Publications
793 results found
SHAHI M, THOM S, POULTER N, et al., 1991, THE EFFECTS OF BLOOD-PRESSURE REDUCTION ON ABNORMAL LEFT-VENTRICULAR DIASTOLIC FUNCTION IN HYPERTENSIVE PATIENTS, EUROPEAN HEART JOURNAL, Vol: 12, Pages: 974-979, ISSN: 0195-668X
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- Citations: 7
SHAHI M, THOM S, POULTER N, et al., 1991, DETERMINANTS OF LEFT-VENTRICULAR FILLING IN HYPERTENSION, JOURNAL OF HUMAN HYPERTENSION, Vol: 5, Pages: 27-34, ISSN: 0950-9240
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- Citations: 2
POULTER N, THOM S, SEVER P, 1991, 1ST LINE TREATMENT IN HYPERTENSION, BRITISH MEDICAL JOURNAL, Vol: 302, Pages: 116-116, ISSN: 0959-8138
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- Citations: 4
SEVER PS, LANGDON CG, GRIMM RH, et al., 1991, PROCEEDINGS OF A SYMPOSIUM - MANAGEMENT OF CORONARY HEART-DISEASE RISK-FACTORS IN HYPERTENSIVE PATIENTS - CLINICAL-EXPERIENCE WITH DOXAZOSIN, LONDON, ENGLAND, JANUARY 26, 1990 - GROUP DISCUSSION, AMERICAN HEART JOURNAL, Vol: 121, Pages: 402-405, ISSN: 0002-8703
POULTER N, 1991, MANAGEMENT OF MULTIPLE RISK-FACTORS FOR CORONARY HEART-DISEASE IN PATIENTS WITH HYPERTENSION, AMERICAN HEART JOURNAL, Vol: 121, Pages: 246-250, ISSN: 0002-8703
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- Citations: 16
Poulter NR, 1991, Treatment of hypertension: a clinical epidemiologist's view., J Cardiovasc Pharmacol, Vol: 18 Suppl 2, Pages: S35-S38, ISSN: 0160-2446
The majority of deaths attributable to hypertension are coronary artery disease (CAD) deaths and, consequently, the prevention of CAD should be the primary aim of hypertension management. Recent meta-analyses confirm the results of the individual hypertension intervention trials, which demonstrated a disappointing shortfall in the observed prevention of CAD events and mortality from lowering blood pressure compared with the expected benefits. These trial results, rather than challenging the validity of the causal nature of the association between hypertension and CAD may be interpreted to suggest that the management of hypertension in the trials was suboptimal. The drugs used in the trials were almost exclusively thiazide diuretics and to a lesser extent beta-blockers. Both of these drug groups have been shown to have adverse effects on lipid profiles--a pivotal risk factor for CAD. In addition to the effects on lipids, diuretics also adversely affect potassium, uric acid, glucose metabolism, and insulin resistance, all of which directly or indirectly affect the incidence of CAD. In the face of a major shortfall in the overall benefit from managing hypertension with diuretics and to a lesser extent beta-blockers, it therefore seems more logical to recommend for the management of hypertension the use of agents with a more metabolic-friendly profile.
SHAHI M, THOM S, POULTER N, et al., 1991, THE TIME COURSE AND DETERMINANTS OF REGRESSION OF LEFT-VENTRICULAR HYPERTROPHY, 2ND INTERNATIONAL SYMP ON CURRENT ADVANCES IN ANGIOTENSIN CONVERTING ENZYME INHIBITION, Publisher: CHURCHILL LIVINGSTONE LTD, Pages: 157-160
POULTER NR, 1991, TREATMENT OF HYPERTENSION - A CLINICAL EPIDEMIOLOGISTS VIEW, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: S35-S38, ISSN: 0160-2446
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- Citations: 4
POULTER NR, 1990, MAJOR RISK-FACTORS FOR CORONARY HEART-DISEASE IN HYPERTENSION - IMPLICATIONS FOR MANAGEMENT, JOURNAL OF HUMAN HYPERTENSION, Vol: 4, Pages: 3-6, ISSN: 0950-9240
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- Citations: 3
Poulter NR, 1990, Major risk factors for coronary heart disease in hypertension: implications for management., J Hum Hypertens, Vol: 4 Suppl 3, Pages: 3-6, ISSN: 0950-9240
Since most deaths attributable to hypertension are the result of coronary heart disease (CHD), the major objective in the management of hypertension should be the prevention of CHD. Data from large population studies, mainly carried out in the USA, leave little doubt that hypertension is causally associated with CHD and we have no reason to believe that the risk factors for CHD in the United Kingdom are any different from those established in the American studies. In addition to the non-modifiable factors of age, sex, and family history, there are modifiable risk factors which include raised serum low density lipoprotein (LDL)-cholesterol, smoking, raised BP, diabetes mellitus, lack of exercise, low high density lipoprotein (HDL)-cholesterol, and use of oral contraceptives. Medicine clearly has a large and critical task in dealing with the current epidemic of CHD-associated illness. However, it is also apparent from prospective data from several countries that a preventative approach by means of public health measures is likely to have a favourable impact upon several of the modifiable risk factors. It is likely that if resources were made available for this purpose in the United Kingdom, a major reduction in morbidity and mortality from CHD would ensue. If we continue to manage hypertension without paying attention to other CHD risk factors, particularly abnormal lipid profiles, then we are unlikely to make an impact on morbidity and mortality from CHD which is our primary objective.
SHAHI M, THOM S, POULTER N, et al., 1990, REGRESSION OF HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY AND LEFT-VENTRICULAR DIASTOLIC FUNCTION, LANCET, Vol: 336, Pages: 458-461, ISSN: 0140-6736
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- Citations: 75
POULTER N, SEVER P, THOM S, 1990, ANTIHYPERTENSIVE AND ADVERSE BIOCHEMICAL EFFECTS OF BENDROFLUAZIDE, BRITISH MEDICAL JOURNAL, Vol: 300, Pages: 1465-1465, ISSN: 0959-8138
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- Citations: 12
POULTER NR, KHAW KT, HOPWOOD BEC, et al., 1990, THE KENYAN LUO MIGRATION STUDY - OBSERVATIONS ON THE INITIATION OF A RISE IN BLOOD-PRESSURE, BMJ-BRITISH MEDICAL JOURNAL, Vol: 300, Pages: 967-972, ISSN: 1756-1833
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- Citations: 304
THOM S, BUNKER J, CALLISTER W, et al., 1989, MULTIPLE RISK FACTOR EVALUATION IN A HYPERTENSION CLINIC, JOURNAL OF HYPERTENSION, Vol: 7, Pages: S330-S331, ISSN: 0263-6352
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- Citations: 1
POULTER N, KHAW K, HOPWOOD T, et al., 1989, LONGITUDINAL-STUDY OF MIGRANTS FROM A LOW-BLOOD-PRESSURE POPULATION IN RURAL KENYA - FINAL RESULTS, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: S392-S393, ISSN: 0263-6352
CARVALHO JJM, BARUZZI RG, HOWARD PF, et al., 1989, BLOOD-PRESSURE IN 4 REMOTE POPULATIONS IN THE INTERSALT STUDY, HYPERTENSION, Vol: 14, Pages: 238-246, ISSN: 0194-911X
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- Citations: 195
SEVER PS, POULTER NR, BULPITT CS, 1989, DOUBLE-BLIND CROSSOVER VERSUS PARALLEL GROUPS IN HYPERTENSION, AMERICAN HEART JOURNAL, Vol: 117, Pages: 735-739, ISSN: 0002-8703
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- Citations: 7
SEVER PS, POULTER NR, 1989, A HYPOTHESIS FOR THE PATHOGENESIS OF ESSENTIAL-HYPERTENSION - THE INITIATING FACTORS, JOURNAL OF HYPERTENSION, Vol: 7, Pages: S9-S12, ISSN: 0263-6352
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- Citations: 29
THOM S, BUNKER J, CALLISTER W, et al., 1989, MULTIPLE RISK FACTOR EVALUATION IN A HYPERTENSION CLINIC, 4TH EUROPEAN MEETING ON HYPERTENSION, Publisher: CURRENT SCIENCE LTD, Pages: S330-S331
POULTER NR, SHIPLEY MJ, BULPITT CJ, et al., 1988, PULSE-RATE AND 24 HOUR URINARY SODIUM CONTENT INTERACT TO DETERMINE BLOOD-PRESSURE LEVELS OF MALE LONDON CIVIL-SERVANTS, JOURNAL OF HYPERTENSION, Vol: 6, Pages: S611-S613, ISSN: 0263-6352
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- Citations: 13
, 1988, Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group., BMJ, Vol: 297, Pages: 319-328, ISSN: 0959-8138
The relations between 24 hour urinary electrolyte excretion and blood pressure were studied in 10,079 men and women aged 20-59 sampled from 52 centres around the world based on a highly standardised protocol with central training of observers, a central laboratory, and extensive quality control. Relations between electrolyte excretion and blood pressure were studied in individual subjects within each centre and the results of these regression analyses pooled for all 52 centres. Relations between population median electrolyte values and population blood pressure values were also analysed across the 52 centres. Sodium excretion ranged from 0.2 mmol/24 h (Yanomamo Indians, Brazil) to 242 mmol/24 h (north China). In individual subjects (within centres) it was significantly related to blood pressure. Four centres found very low sodium excretion, low blood pressure, and little or no upward slope of blood pressure with age. Across the other 48 centres sodium was significantly related to the slope of blood pressure with age but not to median blood pressure or prevalence of high blood pressure. Potassium excretion was negatively correlated with blood pressure in individual subjects after adjustment for confounding variables. Across centres there was no consistent association. The relation of sodium to potassium ratio to blood pressure followed a pattern similar to that of sodium. Body mass index and heavy alcohol intake had strong, significant independent relations with blood pressure in individual subjects.
POULTER NR, KHAW KT, SEVER PS, 1988, HIGHER BLOOD PRESSURES OF URBAN MIGRANTS FROM AN AFRICAN LOW BLOOD PRESSURE POPULATION ARE NOT DUE TO SELECTIVE MIGRATION, AMERICAN JOURNAL OF HYPERTENSION, Vol: 1, Pages: S143-S145, ISSN: 0895-7061
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- Citations: 17
Poulter NR, Khaw KT, Sever PS, 1988, Higher blood pressures of urban migrants from an African low-blood pressure population are not due to selective migration., Am J Hypertens, Vol: 1, Pages: 143S-145S, ISSN: 0895-7061
A longitudinal study has shown that migrants from a remote Kenyan low-blood pressure (BP) community living in an urban environment had significantly higher BPs than a cohort of matched, nonmigrant controls. Selective migration was thought to be the likely explanation for this observation, but the BPs of 90 males studied prior to migration were almost identical to those found in the age-matched rural based controls studied in the low-BP community from which they came (120.9/59.0 mm Hg vs 120.5/60.1 mm Hg). Hence, in view of these premigration data supported by other evidence from the Kenyan Luo Migrant Study, it appears that the higher BP levels of the Luo migrants are not due to selective migration but are consequent upon environmental changes, including changes in electrolyte intake, which occur rapidly after migration.
SEVER PS, POULTER NR, 1987, CALCIUM-ANTAGONISTS AND DIURETICS AS COMBINED THERAPY, JOURNAL OF HYPERTENSION, Vol: 5, Pages: S123-S126, ISSN: 0263-6352
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- Citations: 20
THOMPSON AV, POULTER NR, 1987, CASE-REPORT OF AN ATYPICAL PRESENTATION OF FALCIPARUM-MALARIA, EAST AFRICAN MEDICAL JOURNAL, Vol: 64, Pages: 88-89, ISSN: 0012-835X
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- Citations: 1
POULTER N, THOMPSON AV, SEVER PS, 1987, A DOUBLE-BLIND, PLACEBO-CONTROLLED, CROSSOVER TRIAL TO INVESTIGATE THE ADDITIVE HYPOTENSIVE EFFECT OF A DIURETIC (MEFRUSIDE) TO THAT PRODUCED BY NIFEDIPINE, JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, Vol: 10, Pages: S53-S56, ISSN: 0160-2446
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- Citations: 5
Poulter N, Thompson AV, Sever PS, 1987, A double-blind, placebo-controlled, crossover trial to investigate the additive hypotensive effect of a diuretic (mefruside) to that produced by nifedipine., J Cardiovasc Pharmacol, Vol: 10 Suppl 10, Pages: S53-S56, ISSN: 0160-2446
Several reports suggest that when diuretics are added to nifedipine (N), they do not exert any additional hypotensive effect to that produced by N alone. We present the first double-blind, crossover trial to investigate this interaction. Twenty-four black patients with moderate to severe essential hypertension entered the trial. After an initial "open" 4 weeks of therapy with N slow release (SR) 20 mg. b.i.d., those 17 patients whose blood pressures (BP) were not controlled (greater than 160 mm Hg systolic and/or greater than 90 mm Hg diastolic) were randomly allocated (double-blind) to 4 weeks treatment with N SR 20 mg. b.i.d., plus either mefruside 1 q.d. (a thiazide-like diuretic) or matching placebo. Patients then crossed over for a second 4 week treatment period. Blood pressures were measured at 2 weekly intervals under the same conditions using Hawksley random zero sphgymomanometers by one of two standardized observers after patients had been lying for 5 min and standing for 2 min. Analysis (taking account of period effect) of the mean results for the 16 patients completing the trial confirms that, contrary to what previous uncontrolled data suggest, lying and standing systolic and diastolic BPs are significantly lower (8.5/4.5 mm Hg: 2p less than 0.01 and 7.9/5.0 mm Hg: 2p less than 0.05, respectively) with nifedipine plus diuretic than with nifedipine plus placebo.
POULTER NR, SEVER PS, 1986, MODERATE POTASSIUM SUPPLEMENTATION - INEFFECTIVE IN BLACK NORMOTENSIVES, EAST AFRICAN MEDICAL JOURNAL, Vol: 63, Pages: 798-802, ISSN: 0012-835X
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- Citations: 6
POULTER N, THOMPSON AV, SEVER PS, 1986, DO DIURETICS ENHANCE THE HYPOTENSIVE EFFECT OF NIFEDIPINE - A DOUBLE-BLIND CROSSOVER TRIAL IN BLACK HYPERTENSIVE PATIENTS, JOURNAL OF HYPERTENSION, Vol: 4, Pages: 792-793, ISSN: 0263-6352
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- Citations: 5
POULTER NR, SANDERSON JE, 1986, RESERPINE VERSUS BETA-BLOCKER AS AN ADDITIVE TO A DIURETIC IN THE TREATMENT OF KENYAN HYPERTENSIVES, EAST AFRICAN MEDICAL JOURNAL, Vol: 63, Pages: 412-416, ISSN: 0012-835X
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