Chronobiological approach to the treatment of essential hypertension: preliminary data

The effect on bioperiodic parameters of hypertension elicited by the beta-blocking agent mepindolol, administered as a single dose of 10 mg at 8 a.m. vs 10 mg at 8 p.m., was evaluated in this study. Circadian blood pressure monitoring was performed in age-matched patients with essential hypertension after a two-week wash-out period with placebo and four weeks treatment. Patients were randomly allocated to one of the two treatment groups. Standard blood chemistry and electrocardiogram were performed at the beginning and end of the treatment period. Statistical analysis of blood pressure circadian rhythm characteristics (mesor, amplitude, acrophase) showed a significant decrease of mesor of systolic and diastolic blood pressure in both groups. Values of the mesor were not significantly different between the two groups. Interestingly, changes of acrophase and amplitude induced by the drug were different in regard to the time mepindolol was administered. Side effects were generally mild.

Lack of inhibition of anterior pituitary hormone release during chronic treatment with calcium antagonists

Calcium antagonists are widely used for the treatment of cardiovascular disorders, especially ischaemic heart disease. It has been demonstrated that these drugs, either in vitro or acutely administered in humans, inhibit the basal and stimulated secretion of pituitary hormones by blocking calcium influx through slow calcium channels. To see if a similar effect could be detected after their chronic administration, we studied the basal, TRH- and LHRH-stimulated TSH, PRL, LH and FSH release in 18 male subjects with chronic stable angina before and on the 30th day of oral treatment with verapamil (n = 8;80 mg three times a day) or with nifedipine (n = 10; 10 mg three times a day). Neither drug had any effect on basal TSH, PRL, LH and FSH values or on their response to the specific hypothalamic-releasing hormones. These results suggest that the chronic administration of calcium antagonists, at the usual therapeutic doses, does not effect the process of stimulus-secretion coupling of anterior pituitary hormones, ruling out any impairment of the related target glands which have been expected on the basis of previous studies.

17 alpha-hydroxylase deficiency: mineralocorticoid hormone profiles in an affected family

The plasma concentrations of mineralocorticoid hormones, basal and after stimulation and suppression with ACTH, can identify the heterozygotes in a family with two siblings with 17 alpha-hydroxylase deficiency. Both parents and one sibling had elevated levels of plasma deoxycorticosterone, corticosterone, 18-hydroxydeoxycorticosterone, and 18-hydroxycorticosterone, but normal cortisol and aldosterone concentrations. Stimulation with ACTH effected additional increases in the elevated steroid and cortisol levels, but not in aldosterone, further increasing the discrepancy and the ratio between 18-hydroxycorticosterone and aldosterone. One sibling had normal steroid patterns and an 18-hydroxycorticosterone to aldosterone ratio. Suppression of ACTH restored the steroids to low normal levels. In addition, the ratio of the gas chromatographic analysis of the total major urinary metabolites of corticosterone to total metabolites of cortisol was greater, and the sum of urinary androsterone and etiocholanolone to total corticosterone and cortisol metabolites was less in the heterozygotes than in normal subjects. This identifies deficient 17-hydroxylation, which is required for the production of cortisol and C-19 steroids. These criteria appear unique for the 17 alpha-hydroxylase defect in the heterozygote.

Effect of bromazepam on growth hormone and prolactin secretion in normal subjects

The growth hormone and prolactin response to oral bromazepam (3 mg) was assessed in 5 normal men and 5 normal women. A peak growth hormone response of 11.9 +/- 3.7 ng/ml (mean +/- SD), significantly above the baseline (p less than 0.01), was achieved in the men. On the other hand, there was no statistically significant response of growth hormone secretion in the women. No change in prolactin secretion was observed in either sex.