RESUMEN
Following our previous observation of an aversion to weight reduction in Nigerians with type 2 diabetes, we measured several parameters of body dimensions and preferences in otherwise healthy adults in three communities to study the phenomenon further. The study population of 524 participants (304 F) was 99.8% of Yoruba ethnic origin with a mean age of 43.9 ± 17.2 years. Females had a significantly (p > 0.001) higher body mass index (BMI), waist circumference, hip circumference compared to the males; the values being 24.55 ± 5.5 vs. 21.75 ± 3.71 kg/m(2); 84.98 ± 12.67 vs. 80.92 ± 9.85 cm; 96.32 ± 12.94 vs. 89.36 ± 8.06 cm, respectively. There was a high level of satisfaction amongst respondents with their body size (Kendall's t = 0.52, p < 0.001) which they also predicted with a high degree of certainty even without the prior use of a weighing scale. The relationship between current body size (CBI) and BMI emerged as CBI = 1.22 + 0.32 BMI. In the 41% of respondents who expressed unhappiness with their current body size, there was a strong aversion for a smaller body size and the preference was often for a bigger body figure. Strikingly, many more women than men were less dissatisfied with their bigger body sizes. Stepwise regression indicated that CBI and gender were the two most important variables that best related to casual blood sugar (RBS) among the factors entered. The mathematical relationship between these variables that emerged was: [Formula: see text] where gender = 0 for male and 1 for female. The results suggest that larger body sizes were positively viewed in these communities consistent with our previous observations in type 2 diabetes.
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Imagen Corporal/psicología , Tamaño Corporal , Adulto , Glucemia/análisis , Índice de Masa Corporal , Cultura , Etnicidad/psicología , Conducta Alimentaria/psicología , Femenino , Abastecimiento de Alimentos , Humanos , Masculino , Nigeria/epidemiología , Factores SexualesRESUMEN
BACKGROUND: A survey was undertaken to determine the number of individuals who have access to Mobile phones among those attending our Diabetes clinic in order to explore whether this could replace or become an adjunct to street home address as contact information. METHOD: An observer-based questionnaire was administered to capture parameters of interest at the weekly diabetes clinic in order to answer the survey question RESULTS: 130 individuals aged 15-80 years who attended the clinic in the month of May 2008 were surveyed. Eighty nine (89) patients had active Mobile phone and lines while 70.8% of these were females. Strikingly, 37% percent of the study populations were from across states boundaries and other geographic areas but majority reside in Ilorin metropolis where the facility is based. CONCLUSION: The results indicate that over two thirds of those with diabetes attending the clinic had active Mobile phone line and this could be used as an adjunct to or replace street address as a contact particular between patients and their professional care givers.
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Teléfono Celular/estadística & datos numéricos , Diabetes Mellitus Tipo 2 , Propiedad/estadística & datos numéricos , Pacientes/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Población Negra/estadística & datos numéricos , Recolección de Datos , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Background: Chronic renal failure (CRF) is a major cause of premature death and morbidity in Nigeria. Majority of patients with end stage renal disease (ESRD) are in the productive age bracket. Haemodialysis is the most commonly available mode of renal replacement therapy. The quality of life of the few that can afford the cost of haemodialysis is poor when compared to the transplanted patients. A survey is carried out to assess factors affecting attitudes towards kidney donation in Ilorin; Nigeria. Methods: A total of 600 self administered; semi-structured questionnaires were distributed amongst asymptomatic adults (aged 17years) with a response rate of 88. Data analysis was done using statistical package for social studies (SPSS) version 14. Results: There were 282 males (53.4) and 246 females (46.6) with age range of 17-65years and a mean of 34.76+14.9. Two hundred and ninety two (55) were willing to donate a kidney (165 males; 127 females). Majority of the willing donors (86) were between 30 and 50 years of age. Though educational level positively influenced the knowledge about the kidney failure; it did not influence willingness to donation of a kidney. There was religion related gender disparity in the willingness to donate a kidney as more male Christians and Muslims were willing to donation than their females. Conclusions: The main constraints to kidney donation were fear of surgical pains; belief in life after death and uncertainty of donor outcome. This calls for awareness programmes on the safety of kidney donation for transplantation
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Actitud , Causalidad , Trasplante de Riñón , Obtención de Tejidos y ÓrganosRESUMEN
Individuals with type 2 diabetes are routinely advised to abstain from using dietary sugar for fear of aggravating existing diabetic control; yet the supporting evidence for this recommendation is unavailable, hence this study. The objective of this study was to determine whether the use of dietary sucrose can affect diabetic control. Adults with stable type 2 diabetes [monthly fasting blood sugar (FBS) of
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Glucemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Dieta , Sacarosa en la Dieta/administración & dosificación , Anciano , Peso Corporal , Estudios de Cohortes , Diabetes Mellitus Tipo 2/etnología , Dieta/etnología , Sacarosa en la Dieta/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , NigeriaRESUMEN
To observe the extent to which blood pressure (BP) was reduced to below 140/90 mm Hg in Nigerians with diabetes (DM), data were collected using structured questionnaire, standard sphygmomanometer, and measurement of fasting blood glucose (FBG). Two hundred forty-four subjects (85 males) aged 17-84 years with a mean duration of DM of 7.9 years and who regularly attended the clinic for diabetes at least monthly for no less than 6 months were involved. Eleven percent, 13 of the 115 treated hypertensives, had BP controlled to levels below 140/90 mm Hg. Nifedipine was the most frequently prescribed antihypertensive (44.30%), followed by alpha-methyldopa (15.7%) and then the angiotensin-converting enzyme inhibitors (ACEIs) captopril and lisinopril (11.3%). Thiazides (9.7%) or thiazide-based fixed combination tablets were prescribed in about 25% of the patients. Eighteen percent were on more than one antihypertensive concurrently and dosages were often at threshold. The majority of the hypertensives with BP below 140/90 mm Hg were on thiazide-based medications. In 152 participants, the presence of hypertension did not affect glycemic control (chi2 = 4.41, df = 2, P = .1) observed and 60% of the entire population had FBC < or = 7.9 mmol/L. Lack of access to care does not explain these findings and suggests an area for improvement. Fortunately, the data also show that thiazides were associated with better control of BP at a cost that was affordable without jeopardizing diabetic control.
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Antihipertensivos/uso terapéutico , Diabetes Mellitus/tratamiento farmacológico , Hipertensión/tratamiento farmacológico , Cooperación del Paciente , Autocuidado , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/clasificación , Índice de Masa Corporal , Bloqueadores de los Canales de Calcio/uso terapéutico , Complicaciones de la Diabetes , Diabetes Mellitus/dietoterapia , Combinación de Medicamentos , Quimioterapia Combinada , Humanos , Hipertensión/clasificación , Hipertensión/complicaciones , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Masculino , Metildopa/uso terapéutico , Persona de Mediana Edad , Nifedipino/uso terapéutico , Nigeria/epidemiologíaAsunto(s)
Antihipertensivos/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipertensión/tratamiento farmacológico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Benzotiadiazinas , Bloqueadores de los Canales de Calcio/uso terapéutico , Cloruro de Calcio/efectos adversos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/dietoterapia , Diuréticos , Humanos , Hipertensión/clasificación , Hipertensión/complicaciones , Metildopa/uso terapéutico , Nifedipino/uso terapéutico , Nigeria , Inhibidores de los Simportadores del Cloruro de Sodio/uso terapéuticoRESUMEN
As part of a wider study aimed at establishing baseline data on standard of diabetic care to compare with subsequent reassessment after measures to improve outcomes have been introduced, the case notes of 118 Nigerians (42 males) with diabetes attending a teaching hospital-based diabetic clinic were reviewed to assess the quality of professional care in a year with reference to an international standard of diabetic care. Patient attendance at the clinic averaged about nine times annually and majority of them had been attending the facility for about 6 years. Fasting blood glucose (FBG) was tested four or more times in 92.4% of the patients. The corresponding figures for footcare were 1.7%; referrals for eye, dental, or cardiac examination were 12.7%, while lipid profile, serum creatinine, and urinary protein estimation were documented in 16.9% of the patients. In contrast, high-risk assessment or part of it was documented in all patients, and in 61.9%, high-risk intervention was recorded. The data suggest that the quality of diabetic care was less than optimal, and foot examination and referrals, etc. are specific areas for improvement.
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Diabetes Mellitus/terapia , Servicio Ambulatorio en Hospital/normas , Glucemia/análisis , Pie Diabético/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Garantía de la Calidad de Atención de SaludRESUMEN
In a sub-population of Nigerian children in the southern rain forest of Edo State, we recently observed widespread relative insensitivity to the taste of sodium chloride (NaCl-salt). This prompted the present study, in which we measured taste recognition threshold to NaCl (30, 60, 120, 180 mM) and sucrose (15, 50, 100, 150 mM) in a group of fifth-and sixth-grade pupils in the northeastern semi-Sahel part of Nigeria, in order to observe the extent to which the findings cited above would apply to similar groups of Nigerians with different ethnic backgrounds in other parts of the country. Three hundred twenty-eight pupils (149 boys, 179 girls) from 9 to 18 years of age were involved. Five subjects were taste-blind to the highest concentration (180 mM) of NaCl. In addition, 44.5% of the study population did not taste NaCl until a concentration of 60 mm or higher was used. This distribution was influenced neither by gender (x2 = 2.75, df = 3, P = .43) nor age (r = .029, P = .60). In addition, only 33% of the population recognized sucrose sweetness at a sucrose concentration of 15 mm or lower. The remaining two-thirds of the population had sucrose threshold values of 50 mm or higher and neither gender (x2 = 3.09, df = 3, P = .379) nor age (r = .046, P = .41) influenced these findings. These results substantiate our earlier observations that relative taste insensitivity to salt (NaCl) may be common in Nigerian children. When compared to our earlier data, these results indicate that taste insensitivity to NaCl and sucrose may be more common in children in the northern parts of the country, thus suggesting that geographic location and ethnicity may be important variables in taste perception of NaCl and sucrose in adolescent Nigerians.
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Cloruro de Sodio , Sacarosa , Umbral Gustativo , Niño , Demografía , Femenino , Humanos , Masculino , Nigeria/etnología , Análisis de RegresiónRESUMEN
OBJECTIVE: To observe blood pressure (BP) pattern and its correlates in primary school children of northern Nigeria. DESIGN: Sitting BP and pulse were measured in quadruplicate, then repeated after four weeks in 1,721 healthy children aged five to 16 years. Body weight and height were also measured in their school environment. SETTING: Primary schools located in three communities in Zaria Local Government Area (LGA) of Kaduna State, Nigeria. The communities were Tudun Wada (University community of migrants with some indigenous Hausa settlers), Zaria City (traditional Hausa community) and Zaria Kewaye (a rural Hausa settlement). RESULTS: BP rose with age. However, BP levels particularly systolic was highest in children from Tudun Wada (TW) (urban), followed by those from Zaria city (ZC) (semi urban), and Zaria Kewaye (ZK) (rural). The mean systolic/diastolic BP (mmHg) were: 99/61, 94/62 and 89/60 in children aged five to ten years; and 112/69, 109/68 and 107/68 in those older than 10 years respectively. The differences in BP levels were evident even as early as the age of five years and appears largely independent of physical stature and gender. CONCLUSION: These observations suggest that place of residence and ethnicity may be important factors in the progression of BP with age in some children in northern Nigeria.
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Presión Sanguínea , Adolescente , Niño , Preescolar , Etnicidad , Femenino , Humanos , Masculino , Nigeria , Valores de ReferenciaRESUMEN
We have previously shown that elimination of buffer Ca2+ markedly reduced maximum 5-HT-induced contractions. We have now investigated the effect of L-type Ca2+-channel blockers and 5-HT2 receptor antagonists on 5-HT- and K+-induced contractions in rat aorta to explore the possibility of a relationship between blockade of L-type Ca2+ channels and 5-HT2 receptor antagonism. Sodium nitroprusside, felodipine, nifedipine, diltiazem, cinnarizine, verapamil, ritanserin, cyproheptadine, ketanserin and mianserin inhibited 5-HT-induced contractions of rat aorta with mean IC50 values (concentration (M) resulting in 50% inhibition) of 2.2 x 10(-11), 6.6 x 10(-11), 1.5 x 10(-9), 1.7 x 10(-9), 3.2 x 10(-7), 5.4 x 10(-7), 9.7 x 10(-10), 1.9 x 10(-8), 5.0 x 10(-7) and 6.4 x 10(-7), respectively. The same compounds antagonized K+-induced rat aortic contractions with the rank order of potency (mean IC50, M): felodipine (7.0 x 10(-11)) > nifedipine (4.8 x 10(-9)) > sodium nitroprusside (4.1 x 10(-8)) > verapamil (5.5 x 10(-8)) > cyproheptadine (6.2 x 10(-8)) > diltiazem (4.1 x 10(-7)) > cinnarizine (1.3 x 10(-6)) > ritanserin (1.8 x 10(-6)) > ketanserin (9.0 x 10(-6)) > mianserin (2.0 x 10(-5)). These data are indicative of a highly significant correlation (r=0.81, P=0.03) between potency against 5-HT-induced contraction and that against contractile response to K+ depolarization, and suggest overlap of the pharmacology of L-type Ca2+-channel blockers and 5-HT2 receptor antagonists in rat aorta.
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Bloqueadores de los Canales de Calcio/farmacología , Contracción Muscular/efectos de los fármacos , Músculo Liso Vascular/efectos de los fármacos , Receptores de Serotonina/efectos de los fármacos , Antagonistas de la Serotonina/farmacología , Animales , Aorta Torácica/efectos de los fármacos , Aorta Torácica/fisiología , Bloqueadores de los Canales de Calcio/clasificación , Relación Dosis-Respuesta a Droga , Femenino , Técnicas In Vitro , Masculino , Nitroprusiato/farmacología , Potasio/farmacología , Ratas , Ratas Sprague-Dawley , Serotonina/farmacologíaRESUMEN
We report two cases of gastric tuberculosis (TB) in Nigerians. The first case concerns an elderly man initially thought to have abdominal malignancy but was subsequently found to have extensive and complicated gastric TB coexisting with chronic peptic ulcer disease. The second case involved the extremely rare condition of gastro-bronchial fistula in a young woman. In contrast to previously reported cases, it was of tuberculous origin and pulmonary symptoms were minimal. Both cases were radiologically evident.
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Gastropatías/diagnóstico por imagen , Tuberculosis Gastrointestinal/diagnóstico por imagen , Adolescente , Fístula Bronquial/diagnóstico por imagen , Femenino , Fístula Gástrica/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
This cross-sectional study was undertaken to observe the relationship between taste recognition threshold for NaCl (salt taste sensitivity) and blood pressure (BP) prior to the onset of clinical hypertension. The study involved 160 girls and 159 boys aged ten through seventeen years. Three hundred and nineteen (35%) of the total population were relatively insensitive to NaCl taste (defined as threshold value > or = 60mM NaCl). In this, there was significant gender difference (chi 2 = 9.66, df = 2, p = 0.022) in the distribution of salt taste sensitivity, with more boys than girls having higher threshold values (> or = 60mM NaCl). In addition, a highly significant (p = 0.0103) but weak association (r = 0.1439) between salt taste sensitivity, and systolic BP was evident after adjustment for other confounding variables. This finding appears fairly specific for NaCl sensitivity, as no systematic relationship between any of the individuals parameters of BP (that is systolic, diastolic and mean arterial pressures) and threshold values for sucrose, urea and HCl was apparent. Overall, however, the bulk of the data does not support a major role for NaCl taste sensitivity in the determination of BP levels in this group of Nigerian adolescents. Rather, height and gender were the most important factors that influenced BP.
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Población Negra/genética , Presión Sanguínea/genética , Cloruro de Sodio Dietético , Estudiantes , Umbral Gustativo , Adolescente , Estatura , Niño , Estudios Transversales , Femenino , Humanos , Hipertensión/genética , Masculino , Nigeria , Caracteres Sexuales , Cloruro de Sodio Dietético/efectos adversosRESUMEN
1. In order to determine whether 5HT2 receptor antagonists can modify Ca2+ uptake via voltage-operated Ca2+ channel (VOC) in arterial smooth muscle, a comparative study of the effects of selected Ca2+ uptake blockers and 5HT2 receptor antagonists on K(+)-induced contractions of rat aortic strip was undertaken. 2. The antagonist drugs studied included the Ca2+ uptake blockers verapamil, nifedipine, felodipine, diltiazem and cinnarizine, the 5HT2 receptor antagonists cyproheptadine, ritanserin, mianserin, and ketanserin and the alpha 1-adrenoceptor antagonist prazosin. 3. With the notable exception of prazosin, each of these compounds diminished K(+)-induced aortic responses. 4. The following order of potencies (mean IC50 values in mol/L) was established: felodipine (7.0 x 10(-11)) > nifedipine (4.8 x 10(-9) > verapamil (5.5 x 10(-8)) > cyproheptadine (6.2 x 10(-8)) > diltiazem (4.1 x 10(-7)) > cinnarizine (1.3 x 10(-6)) > ritanserin (1.8 x 10(-6)) > ketanserin (9.0 x 10(-6)) > mianserin (2.0 x 10(-5)). 5. The results suggest that antagonists of 5HT2 receptors can modulate Ca2+ uptake via VOC in rat aorta.
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Aorta Torácica/efectos de los fármacos , Potasio/fisiología , Receptores de Serotonina/efectos de los fármacos , Antagonistas de la Serotonina/farmacología , Animales , Aorta Torácica/fisiología , Cinarizina/farmacología , Ciproheptadina/farmacología , Diltiazem/farmacología , Sinergismo Farmacológico , Felodipino/farmacología , Femenino , Técnicas In Vitro , Ketanserina/farmacología , Masculino , Mianserina/farmacología , Contracción Muscular/efectos de los fármacos , Contracción Muscular/fisiología , Nifedipino/farmacología , Potasio/química , Prazosina/farmacología , Ratas , Ratas Sprague-Dawley , Receptores de Serotonina/metabolismo , Reproducibilidad de los Resultados , Ritanserina/farmacología , Antagonistas de la Serotonina/metabolismo , Verapamilo/farmacologíaRESUMEN
This report concerns a 40 year old Nigerian man whose initial presentation mimicked acute pyelonephritis. He was subsequently found to have a renal tumour which turned out to be a nephroblastoma. In addition, there was marked renal dysplasia and the contralateral kidney was atrophic and foetal in configuration. The possible link between these observations is discussed.
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Neoplasias Renales/complicaciones , Riñón/anomalías , Tumor de Wilms/complicaciones , Adulto , Atrofia , Diagnóstico Diferencial , Humanos , Neoplasias Renales/diagnóstico , Masculino , Urografía , Tumor de Wilms/diagnósticoRESUMEN
To elucidate the complex pharmacological actions of the 5-hydroxytryptamine2A (5-HT2A)-receptor antagonist ketanserin, we investigated certain similarities between these properties and those of the Ca antagonist verapamil. We investigated the interactions of Ca2+, ketanserin, and verapamil on the contractile responses to 5-HT in rat isolated perfused tail artery and aortic strip preparations. In both tissues, variations in perfusate [Ca2+] had similar effects: threshold contractile concentrations of 5-HT were unaffected, and the upper ends of the 5-HT dose-response curves were augmented or decreased by increased or decreased [Ca2+], respectively. Ketanserin competitively antagonised contractile responses to 5-HT in both tissues, with mean pA2 values of 9.17 and 7.46 in tail artery and aorta, respectively. However, increase in [Ca2+], with addition of ketanserin, caused a parallel leftward shift of the 5-HT dose-response curve in tail arteries with a nonparallel leftward shift in aorta. Verapamil nonsurmountably antagonised contractile responses to 5-HT in aorta and competitively antagonised 5-HT in tail arteries. Subsequent addition of ketanserin to the verapamil-containing perfusate caused a further shift to the right of the 5-HT dose-response curve in aorta, but had no additional antagonist effect above that of verapamil alone on tail artery responses to 5-HT. The results show that although the pharmacological properties of ketanserin and verapamil overlapped, there were marked differences between the pharmacologies of the 5-HT2A-receptors in the two tissues studied, suggesting either that the mechanism of the 5-HT-induced influx of Ca2+ is different in the two tissues or that the 5-HT2A receptors differ structurally between tissues.
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Calcio/farmacología , Ketanserina/farmacología , Músculo Liso Vascular/efectos de los fármacos , Verapamilo/farmacología , Animales , Aorta Torácica/efectos de los fármacos , Arterias/efectos de los fármacos , Calcio/fisiología , Técnicas In Vitro , Masculino , Contracción Muscular/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Receptores Adrenérgicos alfa 1/efectos de los fármacos , Flujo Sanguíneo Regional/efectos de los fármacos , Serotonina/farmacología , Antagonistas de la Serotonina/farmacología , Cola (estructura animal)/irrigación sanguíneaRESUMEN
Twenty patients with essential hypertension were randomised to a 7-week period of dose titration with doxazosin, 1-8mg/day or enalapril, 5-20mg/day. In a further 7-week period the dosage level reached with the initial drug was halved, and titration with the second agent was carried out. Blood pressure responses at the end of each treatment period were assessed by clinic measurements made 24 hours post-dose. In the first treatment period, enalapril (mean dose 19mg/day) reduced serum free ACE activity by 40% and had a greater effect than doxazosin (mean dose 5.2mg/day) on clinic supine blood pressure (systolic and diastolic). In the second period, the addition of enalapril to doxazosin was associated with a significant fall in clinic standing blood pressure (systolic and diastolic), despite the doxazosin dose reduction and consequent decrease in median plasma doxazosin concentration (from 10.6 to 5.2ng/ml). Alternatively, when doxazosin was added to enalapril, free ACE activity remained 40% decreased despite enalapril dose reduction, and blood pressure was not further affected. Plasma renin activity was increased by enalapril. No changes were observed in plasma aldosterone or lipid concentrations with either drug. The combination of doxazosin and enalapril was well tolerated and lowered blood pressure overall. Judged by clinic measurements 24 hours post-dose, most of the antihypertensive effect was attributable to the enalapril component. However, ambulatory blood pressure monitoring 0-12 hours post-dose in a subset of patients suggested a contribution of doxazosin earlier in the dose interval.
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Doxazosina/uso terapéutico , Enalapril/uso terapéutico , Hipertensión/tratamiento farmacológico , Acetilcolinesterasa/sangre , Adulto , Anciano , Presión Sanguínea/efectos de los fármacos , Estudios Cruzados , Método Doble Ciego , Doxazosina/administración & dosificación , Doxazosina/sangre , Sinergismo Farmacológico , Enalapril/administración & dosificación , Femenino , Humanos , Hipertensión/sangre , Hipertensión/fisiopatología , Lípidos/sangre , Masculino , Persona de Mediana Edad , Renina/sangreRESUMEN
1. In a controlled, randomized double-blind trial, 15 patients with essential hypertension were treated with enalapril 5-20 mg/day, or doxazosin 1-8 mg/day, during a 7 week dose titration phase. This was followed by 7 weeks of combined treatment with doxazosin and enalapril. 2. Blood was taken after a 2 week placebo run-in phase, and at 3 and 7 weeks in the single-agent and combined treatment phases, for measurement of plasma renin activity (PRA), plasma angiotensin II (AII), plasma aldosterone and serum free and total angiotensin-converting enzyme (ACE) activities. 3. Doxazosin had no effect on serum free or total ACE activities. 4. Enalapril reduced serum free ACE activity and increased serum total ACE activity, which at 7 weeks was significantly greater than in patients receiving doxazosin. 5. In those patients who received enalapril, 10 mg/day for 3 weeks and then 20 mg/day for 4 weeks (n = 12), with or without doxazosin, mean serum total ACE activity increased by 51%. PRA was also increased in this group, but there were no changes in plasma AII or aldosterone concentrations.