 to 10 repetitions were carried out at 2-minute intervals. In the CP all procedures were the same as in the EP, but without the exercises. BP was measured before, immediately after and every ten minutes up to 60 minutes after the EP and CP. RESULTS: There was no significant variation in systolic blood pressure (SBP) or diastolic blood pressure (DBP) in either the EP or the CP immediately after the exercises. In the period up to sixty minutes after the exercises, there was a significant difference in BP, with a decrease in SBP and DBP for both EP and CP. CONCLUSION: The data from the present study offer a good indication that resistance exercises may be prescribed safely to this group of patients. The pressure reduction appears to be influenced by the rest that occurred after the protocols and not by exercise.

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UNLABELLED: Low birth weight (LBW) is associated to an increased incidence of hypertension, renal and cardiovascular diseases in adulthood. The objective of this study was to evaluate possible changes in microalbuminuria (MA) and blood pressure (BP) in children with LBW. MATERIAL AND METHODS: The birth weight (BW) of 1,049 children between 8 and 11 years of age, enrolled in schools in the city of Goiânia/Brazil was investigated. Those in the LBW group (BW < or = 2.5 kg) were compared to a similar group with normal birth weight - NBW (BW > or = 3.0 kg). BP and 24-hour urine MA were evaluated. BW and prematurity (gestational age < 37 weeks) were obtained from the information contained in the children's card. RESULTS: There were 34 children with LBW and 34 with NBW. No significant difference was found regarding age, sex, race, weight, height, BMI, and family history of hypertension or diabetes. Children with LBW presented higher systolic BP (p = 0.019) and more albumin in the 24-hour urine then children with NBW (p = 0.024). CONCLUSION: We concluded that school children with LBW present with higher BP and more albumin excretion in the 24-hour urine. These findings can indicate presence of changes in both blood pressure and microalbuminuria in prepubertal children with low birth weight..

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OBJECTIVE: To evaluate the effects of diet and medication, either isolated or associated, on serum levels of uric acid in patients with hyperuricemia. METHODS: We studied patients from the Hypertension Unit of the University of Goias who had hyperuricemia (men > or =8.5 mg/dL and women > or =7.5 mg/dL). We divided the patients into three groups: G1 (low purine diet), G2 (low purine diet + medication), and G3 (medication only). Patients received allopurinol, 150 mg/day titrated up to 300 mg/dL when necessary. Patients were evaluated with regards to their lifestyles (diet, smoking, physical, activity, alcohol consumption), uric acid, blood pressure, use of medication, body mass index, cholesterol, and triglyceride. Follow-up took place in weeks 0 (M1), 6 (M2), 12 (M3) during the intervention and in week 36 (M4) after the study was completed. RESULTS: Fifty-five patients participated in the study, 31 women, mean age 54.4+/-10.6 years, body mass index 28.6+/-3.9 kg/m2. A similar reduction (p<0.001) in uric acid levels occurred in the three intervention groups. In week 36 (M4), after 24 weeks without intervention, a tendency toward elevation of uricemia was noted in G2 and G3, and a continuous drop in uricemia was noted in G1. No significant modifications were observed in the other variables analyzed. CONCLUSION: Considering the cost x benefit relationship, a diet low in purine should be the 1st therapeutic option for controlling hyperuricemia in patients with similar characteristic to the ones presented in this study.

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OBJECTIVE: To evaluate the anti-hypertensive effect of verapamil COER-24 180/240 mg in a single dose at bedtime as single therapy in mild to moderate hypertensives. METHODS: A multicentric, open, placebo controlled study of 81 hypertensive patients older than 20 years-old followed to 8 weeks. Blood pressure was measured in doctor's office and by 24 h ambulatory monitoring (ABPM). RESULTS: We observed a decreased in systolic and diastolic blood pressure in doctor's office at 4th and 8th weeks. ABPM showed that both systolic, diastolic and mean blood pressure, heart rate and the mean 24-hour blood pressure load decreased after the 8-week treatment. In addition, there was a reduction of the double-product, especially in the morning and 68% of the patients didn't have any adverse events. CONCLUSION: The therapy verapamil COER-24 180/240 mg in a single dose is useful for mild and moderate hypertensive patients, with significant pressure decrease in both office blood pressure measurements and in the ABPM/24 hours, as well as showing good tolerability.

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OBJECTIVE: A double-blind, placebo-controlled multicenter study involving 34 centers from different Brazilian regions was performed to evaluate the antihypertensive efficacy and tolerability of trandolapril, an angiotensin I converting enzyme inhibitor, in the treatment of mild-to-moderate systemic arterial hypertension. METHODS: Of 262 patients enrolled in this study, 127 were treated with trandolapril 2 mg/day for 8 consecutive weeks, and the remaining 135 patients received placebo for the same period of time. Reduction in blood pressure (BP) and the occurrence of adverse events during this period were evaluated in both groups. RESULTS: Significantly reductions in both systolic and diastolic pressures were observed in patients treated with trandolapril when compared with those on placebo. Antihypertensive efficacy was achieved in 57.5% of the patients on trandolapril and in 42% of these normal values of BP were obtained. The efficacy of trandolapril was similar in all centers, regardless of the area of the country. In a subset of 30 patients who underwent ABPM, responders showed a significant hypotensive effect to trandolapril throughout the 24 hour day. The adverse event profile was similar in both trandolapril and placebo groups. CONCLUSION: Our results demonstrate, for the first time in a large group of hypertensive patients from different regions in Brazil, good efficacy and tolerability of trando-lapril during treatment of mild-to-moderate essential systemic hypertension.

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PURPOSE: To evaluate the efficacy and tolerability of different therapies associated with diet in the treatment of hypertensive obese patients. METHODS: In a clinical study we randomly evaluated 39 hypertensive obese patients (body mass index (BMI) > or = 30 kg/m2). After 45 days of diet the patients were again randomly distributed in 3 groups and received in double blind way: group 1-hypocaloric diet+placebo; group 2-hypocaloric diet+dexfenfluramine; group 3-hypocaloric diet+spiruline+fucus+gelatin. We followed their progress during 12 weeks under medication and further 24 weeks without. We evaluated the groups comparing: weight, BMI, blood pressure and side-effects. RESULTS: Twenty seven patients completed the observation. In those patients from groups 1 and 3 no changes in any of parameters were observed. In group 2 we observed a clear loss of weight (-3.8 Kg) and a fall in BMI. Blood Pressure changes were only observed in group 2 (-9.6%). The only patients to maintain weight loss after the termination of use of medicines were those from group 2. We did not observe any side-effects. CONCLUSION: In hypertensive obese patients, when isolated diet is not enough to control weight loss, dexfenfluramine could be useful in association with a controlled diet. The drug assists in weight loss, does not promote side-effects and does not interfere in the treatment of blood pressure.

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PURPOSE: To evaluate arterial blood pressure (BP), variations that occur with age, influence of new habits, in indians of a Xavante tribe, located in the state of Mato Grosso, Brazil. METHODS: The evaluation procedures took place in 9/75 and 10/90. Fifty Xavante were examined in 1975. Thirty-five of them were men and 15 women. The mean age of the men was 45 and of the women, 31. In 1990, only 46 of those indians were re-examined (two were not located and two had already died of cancer and pneumonia), and evaluated with regard to arterial BP, food ingestion, physical activities, obesity, tobacco, alcoholic beverage consumption and social organization. RESULTS: In both occasions we did not find individuals with hypertension. The highest BP observed was of 140 x 90 in a 70-year-old indian. His result is consistent with what had been noted in 1975. Among the women, the highest level was of 130 x 60 in a 55-year-old female indian. The women maintained a lower level of BP as compared to the men of any age group. The average blood pressure showed a discrete increase going from 79.2 to 83.8 mmHg in the men and from 75.7 to 77.0 mmHg in the women. In this tribe we observed the habit of smoking in 30% of the individuals. Alcoholic beverage consumption is rare, physical activities remained constant and obesity is absent. As for the eating habits, with the decrease of hunting grounds, the indians acquired a more rural behavior with regular use of rice and beans. Salt is practically not added to the food. Competitiveness is not an acquired trait to that culture. CONCLUSION: In "isolated" populations that maintain their cultural traits and basic life styles, the occurrence of arterial hypertension is very rare and the increase in BP with age is modest and significant only for systolic.

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PURPOSE: To evaluate clinical efficacy and tolerability of isradipine SRO (I.SRO), 5 mg O.D. in essential hypertensives. METHODS: Eighty-three of 87 selected outpatients with a mean age of 51.3 years (ranging from 25 to 65), 33 male, 48 white, 29 black and others of different races, who had clinical supine and orthostatic diastolic blood pressure (DBP) > or = 95 mmHg and < or = 115 mmHg underwent the study. After a three-week wash-out period, patients received I.SRO 5 mg O.D. at 8:00 am for a six-week period (phase I). After this phase, patients received I.SRO 5 mg O.D. at 8:00 pm for a six-week period (phase II). The patients had a follow-up with an interval of three weeks and the ambulatorial blood pressure monitoring (ABPM) for 24 hours was performed with a SpaceLabs 90207 or Del Mar Avionics devices after the wash-out period and at the end of phases I and II. Measurements were performed at 15-min intervals during the day (6 am to 10 pm) and at 30-min intervals during the night (10 pm to 6 am). RESULTS: a) Heart rate did not show significant changes during the treatment period (phases I and II) when compared with the wash-out period; b) causal blood pressure: at the end of both treatment periods (phases I and II) there were statistically significant decreases (p < 0.001) in supine SBP and DBP compared with wash-out values. The mean SBP decreased from 161.6 +/- 14 to 144.3 +/- 13 mmHg (phase I) and to 141.8 +/- 13 mmHg (phase II). The mean DBP decreased from 103.4 +/- 6 to 91.2 +/- 7 (phase I) and to 89.1 +/- 8 (phase II); c) ABPM: the mean systolic 24-h ambulatory blood pressure was significantly reduced (p < 0.001) from 148.8 +/- 17 to 137.2 +/- 15 mmHg (phase I) and to 133.4 +/- 13 mmHg (phase II). The mean diastolic 24-h ambulatory blood pressure was significantly decreased (p < 0.001) from 94.3 +/- 9 to 87.0 +/- 9 (phase I) and to 85.8 +/- 8 mmHg (phase II). The mean daytime and nighttime, systolic and diastolic 24-h ambulatory blood pressure were: wash-out--152.3 +/- 17, 140.2 +/- 21, 97.4 +/- 9, 86.8 +/- 13; phase I--139.9 +/- 15, 130.0 +/- 17, 89.3 +/- 9, 81.3 +/- 10; phase II--136.7 +/- 13, 125.3 +/- 15, 88.5 +/- 8, 79.1 +/- 10, respectively. Blood pressure load (percentage of systolic blood pressure values > 140 mmHg or of diastolic blood pressure values > 90 mmHg) was significantly reduced from 62.2/62% (SBP/DBP), on the was-out, to 37.9/39.9% (SBP/DBP) on phase I and to 32.3/34.3% (SBP/DBP) on phase II; d) side effects: most frequently related were palpitations (2.3%), headache (1.1%), flush (1%) and ankle oedema (1%). They were in general, mild-to-moderate and disappeared after the first 3 weeks of treatment. Only two patients were withdrawn because of headache (one of them with previous diagnosis of migraine). CONCLUSION: I.SRO, given by oral route, in the dosage of 5 mg O.D. as monotherapy, was effective and well tolerated, promoted significant reduction on 24-h ambulatory blood pressure attenuating the early morning rise and did not interfere with the circadian rhythm of blood pressure. No significant differences were detected in the BP lowering effect when I.SRO was given during the morning or evening. These results may indicate that the drug is as suitable as one of the first choice for treating mild and moderate hypertensive patients.

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