digitoxin and Obesity

Laboratory tests used in clinical practice to assess hypertension include a differential diagnosis, the assessment of complications, and detection of adverse events with medication, which cover a variety of fields of laboratory medicine. I learned laboratory medicine through basic and clinical studies on the pathogenesis of hypertension, and summarized those findings and my interpretations. Basic research using animal models points to a causal role of the central nervous system in essential hypertension; however, since clinical research is technically difficult to perform, this connection has not been confirmed in humans. Recently, renal nerve ablation in humans proved to continuously decrease the blood pressure in the presence of resistant hypertension. Furthermore, when electrical stimulation was continuously applied to the carotid baroreceptor nerve of human adults, their blood pressure lowered. These findings promoted the concept that the central nervous system may actually be involved in the pathogenesis of essential hypertension, which is closely associated with excess sodium intake. We demonstrated that endogenous digitalis plays a key role in hypertension associated with excess sodium intake via sympathetic activation in rats. An increased sodium concentration inside the brain activates epithelial sodium channels and the renin-angiotensin-aldosterone system in the brain. Aldosterone releases ouabain from neurons in the paraventricular nucleus in the hypothalamus. Angiotensin II and aldosterone of peripheral origin reach the brain to augment sympathetic outflow. Collectively essential hypertension associated with excess sodium intake and obesity, renovascular hypertension, and primary aldosteronism and pseudoaldosteronism are all suggested to have a common cause originating from the central nervous system.

Topics: Animals; Baroreflex; Central Nervous System; Digitalis; Epithelial Sodium Channels; Humans; Hyperaldosteronism; Hypertension; Kidney; Medical Laboratory Science; Obesity; Ouabain; Renin-Angiotensin System; Research; Sodium, Dietary; Sympathetic Nervous System

It is well known that the nutritional deficiency possibly causes cardiac dysfunction. Although social hygiene has successfully diminished these cardiac dysfunction in developed countries, patients could be found in certain number under altered clinical profiles than before. Excess intake of carbohydrate drinks and carbohydrates should make beri-beri heart in youth. Not only deficiency but recent dietary habits of excessive nutrition in these developed countries are causing new types of nutritional cardiac dysfunctions such as obesity cardiomyopathy in morbid obese. On the other hand, anorexia nervosa which sometimes shows heart failure and sudden death combines with psychosomatic disorders. In this article, the pathogenesis and treatments are discussed focusing on these three cardiac disorders.

Topics: Anorexia Nervosa; Beriberi; Cardiomyopathies; Diagnosis, Differential; Digitalis; Humans; Nutrition Disorders; Obesity; Phytotherapy; Plants, Medicinal; Plants, Toxic; Prognosis; Thiamine

Digitalis glycosides continue to place high on the list of prescribed drugs. Digoxin is 8th on prescriptions written in the United States in 1980, digitoxin 16th, and digitalis leaf 23rd. There is little doubt that most physicians continue to believe these drugs are useful. The application of more definite indications, smaller doses, and the recognition of the role of pharmacokinetics and drug interactions make use of the glycosides more challenging than ever before in 1985.

Topics: Administration, Oral; Adrenergic beta-Antagonists; Age Factors; Anti-Arrhythmia Agents; Antihypertensive Agents; Arrhythmias, Cardiac; Biological Availability; Bretylium Tosylate; Deslanoside; Digitalis Glycosides; Digitoxin; Digoxin; Dose-Response Relationship, Drug; Drug Interactions; Heart Failure; Humans; Injections, Intramuscular; Injections, Intravenous; Intestinal Absorption; Kidney Failure, Chronic; Lidocaine; Metabolic Clearance Rate; Myocardial Infarction; Obesity; Phenytoin; Potassium; Pulmonary Heart Disease; Thyroid Diseases

Topics: Digitalis Glycosides; Digitoxin; Digoxin; Drug Interactions; Heart Failure; Humans; Hyperthyroidism; Hypothyroidism; Intestinal Absorption; Kidney Failure, Chronic; Molecular Conformation; Obesity

Topics: Administration, Oral; Aged; Digitalis Glycosides; Digitoxin; Digoxin; Feces; Heart Atria; Heart Failure; Humans; Injections, Intramuscular; Injections, Intravenous; Intestinal Absorption; Kidney Diseases; Liver Diseases; Malabsorption Syndromes; Obesity; Tachycardia; Thyroid Diseases; Tritium; Water-Electrolyte Balance

Topics: Biological Availability; Cardiac Glycosides; Creatinine; Deslanoside; Digitalis Glycosides; Digitoxin; Digoxin; Drug Interactions; Humans; Hypokalemia; Kidney Diseases; Liver Diseases; Malabsorption Syndromes; Obesity; Ouabain; Thyroid Diseases

Topics: Administration, Oral; Aged; Arrhythmias, Cardiac; Digitalis Glycosides; Digitoxin; Digoxin; Heart Block; Heart Diseases; Heart Failure; Humans; Hyperthyroidism; Injections, Intravenous; Kidney Failure, Chronic; Middle Aged; Obesity; Ventricular Fibrillation

Topics: Adolescent; Adult; Age Factors; Aged; Amphetamine; Cathartics; Child; Digitalis; Diuretics; Drug Synergism; Female; Heart Diseases; Humans; Hypertension; Male; Methods; Middle Aged; Obesity; Plants, Medicinal; Plants, Toxic; Sex Factors; Thyroid Hormones; Time Factors

Topics: Anesthesia; Digitalis; Gastrointestinal Diseases; Humans; Kidney; Liver; Myocardial Infarction; Nutritional Physiological Phenomena; Obesity; Plants, Medicinal; Plants, Toxic; Preoperative Care; Water-Electrolyte Balance; Wounds and Injuries

Topics: Antihypertensive Agents; Arthritis; Arthritis, Rheumatoid; Blood Pressure Determination; Carbamates; Coronary Disease; Diabetes Mellitus; Digitalis; Geriatrics; Hydrochlorothiazide; Hypertension; Nitroglycerin; Obesity; Parkinsonian Disorders; Prednisolone; Reserpine; Tolbutamide