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Article: Spezifische Aspekte der Hochdruckbehandlung beim alten Menschen.

Obermayr, Rudolf P / Tragl, Karl Heinz

Wiener medizinische Wochenschrift (1946)

2004 Volume 154, Issue 1-2, Page(s) 15–19

Abstract: Hypertension increases in prevalence with age. Population-based studies suggest that more than 50% of people over the age of 65 years may have chronic hypertension, defined as blood pressure (BP) > or = 140/90 mmHg. Hypertension, especially systolic ... ...

Title translation	Perspectives on treatment of hypertension in elderly patients.
Abstract	Hypertension increases in prevalence with age. Population-based studies suggest that more than 50% of people over the age of 65 years may have chronic hypertension, defined as blood pressure (BP) > or = 140/90 mmHg. Hypertension, especially systolic hypertension, is the most common, powerful, however treatable risk factor for cardiovascular morbidity and mortality in the elderly. Large randomised trials have demonstrated that treating elderly and even very old persons (age > 80 years) is highly efficacious. A recent meta-analysis, comparing active treatment with placebo in isolated systolic hypertension demonstrated highly significant benefits: stroke was reduced by 30%, coronary heart disease events by 23%, all cardiovascular events by 26%, and cardiovascular deaths by 13%. The classic strategy of an initial thiazide or thiazide-like diuretic therapy has been verified by the most recent trials. Furthermore it is not appropriate to limit the choice of initial drugs for hypertensive older individuals to a single class of agents, since so many older people have other medical problems that affect this decision and reaching the target blood pressure is the determinant factor for cardiovascular risk reduction. Therefore single drug therapy with long-acting (dihydropyridine-type) calcium-antagonists, beta-blockers, angiotensin-converting-enzyme-inhibitors or angiotensin-receptor-blockers is justified with respect to individual efficacy and comorbidity. If a combination of antihypertensive drugs is needed to reach blood pressure goal, thiazides remain the cornerstone. First line therapy with an alpha-blocker is no longer recommended, even for men with hypertension and benign prostatic hypertrophy. Today, recommended blood pressure goals are the same for younger individuals and the elderly.
MeSH term(s)	Aged ; Aged, 80 and over ; Antihypertensive Agents/therapeutic use ; Humans ; Hypertension/drug therapy ; Randomized Controlled Trials as Topic ; Stroke/prevention & control ; Treatment Outcome
Chemical Substances	Antihypertensive Agents
Language	German
Publishing date	2004-01-01
Publishing country	Austria
Document type	Comparative Study ; English Abstract ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	123613-1
ISSN	1563-258X ; 0043-5341 ; 0254-7945
ISSN (online)	1563-258X
ISSN	0043-5341 ; 0254-7945
DOI	10.1007/s10354-004-0004-0
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Zs.A 903: Show issues

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Article ; Online: Elevated uric acid increases the risk for kidney disease.

Obermayr, Rudolf P / Temml, Christian / Gutjahr, Georg / Knechtelsdorfer, Maarten / Oberbauer, Rainer / Klauser-Braun, Renate

Journal of the American Society of Nephrology : JASN

2008 Volume 19, Issue 12, Page(s) 2407–2413

Abstract: Recent epidemiologic studies suggest that uric acid predicts the development of new-onset kidney disease, but it is unclear whether uric acid is an independent risk factor. In this study, data from 21,475 healthy volunteers who were followed ... ...

Abstract	Recent epidemiologic studies suggest that uric acid predicts the development of new-onset kidney disease, but it is unclear whether uric acid is an independent risk factor. In this study, data from 21,475 healthy volunteers who were followed prospectively for a median of 7 yr were analyzed to examine the association between uric acid level and incident kidney disease (estimated GFR [eGFR] <60 ml/min per 1.73 m(2)). After adjustment for baseline eGFR, a slightly elevated uric acid level (7.0 to 8.9 mg/dl) was associated with a nearly doubled risk for incident kidney disease (odds ratio 1.74; 95% confidence interval 1.45 to 2.09), and an elevated uric acid (> or =9.0 mg/dl) was associated with a tripled risk (odds ratio 3.12; 95% confidence interval 2.29 to 4.25). These increases in risk remained significant even after adjustment for baseline eGFR, gender, age, antihypertensive drugs, and components of the metabolic syndrome (waist circumference, HDL cholesterol, blood glucose, triglycerides, and BP). In a fully adjusted spline model, the risk for incident kidney disease increased roughly linearly with uric acid level to a level of approximately 6 to 7 mg/dl in women and 7 to 8 mg/dl in men; above these levels, the associated risk increased rapidly. In conclusion, elevated levels of uric acid independently increase the risk for new-onset kidney disease.
MeSH term(s)	Adult ; Antihypertensive Agents/pharmacology ; Blood Glucose/metabolism ; Blood Pressure ; Cholesterol, HDL/metabolism ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Diseases/epidemiology ; Kidney Diseases/etiology ; Male ; Middle Aged ; Risk ; Risk Factors ; Uric Acid/metabolism ; Waist Circumference
Chemical Substances	Antihypertensive Agents ; Blood Glucose ; Cholesterol, HDL ; Uric Acid (268B43MJ25)
Language	English
Publishing date	2008-09-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.2008010080
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Zs.A 3344: Show issues

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Article ; Online: Body mass index modifies the risk of cardiovascular death in proteinuric chronic kidney disease.

Obermayr, Rudolf P / Temml, Christian / Gutjahr, Georg / Kainz, Alexander / Klauser-Braun, Renate / Függer, Reinhold / Oberbauer, Rainer

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2009 Volume 24, Issue 8, Page(s) 2421–2428

Abstract: Background: In subjects with end-stage renal disease, a high body mass index (BMI) is inversely related to overall mortality, which has been coined reverse epidemiology phenomenon. This study sought to investigate this paradox as well as a possible risk ...

Abstract	Background: In subjects with end-stage renal disease, a high body mass index (BMI) is inversely related to overall mortality, which has been coined reverse epidemiology phenomenon. This study sought to investigate this paradox as well as a possible risk modification by proteinuria on the relationship of BMI with earlier stages of chronic kidney disease (CKD) concerning cardiovascular mortality. Methods: We used the Vienna Health Screening Initiative, a longitudinal cohort study from 1990 to 2006, including 49 398 volunteers (49.9% women, age 20-89 years): n = 2487 showed mild CKD (proteinuria and GFR >60 ml/min/1.73 m(2)) and n = 392 showed moderate CKD (GFR = 30-59 ml/min/1.73 m(2)). The follow-up period was 5.5 +/- 4.2 years; n = 148 cardiovascular deaths occurred. Exposure variables were BMI, glomerular filtration rate (GFR) and proteinuria. Cox regression models on cardiovascular mortality with adjustment for age, sex, log(cholesterol/HDL), uric acid, smoking, glucose, diabetes, mean blood pressure, hypertension and antihypertensive drug use were fitted. Results: The risk factor paradox is shown in moderate CKD (GFR = 45 ml/min/1.73 m(2)): hazard ratios (HR) of BMI contrasts decreased consistently from 1.28 (95% CI 0.33-5.82) at BMI 20 kg/m(2) versus 25 kg/m(2) to 0.76 (95% CI 0.38-1.50) at BMI 30 kg/m(2) versus 25 kg/m(2) and to 0.58 (95% CI 0.13-2.64) at BMI 35 kg/m(2) versus 25 kg/m(2), thus showing an inverse relationship compared to mild CKD/healthy participants. Examining proteinuria as an effect modifier in this context showed that in moderate CKD (contrast: proteinuria versus no proteinuria) HR decreased more profoundly from 9.43 (95% CI 2.66-27.40) at BMI 25 kg/m(2) to 3.74 (95% CI 0.93-15.70) at BMI 30 kg/m(2) and to 1.95 (95% CI 0.37-22.30) at BMI 35 kg/m(2), and conversely in non-proteinuric subjects, hazards for cardiovascular mortality increased in underweight as well as in overweight/obese subjects in a U-shaped manner. Conclusions: Our results suggest that obese subjects with proteinuric CKD may not be counselled for weight reduction since a higher BMI was associated with a remarkably reduced risk of death.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Cardiovascular Diseases/mortality ; Case-Control Studies ; Cohort Studies ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic/complications ; Longitudinal Studies ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Proteinuria/complications ; Risk Factors ; Smoking ; Survival Rate ; Young Adult
Language	English
Publishing date	2009-02-24
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfp075
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Zs.A 2198: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: The reduced release of GH by GHRH in 8 subjects aged 65-69 years is augmented considerably by rivastigmine, a drug for Alzheimer's disease.

Obermayr, Rudolf P / Mayerhofer, Lothar / Knechtelsdorfer, Maarten / Tragl, Karl H / Geyer, Georg

Gerontology

2003 Volume 49, Issue 3, Page(s) 191–195

Abstract: ... experiment, there was a 20-fold (p = 0.018) increase in GH AUC after rivastigmine pretreatment ...

Abstract	Background: The growth hormone (GH) secretion declines by 14% with each decade of adult life. Several attempts have been made to reverse the manifestations of the senile GH deficiency, termed somatopause, but GH substitution treatment in old age has not yet developed an established regimen. Cholinesterase inhibitors like pyridostigmine are able to elicit GH secretion when administered alone and to enhance the GH response to growth hormone releasing hormone (GHRH), but its clinical use is limited due to the strong peripheral cholinergic side effects. Objective: The aims of our experiments were to find out whether the GH response to GHRH can be augmented by rivastigmine, a new orally applicable and well-tolerated selective inhibitor of cerebral acetylchoinesterase. Methods: Eight healthy volunteers (age range 65-69 years) were studied. After an overnight fast, GHRH tests were done: 1 microg/kg GHRH was injected as an intravenous bolus. Blood samples for an immunoradiometric GH assay were taken at the time of GHRH injection (time 0) and after 15, 30, 45, 60, and 120 min. First, the baseline experiment was done: it consisted of two subsequent GHRH tests which were carried out within an interval of 120 min. Four weeks later the rivastigmine experiment was done identically, but 60 min before performing the second GHRH test, rivastigmine (4.5 mg) was administered orally. The GH secretory responses were expressed as areas under the curve (AUC; median, interquartile range), Wilcoxon's signed-rank test was used for statistical comparisons. Results: Baseline experiment: The GH AUC of the first GHRH test was 1040 (range 420-1250) ng/ml/h. The repeated GHRH stimulation after 120 min (second GHRH test) showed a 13-fold decrease to 80 (range 60-130) ng/ml/h. Rivastigmine experiment: The GH AUC of the first GHRH test was 950 (range 540-1430) ng/ml/h and, therefore, similar to that of the baseline experiment. 60 min after ingestion of the single oral dose of rivastigmine (4.5 mg), the following GHRH stimulation (second GHRH test) nearly doubled the GH AUC to 1580 (range 860-3330) ng/ml/h. Comparing the DeltaGH AUC values (DeltaGH AUC = GH AUC of the first GHRH test minus GH AUC of the second GHRH test), baseline experiment versus rivastigmine experiment, there was a 20-fold (p = 0.018) increase in GH AUC after rivastigmine pretreatment. Conclusions: Rivastigmine is a powerful drug to enhance GH release to repeated GHRH stimulation in healthy elderly human subjects. Future investigations are necessary to find out whether rivastigmine can restore the senile decline of the circadian GH secretion in the long term and, therefore, has new implications for patient treatment.
MeSH term(s)	Aged ; Alzheimer Disease/drug therapy ; Carbamates/pharmacology ; Cholinesterase Inhibitors/pharmacology ; Female ; Growth Hormone/biosynthesis ; Growth Hormone/drug effects ; Growth Hormone-Releasing Hormone/drug effects ; Growth Hormone-Releasing Hormone/physiology ; Humans ; Male ; Phenylcarbamates ; Rivastigmine
Chemical Substances	Carbamates ; Cholinesterase Inhibitors ; Phenylcarbamates ; Growth Hormone (9002-72-6) ; Growth Hormone-Releasing Hormone (9034-39-3) ; Rivastigmine (PKI06M3IW0)
Language	English
Publishing date	2003-05
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	193798-4
ISSN	1423-0003 ; 0304-324X
ISSN (online)	1423-0003
ISSN	0304-324X
DOI	10.1159/000069175
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Ud II Zs.201: Show issues

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Article: The age-related down-regulation of the growth hormone/insulin-like growth factor-1 axis in the elderly male is reversed considerably by donepezil, a drug for Alzheimer's disease.

Obermayr, Rudolf P / Mayerhofer, Lothar / Knechtelsdorfer, Maarten / Mersich, Nicole / Huber, Erik R / Geyer, Georg / Tragl, Karl-Heinz

Experimental gerontology

2005 Volume 40, Issue 3, Page(s) 157–163

Abstract: ... Donepezil treatment group: basal GH levels taken at 08:30 a.m. doubled from 0.4+/-0.3 to 0.8+/-0.4 ng/ml (p ... 0.008). GHRH-test: GH-AUC was 318+/-227 ng/ml/h and increased by 53% to 485+/-242 ng/ml/h (p=0.009 ... too: the baseline IGF-1 levels increased by 31% from 84+/-19 to 110+/-21 ng/ml (p=0.007). This study ...

Abstract	GH secretion declines by 14%/decade of adult life, leading to the suggestion that people over the age of 60 years are functionally GH deficient. Recently, rivastigmine, a novel cerebral selective cholinesterase-inhibitor (ChEI), was shown to be a powerful drug to enhance GH release to repeated GHRH stimulation in healthy elderly human subjects. The present study was designed as a randomised controlled trial to evaluate long term effects of donepezil, a cerebral selective ChEI, on basal GH and IGF-1 levels and on GH response to GHRH (1 microg/kg i.v., GHRH test) before and after an 8-week donepezil treatment period. Donepezil was given orally 5 mg per day for 4 weeks and 10 mg per day for another 4 weeks. Twenty four healthy male volunteers (n=2 x 12, placebo group vs. donepezil group, age: 61-70 years) were studied. Donepezil treatment group: basal GH levels taken at 08:30 a.m. doubled from 0.4+/-0.3 to 0.8+/-0.4 ng/ml (p=0.008). GHRH-test: GH-AUC was 318+/-227 ng/ml/h and increased by 53% to 485+/-242 ng/ml/h (p=0.009). Total serum IGF-1 levels, taken simultaneously with the basal GH levels, showed a considerable increase, too: the baseline IGF-1 levels increased by 31% from 84+/-19 to 110+/-21 ng/ml (p=0.007). This study demonstrated that the age-related down-regulation of the GH/IGF-1 axis is reversed considerably by donepezil in the elderly male. Future investigation will reveal whether such a new therapeutic intervention can delay the onset or even reverse some manifestations of the somatopause in the long term and evaluate its benefit/risk ratio concerning new treatment implications.
MeSH term(s)	Aged ; Aging/metabolism ; Alzheimer Disease/drug therapy ; Analysis of Variance ; Area Under Curve ; Cholinesterase Inhibitors/therapeutic use ; Growth Hormone/blood ; Growth Hormone/metabolism ; Growth Hormone-Releasing Hormone ; Humans ; Indans/therapeutic use ; Insulin-Like Growth Factor I/analysis ; Insulin-Like Growth Factor I/metabolism ; Male ; Piperidines/therapeutic use ; Single-Blind Method
Chemical Substances	Cholinesterase Inhibitors ; Indans ; Piperidines ; Insulin-Like Growth Factor I (67763-96-6) ; donepezil (8SSC91326P) ; Growth Hormone (9002-72-6) ; Growth Hormone-Releasing Hormone (9034-39-3)
Language	English
Publishing date	2005-03
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	390992-x
ISSN	0531-5565
ISSN	0531-5565
DOI	10.1016/j.exger.2004.11.001
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Zs.A 579: Show issues

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Article ; Online: Association between lower urinary tract symptoms and erectile dysfunction.

Ponholzer, Anton / Temml, Christian / Obermayr, Rudolf / Madersbacher, Stephan

Urology

2004 Volume 64, Issue 4, Page(s) 772–776

Abstract: ... increased statistically significantly with age (P <0.0001). In multivariate analysis controlling for age ... comorbidities, and lifestyle, the IPSS (P = 0.0001), the obstructive score of the IPSS (P = 0.0001), nocturia (P ... 0.04), and the LUTS bother score (P = 0.002) correlated statistically significantly ...

Abstract	Objectives: To assess whether the association between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) is confounded by age or whether LUTS represent an independent risk factor for ED. Methods: Men aged 20 to 80 years, who were participating in a health-screening project in the area of Vienna, completed the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5. In parallel, all men underwent a detailed health evaluation, including physical examination, evaluation of various lifestyle factors, and a blood laboratory study with 14 parameters. Results: Within the total study population (n = 2858; mean age 45.8 years, range 20 to 80), the prevalence of LUTS and ED increased statistically significantly with age (P <0.0001). In multivariate analysis controlling for age, comorbidities, and lifestyle, the IPSS (P = 0.0001), the obstructive score of the IPSS (P = 0.0001), nocturia (P = 0.04), and the LUTS bother score (P = 0.002) correlated statistically significantly with the presence of ED (International Index of Erectile Function-5 score less than 22). The odds ratio for the presence of ED was 2.2 (95% confidence interval [CI] 1.8 to 2.8) for LUTS (IPSS greater than 7), 2.0 (95% CI 1.7 to 2.4) for voiding symptoms, 1.4 (95% CI 1.1 to 1.7) for nocturia (score greater than 2), and 2.5 (95% CI 2.0 to 3.1) for the LUTS bother score. Conclusions: The presence of LUTS, in particular voiding symptoms, nocturia, and the quality-of-life impairment due to LUTS, is an independent risk factor for the presence of ED. These findings have implications for the treatment of elderly men with LUTS and open a new area for research.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Austria/epidemiology ; Cohort Studies ; Comorbidity ; Confounding Factors (Epidemiology) ; Erectile Dysfunction/epidemiology ; Humans ; Life Style ; Male ; Mass Screening ; Middle Aged ; Physical Examination ; Prevalence ; Quality of Life ; Risk Factors ; Sleep Wake Disorders/epidemiology ; Urination Disorders/epidemiology ; Urination Disorders/psychology
Language	English
Publishing date	2004-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2004.05.025
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Zs.A 1142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Predictors of new-onset decline in kidney function in a general middle-european population.

Obermayr, Rudolf P / Temml, Christian / Knechtelsdorfer, Maarten / Gutjahr, Georg / Kletzmayr, Josef / Heiss, Susanne / Ponholzer, Anton / Madersbacher, Stephan / Oberbauer, Rainer / Klauser-Braun, Renate

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2008 Volume 23, Issue 4, Page(s) 1265–1273

Abstract: Background: Limited epidemiological data are available on predictors of new-onset kidney disease.: Methods: In this longitudinal cohort study, 17 375 apparently healthy volunteers of the general Viennese population (46.4% women, age range 20-84 years, ...

Abstract	Background: Limited epidemiological data are available on predictors of new-onset kidney disease. Methods: In this longitudinal cohort study, 17 375 apparently healthy volunteers of the general Viennese population (46.4% women, age range 20-84 years, men 20-89 years) performed a baseline examination at some time within the study period (1990-2005) and completed a median of two follow-up examinations [interquartile range (IQR) 1 to 4]; the median follow-up period was 7 years (IQR 4 to 11). The outcome of interest was the development of kidney disease, defined as a decrease of the glomerular filtration rate (GFR) <60 ml/min/1.73 m(2) at the follow-up examinations [calculated by the abbreviated modification of diet in renal disease (MDRD) equation]. Logistic generalized estimating equations were used to analyse the relationship between the covariates and the outcome variable. Results: The following parameters [odds ratios (OR) with 95% confidence intervals] predicted new-onset kidney disease: Age (increase by 5 years), OR = 1.36 (1.34-1.40); National Kidney Foundation-chronic kidney disease (NKF-CKD) stage 1 with proteinuria (+), OR = 1.39 (1.10-1.75); NKF-CKD stage 1 with proteinuria (>/=++), OR = 2.07 (1.11-3.87); NKF-CKD stage 2 with proteinuria (+), OR = 2.71 (2.10-3.51); NKF-CKD stage 2 with proteinuria (>/=++), OR = 3.80 (2.29-6.31); body mass index, OR = 1.04 (1.02-1.06); current-smoker, OR = 1.20 (1.01-1.43); performing no sports, OR = 1.57 (1.27-1.95); uric acid (increase by 2 mg/dl), OR = 1.69 (1.59-1.80); HDL-cholesterol (decrease by 10 mg/dl), OR = 1.12 (1.07-1.17); hypertension stage 1, OR = 1.35 (1.08-1.67); hypertension stage 2, OR = 2.01 (1.62-2.51); diabetes mellitus, OR = 1.44 (1.07-1.93). Conclusions: Cardiovascular risk factors as well as NKF-CKD stages 1 and 2 and proteinuria, the more the higher and an entirely novel finding, performing no sports, predicted new-onset kidney disease.
MeSH term(s)	Adult ; Age Factors ; Age of Onset ; Aged ; Aged, 80 and over ; Austria/epidemiology ; Disease Progression ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney Diseases/epidemiology ; Kidney Diseases/physiopathology ; Male ; Middle Aged ; Population Surveillance ; Prognosis ; Risk Factors
Language	English
Publishing date	2008-04
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfm790
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Zs.A 2198: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke?

Ponholzer, Anton / Temml, Christian / Obermayr, Rudolf / Wehrberger, Clemens / Madersbacher, Stephan

European urology

2005 Volume 48, Issue 3, Page(s) 512–8; discussion 517–8

Abstract: ... for no ED to 13.2% for moderate/severe ED; p < 0.001). Relative risk increase ranged from 13.9 ... for those aged 30-39 yrs (p = 0.121), to 42.2% for 40-49 yrs (p = 0.012), 27.7% for 50-59 yrs (p = 0.048) and 27 ... 1% for 60-69 yrs (p = 0.021). In the stroke risk population (n = 644; 61.3 +/- 5.1 yrs) men ...

Abstract	Background: Considered to be a manifestation of a generalized vascular disease, erectile dysfunction (ED) could serve as an indicator for future cardiovascular events. Aim of this study was therefore to evaluate the role of ED as a predictor for coronary heart disease (CHD) and stroke. Methods: Men participating in a health-screening project in the area of Vienna completed the International Index of Erectile Function-5 questionnaire (IIEF5) to assess prevalence and severity of ED. Additionally, all men underwent a detailed health examination. The risk for CHD or stroke within 10 years depending on the severity of ED was estimated according to Framingham risk profile algorithms. Results: In the CHD risk cohort (n = 2.495; 46.2 +/- 9.9 yrs) men with moderate/severe ED (IIEF5 5-16; n = 163) had a 65% increased relative risk for developing CHD within 10 yrs compared to those without ED (IIEF5 22-25; n = 1.784) (absolute risk: 8.0% for no ED to 13.2% for moderate/severe ED; p < 0.001). Relative risk increase ranged from 13.9% for those aged 30-39 yrs (p = 0.121), to 42.2% for 40-49 yrs (p = 0.012), 27.7% for 50-59 yrs (p = 0.048) and 27.1% for 60-69 yrs (p = 0.021). In the stroke risk population (n = 644; 61.3 +/- 5.1 yrs) men with moderate/severe ED (n = 99) were at a 43% relative risk increase for a stroke within 10 years (absolute risk: 9.3% for no ED to 13.3% for moderate/severe ED; p = 0.041). Increased risk varied between 38.6% for men aged 55-59 yrs (p = 0.013), 24.7% for 60-64 yrs (p = 0.072), 35.9% for 65-69 yrs (p = 0.046) and 43.6% for 70-74 yrs (p = 0.049). Conclusions: Moderate to severe ED, but not mild ED is associated with a considerably increased risk for CHD or stroke within 10 years. A thorough medical surveillance seems therefore advisable for men with ED including cardiological evaluation, treatment of risk factors and lifestyle modifications.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Algorithms ; Analysis of Variance ; Austria/epidemiology ; Coronary Disease/epidemiology ; Erectile Dysfunction/epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Stroke/epidemiology ; Surveys and Questionnaires
Language	English
Publishing date	2005-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	193790-x
ISSN	1421-993X ; 0302-2838
ISSN (online)	1421-993X
ISSN	0302-2838
DOI	10.1016/j.eururo.2005.05.014
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Zs.MO 294: Show issues

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Article: The Reduced Release of GH by GHRH in 8 Subjects Aged 65–69 Years Is Augmented Considerably by Rivastigmine, a Drug for Alzheimer’s Disease

Obermayr, Rudolf P. / Mayerhofer, Lothar / Knechtelsdorfer, Maarten / Tragl, Karl Heinz / Geyer, Georg

Gerontology

2003 Volume 49, Issue 3, Page(s) 191–195

Abstract: ... of the second GHRH test), baseline experiment versus rivastigmine experiment, there was a 20-fold (p = 0.018 ...

Institution	1st Medical Department, Donauspital im Sozialmedizinischen Zentrum Ost der Stadt Wien, and Ludwig Boltzmann Institute for Aging Research, Vienna, and Ludwig Boltzmann Institute for Experimental Endocrinology, University of Vienna Medical School, Vienna, Austria
Abstract	Background: The growth hormone (GH) secretion declines by 14% with each decade of adult life. Several attempts have been made to reverse the manifestations of the senile GH deficiency, termed somatopause, but GH substitution treatment in old age has not yet developed an established regimen. Cholinesterase inhibitors like pyridostigmine are able to elicit GH secretion when administered alone and to enhance the GH response to growth hormone releasing hormone (GHRH), but its clinical use is limited due to the strong peripheral cholinergic side effects. Objective: The aims of our experiments were to find out whether the GH response to GHRH can be augmented by rivastigmine, a new orally applicable and well-tolerated selective inhibitor of cerebral acetylchoinesterase. Methods: Eight healthy volunteers (age range 65–69 years) were studied. After an overnight fast, GHRH tests were done: 1 µg/kg GHRH was injected as an intravenous bolus. Blood samples for an immunoradiometric GH assay were taken at the time of GHRH injection (time 0) and after 15, 30, 45, 60, and 120 min. First, the baseline experiment was done: it consisted of two subsequent GHRH tests which were carried out within an interval of 120 min. Four weeks later the rivastigmine experiment was done identically, but 60 min before performing the second GHRH test, rivastigmine (4.5 mg) was administered orally. The GH secretory responses were expressed as areas under the curve (AUC; median, interquartile range), Wilcoxon’s signed-rank test was used for statistical comparisons. Results: Baseline experiment: The GH AUC of the first GHRH test was 1,040 (range 420–1,250) ng/ml/h. The repeated GHRH stimulation after 120 min (second GHRH test) showed a 13-fold decrease to 80 (range 60–130) ng/ml/h. Rivastigmine experiment: The GH AUC of the first GHRH test was 950 (range 540–1,430) ng/ml/h and, therefore, similar to that of the baseline experiment. 60 min after ingestion of the single oral dose of rivastigmine (4.5 mg), the following GHRH stimulation (second GHRH test) nearly doubled the GH AUC to 1,580 (range 860–3,330) ng/ml/h. Comparing the ΔGH AUC values (ΔGH AUC = GH AUC of the first GHRH test minus GH AUC of the second GHRH test), baseline experiment versus rivastigmine experiment, there was a 20-fold (p = 0.018) increase in GH AUC after rivastigmine pretreatment. Conclusions: Rivastigmine is a powerful drug to enhance GH release to repeated GHRH stimulation in healthy elderly human subjects. Future investigations are necessary to find out whether rivastigmine can restore the senile decline of the circadian GH secretion in the long term and, therefore, has new implications for patient treatment.
Keywords	Growth hormone ; Growth hormone releasing hormone ; Somatopause ; Rivastigmine ; Repeated GHRH test
Language	English
Publishing date	2003-04-17
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Clinical Section
ZDB-ID	193798-4
ISSN	1423-0003 ; 0304-324X
ISSN (online)	1423-0003
ISSN	0304-324X
DOI	10.1159/000069175
Database	Karger publisher's database

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Article: The association between lower urinary tract symptoms and renal function in men: a cross-sectional and 5-year longitudinal analysis.

Ponholzer, Anton / Temml, Christian / Obermayr, Rudolf Paul / Rauchenwald, Michael / Madersbacher, Stephan

The Journal of urology

2006 Volume 175, Issue 4, Page(s) 1398–1402

Abstract: ... there was no association between the degree of LUTS and GFR during 5 life decades (p = 0.55 ... years (-6.0%, p <0.0001). The mean decrease in GFR after 5 years was 4.5 ml per minute (-5.4%) in men ... study cohorts neither I-PSS, nor obstructive or irritative score affected GFR (p >0.05). The only determinants ...

Abstract	Purpose: We assessed the association between LUTS and renal function in men in a cross-sectional and a longitudinal study. Materials and methods: Men participating in health investigation in Vienna entered this study. In the cross-sectional analysis a consecutive series of men were studied and in the longitudinal analysis men were reevaluated after 5 years. LUTS were assessed by I-PSS and renal function was evaluated by GFR, as calculated by the Cockcroft-Gault equation. Results: A total of 2.469 men with a mean age of 47.1 years (range 30 to 80) entered the cross-sectional study and 439 with a mean age of 51.7 years (range 45 to 79) could be assessed in longitudinal analysis. In the cross-sectional study there was no association between the degree of LUTS and GFR during 5 life decades (p = 0.55). An identical pattern was observed for irritative and obstructive scores. In the longitudinal cohort mean GFR +/- SD decreased from 84.3 +/- 20.2 ml per minute at baseline to 79.2 +/- 18.7 ml per minute after 5 years (-6.0%, p <0.0001). The mean decrease in GFR after 5 years was 4.5 ml per minute (-5.4%) in men without/mild LUTS (I-PSS 7 or less at ages 55.4 +/- 11.0 years), 3.9 ml per minute (-4.9%) in those with moderate LUTS (I-PSS 8 to 20 at ages 61.3 +/- 11.6 years) and 4.2 ml per minute (-5.2%) in those with severe LUTS (I-PSS greater than 20 at ages 64.3 +/- 7.4 years). On linear regression analysis in the 2 study cohorts neither I-PSS, nor obstructive or irritative score affected GFR (p >0.05). The only determinants for GFR less than 90 ml per minute were age (p <0.0001) and hypertension (p <0.0001). Conclusions: LUTS do not represent an independent risk factor for impaired renal function in men.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Glomerular Filtration Rate ; Humans ; Kidney/physiopathology ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Prostatic Hyperplasia/complications ; Prostatic Hyperplasia/epidemiology ; Renal Insufficiency/etiology ; Renal Insufficiency/physiopathology ; Time Factors ; Urination Disorders/complications ; Urination Disorders/epidemiology
Language	English
Publishing date	2006-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1016/S0022-5347(05)00641-5
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.MO 331: Show issues

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