The American journal of medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Prazosin versus hydrochlorothiazide as initial antihypertensive therapy in black versus white patients.
A randomized, drug-controlled trial was conducted to evaluate the comparative efficacy of hydrochlorothiazide versus prazosin in controlling mild diastolic hypertension in black and white patients. Serum lipid and lipoprotein levels were also studied. Overall, 22 men and 14 women, of whom 50 percent were black, aged 21 to 69 years, were randomly assigned to treatment with either of these two agents. ⋯ Prazosin therapy reduced total cholesterol levels by 20.5 mg/dl and low-density lipoprotein cholesterol levels by 19.0 mg/dl, and hydrochlorothiazide increased total cholesterol levels by 11.4 mg/dl and increased low-density lipoprotein levels by 9.3 mg/dl; but no differences in triglyceride, high-density lipoprotein, plasma high-density lipoprotein2, or high-density lipoprotein3 levels were noted. Both agents were well tolerated in black and white patients. The combination of effective blood pressure control with no adverse effects on the serum lipid profile may make prazosin preferable to hydrochlorothiazide for treating mild diastolic hypertension in black as well as white patients.
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Both complement and contact system of coagulation have been implicated in the pathophysiology of sepsis. We therefore measured levels of the complement activation products C1-C1-inhibitor complexes and C3a in serial plasma samples (obtained every six hours) from 48 patients with clinically suspected sepsis, and related these levels to the clinical outcome. C4a was also measured in samples obtained on admission. ⋯ On the basis of our results, we propose that activation of the complement system via the classical pathway is involved in the development of fatal complications in sepsis.