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Eight hundred seventy-six men and women with diastolic blood pressure (DBP) of 95–115 mm Hg during a 4-week placebo period were included in a multicenter trial; 479 patients had previously been treated for hypertension. The patients were randomized to receive isradipine or metoprolol; both groups were comparable for age, weight, height, smoking habits, and duration of hypertension. By the end of the placebo period, 79 patients did not fulfill the final entry criteria and were withdrawn. The isradipine group consisted of 398 patients (164 women and 234 men), and the metoprolol group consisted of 399 patients (173 women and 226 men). The initial dose of isradipine was 1.25 mg twice daily (b.i.d.), and the initial dose of metoprolol was 50 mg b.i.d.; the doses were doubled after 4 weeks if DBP had not decreased to ≤90 mm Hg. After 8 weeks, the isradipine group began combination therapy with metoprolol 50 mg b.i.d. and the metoprolol group began combination therapy with isradipine 1.25 mg b.i.d. if DBP was not ≤90 mm Hg. After 8 weeks monotherapy, mean BP (MBP) was reduced by 13/11 mm Hg (161/104 to 148/93) in the isradipine group and by 15/12 mm Hg (160/103 to 145/91) in the metoprolol group. Monotherapy with isradipine normalized DBP to ≤90 mm Hg in 52 with a mean dose of 4.26 mg daily, and monotherapy with metoprolol normalized DBP in 58 with a mean dose of 155 mg daily. After combination therapy, BP was 144/89 mm Hg in the isradipine group and 144/90 mm Hg in the metoprolol group; BP was normalized in 68 in the isradipine group and 66 in the metoprolol group. Thirty-eight percent of patients in the isradipine group and 33 in the metoprolol group had transient side effects. The discontinuation-dropout rate in this 24-week study was 21 (83 patients) in the isradipine group and 18 (73 patients) in the metoprolol group. Quality of life analysis showed that muscular weakness, sweating, and exertional dyspnea occurred significantly more frequently in patients receiving metoprolol monotherapy than in patients receiving isradipine monotherapy. Serum lipids were measured at weeks 0 and 24. No changes were observed during isradipine monotherapy, whereas metoprolol monotherapy induced a significant increase from 1.75 to 2.06 mMin mean triglyceride level and a significant decrease from 1.32 to 1.24 mMin mean high-density lipoprotein (HDL) cholesterol level. Isradipine was a well-tolerated and efficacious antihypertensive drug with no untoward effects on serum lipids, whereas equally well-tolerated and efficacious metoprolol induced untoward lipid changes during a 24-week treatment period.

A two-year randomized, double-blind, placebo-controlled clinical trial used paired serum samples from 122 patients with primary biliary cirrhosis to compare the effect of ursodeoxycholic acid and colchicine on their immune parameters. IgG antibodies to pyruvate dehydrogenase, the major autoantigen in primary biliary cirrhosis, were determined by enzyme-linked immunosorbent assay and immunoblot; enzyme inhibition assay against pyruvate dehydrogenase was used to test the changes of the functional reactivity of the serum autoantibodies. Treatment with ursodeoxycholic acid decreased both the level of IgG antibodies to pyruvate dehydrogenase (P<0.01) and the inhibitory titer of the sera for pyruvate dehydrogenase (P<0.01). Treatment with colchicine or placebo showed no statistically significant changes in either the antibody levels or the inhibitory titers. Ursodeoxycholic acid thus alters the immune parameters of patients with primary biliary cirrhosis. The mechanism of these changes needs further investigation.

During the period 1965–1969 a total of 87 patients with acute myocardial infarction (AMI) have been discharged from hospital alive after recovering from one or more episodes of ventricular fibrillation (VF). The average age was 59 years (39–82). Up to the time of follow‐up the group had been observed for 6–62 months. At the follow‐up 47 of the survivors were alive and the average age was significantly lower than that of the non‐survivors. The prognosis was not found to be significantly better in the cases of “primary” as opposed to “complicating” VF. The actual time of the first VF had no significant influence on the survival rate. Normal heart volume upon discharge was found to be a favourable factor in prognosis. After convalescence 16 of the 44 patients in employment prior to the onset of disease returned to work. Other factors influencing return to work are discussed.

Summary: An annual intramuscular injection of ergocalciferol (150 000 IU) normalized low serum (25(OH)D concentrations in elderly people for 1 year. The treatment had a slight effect on serum 24,25(OH)2D levels but no effect on 1,25(OH)2D levels.