Once a day treatment of hypertension

Two studies are presented on the possibility of treating hypertension with pindolol once daily. In the first one, patients already treated with multiple doses of pindolol, propranolol or alprenolol were shifted to single dose regime with pindolol, given in the morning. In most cases an adequate blood pressure control could be maintained on a dose of up to 20 mg pindolol. In the other study, previously untreated patients with mild to moderate hypertension were treated from the beginning with a single dose of pindolol. An adequate pressure control was also obtained in most of these patients with a dose not surpassing 20 mg pindolol once daily. In non-responders, the addition of a once daily dose of a diuretic resulted in an adequate pressure control. In both studies side-effects were few. The absence of sleep disturbances and beta-blocker induced bradycardia was particularly noteworthy.

A prospective epidemiological survey of cerebrovascular disease in a Swedish community

A prospective epidemiological study of cerebrovascular diseases and transient ischemic attacks (TIA) is presented. During a three-year period the annual incidence of strokes was 2.90 and of TIA 0.45 per thousand population. This difference in incidence and the disparities in age characteristics favour the hypothesis that TIA precedes only a minority of the strokes. The short-term mortality is high among the stroke patients.

Pindolol once daily in the treatment of hypertension

The beta-adrenergic blocking drug pindolol has been used in the treatment of hypertension, using one single dose per day, given in the morning. 16 patients with mild to moderate hypertension were treated with doses which were increased if necessary up to 20 mg, and 14 patients achieved an adequate level of blood-pressure control. The trial was carried out as a single-blind cross-over study. The study shows that pindolol, a non-selective beta-blocker of high potency, may be given once daily as a hypotensive, offering advantages both for patients and physicians. Side-effects were infrequent.

Studies on cerebrovascular stroke. III. Long-term prognosis and clinical findings in a follow-up study of a stroke material

The present paper reports the third part of an investigation of first-time cerebrovascular strokes occurring in people under the age of 70. The long-term prognosis for 214 patients discharged alive from hospital after the acute phase of the stroke is presented. The clinical and laboratory findings for 114 patients alive at the time of a follow-up examination 32 months after the stroke are discussed. The long-term prognosis could be predicted best by a score, calculated from the neurological findings on admission after the acute stroke. Recurrence of stroke was associated with a very high mortality. Forty-five per cent of the patients who survived the first month had died by the time of follow-up. About 15% were able to return to normal life or go back to work. There was a trend among patients originally severely handicapped to improve their performance ability. Factors influencing the chances for rehabilitation are discussed. Among the survivors there was a strikingly high percentage of patients with overt diabetes or decreased glucose tolerance, of patients with arteriosclerotic heart disease and patients with elevated serum triglyceride levels. These findings are discussed.

Studies on cerebrovascular stroke. I. Epidemiology of first-time strokes in persons under 70 years of age

The present investigation was carried out to study the incidence of new cerebrovascular strokes (cerebral haemorrhage, cerebral infarction and cerebral embolism) in people under the age of 70. SUCH INFORMATION HAS HITHERTO BEEN LACKING. The material comprises all cases from Uppsala county occurring between 1967 and 1971. The incidence was found to be 36/100,000 inhabitants. Of the total number of strokes, 25% were recurrences. During the period of study the incidence showed a moderate but significant decrease. It is assumed that this decrease is due to an extended and improved treatment of hypertension. It was observed that there were 6 females below 40 years of age. All had been on oral contraceptives at the time of the stroke. There was a high incidence of diabetes and symptoms of cardiovascular impairment (hypertension, transient ischaemic attack (TIA), cardiosclerotic disease) in the series. A high incidence of myocardial infarction was found among the parents of the cases of cerebral haemorrhage. A high incidence of strokes was found among the parents of those having cerebral infarctions.