Papers by Osvaldo Kohlmann
Blood pressure. Supplement
In this study, 14 mild-to-moderate essential hypertensive patients of both sexes were studied wit... more In this study, 14 mild-to-moderate essential hypertensive patients of both sexes were studied with regard to the effects of two different treatments, urapidil (60 to 180 mg/day) and diuretics (chlorthalidone and hydrochlorothiazide-25 to 50 mg/day) on glucose metabolism, insulin sensitivity and plasma lipid profile. Blood pressure was equally reduced by both treatments. However, urapidil treatment was accompanied by significant lower plasma levels of cholesterol, HDL-cholesterol and triglycerides as compared with diuretic treatment. Also, a significantly higher insulin sensitivity index, determined by the euglycemic insulin clamp technique, was observed during urapidil therapy. Our results demonstrated that urapidil is as effective as diuretics in reducing blood pressure of essential hypertensive patients, with the potential advantage of a favorable profile in regard to the glucose and lipid metabolisms.
Annals of the New York Academy of Sciences, 1993
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Journal of Hypertension, 1993
American Journal of Hypertension, 2002
Both Thromboxane A2 (TXA2) and F2-isoprostane are thought to be agonists for the Thromboxane A2 r... more Both Thromboxane A2 (TXA2) and F2-isoprostane are thought to be agonists for the Thromboxane A2 receptor (ThR), and the androgenic steroids regulate the expression of ThR. The present study was performed to determine if the ThR plays a role in the hypertension in SHR. Male and female SHR, aged 12 weeks, were treated with a ThR antagonist, SQ29548 (1mg/Kg/d via osmotic mini-pump, or ethanol vehicle) 1 week. Prior to and on treatment days 3 and 6 BP was measured by tail plethysmography. On day 7 rats were anesthetized and mean arterial pressures (MAP) and renal function were measured. By day 6, systolic BP was reduced with the SQ29548 but not ethanol vehicle alone. These data were confirmed by direct measurement; MAP was decreased by 13% in SQ treated male rats compared with controls. In the female rats there was no significant difference. Renal function was not affected by SQ treatment. These data support a role for the ThRr in the hypertension of male SHR. Future studies will be necessary to determine if the receptor agonist is TXA2 or F2 isoprostanes. This work was supported by NIHHL 66072
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Arquivos brasileiros de cardiologia, 2010
Errata O nome do autor Altamiro Reis da Costa foi omitido involuntariamente do conjunto de partic... more Errata O nome do autor Altamiro Reis da Costa foi omitido involuntariamente do conjunto de participantes do Grupo 7, coordenado por Celso Amodeo, das VI Diretrizes Brasileiras de Hipertensão, publicadas como suplemento da edição de julho dos Arquivos Brasileiros de Cardiologia [Arq Bras Cardiol 2010; 95(1 supl.1): 1-51]. Esta diretriz deverá ser citada como: Sociedade Brasileira de Cardiologia / Sociedade Brasileira de Hipertensão / Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol 2010; 95(1 supl.1): 1-51 Correspondência: Sociedade Brasileira de Cardiologia -Av. Marechal Câmara, 360/330 -APRESENTAÇÃO As Diretrizes Brasileiras de Hipertensão Arterial agora publicadas resultam da necessidade de uma atualização de sua última versão de 2006, imposta pelo grande número de novas informações geradas e disponibilizadas nesse período de tempo.
of the placebo period and of each treatment period BP and BMI were evaluated and a venous sample ... more of the placebo period and of each treatment period BP and BMI were evaluated and a venous sample was drawn in the morning at the same hour to evaluate pNE. No dietary advice was prescribed for the duration of the study.
fecting serum lipid levels, suggesting it counteracts in vivo LDL oxidation and the consequent up... more fecting serum lipid levels, suggesting it counteracts in vivo LDL oxidation and the consequent up-regulation of VCAM-1 and P-selectin.
dietϩplacebo (GP, n ϭ 11) or ϩmetformin (GM, n ϭ 11) on blood pressure (BP), lipids, insulin, ald... more dietϩplacebo (GP, n ϭ 11) or ϩmetformin (GM, n ϭ 11) on blood pressure (BP), lipids, insulin, aldosterone and catecolamines. BP was controlled by Calcium channel blockers, if necessary after 4 weeks of wash-out of anti-hypertensive drugs. Weight did not change during the study. Office mean BP were similar at baseline and dropped only in GM (106 Ϯ 8 to 99 Ϯ 0 mmHg, p Ͻ 0.05); no difference was noted by ABPM. Glycated hemoglobin decreased in both groups (GP: 6.7 Ϯ 3 vs. 5.9 Ϯ 2.6, p Ͻ 0.05 and GM: 5.3 Ϯ 1.5 vs 4.6 Ϯ 0.9%, p Ͻ 0.05). Only GM showed glucose (154 Ϯ 31 vs 136 Ϯ 24 mg/dl, p Ͻ 0.05), fasting insulin (9.8 Ϯ 8.7 vs 5.3 Ϯ 3.2 U/ml, p Ͻ 0.05) and insulin resistance index (IRI) (3.5 Ϯ 2.7 vs 1.8 Ϯ 1.0, p Ͻ 0.05)reductions. There was no change in aldosterone levels. Serum dopamine increased only in GM: 90.3 Ϯ 110 vs. 344.6 Ϯ 318.2 pg/ml, p Ͻ 0.05. HDL-cholesterol increased in both groups. Metformin did not change BP verified by ABPM, only office BP, probably due to "white colt hypertension" minimization. Dopamine increased, probably because of improve in glycemic control.
American Journal of Hypertension, 2003
Introduction: Omapatrilat (OMA) a single molecule that inhibits simultaneously ACE and NEP, two e... more Introduction: Omapatrilat (OMA) a single molecule that inhibits simultaneously ACE and NEP, two enzymes involved on formation/degradation of several vasoactive peptides improves hemodynamics and heart function of SHRs. Both enzymes are involved in the metabolism of the vasodilator bradykinin.Aim: to evaluate the effects of acute bradykinin inhibition upon hemodynamics and left ventricular function of SHRs chronically treated with OMA.Methods: OMA
American Journal of Hypertension, 2001
We and others have shown previously that BK is involved in the glucose metabolism. The aim of thi... more We and others have shown previously that BK is involved in the glucose metabolism. The aim of this study was to evaluate whether this BK effect occurs through the activation of K+ channels (EDHF, endothelium derived hyper-polarization factor). The insulin sensitivity (IS) of normotensive Wistar rats (NWR) was determined in a euglicemic hyperinsulinemic clamp in the absence or in presence
American Journal of Hypertension, 2000
Objective: To evaluate the effects of Omapatrilat (Oma) upon blood pressure (BP), systemic hemody... more Objective: To evaluate the effects of Omapatrilat (Oma) upon blood pressure (BP), systemic hemodynamics (Hemo) and insulin sensitivity (IS) in Spontaneously Hypertensive Rats (SHR). Rationale: Oma inhibits simultaneously two enzymes involved in the formation/degradation of various vasoactive peptides: ACE and NEP.Material and Methods: Male SHRs were treated with Oma (100 μmol/kg/day) for 12 weeks (SHR + OMA, n = 17).
American Journal of Hypertension, 2005
Background: Cardiovascular diseases (CVD) are responsible for more than 50% of the deaths in pati... more Background: Cardiovascular diseases (CVD) are responsible for more than 50% of the deaths in patients with end-stage renal disease (ESRD). Sleep apnea (SA) has been recognized as a risk factor for CVD. Previous studies have shown a higher prevalence of SA among patients on dialysis.
Arquivos brasileiros de cardiologia, 2004
American Journal of Hypertension, 2001
Background) Hypertension is a risk factor for left ventricular hypertrophy and heart failure, and... more Background) Hypertension is a risk factor for left ventricular hypertrophy and heart failure, and hypertensive patients are clinically more susceptible to heart failure when accompanied with diabetes mellitus. (Objective) To examine the style of left ventricular structural and functional change in diabetic hypertensive patients. (Methods) We performed 24-hour ambulatory blood pressure monitoring (ABPM) and echocardiography in uncomplicated patients with diabetic and/or hypertensive patients (mean age 66.3 years). Patients were divided into 3 groups, hypertension alone (HT, nϭ64), diabetes alone (DM, nϭ30), and diabetic hypertension (DHT, nϭ91). (Results) The office BP was highest in HT, but there was no difference in the left ventricular mass index among the 3 groups. In DHT, left ventricular internal diastolic dimension and left ventricular relative wall thickness were highest followed by DM and HT, but the left ventricular ejection fraction was lowest in DHT. Though the 24 hr BP and the daytime BP were higher in HT than in DHT, there was no difference in the nocturnal BP. Pulse rate (PR) measured by ABPM was highest in DHT, followed by DM and HT. (Conclusion) These results suggested that concentric hypertrophy, decreased contractility and increased sympathetic nerve activity may be factors in heart failure susceptibility in patients of diabetes mellitus.
Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
It is still controversial whether there are synergistic effects among different non-pharmacologic... more It is still controversial whether there are synergistic effects among different non-pharmacological interventions used in the treatment of hypertension. To evaluate the effect of aerobic exercise, oral supplementation of potassium and their combination on blood pressure, glucose metabolism, urinary albumin excretion and glomerular morphology in spontaneously hypertensive rats (SHR). SHR were divided into groups: Control Group (SHR; standard diet and sedentary, n = 10), Exercise Group (SHR + E; trained on a treadmill, standard diet, n = 10), Potassium Group (SHR + K; sedentary, potassium supplementation, n = 10) and Group Exercise + Potassium (SHR + E + K, exercise, potassium supplementation n = 10). Weekly, body weight (BW) and tail blood pressure (TAP) were measured. At the end of 16 weeks, a Oral Glucose Tolerance Test was performed. Albuminuria was determined in the baseline period, at 8th and at 16th week. After sacrifice, the analysis of glomerular sclerosis index and visceral ...
Arquivos brasileiros de cardiologia, 2012
Obesity derived from intra-abdominal fat deposition tends to increase hormonal and cytokine produ... more Obesity derived from intra-abdominal fat deposition tends to increase hormonal and cytokine production, thus worsening insulin sensitivity and leading to endothelial dysfunction. Hyperinsulinemia is considered an independent risk factor for ischemic heart disease and cause of endothelial dysfunction in healthy individuals. To assess the impact of different degrees of insulin resistance, measured by HOMA-IR (Homeostasis Model Assessment of Insulin Resistance), on endothelial function in obese, non-diabetic patients without prior history of cardiovascular events and different metabolic syndrome components. Forty obese individuals were submitted to anthropometric measurements, BP measurements at office and ABPM and laboratory tests, in addition to non-invasive ultrasound assessment of endothelial function. Patients were divided into 3 groups according to the level of insulin resistance: patients with HOMA-IR values from 0.590 to 1.082 were assigned to Group 1 (n=13), from 1.083 to 1.41...
American Journal of Hypertension, 2003
Obesity is frequently associated with hypertension and type 2 diabetes caracterized by an insulin... more Obesity is frequently associated with hypertension and type 2 diabetes caracterized by an insulin resistance state, but in general models of inducible obesity in rats do not show an elevated blood pressure (BP).Aim: to evaluate the effects of an neuroendocrine model of obesity, eg neonatal monosodium glutamate (MSG) administration, on BP and glucose metabolism of spontaneously hypertensive rats (SHR).Methods: SHR
Drugs, 1990
Angiotensin-converting enzyme (ACE) insertion(I)/deletion (D) polymorphism may modify the effect ... more Angiotensin-converting enzyme (ACE) insertion(I)/deletion (D) polymorphism may modify the effect of inhibition of the renin-angiotensin-aldosterone system (RAAS) on survival and cardiorenal outcomes in type 2, diabetes. A consecutive cohort of 2089 Chinese type 2 diabetic patients with mean (7standard deviation) age of 59.7713.1 years were genotyped for this polymorphism by polymerase chain reaction method and were followed prospectively for a median period of 44.6 (interquartile range: 23.7, 57.5) months. Clinical outcomes, including all-cause mortality, cardiovascular and renal end points, were examined. The frequency for I allele was 67.1 and 32.9% for D allele, with observed genotype frequencies of 45.8, 42.6, and 11.6% for 3, DI and DD, respectively. ACE DD polymorphism was an independent predictor for renal end point with hazard ratio (HR) (95% confidence interval) of 1.72 (1.16, 2.56), but not for cardiovascular end point or mortality. After controlling for confounding factors, including ACE I/D genotype, the usage of RAAS inhibitors was associated with reduced risk of mortality (HR 0.34 (0.23, 0.50)) and renal end point (HR 0.55 (0.40, 0.75)). On subgroup analysis, the beneficial effects on survival (II vs DI vs DD: HR 0.29 (0.16, 0.51) vs 0.25 (0.14, 0.46) vs 1. 33 (0.41, 4.31)) and renoprotection (II vs DI vs DD: 0.52 (0.30, 0.90) vs 0.43 (0.25, 0.72) vs 0.95 (0.43, 2.12)) were most evident in II and DI carriers. In conclusion, inhibition of RAAS was associated with reduced risk of mortality and occurrence of renal end point in Chinese type 2 diabetic patients. These benefits were most evident among II and DI carriers.
Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia, 2010
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Papers by Osvaldo Kohlmann